Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Respirology. 2010 Jan;15(1):150-4. doi: 10.1111/j.1440-1843.2009.01662.x. Epub 2009 Nov 23.
Bronchoscopic resection of endobronchial hamartomas has been reported to have a favourable outcome. This study describes the bronchoscopic features of endobronchial hamartoma and reports the clinical outcome of bronchoscopic intervention.
A retrospective analysis was conducted of patients with histologically proven endobronchial hamartomas, diagnosed in the 10-year period 1999-2009 to elucidate the clinical, radiological and bronchoscopic features of hamartoma and to describe the clinical outcomes.
Seventeen of the 135 patients with pulmonary hamartomas were diagnosed as having endobronchial hamartomas. CXR was abnormal in 11 of the 17 patients. On chest CT (n = 16), the median diameter of the lesion was 15.6 mm. Calcification and areas of focal fat in the lesion, the diagnostic CT findings of pulmonary hamartoma, were found in two of 16 (12.5%) patients. At bronchoscopy (n = 16), all tumours had a mass appearance and most were smooth surfaced round masses (50.0%) with 18.8% having a 'stalk'. Bronchoscopic forceps biopsies were performed in 13 patients, which resulted in five patients (38.5%) being diagnosed with endobronchial hamartoma. Fifteen patients were treated with rigid or flexible bronchoscopic resection, one had lobectomy, and one had no intervention. No procedure-related mortalities or late complications developed.
Bronchoscopic intervention appears to be a safe and effective method to resect endobronchial hamartomas.
支气管镜下切除支气管内错构瘤的预后良好。本研究描述了支气管内错构瘤的支气管镜表现,并报告了支气管镜介入的临床结果。
对 1999 年至 2009 年期间经组织学证实的支气管内错构瘤患者进行回顾性分析,以阐明错构瘤的临床、影像学和支气管镜特征,并描述临床结果。
在 135 例肺错构瘤患者中,有 17 例被诊断为支气管内错构瘤。17 例患者中有 11 例 X 线胸片异常。16 例患者的胸部 CT 显示病变的中位直径为 15.6mm。16 例患者中,2 例(12.5%)发现病变内有钙化和局灶性脂肪区,这是肺错构瘤的 CT 诊断特征。16 例患者行支气管镜检查,所有肿瘤均表现为肿块样,多数为表面光滑的圆形肿块(50.0%),18.8%有“茎”。对 13 例患者进行了支气管镜活检,其中 5 例(38.5%)被诊断为支气管内错构瘤。15 例患者接受了硬镜或软镜切除,1 例患者行肺叶切除术,1 例患者未接受干预。无与操作相关的死亡或晚期并发症发生。
支气管镜介入似乎是一种安全有效的切除支气管内错构瘤的方法。