肺炎性假瘤九例临床分析

A Clinical Analysis of 9 Cases with Misdiagnosis of Pulmonary Inflammatory Pseudotumor

目的探讨肺炎性假瘤的临床特点、诊断及手术治疗方法。方法回顾性分析9例肺炎性假瘤患者的临床资料。结果术前诊断为本病者3例,误诊为肺癌5例、结核球1例。行肺叶切除8例,楔形切除1例,均痊愈出院。结论本病从临床症状及影像学上很难与肺癌鉴别,纤维支气管镜及CT引导下经皮肺穿刺活组织检查是术前诊断本病的重要方法。强调选择术式应以术前或术中病理学诊断为依据,避免过多切除正常的肺组织。

Objective To evaluate the clinical characteristics, diagnosis and operative treatment of pulmonary inflammatory pseudotumor （PIP）. Methods The clinical data of 9 cases PIP were retrospectively analyzed. Results Of all the cases, 3 were correctly diagnosed as pulmonary inflammatory pseudotumor, while 6 were misdiagnosed, among them 5 as lung cancer, 1 as tuberculoma. Operative resections were carried out in all cases with 8 lobectomies, 1 wedge - shaped resection. All cases were recovered smoothly and discharged in good condition. Conclusion It is difficult to differentiate PIP from lung cancer in respect of clinical symptoms and imaging manifestations. Fiberoptic bronchoscopic examination and trans - skin puncture biopsy of lung lesion under X - CT guiding are important preoperative diagnostic measures. The proper kind of lung resection should be determined by preoperative or operative pathological biopsy diagnosis of lung lesion, and excessive resection of normal lung tissues should be avoided.