Popp Gabriele, Dragnev Konstantin
Section of Hematology/Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
South Med J. 2003 Jul;96(7):696-8. doi: 10.1097/01.SMJ.0000052064.60558.9A.
A 27-year-old man with no history of cardiopulmonary disease presented with progressive shortness of breath. He was significantly tachypneic and hypoxic, with inspiratory and expiratory wheezing. Evaluation of the chest with computed tomography revealed a large anterior mediastinal mass and interstitial thickening consistent with lymphangitic spread. Plasma beta-human chorionic gonadotropin level was elevated. Bronchoscopic biopsy specimen showed poorly differentiated carcinoma. Pleural fluid obtained via thoracentesis was positive for malignancy. Chemotherapy for the germ cell tumor, consisting of etoposide, ifosfamide, and cisplatin, resulted in dramatic clinical improvement and normalization of the beta-human chorionic gonadotropin level. The lymphangitic changes resolved, although the mediastinal mass persisted. A large, anterior mediastinal, mature teratoma, as well as pleural nodules with adenocarcinoma, was excised after completion of chemotherapy.
一名无心肺疾病史的27岁男性出现进行性气短。他呼吸急促且明显缺氧，伴有吸气和呼气时的哮鸣音。胸部计算机断层扫描显示前纵隔有一个大肿块以及与淋巴管播散一致的间质增厚。血浆β-人绒毛膜促性腺激素水平升高。支气管镜活检标本显示为低分化癌。经胸腔穿刺获得的胸腔积液恶性肿瘤检测呈阳性。由依托泊苷、异环磷酰胺和顺铂组成的生殖细胞肿瘤化疗方案使临床症状显著改善，β-人绒毛膜促性腺激素水平恢复正常。淋巴管改变消失，尽管纵隔肿块仍然存在。化疗结束后切除了一个位于前纵隔的巨大成熟畸胎瘤以及伴有腺癌的胸膜结节。
