支氣管顆粒細胞瘤一例并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

田剛 , 葛繼文 ,  劉心存

濟寧醫學院附屬醫院呼吸內二科（山東濟寧 272029）;

Corresponding?author：

劉心存, Email: tiangang930@126.com

Keywords：

顆粒細胞瘤; 支氣管

DOI：

10.7507/1671-6205.201807001

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目的分析支氣管顆粒細胞瘤（BGCT）的臨床表現、診斷及治療，提高醫務人員對該病的認識。方法回顧性分析濟寧醫學院附屬醫院呼吸科 2017 年 6 月收治的 1 例 BGCT 患者的臨床資料并進行相關文獻復習。以“支氣管，顆粒細胞瘤”、“Granular cell tumor，Bronchus or Bronchial”為關鍵詞檢索 2007 年 1 月至 2017 年 7 月中國知網、萬方數據庫及 PubMed 數據庫的相關文獻，共獲文獻 17 篇，選取臨床資料齊全的文章共 8 篇，其中中文 4 篇，外文 4 篇。結果患者男性，40 歲，因"反復咯血 2 年，再發 2 d"入院。雙源 CT 支氣管動脈血管成像示雙側支氣管動脈未見明顯增粗，右肺中葉部分膨脹不全。電子支氣管鏡檢查示右肺中間段支氣管管壁息肉樣新生物，表面可見血管。于新生物行鉗夾及毛刷檢查，病理報告顆粒細胞瘤。確診為 BGCT 后行氬氣刀局部切除及冷凍治療，2017 年 8 月復查胸部 CT 及支氣管鏡未見明顯異常。文獻復習檢索到 8 篇“支氣管顆粒細胞瘤”相關文獻，均為病例報道，共 8 例，包括本病例在內共 9 例，其中男 4 例，女 5 例，年齡 17～62 歲，中位年齡為 55 歲。3 例為查體發現，6 例有臨床癥狀，臨床癥狀以咯血、胸痛、胸悶、呼吸困難為主。8 例行經支氣管肺活組織檢查，1 例經開胸探查術，均經病理檢查確診，其中 6 例聯合免疫組織化學確診。患者確診后，其中 5 例行外科手術切除，3 例經電子支氣管鏡摘除，1 例未行 GCT 的干預治療。結論 BGCT 罕見，由于臨床表現及影像學檢查缺乏特異性，組織病理學檢查是診斷的金標準。電子支氣管鏡在診斷與治療方面均有重要意義。

Citation： 田剛, 葛繼文, 劉心存. 支氣管顆粒細胞瘤一例并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(1): 76-80. doi: 10.7507/1671-6205.201807001 Copy

1.	張大發, 唐進, 王賓, 等. 原發性支氣管內顆粒細胞瘤一例. 江蘇醫藥, 2007, 3(7): 717.
2.	Joung MK, Lee YJ, Chung CU, et al. A case of granular cell tumor of the trachea. Korean J Intern Med, 2007, 22(2): 101-105.
3.	姚剛, 羅曉琴, 陳永紅. 支氣管顆粒細胞瘤 1 例. 臨床肺科雜志, 2008, 13(3): 294.
4.	Meyer MA, Becker JM, Quinones W. Endobronchial granular cell tumor: a case report. J Radiol Case Rep, 2010, 4(8): 29-35.
5.	王崢, 陳靖, 初建國. 支氣管顆粒細胞瘤一例. 中華放射學雜志, 2013, 47(1): 94.
6.	魏建國, 袁曉露, 孫愛靜. 原發支氣管良性顆粒細胞瘤 1 例. 中國腫瘤臨床, 2014, 41(5): 354.
7.	Kim HJ, An S, Kim HR. Primary bronchial granular cell tumor in an adult male. Korean J Thorac Cardiovasc Surg, 2014, 47(2): 193-196.
8.	Venur VA, Zhang G, Farver C, et al. Coexistent pulmonary granular cell tumor and adenocarcinoma of the lung. Transl Lung Cancer Res, 2014, 3(4): 262-264.
9.	Abrikossoff A. Uber Myome, ausgehend von der quergestreiften Willkürlichen muskulatur. Virchows Arch Pathol Anat, 1926, 260(1): 215-233.
10.	Funan HU. Clinical Dermatology. 12^th revision. In: Demis DJ, McGuire J, editors. Vol. 4. London: Harper and Row Publishers. 1982, 1-5.
11.	Guarnieri T, Cardinale L, Macchia G, et al. Multiphasic multidetector computed tomography study of a rare tracheal tumor: granular cell tumor. Case Rep Pulmonol, 2014, 2014: 807430.
12.	Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol, 1998, 22(7): 779-794.
13.	Fechner RE, Bentinck BR, Askew JB Jr. Acinic cell tumor of the lung. A histologic and ultrastructural study. Cancer, 1972, 29(2): 501-508.
14.	Gayen T, Das A, Shome K, et al. Granular cell tumor: an uncommon benign neoplasm. Indian J Dermatol, 2015, 60(3): 322.
15.	van der Maten J, Blaauwgeers JL, Sutedja TG, et al. Granular cell tumors of the tracheobronchial tree. J Thorac Cardiovasc Surg, 2003, 126(3): 740-743.
16.	Daniel TM, Smith RH, Faunce HF, et al. Transbronchoscopic versus surgical resection of the tracheobronchial granular cell myoblastoma: suggested approach based on follow-up of all treated cases. J Thorac Cardiovasc Surg, 1980, 80(6): 898-903.

