Wang Z Z, Li D, Li J, Gao Y, Zhang X F, Liu S
Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
Department of Thoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2019 Jan 12;42(1):15-19. doi: 10.3760/cma.j.issn.1001-0939.2019.01.006.
To analyze the clinical manifestations of patients with endobronchial hamartoma(EH),and therefore to improve understanding of the disease. Data were retrospectively reviewed to describe the clinical characteristics, diagnosis procedures and prognosis of EH, including 5 patients in Beijing Anzhen Hospital, Capital Medical University from Jun 2007 to Feb 2018 and another 159 patients from Chinese and English literatures published after Jan 2000. The five patients, 4 males and 1 female, aged from 46 to 69 years[mean (56±7) years], were diagnosed with EH in our hospital. There was no fever in the 5 cases, cough and expectoration in 4 cases, hemoptysis in 3 cases and asymptomatic in 1 case. Chest CT revealed that the lesions of all 5 cases were located in the right bronchial tube; 3 as high-density endobronchial mass, 1 as low-density mass, 1 as mixed density mass, and 1 as a "popcorn" lesion. Three cases were accompanied by obstructive pneumonia in the distal part of the EH and 2 cases by atelectasis. CT enhanced scan was performed in 5 cases, 2 showing no enhancement and 3 showing mild enhancement. Four cases showed polyposis under bronchoscopy, and 5 cases received bronchoscopic biopsy with 3 pathologically diagnosed as EH. Four of them received lobectomy, while 1 received removal by biopsy forceps, and all were pathologically confirmed as EH. There was no evidence of recurrence in these 5 patents with follow-up. EH was a rare benign bronchial tumor with nonspecific clinical and imaging manifestations. Endobronchial polyposis could be revealed by bronchoscopy, and pathological study is required to confirm the diagnosis.
分析支气管内错构瘤(EH)患者的临床表现,从而提高对该疾病的认识。回顾性分析EH患者的临床特征、诊断过程及预后,其中包括2007年6月至2018年2月首都医科大学附属北京安贞医院的5例患者,以及2000年1月以后发表的中英文文献中的另外159例患者。我院诊断为EH的5例患者中,男性4例,女性1例,年龄46至69岁[平均(56±7)岁]。5例患者均无发热,4例有咳嗽咳痰,3例有咯血,1例无症状。胸部CT显示,5例患者病变均位于右支气管;3例为高密度支气管内肿块,1例为低密度肿块,1例为混合密度肿块,1例为“爆米花”样病变。3例EH远端伴有阻塞性肺炎,2例伴有肺不张。5例患者均行CT增强扫描,2例无强化,3例轻度强化。4例支气管镜下表现为息肉样改变,5例均行支气管镜活检,3例病理诊断为EH。其中4例行肺叶切除术,1例行活检钳摘除术,术后病理均确诊为EH。这5例患者随访均无复发迹象。EH是一种罕见的良性支气管肿瘤,临床及影像学表现无特异性。支气管镜检查可发现支气管内息肉样改变,确诊需病理检查。