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Clinical Analysis of Primary Pulmonary Chondroma: Four Cases Report and Literature Review

目的探讨原发性肺软骨瘤（chondroma）的临床特点、诊断及其治疗方法，以提高临床医师对本病的认识和诊疗水平 方法回顾性分析我院4例（男2例、女2例，年龄50～63岁）肺软骨瘤的临床资料，并结合国内外1983年1月至2013年9月30年文献报道的51例患者的临床资料进行分析和总结。 结果55例患者中男30例，女25例，发病年龄10～84（42.47± 17.27）岁。主要临床表现有咳嗽、咳痰、痰中带血、胸闷、胸痛、呼吸困难、喉部不适等，也有无临床症状，于体检发现。临床诊断以肺癌、结核、错构瘤、炎性假瘤、肺畸胎瘤及肺部包块等。55例患者都行手术治疗，无手术死亡。 结论肺软骨瘤是临床上一种较为罕见的良性肿瘤，临床表现缺乏特异性，术前误诊率较高，影像资料有助于诊断和鉴别诊断，确诊依靠病理诊断以及肺软骨瘤与Carney’s综合征的关系，手术切除治疗疗效确切。

肺纤维组织细胞瘤一例并文献复习

目的 探讨肺纤维组织细胞瘤的临床病理、诊断及其预后。方法 报告金乡县人民医院收治的1 例肺良性纤维组织细胞瘤患者的临床资料, 并分析国内外相关文献。结果 患者为34 岁女性, 主要症状为胸痛, 胸部CT 示右肺下叶后基底段椭圆形肿块, 无分叶及毛刺。光镜下肿瘤主要由梭形细胞组成, 无瘤巨细胞及细胞核分裂相。术后病理检查确诊为肺纤维组织细胞瘤。患者已生存4 年余。结论 肺良性纤维组织细胞瘤是一种良性生物学行为的肿瘤, 临床少见。术前确诊困难, 主要治疗手段为外科手术切除, 预后较好。

Investigation of symptom clusters and related interference on daily life of lung cancer patients undergoing concurrent chemoradiation therapy

Objective To explore the incidence and severity of symptoms of the lung cancer patients undergoing concurrent chemoradiation therapy, and reveal the influence of symptom clusters on the patients’ daily activities. Method From December 2016 to June 2017, a total of 150 patients with lung cancer who underwent concurrent chemoradiation therapy were investigated by using M. D. Anderson Symptom Inventory of Chinese Version and the revised lung cancer module. Results For the patients during the period of concurrent chemoradiation therapy, the symptoms with severity score >5 were fatigue, nausea, poor appetite, cough, distress, disturbed sleep, vomiting, expectoration, and grief; the symptoms with incidence >80% were fatigue, nausea, disturbed sleep, poor appetite, grief, and cough. Joy of life (87.33%), emotion (74.38%), and work (72.67%) were the top three in terms of high incidence of symptom distress. Exploratry factor analysis revealed 4 major symptom clusters, which were fatigue-related symptom cluster, gastrointestinal symptom cluster, emotion symptom cluster, and respiratory symptom cluster. Conclusions During the period of concurrent chemoradiation therapy, lung cancer patients suffer from multiple symptom clusters. Medical staff should assess symptoms timely, and provide effective interventions, to improve the patients’ quality of life.

Single Chest Tube Application Promotes Fast Track Recovery after Lung Cancer Resection

