42例肺错构瘤临床分析

A clinical analysis of 42 cases of pulmonary hamartoma

目的研究42例肺错构瘤的临床特点、诊断要点、病理特点和治疗方案。方法应用回顾性调查的方法对肺内及支气管腔内型错构瘤进行分析。结果经手术病理证实错构瘤42例,男女比例为1.2∶1,中位年龄52岁,60%体检胸部X线检查时发现病灶,左肺:右肺为1.1∶1。胸片及胸部CT中25%有散在斑点状钙化。3例术前诊断为肺错构瘤,其余分别误诊为肺癌、肺结核、肺囊肿等,误诊率93%(39/42)。结论肺错构瘤的术前误诊率很高,根据临床及病理特点和诊断要点并与临床最易误诊的肺癌、肺结核等展开鉴别诊断,有助于进一步提高确诊率和治疗方案的制订。

Objective To analyze the clinical features, pathological characteristics, diagnosis and treatment of pulmonary hamartoma. Methods Forty - two cases of pulmonary and bronchial hamatoma admitted from 1993 to1999 were retrospectively reviewed and their clinical and pathological features and the diagnosis and treatment were analyzed. Results Most of patients with pulmonary hamartoma had apparent clinical symptoms and 60% were discovered in physical examination of chest. The ratio of site of lesions in left lung to right lung was 1.1 ： 1. In 25% of all chest X - ray and CT scan, scatterred spot - like calcifications were found. Three cases were diagnosed as pulmonary hamatoma while the others were mis - diagnosed as lung cancer, tuberculosis and pulmonary cyst,et al. The rate of miss - diagnosis was 93% （39/42）. Conclusion Pulmonary hamatoma is one of the most common benign tumors but the rate of pre - operative misdiagnosis is high. Therefore, the clinical course of the disease, the characteristics of X - ray and CT scan and the pathological examinations must be carefully studied.