肺部良性肿块的诊治：附128例报告

作者报道128例肺良性肿块的诊治,常见为肺结核瘤、错构瘤和炎症假瘤。右肺多于左肺。体检发现占50.8％。X线诊断符合良性者41.4％,可疑良性者9.4％,拟有恶性者49.2％。作者认为肺良、恶性肿块单从X线征较难确诊,应从年龄、临床表现和实验室综合分析才能获得较准确的诊断。详细研究X线征,也能发现一些规律性;如肺结核瘤多发生在右上肺,尤其上叶的后段和尖段,错构瘤以中、下叶肺最多,边缘光滑,可有爆米花样钙化,炎症假瘤多位于下叶,密度中等,肺门淋巴结不大,抗炎后可有缩小。此外还可作C T检查,水反应和肿瘤倍增时间等帮助鉴别诊断。肺良性肿瘤的治疗以外科为主,作者提出四点手术指征,供同道们参考。

DIAGNOSIS AND TREATMENT OF BENIGN LUNG MASSES

A summary of 128 cases of benign lung masses collected from 1969 to 1986 had been made. The lung tuberculoma, hamartoma and inflammatory pseudotumor were com monly seen. The masses located more likely in right lung than in left one. In this report patients had no complains, 50.8% cases were dicovered during physical examination. The X-ray studies showed 41.4% cases with benign finding, 9.4% were suspected to be ben ign and 49.2% malignant The authors considered that it is difficult to differentiate benign lung mass from malignant only by X-ray. According to the age, clinical manifestations, laboratory data will help to. make a definite diagnosis. Detailed X-ray studies can find out the common and specific features of lung cancer. For example, tuberculoma locates more likely in the upper lobe of the right lung, especially in the posterior and apical segments and there are satellite nodoules. Hamartoma occurs probably in the mid-lower lobe with smooth margin or with popcorn pattern pattern of calcification. Inflammatory pseudotumor appears commonly in the lower lobe with middle density, no hilar lymph nodes enlargement, an inlflam mtory history and conrraction of the mass after antibiotic treatment. On the other hand, C.T. scan, water reaction and calculation of doubling time are helpful for diagnosis. Surgical treatment remains the main therapeutic method for benign lung masses, In order to discuss the operating indication, 4 points were mentioned in this paper.