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一例酷似包虫囊肿的巨大胸膜假黏液瘤:病例报告

A huge pseudomyxoma pleurii mimicking hydatid cyst: A case report.

作者信息

Baset Zekrullah, Hanifi Ahmed Nasir, Ibrahimkhil Abdul Sami, Rastin Mohammad Saboor, Rahimi Mehmood Shah, Malakzai Haider Ali

机构信息

Department of Histopathology and Cytopathology, Human Medical Laboratories (HML) and Research Center, Kabul, Afghanistan.

Central Public Health Laboratories (CPHL), Kabul, Afghanistan.

出版信息

Int J Surg Case Rep. 2023 Apr;105:108098. doi: 10.1016/j.ijscr.2023.108098. Epub 2023 Apr 1.

Abstract

INTRODUCTION

Pseudomyxoma pleurii is a rare disease that is defined by the pleural extension of pseudomyxoma peritonei, usually secondary to a mucinous neoplasm of the appendix or ovary. It is characterized by diffuse mucinous deposits on the pleural surface.

CASE PRESENTATION

A 31-year-old woman presented to the hospital with dyspnea, an increased respiratory rate, and decreased oxygen saturation. Following an appendectomy for a perforated mucinous appendiceal tumor eight years ago, the patient underwent multiple surgeries for the resection of mass deposits in the peritoneal cavity. At presentation, her chest computed tomography with contrast revealed cystic mass deposits on the right-side pleura with a massive multi-locular pleural effusion mimicking hydatid cyst. Upon histopathologic examination, multiple small cystic structures lined by tall columnar epithelium with basally placed bland nuclei floating in the mucin pools were noted.

CLINICAL DISCUSSION

Pseudomyxoma peritonei often leads to abdominal distention, intestinal blockage, anorexia, cachexia, and eventually death. It rarely spreads outside the abdomen, and its extension to the pleura is extremely unusual, with only a small number of cases documented in the literature to date. Radiologically, pseudomyxoma pleurii may resemble hydatid cyst of the lung and pleura.

CONCLUSION

Pseudomyxoma pleurii is a rare entity with a poor prognosis that usually arises secondary to Pseudomyxoma peritonei. The risk of morbidity and mortality is reduced by early diagnosis and treatment. The present case places emphasis on the inclusion of pseudomyxoma pleurii in the differential diagnosis of pleural lesions in patients with the history of appendiceal or ovarian mucinous tumors.

摘要

引言

胸膜假黏液瘤是一种罕见疾病,由腹膜假黏液瘤向胸膜蔓延所致,通常继发于阑尾或卵巢的黏液性肿瘤。其特征为胸膜表面有弥漫性黏液沉积。

病例介绍

一名31岁女性因呼吸困难、呼吸频率增加和氧饱和度降低入院。八年前因穿孔性黏液性阑尾肿瘤行阑尾切除术后,患者又接受了多次手术以切除腹腔内的肿块沉积物。就诊时,她的胸部增强计算机断层扫描显示右侧胸膜有囊性肿块沉积物,伴有大量多房性胸腔积液,类似包虫囊肿。组织病理学检查发现,多个小囊性结构内衬高柱状上皮,细胞核位于基底,呈淡染,漂浮在黏液池中。

临床讨论

腹膜假黏液瘤常导致腹胀、肠梗阻、厌食、恶病质,最终死亡。它很少扩散到腹部以外,蔓延至胸膜极为罕见,迄今为止文献中仅有少数病例记载。在影像学上,胸膜假黏液瘤可能类似肺和胸膜的包虫囊肿。

结论

胸膜假黏液瘤是一种罕见的疾病,预后较差,通常继发于腹膜假黏液瘤。早期诊断和治疗可降低发病和死亡风险。本病例强调,对于有阑尾或卵巢黏液性肿瘤病史的患者,胸膜假黏液瘤应纳入胸膜病变的鉴别诊断。

相似文献

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A huge pseudomyxoma pleurii mimicking hydatid cyst: A case report.一例酷似包虫囊肿的巨大胸膜假黏液瘤:病例报告
Int J Surg Case Rep. 2023 Apr;105:108098. doi: 10.1016/j.ijscr.2023.108098. Epub 2023 Apr 1.
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Pseudomyxoma pleurii: unusual location of a rare disease.胸膜假黏液瘤:一种罕见疾病的不寻常部位
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