Akamine S, Uchiyama Y, Kimino K, Yamaoka N, Azuma K, Matsuo S
Department of Thoracic-Vascular Surgery, Oita Prefectural Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Jul;38(7):1203-8.
Pulmonary sarcoma is a rare tumor of the lung. There are 81 cases in the literature for review, including our two cases. Our first case who was a thirty-seven year old male who was admitted to our hospital with complaints of left back pain. His chest X-ray showed an 11 X 14 cm tumor shadow in the lower left lung area. A left upper lobectomy was performed, and the histological diagnosis was leiomyosarcoma of the pulmonary vein. He died due to mediastinal recurrence 29 months later. Our other case was a fifty-six year old female. Her chest X-ray showed an abnormal shadow that was a tumor shadow in the right central lung area of 4 cm in diameter. As the diagnosis of the transcutaneous lung biopsy was benign tumor, partial resection of lung was performed. The histological diagnosis was leiomyosarcoma of the bronchus, and she is alive and well at 29 months after the operation. As the rate of diagnosis in leiomyosarcoma detected by transcutaneous lung biopsy is low, the most acceptable method of diagnosis is a total examination, including cytology of sputum, bronchoscopic findings, and roentgenoscopy. Probe thoracotomy would also be necessary if malignancy could not ruled out. The treatment of lobectomy should include lymph node resection.
肺肉瘤是一种罕见的肺部肿瘤。文献综述中有81例病例,包括我们的两例。我们的第一例患者是一名37岁男性,因左背痛入院。他的胸部X光片显示左下肺区域有一个11×14厘米的肿瘤阴影。进行了左上肺叶切除术,组织学诊断为肺静脉平滑肌肉瘤。29个月后,他因纵隔复发死亡。我们的另一例患者是一名56岁女性。她的胸部X光片显示右肺中央区域有一个直径4厘米的异常阴影,即肿瘤阴影。经皮肺活检诊断为良性肿瘤,遂行肺部分切除术。组织学诊断为支气管平滑肌肉瘤,术后29个月她仍健在且状况良好。由于经皮肺活检检测平滑肌肉瘤的诊断率较低,最可接受的诊断方法是全面检查,包括痰细胞学检查、支气管镜检查结果和X线透视检查。如果不能排除恶性肿瘤,也有必要进行探查性开胸手术。肺叶切除术的治疗应包括淋巴结切除。