胸内巨大淋巴结增生症的外科诊疗分析

Surgical diagnosis and treatment of giant lymph node hyperplasia in the chest

目的探讨胸内巨大淋巴结增生症的临床特征、影像学表现、治疗方法及预后情况。方法回顾性分析郑州大学第一附属医院胸外科自2009年11月至2015年11月收治的6例巨大淋巴结增生症患者临床资料,分析肿瘤的位置、CT表现、手术结果、病理结果及预后情况。结果 6例患者皆行外科手术完整切除肿瘤,术后病理证实为巨大淋巴结增生症,其中透明血管型4例、浆细胞型1例、混合型1例。6例患者术后随访1～6年,无失访病例,均保持无病生存状态。结论胸内巨大淋巴结增生症多较局限,术前极易误诊,主要采取以手术为主的综合治疗。若能完全切除肿瘤,必要时术后辅助放化疗,几乎可以彻底治愈。

Objective To investigate the clinical characteristics,imaging features,treatment and prognosis of giant lymph node hyperplasia in the chest.Methods The clinical data of 6patients with giant lymph node hyperplasia treated in Department of Thoracic Surgery,The First Affiliated Hospital of Zhengzhou University between November 2009 and November 2015 were retrospectively analyzed.The tumor location,CT findings,surgical results,pathological findings and prognosis were analyzed.Results All patients underwent surgical resection for giant lymph node hyperplasia which was proved by postoperative pathology.Among them,there were 4cases of hyaline vascular variant,1case of plasmacell variant and 1case of mixed variant.Patients were followed up for 1to 6years,and none was lost in follow-up.All patients are still alive and free of disease.Conclusions Most giant lymph node hyperplasia in the chest is limited,which are easy to be misdiagnosed before operation.Comprehensive treatment based on operation is the main treatment.After complete resection and necessary postoperative adjuvant radiotherapy and chemotherapy,the patient can be almost completely cured.