胸腹膜恶性间皮瘤1例并文献复习

目的分析我院1例胸腹膜恶性间皮瘤并总结其临床特点、治疗及预后。方法报告我院1例胸腹膜恶性间皮瘤的临床症状、胸水及腹水常规、生化、病理,并回顾文献对该病的相关报道。结果本例患者临床症状既无明显胸痛,也无腹痛与腹胀,而以进行性加重的呼吸困难为表现。本病例从胸水及腹水中查见恶性间皮瘤细胞而得以确诊。     

恶性腹膜间皮瘤16例分析

恶性间皮瘤是一种少见的恶性肿瘤,恶性腹膜间皮瘤更是少见,占所有间皮瘤的10％～20％。其发病隐匿,症状无特异性,诊断困难,存活时间短,是死亡率高的恶性肿瘤之一。我院自1950年3月～1992年3月收治了资料完整并经病理证实的恶性腹膜间皮瘤16例,现结合文献分析讨论其临床特点、诊断及治疗。     

腹膜恶性间皮瘤误诊为结核性腹膜炎四年一例

患者,女性,25岁.因反复腰围增大4年余入院.该患者4年前出现腰围轻度增加,无发热和腹痛,后因尿急、尿频1周到当地医院检查.B超检查提示盆腔大量积液,腹水检查为渗出液,PPD皮试阳性,血结核抗体IgM（＋）,血结核抗体IgG（-）,腹水结核菌培养（-）,腹水未找到癌细胞,考虑为结核性腹膜炎,给予抗结核治疗1周后不适消失.     

恶性腹膜间皮瘤一例

恶性腹膜间皮瘤是一种罕见的肿瘤 ,我院 2 0 0 0年 11月收治 1例。现报道如下。患者 ,男性 ,5 0岁 ,建筑工人。以腹部胀痛伴盗汗 1个月余就诊。一个月前无明显原因出现上腹部持续性胀痛 ,无放射痛 ,与体位无关 ,伴盗汗 ,无发热、返酸、烧心、纳差、恶心、呕吐、腹泻等 ,曾在当地卫生室服用吗丁啉、普瑞搏思各 1片 ,3次 /ｄ ,治疗 5天 ,症状无减轻 ,且体重下降 5ｋｇ。 2 0 0 0年 11月 2 8日住院治疗。既往无肝炎、结核等病史。体格检查 :Ｔ 36 .8℃ ,Ｐ88次 /ｍｉｎ ,Ｒ 2 0次 /ｍｉｎ ,Ｂｐ 134/ 74ｍｍＨｇ。营养良好 ,神清。全身皮肤粘膜…     

腹膜间皮瘤误诊分析

我院于2007年3月收治1例腹膜间皮瘤误诊病例，现分析报告如下。 1临床资料 患者，女，43岁，以“间断腹胀、腹痛3年伴恶心1个月”于2007年3月入院。患者3年前出现腹胀、腹痛，以右下腹明显，呈隐痛，厌食油腻，感全身乏力，发热，体温最高达38℃，发热无明显规律，否认畏寒、寒战、盗汗，否认咳嗽、胸痛，无皮疹和关节肌肉痛。     

腹腔镜诊断恶性腹膜间皮瘤

恶性腹膜间皮瘤(malignanl peritoneal mesothelioma,MPM)临床上比较少见,病情进展迅速,预后不良,临床表现无特异性,诊断较为困难,误诊率较高。现回顾分析我院1996年至2001年经腹腔镜检查并经病理证实的MPM 20例患者的临床表现及腹腔镜下特点,为MPM的诊断提供一种快速准确的方法。     

恶性胸膜间皮瘤误诊1例

恶性胸膜间皮瘤（malignant pleural masothelioma,MPM）是起源于胸膜间皮细胞及胸膜下间质组织的一种少见的原发性胸膜肿瘤,约占整个胸膜肿瘤的5％,其发病率有逐渐增高的趋势.由于该病早期症状隐匿,后期临床症状无特异性,常常被误诊,误诊率高达40％～50％.现就我院收治的1例MPM患者误诊经过报告如下.     

