Wang Hong-wu, Zhou Yun-zhi, Li Dong-mei, Zhang Nan, Zou Heng, Liang Su-juan
Minimally Invasive Tumor Therapy Center, Meitan General Hospital, Beijing 100028, China.
Zhonghua Er Ke Za Zhi. 2011 Aug;49(8):618-21.
Primary airway neoplasms are extremely rare in the pediatric age group. This paper reports 4 children with primary airway neoplasms to explore the clinical manifestations, safety and efficacy of bronchoscopic interventions.
The data of pathology, photographic documentation and imaging studies were analyzed.
Of the 4 reported lesions, 2 were characterized by low-grade (2 with mucoepidermoid carcinoma) and 2 by high grade malignant (spindle cell carcinoma and malignant lymphoma). Onset of clinical manifestations occurred at the ages of 7 months to 7 years. All of them were initially misdiagnosed as bronchitis, asthma or atelectasis. The lesions located in trachea in 2 patients, in left bronchus of 1 patient and in right middle bronchus of 1 case. Atelectases occurred in bilateral bronchus where the lesions obstructed almost the entire lumen at the time of diagnosis. The diagnosis of airway masses depends upon maintaining a high index of suspicion, complemented by imaging and timely diagnostic endoscopy. The lesions were completely removed in 3/4 patients except 1 died during bronchoscopic procedures.
The children with malignant airway neoplasms were presented with cough and wheezing without specific manifestations. Bronchoscopic interventions were effective in the treatment of non-operative cases. General anesthesia is strongly recommended for interventional bronchoscopy.
原发性气道肿瘤在儿童年龄组中极为罕见。本文报告4例原发性气道肿瘤患儿，以探讨其临床表现、支气管镜介入治疗的安全性和有效性。
分析病理、影像记录和影像学研究数据。
在报告的4例病变中，2例为低级别（2例黏液表皮样癌），2例为高级别恶性（梭形细胞癌和恶性淋巴瘤）。临床表现出现于7个月至7岁。所有患儿最初均被误诊为支气管炎、哮喘或肺不张。病变位于气管2例，左支气管1例，右中间支气管1例。诊断时，病变几乎阻塞整个管腔的双侧支气管出现肺不张。气道肿物的诊断依赖于高度的怀疑指数，并辅以影像学检查和及时的诊断性内镜检查。4例患儿中3例病变被完全切除，1例在支气管镜检查过程中死亡。
患有恶性气道肿瘤的儿童表现为咳嗽和喘息，无特异性表现。支气管镜介入治疗对非手术病例有效。强烈建议在介入性支气管镜检查时采用全身麻醉。
