Nowak Kai, von der Thüsen Jan, Karenovics Wolfram, Padley Simon, Dusmet Michael
Department of Thoracic Surgery, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
Gen Thorac Cardiovasc Surg. 2013 Aug;61(8):479-82. doi: 10.1007/s11748-012-0148-6. Epub 2012 Sep 11.
We report the case of a fit and healthy 41-year-old man, who presented with significant haemoptysis without a history of recurrent infections. His computed tomography scan showed a dense lesion in the left lower lobe with a feeding vessel arising from the abdominal aorta, characteristic for an intra-pulmonary sequestration. To prevent possible further haemoptysis or infections, a left lower lobectomy was performed. The histological examination showed the typical features of a sequestration. However, within the sequestration, a carcinoid tumour without atypical features was found. There was no lymph node involvement. Sequestrations are congenital lesions without communication with the bronchial tree and with a systemic blood supply. They commonly cause recurrent infection. Fatal haemoptysis has also been described, but is rare. There are very few reports of neoplastic lesions in sequestrations. This case illustrates two unusual aspects of sequestrations. Surgery offers definitive treatment for both pathologies, as opposed to embolisation.
我们报告了一例身体健康的41岁男性病例，该患者出现大量咯血，无反复感染病史。他的计算机断层扫描显示左下叶有一个致密病变，有一条供血血管发自腹主动脉，这是肺内隔离症的特征。为防止可能进一步出现咯血或感染，进行了左下叶切除术。组织学检查显示了隔离症的典型特征。然而，在隔离症内部，发现了一个无非典型特征的类癌肿瘤。没有淋巴结受累。隔离症是先天性病变，与支气管树无连通，有体循环供血。它们通常会导致反复感染。也有致命性咯血的报道，但很罕见。关于隔离症中肿瘤性病变的报道非常少。本病例说明了隔离症的两个不寻常方面。与栓塞术不同，手术为这两种病理状况提供了确定性治疗。
