2022 年第 5 期 第 17 卷

以胸腔积液为首发表现的胃癌1例

A case report of gastric cancer with pleural effusion as the first manifestation

作者：赵煜闫席席周跃姚红梅

英文作者：Zhao Yu Yan Xixi Zhou Yue Yao Hongmei

单位：遵义医科大学，遵义563000

英文单位：Zunyi Medical University Zunyi 563000 China

关键词：胃癌；胸腔积液；病理检查

英文关键词：Gastriccancer；Pleuraleffusion；Pathologicalexamination

• 摘要：

• 1例47岁女性患者以“右侧胸腔积液原因待查”收住院。既往无消化系统疾病史，予抗感染治疗效果欠佳，进一步完善胸腔镜检查提示胸膜结节状突起，胸膜病理活检倾向腺癌转移。住院治疗16 d后行胃镜检查，胃黏膜病理活检提示低分化腺癌，部分为印戒细胞癌。明确诊断胃腺癌合并胸膜转移。胃癌早期多以消化道症状为主，以胸腔积液为首发症状者较少，这提示临床医师在诊治胸腔积液时需警惕胃癌可能。

• A 47-year old female patient was admitted as "the cause of right pleural effusion to be investigated". The patient had no previous history of digestive system diseases. The effect of anti-infective treatment was not satisfactory. Thoracoscopy showed that pleural nodular process and pleural pathological biopsy tended to adenocarcinoma metastasis. Gastroscopy was performed after 16 d of hospitalization, and pathological biopsy of gastric mucosa showed poorly differentiated adenocarcinoma, some of which were signet ring cell carcinoma. Definite diagnosis was gastric adenocarcinoma with pleural metastasis. Gastric cancer is mainly caused by digestive tract symptoms in the early stage, but pleural effusion as the first symptom is rare. This suggests that clinicians should be on guard against the possibility of gastric cancer in the diagnosis and treatment of pleural effusion.