Vázquez-Pelillo J C, Peña E, Moreno N, Orusco E, González-Aragoneses F, Folqué E
Servicio de Cirugía Torácica, Hospital General Universitario Gregorio Marañón, Madrid.
Arch Bronconeumol. 1996 Jan;32(1):43-6. doi: 10.1016/s0300-2896(15)30838-3.
Localized fibrous tumor is an uncommon neoplasm that is usually located in the visceral pleura. Histologically these tumors are composed of randomly arranged fascicles or networks of fusiform cells, among which there is a varying amount of collagen. Most authors consider that these cells originate in submesothelial mesenchymal cells. The condition is normally silent, though hypoglycemia, hypertrophic osteoarthropathy or other symptoms sometimes result. The treatment of choice is total resection and imaging techniques are extremely helpful for establishing surgical strategy, even though surgery is often performed before a histopathologic diagnosis is available. We present 2 patients with intrapulmonary fibromas that were histologically identical to localized fibrous pleural tumors. These tumors are rarely found in the parenchyma and multiple bilateral presentation is exceptional, having been described only once in the literature. One of our patients had a single pulmonary node that happened to be noticed on an X-ray. The other had multiple bilateral nodes that required several surgical procedures; the intraparenchymatous location for this type of tumor has not been described to date. We discuss clinical, therapeutic and histopathological aspects of these tumors and review the literature.
局限性纤维瘤是一种罕见的肿瘤,通常位于脏层胸膜。从组织学上看,这些肿瘤由梭形细胞随机排列的束状或网状结构组成,其中有不同数量的胶原纤维。大多数作者认为这些细胞起源于间皮下间充质细胞。这种情况通常没有症状,不过有时会导致低血糖、肥大性骨关节病或其他症状。首选治疗方法是完全切除,尽管手术通常在获得组织病理学诊断之前进行,但成像技术对于制定手术策略非常有帮助。我们报告2例肺内纤维瘤患者,其组织学表现与局限性纤维性胸膜肿瘤相同。这些肿瘤很少见于肺实质,双侧多发的情况更是罕见,文献中仅描述过1次。我们的1例患者有一个偶然在X线检查时发现的单个肺结节。另1例患者有双侧多发结节,需要进行多次手术;迄今为止,尚未有关于此类肿瘤位于肺实质内的报道。我们讨论了这些肿瘤的临床、治疗和组织病理学方面,并对文献进行了综述。