Kosaka Takayuki, Nakazawa Seshiru, Ushikubo Rikuo, Ibe Takashi, Shirabe Ken
Department of Thoracic Surgery, National Hospital Organization (NHO) Takasaki General Medical Center, Gunma, JPN.
Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, JPN.
Cureus. 2025 Mar 30;17(3):e81473. doi: 10.7759/cureus.81473. eCollection 2025 Mar.
A man in his 80s presented with shortness of breath. Chest CT scan showed pleural effusion and a mass in the right lower lobe. He had high inflammatory reaction and was diagnosed as having pulmonary suppuration with empyema. After three weeks of antibiotic treatment, the lesion grew and he was referred to our department for surgical intervention. A complete resection of the right lower lobe was planned to control infection. Intraoperative findings showed that the lower lobe became a large mass and was judged unresectable. The procedure was converted to drainage of the abscess cavity. Pathological examination, combined with clinical and radiological findings, led to the diagnosis of localized sarcoma-type malignant pleural mesothelioma. Localized malignant pleural mesothelioma is a rare disease and most cases have been reported as epithelial type, deriving from the parietal pleura. Our case is quite rare because it was a sarcoma-type, deriving from the visceral pleura.
一名80多岁的男性因呼吸急促前来就诊。胸部CT扫描显示有胸腔积液和右下叶肿块。他有高度炎症反应，被诊断为肺脓肿合并脓胸。经过三周的抗生素治疗，病变仍在增大，随后他被转诊至我科接受手术干预。计划对右下叶进行完整切除以控制感染。术中发现下叶已形成一个大肿块，判断无法切除。手术改为脓肿腔引流。病理检查结合临床和影像学检查结果，诊断为局限性肉瘤型恶性胸膜间皮瘤。局限性恶性胸膜间皮瘤是一种罕见疾病，大多数病例报道为上皮型，起源于壁层胸膜。我们的病例非常罕见，因为它是肉瘤型，起源于脏层胸膜。
