恶性胸腔积液临床病理分析

Clinical pathological analysis of malignant pleural effusion

目的：探讨恶性胸腔积液肿瘤的病理类型、所占比例、临床病理特征及鉴别诊断。方法：利用细胞团块收集器收集体液中脱落细胞,进行病理切片观察细胞形态及免疫组化对108例恶性胸腔积液进行病理诊断及肿瘤病理分型。结果：在119例恶性胸腔积液中,肺腺癌64例,鳞癌6例,小细胞癌10例,恶性间皮瘤15例,胃癌3例,胰腺癌3例,胆囊癌3例,肠癌3例,卵巢癌3例,乳腺癌6例,非何杰金氏淋巴3例。男性61例,女性58例,年龄19-87岁,平均年龄67.8岁。临床主要症状是胸闷、气短、咳嗽、胸痛,伴有原发器官肿瘤病史等。CT表现为胸膜增厚、胸水、多发或单发胸膜结节和原发器官占位性病变。结论：恶性胸腔积液中以肺腺癌多见,其次为恶性间皮瘤,利用细胞团块收集器收集体液中脱落细胞,进行病理切片细胞形态观察及免疫组化,有助于提高癌细胞检出率及肿瘤病理分型,鉴别诊断。

Objective： To investigate the pathological types, the proportion, the clinical pathologic characteristics and the differentialdiagnosis in malignant pleural effusion. Methods ：Using the cell mass collector to collect the shedding cells in body fluid, and to observe thepathological changes of 119 cases of malignant pleural effusion by pathological section and immunohistochemistry. Results：In 119 patientswith malignant pleural effusion, pulmonary adenocarcinoma 64 cases, 6 cases of Squamous cell carcinoma, 10 cases of small cell carcinoma15 cases of malignant mesothelioma, 3 cases of gastric cancer, 3 cases of pancreatic carcinoma, 3 cases of gallbladder cancer, 3 cases ofcolorectal cancer, 3 cases of ovarian cancer and 6 cases of breast cancer s, 3 cases of Non-Hodgkin＇s lymphoma. Male 61 cases, female 58 cases, aged 19 to 87 years old, with an average age of 67.8 years. The main clinical symptoms was chest tightness, shortness of breath, cough,chest pain, with primary tumor organ disease. CT showed pleural thickening, pleural effusion, multiple or solitary pleural nodules and primaryorgan space occupying lesions. Conclusion：Lung adenocarcinoma was common, and the second was malignant mesothelioma in Malignantpleural effusion. Using cell clumps to collector fluid cytology and pathological section to observe cell morphology and immunohistochemical,to improve the detection rate and tumor histological type of cancer cells, differential diagnosis