Zürcher M, Gerber H, Gebbers J O
Pathologisches Institut, Kantonsspital Luzern.
Chirurg. 1996 Sep;67(9):959-62. doi: 10.1007/pl00002546.
Carcinomas of the bronchi often infiltrate veins, particularly in advanced stages. Tumor propagation in pulmonary veins with intra-atrial extension has been reported. Systemic arterial tumor embolism is a potentially fatal hazard that is caused by surgery or it can be the initial manifestation of a bronchogenic carcinoma. The importance of early pulmonary venous ligation in lung cancer surgery, first stressed by Aylwin in 1951, is evident, particularly when intravenous tumor progression has been diagnosed preoperatively by echocardiography or CT scan. We report a case of lethal hemispheric brain infarction following tumor embolism during lobectomy for bronchus carcinoma. A review of the literature on this subject is presented; there were 38 cases of arterial tumor embolism because of primary lung neoplasms.
支气管癌常侵犯静脉，尤其是在晚期。已有报道肿瘤在肺静脉内蔓延并延伸至心房。系统性动脉肿瘤栓塞是一种潜在的致命风险，可由手术引起，也可能是支气管癌的首发表现。1951年艾尔文首次强调了肺癌手术中早期结扎肺静脉的重要性，这一点很明显，尤其是当术前通过超声心动图或CT扫描已诊断出静脉内肿瘤进展时。我们报告了1例在支气管癌肺叶切除术中肿瘤栓塞后发生致命性半球脑梗死的病例。本文对该主题的文献进行了综述；共有38例因原发性肺肿瘤导致的动脉肿瘤栓塞病例。
