Khan Fazal, Hamid Arsalan, Fatima Benish, Hashmi Shiraz, Fatimi Saulat
1 Section of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
2 Medical College, Aga Khan University Hospital, Karachi, Pakistan.
Asian Cardiovasc Thorac Ann. 2017 Jan;25(1):67-69. doi: 10.1177/0218492316684983. Epub 2016 Dec 11.
A 25-year-old man presented with a 2-month history of dysphagia and past history of pulmonary and intestinal tuberculosis. A barium swallow showed a point of constriction 42 mm above the gastroesophageal junction. Computed tomography revealed large opacities in bilateral lung fields, encroaching more on the esophagus. The lesion progressively compressed the esophagus as it moved inferiorly. A right posterolateral thoracotomy was performed for sub-anatomical resection of the mass. A biopsy revealed homogenous whirling hyalinized collagen fibers, highly suggestive of pulmonary hyalinizing granuloma, with no evidence of malignancy. Pulmonary hyalinizing granuloma should be considered in the differential diagnosis of longstanding dysphagia.
一名25岁男性,有2个月吞咽困难病史,既往有肺结核和肠结核病史。吞钡检查显示在食管胃交界处上方42毫米处有一处狭窄点。计算机断层扫描显示双侧肺野有大片致密影,对食管的侵犯更明显。病变向下移动时逐渐压迫食管。行右后外侧开胸术对肿块进行次全切除术。活检显示均质的漩涡状玻璃样变胶原纤维,高度提示为肺玻璃样变肉芽肿,无恶性证据。在长期吞咽困难的鉴别诊断中应考虑肺玻璃样变肉芽肿。