Nishi K, Myou S, Ooka T, Fujimura M, Matsuda T
Division of Pulmonary Medicine, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Jul;31(7):876-80.
We report a rare case of pleural involvement followed by idiopathic retroperitoneal fibrosis in a 55-year-old man. He complained of right chest pain and his chest radiogram showed pleural thickening and calcification. Chest X-ray computed tomogram (CT) also showed a mass-like pleural thickening and a soft tissue density lesion surrounding the thoracic aorta, suggesting fibrosis. By open pleural biopsy, the mass-like pleural lesion was diagnosed as chronic pleuritis. Three years later, the patient experienced difficulty in urination, and bilateral hydronephrosis which was probably due to a retroperitoneal lesion was detected. Abdominal X-ray CT revealed a retroperitoneal lesion of soft tissue density comprised of a smooth and clearly delineated mass which encased the large vessels and ureters, compatible with retroperitoneal fibrosis. Although it was not possible to biopsy the retroperitoneal lesion, the lesion was clinically and radiologically thought to be retroperitoneal fibrosis. We could not determine the etiology of these findings, but such a case of pleural involvement followed by idiopathic retroperitoneal fibrosis was considered to be very rare.
我们报告了一例罕见病例,一名55岁男性先出现胸膜受累,随后发生特发性腹膜后纤维化。他主诉右胸痛,胸部X线片显示胸膜增厚和钙化。胸部X线计算机断层扫描(CT)也显示出肿块样胸膜增厚以及围绕胸主动脉的软组织密度病变,提示纤维化。通过开放性胸膜活检,肿块样胸膜病变被诊断为慢性胸膜炎。三年后,患者出现排尿困难,检测发现双侧肾积水,可能是由腹膜后病变所致。腹部X线CT显示腹膜后软组织密度病变,表现为边界清晰、光滑的肿块,包绕大血管和输尿管,符合腹膜后纤维化。尽管无法对腹膜后病变进行活检,但从临床和影像学角度考虑该病变为腹膜后纤维化。我们无法确定这些表现的病因,但这种先出现胸膜受累,随后发生特发性腹膜后纤维化的病例被认为非常罕见。