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骨化性气管支气管病的临床特征:33例患者的回顾性研究

Clinical Characteristics of Tracheobronchopathia Osteochondroplastica: A Retrospective Study of 33 Patients.

作者信息

Liu Qiliang, Hu Yan, Lei Mei, Mei Chunlin, Yang Chengqing

机构信息

Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, Hubei, 430030, People's Republic of China.

出版信息

Int J Gen Med. 2023 Aug 14;16:3447-3455. doi: 10.2147/IJGM.S418394. eCollection 2023.

Abstract

INTRODUCTION

Tracheobronchopathia osteochondroplastica (TO) is a relatively rare benign tracheobronchial disease, which is often misdiagnosed or missed. To date, there is no specific treatment for TO. The aim of this study was to investigate the clinical manifestations, imaging features, bronchoscopy results, pathological findings, and diagnostic points of TO.

PATIENTS AND METHODS

A total of 33 patients diagnosed with TO were enrolled. Clinical data were collected using retrospective methods in the period from January 2021 and November 2022. Descriptive analysis was used.

RESULTS

Patients included 17 (51.5%) male and 16 (48.5%) female, with a median age of 54 years. The main clinical manifestations included cough in 15 cases, fever in 6 cases, chest tightness in 4 cases, haemoptysis in 3 cases, and chest pain in 4 cases. The time from the onset of symptoms to diagnosis was 1 week to 96 months. Some patients were diagnosed with other lung diseases, including 16 patients with tuberculosis, 2 patients with lung cancer, 3 patients with nontuberculous mycobacteriosis, 3 patients with tuberculous pleurisy, 2 patients with bronchiectasis, and 1 patient with pneumonia. Chest computed tomography (CT) scan demonstrated calcified nodules in 10 (30.3%) patients. In bronchoscopy, entire tracheal involvement was found in 21 (63.6%) patients, 12 (36.4%) patients were found to have involvement of only part of the trachea. The patients were divided into three groups according to the bronchoscopic presentation, the largest proportion was stage II (19/33), followed by stage I (8/33) and stage III (6/33). Histopathological findings showed squamous metaplasia, cartilaginous, and bony tissues.

CONCLUSION

TO is a slowly progressing disease with non-specific clinical symptoms and a low positive rate of imaging diagnosis, making it susceptible to misdiagnosis and missed diagnosis. The disease needs to be diagnosed by combining imaging features, fiberoptic bronchoscopy, and pathological findings.

摘要

引言

气管支气管骨软骨瘤病(TO)是一种相对罕见的良性气管支气管疾病,常被误诊或漏诊。迄今为止,TO尚无特效治疗方法。本研究旨在探讨TO的临床表现、影像学特征、支气管镜检查结果、病理表现及诊断要点。

患者与方法

共纳入33例诊断为TO的患者。采用回顾性方法收集2021年1月至2022年11月期间的临床资料,并进行描述性分析。

结果

患者中男性17例(51.5%),女性16例(48.5%),中位年龄54岁。主要临床表现为咳嗽15例、发热6例、胸闷4例、咯血3例、胸痛4例。从症状出现到确诊的时间为1周至96个月。部分患者被误诊为其他肺部疾病,其中肺结核16例、肺癌2例、非结核分枝杆菌病3例、结核性胸膜炎3例、支气管扩张2例、肺炎1例。胸部计算机断层扫描(CT)显示10例(30.3%)患者有钙化结节。支气管镜检查发现,21例(63.6%)患者气管全部受累,12例(36.4%)患者仅部分气管受累。根据支气管镜表现将患者分为三组,其中II期比例最高(19/33),其次是I期(8/33)和III期(6/33)。组织病理学表现为鳞状化生、软骨和骨组织。

结论

TO是一种进展缓慢的疾病,临床症状不具特异性,影像学诊断阳性率低,易误诊和漏诊。该病需要结合影像学特征、纤维支气管镜检查及病理表现进行诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4af/10438451/bd13276ff5fe/IJGM-16-3447-g0001.jpg

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