横隔胸膜に小結節性病変を認めたMeigs症候群の1例 [in Japanese] Meigs Syndrome Presenting as Diaphragmatic Pleural Nodules [in Japanese]
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症例は52歳, 女性. 原因不明の胸水貯留に対し胸腔鏡検査をおこなった. 横隔胸膜に限局性に2つの小結節性病変を認め内視鏡的には悪性腫瘍の胸膜転移を疑ったが同部位からの生検は非特異的炎症像であった. また全身検索にて右卵巣に径5×5cmの腫瘍を認め同摘出術を施行し, 約2週後に胸水の消失を認めた. 病理診断は漿液性腺線維腫であり, 臨床経過とあわせ Meigs 症候群と診断した. Meigs 症候群における胸膜の結節性病変は胸水貯留機序を考えるうえで興味深い所見と考えられ報告した. 胸膜結節性病変の診断において Meigs 症候群も念頭に入れるべき疾患の一つと考えられた.
A 52-year-old woman was admitted to our hospital because of non-productive coughing and dyspnea on exertion. A chest X-ray film revealed a moderate pleural effusion. The effusion was persistent and progressive in spite of repeated thoracentesis. Because examinations of the effusion did not result in a specific diagnosis, thoracoscopy was done under local anesthesia. Two nodules were found in the surface of the diaphragmatic pleura. Examination of biopsy specimens revealed mesothelial hyperplasia and lymphatic duct proliferation without malignant or granulomatous lesions. Systemic examinations revealed a tumor in the right ovary. The tumor was removed, and examination revealed that it was a serous adenofibroma without malignant lesions. Meigs syndrome was diagnosed. The pleural effusion disappeared quickly, two weeks after the operation.<br>We know of no previous report of diaphragmatic pleural nodules in a case of Meigs' syndrome. Meigs' syndrome should be considered in the differential diagnosis of pleural nodules.
- The Japanese journal of thoracic diseases
The Japanese journal of thoracic diseases 34(1), 80-84, 1996-01-25
The Japanese Respiratory Society