Wu X, Gu M D, Jiang H S, Xu J X
Nanjing Railway Medical College.
Zhonghua Zhong Liu Za Zhi. 1987 Mar;9(2):133-5.
Twenty one patients with bronchial adenoma, treated surgically in our hospital, include three different neoplasms: carcinoid, cylindroma and mucoepidermoid adenoma. In this series, clinical characteristics were: bronchial obstruction when the tumor protrudes into the lumen and infection, first in the bronchus (bronchitis or bronchiectasis) then in the parenchyma (acute, recurrent or chronic pneumonia, tension abscess). Ball-valve action of the tumor may result in lobar or segmental emphysema. Preoperatively, most of the patients had been misdiagnosed as bronchitis, carcinoma of lung, bronchiectasis or acute tension abscess. In our series, all the patients were alive in a follow up of 2-8 years. Yet one patient is living with local recurrence and distant metastasis. To our experience, pneumonia recurring in the same area of the lung, localized wheezing, with or without endocrine symptoms, lobar or segmental emphysema may suggest bronchial adenoma. Tomography and endoscopy are important for diagnosis. For the treatment, sleeve resection of the main bronchus was done in 2, bronchoplastic lobectomy in 7, lobectomy in 10, and pneumonectomy in 2. Sleeve resection of the main bronchus or bronchoplastic lobectomy is recommended as a reliable procedure for this disease.
我院手术治疗的21例支气管腺瘤患者,包括三种不同的肿瘤:类癌、圆柱瘤和黏液表皮样腺瘤。在这组病例中,临床特征为:肿瘤突入管腔时引起支气管阻塞和感染,先是支气管(支气管炎或支气管扩张),然后是肺实质(急性、复发性或慢性肺炎、张力性脓肿)。肿瘤的活瓣作用可导致肺叶或肺段气肿。术前,大多数患者被误诊为支气管炎、肺癌、支气管扩张或急性张力性脓肿。在我们这组病例中,所有患者在2至8年的随访中均存活。然而,有1例患者出现局部复发和远处转移。根据我们的经验,同一肺叶反复出现肺炎、局限性哮鸣音,有无内分泌症状,肺叶或肺段气肿,可能提示支气管腺瘤。体层摄影术和内镜检查对诊断很重要。治疗方面,2例行主支气管袖状切除术,7例行支气管成形肺叶切除术,10例行肺叶切除术,2例行全肺切除术。主支气管袖状切除术或支气管成形肺叶切除术被推荐为此病的可靠术式。