Pneumonic pseudotumor resection

A pneumonia pseudotumor is an inflammatory granulation composed of a variety of cells, newborn capillaries, and fibrous connective tissue. Matsubara et al. (1988) considered pneumococcal pseudotumor to be an alveolar organizing pneumonia. The pathogenesis is unclear and may be related to metabolic disorders, immune responses, lung inflammation, viral infections and aspiration. Gross specimens are substantial swellings of varying sizes, hardness, and morphology. The pseudotumor can be single or multiple, and there is a capsule on the outside. It is actually a pseudo-envelope formed by compression of the surrounding lung tissue. The cellular components of pseudotumors under the microscope are complex. Different sections of different cells, such as foam cells, plasma cells, lymphocytes and eosinophils, are scattered on different sections of the same pseudotumor. The cells differentiated and matured, and the morphology was consistent. Therefore, the name of inflammatory pseudotumor is many, such as luteal tumor, fibrosema, yellow granuloma, histiocytoma, mast cell granuloma, plasma cell granuloma. In 1995, Colby et al considered that inflammatory pseudotumors can be divided into two major categories, namely histiocytoma and plasma cell granuloma. A pseudotumor can occur anywhere in the lungs, even in the bronchi. When the cells proliferate actively, there is inflammation and infiltration and a large number of capillary proliferation, the shadow can increase rapidly; on the contrary, the granulation tissue is mechanized, the blood vessels are hardened, and the lung shadow can not increase for a long time. The disease can occur at any age, but young adults are mostly without gender differences. The patient's symptoms are closely related to the location of the pseudotumor. More than 60% of patients are asymptomatic, and lung shadows are accidentally detected on chest X-rays. If the pseudotumor is located near the large bronchi, it can stimulate the bronchi to cause cough, cough and blood in the sputum. A small number of patients have hemoptysis. The pseudotumor compresses the superior vena cava and can cause venous return to be blocked. Pseudotumor tumors can cause atelectasis and pneumonia in the bronchial cavity. A pseudotumor located on the surface of the lung that causes chest inflammation and pleural adhesions. Laboratory tests have no special diagnostic value. Chest X-ray examination reveals lung shadows, and more than half of the pseudotumors appear as smooth, sharp, well-defined, isolated circular or elliptical nodules. If inflammation is not absorbed around the pseudotumor, it can also show blurred edges and "burrs". Two adjacent pseudotumors are mutually fused or blocked by blood vessels during growth, and "umbilical recession" and "dumbbell type" may occur. The pseudotumor is ischemic and necrotic, and a cavity is visible on the lesion and CT scan. A few have calcification. The small bronchi in the mass can remain unobstructed and behave as an "airway sign." Fiberoptic bronchoscopy and percutaneous lung biopsy are helpful in differential diagnosis. Surgical treatment should be performed in patients with symptoms and those who cannot be differentiated from lung cancer. Surgical resection can not only confirm the diagnosis, but also cure the disease. Treatment of diseases: pneumonia Incision A standard thoracotomy or small chest incision is used depending on the size of the tumor, the location, and the procedure to be performed. 2. Pneumatic wedge resection Applicable to the peripheral part of the lung and small volume of pseudotumor, or poor cardiopulmonary function. 3. Lung or whole lung resection Large tumors, deeper locations, close to the hilar or intraoperative cryosection can not completely rule out malignancy, and patients with good cardiopulmonary function should undergo lobectomy or even pneumonectomy.

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