1. 張大發, 唐進, 王賓, 等. 原發性支氣管內顆粒細胞瘤一例. 江蘇醫藥, 2007, 3(7): 717.
2. Joung MK, Lee YJ, Chung CU, et al. A case of granular cell tumor of the trachea. Korean J Intern Med, 2007, 22(2): 101-105.
3. 姚剛, 羅曉琴, 陳永紅. 支氣管顆粒細胞瘤 1 例. 臨床肺科雜志, 2008, 13(3): 294.
4. Meyer MA, Becker JM, Quinones W. Endobronchial granular cell tumor: a case report. J Radiol Case Rep, 2010, 4(8): 29-35.
5. 王崢, 陳靖, 初建國. 支氣管顆粒細胞瘤一例. 中華放射學雜志, 2013, 47(1): 94.
6. 魏建國, 袁曉露, 孫愛靜. 原發支氣管良性顆粒細胞瘤 1 例. 中國腫瘤臨床, 2014, 41(5): 354.
7. Kim HJ, An S, Kim HR. Primary bronchial granular cell tumor in an adult male. Korean J Thorac Cardiovasc Surg, 2014, 47(2): 193-196.
8. Venur VA, Zhang G, Farver C, et al. Coexistent pulmonary granular cell tumor and adenocarcinoma of the lung. Transl Lung Cancer Res, 2014, 3(4): 262-264.
9. Abrikossoff A. Uber Myome, ausgehend von der quergestreiften Willkürlichen muskulatur. Virchows Arch Pathol Anat, 1926, 260(1): 215-233.
10. Funan HU. Clinical Dermatology. 12^th revision. In: Demis DJ, McGuire J, editors. Vol. 4. London: Harper and Row Publishers. 1982, 1-5.
11. Guarnieri T, Cardinale L, Macchia G, et al. Multiphasic multidetector computed tomography study of a rare tracheal tumor: granular cell tumor. Case Rep Pulmonol, 2014, 2014: 807430.
12. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol, 1998, 22(7): 779-794.
13. Fechner RE, Bentinck BR, Askew JB Jr. Acinic cell tumor of the lung. A histologic and ultrastructural study. Cancer, 1972, 29(2): 501-508.
14. Gayen T, Das A, Shome K, et al. Granular cell tumor: an uncommon benign neoplasm. Indian J Dermatol, 2015, 60(3): 322.
15. van der Maten J, Blaauwgeers JL, Sutedja TG, et al. Granular cell tumors of the tracheobronchial tree. J Thorac Cardiovasc Surg, 2003, 126(3): 740-743.
16. Daniel TM, Smith RH, Faunce HF, et al. Transbronchoscopic versus surgical resection of the tracheobronchial granular cell myoblastoma: suggested approach based on follow-up of all treated cases. J Thorac Cardiovasc Surg, 1980, 80(6): 898-903.

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