24例肺硬化性血管瘤的诊疗分析

Diagnosis and Therapeutics of 24 Cases of Pulmonary Sclerosing Hemangioma

背景与目的:肺硬化性血管瘤是一种少见的肺部良性肿瘤,本研究拟探讨其临床特点、诊断、治疗和预后情况,以进一步提高对该病的认识。方法:收集1999年1月至2007年7月中山大学肿瘤防治中心收治的24例肺硬化性血管瘤的临床资料,回顾性分析其临床特点、诊断、治疗及预后情况。结果:本组24例经石蜡病理切片证实为肺硬化性血管瘤的患者中,男性2例(8.3%),女性22例(91.7%);发病年龄21～76岁,中位年龄54.5岁;10例(41.7%)患者系体检发现,14例(58.3%)因咳嗽、咳血丝痰、胸痛、胸闷或气促等症状而就诊;影像学检查表现多为肺内孤立、边界清晰、密度均匀、圆形或类圆形的结节影,均未见点状钙化及空气新月征;全组病例均接受外科治疗,8例(33.3%)行肺叶切除术,13例(54.2%)行肺楔形切除术,2例(8.3%)行肿瘤摘除术,1例(4.2%)行肺段切除术,无手术相关并发症及手术死亡;术后随访,无复发转移。结论:肺硬化性血管瘤临床症状和影像学表现无特异性,术前诊断困难,确诊依靠病理,外科手术是有效治疗方法,可考虑肺叶切除或局限性切除,系统淋巴结清扫不推荐作为常规。

BACKGROUND ＆ OBJECTIVE： Pulmonary sclerosing hemangioma （PSH） is an uncommon benign lung tumor. The study was to investigate the clinical features, diagnosis, treatment, and prognosis of PSH in order to promote the recognition of this disease. METHODS： Data of 24 pathologically confirmed PSH patients treated in Sun Yat-sen University Cancer Center from Jan. 1999 to Jul. 2007 were reviewed. The clinical features, diagnosis, treatment, and prognosis were summarized. RESULTS.. Of the 24 patients, two （8.3%） were males, and 22 （91.7%） were females. The median age of the patients was 54.5 years old, ranging from 21 to 76 years old. Ten （41.7%） patients were detected upon routine medical examination, while 14 （58.3%） patients phesented clinical symptoms, including cough, hemoptysis, chest pain, chest distress and tachypnea. The imaging examination revealed isolated round or similar round nodules with distinct margins and homogeneous density. No calcification and aerial semilunar sign appeared. All the patients received surgical resection without complications and mortality. Eight patients underwent Iobectomy, 13 underwent wedge resection, two underwent tumor resection and one underwent segmentectomy. There was no recurrence or metastasis during follow-ups, CONCLUSIONS.. Clinical and radiological characteristics of PSH are nonspecific. Thus, accurate diagnosis of PSH before operation is difficult. Confirmation of PSH depends on pathological examination. Surgical resection is an effective treatment for PSH, among which Iobectomy or limited resection is advisable, while systematic lymph node dissection is not recommended.