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━━ Background. Coincidence of a primary lung cancer and pulmonary metastases from other malignancies should be kept in mind at the time of pulmonary resection. Case. Chest CT revealed a small pulmonary nodule (5 mm) in the right upper lobe and swelling of the interlobar lymph node (20 mm) in a 71-year-old man. He underwent resection of the right upper and middle lobes with lymph node dissection. As expected, pathological diagnosis of the lung nodule and the lymph node revealed adenocarcinoma. In addition to the above lesions, multiple microscopic pulmonary metastases of thyroid cancer were found at the time of postoperative detailed histological investigation. No primary thyroid lesion was detected by postoperative examination. Conclusion. Through pathological examination revealed an otherwise undetectable coincident second malignancy. (JJLC. 2009;49:868-871) KEY WORDS━━ Lung cancer, Thyroid cancer, Minimal metastasis Reprints: Teruhisa Takuwa, Department of General Thoracic Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo 663-8501, Japan. Received October 3, 2008; accepted May 18, 2009. 要旨━━背景.肺切除にあたっては原発性肺癌と,他臓 器腫瘍の肺転移巣が併存する場合があることを念頭に置 く必要がある.症例.71 歳の男性.CT上,右肺上葉の小 結節(5 mm大)と腫大した葉間リンパ節(20 mm大)を 指摘された.右肺上中葉切除,1群リンパ節郭清を施行 し,病理学的に肺腺癌の葉間リンパ節転移(pT1N1M0) と診断された.しかし,切除肺には極めて微小な甲状腺 癌の多発肺転移を認めた.現在甲状腺癌の原発巣は同定 されていない.結論.詳細な病理検索により,ともすれ ば見落とし兼ねない微小な甲状腺癌の肺転移巣を明らか にすることができた. 索引用語━━肺癌,甲状腺癌,微小転移

A Case of Coincidence of Primary Lung Cancer and Minimal Metastases of Thyroid Cancer