Moro D, Brambilla E, Brichon P Y, Claraz C, Coulomb M, Sarrazin R, Paramelle B, Brambilla C
Service de Pneumologie, C.H.U. A.-Michallon, Grenoble.
Rev Mal Respir. 1990;7(3):231-8.
We present an anatomical-clinical analysis of ten cases of benign pleural fibroma. This tumour was discovered in a systematic fashion in 8 of the 10 cases and fortuitously in one. Recent radiological examinations enabled the diagnosis to be suspected. Computerised tomography most often precisely identified the pleural topography and imagery by nuclear magnetic resonance in one case visualised fibrous tissue (with a zone of low signals on the scale in T2). The final diagnosis was achieved at the same time as the treatment when an exploratory thoracotomy was performed. In all the cases there was a tumour composed of fusiform cells covered by normal epithelium coming from the viscera pleura 8 times out of 10. The ultrastructure examination and immunohistochemistry of the fusiform cells (Vimentin plus, EMA-, KL1-) allowed for a differentiation of these tumours of connective tissue origin from tumours of mesothelial origin. These analyses constitute an argument in favour of the fibroblastic origin of pleural fibromas.
我们对10例良性胸膜纤维瘤进行了解剖学-临床分析。在10例病例中,有8例是通过系统检查发现该肿瘤的,1例是偶然发现的。近期的放射学检查有助于怀疑该诊断。计算机断层扫描最常能精确识别胸膜的形态,在1例病例中,核磁共振成像显示出纤维组织(在T2加权像上有低信号区)。当进行 exploratory thoracotomy(此处原文可能有误,推测为“ exploratory thoracotomy,即开胸探查术”)时,最终诊断与治疗同时完成。在所有病例中,均存在一个由梭形细胞组成的肿瘤,10例中有8例肿瘤表面覆盖有来自脏层胸膜的正常上皮。梭形细胞的超微结构检查和免疫组织化学检查(波形蛋白阳性,上皮膜抗原阴性,角蛋白1阴性)有助于将这些结缔组织起源的肿瘤与间皮起源的肿瘤区分开来。这些分析支持胸膜纤维瘤起源于成纤维细胞的观点。