Shibuya K, Yusa T, Iyoda A, Hiroshima K
Department of Respiratory Surgery, Chiba Rosai Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Sep;45(9):1581-6.
A 53-year-old male was admitted with cough and chest pain. A chest X-ray film showed left pleural effusion and a chest CT revealed irregular thickening of the pleura. Pleural fluid cytology and percutaneous needle biopsy were negative for malignancy. Thoracoscopic findings revealed fibrin network with pleural effusions and yellow-white pleural thickening, but neither nodules nor masses were found. The thoracoscopic biopsy specimen from the pleural thickening resulted in the diagnosis of malignant pleural mesothelioma. Left pleuropneumonectomy with mediastinal lymph node dissection was performed. Since detailed inspection of the pleural cavity and taking large biopsy samples under thoracoscopic examination are possible, we consider thoracoscopic biopsy to be a useful method for obtaining diagnosis of malignant pleural mesothelioma. Pleuropneumonectomy and systematic lymph node dissection of the pulmonary hilum and mediastinum were believed to be necessary for the surgical treatments.
一名53岁男性因咳嗽和胸痛入院。胸部X光片显示左侧胸腔积液，胸部CT显示胸膜不规则增厚。胸腔积液细胞学检查和经皮针吸活检均未发现恶性肿瘤。胸腔镜检查发现有纤维蛋白网络伴胸腔积液以及黄白色胸膜增厚，但未发现结节或肿块。胸膜增厚处的胸腔镜活检标本确诊为恶性胸膜间皮瘤。遂行左胸膜肺切除术并清扫纵隔淋巴结。由于在胸腔镜检查下可以对胸腔进行详细检查并获取大的活检样本，我们认为胸腔镜活检是诊断恶性胸膜间皮瘤的一种有用方法。胸膜肺切除术以及对肺门和纵隔进行系统性淋巴结清扫被认为是手术治疗所必需的。
