病理确诊的肺硬化性血管瘤26例临床分析并文献复习  

Pulmonary sclerosing hemangioma:a clinical analysis of 26 cases and review of the literature

作　　者：王海英[1] 姚婵[2] 贾中正[3] 翁晓丹[4] 

机构地区：[1]南通大学附属医院呼吸内科,南通226001 [2]南通大学附属医院病理科,南通226001 [3]南通大学附属医院影像科,南通226001 [4]南通大学附属医院胸外科,南通226001

出　　处：《南通大学学报（医学版）》2014年第5期397-399,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:探讨肺硬化性血管瘤(pulmonary sclerosing haemangioma,PSH)的临床特点,以提高对PSH的认识。方法:回顾性分析2009年9月—2012年12月26例经病理证实为PSH患者的临床资料,包括症状、影像学检查、病理。结果:该病病因不明,临床症状少;影像学检查主要表现为肺部孤立境界清楚肿块影;全组25例行手术治疗,术后病理可见PSH特征性结构:实性结构、乳头状结构、硬化性结构、血管瘤区;免疫组化示甲状腺转录因子(thyroid transcription factor-1,TTF-1)、上皮膜抗原(epithelial memberane antigen,EMA)标记阳性;随访均无转移和复发。结论:肺硬化性血管瘤发病率低,多见于中年成人,女性多见;临床症状不典型,多数患者无症状,易误、漏诊;胸部CT扫描显示境界清楚的肿块,较少钙化,偶有囊性变,在发现和诊断PSH上有一定价值,确诊需组织病理学;治疗首选手术切除,预后良好。Objective： To investigate the clinical features and to improve the understanding of pulmonary sclerosing hemangioma（PSH）. Methods： The clinical data of 26 patients with PSH in Affiliated Hospital of Nantong University from Sep.2009 to Dec.2012 were analysed, including symptoms, radiological examinations, and histopathology. Results： The etiology of PSH was unclear. Most cases were asymptomatic or only with mild symptoms. The radiology of PSH often showed isolated nodule with distinct margin in the lung field. 25 patients underwent surgical operation. The tissues contained four characteristic histological patterns of PSH： papillary,sclerotic,solid,and hemorrhagic, and the immuno- histochemical marks of thyroid transcription factor-1（TTF-1） and epithelial memberane antigen（EMA） were positive. There was no postoperative metastasis or recurrence in all patients. Conclusions： Pulmonary sclerosing hemangioma has the following characteristics： it is low incidence,common in middle-aged women. Its clinical symptoms are atypical,which is easily missed and misdiagnosed. Chest CT scan showed clear bump, less calcification, occasional cystic change. It is helpful to the diagnosis of PSH, but making a definitive diagnosis still needs histological examination. Surgical resection is the preferred treatment, which has a good prognosis.

关 键 词：肺硬化性血管瘤 计算机断层扫描显像 病理 

分 类 号：R734.2[医药卫生—肿瘤]