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目的探讨肺组织胞质菌瘤的临床特点、影像学表现、病理特点及治疗方法。方法收集浙江大学医学院附属第二医院自1999年11月至2005年9月经外科手术病理确诊的肺组织胞浆菌瘤相关资料,进行回顾分析。结果本组男性2例,女性1例,人类免疫缺陷病毒抗体(HIV-Ab)均阴性。影像学检查:肺部肿块为首发表现,肿块边界清,钙化明显,肺门和纵隔淋巴结未受侵袭。2例术前诊断为肺结核瘤,1例诊断为转移瘤。本组病例均通过手术切除肿块病理证实。病理大体观可见干酪样坏死,镜检见多核细胞内大量组织胞浆菌。术后随访1、3和5年,均无复发。结论以肺部肿块为首发表现的肺组织胞浆菌瘤极易误诊为肺结核瘤和肺部原发或转移瘤,而术前往往难以诊断,应予手术切除活检。本病预后良好。
Objective To investigate the clinical features, imaging findings, pathological features and treatment of cytosolic lung tumors. Methods The data of pulmonary histoplasmosis diagnosed by surgical operation in the Second Affiliated Hospital of Zhejiang University Medical College from November 1999 to September 2005 were collected and analyzed retrospectively. Results There were 2 males and 1 females in this group, all of which were negative for human immunodeficiency virus (HIV-Ab). Imaging examination: lung lumps as the first performance, clear mass boundary, calcification, hilar and mediastinal lymph nodes not affected. Two cases were diagnosed as pulmonary tuberculosis preoperatively and one case was diagnosed as metastatic tumor. This group of patients were confirmed by surgical removal of lumps. Gross pathology can be seen caseous necrosis, microscopy see a large number of multinuclear cells within the histoplasmosis. Follow-up 1,3 and 5 years after surgery, no recurrence. Conclusions Pulmonary histoplasmosis, with lung mass as the first manifestation, can be easily misdiagnosed as pulmonary tuberculoma and primary or metastatic lung, but it is often difficult to diagnose before operation. Surgical biopsy should be performed. The disease prognosis is good.