悪性中皮腫の進展再発様式の検討

概要

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We studied the modes of extension in 11 patients with malignant mesothelioma of the pleura. Four of them had lymphatic extension only, and four had both lymphatic and blood-borne extension. None had only blood-borne metastasis. Dissemination along aspiration tract and operative wound were observed in two cases. Pneumothorax was observed in four. This may have been caused by invasion of the visceral pleura by tumor cells. Histological examination in the three patients tested revealed nodal involvement of the pulmonary hilum. Complete removal of gross tumor was performed in four patients, but three of them had local recurrence within six months. To improve the prognosis in cases of malignant mesothelioma, systematic lymphatic dissection of the pulmonary hilum, mediastinum and parasternal region are essential. Lavage of the operative field and changes of instruments and apparel are also recommended. More attention should be paid to pneumothorax in elderly patients because it is sometimes due to underlying mesothelioma.
特定非営利活動法人日本呼吸器外科学会の論文