Kono Yuko, Funada Hiroyasu, Urata Keiko, Yosimura Syo, Kotani Yosikazu, Satouti Miyako, Negoro Shuniti, Takada Yosiki
Department of Respiratory Medicine, Hyogo Medical Center for Adults.
Nihon Kokyuki Gakkai Zasshi. 2005 Oct;43(10):622-5.
A 67-year-old woman was hospitalized with right pleural effusion on chest radiography. Chest CT showed a thickened parietal pleura and pleural effusion in the right thorax. Cytological examination of pleural effusion showed atypical plasma cells. We performed thoracoscopy with local anesthesia for diagnosis and observed an about 5 x 5 cm seized red soft tumor on the parietal pleura. Pathological and immunohistochemical examination of the pleural tumor revealed that it was marginal zone B-cell malignant lymphoma. In this case, we could not reach a diagnosis only by cytological examination of the pleural effusion. Thoracoscopy with local anesthesia was safe and useful for diagnosis of malignant lymphoma with pleural effusion. Most cases of primary pleural malignant lymphoma have a history of chronic pyothorax. This case is thought to be a very rare case of primary pleural malignant lymphoma with no history of pyothorax.
一名67岁女性因胸部X线检查发现右侧胸腔积液而住院。胸部CT显示右侧胸壁胸膜增厚并伴有胸腔积液。胸腔积液的细胞学检查发现非典型浆细胞。我们为明确诊断进行了局部麻醉下的胸腔镜检查,观察到胸壁胸膜上有一个约5×5厘米大小的暗红色柔软肿物。对胸膜肿瘤进行病理及免疫组化检查显示为边缘区B细胞恶性淋巴瘤。在本病例中,仅通过胸腔积液的细胞学检查无法确诊。局部麻醉下的胸腔镜检查对于伴有胸腔积液的恶性淋巴瘤诊断安全且有用。大多数原发性胸膜恶性淋巴瘤病例有慢性脓胸病史。本病例被认为是一例非常罕见的无脓胸病史的原发性胸膜恶性淋巴瘤。