A Case of Primary Pleural Angiosarcoma in an Asbestos-exposed Patient Showing Rapid Changes on Thoracoscopy

DOI
  • Hirai Kazuhiro
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Nishiuma Teruaki
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Fujioka Miyu
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Yamamoto Hiroki
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Takahara Yu
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Matsumoto Karin
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Ishida Koichi
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Tokunaga Shuntaro
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Hori Suya
    Department of Respiratory Medicine, Kakogawa Central City Hospital
  • Tamura Daisuke
    Department of Respiratory Medicine, Kakogawa Central City Hospital Tamura Clinic
  • Imai Yukihiro
    Department of Diagnostic Pathology, Kakogawa Central City Hospital

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Other Title
  • 急激な変化を胸腔鏡検査にて確認した石綿曝露歴のある胸膜原発血管肉腫の1例

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Abstract

<p>Background. Pleural angiosarcoma is a rare disease that is difficult to diagnose, shows rapid growth, and has a poor prognosis. Case. A 73-year-old man with left pleural effusion and a history of asbestos exposure was referred to our hospital. Thoracoscopy under local anesthesia was performed, revealing diffuse, rough pleural thickening with scattered white protruded lesion. A pleural biopsy did not lead to a definitive diagnosis. Four months later, the left pleural effusion had massively increased on repeated thoracoscopy. Pleural bleeding and numerous irregular red tumors were observed in the thoracic cavity. A pleural biopsy revealed proliferation and invasion of CD31-positive spindle cells, which turned out to be angiosarcoma. This patient did not respond to outpatient chemotherapy and died six months after the diagnosis. Conclusion. We encountered a rare case of primary pleural angiosarcoma in which rapid pleural changes were visualized by thoracoscopy. It is difficult to suspect or diagnose angiosarcoma based on early lesions in such cases, so a surgical biopsy should be considered.</p>

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