悪性中皮腫との鑑別に気管支鏡による胸腔内観察が有用であったpleural plaquesの1例  [in Japanese] Use of a Bronchoscope for Thoracoscopic Observation and Diagnosis of Pleural Plaques  [in Japanese]

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Abstract

62歳男性. 20年前から研磨材の工場に勤務している. 健診時に両側の肋骨に沿って広汎に拡がる異常影を指摘され来院した. 胸部CT上均一な密度の腫瘤が肋骨および横隔膜に接して認められた. 気管支鏡を胸壁から胸腔内に挿入し観察したところ, 壁側胸膜に境界明瞭な光沢のある白色の腫瘤を多数認めた. 同腫瘤を内視鏡直視下で経皮的に針生検し, 規則的に配列する硝子化した膠原線維を認めた. 内視鏡および生検組織所見から pleural plaques と診断した. pleural plaques は通常胸部X線で診断し経過観察されるが悪性中皮腫などの悪性腫瘍を合併することがある. それらを鑑別するために本症例では胸腔内を観察し生検を行った. その際気管支鏡を使用したが従来の胸腔鏡検査と比べ侵襲が少なく有用であった.

A 62-year-old man was admitted to our hospital for evaluation of bilateral tumor-like shadows along the ribs. He had been a diamond-grinder for twenty years. Thoracoscopic examination with a flexible bronchoscope revealed many well-circumscribed tumors with shiny, smooth, convex surfaces on the parietal pleura. The biopsy specimen had hyaline collagen with no cellular components. Based on these findings the tumors were diagnosed as pleural plaques. Cases of pleural plaques are usually followed up with chest radiography only, but the clinical course may be complicated by malignant mesothelioma and other malignant disease. To differentiate these conditions we performed biopsy during intrathoracic observation. The flexible bronchoscope can be useful in such procedures because it is relatively easy to operate and the procedure is relatively non invasive.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 35(4), 471-476, 1997-04-25

    The Japanese Respiratory Society

References:  15

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008112675
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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