hamartoma
Introduction
Introduction to hamartoma Hamartoma refers to the combination and arrangement of normal tissues in an organ of an organism during development, resulting in a tumor-like malformation. The term "malignant tumor" was first proposed by albrecht in 1904. The hamartoma is not a true tumor. The tumor grows slowly, and the growth of the random body grows, but it increases to a certain extent and stops. It is coordinated with the body and rarely malignant. There are also a few scholars who believe that hamartomas are true tumors (such as renal angiomyolipoma) rather than "abnormal combinations of normal tissues" and should be classified as mesenchymal tumors. The hamartoma can come from many tissues, common in the lungs (mixed by cartilage islands, bronchial epithelium and glands, localized hyperplasia to form localized or diffuse hamartoma), kidney (vascular smooth muscle lipoma), breast (breast lobule) Adipose-forming mammary hamartoma) and infant liver (mesenchymal hamartoma). When the clinical and X-ray can not rule out malignant tumors, surgery should be done as soon as possible. Even the benign misoperation of the hamartoma can avoid complications such as pneumonia, atelectasis, and bronchiectasis caused by the enlargement of the tumor, which may aggravate or complicate the condition. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of infection: non-infectious Complications: pneumonia, atelectasis
Cause
The cause of hamartoma
Improper diet (25%)
Excessive drinking, often eating fat, animal gut, scaleless fish or egg yolk. Because eating too much fatty products, high-cholesterol foods, can cause damp heat, phlegm and dampness, transport disorders, that is, new fat tissue, so that the body's excess fat cells are heterologous, denatured.
Psychological factors (25%)
People who are overworked, irritated, and often angry. Because of liver qi stagnation, poor blood and meridians, the normal adipose tissue and blood can be intertwined, and connective tissue can be wrapped into fat cells for a long time to form lipoma. The principle of treatment: Shugan qi, blood circulation, soft and firm. Through the treatment to open the meridians, dredge the menstrual blood, dissipate the lipoma.
Liver and kidney damage (25%)
I often stay up all night and think about people with too many problems. Because it hurts the liver and kidney, the liver and kidney yin deficiency, yin and yang disorders, so that the body's ability to decompose fat is reduced, the original fat tissue and newborn fat can not be properly arranged, forming an abnormal adipose tissue, that is, "missor tumor", The principle of treatment: nourishing kidney yin, regulating yin and yang balance, soft and firm.
Pathogenesis
From the pathogenesis through years of intensive research, combined with modern biomolecular theory, finally concluded that the root cause of various types of hamartoma formation is "lipoma factor", there is also a lipoma factor in patients Under normal circumstances, this lipomat factor is in an inactive state (inactive state), under normal circumstances, it will not develop disease, but under the influence of various internal and external environment, the activity of this lipomat factor It has a certain activity in an active state. When the external factors change, and the internal environment changes in the body, the activity of the lipoma factor is further enhanced, causing abnormal proliferation of normal fat cells, resulting in deposition of adipose tissue in the smooth muscle tissue of the capillaries. , forming a prominent mass of the organ, called the hamartoma.
Renal hamartoma is a benign tumor of the renal parenchyma, which can occur in both the cortex and the medulla. Pathological examination showed that the size of the tumor was different, and it could grow to the extrarenal or collecting system. There was no complete capsule, but the boundary was clear. The cut surface was grayish, grayish yellow or mixed yellow, and some showed hemorrhagic foci. Microscopically, the tumor is composed of mature adipose tissue, blood vessels and smooth muscle in different proportions, and may also be mixed with fibrous tissue. It is generally believed that the main pathological basis of tumor hemorrhage is that the tumor is rich in vascular tissue, and these blood vessel walls are thick and inelastic, and the blood vessel is distorted and can be aneurysm-like, and can be broken by a slight external force. In addition, there may be two influencing factors: First, the various tissues in the hamartoma have different degrees of maturity, and some contain smooth muscles and fibrous tissues that are actively growing, so that the tumors grow rapidly and blood supply increases. Some people think that these cells have The characteristics of myoblasts and fibroblasts have potentially aggressive behavior and may even be malignant. Second, the rapidly growing tumor compresses the adjacent normal kidney tissue while increasing in volume and weight, causing normal renal tissue atrophy or even focal ischemic necrosis, so that a slight external force can break the interface between the tumor and the kidney. And bleeding.
