摘要
目的探讨肺炎性假瘤(IPL)的临床特征、影像学特点,以期降低误诊率,提高术前诊断率。方法回顾性分析2003年1月至2008年7月收治的53例经病理证实的IPL患者的临床资料。术前误诊为肺癌21例,良性病变19例(包括肺结核8例),肺部占位、恶性待排10例,纵隔肿瘤2例,食道癌肺转移1例,均行手术治疗,肺楔形切除21例,肺叶切除32例(双肺叶切除6例),淋巴结清扫11例。结果术前误诊率达86.9%。术后并发症2例,1例胸腔积液,1例乳糜胸,均治愈出院。随诊2～68个月,4例失访,2例死亡,均死于与IPL无关的疾病,其中1例术后40个月死于高血压脑出血,另1例术后半年死于下肢深静脉血栓、肺栓塞。结论 IPL临床表现和影像学检查缺乏特征性,术前误诊率高,治疗以肺楔形切除或肺叶切除为主,术中病理切片是诊断和决定术式的主要依据。
Objective To investigate clinical features and imaging presentations of inflammatory pseudotumor of the lung（IPL） to reduce the rate of misdiagnosis and enhance the rate of diagnosis before surgery. Methods Clinical data of 53 patients with IPL who were identified by pathological examination from Jan. 2003 to Jul. 2008 was retrospectively reviewed. 21 cases were nfisdiagnosed as lung cancer. 19 cases were suspected having tuberculoma（8 cases） or other benign lung tumors. 10 cases were undefined as occupied lesion in the lung. 2 cases were dignosed as mediastinal tumor. 1 case was dignosed as puhnonary metastasis of esophageal carcinoma. All patients received surgery, including wedge resection in 21 patients, lobectomy in 32 patients（pulmonary two-lobectomy in 6 patients） and lymph node dissection in 11 patients. Results The rate of misdiagnosis before surgery was 86.9%. 2 eases of postoperative complications occurred, including 1 ease of pleural effusions and 1 ease of chylothorax. Both patients were fully recovered and left hospital. 2 death occurred with a follow-up rate of 92.5% （49/53） from 2 to 68 months. 1 case died of hypertensive cerebral hemorrhage after 40 months and 1 ease died of lower limb deep venous thrombosis and pulmonary embolism after 6 months. Both died of other diseases but IPL. Conclusion IPL lacks the characteristic of clinical presentations and imaging examination. The rate of misdiagnosis is high before operation. The main patterns of surgical management are wedge resection and lobectomy. The diagnosis and surgical pattern depend on the intraoperative frozen pathological section.
出处
《中华肺部疾病杂志（电子版）》
CAS
2010年第1期21-23,共3页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
炎性假瘤
诊断
误诊
外科治疗
Inflammatory pseudotumors
Diagnosis
Misdiagnosis
Surgical treatment
