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目的提高对肺硬化性血管瘤的认识。方法结合15例肺硬化性血管瘤患者的临床资料和文献复习,详细分析该病的病因、临床表现、诊断、鉴别诊断、治疗及预后等。结果该病病因不清,组织来源不明,临床症状较少且轻微,影像学检查主要表现为肺部孤立、境界清楚的结节影。病理学检查主要特征是:(1)实性细胞团及黏液样基质内散在有白细胞;(2)血管瘤样增生伴有管壁硬化倾向;(3)增生的小血管呈乳头状突向肺泡腔内;(4)存在出血及硬化区。免疫组织化学至今不能确定其组织来源。肺硬化性血管瘤术前难于确定诊断,而临床上与肺恶性肿瘤有类似症状,13例术前诊断为恶性肿瘤,误诊率高。但本病尚属良性肿瘤,宜早期手术。手术预后均良好。结论肺硬化性血管瘤发病率低,极易误诊,应予重视。
Objective To raise awareness of pulmonary sclerosing hemangiomas. Methods The clinical data and literature review of 15 patients with pulmonary sclerosing hemangioma were reviewed. The etiology, clinical manifestations, diagnosis, differential diagnosis, treatment and prognosis of the patients were analyzed in detail. Results The etiology of the disease was unclear, the source of the tissue was unclear, the clinical symptoms were less and slight, and the imaging examination mainly manifested as isolated pulmonary nodules with clear nodules. Pathological examination of the main features are: (1) solid cell mass and mucus-like matrix interspersed with white blood cells; (2) hemangioid hyperplasia with a tendency to hardening of the wall; (3) hyperplasia of small blood vessels was papillary processes to the alveoli Cavity; (4) there is bleeding and sclerosis area. Immunohistochemistry has so far not been able to determine its tissue source. Preoperative pulmonary sclerosing hemangioma difficult to determine the diagnosis, and clinically with lung cancer have similar symptoms, 13 cases of preoperative diagnosis of malignant tumor, misdiagnosis rate. However, the disease is still a benign tumor, should be early surgery. The prognosis is good. Conclusions The incidence of pulmonary sclerosing hemangioma is low and easily misdiagnosed.