青年恶性胸膜间皮瘤1例临床分析

Young patient with malignant pleural mesothelioma：a case report and clinical analysis

目的探讨恶性胸膜间皮瘤（MPM）的临床特点、诊断及治疗。方法报告2013年2月甘肃省人民医院呼吸科收治的1例青年MPM病例及相关内容综述。结果患者，男，20岁，否认石棉接触史，咳嗽、气短2周，胸片提示左侧大量胸腔积液。引流胸水10000ml后复查胸部CT示左侧胸腔内低密度肿块影，行胸膜穿刺活检，病理结果为：MPM（腺管乳头状型）。结合此例患者特点和文献复习，青年MPM患者少见，可仅表现为胸腔积液，亦可无任何临床表现。结论MPM属高度侵袭性肿瘤，临床表现缺乏特异性，可发生于任何年龄，亦可无石棉接触史，需提高对该疾病的认识及诊断水平，以便早期诊断、早期治疗，提高患者生存质量及生存期。

Objective To discuss the clinical features,diagnosis,and treatment of malignant pleural mesothelioma （MPM）. Methods One young case of MPM treated in the department of respiratory medicine,Gansu provincial people＇s hospital in February 2013 was reported and related literatures were reviewed. Results The male patient, 20 years old, denied the history of asbestos exposure, had cough and shortness of breath for more than two weeks. Chest X-ray showed large pleural effusion in the left. After the drainage of pleural effusion for 10 000 ml,chest CT showed low-density mass in the left chest. After pleural biopsy, pathology result showed MPM （tubular papillary variant）. Combined with the characteristics of this patient and review of the literatures, young patients with MPM were rare, characterized with only pleural effusion, or without any clinical manifestations. Conclusions MPM is a highly aggressive tumor,lacking of specific clinical manifestations. It can not only occur at any age, but also have no history of asbestos exposure. It should be emphasized to raise awareness of the disease for early diagnosis and early treatment in order to improve the quality of life and survival of patients.