支气管内型错构瘤五例临床分析  

Clinical analysis of 5 cases of endobronchial hamartoma

作　　者：王增智[1] 李栋[2] 李杰[1] 高杨[1] 张向峰[1] 刘双[1] Wang Zengzhi;Li Dong;Li Jie;Gao Yang;Zhang Xiangfeng;Liu Shuang(Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China;Department of Thoracic Surgery,Belting Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院呼吸与危重症医学科北京市心肺血管疾病研究所,北京100029 [2]首都医科大学附属北京安贞医院胸外科北京市心肺血管疾病研究所,北京100029

出　　处：《中华结核和呼吸杂志》2019年第1期15-19,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的分析支气管内型错构瘤患者的临床资料,提高临床医生对本病的认识。方法收集2007年6月至2018年2月首都医科大学附属北京安贞医院确诊的5例支气管内型错构瘤病例,并结合2000年1月以后国内外文献报道的病例,对支气管内型错构瘤的临床特点、诊治过程以及预后进行回顾性分析。结果5例患者中,男4例,女1例,年龄为46~69岁,平均(56±7)岁。5例患者均无发热,咳嗽、咳痰4例,咯血3例,1例无临床症状。胸部CT示5例瘤体均位于右侧支气管,3例瘤体为单纯高密度灶,1例为单纯低密度灶,1例为混杂密度灶,瘤体呈"爆米花"样改变1例。5例中3例伴瘤体远端的阻塞性肺炎,2例伴肺不张。5例均行胸部CT增强扫描,3例瘤体轻度强化,2例无强化。5例中4例气管镜下见息肉样肿物。5例均行诊断性活检,病理结果3例明确为支气管内型错构瘤。4例患者行肺叶切除术,1例行气管镜下瘤体切除,5例病理均确诊为支气管内型错构瘤。术后随访时间为6个月至5年,均未见复发。结论支气管内型错构瘤是少见的支气管内良性肿瘤,临床症状及影像学无特异性。气管镜下可见息肉样肿物。病理学是确诊的金标准。Objective To analyze the clinical manifestations of patients with endobronchial hamartoma(EH),and therefore to improve understanding of the disease. Methods Data were retrospectively reviewed to describe the clinical characteristics, diagnosis procedures and prognosis of EH, including 5 patients in Beijing Anzhen Hospital, Capital Medical University from Jun 2007 to Feb 2018 and another 159 patients from Chinese and English literatures published after Jan 2000. Results The five patients, 4 males and 1 female, aged from 46 to 69 years[mean (56±7) years], were diagnosed with EH in our hospital. There was no fever in the 5 cases, cough and expectoration in 4 cases, hemoptysis in 3 cases and asymptomatic in 1 case. Chest CT revealed that the lesions of all 5 cases were located in the right bronchial tube;3 as high-density endobronchial mass, 1 as low-density mass, 1 as mixed density mass, and 1 as a "popcorn" lesion. Three cases were accompanied by obstructive pneumonia in the distal part of the EH and 2 cases by atelectasis. CT enhanced scan was performed in 5 cases, 2 showing no enhancement and 3 showing mild enhancement. Four cases showed polyposis under bronchoscopy, and 5 cases received bronchoscopic biopsy with 3 pathologically diagnosed as EH. Four of them received lobectomy, while 1 received removal by biopsy forceps, and all were pathologically confirmed as EH. There was no evidence of recurrence in these 5 patents with follow-up. Conclusions EH was a rare benign bronchial tumor with nonspecific clinical and imaging manifestations. Endobronchial polyposis could be revealed by bronchoscopy, and pathological study is required to confirm the diagnosis.

关 键 词：支气管 错构瘤 支气管镜 

分 类 号：R734.1[医药卫生—肿瘤]