Fukuse T, Nakamura A, Kosaka S, Tamada J, Wazawa H
Department of Respiratory Disease, Kurashiki Central Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Sep;38(9):1492-6.
An operative case of malignant localized mesothelioma of the pleura, a 63-year-old male, came to our clinic with the chief complaint of hemosputa. On suspicion of lung tumor, right upper lobectomy and lymph node cleaning were performed. The tumor was embedded in the lung; there was no infiltration into the chest wall. After the operation, radiotherapy was added but tumor recurrence occurred in the 5th month, and the patient died 7 months after surgery. From the form of the recurrence it was considered a diffuse-type transition case. The prognosis of this disease is known to be poor, but since there have also been cases of long survival, cases of resection are studied in Japan. Based on macroscopic tumor findings, cases of occurrence in the visceral pleura have poor prognosis if embedded in the lung, while cases of occurrence in the parietal pleura have varied prognoses, but the differentiation line is yet unclear. Among six cases of diffuse-type transition, including this case, five cases were of the histological type which included the epithelial component. Further study of these cases is necessary in the near future.
一名63岁男性胸膜恶性局限性间皮瘤手术病例,以咯血为主诉前来我院就诊。因怀疑肺部肿瘤,行右上叶切除术及淋巴结清扫术。肿瘤包埋于肺内,未侵犯胸壁。术后加行放疗,但术后第5个月肿瘤复发,患者术后7个月死亡。从复发形式看,考虑为弥漫型转变病例。已知本病预后较差,但也有长期生存病例,日本正在研究手术切除病例。根据大体肿瘤表现,发生于脏层胸膜且包埋于肺内的病例预后较差,而发生于壁层胸膜的病例预后各异,但分化界限尚不清楚。包括本病例在内的6例弥漫型转变病例中,5例为包含上皮成分的组织学类型。近期有必要对这些病例进行进一步研究。