拟诊肺癌而行全肺切除的良性病变

Pulmonary Benign Disease Misdiagnosed as Lung Cancer Treated with Pneumonectomy

[目的]探讨肺内良性病变诊为肺癌而行全肺切除的原因。[方法]回顾性分析1998年8月～2008年8月因拟诊肺癌而行全肺切除的良性疾病患者14例的临床资料。[结果]14例患者术前均拟诊为肺癌,行左全肺切除术11例,右全肺切除3例。术后病理为肺结核8例(3例伴淋巴结结核),肺脓肿2例,炎性假瘤2例,炎性肉芽肿1例,错构瘤1例。术后3例出现并发症(肺动脉栓塞2例,ARDS1例),并发症发生率为21.4%,无围手术期死亡发生。[结论]肺结核、炎性肉芽肿、肺脓肿、炎性假瘤、错构瘤是最易诊为肺癌而行全肺切除的良性疾病,应严格把握肺内良性病变行全肺切除的手术指征。

[Purpose] To explore the cause of pulmonary benign disease misdiagnosed as lung cancer treated with pneumoneetomy. [Methods] The clinical data of 14 cases with pulmonary benign diseases misdiagnosed as lung cancer treated with pneumonectomy from Aug. 1998 to Aug. 2008 were analyzed retrospectively. [Results] Of the 14 Cases, 11 cases underwent left pneumonectomy; 3 cases, fight pneumonectomy. Postoperative pathological revealed 8 cases with pulmonary tuberculosis （3 cases with lymph node tuberculosis）, 2 cases with lung abscess, 2 cases with inflammatory pseudotumor of lung, 1 case with inflammatory granuloma and 1 case with hamartoma. Postoperative complication was found in 3 cases （21.4%） including 2 cases with pulmonary embolism and 1 ARDS. No death occurred perioperation. [Conclusion] The most common benign diseases misdiagnosed as lung cancer undergoing pneumoneetomy are pulmonary tuberculosis, hamartoma, inflammatory pseudotumor, lung abscess, inflammatory granuloma and hamartoma. More attention should be paid to surgical indication for total pneumonectomy with pulmonary benign diseases.