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小儿诊断中酷似肌成纤维细胞性气管肿瘤的哮喘症状

Asthma Symptoms Mimicking Myofibroblastic Tracheal Tumor in Pediatric Diagnosis.

作者信息

Figueroa-Hurtado Esperanza, Peña Mario J, Cortes-Telles Arturo

机构信息

Respiratory Diseases Clinic, Regional Hospital of High Specialty of the Yucatan Peninsula, Instituto Mexicano del Seguro Social-Bienestar, Merida, MEX.

Thoracic Surgery, Hospital Infantil de México Federico Gomez, Mexico City, MEX.

出版信息

Cureus. 2024 Nov 20;16(11):e74097. doi: 10.7759/cureus.74097. eCollection 2024 Nov.

DOI:10.7759/cureus.74097
PMID:39712775
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11661893/
Abstract

Tracheal tumors in pediatric patients are rare, accounting for 2% of all airway abnormalities and 0.2% of all pediatric tumors. Diagnosis is often delayed due to the heterogeneity of presenting symptoms, such as stridor and wheezing, which are frequently misattributed to other conditions. We report the case of a previously healthy nine-year-old male who was diagnosed with an inflammatory myofibroblastic tumor (IMT) following five months of persistent airway symptoms, including cough, biphasic stridor, wheezing, and dyspnea. Despite evaluation by multiple physicians and treatment for presumed asthma, his symptoms did not fully resolve. Imaging studies ultimately confirmed the diagnosis, and surgical resection of the tracheal tumor was performed. In the late postoperative period (12 weeks), the patient continued to experience cough and dyspnea. Given a family history of asthma (father with asthma), spirometry with a bronchodilator was conducted, confirming a diagnosis of asthma alongside IMT. The patient is currently alive and undergoing treatment in Step 2 of the Global Initiative for Asthma (GINA) guidelines. This case highlights the importance of a thorough evaluation in children with persistent stridor and wheezing to rule out underlying tracheobronchial pathologies.

摘要

小儿气管肿瘤较为罕见,占所有气道异常的2%,占所有小儿肿瘤的0.2%。由于症状表现的异质性,如喘鸣和喘息,诊断往往会延迟,这些症状常常被误诊为其他疾病。我们报告一例病例,一名既往健康的9岁男性,在持续出现气道症状(包括咳嗽、双相性喘鸣、喘息和呼吸困难)5个月后,被诊断为炎性肌纤维母细胞瘤(IMT)。尽管经过多位医生的评估并接受了疑似哮喘的治疗,但其症状并未完全缓解。影像学检查最终确诊,随后对气管肿瘤进行了手术切除。术后晚期(12周),患者仍持续咳嗽和呼吸困难。鉴于其家族中有哮喘病史(父亲患有哮喘),进行了支气管扩张剂肺功能测定,确诊为哮喘合并IMT。该患者目前健在,正在按照全球哮喘防治创议(GINA)指南的第2步接受治疗。本病例强调了对持续喘鸣和喘息的儿童进行全面评估以排除潜在气管支气管病变的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33d3/11661893/c9ef474aa084/cureus-0016-00000074097-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33d3/11661893/c9ef474aa084/cureus-0016-00000074097-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33d3/11661893/c9ef474aa084/cureus-0016-00000074097-i01.jpg

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