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呼吸困难与喘息:仍是肺科医生面临的挑战。

Dyspnea and wheezing: still a challenge for pulmonologists.

作者信息

Castro Ana Sofia, Barroso Ana, Conde Sara, Parente Bárbara

机构信息

Pulmonology Department, Centro Hospitalar Vila Nova Gaia-Espinho (CHVNG-E), 4434-502 Vila Nova de Gaia, Portugal.

出版信息

Case Rep Pulmonol. 2012;2012:610949. doi: 10.1155/2012/610949. Epub 2012 Dec 22.

Abstract

Schwannoma is a neurogenic tumor originating from the nerve sheath Schwann cells. Intrathoracic location is rare, and the endobronchial location is exceptional. Schwannoma is a rare tumor; the majority of lesions are benign and usually asymptomatic. The authors present a case report of a 83-year-old woman, nonsmoker, observed in the emergency department for wheezing and cough lasting for 2 months. Chest tomography showed a right hilar pulmonary mass, ill defined, with thick and irregular walls, centered on the upper lobe bronchus, which was obliterated. Fiberoptic bronchoscopy showed a necrotic mass obstructing the right upper lobe bronchus whose biopsy allowed the diagnosis of benign schwannoma. Subsequently, the patient carried tumor ablation by laser bronchoscopy, with the resolution of the respiratory symptoms. This case stands out for its rarity but also because it is an excellent example of the importance of endoscopic techniques for therapeutic purposes. Schwannoma is a benign tumor in which surgical or endoscopic intervention generally prevents local recurrence and associated clinical manifestations.

摘要

神经鞘瘤是一种起源于神经鞘雪旺细胞的神经源性肿瘤。胸内发生罕见,支气管内发生则更为罕见。神经鞘瘤是一种罕见肿瘤;大多数病变为良性,通常无症状。作者报告了一例83岁非吸烟女性病例,该患者因喘息和咳嗽持续2个月在急诊科就诊。胸部断层扫描显示右肺门有一肺部肿块,边界不清,壁增厚且不规则,以上叶支气管为中心,支气管闭塞。纤维支气管镜检查显示一坏死性肿块阻塞右上叶支气管,活检诊断为良性神经鞘瘤。随后,患者接受了激光支气管镜下肿瘤消融治疗,呼吸道症状得以缓解。该病例因其罕见性而突出,同时也是内镜技术用于治疗目的重要性的一个极佳范例。神经鞘瘤是一种良性肿瘤,手术或内镜干预通常可预防局部复发及相关临床表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f0f/3539336/daef19ef97c2/CRIM.PULMONOLOGY2012-610949.001.jpg

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