Yao Guangyu, Yang Mingtian, Wang Siyu, He Ping, Wang Junye, Chen Jiexin
Zhongguo Fei Ai Za Zhi. 2005 Apr 20;8(2):132-5. doi: 10.3779/j.issn.1009-3419.2005.02.13.
Pulmonary blastoma is a rare primary malignancy of the lung. It is now recognized in two forms: adult type pulmonary blastoma and childhood pleuropulmonary blastoma. The clinical characteristics, diagnosis and treatments of adult type pulmonary blastoma are discussed in this article.
The clinical records of 5 patients with adult type pulmonary blastoma admitted in Cancer Center, Sun Yet-sen University from 1964 to 2004 were analyzed and the literature on pulmonary blastoma was reviewed.
Three patients were male and two were female with the ages ranged from 22 years old to 70. Their symptoms consisted mainly of cough, hemoptysis and chest pain. The pulmonary blastomas were mainly manifested as a solitary parenchymal mass of the lung on chest radiograph and CT. None of these patients was diognosed by fibrobronchoscopy nor sputum cytology. Three patients underwent lobectomy, one underwent pneumonectomy, and these four patients underwent mediastinal lymph node resection also. The fifth one received wedge resection and postoperative chemotherapy. At the end of follow-up, three patients died and two was alive, and the survival time was from 6 months to 11 years.
Pulmonary blastoma is difficult to be diagnosed before operation. Surgery is the best therapeutic choice up to now. It has poor response to radiotherapy and chemotherapy. The prognosis of patient with pulmonary blastoma is variable.
肺母细胞瘤是一种罕见的原发性肺恶性肿瘤。目前认为有两种类型：成人型肺母细胞瘤和儿童胸膜肺母细胞瘤。本文讨论成人型肺母细胞瘤的临床特征、诊断及治疗。
分析1964年至2004年中山大学肿瘤防治中心收治的5例成人型肺母细胞瘤患者的临床资料，并复习有关肺母细胞瘤的文献。
3例男性，2例女性，年龄22岁至70岁。主要症状为咳嗽、咯血和胸痛。胸部X线片及CT显示肺母细胞瘤主要表现为肺部孤立性实质性肿块。所有患者均未通过纤维支气管镜检查及痰细胞学检查确诊。3例行肺叶切除术，1例行全肺切除术，这4例患者均行纵隔淋巴结清扫术。第5例接受楔形切除术及术后化疗。随访结束时，3例死亡，2例存活，生存时间为6个月至11年。
肺母细胞瘤术前难以诊断。目前手术是最佳治疗选择。其对放疗和化疗反应较差。肺母细胞瘤患者的预后各不相同。
