Shimizu T, Furuichi S, Takahashi N, Koya Y, Akashiba T, Horie T
First Department of Internal Medicine, Nihon University, School of Medicine, 30-1 Oyaguchikamimachi, Itabashi-Ku, Tokyo, Japan.
Nihon Kokyuki Gakkai Zasshi. 2001 Oct;39(10):748-52.
A 70-year-old man was diagnosed as having retroperitoneal fibrosis 12 years ago. The patient was admitted to our hospital with complaints of fever and left chest pain. On admission, chest radiography revealed left pleural effusion and left pleural thickening. Percutaneous pleural biopsy was performed, and the pleural tissue gave a chronic inflammatory reaction characterized by proliferation of collagen fibers and chronic inflammatory cellular infiltration. Since the retroperitoneal fibrosis had been diagnosed in similar tissue, it was considered that this condition had extended to the pleura. On administration of prednisolone, the intrathoracic lesions and clinical symptoms were improved, but the patient later died of pneumonia. Autopsy showed fibrous pleuritis and chronic fibrosing lung disease. This was an extremely rare case. Prednisolone appears to be useful in the treatment of intrathoracic extension of retroperitoneal fibrosis.
一名70岁男性12年前被诊断为腹膜后纤维化。患者因发热和左胸痛入院。入院时,胸部X线检查显示左侧胸腔积液和左侧胸膜增厚。进行了经皮胸膜活检,胸膜组织呈现出以胶原纤维增生和慢性炎症细胞浸润为特征的慢性炎症反应。由于在类似组织中已诊断出腹膜后纤维化,故认为该病症已蔓延至胸膜。给予泼尼松龙治疗后,胸腔内病变及临床症状有所改善,但患者后来死于肺炎。尸检显示为纤维性胸膜炎和慢性纤维化性肺病。这是一例极其罕见的病例。泼尼松龙似乎对治疗腹膜后纤维化的胸腔内蔓延有效。