阴囊特发性钙沉着症3例临床病理分析

目的 探讨阴囊特发性钙沉着症的临床病理特征及鉴别诊断.方法 复习3例患者的临床资料、病理特征并进行文献复习.结果 3例患者均表现为阴囊皮肤多发质硬结节,镜下可见真皮深部至皮下组织内大小不等的深蓝色钙沉积团块,团块为无定形均质物质.结论 阴囊特发性钙沉着症临床罕见,易误诊, 最终需要病理检查确诊.     

阴囊特发性钙盐沉着症1例报告并文献复习

目的：报告1例阴囊特发性钙盐沉着症。方法：分析1例阴囊特发性钙盐沉着症的诊断与治疗并复习相关文献。结果：患者男，37岁，阴囊起白色硬性结节7a，病理符合阴囊特发性钙盐沉着症。结论：阴囊特发性钙盐沉着症临床罕见，本病需与多发性脂囊瘤相鉴别。     

Fahr病2例

Fahr病又称“特发性基底节钙化症”、“特发性家族性脑血管亚铁钙沉着症”、“锥体外系铁钙沉着症”等[1],由Fahr于1930年首先描述,是以双侧基底节区、丘脑、小脑齿状核及皮层下中枢对称性钙质沉着为主要病理特征的疾病,现将我们收治的2例报告如下:1临床资料患者,女性,14岁。因     

Fahr病1例并文献复习

Fahr病又称"特发性家族性脑血管亚铁钙沉着症"、"基底节钙化症"等,由Fahr于1930年首先报道,是一种散发或者家族性的双侧基底节等部位特发性钙化而导致进行性痴呆、精神异常、运动障碍等症状的疾病[1].现报道我院最近诊断的1例患者临床资料,并对近期关于该病的研究进展进行综述.     

Fahr病2例

Fahr病又称"特发性基底节钙化症"、"特发性家族性脑血管亚铁钙沉着症"、"锥体外系铁钙沉着症"等[1],由Fahr于1930年首先描述,是以双侧基底节区、丘脑、小脑齿状核及皮层下中枢对称性钙质沉着为主要病理特征的疾病,现将我们收治的2例报告如下:     

成人特发性肺含铁血黄素沉着症合并肺动脉高压1例并文献分析

本文回顾分析1例在首都医科大学宣武医院急诊科确诊的成人特发性肺含铁血黄素沉着症患者的临床表现、实验室检查、辅助检查、治疗及转归等资料,并复习相关文献。探讨成人特发性肺含铁血黄素沉着症的发病数量、临床表现及治疗方法。成人特发性肺含铁血黄素沉着症临床表现缺乏特异性,诊断需要与其他原因引起的弥漫性肺泡出血相鉴别;同时呼吁相关专科建立全国性的疾病数据库,以更好地进行临床和基础研究。     

特发性肺含铁血黄素沉着症的诊断和治疗（附20例分析）

特发性肺含铁血黄素沉着症的诊断和治疗（附２０例分析）浙江医科大学附属儿童医院陈志敏张在珍特发性肺含铁血黄素沉着症（ＩＰＨ）临床上较少见。我院１９８８～１９９３年收治ＩＰＨ２０例，现总结并讨论如下。临床资料１．一般资料：共２０例，其中男１１例，女９例；...     

特发性肺含铁血黄素沉着症一例误诊分析

目的 探讨特发性肺含铁血黄素沉着症的临床特点、误诊原因及诊断、治疗.方法 对1例特发性肺含铁血黄素沉着症的临床资料进行回顾性分析.结果 患儿反复气促、心慌2年,先后误诊为支气管肺炎、双肺感染、营养性缺铁性贫血等,予抗感染及输血治疗,效果一般,易复发.综合病情特点结合实验室检查及影像资料拟诊特发性肺含铁血黄素沉着症,后经纤维支气管镜(纤支镜)检查及支气管肺泡灌洗液分析找到含铁血黄素巨噬细胞而确诊.予糖皮质激素及免疫抑制剂硫唑嘌呤正规治疗.随访患儿未再发生气促及贫血.结论 对于本病诊断须重视影像资料分析,寻找贫血原因.纤支镜检查及支气管肺泡灌洗液分析发现含铁血黄素巨噬细胞对诊断有重要意义.     

