以胸腔积液为主要表现的成人型胸膜肺母细胞瘤

Pleuropulmonary blastoma in an adult women with pleurorrhea as the major clinical manifestation:report of a case

胸膜肺母细胞瘤是一种非常少见的小儿肺部胚胎样恶性肿瘤,而成人型胸膜肺母细胞瘤尤为罕见。本文报告1例并复习文献。该患者以顽固性胸腔积液为主要临床表现,曾误诊为结核性胸膜炎并经抗结核治疗3周,后经手术及病理分析而得到确诊。术后经过4个疗程化疗,患者于术后20周左侧胸膜出现肿瘤复发。

Pleuropulmonary blastoma （PPB） is a rare dysontogenetic neoplasm in children and has been recognized as a distinct clinicopathological entity different from the ordinary pulmonary blastoma of adulthood. We report a very rare adult case of PPB. A 43oyear-old female patient presented with massive pleural infusion, and a misdiagnosis of pleural tuberculosis （TB） was made on the basis of ultrasound scan and CT images, for which therapy with TB drugs was administered for 3 weeks. Subsequent operation and pathologic examination of the mass revealed a multicystic neoplasm consisting of malignant mesenchymal cells immunohistochemically positive for vimentin and actin. Local recurrence occurred in the left pleural 20 months after the surgical tumor resection and 4 cycles of adjuvant chemotherapy.