Yuasa H, Tomoyasu M
Department of Surgery, Mito General Hospital, Ibaraki, Japan.
Kyobu Geka. 1999 Sep;52(10):836-9.
Because we experienced each 1 operative case of diffuse malignant mesothelioma of the pleura and pseudomesotheliomatous carcinoma of the lung discovered with pleural effusion, clinical comparison investigated both. The first case was suspected diffuse malignant mesothelioma of the pleura before operation, and we performed pleuropneumonectomy. But the pathologic diagnosis was adenocarcinoma of the lung, what is so called pseudomesotheliomatous carcinoma. The second case had inhaled asbestos and his pleural effusion revealed high concentrations of hyaluronic acid. Thoracoscopic biopsy showed malignant mesothelioma, and we performed pleuropneumonectomy. The pathologic final diagnosis was diffuse malignant mesothelioma of the pleura. In clinical differential diagnosis of diffuse malignant mesothelioma of the pleura and pseudomesotheliomatous carcinoma of the lung, history of inhalation of asbestos and concentrations of hyaluronic acid in pleural effusion are helpful. And thoracoscopic biopsy is necessary in established diagnosis.
因为我们经手了每一例通过胸腔积液发现的胸膜弥漫性恶性间皮瘤和肺假间皮瘤样癌的手术病例，所以对两者进行了临床比较研究。第一例术前怀疑为胸膜弥漫性恶性间皮瘤，我们实施了胸膜肺切除术。但病理诊断为肺腺癌，即所谓的假间皮瘤样癌。第二例曾吸入石棉，其胸腔积液显示透明质酸浓度很高。胸腔镜活检显示为恶性间皮瘤，我们实施了胸膜肺切除术。最终病理诊断为胸膜弥漫性恶性间皮瘤。在胸膜弥漫性恶性间皮瘤和肺假间皮瘤样癌的临床鉴别诊断中，石棉吸入史和胸腔积液中透明质酸的浓度是有帮助的。而胸腔镜活检对于确诊是必要的。
