口腔局灶性黏蛋白沉积症1例

<正>患者女性,20岁,因发现左侧舌部肿物及右侧下颌磨牙区疼痛1个月入院。查体见左侧舌部肿物无疼痛,吞咽感不适,双侧面部不对称,右侧面部轻度肿胀,压痛明显。CBCT示右侧下颌边缘性颌骨骨髓炎,行右侧下颌骨病损切除术+下颌骨部分切除术+左侧舌部病损切除术+舌部分切除术。术中见左侧舌远一肿物,大小0.3 cm×0.3 cm,位于黏膜下,边界清楚,质硬,包膜完整。病理检查眼观:灰红、灰白色组织,绿豆大小,切面灰白色,质中。镜检:低倍镜下为复层     

富黏液型涎腺导管癌1例

<正>患者女性，68岁，因左侧腮腺区肿物1年入院。1年前出现左眼无法闭合、嘴角歪斜，半年前发现左侧腮腺区有一约花生米大小肿物，增长迅速伴疼痛。入院后查体：左侧耳垂前下方扪及一质硬包块，活动度欠佳。B超示左侧腮腺内见低回声区，大小4.0 cm×3.7 cm×3.0 cm, 形态不规则，边界不清。病理检查 眼观：涎腺组织1个，大小5.5 cm×5.5 cm×4.0 cm, 切面见一肿物，大小3.5 cm×3.0 cm×2.5 cm,     

婴幼儿原始黏液样间叶性肿瘤1例

<正>患者男童,3岁,因发现左大腿肿块3天入院。体检发现左大腿中段外侧一质韧包块,大小3.5 cm×3.0 cm×2.5cm,无明显压痛,周围无明显红肿,皮肤无破溃。外院MRI示左大腿外侧肌间有一椭圆形界限清楚的肿块,T1WI低信号,T2WI高信号,且内部信号均匀(图1)。术中发现肿块位于股外侧肌中,有包膜,与周围组织不粘连,大小3.5 cm×2.5 cm×2.5 cm。     

甲状腺玻璃样变梁状腺瘤2例

例1,女性,43岁,因发现颈部肿块2个月余入院。劳累时呼吸急促,全身无明显症状。查体:消瘦,甲状腺增大,左侧触及一4cm×3cm×3cm大小肿物,质中等,边界清楚,无压痛。心肺检查正常,肝肋下2cm,质软,脾未触及,腹区未触及肿物,肾区无扣击痛。甲状腺B超检查发现左甲状腺内肿物,内部回声     

成牙骨质细胞瘤一例

患者男, 23岁。5年前发现左下颌骨小肿物,伴疼痛、咀嚼痛,未予处理。肿物渐增大。患者局部无红肿热痛症状,体重无降低。体检:双侧面部基本对称,无面瘫,颞下颌关节区无压痛,开口度及开口型均无异常。口内第一磨牙区颊舌侧可见一 2cm×2cm大小的肿物,颊舌向膨胀,质硬,界限清楚,移动度差,按压痛。表面黏膜颜色正常,未触及骨质破坏。颌颈部未及肿大淋巴结。曲面断层片示:左第一磨牙牙根周围 2cm×2cm大小不均匀斑片状高密度影,累及牙根,肿物周围可见一清晰的环状透亮带。患者入院后行肿物及受累牙齿完整切除术加周围软组织刮除术。术后病人…     

腹壁畸胎瘤1例

腹壁畸胎瘤实属罕见,我院遇见一例,并经手术切除,现报告如下。 患者王某某,女44岁,该患自幼年起,右下腹部即有一约花生米大小包块、不痛、不痒及任何不适感,一直未引注意,有关年龄的增长腹部包块也逐渐增大。近半年来畸有疼痛曾在某县、市医院及某医科大学诊断为腹壁皮脂腺瘤合并感染,嘱期手术治疗,故于1993年8月6日前来我院就诊。 查体所见:于右下腹近腹股沟管处并沿其走行可见一约8.0×4.0×4.0cm之圆柱形包块,表面与皮肤显梭形粘连约6.0×3.0cm,粘连之皮肤呈灰褐色,皮面光滑及无桔皮样改变,未见增粗之皮脂腺管开口,瘤体表面光滑,无触痛,内侧半坚硬如石,外侧1/3有囊性感,张力较大肿物与周围组织呈广泛性粘连,不能活动,但可随周围组织而     

