肺海绵状血管瘤二例并文献复习

Clinical analysis of pulmonary cavernous hemangioma:a report of two cases and review of the literature

目的探讨肺海绵状血管瘤(cavernous hemangioma)的临床特点、诊断及治疗方法。方法报告我院2例肺海绵状血管瘤,并结合国内1981年1月至2010年10月近30年间文献报道的41例患者的临床资料进行分析。结果 43例患者中女32例,男11例,发病年龄13～72岁,平均(44.3±15.9)岁。临床表现为咳嗽、咳痰、痰中带血、咯血、胸闷、胸痛以及突发呼吸困难和休克等,也可无临床症状,于体检发现。临床诊断3例患者为血管瘤,其余误诊为肺癌、结核、炎性假瘤、肺囊肿、肺隔离症、何杰金氏病、错构瘤及自发性血气胸等。43例患者均行手术治疗,无手术死亡。结论肺海绵状血管瘤是一种肺部罕见良性肿瘤,临床表现缺乏特异性,术前误诊率高,影像资料有助于诊断,确诊依靠病理诊断,手术切除治疗疗效确切。

Objective To study the clinical characteristics and diagnosis, treatment of pulmonary cavernous hemangioma. Methods The clinical records of 2 patients with pulmonary. cavernous hemangioma admitted in our hospital were analyzed and the other 41 cases from the domestic literature from Jan 1981 to Oct. 2010 were reviewed. Results There were 43 pulmonary cavernous hemangioma patients（ 32 patients were female）. The average age of patients was（44.3 ± 15.9） years （rang, 13-72 years ）. Their main clinical manifestations were cough, expectoration, bloody sputum, hemoptysis, chest pain and chest distress, sudden dyspnoea, shock, and so on. Whereas, without any symptoms, some of these cases were found in the ordinary physical examination. Unfortunately, only 3 patients were diagnosed as pulmonary hemangioma, the others were misdiagnosed as lung cancer, tuberculosis, inflammatory pseudotumor, pulmonary cyst, lung isolation, Hodgkin~ disease, hamartomas, spontaneous pneumohemothorax, and so on. All of the 43 patients were underwent the operation without any complications and death. Conclusion Pulmonary cavernous hemangioma was a rare benign tumor of lung, which were often wrongly diagnosed because of atypical clinical behaviors, radiological features were helpful for the diagnosis of pulmonary cavernous hemangioma, however, pathology diagnosis can make a definite diagnosis about the disease. The surgical effect was confirmed.