肺炎性肌纤维母细胞瘤临床病理特点与预后分析

目的：回顾性分析肺炎性肌纤维母细胞瘤的临床病理特点、诊治现状及预后。方法：选取2009—01-01—2012—12—31河北医科大学第四医院7例因患肺炎性肌纤维母细胞瘤而入院治疗患者，对其临床症状、影像学表现、病理特征及随访资料进行分析。结果：共7例肺炎性肌纤维母细胞瘤患者，占同期胸外科手术的0．078％（7／8968）。男3例，女4例。年龄23～71岁，平均年龄48．1岁。有呼吸道症状者3例，其余患者均为体检发现，病变位于左上叶者4倒，左下叶者2例，右下叶者1例。病灶呈周围型3例，中心型3例，浸润生长1例；术前诊断考虑为癌或癌可能性大的5例，考虑为良性病变者1例，术前明确诊断为肺炎性肌纤维母细胞瘤者1例；本组7例均行手术治疗，其中肺楔形切除2例，肺段切除1例，肺叶切除4例，术后病理诊断均未发现肺门淋巴结转移。所有7例均在定期随访中，1例术后9个月发现纵膈、对侧肺及心包的转移，于术后17个月死亡，其余患者未发现复发或转移。结论：肺炎性肌纤维母细胞瘤是肺部少见的肿瘤，具有一定的异质性，术前明确诊断困难，手术完全切除是首选治疗，多数患者预后良好。

Clinicopathological feature and prognosis of pulmonary inflammatory myofibroblastic tumor

OBJECTIVE： To evaluate the clinicopathological features,treatment and prognosis of patients with inflam- matory myofibroblastic tumor （IMT） of the lung. METHODS： We reviewed the medical data of patients with IMT of the lung in Fouth Hospital, Hebei Medical University from 2009 to 2012 ,retrospectively. Chief complaints, radiologic imaging features,pathologic represents and follow-ups were analyzed in detail. RESULTS： These were 7 patients included 3 men and 4 women in this series which accounts of 0. 078% （7/8 968） of all thoractomy patients. The mean age was 48.1 years old. Of the 7 patients, 3 had respiratory symptoms and 4 of them were diagnosised by routine checkups. Four lesions of IMT of the lung were found in left upper lobe. Whereas 3 were found in the left inferior lobe and 1 was found in ther right inferior lobe. Three patients were central type and 3 were peripheral type with 1 case as invasive growth. Five patients were diagnosised as malignancy and 1 was considered as benign. Only 1 patent was diagnosed accurately pretreatmently. Surgical were performed to all the patients including 4 lobectomies,2 wedge excisions and 1 segmental resection. No lymph nodes metastasis was observed postoperatively. All the 7 patients were under routine follow-ups. One was detected metas- tasis in the contralateral of lung and mediastinal lymph nodes 9 months later and died 17 months after surgery. Other 6 pa- tients were in good health condition during the follow-ups with no recurrences or metastasis. CONCLUSIONS： IMT of the lung is a rare tumor with heterogenicity features. Pretreatment diagnosis is difficult and surgery is the first choice of treat- ment. Most patients have good prognosis.