Ma Shaohua, Sun Yu, Du Changzheng, Liang Zhen, Xiong Hongchao, Chen Keneng
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery I, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China.
Zhongguo Fei Ai Za Zhi. 2011 Aug;14(8):674-8. doi: 10.3779/j.issn.1009-3419.2011.08.07.
The concept of pulmonary sclerosing hemangioma (PSH) was proposed only 50 years ago. PSH features several characteristics that should be differently diagnosed with lung cancer. The aim of this study is to retrospectively review the diagnosis and treatment of 48 cases of PSH, review recent publications about this topic, and address reasonable diagnosis and treatment methods.
Forty-eight patients with PSH were enrolled and consecutively treated from January 2001 to April 2011. Clinical presentations, image characteristics, pathologic morphologies, and prognostic data were analyzed.
Twenty-seven PSH cases (56.3%) were asymptomatic. Tumor diameters ranged from 0.2 to 7.0 cm, with an average diameter of 2.1 cm, and involved both lobes of the lungs. Enlarged lymph nodes in the mediastinum were detected via computed tomography (CT) scans in 15 cases (31.3%). Only 47 patients underwent surgery. Pulmonary wedge resection was performed in 29 cases (61.7%) while lobectomy was performed in 14 (29.8%). The tumor was removed in 3 cases (6.4%) and anterior mediastinal tumor resection was performed in 1 case (2.1%). Forty-seven patients reported no recurrence during follow-up while one patient refused surgery after a CT-guided biopsy with no progression during the 28-month follow up period.
The exact diagnosis of PSH is difficult prior to surgery. Surgery is an effective method of treatment that allows both definite diagnosis and accurate therapy. The prognosis of PSH is favorable.
肺硬化性血管瘤（PSH）的概念仅在50年前被提出。PSH具有一些应与肺癌进行鉴别诊断的特征。本研究旨在回顾性分析48例PSH的诊断和治疗情况，复习近期关于该主题的文献，并探讨合理的诊断和治疗方法。
纳入2001年1月至2011年4月连续治疗的48例PSH患者。分析其临床表现、影像特征、病理形态及预后数据。
27例（56.3%）PSH患者无症状。肿瘤直径0.2至7.0 cm，平均直径2.1 cm，累及双肺叶。15例（31.3%）患者经计算机断层扫描（CT）发现纵隔淋巴结肿大。仅47例患者接受了手术。29例（61.7%）行肺楔形切除术，14例（29.8%）行肺叶切除术。3例（6.4%）行肿瘤摘除术，1例（2.1%）行前纵隔肿瘤切除术。47例患者随访期间无复发，1例患者在CT引导下活检后拒绝手术，在28个月随访期内病情无进展。
PSH术前准确诊断困难。手术是一种有效的治疗方法，既能明确诊断又能精准治疗。PSH预后良好。
