胸膜横纹肌肉瘤一例报道并文献复习

doi:10.3877/cma.j.issn.1674-6902.2017.01.012

中华肺部疾病杂志(电子版) ›› 2017, Vol. 10 ›› Issue (01) : 55 -58. doi: 10.3877/cma.j.issn.1674-6902.2017.01.012

所属专题：经典病例；文献；

论著

胸膜横纹肌肉瘤一例报道并文献复习

欧延武¹, 李弘立², 刘禹³, 王彦³, 王关嵩³, 陈松林⁴, 杨鑫⁴, 陈琴琴³, 姚伟³^,^†(

)

^1. 675800　临沧，云南省临沧市云县人民医院
^2. 400037　重庆，第三军医大学新桥医院呼吸内科　重症医学科·全军呼吸内科研究所；610213　成都，武警警官成都学院医院
^3. 400037　重庆，第三军医大学新桥医院呼吸内科　重症医学科·全军呼吸内科研究所
^4. 610213　成都，武警警官成都学院医院

收稿日期:2016-03-28 出版日期:2017-02-25
通信作者: 姚伟
基金资助:
国家自然科学基金资金项目(81370168)

Pleura rhabdomyosarcoma: a case report and review of the literature

Yanwu Ou¹, Hongli Li², Yu Liu³, Yan Wang³, Guansong Wang³, Songlin Chen⁴, Xin Yang⁴, Qinqin Chen³, Wei Yao³^,^†()

^1. Department of Respiratory Diseases, People's Hospital of Yunxian, Lincang 675800, China
^2. Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China; Department of Respiratory Diseases, Hospital of Armed Police College, Chengdu 610213, China
^3. Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
^4. Department of Respiratory Diseases, Hospital of Armed Police College, Chengdu 610213, China

Received:2016-03-28 Published:2017-02-25
Corresponding author: Wei Yao
About author:
Corresponding author: Yao Wei, Email: weiyao.weiyao@live.cn

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引用本文：

欧延武, 李弘立, 刘禹, 王彦, 王关嵩, 陈松林, 杨鑫, 陈琴琴, 姚伟. 胸膜横纹肌肉瘤一例报道并文献复习[J]. 中华肺部疾病杂志(电子版), 2017, 10(01): 55-58.

Yanwu Ou, Hongli Li, Yu Liu, Yan Wang, Guansong Wang, Songlin Chen, Xin Yang, Qinqin Chen, Wei Yao. Pleura rhabdomyosarcoma: a case report and review of the literature[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(01): 55-58.

目的

探讨原发性胸膜横纹肌肉瘤及肺内横纹肌肉瘤疾病的临床特点及诊治方案，以提高对该类疾病的认识。

方法

通过我们诊治的1例原发性胸膜横纹肌肉瘤病例，并行X线、PET-CT、胸、腹部多谱勒彩超及病理活组织检查，并检索近20年相似病例的文献，进行分析总结。

结果

双肺纹理增多，右侧胸腔中下份可见大片高密度影，右肺上叶可见絮状稍高密度模糊影。PET-CT显示：右侧胸膜见结节状、团块状软组织密度影，放射性摄取增高，纵膈内见增大淋巴结。胸水彩超检查及穿刺定位所见：右侧胸腔可探及一巨大的实质性肿块影像。病灶穿刺病理确诊为横纹肌肉瘤。

结论

原发性胸膜及肺内横纹肌肉瘤发病率极低，临床及影像学表现无特异性，胸片表现以肺部块影居多。易误诊为其他肺部肿瘤，其诊断主要依赖于病理学。在临床工作中应考虑到发病可能，进行鉴别诊断。

关键词: 肺, 胸膜, 横纹肌肉瘤, 文献复习

Objective

Based on reported a case of pleura rhabdomyosarcoma and reviewed the above mentioned diseases in recent years, to summarize the clinical features, diagnosis and treatment of this disease for improve the understanding of this disease.

Methods

Reported a case of pleura rhabdomyosarcoma that we diagnosis and treatment, and retrieval of similar cases in 20 years in literature. Then summarizes the clinical features, diagnosis and treatment. Case: 65 year old male patient with right chest pain in 1 month, with irritating cough and a small amount of white mucus sputum, chest radiographs: the lung texture is increase, right pleural has a visible large high density shadow, right upper lung lobe shows flocculent slightly higher fuzzy density. PET-CT shows right pleura lesion has a nodular soft tissue density shadow, which has increased radioactivity. And some lymph nodes in Mediastinal are larger than normal. Color ultrasound examination of pleural effusion shows right pleura lesion detects a huge substantial tumor.

Results

The centesis biopsy was confirmed as rhabdomyosarcoma. Patient was not treated and leaves hospital after diagnosis. After a few days the disease progressed and the patient died at home, the direct cause of death is unknown.

Conclusions

The incidence rate of pleura rhabdomyosarcoma is very low; The clinical and imaging manifestations of pleura rhabdomyosarcoma are not specific. Chest radiographs are mainly performance as lung high density shadow. The diagnosis mainly depends on pathology, and is easy to be misdiagnosed as other common lung cancer. It should be paid enough attention to these diseases in clinical practice.

Key words: Lung, Pleura, Rhabdomyosarcoma, Literature review

图1 胸部正位片显示右侧胸腔中下份高密度影

图2 彩超显示：右侧胸腔一形态不规则实质性肿块(红色箭头)，其前方肺组织实变(蓝色箭头)，左侧见条形包裹性胸腔积液

图3 镜下见瘤细胞排列紊乱、形态多样，可见向横纹肌细胞分化趋势。(HE×100)

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