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[原发性胸膜上皮样血管内皮瘤,一种常被误诊的罕见肿瘤]

[Primary pleural epithelioid hemangioendothelioma, an often-misdiagnosed rare tumor].

作者信息

Tossan P, Pichon E, Arbion F, Sizaret D, Simionca G, Marchand-Adam S

机构信息

Service de pneumologie et explorations fonctionnelles respiratoires, Centre hospitalo-universitaire de Tours, 2, boulevard Tonnellé, 37000 Tours, France.

Service de pneumologie et explorations fonctionnelles respiratoires, Centre hospitalo-universitaire de Tours, 2, boulevard Tonnellé, 37000 Tours, France.

出版信息

Rev Mal Respir. 2022 Apr;39(4):398-406. doi: 10.1016/j.rmr.2022.03.005. Epub 2022 May 6.

Abstract

INTRODUCTION

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that develops in various organs. Primary pleural epithelioid hemangioendothelioma is an exceptional occurrence, with only forty cases reported in the literature. On account of its rarity, pleural EHE is difficult to diagnose. Differential diagnoses such as malignant pleural mesothelioma or lung carcinoma are often initially suspected.

METHODS

We herein describe the case of a 52-year-old man presenting with a primary pleural epithelioid hemangioendothelioma revealed by thoracic pain and having evolved for three months. Having reviewed the literature, we consider the clinical presentation and diagnosis modalities of this rare tumor.

RESULTS

After an initial diagnosis of lung carcinoma, an ultrasound-guided biopsy was performed, confirming the diagnosis of pleural EHE in our patient. Ours is the first case of pleural EHE to be diagnosed with ultrasound-guided echography. Presentation of pleural EHE is often clinically and radiologically nonspecific. Most diagnoses are obtained by thoracoscopy, which allows for targeted biopsies and evacuation of pleural effusion.

CONCLUSION

The diagnostic process for this rare tumor must be rigorous. Ultrasound-guided biopsy may be considered, provided that the lesions are accessible.

摘要

引言

上皮样血管内皮瘤(EHE)是一种罕见的血管肿瘤,可发生于多个器官。原发性胸膜上皮样血管内皮瘤极为罕见,文献中仅报道过40例。由于其罕见性,胸膜EHE难以诊断。通常最初会怀疑为恶性胸膜间皮瘤或肺癌等鉴别诊断。

方法

我们在此描述一例52岁男性患者,因胸痛就诊,病程3个月,被诊断为原发性胸膜上皮样血管内皮瘤。在回顾文献后,我们探讨了这种罕见肿瘤的临床表现和诊断方法。

结果

最初诊断为肺癌后,进行了超声引导下活检,确诊为胸膜EHE。我们的病例是首例通过超声引导超声检查诊断的胸膜EHE。胸膜EHE的表现通常在临床和影像学上无特异性。大多数诊断通过胸腔镜获得,胸腔镜可进行靶向活检并引流胸腔积液。

结论

对于这种罕见肿瘤的诊断过程必须严谨。如果病变部位可及,可考虑超声引导下活检。

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