钱祥云 1戈伟 1宋婧 1罗卫 1王紫润 1尹竺晟 1徐敏 1张文君1
作者信息
- 1. 430060 武汉，武汉大学人民医院肿瘤中心
- 折叠
摘要
Abstract
Objective To investigate the clinical features of the pulmonary sclerosing hemangioma (PSH) and ana-lyze the causes of misdiagnosis , in order to reduce the occurrence of misdiagnosis and missed diagnosis .Methods The clini-cal data of 10 patients confirmed by pathological examination of PSH in the Cancer Center , Renmin Hospital of Wuhan Univer-sity during April 2014 and April 2015 were analysed retrospectively .Results Of the 10 patients, 4 patients were detected in routine medical examinations , while 6 patients presented clinical symptoms , including renal pelvis calculus , severe hydrone-phrosis, cough, hemoptysis, fever, chest pain, chest stuffiness and irritating cough , etc.The imaging examination revealed round or similar isolated nodules with distinct margins and lump in the lungs , and the average tumor diameter was 2.7 cm.Le-sions of the 10 patients were single nodule, four lesions arose in the left lung (3 in left upper lobe, 1 in left lower lobe), 6 in the right (1 in right upper lobe, 1 in right middle lobe, 4 in right lower lobe).One patient underwent preoperative transtho-racic needle biopsy with a histopathological diagnosis of PSH;the remaining 9 cases were diagnosed as lung occupying lesions . All the patients underwent surgical resection , 7 patients underwent video-assisted thoracoscopes surgery , 3 underwent tradi-tional open surgery;wedge resection was carried out in 5 patients and the other 5 underwent lobectomy , mediastinal , hilar and subcarinal lymph nodes dissection were performed in 2 patients.Intraoperative frozen-section assessment was undertaken in 10 patients, all of whom were diagnosed with PSH by postoperative routine pathologic examination .The results of intraoperative frozen-section revealed that 6 cases were diagnosed as benign lesions , 1 case could not be identified whether it was a benign or malignant lesion , 1 case as a inflammatory lesion , 2 cases as lung cancer .All patients recovered well after the operation , and were discharged from the hospital with good wound healing .There was no recurrence and metastasis during follow-ups of 5-17 months.Conclusion Clinical and radiological characteristics of PSH are nonspecific .The incidence rate of PSH is low , and the misdiagnosis rate is high .Improving the awareness of PSH , undergoing timely relevant medical examinations , paying more attention to the differential diagnosis and analyzing the condition of patients comprehensively may contribute to avoiding or reducing the misdiagnosis and mis-treatment of PSH .关键词
肺硬化性血管瘤/体层摄影术,螺旋计算机/误诊Key words
Pulmonary sclerosing hemangioma/Tomography , spiral computed/Misdiagnosis分类
医药卫生
