Mizuki M, Yukishige K, Abe Y, Tsuda T
Third Department of Internal Medicine, Oita Medical University, Japan.
Respirology. 1997 Sep;2(3):201-5. doi: 10.1111/j.1440-1843.1997.tb00079.x.
We report the case of a 75-year-old Japanese man who developed malignant mesothelioma in the left hemithorax 50 years after the dropping of the atomic bomb on Nagasaki in 1945. This may be the first reported case of malignant mesothelioma following exposure to atomic radiation. Asbestos is the leading cause of malignant mesothelioma, but radiation therapy is the primary non-asbestos-related cause. In the case of radiation therapy, the interval between exposure and the occurrence of malignant mesothelioma tends to be many years. This patient was at a high risk of malignant mesothelioma as he had been exposed to radiation from the atomic bomb and may also have had a history of asbestos exposure at the munitions factory where he was employed as a shipbuilder for 2 years. It has been suggested that combined exposure to atomic radiation and asbestos is associated with an increased incidence of malignant mesothelioma. If thickening of the pleura or pleural effusion is found in atomic bomb survivors, malignant mesothelioma should be considered as one of the options in the differential diagnosis, even although the atomic bomb attacks occurred several decades ago.
我们报告了一例75岁日本男性的病例，该患者于1945年原子弹在长崎爆炸50年后，左半胸发生恶性间皮瘤。这可能是首例报道的因接触原子辐射后发生恶性间皮瘤的病例。石棉是恶性间皮瘤的主要病因，但放射治疗是主要的非石棉相关病因。就放射治疗而言，从接触到发生恶性间皮瘤的间隔时间往往长达数年。该患者因曾遭受原子弹辐射，且可能在其作为造船厂工人工作了两年的军工厂有石棉接触史，故而患恶性间皮瘤的风险很高。有人提出，原子辐射与石棉的联合接触会增加恶性间皮瘤的发病率。即使原子弹袭击发生在几十年前，但如果在原子弹爆炸幸存者中发现胸膜增厚或胸腔积液，在鉴别诊断中应将恶性间皮瘤视为可能的诊断之一。