颌下腺滤泡性非何杰金淋巴瘤一例

患者女，36岁。因左颌下肿块2周子1994年3月29日入院。患者年轻时有左颌下胀痛，触压无肿块，无流脓，无口内特殊分泌物或口腔异味。入院前2周感左颌下肿痛，触之有一鸽蛋大肿物，质软，活动。近二天肿块明显增大，鸡蛋大小，质软，活动度较大。体检：左颌下可及5cm×4cm ×3．5cm椭圆形肿块，活动，质地中等。双合诊可触及，无压痛，表面不光滑。口内无颌下腺导管结石，无舌运动障碍。病理检查：额下腺1个，7cm×3Cm×3cm大小，包膜完整。切面偏一侧见一个4．5cm×3cm×3cm大小肿瘤，似有包膜，质软细腻，灰红色背景上有灰白色密集斑点。…     

额部黏液炎性纤维母细胞性肉瘤1例

正患者女性,91岁,2年前发现左侧额部有一黄豆大小包块,偶有瘙痒,未予治疗,肿块渐增大至乒乓球大小,局部皮肤反复破溃、溃疡(图1),无发热、头痛、视物模糊等。既往无特殊病史。头颅专科查体:头颅大小、形状正常,左侧额部头皮见一肿物突出皮肤表面,大小3 cm×2.5 cm×2 cm,表面暗红色,质脆,触之易出血,边界尚清,基底部固定。口眼耳鼻无明显异常。CT示左侧额部头皮软组织内见一大小1.8 cm×2.8 cm×3.0 cm肿物,宽基底向外     

孤立性髓系肉瘤合并甲状腺乳头状癌1例

<正>患者女性,53岁,发现左下颌部肿物1个半月,颈部肿物1周。专科检查:左下颌部可触及质韧肿物,大小3 cm×3 cm,活动度可,无触痛及压痛,左侧颈部可触及质韧性肿物,大小1 cm×1 cm,可随吞咽上下移动,活动度可,与周围组织无明显粘连,双侧颈部未及明显肿大淋巴结;各项实验室检测均未见异常。颈部增强CT示下颌骨左下缘可见软组织密度影,形态不规则边界欠清,下颌骨骨质未见明显改变,增强后呈明显强化(图1)。甲状腺左叶多发低密度结节,左叶结     

外阴浅表性血管黏液瘤2例

例1,42岁,发现左侧外阴部包块5年,进行性增大,有压痛。查体:左侧外阴可触及皮下包块,大小3.0 cm×3.0cm×2.5 cm,表面皮肤无红肿及破溃,与周围组织边界清。例2,26岁,左侧外阴部包块2年,逐渐增大,无明显不适。查体:左侧外阴皮下包块,大小0.5 cm×0.5 cm×0.5 cm,表面光滑,略呈分叶状,与周围组织边界较清。病理检查眼观:例1,带皮肿物1个,大小2.5 cm×2.0 cm×1.5 cm,肿物位于真皮及皮下,略呈分叶状,无包膜,边界较清,切面灰白色,实性,有黏液感,质中,基底部未     

Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy

PurposeTo evaluate the prognosis of nasopharyngeal carcinoma (NPC) patients who developed bone-only metastasis after primary treatment and the stratification of these patients into different risk groups based on independent prognostic factors.ResultsThe median follow-up time was 15.5 months (range, 2–67 months) for the whole cohort. The median overall metastatic survival (OMS) time and the 2-year estimate OMS rate were 26.5 months and 52%, respectively. Multivariate analysis indicated that patients with short metastases-free interval, multiple bone metastases sites, high serum lactic dehydrogenase levels, and treated with radiotherapy or chemotherapy alone had significantly worse outcomes. Patients were stratified into three different risk groups based on the number of adverse factors present. The OMS curves of the three groups were all significantly different (p<0.001).ConclusionSeverl prognostic factors were found to be associated with worse outcomes. According to the number of adverse factors present, bone-only metastasis patients can be stratified into three risk groups with significantly different prognoses. Such grouping may help in improving the design of clinical trials and in guiding individualized treatment for NPC patients with bone-only metastasis.     

