PDF(Pubmed)
Abstract：
When a mass occurs at the staple line following lung resection, it can be difficult to distinguish between local cancer recurrence and granuloma. We present a case of a staple-line granuloma with 18F-fluorodeoxyglucose-positron emission tomography uptake and elevated serum carbohydrate antigen 19-9 (CA19-9) in a patient with ovarian cancer lung metastasis. After granuloma resection, serum CA19-9 levels normalized, and CA19-9 positive cells were identified in the resected tumor. Therefore, serum CA19-9 elevation does not rule out a staple-line granuloma. Whereas granulomas on computed tomography (CT) scans tend to show smooth shadows along the staple line unilaterally, detailed CT evaluation may help diagnostic differentiation. Differentiation based on imaging and tumor markers has limitations. However, core needle biopsy has the risk of misdiagnosis and tumor cell dissemination, therefore surgical resection should be considered when comprehensive findings indicate a potential recurrence.
摘要：
当肺切除术后在钉合线处出现肿块时，很难区分局部癌症复发和肉芽肿。我们介绍了一例卵巢癌肺转移患者中18F-氟代脱氧葡萄糖-正电子发射断层扫描摄取和血清碳水化合物抗原19-9（CA19-9）升高的钉合肉芽肿。肉芽肿切除后，血清CA19-9水平正常化，在切除的肿瘤中鉴定出CA19-9阳性细胞。因此,血清CA19-9升高并不能排除吻合性肉芽肿。而在计算机断层扫描（CT）扫描上的肉芽肿倾向于单侧显示沿着钉合线的平滑阴影，详细的CT评估可能有助于鉴别诊断.基于成像和肿瘤标志物的鉴别具有局限性。然而,芯针活检有误诊和肿瘤细胞播散的风险，因此，当综合发现提示可能复发时，应考虑手术切除。
