Department of Respiratory Disease, Daping Hospital, Army Medical University, Chongqing, 400042, China.
BMC Pulm Med. 2021 May 10;21(1):156. doi: 10.1186/s12890-021-01507-5.
Capillary hemangioma can be found in many organs, but rarely in pleura. Previously, only localized pleural capillary hemangioma cases have been reported. Corticosteroids are the most commonly recommended drugs in capillary hemangioma.
Here, we present a case of a young woman with recurrent hemorrhagic pleural effusion. Despite repeatedly thoracentesis, the routine examinations, including chest computed tomography (CT) scan, pleural effusion biochemical test, and cytology all failed to make a definite diagnosis. Thus, single port video-assisted thoracoscopy (VATS) was then performed. Numerous nodules arising from the parietal pleura were found, and biopsies showed multifocal pleural capillary. However, recurrent pleural effusion was successfully managed by oral azathioprine, after failure of dexamethasone treatment.
To our knowledge, this is the first case of a patient with recurrent hemorrhagic pleural effusion masquerading as malignant pleurisy, but in fact caused by multifocal pleural capillary hemangioma.
毛细血管血管瘤可见于许多器官，但在胸膜中很少见。以前，仅报道过局限性胸膜毛细血管血管瘤病例。在毛细血管血管瘤中，皮质类固醇是最常推荐的药物。
这里，我们介绍了一位年轻女性反复发生血性胸腔积液的病例。尽管反复进行了胸腔穿刺术，但包括胸部 CT 扫描、胸腔积液生化检查和细胞学检查在内的常规检查均未能做出明确诊断。因此，随后进行了单端口电视辅助胸腔镜手术(VATS)。发现壁层胸膜上有许多结节，活检显示多灶性胸膜毛细血管。然而，在使用地塞米松治疗失败后，口服硫唑嘌呤成功地控制了复发性胸腔积液。
据我们所知，这是首例以恶性胸腔积液为表现的复发性血性胸腔积液患者，但实际上是由多灶性胸膜毛细血管血管瘤引起的。