特发性肺含铁血黄素沉着症9例临床分析

目的　提高临床和病理医生对特发性肺含铁血黄素沉着症的认识。方法　回顾分析9例特发性肺 含铁血黄素沉着症的临床表现、误诊情况、治疗与转归。结果　9例患者中4例强的松治疗3～7周后缓解,1例强 的松治疗2月无效后加用环磷酰胺治疗缓解,4例治疗无效死亡。结论　特发性肺含铁血黄素沉着症是一种少见 病,发病原因迄今无确切认识。目前尚无特异疗法,病死率高,儿童预后较成人差。     

特发性肺含铁血黄素沉着症的诊断讨论

特发性肺含铁血黄素沉着症(IPH)较少见。由于基层医生对此病认识不足,临床往往漏诊和误诊。下面结合本院收治并确诊的1例,浅谈基层医生对该病的诊断意识。     

钙化征在CT诊断甲状腺良、恶性结节中的价值

目的 分析甲状腺结节钙化的CT特点,探讨甲状腺结节的钙化特征对其良恶性诊断与鉴别诊断中的价值。 方法 回顾性分析259例277个经病理证实的甲状腺钙化结节的CT特点,重点观察结节钙化的大小、边缘、位置及数量。 结果 纳入259例患者,年龄16~84岁（54.73±12.43岁）,男性66例,女性193例。总277个钙化结节,良性钙化结节205个,占总钙化结节74.01%,恶性钙化结节72个,占总钙化结节25.99%。边缘毛糙、微小钙化（直径<2 mm）的恶性率明显高于边缘光滑、粗大结节样的钙化组（χ2=13.669~13.950,P<0.001）。边缘毛糙、细颗粒微钙化对恶性结节诊断的敏感度分别为30.56%、59.72%,特异度分别为88.29%、65.36%,准确度分别为73.29%、63.90%,阳性预测值分别为47.83%、37.72%,阴性预测值分别为78.35%、82.21%。良恶性结节平均年龄差异具有统计学意义（t=4.452,P<0.001）。良恶性钙化结节在位置、数量、形状及性别之间差异无统计学意义（P>0.05）。 结论 MSCT检查甲状腺结节钙化特点对鉴别甲状腺良恶性病变有重要指导意义,微钙化、钙化结节边缘毛糙提示恶性结节,临床医生对这类结节应提高警惕并应进一步细针穿刺检查。       

Relative risk of cancer in sonographically detected thyroid nodules with calcifications

PURPOSE: The aim of this prospective study was to evaluate the significance of sonographically detected thyroid calcifications in the diagnosis of thyroid cancer. METHODS: One hundred eighty-eight patients with thyroid disease, including 37 with thyroid cancer, were included in the study. Each patient underwent preoperative, high-resolution sonography to evaluate the thyroid gland for the presence of calcifications. RESULTS: The highest incidence of calcification was found in thyroid cancer (54%), followed by multinodular goiter (40%), solitary nodular goiter (14%), and follicular adenomas (12%). The incidence of cancer was significantly higher in calcified nodules (29%) than in noncalcified nodules in the entire group (14%) (p = 0.019), with a relative risk of 2.5. In the group of solitary thyroid nodules, the incidence of cancer in the calcified nodules (55%) was higher than in the nodules without calcification (23%) (p = 0.016). Multiple noncalcified thyroid nodules harbored cancer in only 5% of cases. Compared with multiple noncalcified thyroid nodules, the solitary calcified nodules demonstrated a relative risk of 22.8. In both the solitary and multiple nodules, the relative risk in the presence of calcification was about the same, around 4. Patients younger than 40 years with calcified nodules constituted a high-risk group, with a relative risk of 3.8 versus 2.5 in patients older than 40 years with calcified nodules. CONCLUSIONS: The detection of thyroid calcifications by sonography is diagnostically valuable, especially in cases involving a solitary nodule or a young person. The presence of calcifications in these cases should raise the suspicion of malignancy. The low incidence of cancer in patients with multiple noncalcified thyroid nodules suggests that a more conservative approach may be appropriate in such cases.     

