摘要
目的探讨呼吸系纵隔血管瘤的临床症状、影像学表现、病理诊断特点。方法回顾性分析中国知网1982～2018年杂志公开发表的52例呼吸系纵隔血管瘤患者的临床资料,总结临床症状、影像学表现、病理特点,为临床诊断提供理论依据。结果①临床症状。52例患者中35例存在临床症状,咳嗽5例(9.6%),胸痛7例(13.5%),背痛2例(3.8%),胸闷7例(13.5%),吞咽困难4例(7.7%),神经压迫4例(7.7%),脊髓压迫3例(5.8%),上腔静脉压迫3例(5.8%)。② X线及CT影像学表现。患者纵隔血管瘤大小为2 cm×1 cm×1 cm～20 cm×16 cm×15 cm。前纵隔26例(50.0%),后纵隔19例(36.5%),中纵隔3例(5.8%),多区域4例(7.7%)。发生于单侧43例(82.7%),双侧9例(17.3%)。肿瘤边缘清楚34例(65.4%),模糊18例(34.6%);密度均匀42例(80.8%),密度不均匀10例(19.2%);有包膜13例(25.0%),肿瘤中可见圆点状钙化或静脉石14例(26.9%)。③病理诊断结果。52例患者中血管性肿瘤47例(其中14例肿瘤内有静脉石,且多为良性),其中海绵状血管瘤42例(80.8%),纤维血管瘤2例(3.8%),毛细血管瘤1例(1.9%),血管淋巴管瘤2例(3.8%,其中1例为低度恶性, 1例为良性)。肿瘤性血管瘤5例,其中外皮瘤4例(7.7%,其中1例良性, 3例恶性),平滑肌瘤1例(1.9%),无一例内皮瘤。结论纵隔血管瘤多无明显的临床表现, X线、CT表现各有特征,确诊需依据病理诊断。
Objective To investigate the clinical symptoms, imaging manifestations and pathological features of mediastinal hemangioma. Methods The clinical data of 52 patients with mediastinal hemangioma published by CNKI in 1982 ~ 2018 were retrospectively analyzed. The clinical symptoms, imaging manifestations and pathological was summarized to provide theoretical basis for clinical diagnosis. Results①Clinical symptoms. Among 52 patients, 35 cases had clinical symptoms, including cough in 5 cases(9.6%), chest pain in 7 cases(13.5%), back pain in 2 cases(3.8%), chest tightness in 7 cases(13.5%), dysphagia in 4 cases(7.7%), nerve compression in 4 cases(7.7%), spinal cord compression in 3 cases(15.8%) and superior vena cava compression in 3 cases(15.8%).② X-ray and CT imaging manifestation. The size of mediastinal hemangioma ranged 2 cm × 1 cm×1 cm ~ 20 cm×16 cm×15 cm. There were 26 cases(50.0%) of anterior mediastinum, 19 cases(36.5%) of posterior mediastinum, 3 cases(5.8%) of middle mediastinum and 4 cases(7.7%) of multiregional. 43 cases(82.7%) occurred unilaterally and 9 cases(17.3%) bilaterally. The tumor margin was clear in 34 cases(65.4%), blurred in 18 cases(34.6%);density was uniform in 42 cases(80.8%), density was uneven in 10 cases(19.2%). Punctate calcification or venous stones in tumor can be found in 14 cases(26.9%).③Pathological diagnosis results. Among the 52 patients, 47 cases were vascular tumors(14 cases had venous stones in the tumor, and most of them were benign), including 42 cases of cavernous hemangioma(80.8%), 2 cases of fibrous hemangioma(3.8%), 1 case of capillary hemangioma(1.9%), and 2 cases of vascular lymphangioma(3.8%, 1 case of low malignant case and 1 benign case). 5 cases of neoplastic hemangioma, including 4 cases of cutaneous tumor(7.7%, 1 case of benign, 3 cases of malignant), 1 case of leiomyomas(1.9%), no case of endothelium. Conclusion Most of mediastinal hemangiomas have no obvious clinical manifestations, and their X-ray and CT manifestations have their own characteristics
作者
秦鑫
秦蕾
刘又宁
QIN Xin;QIN Lei;LIU You-ning(Department of Respiratory Medicine,Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中国实用医药》
2019年第2期22-24,共3页
China Practical Medicine
基金
山西省留学人员科研资助项目(项目编号:2014-038)
关键词
纵隔血管瘤
临床表现
X线
CT影像
病理
Mediastinum hemangioma
Clinical manifestations
X-ray
CT imaging
Pathology
