原发性肺癌与气胸(附四例报告)

Primary bronchial carcinoma and pneumothorax (report of 4 cases)

作者从1982年4月到1987年6月诊治肺癌合并气胸4例,气胸与癌肿均在同侧,3例鳞癌,1例小细胞肺癌。3例在常规检查中发现1例在放射治疗中出现。气胸发生的原因主要有三种,即肿瘤直接侵犯形成胸膜瘘;肿瘤堵塞气道发生肺气肿、肺大疱破裂而形成气胸;由于放化疗使肿瘤组织迅速坏死而修复困难形成瘘。

From April 1982 to June 1987, 4 cases of primary bronghial carcinoma complicated with pneumothorax were treated. Cancer and pneumothorax all occurred on ipsilateral lung. 3 cases had squamous cell carcinoma, 1 with small cell carcinoma. 3 cases had no complaint on pneumothorax which were discovered by routine examination. 1 case was detected during the course of radio-therapy. Three probable mechanisms for development of pneumothorax in primary bronchial carcinoma have been suggested. Firstly, the growth invades pleura directly to form fistula; Secondly, the pneumothorax is developed by obstruction of the airway resulting in aball-valve effect and rupturing a subpleual bleb; Thirdly, during chemotherapy and radiotherapy the necrosis of tumor developed too fast to repair due to defective regenerative process and resulting in a bronchopleual fistula.