Faynberg Tatyana, Patel Neha, Nayar Amrit P, Shienbaum Alan J
Department of Surgery, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
Department of Surgery, Kennedy University Hospital, Cherry Hill, NJ, USA.
Gen Thorac Cardiovasc Surg. 2017 Nov;65(11):667-669. doi: 10.1007/s11748-017-0758-0. Epub 2017 Mar 7.
Talc pleurodesis is a well-established procedure performed to obliterate the pleural space to prevent recurrent pleural effusion and/or recurrent pneumothorax. Pleurodesis is commonly accomplished by draining the pleural fluid, if present, followed by either a mechanical procedure, such as abrasion, pleurectomy, or instillation of a chemical irritant into the pleural space, which results in inflammation and fibrosis which obliterates the pleural space. The reported complications of talc pleurodesis are hypoxemia, hypotension, tachycardia, dyspnea, chest pain, and fever.
Herein, we present a case of a 43-year-old female patient who developed an intense mesothelioid reaction which occurred 7 years following talc pleurodesis.
This case represents a unique mesothelioid reaction which became manifested several years after recurrent talc pleurodesis. Such a mesothelioid reaction can clinically and radiographically mimic malignant mesothelioma. We conclude that Talc pleurodesis played a causative role in this patient developing an intense mesothelioid reaction. A mesothelioid reaction should be included in the differential diagnosis in patients with pleural thickening/pleural plaque formation who have previously been treated with talc pleurodesis.
滑石粉胸膜固定术是一种成熟的手术,用于消除胸膜腔以预防复发性胸腔积液和/或复发性气胸。如果存在胸腔积液,胸膜固定术通常通过引流胸腔积液来完成,随后进行机械手术,如胸膜摩擦、胸膜切除术,或将化学刺激剂注入胸膜腔,这会导致炎症和纤维化,从而消除胸膜腔。滑石粉胸膜固定术报道的并发症有低氧血症、低血压、心动过速、呼吸困难、胸痛和发热。
在此,我们报告一例43岁女性患者,在滑石粉胸膜固定术后7年出现强烈的间皮样反应。
该病例代表了一种独特的间皮样反应,在复发性滑石粉胸膜固定术后数年出现。这种间皮样反应在临床和影像学上可模拟恶性间皮瘤。我们得出结论,滑石粉胸膜固定术在该患者发生强烈的间皮样反应中起了致病作用。对于先前接受过滑石粉胸膜固定术且出现胸膜增厚/胸膜斑形成的患者,鉴别诊断中应考虑间皮样反应。