局限性胸膜间皮瘤的诊断和外科治疗

Clinical Analysis of 15 Patients with Localized Mesothelioma of the Pleura

目的:探讨经手术病理证实的15例局限性胸膜间皮瘤的临床经验。方法:对手术后病理确诊为局限性胸膜间皮瘤的15例患者,进行临床资料分析,包括石棉接触史、临床表现、影像学检查、特殊检查。结果:15例患者中,11例术后病理为局限性良性纤维型间皮瘤,其中1例术后3年复发,第二次手术病理报告为恶性。2例术后病理为局部区域上皮细胞丰富,局部细胞有恶性变;1例术后病理为低度恶性;1例术后病理为恶性。结论:胸片或CT示弧立、类圆形阴影、边界光整、密度均匀、与胸膜紧邻,应考虑到局限性胸膜间皮瘤的可能,少数病例可表现为双侧多发类圆形阴影,位于肺实质内,外科手术为首选治疗。

Objective: To explore the experience in the diagnosis of localized mesothelioma of the pleura. Methods: The clinical data of the fifteen patients with localized mesothelioma of the pleura we restudied, including history of exposure to a sbestos, clinical manifestations, X ray of chest, as well as contrasting the results of the fifteen operative patients. Results: Eleven of the fifteen cases were showed localized benign fiberous pleura tumors post-surgery pathology, in which 1 case of localized benign pleura tumor had relapsed in the same site after three years of surgery,and it turned to malignancy. Two of fifteen cases had found some malignant cells in some areas. One of fifteen cases was found low-degree malignancy,and one of fifteen cases was malignancy in post-surgery pathology. Conclusion: Surgical intervention was the optimal.