论文部分内容阅读
目的总结嗅神经母细胞瘤源性气管支气管转移瘤的诊断及治疗现状。方法报道我院收治的1例嗅神经母细胞瘤源性气管支气管转移瘤患者,并查阅相关报道资料进行文献复习与总结。结果患者男性,55岁,因“咳嗽2个月,伴气促、声音嘶哑半个月”收治入院。外院颈部及胸部CT示气管上段新生物(2个),气管重度阻塞。入院后行电子支气管镜示气管内新生物,气管重度狭窄。行镜下病理活检,新生物行圈套、基底部高频电凝及氩离子束凝固术。患者经支气管镜治疗后,咳嗽、气促症状缓解,病情稳定。3个月后出现右中肺、左肺、纵隔淋巴结及左侧胸膜多发转移瘤。患者拒绝进一步治疗,自动出院。结论对于既往有肺外恶性肿瘤史的患者,当其出现咳嗽、咯血、呼吸困难等呼吸道相关症状时,除考虑肺部转移外,也应考虑气管支气管转移,尽快予以影像学检查、支气管镜检,甚至病理及免疫组化活检等明确诊断。及早积极治疗有助于改善气管支气管转移瘤患者生存质量甚至预后。
Objective To summarize the diagnosis and treatment of neuroblastoma-originated tracheobronchoma. Methods Reported in our hospital admitted a case of olfactory neuroblastoma-derived patients with tracheobronchoma, and access to relevant information reported in the literature review and summary. Results Male patients, 55 years old, because of “cough for 2 months, with shortness of breath, hoarseness for half a month ” admitted to hospital. Outside the hospital neck and chest CT showed tracheal upper newborn (2), severe obstruction of the trachea. After admission, electronic bronchoscopy showed new endotracheal tubes and severe tracheal stenosis. Histopathological biopsy, neoplasms of neonate, high frequency electrocoagulation of basement and argon ion beam coagulation. Bronchoscopy patients after treatment, cough, shortness of breath symptoms relieve, stable condition. Three months after the emergence of the right middle lung, left lung, mediastinal lymph nodes and the left pleural multiple metastases. Patients refused to further treatment, discharged automatically. Conclusions In patients with previous history of extrapulmonary malignant tumors, when they have respiratory-related symptoms such as cough, hemoptysis and dyspnea, they should consider bronchial metastases in addition to lung metastases, as soon as possible to be imaged, bronchoscopy , And even a clear diagnosis of pathology and immunohistochemistry biopsy. Early active treatment helps to improve the quality of life and even the prognosis of patients with tracheobronchoma.