1986 Volume 8 Issue 2 Pages 286-290
A 70 year-old woman was admitted to our hospital because of bloody sputum. Chest X-ray films showed a tumor-like shadow in the right lower lobe. A granulation with epitheloid cells, which was indicative of tuberculosis or sarcoidosis, was revealed by TBLB. Lung cancer was strongly suspected, even though no malignant cells were found by TBLB, and therefore sputum examination for cytology was repeated. At last, one month after TBLB, malignant cells were found in the sputum. Right lower lobectomy with mediastinal lymphnode dissection was performed. Histological examination of the resected lung revealed a moderatedly differentiated adenocarcinoma, which was surrounded with a granulomatous tissue with epitheloid cells and giant cells. It was considered to be a sarcoid-like reaction with the carcinoma. No metastasis and no sarcoid-like reaction was found in the dissected regional lymphnodes. This case is indicates the possibility for TBLB to reveal only granulation, when granulation of sarcoidlike reaction is coexists with carcinoma of lung. This fact must be always kept in mind in the diagnosis of lung cancer by TBLB.