ObjectiveTo compare clinical results between single and double chest tube applications after lung cancer resection, and explore the role of single chest tube in postoperative fast track recovery. MethodNinety-three patients with lung cancer who underwent lobectomy between March and December of 2009 in West China Hospital of Sichuan University were included in this study. All the patients were divided into a single-tube group including 46 patients (39 males and 7 females) with their age of 58.4±9.5 years, and a double-tube group including 47 patients (32 males and 15 females) with their age of 58.2±9.0 years. Drainage amount, duration, postoperative hospital stay, and incidences of pneumothorax and pleural effusion after removal of chest tubes were compared between the 2 groups. ResultsThe percentage of patients undergoing complete video-assisted thoracic surgery (VATS) of the double-tube group was significantly higher than that of the single-tube group, and the percentage of patients undergoing thoracotomy of the double-tube group was significantly lower than that of the single-tube group (P < 0.05). Drainage amount of the double-tube group was significantly larger than that of the single-tube group (824.4±612.5 ml vs. 510.7±406.7 ml, P < 0.05). There was no statistical difference in drainage duration, postoperative hospital stay, the incidences of subcutaneous emphysema, pneumothorax, pleural effusion or re-insertion of chest drain between the 2 groups (P > 0.05). ConclusionClinical results of single chest tube is better than or equivalent to those of double chest tubes after lung cancer resection, and drainage duration of single chest tube application might be shorter.

发生于肺腺癌患者的节段状视网膜动脉周围炎一例

Chest CT comparison of ground glass opacity-like 2019 novel coronavirus pneumonia and early-stage lung carcinoma

ObjectiveTo investigate CT image features of ground glass opacity (GGO)-like 2019 novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) and early-stage lung carcinoma for control and therapy of this acute severe respiratory disease.MethodsWe retrospectively analyzed the clinical data of 71 GGO-like COVID-19 patients who received therapy in Tongji Hospital of Huazhong University of Science and Technology between January 17th and February 13th, 2020. These 71 GGO-like COVID-19 patients were as a COVID-19 group. And 80 GGO-like early-stage lung carcinoma patients who underwent resection were as a lung carcinoma group. Clinical features such as sex, age, symptoms including fever, cough, fatigue, myalgia and dyspnea, detailed exposure history, confirmatory test (SARS-CoV-2 quantitative RT-PCR) and pathologic diagnosis were analyzed.ResultsSignificantly different symptoms and exposure history between the two groups were detected (P<0.001). More lesions (61 patients at percentage of 85.92%, P<0.001), relative peripheral locations (69 patients at percentage of 97.18%, P<0.001) and larger opacities (65 patients at percentage of 91.55%, P<0.001) were found in chest radiographs of GGO-like COVID-19 compared with GGO-like early-stage lung carcinoma. Similar features appeared in early-stage of COVID-19 and lung carcinoma, while pneumonia developed into more extensive and basal predominant lung consolidation. Coexistence of GGO-like COVID-19 and early-stage lung carcinoma might occur.ConclusionConsidering these similar and unique features of GGO-like COVID-19 and early-stage lung carcinoma, it is necessary to understand short time re-examination of chest radiographs and other diagnostic methods of these two diseases. We believe that the findings reported here are important for diagnosis and control of COVID-19 in China.

肺鳞癌组织中脆性组氨酸三联体基因的表达

目的 探讨肺鳞癌组织中脆性组氨酸三联体(fragile histidine triad, FHIT)基因的表达及其与临床病理特征的关系。 方法 应用免疫组织化学treptavidin peroxidase，SP)法检测FHIT在42例肺鳞癌患者癌组织及13例癌旁组织中的表达，并研究FHIT蛋白阳性表达与肺癌临床病理特征、临床病理分期的关系。 结果 肺癌组织中FHIT蛋白阳性表达率显著低于癌旁组织(47.6% vs. 92.3%，Plt;0.05)。中/高分化患者FHIT蛋白阳性表达率显著高于低分化患者(54.2% vs. 38.9%，Plt;0.01)；有淋巴结转移患者FHIT蛋白阳性表达率显著低于无淋巴结转移患者［45.9%(17/37) vs. 60.0%(3/5)，Plt;0.05］；Ⅰ期+Ⅱ期患者FHIT蛋白阳性表达率显著高于Ⅲ期患者［55.0%(11/20) vs. 45.5%(10/22)，Plt;0.05］。 结论 FHIT基因在肺鳞癌的发生、发展中起重要作用，对其蛋白的检测有望作为判定肺鳞癌发生及转移能力的客观指标之一。

The clinico-pathological analysis of choroidal metastatic carcinom aarising from lung carcinoma

