右侧胸膜平滑肌瘤合并肺炎1例

目的:平滑肌瘤是一种罕见的起源于平滑肌纤维的良性肿瘤。平滑肌瘤在呼吸道是罕见的,在胸膜更是少见。这是我们决定报道这个右侧胸膜平滑肌瘤合并肺炎病例的主要原因。病例报告：我们报告一例50岁男性患者,以“右侧胸痛、气短1天”之主诉入院,行胸部X线及薄层CT(HRCT, high-resolution computed tomography)提示右侧胸腔积液伴右下肺炎症,行相关化验、支气管镜检查及B超引导下胸腔穿刺术均未能明确诊断,在超声引导下行右侧胸膜穿刺活检术,结合组织病理学和免疫组织化学检查考虑为右侧胸膜平滑肌瘤。经对症治疗肺炎症状渐缓解,必要时行手术治疗。结论:在考虑胸膜肿瘤的鉴别诊断时,原发性胸膜平滑肌瘤仍有可能。该病的诊断主要依靠组织病理学检查。

One case of right pleural leiomyoma complicated with pneumonia

Objective: Leiomyoma is a rare benign tumor originating from smooth muscle fibers. Leiomyomas are rare in the respiratory tract and even rarer in the pleura. This is the main reason why we decided to report this case of right pleural leiomyoma with pneumonia. Case Report: We report a case of a 50-year-old man who was admitted to hospital with a complaint of "right chest pain and shortness of breath for 1 day" and received chest X-ray and high-resolution computed tomography (HRCT) indicating right pleural effusion with right lower pneumonia. Relevant laboratory tests, bronchoscopy and b-ultrasound-guided pleural puncture failed to confirm the diagnosis, so the right pleural puncture biopsy was performed under the guidance of ultrasound, and was considered as right pleural leiomyoma combined with histopathological and immunohistochemical examination. After symptomatic treatment, the symptoms were gradually relieved, and surgery was performed when necessary. Conclusion: Primary pleural leiomyoma is still possible in the differential diagnosis of pleural tumor. The diagnosis of this disease is mainly based on histopathological examination.