Yoshida J, Kajiwara T, Akao M, Tanimura A
Division of Chest Surgery, Shimonoseki City Hospital, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Mar;48(3):190-3. doi: 10.1007/BF03218120.
Hemopneumothorax and hemoperitoneum coincide rarely in nontraumatic cases. Here, a 70-year-old male presented a left axillary lymph node and was diagnosed as having metastatic squamous cell carcinoma. Under the same diagnosis, another lesion developed in the right femur and was resected. One year later, computed tomography detected another tumor in the left adrenal gland. Shortly afterwards, left pneumothorax developed and a chest operation revealed hemopneumothorax due to a ruptured cavitary form of large cell carcinoma. The serum showed a human chorionic gonadotropin-beta level of 1,100 ng/ml. At three-months later, he died of hemoperitoneum. The autopsy demonstrated hepatic metastases and a ruptured adrenal metastasis; microscopy showed marked trophoblastic and squamous cell changes in these organs. This patient was unique in that the rupture of the pulmonary and the adrenal lesions caused clinical manifestation.
血胸和气腹在非创伤性病例中很少同时出现。在此，一名70岁男性出现左腋窝淋巴结，被诊断为转移性鳞状细胞癌。在相同诊断下，右股骨出现另一病变并被切除。一年后，计算机断层扫描在左肾上腺发现另一个肿瘤。不久后，出现左侧气胸，胸部手术显示因大细胞癌空洞破裂导致血胸和气胸。血清中人绒毛膜促性腺激素β水平为1100 ng/ml。三个月后，他死于腹腔积血。尸检显示有肝转移和肾上腺转移破裂；显微镜检查显示这些器官有明显的滋养层和鳞状细胞变化。该患者的独特之处在于肺部和肾上腺病变的破裂引起了临床表现。
