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[腹腔镜诊断弥漫性恶性腹膜间皮瘤伴继发性肝侵犯——病例报告]

[Diffuse Malignant Peritoneal Mesothelioma with Secondary Liver Invasion Diagnosed Using Laparoscopy - A Case Report].

作者信息

Yasuda Hiroshi, Okumura Satoshi, Toyoda Shou, Yamamoto Kansuke, Mizumura Naoto, Itou Aya, Ogawa Masao, Kawasaki Masayasu, Kameyama Masao

机构信息

Division of Surgery, Bellland General Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 Mar;45(3):449-453.

Abstract

A 69-year-old man with right upper quadrant abdominal pain and fever was referred to our hospital. He had a history of asbestosis exposure. Computed tomography(CT)revealed a mass at the right subhepatic space, and an antibiotic was administered after a diagnosis of an abdominal abscess. However, the patient did not respond to the treatment, and finally, exploratory laparoscopy was performed. A sheet of combined white nodules surrounding the right lobe of the liver was found, and the mass was continuous with the covering particles. Biopsy of the mass and immunohistochemical examination was performed. The resulting diagnosis was diffuse epithelial malignant peritoneal mesothelioma(MPM). Postoperative systematic chemotherapy of pemetrexed and cisplatin was administered. Laparoscopy was useful to evaluate the distribution of the MPM, which led to adequate therapeutic determination.

摘要

一名69岁男性,因右上腹腹痛和发热转诊至我院。他有石棉沉着病接触史。计算机断层扫描(CT)显示肝下间隙右侧有一个肿块,诊断为腹腔脓肿后给予抗生素治疗。然而,患者对治疗无反应,最终进行了腹腔镜探查。发现肝脏右叶周围有一片白色结节,肿块与覆盖颗粒相连。对肿块进行活检并进行免疫组化检查。最终诊断为弥漫性上皮性恶性腹膜间皮瘤(MPM)。术后给予培美曲塞和顺铂的全身化疗。腹腔镜检查有助于评估MPM的分布,从而做出适当的治疗决定。

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