心脏右房恶性间皮瘤误诊1例报告

1　临床资料患者 ,男性 ,68岁 ,以活动后心悸、气促 10天为主诉入院。体检血压 165/90 mm Hg ( 1mm Hg=0 .133k Pa) ,神清 ,颈静脉稍充盈 ,肺音清 ,心界无扩大 ,心律齐 ,心率 75次 /分 ,无杂音 ;腹软 ,肝右肋下 2 cm,肝颈回流征 (± ) ,移动性浊音 ( ) ,双下肢呈凹陷性浮肿 ,余 ( - )。ECG示肢导联低电压 ,Holter呈偶发室早 ,胸片 ( - )。彩超于右房靠下腔静脉入口处探及一 3.0 5× 3.0 8cm2 境界清晰 ,椭圆形 ,中等强度光团状回声 ,其蒂与房间隔相连 ,活动度差 ,其内呈均匀细光 ;左室壁稍增厚 ,于心尖部脏、壁层心包间探及 1.0 cm无回…     

超声诊断原发性腹膜恶性间皮瘤5例

本文报道我院经尸检或活检病理证实的原发性腹膜恶性间皮瘤5例,重点介绍超声图象及临床特点。 1 对象和方法 1.1 对象 住院患者,男性3例,女性2例。年龄21-77岁,中位55岁。病期1-12个月。主要腹部症状:腹痛5例、腹胀5例。全身症状:乏力5例、消瘦5例、纳差5例。主要腹部体征:腹块2例、大量顽固性腹水5例和腹部触诊板块腹感5例。腹水检查:5例均为渗出液,其中血性腹水3例。未查见抗酸杆菌,细菌培养阴性。1例查见大量异型间     

腹膜间皮瘤侵袭肝脏1例回顾及文献复习

49岁男性患者，因右上腹痛半个月，全腹胀10天入院。血CA199及CA125升高，腹水呈黄色微混浊，化验示渗出液，MRI提示肝周腹膜增厚，肝方叶前缘占位病灶。患者入院后经利尿、抽腹水治疗效果不佳，后行腹腔镜检查，术后石蜡切片病理证实为腹膜间皮瘤。本例患者MRI表现容易与原发性肝癌混淆，医师在临床工作中应提高对腹膜间皮瘤的认识，以期及早诊断，为完全切除肿瘤创造条件。     

原发性腹膜恶性间皮瘤伴肝转移癌1例报告

腹膜恶性间皮瘤是一种原发于腹膜的间皮和间皮下层的肿瘤,发病率低,临床罕见,表现缺乏特异性,早期诊断困难,容易误诊,本院于2014年2月误诊1例,现报道如下。1病历资料患者男性,69岁,农民。因"腹胀半年余、加重伴尿少3个月余"入院。患者2013年8月无明显诱因出现腹胀,无明显乏力、纳差等症状,症状逐渐加重,于2013年10月先后就诊于当地乡医院、市医院、北京某医院,化验乙型肝炎病毒学标志物阴     

A narrative review of the health disparities associated with malignant pleural mesothelioma

Malignant pleural mesothelioma (MPM) is a cancer of the mesothelial lining of the pleura that has traditionally been associated with asbestos exposure in an industrial setting. Asbestos usage has fortunately been banned or phased out in most industrialized countries resulting in its decline in countries such as the United States. Despite this, MPM continues to place significant burden on its affected patients resulting in overall poor prognosis and survival. Questions arise as to what factors, especially what health disparities, contribute to the disease’s dismal prognosis. This article will present a narrative review of recent literature that identifies the impact age, sex, race, access to medical centers, and economics have on the diagnosis, treatment, and prognosis of MPM. As will be discussed, research has shown that factors including younger age, female sex, non-white race, private insurance, Medicare, and higher income have been associated with better survival in MPM. Whereas older age, male sex, white race, lack of insurance, and lower income are associated with worse survival. The identification of these and other health disparities related to MPM may allow for future research, clinical guidelines, and policies to be implemented to decrease the burden health disparities create in the diagnosis, treatment, and prognosis of patients with MPM.     

Epidemiology,diagnosis and treatment of the malignant pleural mesothelioma,a narrative review of literature

The malignant pleural mesothelioma is a very aggressive tumor which is arising from mesothelial cells and is associated with asbestos exposure. It is a heterogeneous cancer that shows a complex pattern of molecular changes, including genetic, chromosomic, and epigenetic abnormalities. The malignant pleural mesothelioma is characterized by a silent and slow clinical progression with an average period of 20–40 years from the asbestos exposure phase to the start of the symptoms. Unfortunately, to date, the therapeutic options are very limited, especially if the tumor is detected late. This narrative review provides an extended overview of the present evidence in the literature regarding the epidemiology, diagnostic pathways and treatment approaches of the malignant pleural mesothelioma. The treatment of mesothelioma has evolved slowly over the last 20 years not only from a surgical point of view but also radiotherapy, chemotherapy and immunotherapy play nowadays a key role. Several surgical strategies are available ranging from extrapleural pneumonectomy to cytoreductive surgery but a multidisciplinary approach seems to be mandatory because a single approach has not proved to date to be resolutive. New non-surgical treatment options appear to be promising but the results have to be taken in account with caution because clear evidence with high-quality studies is still lacking     

