Matsuzawa K, Hamada K, Tokuyama T, Yoneda T, Narita N, Sawabata A, Iioka S, Imai S, Sakaguchi Y, Miyataka K
Division of Internal Medicine, Tenri City Hospital, Nara, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Nov;33(11):1288-92.
A 43-year-old man was admitted to Nara Medical University Hospital because of right-sided chest pain. Computed tomographic examination revealed a right pleural effusion and diffuse pleural thickening. Malignant mesothelioma was diagnosed from the results of a percutaneous pleural biopsy, and the patient then underwent right pleuro-pneumonectomy. The resected specimen was examined by light and electron microscopy, which revealed scattered sarcoma-like malignant cells with some epithelial differentiation, in abundant extracellular collagen with storiform derangement. Therefore, desmoplastic malignant mesothelioma (mixed type) was diagnosed. This is a rare histological subgroup of malignant mesotheliomas. The patient died 2 months after the operation, due to multiple and rapidly growing metastases. After lung tissue was dissolved, ferruginous (asbestos) bodies were counted, and the results were consistent with occupational exposure to asbestos (413 asbestos bodies per 5 g of lung tissue).
一名43岁男性因右侧胸痛入住奈良医科大学医院。计算机断层扫描检查显示右侧胸腔积液和弥漫性胸膜增厚。经皮胸膜活检结果诊断为恶性间皮瘤,随后患者接受了右胸膜肺切除术。对切除标本进行光镜和电镜检查,结果显示散在的肉瘤样恶性细胞,有一些上皮分化,存在于大量细胞外胶原中,呈席纹状排列紊乱。因此,诊断为促纤维增生性恶性间皮瘤(混合型)。这是恶性间皮瘤中一种罕见的组织学亚组。患者术后2个月因多发且迅速生长的转移灶死亡。肺组织消化后,对含铁小体(石棉)进行计数,结果与职业性石棉暴露相符(每5克肺组织中有413个石棉小体)。