Pais Ana, Pinto Nicole, Cardoso João, Fernandes Manuel, Coutinho Ana Isabel, Oliveira Ana Sofia, Carvalho Lurdes, Bárbara Cristina
Serviço de Pneumologia. Hospital Pulido Valente. Centro Hospitalar de Lisboa Norte. Lisboa. Portugal.
Acta Med Port. 2020 Feb 3;33(2):143-146. doi: 10.20344/amp.11406.
Pleural mesothelioma is a disease associated with exposure to asbestos. Although rare, it is the most common malignant pleural neoplasm. It is difficult to diagnose and it has a poor prognosis. We report the case of a 62-year-old male patient with a history of prolonged occupational exposure to asbestos, with dyspnea for minor exertion and productive cough, for several months. Imaging studies revealed extensive interstitial involvement with marked thickening of the interlobular and centrilobular septa and tenuous pleural involvement. Several differential diagnoses were considered such as, asbestosis, cryptogenic organizing pneumonia, desquamative interstitial pneumonia, pleuropulmonary metastases, and/or bronchopulmonary infection, but the histological and immunohistochemical results were compatible with pleural mesothelioma - a rare malignant neoplasm, with pleural origin, with a high mortality rate.
胸膜间皮瘤是一种与接触石棉有关的疾病。虽然罕见，但它是最常见的恶性胸膜肿瘤。其诊断困难，预后不良。我们报告一例62岁男性患者，有长期职业性接触石棉史，数月来轻微活动即感呼吸困难并伴有咳痰。影像学检查显示广泛的间质受累，小叶间隔和小叶中心间隔明显增厚，胸膜受累较轻。考虑了几种鉴别诊断，如石棉肺、隐源性机化性肺炎、脱屑性间质性肺炎、胸膜肺转移瘤和/或支气管肺部感染，但组织学和免疫组化结果与胸膜间皮瘤相符——一种罕见的恶性肿瘤，起源于胸膜，死亡率高。
