Liewald F, Sunder-Plassmann L, Dienemann H, Mezger J
Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Langenbecks Arch Chir. 1989;374(2):105-10. doi: 10.1007/BF01261619.
Patients with benign pleurafibromas should undergo surgery as suspect thoracic tumors have the potential to become malignant. In benign cases diagnosis can easily be made during the operation. In such a case the prognosis is good and it is seldom necessary to undergo repeated surgery due to recurrence. In the case of malignant pleuramesothelioma the preoperative diagnosis with an exact staging of the tumor is very important to determine an adequate therapeutic regimen. X-ray, CT-scanning, tapping of the pleura fluid and biopsy of the pleura are together insufficient to diagnose a pleuramesothelioma correctly. Since it is not always possible to diagnose a malignant pleuramesothelioma even at thoracoscopy, one should not hesitate to perform an open lung biopsy in order to obtain enough material under adequate vision.
患有良性胸膜纤维瘤的患者应接受手术,因为疑似胸内肿瘤有可能恶变。在良性病例中,术中很容易做出诊断。在这种情况下,预后良好,很少因复发而需要再次手术。对于恶性胸膜间皮瘤,术前进行准确的肿瘤分期诊断对于确定合适的治疗方案非常重要。X线、CT扫描、胸腔积液穿刺和胸膜活检一起不足以正确诊断胸膜间皮瘤。由于即使在胸腔镜检查时也并非总能诊断出恶性胸膜间皮瘤,因此为了在足够的视野下获取足够的材料,不应犹豫进行开胸肺活检。