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引起胸膜炎的疾患包括多种,其鉴别诊断未必容易。特别是因肺野病变不明的所谓特发性胸膜炎的诊断往往困难。渗出性胸膜炎以结核和癌症居多,近年老年人渗出性胸膜炎增多,并且肺癌患者伴有胸膜炎的病例也增加,这种良性与恶性的鉴别在治疗及判断预后上极其重要。作者报告186例胸水病人,恶性胸膜炎114例,良性胸膜炎72例。研究方法:(1)胸水细菌学检查:一般细菌及抗酸杆菌;(2)胸水细胞学检查:进行巴氏染色以日本肺癌学会癌细胞型分类标准判定;(3)经胸壁胸膜穿刺活检:用Vim-Silverman氏针取3～5个组织片,10％福尔马林固定,石蜡封闭后连续切片作标本,FE染色进行组织学检查;(4)
There are many kinds of diseases that cause pleurisy, and the differential diagnosis may not be easy. In particular, the diagnosis of so-called idiopathic pleurisy with unknown lesions in the lung field is often difficult. Exudative pleurisy is dominated by tuberculosis and cancer. In recent years, exudative pleurisy in the elderly has increased, and cases of lung cancer patients with pleuritis have also increased. This benign and malignant identification is extremely important in the treatment and prognosis. The authors reported 186 patients with pleural effusion, 114 with malignant pleurisy, and 72 with benign pleurisy. Research methods: (1) Bacterial examination of pleural effusions: general bacteria and acid-fast bacilli; (2) Pleural fluid cytology test: Pap staining was performed to determine the cancer cell type criteria of Japan Lung Cancer Society; (3) Transthoracic pleural biopsy: Using Vim-Silverman’s needle to take 3 to 5 pieces of tissue, fixed in 10% formalin, paraffin block, serially sectioned as specimen, FE staining for histological examination; (4)