An Unusual Presentation of Pleural Effusion Caused by Mediastinal Angiomyolipoma: A Case Report and Literature Review

縱膈腔血管肌脂瘤併發肋膜積液為不尋常之表現：病例報告及文獻回顧

陳逸燕(I-Yen Chen) ； 韓孟志(Meng-Zhi Han) ； 陳盈妊(Ying-Ren Chen) ； 張孔昭(Kung-Chao Chang) ； 顏亦廷(Yi-Ting Yen) ； 張漢煜(Han-Yu Chang)

《胸腔醫學》 30卷1期 (2015/02) Pp. 24-29

摘要

血管肌脂瘤為良性腫瘤且大多好發在腎臟，在過去文獻中有被報告過發生於肝臟、後腹腔、口腔、皮膚、脊椎，但僅有極少數案例發現於縱膈腔內，至於跟肋膜積水的相關性就更少提及。本篇案例報告介紹了一名五十一歲女性一開始表現為肋膜積液引起喘的症狀，電腦斷層顯示有一縱膈腔腫瘤（約六公分），經外科手術切片後病理報告顯示為血管肌脂瘤，術後患者順利出院，並無惡性腫瘤之跡象。據文獻指出血管肌脂瘤所引起的肋膜積液皆為乳糜胸，在此，我們報告一位縱膈腔血管肌脂瘤引起肋膜滲出液之罕見病例。

關鍵字

血管肌脂瘤 ； 縱膈腔 ； 肋膜積液

並列摘要

Angiomyolipomas (AMLs) are benign tumors composed of various tissues, including fat, abnormal blood vessels and smooth muscle cells. Renal AMLs are often associated with tuberous sclerosis complex (TSC) or pulmonary lymphangio- leiomyomatosis (LAM). However, mediastinal AMLs are less reported and the association with pleural effusion are less frequently reported. We present a case of middle-aged woman with left pleural effusion. The analysis of pleural effusion shows exudate with macrophage/monocyte-predominant exduate. Chest computed tomography (CT) reveals mediastinal mass (about 6.0cm). Mediastinal tumor was excised through video-assisted thoracoscopic surgery (VATS) and pathology revealed angiomyolipoma. After tumor excision, pleural effusion didn't recur. We reported this unusual presentation of pleural effusion caused by mediastinal angiomyolipoma, and review the related articles.

並列關鍵字

angiomyolipoma ； mediastinum ； pleural effusion