Kanemura Shingo, Kuribayashi Kozo, Moriya Yumiko, Shimizu Shigeki, Tsujimura Tohru, Nakano Takashi
Department of Respiratory Medicine Hyogo College of Medicine Hyogo Japan.
Department of Pathology Hyogo College of Medicine Hyogo Japan.
Respirol Case Rep. 2016 Sep 25;4(6):e00191. doi: 10.1002/rcr2.191. eCollection 2016 Nov.
A 31-year-old woman presented with a 2-month history of dull left back pain. Chest roentgenography revealed pleural thickening in the left lung apex, whereas chest computed tomography showed a left pleural effusion with diffuse pleural thickening. Based on these findings, malignant mesothelioma was suspected. Video-assisted thoracoscopic pleural biopsy was performed, and subsequent staining of the specimen revealed negative results for anti-cytokeratin antibodies and positive results for vascular endothelial immunohistochemical markers. Therefore, a diagnosis of epithelioid hemangioendothelioma (EHE) was made, and chemotherapy with carboplatin, pemetrexed, and bevacizumab was initiated. After the fourth course of treatment, the disease was well controlled with a 90% reduction of the left pleural effusion. This case is very rare in that the EHE originated from the pleura. Additionally, there has been no report of pemetrexed for treatment of EHE.
一名31岁女性，有2个月的左背部钝痛病史。胸部X线检查显示左肺尖胸膜增厚，而胸部计算机断层扫描显示左侧胸腔积液伴弥漫性胸膜增厚。基于这些发现，怀疑为恶性间皮瘤。进行了电视辅助胸腔镜胸膜活检，随后对标本进行染色，结果显示抗细胞角蛋白抗体为阴性，血管内皮免疫组化标记物为阳性。因此，诊断为上皮样血管内皮瘤（EHE），并开始使用卡铂、培美曲塞和贝伐单抗进行化疗。在第四个疗程的治疗后，病情得到了很好的控制，左侧胸腔积液减少了90%。该病例非常罕见，因为EHE起源于胸膜。此外，尚无培美曲塞治疗EHE的报道。
