A CASE OF ADVANCED CECAL CANCER COMBINED WITH TUBERCULOUS MESENTERIC LYMPHADENITIS
A CASE OF ADVANCED CECAL CANCER COMBINED WITH TUBERCULOUS MESENTERIC LYMPHADENITIS
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晚期盲肠癌合并结核性肠系膜淋巴结炎一例
DOI：
10.3919/jjsa.59.432
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
N. Kaibara
中科院分区：
文献类型：
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作者：
N. Yamane;M. Makino;Y. Yamashiro;N. Kaibara
我们报告一例晚期盲肠癌合并结核性肠系膜淋巴结炎，在手术中被误诊为盲肠癌远处淋巴结转移（N4+）。一名68岁的妇女在仔细检查后发现盲肠癌，希望接受手术。她和她的家人以前没有结核病史。开腹时，淋巴结呈串珠状肿大，大小为1_?？回肠结肠至肠上动脉及空肠第一、第二动脉处有3 ~ 3cm。我们误诊这些淋巴结肿大为盲肠癌的转移（N4+），并进行了可能的淋巴结清扫的右半结肠切除术。组织病理学检查显示淋巴结不是转移，而是结核性肠系膜淋巴结炎。未发现盲肠并发结肠结核。当我们发现结直肠癌患者腹内淋巴结肿大异常扩大而无其他远处转移时，必须排除结核性肠系膜淋巴结炎共存的可能性。
We report a case of advanced cecal cancer combined with the tuberculous mesenteric lymphadenitis that was miss-diagnosed as distant lymph node metastases (N4+) of the cecal cancer during operation. A 68-year-old woman was admitted to the hospital in the hope of undergoning surgery for a cecal cancer which was detected with close examination. She and her family had no previous history of tuberculosis. At laparotomy, beaded swelling of lymph nodes sized as 1_??_3cm were observed along from the ileocolic to the supramesenteric artery, and at the 1st and 2nd jejunal arteries. We missdiagnosed these lymph nodes swelling as metastases (N4+) of the cecal cancer and a right hemicolectomy with possible lymph node dissection was performed. Histopathological study revealed that the lymph nodes were not metastases but tuberculous mesenteric lymphadenitis. There was no findings of coexisting colonic tuberculosis at the cecum. A possibility of coexisting tuberculous mesenteric lymphadenitis must be ruled out when we find the extraordinarily extended intraabdominal lymph node swelling without other distant metastases in patients with coloreectal cancer.