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胸腔镜、纤维支气管镜诊断肺淋巴管肌瘤病9例体会

Clinical Analysis of 9 Cases of Pulmonary Lymphangioleiomyomatosis Diagnosed by Video-assisted Thoracospy and Fiberoptic Bronchoscopy

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【作者】 李树本; 何建行; 陈汉章; 李时悦; 葛林虎; 韦兵; 殷伟强; 成向阳; 刘君;

【Author】 Li Shuben,He Jianxing,Chen Hanzhang et al The First Affiliated Hospital of Guangzhou Medical College,Guangzhou Institute of Respiratory Disease,Guangzhou 510120

【机构】 广州医学院第一附属医院广州呼吸疾病研究所胸外科;

【摘要】 目的总结肺淋巴管肌瘤病早期诊断的经验,进一步提高对本病的认识。方法回顾分析9例经胸腔镜、纤维支气管镜(纤支镜)活检病理确诊的肺淋巴管肌瘤病患者的临床影像学表现、腔镜检查结果。结果9例皆为女性,平均年龄35岁(20~49岁)。胸部CT检查可见两肺弥漫多发小囊状透光区,其中3例行腹部CT检查见腹膜后多发淋巴结肿大。9例均为肺组织病理活检确诊,其中胸腔镜手术3例,纤支镜检查6例。术后病理诊断与术前诊断符合率为44.4%(4/9)。结论肺淋巴管肌瘤病临床罕见,CT检查可提示诊断,运用胸腔镜及纤支镜活检是早期确诊的重要手段。

【Abstract】 Objective To review the experience of using endoscopic technique in early diagnosis of pulmonary lymphangioleiomyomatosis(PLAM).Methods The clinical symptoms,chest roentgenographic presentations,bronchoscopic and thoracospic findings of 9 cases of PLAM were retrospectively analyzed.Results All patients were female,aged 20-49 years old(average 35.0).Chest roentgengraphic presentations of 9 cases were typically featured by multiple small pulmonary cysts.Among them,multiple retroperitoneal lymph node enlargement was found in 3 cases by abdominal CT scan.All cases were confirmed by pathology.Six cases were subjected to fiberoptic bronchoscopy,and 3 cases to video-assisted thoracospy biopsy.The accurate rate of the pre-operative diagnosis was 44.4%(4/9).Conclusion PLAM is a rare lesion.CT scan can achieve a definite diagnosis by showing the reticular changes with multiple small round areas.An early fiberoptic bronchoscopy and video-assisted thoracospy biopsy is the most important step to get an accurate diagnosis.

  • 【文献出处】 华中科技大学学报(医学版) ,Acta Medicinae Universitatis Scientiae et Technologiae Huazhong , 编辑部邮箱 ,2009年01期
  • 【分类号】R734.2
  • 【被引频次】1
  • 【下载频次】153
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