胸膜间皮瘤伴巨大血管前淋巴结：N1 累及还是其他不同情况？

Mesothelioma With a Large Prevascular Lymph Node: N1 Involvement or Something Different?

机构信息

Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium.

出版信息

Ann Thorac Surg. 2018 May;105(5):e189-e191. doi: 10.1016/j.athoracsur.2017.12.016.

DOI:10.1016/j.athoracsur.2017.12.016

Abstract

A 64-year-old man presented with a large amount of right-sided pleural fluid on imaging, together with calcified pleural plaques and an enlarged nodular structure in the prevascular mediastinum, presumably an enlarged lymph node. Pleural biopsies were obtained during video-assisted thoracoscopic surgery to exclude malignancy. Histopathology showed an epithelial malignant pleural mesothelioma. Induction chemotherapy with cisplatin and pemetrexed was administered followed by an extended pleurectomy and decortication with systematic nodal dissection. Histopathology confirmed the diagnosis of a ypT3N0M0 (stage IB) mesothelioma, and an unexpected thymoma type B2 (stage II) was discovered in the prevascular nodule. Simultaneous occurrence of a mesothelioma and thymoma is extremely rare.

摘要

一位 64 岁男性在影像学检查中表现为大量右侧胸腔积液，同时伴有钙化性胸膜斑块和前血管纵隔中结节状结构增大，推测为淋巴结肿大。胸腔镜手术中进行了胸膜活检以排除恶性肿瘤。组织病理学显示上皮性恶性胸膜间皮瘤。给予顺铂和培美曲塞诱导化疗，随后进行广泛的胸膜切除术和剥除术，并进行系统性淋巴结清扫。组织病理学证实了 ypT3N0M0（IB 期）间皮瘤的诊断，并在前血管结节中发现了意外的胸腺瘤 B2 型（II 期）。同时发生间皮瘤和胸腺瘤极为罕见。