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经支气管内镜切除治疗支气管神经纤维瘤 1 例罕见病例报告并文献复习。

A rare case report of endobronchial neurofibroma treated with transbronchial endoscopic resection and literature review.

机构信息

Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang Province, China.

Department of Pathology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2024 Sep 20;103(38):e39730. doi: 10.1097/MD.0000000000039730.

Abstract

RATIONALE

Endobronchial neurofibroma is an extremely rare neoplastic disease. The majority of endobronchial neurofibroma are symptomatic, but nonspecific. The treatment of endobronchial neurofibroma is controversial that surgery is previously considered to be the main option. With the development of bronchoscopic intervention, most endobronchial neurofibroma can be treated with transbronchial endoscopic resection with few complications. Here we reported a case of diagnosed endobronchial neurofibroma that was successfully resected with transbronchial electrical snaring and laser coagulation. Moreover, the relevant literature was reviewed to raise awareness of this disease.

PATIENT CONCERNS

A 57-year-old man presented to our hospital with cough, sputum, and shortness of breath for 2 days. Physical examination was normal. Laboratory tests revealed moderately increased C-reactive protein. Chest computed tomography showed a 10 × 8 mm round, polypoid-shaped nodule located in the left main bronchus, which was heterogeneous after contrast enhancement. It demonstrated a smooth, round, hypervascularized neoplasma obstructing most of the lumen of the upper left main bronchus under bronchoscopy.

INTERVENTIONS AND OUTCOMES

The tumor was removed with electrical snaring and laser coagulation completely instead of surgical resection, without any complications. Pathologically, it was confirmed of endobronchial neurofibroma. Repeated bronchoscopy showed no recurrence of the tumor, and the procedure site healed with a little of fibrotic scar formation.

LESSONS

Endobronchial neurofibroma is rare. Although the standard treatment for endobronchial neurofibroma is surgery, transbronchial endoscopic resection (electrical snaring and laser coagulation) is an applicable option, especially for those lesions strictly in the lumen.

摘要

背景

支气管神经纤维瘤是一种极为罕见的肺部肿瘤。大多数支气管神经纤维瘤是有症状的,但缺乏特异性。支气管神经纤维瘤的治疗存在争议,传统上手术被认为是主要的治疗手段。随着支气管镜介入技术的发展,大多数支气管神经纤维瘤可以通过经支气管内镜切除来治疗,且并发症较少。在此,我们报告了一例成功通过经支气管电圈套和激光凝固切除的支气管神经纤维瘤病例,并对相关文献进行了复习,以提高对这种疾病的认识。

病例介绍

一名 57 岁男性因咳嗽、咳痰和呼吸困难 2 天就诊于我院。体格检查正常。实验室检查显示 C 反应蛋白中度升高。胸部 CT 显示左主支气管内有一个 10×8mm 的类圆形、息肉样结节,增强后不均匀。支气管镜下可见一个光滑、圆形、富血管的肿瘤,阻塞了左上主支气管的大部分管腔。

干预措施和结果

该肿瘤通过电圈套和激光凝固完全切除,而不是手术切除,没有任何并发症。病理证实为支气管神经纤维瘤。重复支气管镜检查显示肿瘤无复发,术区愈合,仅留有少许纤维性瘢痕。

结论

支气管神经纤维瘤罕见。虽然支气管神经纤维瘤的标准治疗方法是手术,但经支气管内镜切除(电圈套和激光凝固)是一种可行的选择,尤其是对于那些局限于管腔的病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98c/11419446/fd68d39479d2/medi-103-e39730-g001.jpg

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