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胸水貯留の原因としてMeigs症候群が疑われたが、結核性胸膜炎と診断された一例
http://hdl.handle.net/10271/00003760
http://hdl.handle.net/10271/00003760263f7d01-4ca8-4def-b934-ec9b0209f9c4
名前 / ファイル | ライセンス | アクション |
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jsog_9_2_8 (556.8 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2020-10-14 | |||||
タイトル | ||||||
言語 | ja | |||||
タイトル | 胸水貯留の原因としてMeigs症候群が疑われたが、結核性胸膜炎と診断された一例 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | A case of tuberculous pleurisy and an ovarian tumor who was initially suspected to have Meigs syndrome | |||||
言語 | ||||||
言語 | jpn | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | tuberculosis | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Ovarian tumor | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Pleural effusion | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Malignant tumor | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Meigs syndrome | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
井手, 香甫
× 井手, 香甫× 深瀬, 正人× 内藤, 成美× 辻井, 篤× 廣田, 浩介× 吉田, 康秀× 門, 智史 |
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書誌情報 |
ja : 静岡産科婦人科学会雑誌 巻 9, 号 2, p. 8-14, 発行日 2020-10 |
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出版者 | ||||||
言語 | ja | |||||
出版者 | 静岡産科婦人科学会 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 胸水の鑑別診断は多岐にわたり、Meigs症候群はその一つである。今回、胸水貯留の原因としてMeigs症候群が疑われたが、結核性胸膜炎が原因であった一例を経験したので報告する。45歳、0妊0産。呼吸困難を主訴に近医A病院を受診し、胸水貯留、右卵巣腫瘍、子宮筋腫を指摘された。B病院を紹介受診し、胸水細胞診は陰性で、卵巣腫瘍は画像上、良性の所見であったため、Meigs症候群を疑われた。その後、当科に紹介となった。経腟超音波検査で右卵巣腫瘍、子宮筋腫を認めた。再度、胸部-骨盤部computed tomography(CT)検査を施行したところ、左肺上葉に空洞を伴う腫瘤を認め、結核を疑った。呼吸器内科を受診し、気管支洗浄液での結核菌polymerase chain reaction(PCR)は陽性で、胸水中のadenosine deaminase(ADA)は高値であり、結核と診断された。抗結核薬の内服を開始し、半年間の治療後、結核性胸膜炎は改善したため、婦人科手術可能となった。単純子宮全摘術、左卵管切除術、右付属器切除術を施行し、最終病理診断は、成熟奇形腫と子宮筋腫であった。術後経過良好である。良性卵巣腫瘍に胸水貯留を伴う場合、Meigs症候群だけでなく、結核など、卵巣腫瘍と関係がない他疾患の可能性を考慮する必要がある。 | |||||
言語 | ja | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | If an ovarian tumor and pleural effusion are detected, then we must differentiate between ovarian cancer and Meigs syndrome in the differential diagnosis. We encountered a case which was diagnosed with mature cystic teratoma and pleural effusion caused by tuberculosis. The patient was a 45-year-old female with a history of 0 pregnancies and 0 births. She complained of dyspnea and visited a nearby physician. She was diagnosed with pleural effusion, a right ovarian tumor, and uterine leiomyoma. She was thus referred to a cancer center. She was suspected to suffer from Meigs syndrome because a cytological examination of her pleural effusion was negative. A right ovarian tumor and uterine leiomyoma was revealed by transvaginal ultrasonography. She was suspected to have a thrombus because the D-dimer 4.3 μg/mL level was high. To examine her for a thrombus we performed Chest-pelvic computed tomography(CT). Although no thrombus was identified, we did detect a tumor with a cavity in the left lung upper lobe which was not considered to be tuberculosis. She was referred to the Department of Repiratory Medicine, and showed a positive finding for TB by bronchial lavage fluid polymerase chain reaction(PCR)testing. She also showed a high pleural adenosine deaminase(ADA)level. She was thus diagnosed with tuberculosis, and was therefore administered antituberculous drugs. After six months of treatment, a CT scan revealed the pleural effusion and the cavernous lesions in the upper lobe of the lung to have both decreased. Abdominal total hysterectomy and bilateral salpingo-oophorectomy were performed, and the patient was diagnosed with mature teratoma. When encountering patients with an ovarian tumor and pleural effusion, a careful differential diagnosis is necessary. | |||||
言語 | en | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 21871914 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 |