common disease90

【臨床症状】60代 男性 胸部Xpで異常陰影

【問題】画像所見と診断名は?

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    ▶答えはこちら
    • 右肺S5に分葉状の2cm程度の結節影を認める
    • 内部に石灰化を認め、いわゆるポップコーン石灰化
    • 比較的境界明瞭であり、内部に死亡成分は認めないが、石灰化を有する事から肺過誤腫が疑われフォローされている
    • その後、大きな変化は認めていない

    【肺過誤腫】

    ・気管支周囲の間葉系の良性腫瘍

    ・肺良性腫瘍の中で最多(70%以上)で、40代以降の男性に多い

    ・軟骨や脂肪、平滑筋、呼吸器系成分などで構成されている

    ・抹消に発生する事が多く、通常は単発(時に多発する事もある)

    ・稀に中枢気管支内に発生する事もある

    ・画像上は、肺野抹消で境界明瞭な分葉状の腫瘤影で、内部にポップコーン状の石灰化(30%)や、脂肪成分を認める事が多い

    ・造影効果は乏しく、FDG-PETでは低集積

    ・サイズの変化がない(もしくは緩徐)である事が多いが、稀に急速増大する事もある

    ・切除を行えば、再発は無いとされている

    参考書籍:困ったときの胸部の画像診断