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[肺错构瘤:非典型病例及当前的治疗理念]

[Pulmonary hamartoma: atypical cases and current concept of management].

作者信息

Nagamatsu K, Iwasaki A, Matsuzoe D, Kume T, Yoshinaga Y, Yoneda T, Yamashita Y, Shirakusa T

机构信息

Second Department of Surgery, Fukuoka University, School of Medicine.

出版信息

Rinsho Kyobu Geka. 1994 Dec;14(6):535-9.

PMID:9423136
Abstract

Twenty seven cases of surgically excised pulmonary hamartomas were reviewed. Patient's ages varied from twenty eight year-old to seventy seven year-old with an average of fifty three year-old. Of twenty seven cases, seventeen cases were man, seventeen cases has mass on right lung, and twenty six cases has solitary mass. While twenty five cases were asymptomatic, one case had cough, and the other cases had a history of hemoptysis (Case 3). Medical treatment for pulmonary tuberculosis had been continued unless the confirmed diagnosis on two cases. On one case followed as tuberculosis for twelve years, size of tumor shadow grew to two times bigger on chest X-ray films (Case 1). One of 27 cases showed multiple mass (Case 2). Histopathologically, twenty six cases were chondromatous hamartoma, and one case was non-chondromatous hamartoma. Pulmonary hamartoma is a benign tumor, and majority of cases are asymptomatic and not growing. On cases with presumed pulmonary hamartoma, less invasive thoracoscopic surgery seemed valuable for both therapeutic and diagnostic purpose to avoid continuous non-rational treatment and mental pressure of patient by prolonged follow up with unconfirmed diagnosis since complete differentiation from malignant neoplasm should not satisfactory on many cases.

摘要

回顾了27例手术切除的肺错构瘤病例。患者年龄从28岁至77岁不等,平均年龄为53岁。27例中,男性17例,17例肿块位于右肺,26例为孤立性肿块。25例无症状,1例有咳嗽,其他病例有咯血史(病例3)。2例未经确诊前一直按肺结核进行治疗。1例按肺结核随访12年,胸部X线片显示肿瘤阴影增大至原来的2倍(病例1)。27例中有1例显示为多发肿块(病例2)。组织病理学检查,26例为软骨瘤型错构瘤,1例为非软骨瘤型错构瘤。肺错构瘤是一种良性肿瘤,大多数病例无症状且不生长。对于疑似肺错构瘤的病例,由于在许多情况下与恶性肿瘤的完全鉴别并不令人满意,通过长期随访未确诊会给患者带来持续的不合理治疗和心理压力,因此微创胸腔镜手术对于治疗和诊断目的似乎都很有价值,可以避免这种情况。

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