Wongsangiem M, Tangthangtham A
Central Chest Hospital, Nonthaburi, Thailand.
J Med Assoc Thai. 1996 Nov;79(11):689-97.
A series of 190 patients with primary mediastinal tumors have been reviewed, typing of the tumors is according to pathological findings. The most common type of primary mediastinal tumors in this study was tumors of germ cell origin which comprised 38.9 per cent of total cases. Most patients were adults with a median age of 33.1 years and male to female ratio was 1.24:1. The characteristic of each type of tumor has been discussed. The common presenting symptoms were dyspnea, chest pain, and coughing, hemoptysis may occur in some cases. Only 7.9 per cent of cases were asymptomatic and all were discovered during the so-called "routine" chest X-ray examination. The diagnosis can be reached by the radiographic finding of mediastinal shadows. Bronchoscopy is commonly valuable to confirm external compression of the trachea and bronchi as well as revealing the invasion of the mediastinal tumors into the bronchial lumen. Pathological findings of the tissue sections obtained from fine needle aspiration or biopsy, as well as surgical specimen can provide the definite diagnosis and classification of the tumors. The benign tumors were successfully removed by surgery. As some types of malignant tumors are either chemosensitive or radiosensitive; chemotherapy and/or radiotherapy carries a potential survival benefit and should be incorporated into the multimodality approach to prolong disease-free survival.
回顾了190例原发性纵隔肿瘤患者，肿瘤分型依据病理结果。本研究中最常见的原发性纵隔肿瘤类型是生殖细胞起源的肿瘤，占总病例数的38.9%。大多数患者为成年人，中位年龄为33.1岁，男女比例为1.24:1。讨论了每种肿瘤类型的特点。常见的症状为呼吸困难、胸痛、咳嗽，部分病例可能出现咯血。仅7.9%的病例无症状，均在所谓的“常规”胸部X线检查时发现。通过纵隔阴影的影像学表现可作出诊断。支气管镜检查通常有助于确认气管和支气管的外部受压情况，以及揭示纵隔肿瘤侵犯支气管腔的情况。经细针穿刺或活检获取的组织切片以及手术标本的病理结果可提供肿瘤的明确诊断和分类。良性肿瘤通过手术成功切除。由于某些类型的恶性肿瘤对化疗或放疗敏感；化疗和/或放疗具有潜在的生存益处，应纳入多模式治疗方法以延长无病生存期。
