Deciduoid epithelial mesothelioma of the pleura with focal rhabdoid change.
Deciduoid epithelial mesothelioma of the pleura with focal rhabdoid change.
复制标题
胸膜蜕膜样上皮间皮瘤伴局灶性横纹肌样改变。
DOI：
10.1097/00000478-200010000-00021
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
G. Nguyen
中科院分区：
文献类型：
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作者：
L. Puttagunta;R. Vriend;G. Nguyen
我们饶有兴趣地阅读了 Shanks 等人关于具有蜕膜形态的间皮瘤的论文。 9 以及 Ordonez 撰写的关于具有蜕膜样特征的上皮间皮瘤的文章 7，我们希望贡献一例伴有局灶性横纹肌样改变的胸膜蜕膜样上皮间皮瘤病例。我们的病例记录在加拿大阿尔伯塔省埃德蒙顿阿尔伯塔大学医院实验医学和病理学部的档案中。患者是一名 41 岁男性，没有石棉职业接触史。 27岁时，他被诊断为纵隔霍奇金病，结节硬化型。经过三个疗程的长春碱、丙卡巴肼、苯丁酸氮芥、泼尼松化疗，并接受总剂量3500 cGy的大野放疗，霍奇金病得到成功控制。 14 年后，他出现了 6 个月的进行性劳力性呼吸困难并伴有胸膜炎型胸痛。胸部X线检查显示左侧大量胸腔积液，并排出约1200毫升稻草色浆液。他的胸腔积液细胞含量很少，仅显示少数单个和簇状良性间皮细胞。 2周后左侧胸腔积液再次出现。再次引流，只显示出一些反应性间皮细胞，其形态特征与他第一次积液中的形态特征相似。进行了胸部计算机断层扫描，显示位于左侧壁层和脏层胸膜上的多个基于胸膜的小肿块病变。随后的左侧胸膜镜检查证实了上述计算机断层扫描结果，并对两个单独的胸膜病变进行了活检。获得的组织碎片颜色为白色，最大尺寸达1厘米。对一个组织碎片进行冰冻切片，建议诊断为上皮间皮瘤。将活检组织碎片固定在福尔马林中以进行常规组织学和免疫组织化学研究，并将几个最大尺寸达 1 mm 的小组织样本固定在 2% 戊二醛中并进行处理以用于电子显微镜检查。
We read with interest the paper on mesotheliomas with deciduoid morphology by Shanks et al. 9 and the article on epithelial mesothelioma with deciduoid features by Ordonez, 7 and we want to contribute a case of deciduoid epithelial mesothelioma of the pleura with focal rhabdoid changes. Our case is documented in the files of the Department of Laboratory Medicine and Pathology at the University of Alberta Hospitals, Edmonton, Alberta, Canada.The patient was a 41-year-old man with no history of occupational exposure to asbestos. He was diagnosed as having mediastinal Hodgkin's disease, nodular sclerosing type, at the age of 27. His Hodgkin's disease was successfully controlled with three courses of chemotherapy with vinblastin, procarbazine, chlorambucil, and prednisone followed by extended-field radiotherapy with a total dose of 3500 cGy. He presented 14 years later with a 6-month history of progressive exertional dyspnea associated with pleuritic-type chest pain. Chest roentgenograms revealed a large left pleural effusion, and approximately 1200 mL of a straw-colored serous fluid was drained. His pleural effusion was scanty in cellularity and showed only a few single and clustered benign mesothelial cells. The left pleural effusion recurred 2 weeks later. It was drained again and showed only a few reactive mesothelial cells with morphologic features similar to those present in his first effusion. A chest computed tomography scan was performed and revealed multiple small pleural-based mass lesions located on the left parietal and visceral pleurae. Subsequent left pleuroscopy confirmed the above-mentioned computed tomography findings, and biopsy of two separate pleural lesions was performed. The tissue fragments obtained were white in color and measured up to 1 cm in greatest dimension. A frozen section was performed on one tissue fragment, and a diagnosis of epithelial mesothelioma was suggested. The biopsied tissue fragments were fixed in formalin for routine histologic and immunohistochemical studies, and several small tissue samples measuring up to 1 mm in greatest dimension were fixed in 2% glutaraldehyde and processed for electron microscopic examination.