肺内孤立结节病灶24例临床分析

Clinical analysis of 24 cases of solitary pulmonary nodules

目的:分析24例肺内孤立性肺病灶(SPN)的发病特点、影像学表现、病理诊断、治疗及随访结果。方法:回顾性分析2007年7月-2010年12月经手术治疗的24例肺内孤立结节病灶的临床资料。结果:24例中恶性11例(45.8%):肺腺癌7例,鳞癌2例,小细胞癌1例,肺转移癌1例。肺良性病变13例(54.2%):肺结核球4例,错构瘤3例,硬化性血管瘤3例,炎性假瘤、神经纤维瘤、肺霉菌病各1例。结论:肺内孤立性肺病灶,病因多样,恶性约占50%,鉴别诊断上仍有一定困难。治疗上应采取积极的态度,及早手术切除,术中病理检查,恶性者以肺叶切除为主,良性者则应行局部切除包括肺楔形或病灶剔除术。

Objective：To analyze the etiology,imaging,pathological theraputic characteristics of solitary pulmonary nodules（ SPN）,and follow-up outcome. Methods：The clinical data of 24 patients with SPN underwent surgical oper-ation,from July 2007,to December 2010,were retrospectively analyzed. Results：Of 24 cases,11（45. 8%）cases were malignant including adenocarcinoma in 7,squamous cell carcinoma in 2,small cell carcinoma in 1 and metastatic tumor in 1. Another 13（54. 2%）cases were benign including tuberculoma in 4,hamartoma in 3,sclerosing hemangio-ma in 3,inflammatory pseudotumor,neurofibroma and fungal disease in 1. The wedge resection and lobectomy were performed based on the intraoperative pathological findings. Conclusion：SPN is comprised of various causes. Approxi-mately 50% are malignant which leads the differential diagnosis is difficult. Surgical intervention should be actively taken.