Lymph node metastasis, in which the pathological diagnosis is inconsistent with lung cancer lesions, may lead to the discovery of other intrapulmonary lesions. Conversely, there are no reports of cases in which oropharyngeal cancer was discovered after lymph node metastasis was diagnosed in the hilar lymph nodes. The patient was a 73-year-old man. Chest computed tomography revealed a mass at the base of the right lung, and transbronchial lung biopsy revealed adenocarcinoma. Lower lobectomy of the right lung and lymph node dissection were conducted. Histopathological examination revealed that the tumor was an adenocarcinoma, but the right main peribronchial lymph node (#Rt10) showed a squamous cell carcinoma (SCC). Postoperative fiberoptic laryngeal examination revealed a neoplastic lesion on the lateral wall of the right middle pharynx. Biopsy results confirmed the diagnosis of moderately to highly differentiated SCC; therefore, lumpectomy was performed. Histopathological examination revealed a morphologically similar lesion to #Rt10. Although it is straightforward to determine multiple lung cancers due to discrepancies between the pathological diagnosis of a tumor and lymph node metastasis, there are few reports of multiple cancers found in other organs, as in the present case. Preoperative diagnosis of patients at high risk of cancer should be performed more cautiously.
"},{"@language":"ja","@value":"肺癌病巣と病理診断が乖離したリンパ節転移所見により，他の肺内病変が発見されることがある．一方で，肺門リンパ節転移の診断を契機に中咽頭癌が発見された報告はない．症例は73歳，男性．胸部CT検査で右肺底部に腫瘤を認めた．経気管支肺生検の結果，腺癌の診断となった．右肺下葉切除術＋リンパ節郭清術が施行された．病理組織学的検査で腫瘍部位は腺癌であったが，右側主気管支周囲リンパ節（#Rt10）は扁平上皮癌であった．術後に施行された喉頭ファイバーで右中咽頭側壁に腫瘍性病変を認めた．生検の結果，高～中分化な扁平上皮癌の診断となり中咽頭腫瘍摘出術が施行された．病理組織学的検査で#Rt10の病変と形態的に類似の像を認めた．腫瘍とリンパ節転移の病理診断との乖離により多発肺癌の発見は経験するが，本症例の如く，他臓器に発見された重複癌の報告は少ない．また，癌高リスク症例に対する術前診断はより慎重に行う必要がある．
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