Trousse D, Avaro J-P
Service de Chirurgie Thoracique et Maladies de l'Oesophage, Hôpital Sainte-Marguerite, Université de la Méditérranée, 270 boulevard Sainte-Marguerite, 13274 Marseille cedex 9, France.
Rev Pneumol Clin. 2010 Feb;66(1):3-16. doi: 10.1016/j.pneumo.2009.12.008. Epub 2010 Feb 19.
Mediastinal tumors are relatively uncommon, usually incidentally discovered on a chest X-ray in asymptomatic patients. Young adults are particularly concerned. Mediastinal masses represent a group of heterogeneous histological type cell. A definite diagnosis is essential leading to an adequate prompt therapeutic strategy when either benign disease or aggressive malignant tumor is conceivable. Indeed the therapeutic management of such tumors could be strictly medical, requiring exclusive surgical approach or includes a multimodal treatment. Clinical examination and imaging are important tools in the diagnostic approach. However the specific diagnosis could be complex and requires histological confirmation by an experienced pathologist after examination of large biopsies of the tumor. Several investigations, including surgical invasive exploration, should be quickly requested in order to achieve a final diagnosis and refer patients in an adequate therapeutic scheme without delay. The aim of this article is to point out the available diagnostic tools in mediastinal masses, including surgical approach, and to identify the role of surgical resection in specific subtypes.
纵隔肿瘤相对不常见,通常在无症状患者的胸部X光检查中偶然发现。年轻成年人尤其需要关注。纵隔肿块代表一组组织学类型各异的细胞。当考虑到良性疾病或侵袭性恶性肿瘤时,明确诊断对于制定适当的及时治疗策略至关重要。实际上,此类肿瘤的治疗管理可能严格采用医学方法,需要单独的手术方法,或者包括多模式治疗。临床检查和影像学检查是诊断方法中的重要工具。然而,具体诊断可能很复杂,需要经验丰富的病理学家在检查肿瘤的大活检标本后进行组织学确认。应迅速要求进行包括手术侵入性探查在内的多项检查,以便做出最终诊断,并及时将患者转至适当的治疗方案。本文的目的是指出纵隔肿块可用的诊断工具,包括手术方法,并确定手术切除在特定亚型中的作用。