Trahealna lokalizacija inflamatornog miofibroblastnog tumora kod odraslih
Sažetak
Uvod: Inflamatorni miofibroblastni tumor (IMT) je retka neoplazma. Bolest je nepredvidivog toka i nejasne etiologije za čiju definitivnu dijagnozu je potrebna detaljna patohistološka analiza uz primenu imunohistohemije. Mikroskopski ga čine miofibroblastne vretenaste i inflamatorne ćelije u različitom odnosu. Ređe se viđa kod starijih osoba i nespecifične je simptomatologije. Opisano je prisustvo IMTa na svim anatomskim lokalizacijama, a trahealna lokalizacija je posebno veoma retka.
Prikaz Slučaja: Bolesnica stara 41.godinu javila se u našu ustanovu zbog progresije simptoma sličnih astmi u vidu otežanog disanja, kašlja i brzog zamaranja. Ranije je lečena bronhodilatatornom terapijom bez uspeha. Na kontrolnim ambulantnim pregledima radiografijom grudnog koša uočena je suspektna promena u distalnom delu traheje. Nakon prijema u našu ustanovu učinjene su dijagnostičke metode spirometrija, kompjuterizovana tomografija (CT) grudnog koša, nuklearna magnetna rezonanca (NMR) grudnog koša i bronhoskopija. Navedene dijagnostičke pretrage su potvrdile postojanje promene u distalnoj trećini traheje. Učinjena je desna torakotomija sa mobilizacijom pluća i resekcijom traheje i termino-terminalnom (T-T) anastomozom. Histopatološkom analizom operativnog materijala uz primenu imunohistohemije postavljena je dijagnoza IMTa. Bolesnica je četiri godine nakon operacije bez recidiva bolesti.
Zaključak: Za postavljanje dijagnoze IMTa su potrebne detaljne dijagnostičke pretrage, posebno adekvatna histopatološka analiza sa imunohistohemijom. Metod izbora u lečenju IMTa je kompletna hirurška resekcija. Dalje kontrole su neophodne u cilju detekcije mogućih recidiva.
Reference
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