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目的:为提高对胸膜间皮瘤的认识,争取早期诊断、及时治疗,以获良好预后。材料与方法:总结经手术与病理证实的18例间皮瘤的临床和影像学表现。同时,结合文献报道,对312例胸膜间皮瘤进行回顾与综合分析。结果:恶性276例,良性48例,未分型4例。明确记录的260例中男性171例,女性89例。年龄4～75岁,平均44岁。临床表现胸痛胸闷225例,咳嗽169例,气短88例,发热74例,其它51例。X线显示局限性或弥漫性胸膜增厚、胸膜结节193例,合并胸水127例,合并肺内或纵隔淋巴结转移21例。讨论:(1)恶性多于良性,弥漫性均为恶性。(2)男多于女,好发于40岁左右。(3)临床起病隐匿,多有胸部症状,但无特异性。(4)X线显示局限性或弥漫性胸膜结节、胸膜增厚占36%,合并胸水占32.4%,合并它处转移占3.6%。(5)误诊为肺癌、肺结核、结核性胸膜炎者居多,亦有误诊为转移瘤、纵隔肿瘤等。
Objective: To improve the understanding of pleural mesothelioma for early diagnosis and timely treatment to get a good prognosis. Materials and Methods: To summarize the clinical and radiological findings of 18 cases of mesothelioma confirmed by surgery and pathology. At the same time, combined with the literature, 312 cases of pleural mesothelioma retrospective and comprehensive analysis. Results: 276 cases were malignant, 48 cases were benign and 4 cases were not classified. Of the 260 documented cases, 171 were male and 89 were female. Age 4 to 75 years old, average 44 years old. Clinical manifestations chest pain 225 cases of chest pain, 169 cases of cough, shortness of breath in 88 cases, 74 cases of fever, the other 51 cases. X-ray showed limited or diffuse pleural thickening, pleural nodules in 193 cases, with pleural effusion in 127 cases, combined with pulmonary or mediastinal lymph node metastasis in 21 cases. Discussion: (1) malignant than benign, diffuse are malignant. (2) more men than women, occurs in 40 years old. (3) clinical onset of occult, more chest symptoms, but no specificity. (4) X-ray showed limited or diffuse pleural nodules, pleural thickening accounted for 36%, combined pleural effusion accounted for 32.4%, combined with its transfer accounted for 3.6%. (5) misdiagnosed as lung cancer, tuberculosis, tuberculous pleurisy are mostly misdiagnosed as metastases, mediastinal tumors.