超声检查甲状腺结节钙化类型与甲状腺癌的关系分析

目的 探讨甲状腺结节钙化类型对结节良恶性鉴别诊断的意义.方法 回顾性分析522例患者576个甲状腺结节的术前二维及彩色多普勒超声检查和术后病理结果.结果 甲状腺良性结节钙化发生率低于恶性结节钙化发生率(P＜0.001).恶性结节I型钙化发生率高于良性结节(P＜0.001).I型微钙化诊断恶性结节的敏感性60%,特异性88%,准确率82%,比值比(OR)为11.28.Ⅳ型钙化均见于良性结节.Ⅱ、Ⅲ型钙化发生率在良恶性结节中差异无统计学意义.年龄＜45岁的患者结节钙化时患甲状腺癌的OR为11.33.单发结节钙化时患甲状腺癌的OR为20.48.结论 甲状腺结节钙化与甲状腺癌有关,特别是结节内出现I型微钙化、患者年龄＜45岁和单发结节出现钙化时,其患甲状腺癌的危险性明显增加.     

Elastography Can Effectively Decrease the Number of Fine-Needle Aspiration Biopsies in Patients with Calcified Thyroid Nodules

When calcification, frequently found in both benign and malignant nodules, is present in thyroid nodules, non-invasive differentiation with ultrasound becomes challenging. The goal of this study was to evaluate the utility of elastography in differentiating calcified thyroid nodules. Consecutive patients (165 patients with 196 nodules) referred for fine-needle aspiration who had undergone both ultrasound elastography and B-mode examinations were analyzed retrospectively. Calcification was present in 45 benign and 20 malignant nodules. On 65 calcified nodules, elastography had 95% sensitivity, 51.1% specificity, 46.3% positive predictive value and 95.8% negative predictive value in detecting malignancy. Twenty-three of 45 benign calcified nodules were correctly diagnosed with elastography compared with 4 of 45 by B-mode ultrasound. Although it is difficult to differentiate benign and malignant calcified thyroid nodules solely with B-mode ultrasound, elastography has the potential to reduce the number of fine-needle aspiration biopsies performed on calcified nodules.     

高频彩超对甲状腺癌的诊断分析

目的探讨甲状腺癌超声特征。方法对54例经手术病理证实的甲状腺癌患者进行声像图回顾性分析。结果甲状腺癌的超声诊断符合率为68.5%(37/54)。甲状腺癌声像图特征表现以低回声为主,无包膜,后方衰减,肿块内见砂粒样微钙化灶。结论高频彩超对甲状腺癌有诊断价值,但部分甲状腺癌声像图不典型或与良性病变有交叉现象,诊断时必须综合判断。     

超声探测甲状腺结节内钙化的临床意义

目的　评价超声探测甲状腺结节内钙化在诊断甲状腺癌疾病中的临床意义。方法　 16 1例甲状腺疾病患者 ,其中良性病变 14 4例 ,恶性病变 17例。术前患者均进行甲状腺高频超声检查 ,重点观察甲状腺内有无钙化。结果　甲状腺癌中钙化合并率最高 (5 9% ,10 / 17) ,其次为多发结节性甲状腺肿 (39% ,33/ 84 ) ,单发结节性甲状腺肿 (16 % ,3/ 19) ,滤泡腺瘤 (12 % ,4 / 33)。与无钙化组相比 ,钙化组癌变发生率明显增高 (P<0 .0 5 )。单发甲状腺结节组 ,有钙化者癌变率 (19% )较无钙化者 (6 % )明显增高。结论　钙化的存在增加了恶变的可能 ,应用高频超声探测甲状腺钙化具有重要临床诊断价值 ,尤其在单发结节患者。     

