両側の胸水貯留で発症した特発性線維性縦隔炎の1例  [in Japanese] A case of idiopathic fibrosing mediastinitis presented with bilateral pleural effusion  [in Japanese]

Access this Article

Search this Article

Author(s)

Abstract

症例は56歳,男性.労作時息切れと両側の胸水貯留で発症し, CTにて縦隔下部の胸部大動脈周囲から後腹膜の腫瘤と両側胸膜の肥厚を指摘された. CRP高値,血沈促進, IgG高値を認め,肺活量は著明に減少していた.縦隔,胸膜の生検では,腫瘤は脂肪組織と線維組織からなり,軽度の細胞浸潤を認めた.以上の所見より特発性線維性縦隔炎と診断した.プレドニゾロン40mg/日投与により炎症反応は陰性化したが, CTでの腫瘤のサイズはごくわずかに縮小したのみで,胸水の量や肺活量には変化を認めなかった.

A case is reported of a 56-year-old male who presented with bilateral pleural effusion as an initial manifestation of idiopathic fibrosing mediastinitis. The patient showed shortness of breath with severe loss of vital capacity and weight loss. A mediastinal mass surrounding the thoracic aorta and bilateral pleuritis was identified by the chest CT scan. The mass extended, along the abdominal aorta, to the upper portion of retroperitoneum. Laboratory data showed elevated levels of C-reactive protein (CRP), erythrocyte sedimentation ratio (ESR), and IgG. Biopsy of the mediastinal and the pleural mass showed adipose tissue and fibrosis with mild perivascular inflammatory infiltration. A diagnosis of idiopathic fibrosing mediastinitis was made, and 40mg/day of prednisolone was administered. Although CRP and ESR was normalized, the mass size and vital capacity were almost unchanged.

Journal

  • Japanese Journal of Clinical Immunology

    Japanese Journal of Clinical Immunology 25(2), 177-183, 2002-04-30

    The Japan Society for Clinical Immunology

References:  15

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008353553
  • NII NACSIS-CAT ID (NCID)
    AN00357971
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09114300
  • Data Source
    CJP  CJPref  J-STAGE 
Page Top