Suzuki S, Okada S, Nagamoto N, Handa M, Koike K, Fujimura S
Department of Surgery, Tohoku University, Sendai, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Aug;38(8):1371-4.
A case of invasive thymoma with pleural disseminations, treated with pleuropneumonectomy and thymectomy , is presented. A 30-year-old woman was admitted with abnormal shadows in left lung field and mediastinum. On chest CT examination, the tumor shadows were located anterior mediastinum and left chest wall. Thymoma with pleural disseminations was the most likely consideration by the needle biopsy specimen of the tumor under left chest wall. Preoperative radiotherapy for anterior mediastinum mass was effective. Pleuropneumonectomy and thymectomy combined with partial resections of intercostal muscles and diaphragm were performed. Histologically, the tumor was arranged in lobular structure, composed of epithelial cells, with poorly infiltration of lymphocytes, and invaded into intercostal muscles or lung. Postoperative radiotherapy for mediastinum and left chest wall was added. Tumors may be removed completely by pan-pleuropneumonectomy and thymectomy for invasive thymoma with pleural disseminations.
本文报告一例侵袭性胸腺瘤伴胸膜播散患者,接受了胸膜肺切除术和胸腺切除术。一名30岁女性因左肺野和纵隔出现异常阴影入院。胸部CT检查显示,肿瘤阴影位于前纵隔和左胸壁。经左胸壁肿瘤穿刺活检标本,最可能的诊断为胸腺瘤伴胸膜播散。对前纵隔肿块进行术前放疗有效。实施了胸膜肺切除术和胸腺切除术,并联合部分肋间肌和膈肌切除术。组织学检查显示,肿瘤呈小叶结构,由上皮细胞组成,淋巴细胞浸润较少,并侵犯了肋间肌或肺。术后对纵隔和左胸壁进行了放疗。对于侵袭性胸腺瘤伴胸膜播散,全胸膜肺切除术和胸腺切除术可完全切除肿瘤。