A CASE OF CHEST PULMONARY LYMPHOEPITHELIOMA-LIKE CARCINOMA REQUIRING A COMBINED RESECTION WITH THE PERICARDIUM

症例は65歳，女性．1カ月前より続く咳嗽を主訴に当院受診となった．胸部レントゲン写真にて右下肺野に異常影を認めたため精査目的で入院となった．胸部CTでは右肺S5に8×5cm大の不均一に造影される腫瘤を認め，エコー下針生検にて低分化癌と診断されたため手術となった．手術所見では腫瘍は心嚢に直接浸潤しており術式は右中葉切除術，心嚢合併切除術となった．病理組織学的には肺原発リンパ上皮腫様癌と診断され，病期診断はT3N0M0 stageIIBであった．腫瘍組織のEBER（EB virus encoded RNA) in-situ hybridizationは陽性でありEBウィルスとの関連が示唆された．現在術後5カ月が経過し無再発にて化学療法施行中である．本邦での肺原発リンパ上皮腫様癌の報告は稀であり，若干の文献的考察を加え報告する．

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