胸膜孤立性纤维瘤5例并文献复习.docVIP

胸膜孤立性纤维瘤5例并文献复习 　　【摘要】 目的：探讨胸膜孤立性纤维瘤（solitary fibrous tumor of the pleura，SFTP）的诊断和治疗方法。方法：回顾分析2010-2014年本院胸外科收治的5例SFTP患者的临床资料，并综合国内外文献复习。结果：患者包括男2例，女3例；年龄53～69岁，临床症状有胸背痛、咳嗽、咳痰等。患者术前均行胸部CT检查，且行经皮肺穿刺活检，诊断阳性率40%；患者均行手术治疗，切除率100%，术后恢复好，无并发症；术后病理均证实为孤立性纤维瘤，其中1例恶性；术后随访26个月～6年，均存活，无复发。结论：SFTP术前诊断困难，不建议术前行经皮穿刺活检，若无禁忌证可考虑直接手术探查，外科手术切除是治疗SFTP唯一有效的治疗方法。 　　【关键词】 孤立性纤维瘤； 胸膜； 临床特点； 手术治疗； 术前检查 　　【Abstract】 Objective：To investigate the diagnosis and treatment method of the solitary fibrous tumor of the pleura（SFTP）.Method：A retrospective analysis of the clinical data of five patients with SFTP，who were admitted in our hospital from 2010 to 2014，and domestic and foreign literature were reviewed comprehensive.Result：5 patients were included in our study with 2 male and 3 female，age from 53～69 years，clinical symptoms had chest pain，cough and expectoration.All patients underwent chest CT examination before operation，and percutaneous lung biopsy was performed，the positive rate was 40%.All patients underwent surgical treatment，the resection rate was 100%，postoperative recovery was good and no complications.The postoperative pathological findings were solitary fibrous tumors，which 1 case was malignant.All patients were followed up for 26 months to 6 years，all patients were alive and without recurrence.Conclusion：Preoperative diagnosis of SFTP is difficult，percutaneous biopsy is not recommend，we recommend direct surgical exploration if there is no contraindications.Surgical resection is the only effective treatment with SFTP. 　　【Key words】 Solitary fibrous tumor； Pleural； Clinical characteristics； Surgical treatment； Preoperative examination 　　孤立性纤维瘤（solitary fibrous tumor，SFT）是一种较少见的软组织肿瘤，其组织形态多样，发病部位广泛，但最常见的是胸膜孤立性纤维瘤（solitary fibrous tumor of the pleura，SFTP）。2010-2014年本院胸外科共收治5例SFTP患者，治疗效果满意。现对其临床表现、诊断、治疗、病理及预后等情况进行分析总结。 　　1 临床资料 　　1.1 病例1 男，63岁，以“左胸背隐痛5年，活动后气促2年”为主诉于2011年4月入院。阳性体征有：左下肺语颤减弱，叩诊浊音，呼吸音低，双下肢水肿，杵状指阳性。胸部CT检查提示：左下肺巨大占位，20.0 cm×16.2 cm×11.0 cm，密度欠均匀，考虑胸膜孤立性纤维瘤可能性大。术