Division of Thoracic Diseases, Chiba Cancer Center, 666-2 Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan.
Surg Today. 2011 Jul;41(7):989-91. doi: 10.1007/s00595-010-4379-9. Epub 2011 Jul 12.
We report a case of schwannoma arising from the 9th intercostal nerve, which caused a bloodstained pleural effusion. The patient, a 37-year-old woman, presented with left-sided back pain. A chest X-ray showed left pleural effusion, which was subsequently found to be bloodstained but without malignant cells. Chest magnetic resonance imaging showed a 76-mm tumor arising from the 9th intercostal nerve. The tumor and intercostal nerve were successfully resected. Histological examination revealed that the tumor comprised spindle cells with both Antoni types A and B patterns. There were necrotic changes and cystic degeneration, but no atypical or mitotic cells. Based on these findings, benign schwannoma was diagnosed. Schwannoma is rarely accompanied by bloody pleural effusion, which we assume was caused by partial tumor rupture. Magnetic resonance imaging proved very useful in localizing and characterizing the tumor in this case.
我们报告一例源于第 9 肋间神经的神经鞘瘤，导致血性胸腔积液。患者为 37 岁女性，表现为左侧背痛。胸部 X 线片显示左侧胸腔积液，随后发现为血性但无恶性细胞。胸部磁共振成像显示起源于第 9 肋间神经的 76mm 肿瘤。成功切除了肿瘤和肋间神经。组织学检查显示肿瘤由梭形细胞组成，具有 Antoni A 型和 B 型两种模式。有坏死性改变和囊性变性，但无非典型或有丝分裂细胞。根据这些发现，诊断为良性神经鞘瘤。神经鞘瘤很少伴有血性胸腔积液，我们推测这是由于部分肿瘤破裂所致。磁共振成像在本例中对肿瘤的定位和特征化非常有用。
