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碘化滑石胸膜固定术后的胸壁肿瘤

Chest wall tumour following iodized talc pleurodesis.

作者信息

Jackson J W, Bennett M H

出版信息

Thorax. 1973 Nov;28(6):788-93. doi: 10.1136/thx.28.6.788.

Abstract

, , 788-793. A man of 37 had an iodized talc pleurodesis carried out for recurrent spontaneous pneumothorax. There was no history of industrial exposure to asbestos. Two years later he presented with pain in the right chest and radiographs at that time showed some localized pleural thickening at the site of the thoracoscopy cannulation for introduction of talc. A provisional diagnosis of talc granuloma, chemical abscess or tumour was made and exploratory thoracotomy revealed a tumour involving the chest wall, lung, and pleura which, on histological examination, showed adenocarcinoma of varying degrees of differentiation and in some parts also presenting a more squamoid appearance. Numerous doubly refractile talc particles were intimately associated with the tumour and fibrous tissue. Shortly after excision the patient developed evidence of systemic dissemination of the disease and died four months later. The possibility of this tumour being induced by the talc is discussed. A brief review is made of the various forms of talc used in surgery over the past 40 years and attention is drawn to the significance of the proportion of asbestos mineral which is present in talc as mined in various parts of the world. We do not consider that this is a case of mesothelioma of the pleura.

摘要

37岁男性因复发性自发性气胸接受碘化滑石胸膜固定术。无工业接触石棉史。两年后,他出现右胸痛,当时的X线片显示在用于注入滑石粉的胸腔镜套管插入部位有一些局限性胸膜增厚。初步诊断为滑石肉芽肿、化学性脓肿或肿瘤,开胸探查发现肿瘤累及胸壁、肺和胸膜,组织学检查显示为不同程度分化的腺癌,部分区域还呈现更鳞状的外观。大量双折射滑石颗粒与肿瘤和纤维组织密切相关。切除后不久,患者出现疾病全身播散的证据,4个月后死亡。讨论了该肿瘤由滑石诱发的可能性。简要回顾了过去40年手术中使用的各种滑石形式,并提请注意世界不同地区开采的滑石中石棉矿物的比例的重要性。我们认为这不是一例胸膜间皮瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea93/470116/54dc9b15ae24/thorax00132-0123-a.jpg

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