English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

━━ Objective.We reviewed the clinical findings and diagnostic methods used in the diagnosis of malignant pleural mesothelioma (MPM) in patients with pleural effusion with low levels of adenosine deaminase (ADA), but without signs of acute inflammation or pleural thickening. Materials and Methods. The hospital records of 40 patients with pleural effusion of unknown origin or pleural thickening were retrospectively investigated. In all of those studies, pleural effusion was exudative, lymphocyte-dominant, no mycobacteria or other bacteria, and low levels of ADA. Results. There were 30 men and 10 women with an average age of 62.8 years old. The diagnosis of MPM was obtained by cytology of the pleural effusion in 3 patients and by core-needle biopsy of the thickened pleura in 3. Thoracoscopic pleural biopsy under general anesthesia was performed for the other 34 patients. The pathologic diagnosis of pleural biopsy was MPM in 20 patients, inflammatory change in 12, and pleural dissemination of cancer in 2. All of the 7 patients with more than 100 μg ml of hyaluronic acid in their pleural effusion received a diagnosis of MPM. A total of 20 of 23 patients with irregular or nodular pleural thickening on computed tomography findings were confirmed to have MPM. Moreover, 6 of 17 patients with smooth pleural thickening were confirmed to have MPM. In patients with nodular pleural thickening it was easy to make the diagnosis. However, in those with smooth thickening, careful observation was required to select the appropriate biopsy site and resection margins of full-thickness pleura. Conclusion. As the rate of MPM in the patients with pleural effusion with low levels of ADA, but without signs of acute inflammation or pleural thickening is high (65%), an early thoracoscopic pleural biopsy is strongly recommended. (JJLC. 2012;52:10-16) KEY WORDS━━Malignant pleural mesothelioma, Pleural effusion, Pleural thickening, Thoracoscopic pleural biopsy Reprints: Satoru Moriyama, Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Science, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan (e-mail: morihige@med.nagoya-cu.ac.jp). Received February 22, 2011; accepted December 22, 2011. 要旨━━目的.悪性胸膜中皮腫(malignant pleural mesothelioma:MPM)が疑われる,急性炎症所見がない 1名古屋市立大学腫瘍・免疫外科;2聖隷三方原病院呼吸器セン ター外科;3刈谷豊田総合病院呼吸器外科. 別刷請求先:森山 悟,名古屋市立大学腫瘍・免疫外科,〒4678601 名 古屋 市 瑞 穂 区 瑞 穂 町 川 澄 1 (e-mail: morihige@med. nagoya-cu.ac.jp). 受付日:2011 年 2 月 22 日,採択日:2011 年 12 月 22 日. (肺癌.2012;52:10-16) 2012 The Japan Lung Cancer Society Early Diagnosis for Pleural Effusion and Pleural Thickening―Moriyama et al Japanese Journal of Lung Cancer―Vol 52, No 1, Feb 20, 2012―www.haigan.gr.jp 11 アデノシンデアミナーゼ(adenosine deaminase:ADA) 低値原因不明胸水および胸膜肥厚症例の臨床所見および 診断方法について retrospective に検討した.対象と方 法.滲出性,リンパ球優位,抗酸菌および一般細菌検査 陰性,ADA低値の原因不明胸水および胸水を伴う,伴わ ないにかかわらず,胸膜肥厚を認めた 40 例を対象に解析 した.結果.男性 30 例,女性 10 例,平均年齢 62.8 歳で あった.胸水細胞診で 3例,胸膜肥厚部の core-needle biopsy で 3 例がMPMと診断され,未確診の 34 例に全 麻下胸腔鏡による胸膜生検を施行した.診断はMPM 20 例,炎症性変化 12 例,悪性腫瘍の胸膜播種 2例であった. 胸水ヒアルロン酸が 100 μg ml 以上の 7例は全例MPM であった.胸部CTの胸膜不整肥厚・腫瘤形成群 23 例中 20 例と胸膜平滑肥厚群 17 例中 6例がMPMと診断され た.胸腔鏡所見では隆起型は隆起部の生検にて容易に診 断可能であったが,肥厚型では丹念な観察による生検部 位の選択と胸膜全層生検が必要と考えられた.結語.急 性炎症所見がないADA低値原因不明胸水および胸膜肥 厚症例では 65%がMPMであり,胸腔鏡による胸膜生検 を要する. 索引用語━━悪性胸膜中皮腫,胸水,胸膜肥厚,胸腔鏡 下胸膜生検

haigan

Identification of Pleural Effusion with Low Levels of Adenosine Deaminase but Without Signs of Acute Inflammation or Pleural Thickening to Diagnose Early Malignant Pleural Mesothelioma