Liu Xiaojing, Huang Zhihao, Zhang Jianyong
The Second Department of Pulmonary and Critical Care Medicine, Affliated Hospital of Zunyi Medical University, Zunyi 563000, China.
Zhongguo Fei Ai Za Zhi. 2020 Dec 20;23(12):1049-1058. doi: 10.3779/j.issn.1009-3419.2020.103.19.
Pulmonary sclerosing pneumocytoma (PSP) is rare benign lung tumor which usually develops in middle-aged women without typical clinical and imaging findings. PSP consists of two basic cell types (surface cubic epithelial cells and round mesenchymal cells) and four histological types (hemorrhagic, sclerotic, solid and papillary). It grows slowly, but it can metastasize to distant organs. The pathology before surgery is easily misdiagnosed. This study aims to improve clinicians' understanding of PSP by discussing the clinical characteristics of the disease.
This represents a retrospective study of thirty-five patients diagnosed with pulmonary sclerosing pneumocytoma by pathological examination from January 2011 to December 2019.
A total of 35 patients in this study, 12 cases were male and 23 cases were female, the average age is 51 years old. 7 cases were discovered accidentally by physical examination or routine chest computed tomography (CT), and 28 cases were found due to symptoms such as cough, sputum, hemoptysis and chest pain. The imaging changes is mainly featured with isolated or clear circular or round-like single nodule and lump in the lungs. In this group, 12 cases underwent percutaneous lung biopsy, only 7 cases were diagnosed with PSP. A total of 28 patients underwent surgery, 24 cases underwent rapid frozen pathological biopsy, only 5 cases diagnosed with PSP. Postoperative pathological examination results shows that 1 case was diagnosed with keratotic squamous cell carcinoma with partial PSP, and the rest were diagnosed with PSP. The surgical and non-surgical patients were followed up for 1 to 8 years after discharge, and the overall recovery was good. The patients were no recurrence and metastasis on chest CT review.
PSP is a clinically rare benign lung tumor, which is more common in middle-aged women. The clinical manifestations and imaging features are lack of significance. Percutaneous lung puncture pathological examination and intraoperative rapid frozen pathological sections often leads to misdiagnosis. Final diagnosis relies on postoperative pathological work-up for most cases.
肺硬化性细胞瘤（PSP）是一种罕见的良性肺肿瘤，通常发生于中年女性，无典型的临床和影像学表现。PSP由两种基本细胞类型（表面立方上皮细胞和圆形间充质细胞）和四种组织学类型（出血型、硬化型、实性型和乳头型）组成。它生长缓慢，但可转移至远处器官。术前病理易误诊。本研究旨在通过讨论该疾病的临床特征，提高临床医生对PSP的认识。
本研究为回顾性研究，收集了2011年1月至2019年12月间经病理检查确诊为肺硬化性细胞瘤的35例患者的资料。
本研究共35例患者，男性12例，女性23例，平均年龄51岁。7例因体检或胸部常规计算机断层扫描（CT）偶然发现，28例因咳嗽、咳痰、咯血及胸痛等症状就诊发现。影像学表现主要为肺部孤立或清晰的圆形或类圆形单发病灶及肿块。该组中，12例行经皮肺穿刺活检，仅7例诊断为PSP。共28例患者接受手术，24例行术中快速冷冻病理活检，仅5例诊断为PSP。术后病理检查结果显示，1例诊断为角化型鳞状细胞癌伴部分PSP表现，其余均诊断为PSP。手术及非手术患者出院后随访1至8年，总体恢复良好。胸部CT复查未见复发及转移。
PSP是一种临床罕见的良性肺肿瘤，多见于中年女性。临床表现及影像学特征缺乏特异性。经皮肺穿刺病理检查及术中快速冷冻病理切片常导致误诊。多数病例最终诊断依赖术后病理检查。
