Eiji Nakajima

Hiromi Serizawa

Hiroyuki Miura

Kyong Ii Kim

Norihiko Ikeda

Toru Sano

Yujin Kudo

三浦 弘之

中嶋 英治

佐野 達

工藤 勇人

池田 徳彦

芹澤 博美

金 慶一

高橋 秀暢

Tokyo Medical University Institutional Repository / 東京医科大学学術情報リポジトリ

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: CT
CT : 4
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CT 40 mm B10
CT 4 9 1 6
CT B10 :
CT
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4-8
CT 4
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S1+2 10 mm
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TEL : 042-665-5611 2470 FAX : 042-665-1796
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CT
Fig. 1A 3
4 9 CT
B10 2 mm
Fig. 1B
5 3 CT S10
Fig. 1C 1
6 3 CT
S10 40 mm
Fig. 1D B10
Fig. 2 Transbron-
chial biopsy TBB
Class IIIB
Fig. 1 Follow-up CT revealed development along bronchial duct. A  1 year and 9 months before right lung lower lobectomy.
B  1 year and 6 months before right lung lower lobectomy. C  1 year before right lung lower lobectomy. D  At right 
lung lower lobectomy.
Fig. 2 Bronchoscopic view revealed polypoid mass in right seg-
mental bronchus B10 .
71 3284
3
T2bN0M0 IIA
Class IIIB
Fig. 3A
ND2a-1
B10b+c 
B10 B10b
B10c Fig. 4
CT Fig. 3B
Fig. 3 Preoperative chest X-ray film A  and coronary slice of chest CT B  revealed tumor on lower lobe of right lung at right 
lower lobectomy.
Fig. 4 Resected sample showed intrabronchial spread of metastasis from renal cell carcinoma in right segmental bronchus B10 .
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60*40*30 mm
HE
Fig. 5B
CD10
TTF-1
Fig. 5A
B10
1-3
CT 4
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5 4-8
1  9
B10
Fig. 4
4 6
CT
B10 Fig. 
1A 3 4
9 CT
B10 2 mm
Fig. 1B
CT
CT
CT 6
Fig. 5 Hematoxylin-eosin staining 100 showed small round nuclei with clear or eosinophilic foamy cytoplasm and nest-like 
structure. A  Primary renal cell carcinoma. B  Bronchial metastasis from renal cell carcinoma.
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CT S10
Fig. 1C
B10
CT
CT S10 1
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B10b+c 
Fig. 4
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B10
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CT
CT
1  Braman  SS,  Whi tcomb ME : Endobronchia l 
metastasis. Arch Intern Med 135 : 543-547, 1975
2  Greenberg BE, Young JM : Pulmonary metastasis 
from  occult  primary sites resembling bronchogenic 
carcinoma. Dis Chest 33 : 496-505, 1958
3  Baumgartner WA, Mark JB. Metastatic malignan-
cies from distant sites to the tracheobronchial tree. J 
Thorac Cardiovasc Surg 79 : 499-503, 1980
4  Kyoda Y, Kobayashi K, Hirobe M, Shindo T, Fukuta F, 
Hashimoto K, Tanaka T, Tonooka A, Kitamura H, 
Takahashi S, Masumori N, Hasegawa T, Tsukamoto 
T : Evaluation of long-term outcome for patients 
with renal cell carcinoma after surgery : analysis of 
cancer deaths occurring more than 10 years after ini-
tial treatment. Int J Clin Oncol 3 : DOI 10.1007/
s10147-013-0533-x, 2013
5  Uchida K, Miyao N, Masumori N, Takahashi A, Oda 
T, Yanase M, Kitamura H, Itoh N, Sato M, Tsuka-
moto T : Recurrence of renal cell carcinoma more 
than 5 years after nephrectomy. Int J Urol 9 : 19-
23, 2002
6  Noy S, Michowitz M, Lazebnik N, Baratz M :  
Endobronchial metastasis of renal cell carcinoma. J 
Surg Oncol 31 : 268-270, 1986
7  Sakumoto N, Inafuku S, Shimoji H, Nomura K, 
Honma K, Kawabata T, Ohta M, Kuniyoshi M, 
Ishikawa K, Genka K : Endobronchial Metastasis 
from Renal Cell Carcinoma : Report of a Case.
Surg Today 30 : 744-746, 2000
8  Froehner M, Manseck A, Lossnitzer A, Wirth MP :
Late Local and Pulmonary Recurrence of Renal Cell 
Carcinoma. Urol Int 60 : 248-250, 1998
9  Gerler, Felson B : Metastatic endobronchial hyper-
nephroma.    Dis Chest 44 : 225-233, 1963
:
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Development along bronchial duct in metastasis from renal cell carcinoma detected 
by retrospective chest CT findings
Eiji NAKAJIMA1 , Toru SANO1 , Kyong Ii KIM1 , Yujin KUDO1 , Hiroyuki MIURA1 , Hidenobu 
TAKAHASHI1 , Hiromi SERIZAWA2 , Norihiko IKEDA3
1 Tokyo Medical University Hachioji Medical Center, Department of Thoracic Surgery 
2 Tokyo Medical University Hachioji Medical Center, Department of Pathology 
3 Tokyo Medical University, Department of Thoracic Surgery
Abstract
Background : Bronchial metastases are often observed as recurrence sites of renal cell carcinoma. Periodic chest CT is 
available after nephrectomy, and occasionally bronchoscopy is necessary for the early detection of metastasis in the respiratory 
airway. Case : The patient had undergone left nephrectomy for renal cell carcinoma. Four years and 6 months later, partial 
resection of the left upper lobe of the lung was performed for metastasis of renal cell carcinoma. A chest CT at 6 years and 3 
months after the nephrectomy revealed a 40 mm tumor in the right lower lobe of the lung. Bronchoscopy findings showed a 
polypoid tumor right, B10 , and subsequent brushing cytology suggested primary lung squamous cell carcinoma. A right lung 
lower lobectomy was performed, and the pathological diagnosis was metastasis from renal cell carcinoma. Retrospective chest 
CT findings revealed a tiny abnormal lesion at the segmental bronchus right, B10  at 1 year and 6 months before right lung 
lower lobectomy.
Conclusion : In the follow-up chest CT for early detection of respiratory airway metastasis from renal cell carcinoma, 
peripheral non-tumorous bronchial change is important in the detection of endobronchial metastasis.
Key words : Bronchial metastasis, Renal cell carcinoma, Development along bronchial duct


後向き観察において気管支内腔を鋳型とする発育進展が確認された腎細胞癌気管支転移の一切除術例

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後向き観察において気管支内腔を鋳型とする発育進展が確認された腎細胞癌気管支転移の一切除術例

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