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目的 探讨肺炎性假瘤 (IP)的临床病理特点、病因及其与恶性肿瘤的鉴别诊断。方法 对 2 3例肺IP的临床资料及病理特点进行分析。结果 2 3例中有 2例误诊 ,将炎性恶性纤维组织细胞瘤 (MFH )误诊为炎性假瘤。其余 2 1例主要发生于中年男性 ,以右肺多见 (12 /2 1) ,2例发生于支气管 ,5例局部有侵袭行为。随访过程中无 1例直接死于IP。病理诊断IP的前提是肺组织结构完全消失 ,其具体形态分为 2型 :纤维组织细胞型及浆细胞肉芽肿型。肺IP缺乏明显细胞核异型性、病理性核分裂及凝固性坏死。大部分病例病变周边肺组织无明显炎症改变 ,仅 8例病变周边可见机化性肺炎。结论 肺IP是原因不明的良性病变 ,尽管它可以发生局部侵袭 ,但形态上仍属良性 ,且愈后较好。该病变的病理诊断有严格标准 ,其梭形细胞有无核异型性、病理性核分裂及坏死等 ,是与恶性肉瘤的主要鉴别点。
Objective To investigate the clinicopathological characteristics, etiology and differential diagnosis of malignant tumor of pulmonary inflammatory pseudotumor (IP). Methods Clinical data and pathological features of 23 cases of pulmonary IP were analyzed. Results 2 of 23 cases were misdiagnosed, and the diagnosis of inflammatory malignant fibrous histiocytoma (MFH) was misdiagnosed as inflammatory pseudotumor. The remaining 21 cases occurred mainly in middle-aged men, more common in the right lung (12/21), 2 in the bronchi, and 5 in the local invasion. No one died of IP directly during follow-up. Pathological diagnosis of IP premise is completely disappeared lung tissue structure, the specific form is divided into 2 types: fibrous tissue cell type and plasma cell granuloma type. Lung IP lack of significant nuclear atypia, pathological mitosis and coagulation necrosis. Most cases of lung lesions around the lesion no significant inflammatory changes, only 8 cases of peripheral lesions seen in opportunistic pneumonia. Conclusions Lung IP is a benign disease of unknown cause. Although it may local invasion, it is still benign in shape and better after healing. The pathological diagnosis of the disease have strict standards, the spindle cells with or without nuclear atypia, pathological mitosis and necrosis, and malignant sarcoma is the main point of identification.