胸膜下肉样瘤病:模仿转移性肺癌的罕见表现。

IF 0.8 Q4 RESPIRATORY SYSTEM Respirology Case Reports Pub Date : 2024-07-30 eCollection Date: 2024-08-01 DOI:10.1002/rcr2.1438
Eugene Gan, Chee Kiang Tay
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引用次数: 0

摘要

一名来自缅甸的 66 岁男性因咳嗽和全身症状就诊 3 个月。他以前吸烟,没有明显的病史或接触史。胸部 X 光片显示双侧不明不白的肺不张和左侧胸腔积液。胸部 CT 显示两个右下叶肿块和一个中等大小的左胸腔积液。PET-CT 显示增厚的结节性胸膜、心包和腹腔/纵隔淋巴结有高代谢摄取。气管旁右下结节的 EBUS-TBNA 和右下叶肿块的 TBLB 发现了由多核巨细胞、上皮样组织细胞和淋巴浆细胞组成的上皮样肉芽肿。胸腔镜检查发现了坚硬的白色块状胸膜顶膜斑块,胸膜活检显示了相同的组织病理学结果。在开始使用每天 25 毫克的泼尼松龙后,他的症状很快得到缓解。6 个月后的胸部 CT 显示,实质肿块和胸腔积液几乎完全消退。我们重点介绍这例在结核病流行地区发生的模仿转移性肺癌的胸膜实质肉样瘤病。
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Pleuroparenchymal sarcoidosis: A rare manifestation mimicking metastatic lung cancer.

A 66-year-old male from Myanmar presented with 3 months of cough and constitutional symptoms. He was an ex-tobacco user with no significant medical or exposure history. Chest x-ray showed ill-defined bilateral opacities and a left pleural effusion. Chest CT revealed two right lower lobe masses, and a moderate-sized left pleural effusion. PET-CT demonstrated hypermetabolic uptake in the thickened nodular pleura, pericardium, and hilar/mediastinal lymph nodes. EBUS-TBNA of the right lower paratracheal node and TBLB of the right lower lobe mass yielded epithelioid granulomas comprising multinucleated giant cells, epithelioid histiocytes and lymphoplasmacytic cells. Thoracoscopy revealed hard, whitish mass-like parietal pleural plaques, and pleural biopsy revealed identical histopathologic results. His symptoms resolved quickly after commencing prednisolone 25 mg daily. Chest CT at 6 months demonstrated near complete resolution of the parenchymal masses and pleural effusion. We highlight this unique case of pleuroparenchymal sarcoidosis mimicking metastatic lung cancer in a tuberculosis-endemic region.

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来源期刊
Respirology Case Reports
Respirology Case Reports RESPIRATORY SYSTEM-
CiteScore
1.40
自引率
0.00%
发文量
178
审稿时长
8 weeks
期刊介绍: Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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