Moran C A, Suster S, Koss M N
Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, D.C.
Mod Pathol. 1994 Feb;7(2):212-4.
Four cases of endobronchial lipomas are presented. The patients were men between 45 and 54 yr of age. Clinically, two of the patients presented with cough and one with shortness of breath. Two lesions were located in the left lower lobe, one in the right upper lobe, and one in the right lower lobe. Because of the clinical suspicion of malignancy, all patients underwent radical surgical procedures; lobectomy was performed in 3 patients, and pneumonectomy in one. Grossly, all the lesions were characterized by well-circumscribed, soft, yellow nodules that ranged in size from 1.2 to 3.0 cm in greatest diameter. Histologically, the tumors resembled lipomas in other locations, i.e., they were composed of mature adipose tissue devoid of atypia. In two cases, prominent spindle cell areas were also present similar to those of spindle cell lipoma. Identification of the lesion by endoscopic and radiologic means may help avoid unnecessary radical surgery. A review of the literature on these unusual lesions is presented along with a discussion of their differential diagnosis.
本文报告了4例支气管内脂肪瘤病例。患者为45至54岁的男性。临床上，2例患者表现为咳嗽，1例表现为呼吸急促。2个病灶位于左下叶，1个位于右上叶，1个位于右下叶。由于临床怀疑为恶性肿瘤，所有患者均接受了根治性手术；3例行肺叶切除术，1例行全肺切除术。大体上，所有病灶均表现为边界清楚、质地柔软的黄色结节，最大直径为1.2至3.0厘米。组织学上，肿瘤与其他部位的脂肪瘤相似，即由无异型性的成熟脂肪组织组成。在2例病例中，还存在类似于梭形细胞脂肪瘤的显著梭形细胞区域。通过内镜和放射学手段识别病变可能有助于避免不必要的根治性手术。本文对这些不常见病变的文献进行了综述，并讨论了它们的鉴别诊断。
