Saeki Sho, Kurosawa Rin, Yamada Akihiro, Shimamura Minori, Inaba Megumi, Tashiro Takahiro, Sakagami Akiko, Hirata Naomi, Jodai Yasumiko, Iyama Shinji, Tomita Yusuke, Sakagami Takuro
Department of Respiratory Medicine Kumamoto Chuo Hospital Kumamoto Japan.
Department of Respiratory Medicine Kumamoto University Hospital Kumamoto Japan.
Respirol Case Rep. 2025 Sep 18;13(9):e70342. doi: 10.1002/rcr2.70342. eCollection 2025 Sep.
We report the case of a 41-year-old woman who developed an epithelioid-type pleural mesothelioma (PM) decades after treatment for childhood acute myeloid leukaemia (AML), who was treated with chemotherapy and total body irradiation (TBI). The diagnosis was confirmed by thoracoscopic pleural biopsy and immunohistochemical staining. Although PM is classically associated with asbestos exposure, the patient had no known history of exposure. This case report highlights the fact that PM can occur as a late-onset secondary malignancy following radiation therapy in childhood cancer survivors. Although radiation-induced PM has been reported primarily in survivors of Hodgkin lymphoma or breast cancer, incidences following treatment for leukaemia are exceptionally rare. This case report highlights the importance of considering prior therapeutic irradiation, including total-body irradiation, as a potential etiological factor for non-asbestos-related PM. It also emphasises the need for the long-term surveillance and monitoring of childhood cancer survivors, particularly those who have received radiation therapy.
我们报告了一例41岁女性病例，该患者在儿童期急性髓系白血病（AML）接受化疗和全身照射（TBI）治疗数十年后，发生了上皮样型胸膜间皮瘤（PM）。通过胸腔镜胸膜活检和免疫组化染色确诊。虽然PM通常与石棉暴露有关，但该患者并无已知的暴露史。本病例报告强调了这样一个事实，即PM可作为儿童癌症幸存者放疗后迟发性继发性恶性肿瘤出现。虽然辐射诱发的PM主要在霍奇金淋巴瘤或乳腺癌幸存者中报道，但白血病治疗后的发生率极为罕见。本病例报告强调了将既往包括全身照射在内的治疗性放疗视为非石棉相关PM潜在病因的重要性。它还强调了对儿童癌症幸存者，尤其是接受过放疗的幸存者进行长期监测的必要性。
