胸膜孤立性纤维瘤误诊1例并文献复习  

Solitary fibrous tumor of pleura：a case report and literature review

作　　者：程克斌[1] 顾淑一[1] 高蓓兰[1] 徐金富[1] 谢博雄[2] 揭冰[3] 武春燕[4] 

机构地区：[1]同济大学附属上海市肺科医院呼吸科,200433 [2]同济大学附属上海市肺科医院胸外科,200433 [3]同济大学附属上海市肺科医院影像科,200433 [4]同济大学附属上海市肺科医院病理科,200433

出　　处：《国际呼吸杂志》2015年第22期1703-1706,共4页International Journal of Respiration

摘　　要：目的加强对胸膜孤立性纤维瘤（sFTP）的临床、影像、病理特点的认识，提高SFTP的早期诊断和治疗水平。方法分析2014年5月收治的1例SFTP患者临床资料及诊治经过，并结合文献进行复习。截至2014年7月，以“solitaryfibroustumor、pleura”为检索词，在PubMed检索系统进行检索，在万方数据库中以“孤立性纤维瘤、胸膜”为检索词进行检索。结果SFTP临床表现及影像学检查缺乏特异性，诊断主要依靠手术病理及免疫组化检查。SFTP预后好，但术后应定期随访。患者有咳嗽、左胸痛的症状，影像学表现为左下肺孤立性肿块，抗感染治疗无效，最终外科手术确诊为左胸膜孤立性纤维瘤。术后患者咳嗽、胸痛症状缓解。结论临床医师应当提高对SFTP的警惕，对于临床拟诊患者应尽早手术明确病理，避免误诊。Objective To improve the knowledge of clinical features, image and pathology of solitary fibrous tumor of the pleura （SFTP）. Methods The clinical data,image and pathological features of one male patient aged 58 years with SFTP were analyzed. PubMed （1967.1 to 2014.7） and Wanfang database （1990. 1to 2014. 7） were searched with ＂ solitary fibrous tumor, pleura＂ as search terms. Results The clinical presentations and imaging features were nonspecific, so the correct diagnosis of SFTP should depend on pathological examination and immunohistochemicat analysis. Complete resection was the mainstay treatment of SFTP, and after it a very long survival could be expected in almost all cases. But all patients with SFTP need long-term follow-up because of the possibility of late recurrences. This patient had cough and left-side chest pain, and his imaging findings showed an isolated mass in the left lower lung. After the treatment of anti-infection, his clinical symptoms and imaging features were not improved. So he underwent surgical resection by video-assisted thoracic surgery. Thereafter, the patient was diagnosed with SFTP. After complete resection,the patientrs symptoms were significantly improved. Conclusions Awareness of the presentation and clinical course may help the clinician provide prompt referral to the thoracic surgeon for resection.

关 键 词：孤立性纤维瘤 胸膜 误诊 

分 类 号：R734.3[医药卫生—肿瘤]