超声探测甲状腺钙化模式的临床意义

目的探讨甲状腺钙化模式在诊断甲状腺癌中的意义。方法对121例共191个甲状腺结节行术前超声检查。结果72个(38%)结节内发现钙化,其中41个(57%)结节被组织病理证实为甲状腺癌,按照钙化分型,伴微钙化的结节12个(86%),伴粗钙化的结节23个(52%),伴周边钙化的结节5个(45%),周围无甲状腺结节的孤立钙化斑1个(33%)被证实为甲状腺癌。结论钙化是诊断甲状腺癌的一个特异性的指标,从筛查甲状腺癌的角度来讲,声像图中的每一种钙化都有恶性的风险,不仅微钙化,其他类型的钙化也要仔细检查。     

高频彩色多普勒超声在阴囊、睾丸疾病中的诊断价值

目的探讨高频彩色多普勒超声在阴囊、睾丸疾病中的诊断价值。方法对151例经手术及病理证实的阴囊、睾丸疾病声像图和彩色血流进行回顾性分析。结果151例中包括:睾丸肿瘤6例(其中精原细胞瘤3例、胚胎细胞癌1例、畸胎瘤1例、恶性淋巴瘤1例);睾丸囊肿1例;睾丸微石症4例;睾丸炎5例;睾丸结核4例;睾丸扭转5例;睾丸创伤10例;附睾肿块35例(其中附睾囊肿21例、附睾炎性结节11例、附睾结核3例);鞘膜积液39例(其中睾丸鞘膜积液27例、精索鞘膜积液4例、精索睾丸鞘膜积液6例、交通性鞘膜积液2例);隐睾6例(均为腹股沟型);精索静脉曲张36例(其中21例为左侧、7例为右侧、8例为双侧);均经手术及病理证实。结论高频彩色多普勒超声能显示各种阴囊、睾丸疾病的声像图和血供特点,为临床诊断提供了重要价值。     

阴囊Paget′s病伴多系统转移1例报告并文献复习

目的：提高阴囊Paget’s病伴多系统转移的认识。方法：报道1例阴囊Paget’s病伴多系统转移并文献复习。结果：阴囊Paget‘s病伴多系统转移临床少见。结论：阴囊Paget’s病伴多系统转移临床少见，早期诊断、早期治疗是关键。     

Subcutaneous angiolipoma in the scrotum: A case report

BACKGROUNDAngiolipoma has been reported in many cases, and it often occurs in the skin of the trunk and limbs. However, angiolipoma in the scrotum is a rare disease with unknown etiology. This condition is difficult to diagnosis with other lumps in the scrotum.CASE SUMMARYA 32-year-old man presented to the urinary department with a history of an enlarged left scrotum with increasing discomfort for about 5 years. Physical examination revealed that there were a palpable mass measuring about 7.0 cm × 6.5 cm in the left scrotum, with smooth surfaces but without tenderness or adhesion to the skin. Ultrasound showed that there was a hyperechoic mass under the skin of the top scrotum, about 72 mm × 64 mm × 21 mm in size, with clear borders, uneven internal echo, and abundant blood flow signals. Serum human chorionic gonadotropin and alpha-fetoprotein were in normal level. Subcutaneous mass resection at the bottom of the left scrotum was performed under local anesthesia with 1% lidocaine. Postoperative pathological examination resulted in a diagnosis of subcutaneous angiolipoma of the scrotum. No evidence of recurrence was found at 6 mo after surgery and there were no complaints of discomfort.CONCLUSIONAngiolipoma is an extremely rare type of benign tumor extremely rarely found in the scrotum, but needs to be considered when evaluating scrotal masses especially when the mass is solid. According to the characteristics of angiolipoma, surgical resection is the best treatment strategy and it is not prone to recurrence after resection.