| | | 肺硬化性血管瘤61例的临床病理与外科治疗分析
| | 临床医学论文【关键词】 肺；皮肤纤维瘤；诊断；外科手术
Clinicopathological features and surgical treatment of 61 cases with pulmonary sclerosing hemangioma
YU ChangHai, LI Jie, LIU Ying, WANG Tao, DAI WeiMin
Department of Thoracic Surgery, First Affiliated Hospital, PLA General Hospital, Beijing 100037, China
【Abstract】 AIM: To investigate the clinicopathological features, surgical treatment and prognosis of pulmonary sclerosing hemangioma. METHODS: The clinicopathological features, operative treatment and prognosis of 61 patients with pulmonary sclerosing hemangioma in our hospital from January, 1970 to April,2005 were analyzed retrospectively. RESULTS: There were 11 males（18.03%）and 50 females （81.97%）. The mean age was 39.24（15-59）years old. The 38（62.30%） patients were free of symptoms . By radiography, the tumor presented as a round or nearly round nodule, with uniform dersity in 47 (77.05%) cases and calcification in 14 (22.95%) cases. All patients received operation, without complications and death. Immunohistochemical findings suggested that the tumor might originate from epithelium. During postoperative followup of about 8.25 years, there was no recurrence or metastasis. CONCLUSION: It is very difficult to diagnose pulmonary sclerosing hemoangioma before operation, for it mainly depends on pathological examination postoperatively. A good prognosis can be achieved through surgical treatment.
【Keywords】 lung; dermatofibroma; diagnosis; surgical procedures, operative
【摘要】 目的临床医学论文： 探讨肺硬化性血管瘤（PSH）的临床医学论文临床病理特点、外科治疗及其预后情况.方法： 回顾分析总结我院197001/200504收治的61例PSH临床病理特点、诊治方法及随访情况. 结果： 全组男性11例（18.03%）,女性50例（81.97%），平均年龄39.24岁；38例（62.30%）无症状.放射影像学表现为边缘清晰的圆形或类圆形软组织结节影，47例（77.05%）密度均匀，14例（22.95%）有钙化；全部行手术治疗，无手术并发症和死亡；术后病理及免疫组化结果证实PSH并支持肿瘤来源于上皮组织；术后平均随访8.25 y，无复发、转移. 结论： PSH术前诊断困难，确诊主要依靠术后病理，手术是PSH的有效治疗方法.
【关键词】 肺；皮肤纤维瘤；诊断；外科手术
0引言
肺硬化性血管瘤（pulmonary sclerosing hemangioma, PSH）是一种发生在肺实质的少见肿瘤，术前确诊较困难，易误诊为恶性肿瘤，最后确诊依靠病理学检查.我院自197001200504年间共收治的61例PSH，占同期切除肺部肿瘤的2.17%，现就其临床病理特点、诊断与外科治疗等方面进行探讨、分析，以提高对此疾病的认识与诊治能力.
1对象和方法
1.1对象 本组共61（男11，女50）例患者，男∶女为1∶4.6；年龄15～69(平均39.24)岁.61例中无症状38例，常规查体发现；咳嗽、咯血23例（咳嗽23例中痰中带血5例，胸闷气短4例，胸痛1例）.查体均无阳性体征. 全组均行胸部X线检查，其中40例行CT扫描，13例行增强CT扫描.病变部位：右肺36例（上叶7例、中叶13例、下叶16例）、左肺25例（上叶9例、下叶16例）.位于肺周边53例，肺门处8例.均为单发肺内软组织结节影，直径1～5（平均2.0）cm，圆形14例，类圆形45例，不规则形2例；肿块密度均匀、边缘清晰者47例，有钙化14例.在13例增强CT检查中，有9例强化，仅1例同时伴有肺门淋巴结肿大.行纤维支气管镜检查12例，均未见异常.61例术前无一确诊为PSH，诊断为良性肿瘤43例，肺癌6例，肺结核球3例，肺部阴影、性质未定9例.
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