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< マイ手帳大賞30：感動する心忘れずに/ハ... | メイン | 消化管転移をした悪性胸膜中皮腫／マネジメ... >
2010.10.31 20:00 |  診療  |  医療制度 / 行政  |  その他（一般）  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

心膜原発悪性中皮腫/研究会準備

・石綿による中皮腫は、胸膜、腹膜、心膜、精巣鞘膜があります。特に、今年、7月1日労災の認定基準が変わっているので、お気をつけください↓

http://www.mhlw.go.jp/new-info/kobetu/roudou/gyousei/rousai/dl/061013-4.pdf

さて、心膜および精巣鞘膜の中皮腫は非常にまれな疾患です。以下のような、症例報告がありましたので、ご参考までに↓

肺腺癌を合併した心膜原発悪性中皮腫の1 例

http://www.jrs.or.jp/quicklink/journal/pdf/047020104j.pdf

要旨：症例は63 歳，男性．心不全徴候を主訴に受診．心エコーと胸部画像所見にて著明な心囊水と左下葉に空洞を伴う結節性病変を認めた．心囊水細胞診の免疫染色検査・ヒアルロン酸測定やPET 検査により心膜原発悪性中皮腫の診断となったが，左下葉の肺内病変については生前診断が困難であった．対症療法として心膜癒着術を施行したところ心囊水貯留速度が減速した．しかし，徐々に原発巣の増大とそれに伴う心不全増悪を認め，診断から約10 カ月後に永眠された．病理解剖にて心膜原発悪性中皮腫の確定診断とともに左肺の結節性病変は原発性肺腺癌p-T1N0M0stageIA と診断された．心膜原発悪性中皮腫自体が稀な疾患であるが原発性肺癌を合併した症例報告は本邦では2 例目であり，貴重な症例と思われた．

 ・この方の職業歴は、本文から引用すると、「北海道出身の漁師．長期間のディーゼル船乗船歴があり石綿曝露の可能性あり．」です。そうです、船に乗る人は、石綿暴露の可能性があるので、ご注意ください。この方は、漁師であり、つまり、多分自営業です。ということは、労災補償の対象ではありません。しかし、石綿新法の対象になるのではないかと考えますが、この方の「救済」はどうなったのでしょうか？この論文からでは分かりませんが．．．この方の場合、2005年に亡くなっています。石綿新法（石綿による健康被害の救済に関する法律）の成立は、2006年3月27日です。「アスベスト（石綿）による健康被害救済給付の概要」については↓

http://www.erca.go.jp/asbestos/relief/seido/kyufu.html

 

上記を参照すると、申請していれば、医療費の給付がもらえたし、また、特別遺族弔慰金・特別葬祭料は、もし、給付されていなければ、今でももらう権利があるはずです。どうだったのでしょうか？気になるところです。

 

以下日記

・本日は、仕事は休みでしたが、11月中旬にある研究会の準備のため病院へ。13時過ぎまで、発表の準備＋ちょっとした事務処理を行いました。帰りは、金光町のラーメン屋によって、細麺を頼んだのですが、これが、うまかった。久々においしい麺でした。（つい最近もここに来ていたのですが、普通のラーメンは、普通でした）ちょっと、感動。また、来よう。14時過ぎに帰宅して、ウーロン茶で一服。録画のスペックを見ました。前回のスペックは、やはり、ディーテイルでおかしいところあったのですが、今回も、やや説明不足なところあり。まあ、許すが．．．あと、洗い物と部屋の片づけをしました。あとは、風呂に早く入って、すでに酔っぱらい状態です。早く寝るぞ～～～っ！

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