Objective To enhance the understanding of pulmonary hemangiopericytoma. Methods With a case report and reviewing related literatures, the etiology, clinical manifestations, radiological features,pathological features, diagnosis, treatment and prognosis of pulmonary hemangiopericytoma were discussed.Results The etiology of this rare disease remains unknown. Clinical symptoms are rare and non-specific.Radiological features show a round, homogeneous, soft-tissue mass without calcification. Pathologic feature reveals a large number of capillary lumen, and some tumors can be dressed with pseudo capsule or show infiltration growth to the surrounding tissue. The diagnosis of pulmonary hemangiopericytoma is mainly based on the imaging findings, and pathological examination is needed for final diagnosis. The best choice of treatment is surgery, combined with chemotherapy and radiotherapy.Conclusions Pulmonary hemangiopericytoma is rare and often misdiagnosed as other pulmonary diseases. More attention should be paid to improve its therapeutic effect and prognosis.
ObjectiveTo investigate the clinical features, diagnosis, treatment and prognosis of pulmonary tumor thrombotic microangiopathy (PTTM).MethodsA patient with PTTM was reported. Literatures about PTTM searched by WanFang databases and PubMed were reviewed for its clinical characteristics.ResultsA 62-year-old female was admitted with chief complaint of dry cough, dyspnea and hemoptysis. Progressive dyspnea, pulmonary hypertension and hypoxemia occurred during hospitalization. Computed tomography angiography (CTA) of the lung excluded pulmonary embolism. Peripheral blood appearing a large number of late erythroblasts and erythrocyte debris and progressively decreasing platelets suggested that the patient suffer from thrombotic microvascular disease. CT showed widely metastatic lesions at the vertebrae and sternum. On the basis of above clinical characteristics, PTTM was diagnosed clinically. Although the patient accepted respiratory support therapy, anticoagulation therapy and resuscitation, she still died 5 days later after hospitalization. Literatures about PTTM with complete clinical information were reviewed. A total of 92 PTTM cases were reviewed and the main reasons of these patients admitted were progressive dyspnea and chronic cough. During hospitalization, they all suffered varying degrees of hypoxia, while radiological findings of the lungs lack specificity. No abnormal sighs were found by lung CTA. The results of ultrasonic cardiography or the Swan–Ganz catheter indicated varying degrees of pulmonary hypertension, some patients were proved with disseminated intravascular coagulation and/or microangiopathic hemolytic anemia. The definite diagnosis of PTTM depended on the histologic evidence which were often obtained from post-mortem examination, because many patients couldn’t tolerate the lung biopsy due to rapid aggravation. The treatment of PTTM included respiratory support therapy, anticoagulation therapy, antipulmonary hypertension and the chemotherapy of primary or metastatic tumour. The prognosis of PTTM was poor and almost all of the patients died in a short term, ranged from 48 hours to 3 months.ConclusionIf a patient with a history of cancer or evidence of cancer metastasis has hypoxemia and pulmonary hypertension but without abnormal lung CTA signs, PTTM should be considered.
ObjectiveTo explore and analyze the related influencing factors for common intraoperative complications during CT-guided percutaneous radiofrequency ablation of pulmonary tumor. MethodsWe retrospectively analyzed the clinical data of the patients who underwent CT-guided percutaneous radiofrequency ablation of pulmonary tumor in our hospital from December 2018 to December 2019, and analyzed the influencing factors for complications. ResultsA total of 106 patients were enrolled. There were 58 (54.7%) males and 48 (45.3%) females aged 46-81 (68.05±8.05) years. All patients successfully completed the operation. The operation time was 47.67±16.47 min, and the hospital stay time was 2.45±1.35 d. The main intraoperative complications were pneumothorax (16.0%, 17/106) and intrapulmonary hemorrhage (22.6%, 24/106). Univariate analysis showed that the number of pleural punctures had an impact on the occurrence of pneumothorax (P=0.00). The length of the puncture path (P=0.00), ablation range (P=0.03) and ablation time (P=0.00) had an impact on the occurrence of intrapulmonary hemorrhage. Multivariate logistic regression analysis showed that the size of the lesion (OR=17.85, 95%CI 3.41-93.28, P=0.00) and the number of pleural punctures (OR=0.02, 95%CI 0.00-0.11, P=0.00) were independent influencing factors for the occurrence of pneumothorax. The length of the puncture path (OR=15.76, 95%CI 5.34-46.57, P=0.00) was the independent influencing factor for the occurrence of intrapulmonary hemorrhage. ConclusionPercutaneous radiofrequency ablation of pulmonary tumor is safe and with a high success rate, but intraoperative complications are affected by many factors, so the surgeons should be proficient in operating skills to avoid complications.