Kishimoto T, Okahara M, Chikamori K, Ozaki S, Aoe K, Ohke M, Fujioka H, Kimura K, Yonei T
Department of Internal Medicine, Okayama Rousai Hospital, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Jan;36(1):18-22.
Seventeen cases of benign asbestos pleurisy were evaluated clinically. All cases were male and almost all cases were more than 60 years-old. Most cases presented with chief complaints of chest pain and dyspnea, but 2 cases had no complaints. Pleural effusion appeared predominantly in the right side. Six cases had 2 or 3 episodes of pleural effusion, and 1 case had 5. Ten cases had an occupational history of asbestos exposure in shipyards and 5 other cases had a history in building construction. Almost all cases had more than 30 years of exposure to asbestos and benign asbestos pleurisy appeared after more than 30 years from the first exposure to asbestos. Among the patients, 6 cases had diffuse pleural thickening and 2 cases had malignancies. Pleural fluid was bloody in 14 of 17 cases (82%) and all pleural fluid showed an exudate. Lymphocytes represented 70% and eosinophils 15% of the cellular population of the pleural fluid. Hyaluronic acid in pleural fluid in cases of benign asbestos pleurisy averaged 29.5 micrograms/ml, which was significantly (p < 0.05) lower than in malignant pleural mesothelioma. Leukocytosis in peripheral blood and a high CRP value were uncommon in benign asbestos pleurisy.
对17例良性石棉性胸膜炎患者进行了临床评估。所有病例均为男性,几乎所有病例年龄均超过60岁。大多数病例以胸痛和呼吸困难为主诉,但有2例无任何症状。胸腔积液主要出现在右侧。6例有2至3次胸腔积液发作,1例有5次。10例有在造船厂接触石棉的职业史,另外5例有建筑施工接触史。几乎所有病例接触石棉的时间都超过30年,良性石棉性胸膜炎在首次接触石棉30多年后出现。患者中,6例有弥漫性胸膜增厚,2例有恶性肿瘤。17例中有14例(82%)胸腔积液为血性,所有胸腔积液均为渗出液。胸腔积液细胞成分中淋巴细胞占70%,嗜酸性粒细胞占15%。良性石棉性胸膜炎病例胸腔积液中的透明质酸平均为29.5微克/毫升,显著低于恶性胸膜间皮瘤(p<0.05)。良性石棉性胸膜炎外周血白细胞增多和CRP值升高并不常见。