Shibata M, Oki Y, Iwata M, Ogasawara B, Watanabe H, Noda Y, Takagi K, Imaizumi M
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Sep;27(9):1100-5.
A 47-year-old man was admitted with a cough on January 4, 1986. A chest X-ray film showed a mass shadow in the left lower lung, which was revealed to be a bronchogenic cyst by CT scanning and ultrasonography. Thoracotomy was performed on March 3, 1986 because cytologic tests on the fluid in the cyst suggested malignancy. A cyst, two tumors on the diaphragm and pleural thickening were revealed. Microscopic examination showed a benign bronchogenic cyst and a mixed-type malignant mesothelioma. In spite of chemotherapy (ADR, Cis-DPP, 5-fluorouracil) and immunotherapy (OK-432, PSK), the pleural thickening progressed, as was demonstrated by CT scanning and ultrasonography. Although cardiac tamponade due to invasion by the malignant mesothelioma developed, this was improved by cardiocentesis. The patient died of pneumonia on March 28, 1987. We studied the concentration of mineral fibers in lung and tumor tissues of this case by Energy Dispersive X-ray Analyser because asbestos or non-asbestos inorganic fibers might cause malignant mesothelioma. This case of malignant pleural mesothelioma accompanied by a bronchogenic cyst is very rare.
一名47岁男性于1986年1月4日因咳嗽入院。胸部X线片显示左肺下叶有一肿块阴影,CT扫描和超声检查显示为支气管囊肿。由于对囊肿内液体的细胞学检查提示恶性,于1986年3月3日进行了开胸手术。术中发现一个囊肿、膈肌上的两个肿瘤及胸膜增厚。显微镜检查显示为良性支气管囊肿和混合型恶性间皮瘤。尽管进行了化疗(阿霉素、顺铂、5-氟尿嘧啶)和免疫治疗(溶链菌制剂、云芝多糖K),但CT扫描和超声检查显示胸膜增厚仍在进展。尽管因恶性间皮瘤侵犯导致心包填塞,但通过心包穿刺得以改善。患者于1987年3月28日死于肺炎。我们用能量色散X射线分析仪研究了该病例肺组织和肿瘤组织中矿物纤维的浓度,因为石棉或非石棉无机纤维可能导致恶性间皮瘤。这种伴有支气管囊肿的恶性胸膜间皮瘤病例非常罕见。