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原发性膈肌恶性间皮瘤伴肝脏侵犯:一例报告及文献复习

Primary malignant mesothelioma of the diaphragm with liver invasion: A case report and review of literature.

作者信息

Huang Wen-Jing, Li Zhi-Han, Wang Zhao, Yang Mai-Qing, Xu Hong-Tao

机构信息

Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China.

出版信息

Medicine (Baltimore). 2019 Apr;98(15):e15147. doi: 10.1097/MD.0000000000015147.

Abstract

RATIONALE

Malignant mesothelioma is a malignant tumor with poor prognosis, which usually originates in the pleura, peritoneum, and pericardial cavity. Mesotheliomas that originate from the diaphragm are very rare. Here, we report a case of primary malignant mesothelioma of the diaphragm with liver invasion.

PATIENT CONCERNS

A 66-year-old woman was admitted to our hospital because of a "liver space-occupying lesion," without any special clinical symptoms. Imaging examinations suggested a cystic-solid mixed lesion in the right lobe of the liver.

DIAGNOSIS

The tumor was diagnosed as epithelioid mesothelioma of the diaphragm with liver invasion.

INTERVENTION

The patient underwent abdominal surgery in our hospital to remove the diaphragmatic mass, liver mass, and part of the diaphragm.

OUTCOMES

The postoperative course was uneventful.

LESSONS

Primary diaphragmatic malignant mesothelioma is very rare and may involve liver or lung tissue and be mistaken for liver or lung tumor. Accurate diagnosis depends on careful pathological examination. Immunohistochemical staining is very useful to distinguish this tumor from other liver or diaphragmatic tumors.

摘要

原理

恶性间皮瘤是一种预后较差的恶性肿瘤,通常起源于胸膜、腹膜和心包腔。起源于膈肌的间皮瘤非常罕见。在此,我们报告一例原发性膈肌恶性间皮瘤伴肝脏侵犯的病例。

患者情况

一名66岁女性因“肝脏占位性病变”入院,无任何特殊临床症状。影像学检查提示肝脏右叶有囊实性混合病变。

诊断

该肿瘤被诊断为膈肌上皮样间皮瘤伴肝脏侵犯。

干预措施

患者在我院接受腹部手术,切除膈肌肿物、肝脏肿物及部分膈肌。

结果

术后过程顺利。

经验教训

原发性膈肌恶性间皮瘤非常罕见,可能累及肝脏或肺组织,易被误诊为肝脏或肺部肿瘤。准确诊断依赖仔细的病理检查。免疫组化染色对于鉴别该肿瘤与其他肝脏或膈肌肿瘤非常有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afa9/6485870/b77e1fd97bcb/medi-98-e15147-g001.jpg

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