RESUMEN
A discrete pulmonary mass lesion has different implications in children and in adults. Although infectious, congenital and metastatic etiologies are part of the differential diagnosis, inflammatory pseudotumour of the lung, or plasma cell granuloma, has emerged as the most common entity. The authors describe two patients with this poorly understood lesion and review the current state of knowledge. Both patients were young (4 and 5 years) and had recurrent lower respiratory tract infections; one patient was asthmatic. Both had persistent cough, and discrete lung lesions were apparent radiologically. Both children were treated by thoracotomy and excision of the tumour. There were no operative complications, and the convalescent period was uncomplicated. There were no signs of recurrence at follow-up 1 and 2 years postoperatively. This lesion is almost always benign, but aggressive behaviour has been documented. The authors recommend prompt conservative surgical excision.
Asunto(s)
Granuloma de Células Plasmáticas del Pulmón/patología , Preescolar , Diagnóstico Diferencial , Humanos , Masculino , Granuloma de Células Plasmáticas del Pulmón/cirugía , Estudios RetrospectivosRESUMEN
At the University of Alberta Hospital between 1950 and 1988, 17 patients who had a diagnosis of carotid body tumour were seen; 15 of them were followed up for an average of 8 years (range from 1 to 38 years). In 14 patients the tumour was removed surgically. There were no operative deaths and no strokes occurred. The most frequent complication was cranial nerve deficit. Of the 15 patients followed up, 10 (67%) manifested a deficit of the facial, vagus or hypoglossal nerve. The primary tumour was diagnosed histologically as a benign neoplasm in all 14 patients operated on, but in 3 distant metastases developed or there was invasive local recurrence. Patients with malignant tumour were significantly (p less than or equal to 0.01) younger than those with a benign tumour. Carotid body tumours can be managed safely with respect to stroke complications, but cranial nerve injuries continue to be a problem. Malignant tumours are difficult to distinguish from benign tumours except that they tend to occur in younger patients. Prompt surgery and close follow-up is particularly important in patients with carotid body tumour.