Sheard J D, Taylor W, Soorae A, Pearson M G
Department of Pathology, Aintree Chest Centre, Liverpool.
Thorax. 1991 Aug;46(8):584-5. doi: 10.1136/thx.46.8.584.
Five patients over the age of 40 with malignant mesothelioma of the pleura presented with a spontaneous pneumothorax in the course of five years. The diagnosis of malignant mesothelioma was not suspected at surgery but was made by histological examination of the pleurectomy specimens. During this time 91 pleurectomies for recurrent pneumothorax were performed, 45 in patients over the age of 40; malignant mesothelioma therefore accounted for 11% of spontaneous pneumothorax requiring pleurectomy in this age group. The association of spontaneous pneumothorax and malignant mesothelioma is not emphasised in current publications. These five cases highlight the need for all pleurectomy specimens in cases of spontaneous pneumothorax to be sent for histological examination and for a full occupational history to be taken, especially in older patients.
在五年期间,有5例40岁以上的胸膜恶性间皮瘤患者出现了自发性气胸。手术时并未怀疑有恶性间皮瘤,而是通过胸膜切除术标本的组织学检查确诊的。在此期间,因复发性气胸进行了91例胸膜切除术,其中45例患者年龄在40岁以上;因此,恶性间皮瘤占该年龄组需要进行胸膜切除术的自发性气胸的11%。目前的出版物中并未强调自发性气胸与恶性间皮瘤之间的关联。这5例病例凸显了对于自发性气胸病例,所有胸膜切除术标本都需要送去做组织学检查,以及需要获取完整职业史的必要性,尤其是对于老年患者。