12例肺恶性纤维组织细胞瘤的诊断与治疗

Diagnosis and Treatment of Primary Malignant Fibrous Histocytoma of the Lung(Report of 12 Cases)

对肺恶性纤维组织细胞瘤１２例进行了回顾性分析，旨在提高对其临床表现、诊断和外科处理的认识。结果本组病人病程长短差异较大，胸部Ｘ线、ＣＴ检查缺乏特征性表现，气管镜及痰脱落细胞学检查阳性率不高，术后局部复发率为３３．３％，远处转移率为４１．７％，３年生存率为２５％。结论：肺恶性纤维组织细胞瘤应以手术治疗为主，如能早期诊断，彻底切除并配合放、化疗综合治疗，可望改善其不良预后。

Aim:To summarize the clinical features and the results of surgical treatment of primary pulmonary malignant fibrous histocytoma(MFH).Clinical material and method:Twelve patients with MFH were treated surgically.There were 7 men and 5 women.The mean age was 52 years with a range of 16 to 64 years.The duration of the disease ranged from 1 month to 13 years.6 patients had a history of smoking.Preoperative chest radiographys showed a mass lesion in 10 and a giant tumor occupied hemithorax in 2.MFH was located in following sites:7 for the upper lobe,4 for the lower lobe and 1 for the middle lobe.The average size of the tumor was 7.2 cm with a range of 3.5 to 22.0 cm.Results:All 12 patients were misdiagnosed before surgery(lung cancer,8;inflammatory pseudotumor,2;and mediastinal teratoma,2).The local recurrence rate and metastatic rate were 33.3% and 41.2%,respectively.The 3year survival rate was 25%.Conclusion:Because this disease is not common and has similar clinical features as other lung neoplasms,there is often a delay in diagnosis and a poor prognosis.Early diagnosis,radical resection and the combination of postoperative chemoradiotherapy may improve the outcome.