Objective To observe the clinical and pathological characteristics of choroidal metastatic carcinoma from lung carcinoma.Methods The clinical and pathological data of 6 patients with choroidal metastatic carcinoma from lung carcinima were analysed retrospectively.Results All the 6 patients had severe visual impairment, including 3 with severe ophthalmalgia. Flat neoplasm were seen in the posterior pole of the eyes in all the 6 patients and retinal detachment were found in 5 patients. Fundus fluorescein angiography (FFA) examination had been performed on 1 patient and blocked fluorescence and hyperfluorescence were seen in the lesion with pinpoint fluorescein leakage loop around it. CT examination had been performed on 3 patients and the shadow of flat homogenous tumor was seen. MRI examination had been performed on 1 patient and high signal intensit ies on T1W and low signal intensities on T2W were found. In all the 6 patients with primary lung carcinoma, 5 were diagnosed with adenocarcinoma and 1 with cellule carcinoma through pathological examination, and 5 patients were diagnosed with choroidal metastatic carcinoma from adenocarcinoma and 1 with choroidal metastatic carcinoma from cellule carcinoma through pathological examination.Conclusion Rapid visual acuity decrease, severe ophthalmalgia, flat neoplasm in ocular fundus and secondary retinal detachment are the main clinical characteristics of the choroidal metastatic carcinoma from lung carcinoma. Most histopathologica l manifestations of the metastatic carcinoma like that of the primary focus, and adenocarninoma is the most common histoclassification. (Chin J Ocul Fundus Dis，2003，19：333-404)

Value of Positron Emission Tomography - computed Tomographic Simulator Treated with Intensity Modulated Radiotherapy in Patients with Non-small Cell Lung Cancer Complicated with Atelectasis

目的:探讨PET-CT模拟定位对非小细胞肺癌合并肺不张适形调强放疗靶区确定的临床价值。方法:对经影像学和病理证实伴有肺不张的非小细胞肺癌12例患者,进行PET-CT模拟定位。根据PET-CT扫描显像结果,分别以GTV CT和GTVPET-CT勾画原发病灶,对用治疗计划系统计算出的两组数值加以比较。结果:GTVCT平均为141 cm3(99～185 cm3),GTVPET-CT平均为113 cm3(60～165 cm3),两者差异有显著性(t=5.497,Plt;0.001)。12例患者原发病灶体积的GTVPET-CT均较GTV CT有不同程度的缩小,平均缩小体积28 cm3(19%)。结论:PET-CT模拟定位,对非小细胞肺癌合并肺不张患者放疗靶区的精确定位具有重要的临床意义。

Efficacy of bronchoscopy-guided 125I seeds implantation combined with chemotherapy for advanced central type lung cancer

Objective To explore the efficacy and safety of bronchoscopy-guided radioactive 125I seeds implantation combination with chemotherapy for advanced central type lung cancer. Methods Sixty-six patients with central type lung cancer in stage Ⅲb or Ⅳ were enrolled in this study from May 2014 to July 2016. The patients were randomly divided into two groups, ie. bronchoscopy-guided seeds implantation combined with chemotherapy group (experimental group, n=30) and chemotherapy group (control group, n=36). All patients accepted GP regimen (gemcitabine plus cisplatin) chemotherapy and were followed up by CT and electric bronchoscopy (EB) examination 1, 3, 5 months later. According to WHO unified standard, the efficacy and adverse effects were evaluated . Results In the experimental group and the control group, the response rate (complete response plus partial response) was 80.00% and 50.00%, respectively. There was significant difference between two groups (P<0.05). The incidence rate of hemoptysis in the experimental group was significantly higher than that in the control group (P<0.05), but there was no significant difference between the two groups in the incidence rate of pneumothorax, fever or bone marrow suppression (allP>0.05). All adverse reactions were light and could be controlled. Conclusions The short-term clinical efficacy is better in the bronchoscopy-guided seeds implantation combined with chemotherapy group. The bronchoscopy-guided seeds implantation combined with chemotherapy is a safe and minimally invasive treatment for advanced central type lung cancer.