Prevention
Malatoma prevention
Although the disease is not very clear from the etiology, there is no effective preventive measure. At present, more attention should be paid to the careful choice of surgical methods. For patients who need surgery, try to preserve normal lung tissue and avoid excessive surgery. This has also become the principle of surgical treatment of such patients in recent years.
At the same time, nutritious and healthy eating habits and regular work and rest are of great significance for the prevention of this disease.
Complication
Hamartoma complications Complications, pneumonia, atelectasis
The complications of this disease are rarely reported. For patients who need surgery, careful selection of surgical methods, preservation of normal lung tissue as much as possible, and prevention of excessive resection can also prevent intraoperative and postoperative complications. The occurrence of the disease. However, if the tumor is large, it may cause compression symptoms on the large blood vessels and lung tissues of the heart, causing thoracic deformity, which may also cause complications such as pneumonia, atelectasis, and bronchiectasis, which may aggravate or complicate the condition. Therefore, when the clinical and X-ray can not rule out malignant tumors, surgery should be performed as soon as possible.
Symptom
Hamartoma Symptoms Common Symptoms Abdominal Discomfort Hypertension Abdominal Tumor Hematuria Proteinuria
The age of hamartoma is mostly over 40 years old, and more men than women. The vast majority of hamartomas (about 80% or more) grow in the peripheral part of the lungs, clinging to the visceral pleura of the lungs, sometimes protruding from the surface of the lungs.
The vast majority of patients with hamartoma are asymptomatic. Most of the main causes of symptoms are related to the growth site, size, number, growth rate of the renal hamartoma, and the relationship with the surrounding organs. During the physical examination, some patients may have the following symptoms due to the increase of the tumor itself and the pressure in the tumor, infection, etc.:
1 Waist, abdominal discomfort or pain: The reason is that due to enlargement and expansion of the kidney, the renal capsule tension is increased, the renal pedicle is pulled, or the adjacent organs are stressed. In addition, the large kidney hamartoma causes the kidney to become heavy, and it can cause waist pain when it is pulled down. Pain is characterized by dull pain, dull pain, fixed on one or both sides, radiating to the lower and lower back. If there is bleeding inside the tumor or secondary infection, the pain will suddenly increase. Renal colic can occur if the blood clot blocks the urinary tract after merging stones or bleeding.
2 hematuria: can be expressed as microscopic hematuria or gross hematuria. The episode is periodic. Low back pain is often exacerbated during seizures, and strenuous exercise, trauma, and infection can be induced or aggravated.
3 Abdominal mass: Sometimes the main reason for patients to see a doctor, 60% to 80% of patients can reach the enlarged kidney.
4 proteinuria: the general amount is not much, 24 hours urine will not exceed 2g. More than no kidney disease syndrome.
5 hypertension: the solid tumor compresses the kidney, causing renal ischemia, causing increased renin secretion and causing hypertension. When kidney function is normal, more than 50% of patients have hypertension, and the incidence of hypertension is higher when renal dysfunction occurs.
6 renal dysfunction: due to the tumor occupying and oppression, the normal kidney tissue is significantly reduced, and renal function is progressively reduced.
Examine
Malformation examination
(1) X-ray chest examination is the main method. The chest radiographs vary in size. The single circle or elliptical edge has smooth shadows and may have lobes. Sometimes the calcification or low density shadow is visible in the tumor.
(B) CT chest scan is more helpful for diagnosis.
(C) through the chest wall lung biopsy to help the diagnosis of peripheral tumors of the lung.
Diagnosis
Diagnosis of hamartoma
diagnosis
First, medical history, symptoms: more common in adults, generally asymptomatic. The tumor is large, and it may have irritating cough, sputum, dyspnea caused by airway obstruction, obstructive pneumonia and other symptoms when growing in or near the bronchi. Occasionally hemoptysis and purpura.
Second, physical examination found: more no positive signs, or limited breathing sounds and wheezing. When there is an inflammatory infection or obstructive atelectasis, the corresponding lung signs appear.
Third, auxiliary examination: (A) X-ray chest examination as the main means, chest radiographs vary in size, a single round or oval edge smooth shadow, may have lobes, sometimes visible calcification or low density shadow in the tumor. (B) CT chest scan is more helpful for diagnosis. (C) through the chest wall lung biopsy to help the diagnosis of peripheral tumors of the lung.
Differential diagnosis
Should be distinguished from lung cancer and other benign lung tumors.
