A Case of Adenocarcinoma in Situ Accompanied by an Intrapulmonary Lymph Node witha Sarcoid-Like Reaction

A 65-year-old male underwent a chest CT scan, which revealed an 8 mm nodule on the wall of a bulla in the left lower lobe of the lung, and was thus suspected to be lung cancer. Pulmonary wedge resection of the left lower lobe by means of video-assisted thoracoscopic surgery was thus performed. A specimen of the lung revealed the presence of intrapulmonary lymph node on the wall of a bulla. The histopathological findings of the resected lung specimen showed non-caseating granulomas in the lymph node, and adenocarcinoma in situ. We concluded that the sarcoid-like reaction observed in the intrapulmonary lymph node was therefore related to the adenocarcinoma in situ.サルコイド様反応とは主として局所リンパ節にサルコイドーシスと同様の非乾酪性類上皮肉芽腫を認めるものであるが, 悪性腫瘍の所属リンパ節にサルコイド様反応を認めることがあり, 肺癌におけるリンパ節転移との鑑別が問題となることがある. 今回, 我々は肺囊胞壁発生の肺癌を疑って肺部分切除術を行ったところ, サルコイド様反応を伴った肺内リンパ節であり, その近傍に偶然発見されたAdenocarcinoma in situ（AIS）の1例を経験したので, 文献的考察を加えて報告する