Ma Dong-Jie, Liu Hong-Sheng, Li Shan-Qing, Zhou Xiao-Yun, Cui Yu-Shang, Wu Huan-Wen, Zhou Wei-Xun
Department of Thoracic Surgery Department of Pathology, Peking Union Medical College Hospital, Beijing, China.
Medicine (Baltimore). 2017 Sep;96(35):e7733. doi: 10.1097/MD.0000000000007733.
Placental transmogrification of the lung (PTL) is rare cystic lesion. Thus, we summarized the characteristics of PTL to explore the strategy of diagnosis and treatment.
Two patients pathologically confirmed PTL were treated in our hospital. Retrospectively analysis was performed on such 2 cases and 34 cases of PTL reported in abroad. The basic information and clinical characteristics from each patient were gathered and analyzed.
The imaging findings of 2 patients were the pulmonary solid mass with peripheral multiple pulmonary bullae. After the improvement of preoperative examination and the multidisciplinary discussion of thoracic surgery, respiration, imaging, and anesthesia, the possibility of benign pulmonary lesions was improved in all cases. Thoracoscopic lobectomy was carried out under general anesthesia, and the intraoperative frozen pathology showed bullae of lung. Ultimately, PTL was confirmed by paraffin pathological diagnosis. Both 2 PTL patients had satisfied recovery without obvious complications or imaging abnormalities. In addition, the literature review of 34 PTL cases from PubMed database was summarized between 1995 and 2015. A total of 36 patients were retrospectively analyzed in our study. The age of 34 cases ranged from 24 to 72 years (an average age of 45.6 ± 13.5 years). Among these, 8 cases were no obvious symptoms. In addition, the other 25 cases had respiratory symptoms such as chest tightness, cough, and chest pain. Moreover, the mean size of pulmonary bulla was 6.5 ± 5.5 cm. The size of the solid lesions in 23 cases was 3.3 ± 3.4 cm (ranging from 0.5 to 15). The follow-up period was 2 to 96 months (average 27.3 ± 29.8 months).
Early diagnosis and surgical operation of PTL should be performed as soon as possible. These lesions are best treated by minimally invasive surgery, so as to preserve more normal lung tissue and avoid the pneumonectomy.
肺胎盘样化生（PTL）是一种罕见的囊性病变。因此，我们总结了PTL的特征，以探索其诊断和治疗策略。
我院收治了2例经病理确诊为PTL的患者。对这2例患者以及国外报道的34例PTL病例进行回顾性分析。收集并分析了每位患者的基本信息和临床特征。
2例患者的影像学表现为肺部实性肿块伴周边多发肺大疱。经过术前检查的完善以及胸外科、呼吸科、影像科和麻醉科的多学科讨论，所有病例中良性肺部病变的可能性均有所提高。在全身麻醉下进行了胸腔镜肺叶切除术，术中冰冻病理显示为肺大疱。最终，石蜡病理诊断确诊为PTL。2例PTL患者均恢复良好，无明显并发症或影像学异常。此外，总结了1995年至2015年从PubMed数据库中检索到的34例PTL病例的文献。本研究共对36例患者进行了回顾性分析。34例患者的年龄在24至72岁之间（平均年龄45.6±13.5岁）。其中，8例无明显症状。此外，其他25例有胸闷、咳嗽、胸痛等呼吸道症状。而且，肺大疱的平均大小为6.5±5.5厘米。23例实性病变的大小为3.3±3.4厘米（范围为0.5至15厘米）。随访时间为2至96个月（平均27.3±29.8个月）。
PTL应尽早进行早期诊断和手术治疗。这些病变最好通过微创手术治疗，以保留更多正常肺组织，避免全肺切除术。
