Cottin Vincent, Brillet Pierre-Yves, Combarnous François, Duperron Florence, Nunes Hilario, Cordier Jean-François
Louis Pradel Hospital, Respiratory Medicine, 28 Avenue Doyen Lepine, Lyon, 69677, France.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.09.2008.0917. Epub 2009 Feb 2.
Two case histories are described of pleural and anterior mediastinal fibrosis presenting as a continuous fibrotic process with thick parietal pleural plaques extending from one pleura to the contralateral pleura through the retrosternal area, and with retroperitoneal fibrosis. Follow-up over 4 years in one case demonstrated rapid progression of disease, with pleural fibrosis preceding retrosternal and retroperitoneal fibrosis. Histopathological analysis in both cases showed non-tumoral fibrosis with broad fibrous bundles surrounding fibroblasts (and lymphocytes in one case). Possible causes such as infections and exposure to ergot derivatives were excluded. Both patients had been slightly or moderately exposed to asbestos.
描述了两例胸膜和前纵隔纤维化病例,表现为连续性纤维化过程,胸膜壁层增厚形成斑块,从一侧胸膜经胸骨后区域延伸至对侧胸膜,并伴有腹膜后纤维化。其中一例随访4年显示疾病进展迅速,胸膜纤维化先于胸骨后和腹膜后纤维化出现。两例的组织病理学分析均显示为非肿瘤性纤维化,有宽阔的纤维束围绕成纤维细胞(其中一例还有淋巴细胞)。排除了感染和接触麦角衍生物等可能原因。两名患者均有轻微或中度石棉接触史。