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目的 总结20例恶性胸膜间皮瘤的诊断方法。方法 分析20例恶性胸膜间皮瘤的临床资料,包括年龄、石棉接触史、临床表现、影像学检查及实验室检查。结果 1例病人有石棉接触史。13例病人(65％)有明显胸痛,14例病人(70％)发现胸腔积液,X线检查18例病人(90％)纵隔未向健侧移位,11例病人(55％)CT发现胸膜肥厚或肿块。4例病人胸水中查到恶性间皮细胞,B超引导下经皮胸膜穿刺活检确诊10例。结论 石棉接触史并非恶性胸膜间皮瘤的唯一病因,恶性胸膜间皮瘤病人多数伴有与呼吸运动无关的持续性胸痛。X线、CT、B超对发现恶性胸膜间皮瘤有一定价值,B超引导下经皮胸膜穿刺活检对恶性胸膜间皮瘤的诊断有重要价值。
Objective To summarize the diagnostic methods of 20 cases of malignant pleural mesothelioma. Methods The clinical data of 20 cases of malignant pleural mesothelioma were analyzed including age, history of exposure to asbestos, clinical manifestations, imaging and laboratory tests. Results One patient had a history of asbestos exposure. Pleural effusion was found in 13 patients (65%), pleural effusion in 14 patients (70%), uncontrolled mediastinal in 18 patients (90%) on X-ray examination, and CT findings in 11 patients (55%) Pleural thickening or lumps. Malignant mesothelial cells were found in pleural effusion of 4 patients, and 10 cases were diagnosed by percutaneous pleural puncture biopsy under B-ultrasound. Conclusion Asbestos exposure history is not the only cause of malignant pleural mesothelioma. Most patients with malignant pleural mesothelioma are accompanied by persistent chest pain unrelated to respiratory motion. X-ray, CT, B ultrasound to find malignant pleural mesothelioma has some value, B-guided percutaneous pleural puncture biopsy of malignant pleural mesothelioma diagnosis of great value.