腹膜恶性间皮瘤合并输卵管积水一例并文献复习

doi:10.12280/gjszjk.20220580

摘要/Abstract

摘要：

腹膜恶性间皮瘤（malignant peritoneal mesothelioma）是一种罕见且恶性程度极高的肿瘤。该病起病隐匿，缺乏特异性临床表现、实验室指标以及影像学特征，临床医生难以早期诊断。目前腹膜恶性间皮瘤的诊断依赖于通过手术获取病变组织，进行病理学及免疫组织化学检查。报告1例海南医学院第一附属医院收治的育龄期女性患者，原发性不孕3年，因输卵管积水行腹腔镜手术发现为腹膜恶性间皮瘤。该患者无石棉接触史，病因不明确，临床表现不典型，诊断较为困难。通过对该患者的病历资料进行回顾性分析，并对既往文献进行复习，旨在探讨腹膜恶性间皮瘤的可能病因、诊断和治疗原则，加深临床医生对该病的认识，并提高诊治能力。

关键词: 恶性间皮瘤, 免疫组织化学, 病例报告, 腹膜恶性间皮瘤

Abstract:

Malignant peritoneal mesothelioma is a rare and extremely malignant tumor. It is difficult for clinicians to diagnose early for its insidious onset and lack of specific clinical manifestations, laboratory indicators and imaging characteristics. At present, the accurate diagnosis dependes on the pathological examination and immunochemistry. In this paper, we report a case of malignant peritoneal mesothelioma found by the laparoscopic surgery due to "hydrofallopian tube". This is a female patient of childbearing age who had primary infertility for 3 years. The patient had no history of asbestos exposure, unclear etiology, atypical clinical manifestations. The diagnosis of malignant peritoneal mesothelioma was very difficult before histopathological examination. We analyze retrospectively the medical records of the patient and review of the previous literature. We explore the etiology, diagnosis and treatment of malignant peritoneal mesothelioma and enhance clinicians′ comprehension.

Key words: Mesothelioma, malignant, Immunohistochemistry, Case reports, Malignant peritoneal mesothelioma

黄秋芳, 路广美, 刘宝琴, 黎明鸾, 张毅. 腹膜恶性间皮瘤合并输卵管积水一例并文献复习[J]. 国际生殖健康/计划生育杂志, 2023, 42(4): 296-300.

HUANG Qiu-fang, LU Guang-mei, LIU Bao-qin, LI Ming-luan, ZHANG Yi. Malignant Peritoneal Mesothelioma and Hydrosalpinx: A Case Report and Literature Review[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(4): 296-300.

图/表 3

图1 术中所见病灶图注：图A~C为术中肿瘤结节（箭头所示），术中子宫膀胱腹膜返折、直肠子宫陷凹、双侧盆壁、腹腔前腹膜、大网膜、肝脏部位前腹壁均可见脂肪球样赘生物，部分聚集呈菜花样。

图2 肿瘤病灶免疫组织化学图（×100）注：肿瘤细胞呈圆形或椭圆形，大小较一致，可见小核仁，呈乳头状、巢团状及片状结构，核分裂象少见，浸润间质生长。

图3 活检术后全腹CT图注：腹腔MPM腹腔镜手术后改变，中腹腔侧腹膜和双侧盆壁腹膜稍增厚，腹腔增大淋巴结。

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