Zhang Ying, Zhang Qiu-Ping, Ji Ying-Qun, Xu Jian
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China.
Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China.
World J Clin Cases. 2021 May 16;9(14):3320-3326. doi: 10.12998/wjcc.v9.i14.3320.
Glomus tumors (GTs), defined by modified smooth cells and normal glomus body cells, usually present with a small mass occurring in the soft tissue or dermis of an extremity, especially in the subungual region. However, other unusual sites, such as the respiratory tract, have also been reported. They are usually sporadic. Their imaging findings are usually nonspecific and likely to appear as a well-delineated round mass that usually lacks calcification. To our knowledge, we report the first case of bronchial GTs with calcification, reminding clinicians and radiologists that GT is one of the differential diagnoses when a calcified nodular mass is found.
We report a case of a 33-yr-old Chinese man with cough and sputum for 11 d and hemoptysis for 5 d. Chest computed tomography revealed a calcified nodular lesion on the compressed posterior wall of the lower left main bronchus and bronchiectasis in the lower lobe of the left lung. To confirm the characteristics of calcified nodules, we performed fiberoptic bronchoscopy. The tumor tissue from the biopsy of bronchial mucosal lesions established the diagnosis of GT. Because the patient had no life-threatening symptoms, he was not treated with surgery. Clinical follow-up for 25 mo showed that the patient survived well without any discomfort.
Bronchial GTs are usually not accompanied by calcification on computed tomography scans. To our knowledge, we report the first calcified bronchial GT. We recommend that clinicians consider GT as a possible differential diagnosis when a calcified mass of the bronchi is found.
血管球瘤（GTs）由改良的平滑肌细胞和正常的血管球体细胞构成，通常表现为出现在四肢软组织或真皮中的小肿块，尤其是在甲下区域。然而，其他不常见的部位，如呼吸道，也有相关报道。它们通常是散发性的。其影像学表现通常不具有特异性，可能表现为边界清晰的圆形肿块，通常无钙化。据我们所知，我们报告了首例伴有钙化的支气管血管球瘤，提醒临床医生和放射科医生，当发现钙化结节性肿块时，血管球瘤是鉴别诊断之一。
我们报告一例33岁中国男性，咳嗽、咳痰11天，咯血5天。胸部计算机断层扫描显示左下主支气管受压后壁有一个钙化结节性病变，左肺下叶有支气管扩张。为明确钙化结节的特征，我们进行了纤维支气管镜检查。支气管黏膜病变活检的肿瘤组织确诊为血管球瘤。由于患者没有危及生命的症状，未接受手术治疗。25个月的临床随访显示患者存活良好，无任何不适。
支气管血管球瘤在计算机断层扫描中通常不伴有钙化。据我们所知，我们报告了首例钙化性支气管血管球瘤。我们建议临床医生在发现支气管钙化肿块时，将血管球瘤作为可能的鉴别诊断。
