Moss S F, Lehner P J, Gilbey S G, Kennedy A, Hughes J M, Bloom S R, Hodgson H J
Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Q J Med. 1993 Jan;86(1):49-53.
Tissue fibrosis is a recognized complication of the carcinoid syndrome but pleural changes have not been described. Prompted by the finding of severe pleural thickening in two patients with the metastatic carcinoid syndrome but no thoracic metastases or previous pleural disease we reviewed the chest radiographs and CT scans in 50 patients with the carcinoid syndrome investigated from 1981 to 1990. Pleural abnormality was noted in 14 of the 50 patients (28%), five of whom had other possible causes for pleural disease. However, nine (18%) patients had 'idiopathic' pleural thickening. Pleural disease had developed within 2 years of the diagnosis in all cases, and seven of the nine patients had fibrosis elsewhere (heart valves, skin or mesentery). There were no features to suggest a more rapid disease progression in the patients with pleural disease. We suggest that the pleural abnormality is a complication of metastatic carcinoid disease.
组织纤维化是类癌综合征公认的并发症，但胸膜改变尚未见报道。在两名转移性类癌综合征患者中发现严重胸膜增厚，且无胸内转移或既往胸膜疾病，受此启发，我们回顾了1981年至1990年期间接受检查的50例类癌综合征患者的胸部X光片和CT扫描。50例患者中有14例（28%）存在胸膜异常，其中5例有其他可能导致胸膜疾病的原因。然而，9例（18%）患者有“特发性”胸膜增厚。所有病例中胸膜疾病均在诊断后2年内出现，9例患者中有7例在其他部位（心脏瓣膜、皮肤或肠系膜）有纤维化。胸膜疾病患者没有提示疾病进展更快的特征。我们认为胸膜异常是转移性类癌疾病的一种并发症。
