肺硬化性血管瘤的诊治

BACKGROUND AND OBJECTIVE: The concept of pulmonary sclerosing hemangioma (PSH) was proposed only 50 years ago. PSH features several characteristics that should be differently diagnosed with lung cancer. The aim of this study is to retrospectively review the diagnosis and treatment of 48 cases of PSH, review recent publications about this topic, and address reasonable diagnosis and treatment methods. METHODS: Forty-eight patients with PSH were enrolled and consecutively treated from January 2001 to April 2011. Clinical presentations, image characteristics, pathologic morphologies, and prognostic data were analyzed. RESULTS: Twenty-seven PSH cases (56.3%) were asymptomatic. Tumor diameters ranged from 0.2 to 7.0 cm, with an average diameter of 2.1 cm, and involved both lobes of the lungs. Enlarged lymph nodes in the mediastinum were detected via computed tomography (CT) scans in 15 cases (31.3%). Only 47 patients underwent surgery. Pulmonary wedge resection was performed in 29 cases (61.7%) while lobectomy was performed in 14 (29.8%). The tumor was removed in 3 cases (6.4%) and anterior mediastinal tumor resection was performed in 1 case (2.1%). Forty-seven patients reported no recurrence during follow-up while one patient refused surgery after a CT-guided biopsy with no progression during the 28-month follow up period. CONCLUSIONS: The exact diagnosis of PSH is difficult prior to surgery. Surgery is an effective method of treatment that allows both definite diagnosis and accurate therapy. The prognosis of PSH is favorable.