Benign multicystic peritoneal mesothelioma： A case report and review of the literature

INTRODUCTION Benign multicystic peritoneal mesothelioma (BMPM), also known as multilocular peritoneal inclusion cysts, is an uncommon lesion arising from the peritoneal mesothelium that covers the serous cavity. This lesion occurs most frequently in women…     

Malignant peritoneal mesothelioma a clinical and laparoscopic study of ten cases

Summary A retrospective study of 10 cases of malignant peritoneal mesothelioma from two centers is reported. All cases were initially diagnosed between 1967 and 1986 utilizing laparoscopy and the histologic interpretation of laparoscopic biopsy samples. Subsequently, the original diagnosis was confirmed by two independent pathologists employing both histological and histochemical techniques. In five cases immunohistochemical studies were also performed. The clinical findings and course of the disease were similar to other reported series. Laparoscopic findings of mesothelioma were indistinguishible from metastatic peritoneal neoplasms. However, the presence of homogeneous spreading of nodules, plaques, or fleshy masses on both parietal and visceral peritoneum; the absence of direct or indirect signs of other abdominal neoplasms; and the absence of hepatic metastases or the possible presence of nodules or plaques on Glisson's capsule without any parenchymal involvement, when observed, allowed the laparoscopist to suspect the disease in four of 10 cases. Laparoscopy may be useful in detecting mesothelioma. The diagnosis is mainly morphological, but even morphology has its inherent limitations. Further studies are necessary to improve the diagnostic accuracy of this tumor.A part of this study was presented during the 12th International Congress of Gastroenterology and the 5th International Congress of Gastrointestinal Endoscopy in Lisbon, Portugal, September 16–22, 1984.     

胃原发性恶性黑色素瘤1例并文献复习

胃原发性恶性黑色素瘤是一种罕见的高度恶性肿瘤,应该与转移性胃恶性黑色素瘤、胃低分化腺癌、胃其他原发性肿瘤及转移瘤等相鉴别。该肿瘤位于胃底部,呈浸润性生长。镜下可见肿瘤细胞弥漫性片状分布,细胞呈多形性,细胞核呈空泡状,核仁明显,核分裂象易见,肿瘤细胞内见少量黑色素颗粒。免疫组织学检查发现肿瘤细胞中HMB45、S-100蛋白呈强阳性表达,而不表达Cytokeratin、EMA、CEA。我们通过对1例胃原发性恶性黑色素瘤患者的报道并文献复习,提高对该病的认识。     

Clinicopathological characteristics of primary peritoneal epithelioid mesothelioma of clear cell type: A case report

Rationale:Primary peritoneal epithelioid mesothelioma of clear cell type is an extremely rare entity composed of clear cytoplasm. It is challenging to diagnose because of the morphological resemblance to clear cell tumor.Patient''s concerns:A 69-year-old male patient had swollen lymph nodes in the right inguinal region for 7 months and was constipated for 1 month.Diagnosis:The patient was diagnosed as peritoneal epithelioid mesothelioma of clear cell type based on computed tomography scan, pathology, immunohistochemistry, special staining and whole-exome sequencing. This patient harbored VHL gene alteration in exon 1 and homologous recombination defect (with a score of 45). This finding indicated that this patient might be sensitive to platinum-based therapy and Poly ADP-ribose Polymerase (PARP) inhibitor. This patient carried no microsatellite instability, a low level of tumor mutation burden, and a high extent of intratumoral heterogeneity. Eighteen neoantigens were detected.Interventions:The patient received surgery-based multidisciplinary treatment by integrating cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC was administered with docetaxel 120 mg plus cisplatin 120 mg, at 43°C, for 60 minutes. After operation, the patient received intravenous (IV) chemotherapy with docetaxel 60 mg, pemetrexed 750 mg and cisplatin 100 mg, and then intraperitoneal (IP) chemotherapy with docetaxel 40 mg. The patient received interventional therapy of hepatic artery embolization for 5 times.Outcomes:Regular follow-up was performed until Oct 14, 2020. The patient died 31.6 months later owing to incomplete intestinal obstruction.Lessons:Primary peritoneal epithelioid mesothelioma of clear cell type needs to be differentiated from a variety of clear cell tumors. This disease is characterized by specific genetic alteration. Whole-exome sequencing contributes to guide individualized therapy. CRS-HIPEC helps achieve long-term overall survival.