Rahnemai-Azar Amir A, Rahnemai-Aazr Ata A, Robinson Philip, Pham Si
Department of Surgery, University of Miami, Miami, Florida, USA.
BMJ Case Rep. 2013 Jul 4;2013:bcr2013009939. doi: 10.1136/bcr-2013-009939.
A 33-year-old African-American woman presented with left-sided chest pain for 2 months before admission. Physical examination revealed no breath sound in the left chest and CT scan of the chest showed total obliteration of the left pleural cavity. The patient also had hypertension and elevated urinary metanephrines, leading to a tentative diagnosis of a catecholamine-secreting paraganglioma. MRI revealed a large, heterogeneous soft tissue mass that occupied the entire left chest cavity, causing displacement of the heart and mediastinal structures to the right. Through a left thoracotomy incision, a tumour weighing 2790 g was removed along with a small portion of adherent lung. The tumour was positive for CD34 but negative for S-100, keratin, desmin and progesterone-receptor, which is consistent with pathological diagnosis of a solitary fibrous tumour of the pleura. The patient remains symptom free 4 years after the operation.
一名33岁非裔美国女性入院前左侧胸痛2个月。体格检查发现左胸无呼吸音，胸部CT扫描显示左胸腔完全闭塞。患者还患有高血压且尿甲氧基肾上腺素升高，初步诊断为分泌儿茶酚胺的副神经节瘤。MRI显示一个巨大的、不均匀的软组织肿块占据了整个左胸腔，导致心脏和纵隔结构向右移位。通过左胸切口，切除了一个重2790g的肿瘤及一小部分粘连的肺组织。肿瘤CD34阳性，但S-100、角蛋白、结蛋白和孕激素受体阴性，这与胸膜孤立性纤维瘤的病理诊断相符。术后4年患者症状消失。