Bloom''s syndrome with porokeratosis of Mibeili and multiple cancers of the skin, lung and colon

A 38-year-old Japanese male with Bloom's syndrome (BS) and porokeratosis of Mibelli (PM) developed multiple carcinomas of the skin and lung. There were multiple, spontaneous chromosomal aberrations and frequent sister chromatid exchanges (SCE). Cutaneous delayed-type hypersensitivity reactions were defective and serum IgM was decreased. The lung cancer was treated with radiation, which was effective but caused a severe pulmonary atelectasis and esophageal stricture. The patient expired one-and-a-half years later because of pneumonia. Autopsy disclosed an adenocarcinoma of the colon. The concurrent PM was considered responsible for the occurrence of multiple skin cancers.     

Solid pseudopapillary tumor: an invasive case report of primary ovarian origin and review of the literature

Solid pseudopapillary neoplasm occurring as a primary tumor outside the pancreas is a rare event. We report a case of an ovarian primary occurring with an ill-defined cystic mass in a 39-year-old woman. The morphologic and immunohistochemical features of the ovarian neoplasm described in this report are compatible with those of solid pseudopapillary neoplasm of the pancreas. Histologically, the tumor cells of the case we report infiltrate into the ovarian parenchyma. Because of the diagnosis is not clear before surgery, the patient had a reoccurrence two months after the operation in which laparoscopic simple ovarian cystectomy and part ovarian tissue removal, followed by the right salpingo-oophorectomy. The case herein confirms that solid pseudopapillary neoplasm of the ovary belongs to the class of low-grade malignant tumor with certain invasiveness. The diagnosis should be taken into serious consideration in order to avoid missed diagnosis and delay treatment. Through this case we have a better understanding of the biological behavior of solid pseudopapillary neoplasm of the ovary.     

Fine-needle cytology of an eccrine spiradenoma of the breast: diagnosis made by a holistic approach.

Eccrine spiradenoma is a rather rare adnexal tumor of the skin. When the clinical presentation is that of a breast neoplasm, diagnosis can be difficult. As cytology was a new procedure for this tumor, the approach of choice appeared to be a holistic one. The cytologic picture showed bland groups of uniformly sized cuboid cells with scant cytoplasm, round to ovoid nuclei, and inconspicuous nucleoli, while in the groups rosettelike structures could be discerned. Only by integrating the data of clinical history, inspection, palpation, reaction on breast puncture, and immunologic findings could the diagnosis be made.     

Cystic neoplasms of the exocrine pancreas

The increasing use of radiological imaging has led to greater detection of small and asymptomatic cystic lesions of the pancreas. Most are resectable, but not all are neoplastic. This review provides an update on the histopathology, immunohistochemistry, molecular biology, pathogenesis and management of cystic neoplasms of the exocrine pancreas. These include the serous, the mucinous cystic, the intraductal papillary mucinous and the solid pseudopapillary neoplasms. Recently reported variants are described and very rare cystic variants of other pancreatic epithelial and mesenchymal neoplasms are briefly mentioned.     

A case of blastic plasmacytoid dendritic cell neoplasm with ecchymotic lesions on the whole body

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) derived from plasmacytoid dendritic cell precursors is a very rare, and characterized by cutaneous and bone marrow involvement and leukemic spread. The neoplasm presents with an aggressive behavior, and the clinical findings include cytopenia, particularly thrombocytopenia. The tumor cells are negative for antigens of T- and B- cell lines. However, these cells express CD4, CD56 and CD123, which are markers of plasmacytoid dendritic cells, and negative for Epstein-Barr virus (EBV). From this point of view, a 71-year-old man who was initially found to have a cutaneous mass on his face and thorax was reported here, and initially was diagnosed as “eczema”. The skin rashes then became aggravated on a trial of low dose topical corticosteroid for 2 months. According to skin biopsy, the tumor cells reveal an immature blastic appearance and positive for CD4 and CD56, negative for CD3, CD20, indicating a diagnosis of BPDCN. Here, we report the dismal course of a patient with BPDCN without accepting further therapy, and only survived 3 months.     

