原发性肺动脉肿瘤1例报道并文献复习

Primary pulmonary artery tumor: A case report and literature review

目的探讨原发性肺动脉肿瘤的临床特点、诊断和治疗方法。方法报道我院2011年收治的1例原发性肺动脉肿瘤患者临床特征、诊疗经过及随访结果,并结合文献进行回顾性分析。结果患者男性,47岁,有进行性活动时气短症状,增强CT示主肺动脉低密度肿块影并累及双侧肺动脉干,诊断为肺动脉恶性肿瘤。由于肿块位置特殊,未能行穿刺取病理及手术切除,予多西他赛+奈达铂化疗同时联合放疗和中医药等综合治疗措施,治疗后症状明显好转。25个月后发现腹腔肿物,术后病理显示梭形细胞恶性肿瘤,考虑可能为肺动脉肿瘤转移。患者随访至2014年6月仍存活,且生存状态良好。结论原发性肺动脉肿瘤十分少见,极易误诊为肺栓塞。CT等影像学检查可提高早期诊断率,确诊依赖于组织病理学诊断。化疗、放疗等综合治疗有显著疗效。

Objective To study the clinical features,diagnosis and treatment of primary pulmonary artery tumor.Methods One case diagnosed with primary pulmonary artery tumor in our hospital in 2011 was enrolled in this study.The clinical characteristics,diagnosis,treatment and follow-up results of the patient were retrospectively analyzed and its related literatures were reviewed.Results The patient was a 47-year-old male.His main symptom was short of breath after doing activities.The enhanced CT showed a low-density mass in main pulmonary artery extending to bilateral pulmonary artery trunk,and pulmonary artery malignant tumor was diagnosed in the clinic.Due to the special location of the mass,the fine needle acupuncture biopsy could not be done for pathological diagnosis and surgical operation was not performed.The patient was treated with chemotherapy of docetaxel plus nedaplatin,radiotherapy,traditional Chinese medicine and so on.The symptoms of the patient were distinctly improved after careful treatments.An abdominal mass was found after 25 months＇ treatment,and the postoperative pathology showed malignant spindle cell tumor which was considered from pulmonary artery tumor metastasis.The patient was followed up for survival in good condition until June 2014.Conclusion Primary pulmonary artery tumor is a rare disease,which is easily misdiagnosed as pulmonary embolism in clinical practice.Enhanced computed tomography can improve early diagnosis.The proven diagnosis depends on histopathological examination.Comprehensive treatment such as chemotherapy and radiotherapy shows solid therapeutic effects.