肺原发性脑膜瘤的诊断与治疗

Primary Pulmonary Meningioma: Diagnosis and Treatment

摘要: 目的：探讨肺原发性脑膜瘤的临床表现，影像学特征，诊断标准以及治疗方案，以提高对该疾病的认识。方法：我们报道了1例由我院治疗并经组织病理学证实为肺原发性脑膜瘤的病例，并回顾性分析了患者的临床表现、影像学表现以及病理学特征等资料，并根据国内外关于该疾病的文献报道进行总结与分析。结果：结合患者临床资料及影像学表现，决定行胸腔镜下肺叶楔形切除术 + 术中快速冰冻检查，冰冻结果示：(左肺下叶)考虑脑膜瘤伴较多砂砾体形成。患者术后恢复良好，无手术相关并发症，出院后随访至今，并无肿瘤复发表现。结论：肺原发性脑膜瘤极为罕见，影像学通常表现为孤立性肺结节，易误诊，明确诊断主要依赖于组织病理学检查，行肺叶楔形切除并做术中组织病理学检查是目前首选的治疗方案。

Abstract: Objective: Our purpose is to investigate the clinical manifestations, imaging features, diagnostic criteria and treatment of primary pulmonary meningioma, so as to improve the understanding of this disease. Methods: We reported a case of primary pulmonary meningioma treated by our hospital and confirmed by histopathology, and retrospectively analyzed the clinical, imaging and pathological features of the patient. We summarized and analyzed the literatures about this disease at home and abroad. Results: Combined with the patient’s clinical data and imaging findings, we decided to perform thoracoscopic wedge resection of the lung and intraoperative frozen section biopsy. The results showed that: meningioma of left lower lobe of lung with numerousgravel body. The patient recovered well after the operation, and there were no operative complications. No tumor recurrence has been observed up to now. Conclusion: Primary pulmonary meningioma is extremely rare and usually presents as isolated pulmonary nodules in imaging, which is easy to be misdiagnosed. The definitive diagnosis mainly depends on histopathological examination. Pulmonary wedge resection and histopathological examination duringoperation are the preferred treatment at present.