Shimaoka Shunji, Tashiro Kotaro, Matsuda Akio, Nioh Tatsuyuki, Niihara Toru, Ohi Hidehisa, Yamasuji Tadashi, Nishimata Yoshito, Nishimata Hiroto, Suenaga Toyokuni, Kajiya Yoriko
Department of Gastroenterology, Nanpuh Hospital, 14-3 Nagata-cho, Kagoshima 892-0854, Japan.
J Gastroenterol. 2003;38(9):900-4. doi: 10.1007/s00535-002-1169-1.
A 70-year-old Japanese man with no history of pancreatitis visited his local practitioner, complaining of dyspnea on effort. Left massive pleural effusion was detected and he was then referred to our hospital. A plain chest film showed marked left pleural effusion. Thoracentesis yielded 2000 ml of bloody fluid with high amylase content (22,665 IU/l). Endoscopic retrograde pancreatography revealed a tapered occlusion of the main pancreatic duct. Pancreatic cancer was suspected, and a distal pancreatectomy and a splenectomy were performed. Histologically, the diagnosis was ductal adenocarcinoma of the pancreas, 5 x 6 mm in size, with regional lymph node metastasis. He has experienced no recurrence of cancer or pleural effusion since the operation.
一名70岁无胰腺炎病史的日本男性因劳力性呼吸困难前往当地诊所就诊。检查发现左侧大量胸腔积液，随后他被转诊至我院。胸部X线平片显示左侧胸腔积液明显。胸腔穿刺抽出2000毫升含高淀粉酶含量（22,665国际单位/升）的血性液体。内镜逆行胰胆管造影显示主胰管呈锥形闭塞。怀疑为胰腺癌，遂行胰体尾切除术和脾切除术。组织学检查诊断为胰腺导管腺癌，大小为5×6毫米，伴有区域淋巴结转移。自手术以来，他未出现癌症复发或胸腔积液。
