Zhang Guang-Lei, Chen Shu, Li Jin-Dong, Wang Chun-Guang
Department of Thorax, Second Hospital of Jilin University, Changchun, China.
Front Surg. 2021 May 21;8:658749. doi: 10.3389/fsurg.2021.658749. eCollection 2021.
The definition of endobronchial metastasis (EBM) lacks clarity because it is currently based on the judgments of surgeons; it is rare in patients with nonpulmonary malignancies. Although EBM represents an advanced stage of malignancy, it does not necessarily indicate a poorer prognosis than that for its primary tumors. The present study defines EBM as bronchoscopy-visible lesions with histologically confirmed primary extrapulmonary tumors, excluding those primary lung tumors with involvement of the bronchial lumen. A bronchoscopy and biopsy provide strong proof for diagnosis. Complete surgical resection is the best choice for patients with EBM. This study analyzed the case of a 69-year-old male patient who had undergone a radical left nephrectomy several years previously after the identification of a bronchoscopy-visible lesion in the left main bronchus. The lesion was initially diagnosed as an angiogenic tumor but was eventually confirmed by surgical biopsy as EBM from the left kidney. After diagnosis, the patient underwent a left pneumonectomy. The analysis of this case focused on diagnosis, symptoms, radiographic findings, treatment, and prognosis. A review of the previous literature relating to EBM was also conducted.
支气管内转移（EBM）的定义尚不明确，因为目前它是基于外科医生的判断；在非肺部恶性肿瘤患者中较为罕见。尽管EBM代表恶性肿瘤的晚期阶段，但它并不一定意味着预后比其原发肿瘤更差。本研究将EBM定义为经组织学证实的原发性肺外肿瘤且支气管镜可见的病变，不包括累及支气管腔的原发性肺肿瘤。支气管镜检查和活检为诊断提供有力证据。对于EBM患者，完整的手术切除是最佳选择。本研究分析了一名69岁男性患者的病例，该患者几年前在左主支气管发现支气管镜可见病变后接受了根治性左肾切除术。该病变最初被诊断为血管生成性肿瘤，但最终经手术活检确认为来自左肾的EBM。确诊后，患者接受了左肺切除术。该病例分析聚焦于诊断、症状、影像学表现、治疗及预后。同时还对先前有关EBM的文献进行了综述。
