肺组织胞浆菌瘤三例  

Diagnosis and treatment of pulmonary histoplasmoma:report of 3 cases

作　　者：沈钢[1] 柴(王莹) 张国飞[1] 魏红权[2] 岳岚[3] 

机构地区：[1]浙江大学医学院附属第二医院胸外科,杭州310009 [2]浙江大学医学院附属第二医院病理科,杭州310009 [3]浙江大学医学院附属第二医院内分泌科,杭州310009

出　　处：《中华医学杂志》2007年第11期760-762,共3页National Medical Journal of China

摘　　要：目的探讨肺组织胞质菌瘤的临床特点、影像学表现、病理特点及治疗方法。方法收集浙江大学医学院附属第二医院自1999年11月至2005年9月经外科手术病理确诊的肺组织胞浆菌瘤相关资料,进行回顾分析。结果本组男性2例,女性1例,人类免疫缺陷病毒抗体(HIV-Ab)均阴性。影像学检查:肺部肿块为首发表现,肿块边界清,钙化明显,肺门和纵隔淋巴结未受侵袭。2例术前诊断为肺结核瘤,1例诊断为转移瘤。本组病例均通过手术切除肿块病理证实。病理大体观可见干酪样坏死,镜检见多核细胞内大量组织胞浆菌。术后随访1、3和5年,均无复发。结论以肺部肿块为首发表现的肺组织胞浆菌瘤极易误诊为肺结核瘤和肺部原发或转移瘤,而术前往往难以诊断,应予手术切除活检。本病预后良好。Objective To investigate the diagnosis and treatment of pulmonary histoplasmoma. Methods The clinical data of 3 patients with pulmonary histoplasmoma. 2 males, both 49-years-old, and 1 female, 27-years-old, were analyzed. Results Nodules in the lung, regardless solitary or multiple, with clear border and calcification, were the first radiological finding. All 3 patients were misdiagnosed as with tuberculosis or primary or metastatic lung neoplasm and underwent operation. The diagnosis was confirmed after surgery. Pathological examination showed caseous necrosis and a great amount of histoplasma in the multinuclcar cells. Follow-up lasting 1, 2, and 3 years respectively showed no recurrence. Conclusion Pulmonary nodule, regardless solitary or multiple, with clear border and calcification, is the first radiological finding of pulmonary histoplasmoma Autopsy is necessary for diagnosis of pulmonary histoplasmoma, difficult to diagnose, however, with a good prognosis.

关 键 词：组织胞浆菌病 肺 诊断 

分 类 号：R519[医药卫生—内科学]