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高龄患者的类癌性胸腺瘤:纵隔穿刺活检联合计算机断层扫描的诊断价值

[Carcinoid thymus tumor at an advanced age: diagnostic value of mediastinal needle biopsy with computerized tomography].

作者信息

Perdu D, Lavaud F, Masure M, Prévost A, Delépine G, Baehrel B, Adnet J J

机构信息

Département des Maladies Respiratoires et Allergiques, Reims.

出版信息

Rev Mal Respir. 1996;13(2):187-90.

PMID:8711239
Abstract

Carcinoid tumour of the thymus is a rare neuroendocrine tumour particularly at an advanced age. The authors report a case of a mediastinal mass in a man aged 85, the mass had remained asymptomatic for a long time. It was decided to achieve a diagnosis because the tumour was causing local compression: a mediastinal needle biopsy under computerised tomographic control confirmed that this was a carcinoid tumour and a study of the biopsy material using an electron microscope showed neurosecretory granules. A sternotomy enabled the tumour to be excised but a post-operative Pseudomonas pneumonia led to the death of the patient. This case underlines the diagnostic place of mediastinal needle biopsy in the presence of a mediastinal tumour. The technique can be carried out under computerised tomography or ultrasonography and this can be associated with a study of the biopsy specimen using electron microscopy which enables the diagnosis to be made before any therapeutic decisions. The treatment of choice of a carcinoid tumour of the thymus is surgery which confirms the tumour limits and also its thymic origin. Tumour excision can be completed using radiotherapy or even chemotherapy.

摘要

胸腺类癌是一种罕见的神经内分泌肿瘤,在老年人群中尤为少见。作者报告了一例85岁男性纵隔肿块病例,该肿块长期无症状。由于肿瘤引起局部压迫,决定进行诊断:在计算机断层扫描控制下进行纵隔针吸活检,证实为类癌肿瘤,对活检材料进行电子显微镜检查显示有神经分泌颗粒。胸骨切开术使肿瘤得以切除,但术后发生的铜绿假单胞菌肺炎导致患者死亡。该病例强调了在纵隔肿瘤存在时纵隔针吸活检的诊断地位。该技术可在计算机断层扫描或超声检查下进行,并且可以结合对活检标本进行电子显微镜检查,这能够在做出任何治疗决策之前进行诊断。胸腺类癌的首选治疗方法是手术,手术可确定肿瘤边界及其胸腺起源。肿瘤切除后可辅以放疗甚至化疗。

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