Pseudo-Meigs' Syndrome Presenting as Lymphocytic Pleural Effusion with Elevated Adenosine Deaminase Activity-A Case Report

以ADA活性偏高之淋巴球性肋膜積水爲表現的Pseudo-Meigs症候群－病例報告

吳宗翰(Zhung-Han Wu) ； 鍾啟禮(Chi-Li Chung)

《胸腔醫學》 25卷1期 (2010/02) Pp. 44-50

https://doi.org/10.29806/TM.201002.0008

摘要

Pseudo-Meigs症候群的定義是，除了良性實體卵巢腫瘤外，凡其它任何良性或惡性之骨盆腔腫瘤之患者，合併發生非惡性之肋膜積水及腹水。我們報告一位三十八歲的肥胖女性患者，因大量右側肋膜積水而住院；其肋膜積水之數據顯示為以淋巴球為主，且腺苷酸脫氨基酶(adenosine deaminase, ADA)活性高之滲出液(exudate)。這位患者起初被懷疑為結核性肋膜炎接受抗結核藥物治療，然而其肋膜積水並未改善，每天仍有高達1100~1800 ml 從胸管引流出來；進一步檢查發現了合併產生的腹水及卵巢癌。經外科手術切除卵巢腫瘤後，肋膜積水及腹水皆明顯減少，且經過一年的持續追蹤後，並無復發的情況。這份病例報告顯示在pseudo-Meigs症候群患者的肋膜積水為以淋巴球為主且ADA的活性是增加的。雖然pseudo-Meigs症候群是一相對少見的疾病，但是當發現有高ADA活性與淋巴球為主之滲出性肋膜積水時，仍應將其列為鑑別診斷之一。

關鍵字

腺苷酸脫氨基酶 ； 胸水 ； 肋膜積水 ； Pseudo-Meigs症候群

並列摘要

Pseudo-Meigs' syndrome is defined as the association of nonmalignant hydrothorax and ascites with any benign or malignant pelvic tumor other than benign solid ovarian tumor. We reported a 38-year-old obese woman who was admitted for massive right-side pleural effusion. The analysis of the pleural fluid revealed an exudate with lymphocyte predominance and an increased adenosine deaminase (ADA) level (49 IU/L). The patient was treated as having tuberculous (TB) pleurisy initially. However, the pleural effusion did not resolve and further examinations disclosed ascites and ovarian cancer. After surgical resection of the ovarian tumor, both the hydrothorax and the ascites resolved markedly and did not recur during the 1-year follow-up. This report described mildly elevated ADA activity in pleural effusions associated with pseudo-Meigs' syndrome. Although a relatively uncommon etiology, pseudo-Meigs' syndrome should be included in the differential diagnosis of a lymphocytic pleural exudate with high ADA activity.

並列關鍵字

adenosine deaminase ； hydrothorax ； pleural effusion ； Pseudo-Meigs' syndrome