A novel approach to biliary tract pathology based on similarities to pancreatic counterparts: Is the biliary tract an incomplete pancreas?

There are peribiliary glands around the biliary tract, and these glands drain into the bile duct lumen. Interestingly, small amounts of pancreatic exocrine acini are intermingled with these glands. Experimental studies using animals suggest that the biliary tract shows some potential for pancreatic differentiation. It is noteworth that the biliary tract and pancreas have similar pathological features. IgG4‐related sclerosing cholangitis and autoimmune pancreatitis are representative inflammatory diseases with similar features. Intraductal papillary neoplasms are found in the biliary tract and also in the pancreas: intraductal papillary neoplasm of the bile duct (IPNB) and intraductal papillary mucinous neoplasm of the pancreas (IPMN). IPNB and IPMN share common histologic and phenotypic features and biological behaviors. Interestingly, mucinous cystic neoplasm (MCN) arises in both the pancreas and the heaptobiliary system. Intraductal tubular neoplasia is found in both the biliary tract and pancreas as well. Intraepithelial neoplasm is found in the biliary tract and pancreas: biliary intraepithelial neoplasm (BilIN) and pancreatic intraepithelial neoplasm (PanIN). BilIN and PanIN are followed by conventional invasive adenocarcinoma, while IPNB and IPMN are followed by tubular adenocarcinoma and mucinous carcinoma in both organs. Further study of the biliary tract's pathophysiology based on its similarity to pancreatic counterparts is warranted.     

Intraductal papillary mucinous neoplasm (IPMN) of the gastric-type with focal nodular growth of the arborizing papillae: a case of high-grade transformation of the gastric-type IPMN

We present a case of intraductal papillary mucinous neoplasm (IPMN) of the pancreas, demonstrating a process of high-grade transformation of the gastric-type IPMN. An 83-year-old Japanese woman underwent pylorus-preserving pancreatoduodenectomy for removal of a multicystic mass of the pancreas head, which had been followed up for 7 years. The removed tumor was a low-grade gastric-type IPMN spreading in the branch ducts, focally forming an intraluminal nodular lesion. The nodular lesion was comprised of arborizing papillotubular proliferation of cuboidal to columnar epithelia with high-grade atypia, and was characterized by diffuse MUC1 expression and a gastric mucin phenotype (focal MUC5AC and MUC6 expressions). Therefore, the nodular lesion was consistent with the pancreatobiliary-type IPMN, and the present case suggests that the low-grade gastric-type IPMN may progress to a focal intraductal carcinoma over the years, and the pancreatobiliary-type IPMN may be one of the forms of such high-grade transformation of the gastric-type IPMN. One of the cystic lesions was an oligocystic-type serous cystic neoplasm (serous cystadenoma), which might be an incidental concomitance or have a common basis.     

肝癌发生与转移过程中E—选择素在裸鼠肝、肺、肾微血管内皮细胞的表达

目的：观察肝原位种植肝癌裸鼠模型在肿瘤发生与转移过程中E－选择素在肝、肺、肾组织中的表达。方法：将人肝癌组织块直接种植于裸鼠肝内,术后15、17、19、21、40天取材,免疫组化法观察。结果：肝癌种植后第15－17天,肝、肺、肾组织中微血管内皮细胞E－选择素呈弱阳性表达,种植后第19天,肝血窦内皮细胞呈强阳性表达。种植后第19天,肺组织内E－t选择素表达增强。至40天时,表达最强,结论：E－选择素的表达和增强与肝癌的发生和转移有关。