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胸腺瘤是局限性很强的肿瘤,多呈局部浸润,但引起胸膜和心包浸润的并非罕见,有时还可出现远隔转移.根据这些性质,常采用如下病程分类.Ⅰ期:肉眼和组织学均看不到浸润者;Ⅱ期:肉眼可见与胸膜或周围脂肪组织粘连,或组织学上有被膜浸润者;Ⅲ期:周围脏器浸润;Ⅳa 期:胸膜、心包种植转移;Ⅳb 期:血行或淋巴转移。由于胸腺瘤局限性强,所以一般常首选外科治疗.Ⅰ、Ⅱ期可完全切除,Ⅲ期依浸润脏器及切除情况可分三种,①完全切除者;②切除大部分肿瘤(次全切除);③不能切除者(部分切除、开胸探查或非手术).Ⅳa 期和Ⅳb 期一般不能全切除.胸腺瘤的复发形式有三种,①局部复发;②播散转移;③远隔转移。局部复发常发生在首次手术时肿瘤未切净或合并切除周围浸润脏器的病人,但有时认为已完全切除的Ⅰ、Ⅱ期病人也有局部复发的,这可能是瘤细胞透过被膜所致的局部播散.
Thymoma is a very localized tumor, with localized infiltration, but it is not uncommon for pleural and pericardial infiltration to occur. Sometimes distant metastases can also occur. Based on these properties, the following disease classifications are often used. Phase I: gross and histological None of the infiltrants were visible; Phase II: visible to the naked eye, adhesion to the pleura or surrounding adipose tissue, or histologically infiltrated envelopes; Stage III: Peripheral organ infiltration; Stage IVa: pleural, pericardial metastases; Stage IVb: Blood Or lymphatic metastasis. Due to the limitations of thymoma, surgical treatment is generally preferred. Stages I and II are completely resected. Stage III is divided into three categories according to infiltrating organs and resection. 1 Complete resection; 2 Resection of most tumors (subtotal resection) ); 3 can not be resection (partial resection, open chest exploration or non-surgical). IVa and IVb generally can not be completely removed. The recurrence of thymoma in three forms, 1 local recurrence; 2 disseminated metastasis; 3 distant metastasis. Local recurrence often occurs in patients with unclear tumors or resection of surrounding infiltrating organs at the time of first surgery, but it is sometimes considered that locally relapsed stage I and II patients also have local recurrence, which may be caused by the passage of tumor cells through the capsule. Local dissemination.