Messineo A, Mognato G, D'Amore E S, Antoniello L, Guglielmi M, Cecchetto G
Department of Pediatrics, University of Padua, Italy.
Med Pediatr Oncol. 1998 Aug;31(2):100-4. doi: 10.1002/(sici)1096-911x(199808)31:2<100::aid-mpo10>3.0.co;2-r.
Inflammatory pseudotumors (inflammatory myofibroblastic tumors) of the lung are myofibroblastic lesions of controversial nosology. The concept that these are benign lesions has been recently questioned given their capacity for local invasion and recurrence.
We observed five children with inflammatory pseudotumors of the lung in whom the tumor was resected using the most limited excision possible. Unusually, in all five cases the tumor was localized in the right upper lobe: Three were parenchymal, and the others involved the bronchus. The three parenchymal masses underwent wedge resection, whereas the two bronchial lesions required ex-cision followed by a bronchoplasty and an up-per lobectomy, respectively. In all, the pathology showed a complete resection, and the patients had uneventful recoveries. Follow-ups, including CT and bronchoscopies, ranged from 4 to 8 years (mean of 6.4 years) with no signs of recurrence.
Our limited experience supports the idea that excisional surgery is the treatment of choice for inflammatory pseudotumors of the lung. Such excisions, both diagnostic and curative, carry minimal risks and avoid unnecessary mutilation. Closely monitored follow-up is mandatory, as the natural history of this lesion is not yet well understood.
肺炎性假瘤（炎性肌纤维母细胞瘤）是分类学上存在争议的肌纤维母细胞性病变。鉴于其具有局部侵袭和复发的能力，其为良性病变这一概念最近受到了质疑。
我们观察了5例肺炎性假瘤患儿，尽可能采用最有限的切除方式切除肿瘤。不同寻常的是，所有5例肿瘤均位于右上叶：3例为实质性肿瘤，另外2例累及支气管。3例实质性肿块行楔形切除术，而2例支气管病变分别需要切除并进行支气管成形术和上叶切除术。总体而言，病理显示为完全切除，患者恢复顺利。随访包括CT和支气管镜检查，时间为4至8年（平均6.4年），无复发迹象。
我们有限的经验支持这样的观点，即手术切除是肺炎性假瘤的首选治疗方法。这种切除，无论是诊断性还是治愈性的，风险极小，且可避免不必要的致残。由于对该病变的自然病程尚未完全了解，因此必须进行密切监测随访。
