부산대학교 도서관

Background. Although intrapulmonary lymph nodes may masquerade as metastatic pulmonary nodules, metastasis from lung cancer is rare. Case. An 81-year-old woman presented with primary left upper lobe non small cell carcinoma associated with undiagnosed subpleural nodules in the ipsilateral upper and lower lobes. Because she wanted radical left upper lobectomy, she received thoracoscopic thoracotomy to confirm that these nodules were located in the lower lobe. A frozen section in situ analysis revealed intrapulmonary lymph nodes metastases from the primary lung cancer, and therefore further resection was not possible. To the best of our knowledge, the present case is the first report of lung cancer involving ipsilateral intrapulmonary lymph nodes within another lobe. The potential mechanisms of the rare lymphatic metastases are discussed. Conclusion. Although one of the most likely diagnoses of subpleural nodules is intrapulmonary lymph nodes, the nodes may be involved by other malignancies in the lung. General thoracic surgeons should not hesitate in diagnosing the nodules to evaluate the accurate extent of the pulmonary malignancy as their locations are easy to access.