肺硬化性血管瘤的诊断与治疗——附15例临床分析

· 308 · 肺硬化性血管瘤的诊断与治疗 — — 附 15例临床分析 王冬滨 ， 赵锡江 1．天津市大港 医院外科 ，天津 300270 2．天津市肿瘤 医院食管肿瘤科 ，天津 300060 王冬滨，等 肺硬化性血管擅 堑皇渔痘二= 《临床应用I 【摘要】 对 15例肺硬化性血管瘸(SHL)患者临床资料进行回顾性分析。结果显示，15例术前均未确诊 ，多误诊为 肺癌。影像学表现为肺周围性孤立性圆形或类圆形肿块；CT多表现为瘸体 内血运丰富；强化 CT见瘸体内大幅度均 匀增强。4例行术中冰冻病理检查均误诊 。所有病例均行手术治疗，以肺叶切除术为主。回顾性分析结果提示， SHL术前多误诊。本病好发于中年女性，右肺多于左肺，下叶多于上叶。CT表现为瘸体 内血运丰富，增强CT见瘸 体大幅均匀增强有一定诊断价值。术 中冰冻病理检查误诊率高，应提高对本病冰冻病理形态学认识。 中华肿瘤防治杂志 ，2006，13(4)：308—309 Diagnosis and treatment of asclerosing hemangioma in lung：a clinical analysis of 1 5 cases WANG Dong—bin ，ZHAO xi—jiang 1．Department of Surgery，Tianjin Dagang Hospital，Tianjin 300270，P．R．China 2．Department ofEsophageal Neoplasms，AffiliatedCancer Hospital of Tia， in Medical University，Tia， in 300060，P．R．China [A】Bs1 Acr] Tlhe objective of this paper was to analyse retrospectively 15 cases of SHL proved by surgical-patholgy．All the fifteen cases did not receive exact diagnosis before operation and most of them were misdiagnosed as lung cancer．Imaging finding of SHL was single circular or circular-like mass Cocated in peripheral area of the lung ；CT finding was rich blood cir— eulation within／／lost of the tumors．The density within the tumor displayed markedly and equally enhancement in the en— hancement CT．In-operation，iced-pathological inspections were performed in four cases but all of which were misdiagnosed ． All cases were treated by operations．Most of the operations were lobeetomy of the lung．Majority of the cases of SHL were misdiagnosed before operation．Most of the eases of SHL were middle-aged fema le．The incidence rate of this disease was more in right lung than tha t occurred in the left lung and to inferior lobe more than superior lobe．CT finding showed rich blood circulation within the tumor．It had some diagnostic value that the density within the tumor displayed ma rkedly and e— qually enhancement in the enhancement CT．The misdiagnosis rate of in-operation iced-pathology was high．Therefore．we should improve the related iced-histopathological observation of the SHL． Ch而 _，Caricer Prey Treat，2006，13(4)：308—309 【关t词】 肺表面活性荆／代谢；肺肿瘤／6"断；血管瘸／放射摄影术 [r~YWORDS] pulmonary surfactants／metabolism；lung neoplasms／diagnosis；hemangioma／radiography 肺硬化性血管瘤(sclerosing hemangioma of the lung，SHL) 是一种少见的肺部肿瘤，因其发病率低，故而I临床上对其认识还 有待进一步提高。天津肿瘤医院共收治SHL患者 15例，均经手 术及术后病理确诊，结合文献做一分析总结报道如下。 1 临床资料 1．1 一般资料 1996年 3月 18日~2003年 6月 25日天津市肿瘤医院共 【通讯作者筒介】 王冬滨，男，天津大港人，主治医师，主要从 事肿瘤外科的研究工作。 Tel：86—22—62095901 E-mail：tjdgwdb@tom．corn 手术治疗 SHL患者 15例 其中男 2例。女 13例。年龄 35～ 6O岁，平均年龄 45．6岁，中位年龄 48．7岁。病史 1个月～12 年，1年以内者有 1l例。其中 6例有不同程度的症状，表现为 咳嗽、痰中带血、低热、胸痛、胸闷和胸部不适等，另 9例为体检 发现。术前仅 3例考虑为 良性。1例甲状腺癌术后患者考虑为 转移瘤 ，其余均诊为肺癌。 1．2 影像学检查 胸片或 CT多表现为肺周围性孤立性圆形或类圆形肿块 或结节影，位于右下叶6例，右中叶 2例，右上叶 3例，左上叶 1 例。左下叶 3例。边缘光滑 1O例。欠光滑3例。不光滑 2例。密 度均匀 1O例，不均匀5例。肿块有分叶者7例。无分叶者8例。 钙化3例。有气新月征 1例。直径 1．3～7 cm。平均2．8 cm。8 维普资讯 http://www.cqvip.com 维普资讯 http://www.cqvip.com