82例肺部炎性假瘤的外科治疗

Surgical treatment of the pulmonary inflammatory pseudotumor:a report of 82 cases

目的探讨肺部炎性假瘤的临床特点、诊断和治疗。方法回顾我院自1995年1月至2005年1月期间收治82例肺部炎性假瘤患者的临床资料。结果全组患者均行手术治疗且病愈出院,术前诊断为炎性假瘤32例,结核球12例,肺癌12例,错构瘤7例,肺部占位病变性质待定19例;行肺叶切除59例(80.0%),肺叶楔型切除16例(19.5%),肺段切除6例(7.3%),全肺切除1例(1.2%)。结论肺炎性假瘤是肺实质内的增生性肉芽肿,由于其临床表现和影像学特征缺乏特异性,诊断困难,误诊率高,常误诊为肺癌,有必要提高对本病的认识。治疗原则仍为手术治疗,术中常规组织冰冻检查是决定手术方式的关键,手术应尽可能保留正常肺组织。

Objective To explore the clinical characteristics, diagnosis and the treatment of the pulmonary inflammatory pseudotumor. Methods From January 1995 to January 2005, eighty-two cases of inflammatory pseudoneoplasm were treated in our hospital. The clinical data were analysed retrospectively. Resuits All patients underwent operation. The number of patients with pulmonary inflammatory pseudotumors, tuberculoma,lung cancer, hamartoma and other lung benign tumors were diagnosed in 32, 12, 12, 7, 19 cases respectively before operation. Among them, 59 （71.9%） cases received lobectomy, 16 cases （ 19. 5% ） received wedge resection of lung, 6 cases（7. 3% ）received segmental resection of lung and 1 case（ 1.2% ） received pneumonectomy. All the patients were cured and discharged. Conclusions The inflammatory pseudotumor is the proliferative granuloma in the pulomonary parenchyma. Because it lacks characteristic clinical feature and radiographic imaging, the diagnosis of inflammatory pseudotumor of lung is quite difficult, and it was often misdiagnosed as lung cancer, the misdiagnosis rate before operaton is high. It is necessary to improve the knowledge of this disease. The principle of treatment is surgery and frozen biopsy during the operation is helpful to determining the modality of operation. The operation should reserve the normal lung tissues as far as possible.