Supraclavicular lymphadenopathy following COVID-19 vaccination: an increasing presentation to the two-week wait neck lump clinic?

The first COVID-19 vaccination was given in December 2020 and there is an effort to vaccinate the international population on a massive scale. Common side effects from the vaccine include headache and tiredness. Regional lymphadenopathy has been described in relation to other vaccines. We describe two cases of supraclavicular reactive lymphadenopathy presenting in patients who had the COVID vaccination in the ipsilateral arm. Awareness of this diagnosis is important for patients presenting to the neck lump clinic.     

An unusual neck lump: intramuscular haemangioma of the sternocleidomastoid muscle

Neck lumps can often present a diagnostic dilemma, with a wide pre-operative differential diagnosis. We present an unusual case of an intramuscular haemangioma arising in the sternocleidomastoid muscle. Pre operative diagnosis is often difficult, as these lesions are extremely rare in the head and neck region and only few sporadic cases have been reported in the literature. We report the presentation diagnosis and management of intramuscular haemangiomas of the sternocleidomastoid muscle.     

山楂结块体外凝结、离解的实验研究

目的:探讨山楂结块形成的机制,以指导预防和治疗。方法:配制以胃蛋白酶为基本液的模拟胃液,对60个山楂糊团和500g山楂糊进行酸凝实验。使用6％和8％浓度的碳酸氢钠溶液对酸凝后的山楂糊团、山楂糊做碱离解试验。设搅拌、非搅拌组和清水对照组作对比。结果:酸凝实验:山楂团硬度增加。清水对照组山楂团硬度明显低于酸凝组。散放入模拟胃液中的山楂糊相互接触处发生凝结,形态仍呈不规则片块状。碱离解实验:6h后碳酸氢钠溶液中均出现酸碱中和现象。非搅拌组:结块表面有碎屑脱落,至第10天碳酸氢钠溶液和清水中的结块均未自行碎解。搅拌组:搅拌时有较多碎屑脱落。第3天,1个结块碎解。至第10天,20个结块全部碎解。清水对照组:仅1个结块在第8天碎解。结论:山楂团酸凝后硬度增大。散放入的山楂糊酸凝后形态仍呈不规则片块状。碱溶液通过酸碱中和可使山楂结块表面松解,无外力作用时不能使结块碎解。     

Investigation and management of the neck lump

A neck lump is a common presenting sign in both the paediatric and adult population and may represent a broad range of benign or malignant diagnoses. The appropriate initial assessment, investigation and management is key to delivering appropriate treatments and to avoid missing potentially serious diagnoses. There is a range of imaging modalities available to the treating clinician and huge variability in the appropriate surgical or non-surgical management of disease. In this article we discuss the approach to the assessment of patients with a neck lump, including the history and examinations which should take place. We discuss the imaging modalities which are most appropriate for each condition and the range of management options available. Both common and rarer diagnoses are discussed through the course of the review.     

CT引导胸部病灶穿刺活检技术

目的 总结CT引导下胸部病灶穿刺活检质量控制的经验．方法 用质量控制的方法全部在CT引导下进行经皮穿刺活检80例胸部肿块。结果 一次穿刺成功率100％，明确诊断率94％，胸部并发症的发生率明显减少。结论 用质量控制的方法在CT引导下进行经皮穿刺活检准确率高，并发症少。     

平调饮治疗原发性肝癌的实验研究

目的研究平调饮对小鼠S180肉瘤抑瘤效应及免疫功能的影响,及对H22肝癌小鼠生命延长作用,为平调饮的临床应用提供实验依据。方法取雄性昆明小鼠,(对S180实验取75只,对H22实验取50只),体重:18±2g,随机各等分为5组,造模第2天开始给药。对S180小鼠,实验结束后第2天处死,称其体重、脾脏、胸腺及移植瘤重量,计算抑瘤率、脾脏指数、胸腺指数;对H22小鼠,观察生存时间,计算生命延长率。结果①平调饮各组对S180肉瘤小鼠的抑瘤率均显著高于模型组(P<0.05);②平调饮各组与模型组及5-Fu治疗组相比较,可使胸腺指数、脾脏指数明显升高(P<0.01);③对H22小鼠生存时间亦明显长于模型组和5-Fu治疗组(P<0.01)。结论平调饮对小鼠S180肉瘤有较强的抑瘤作用,并能显著提高机体免疫功能,还可以延长H22肝癌小鼠生存时间,这是一值得进一步研究的临床课题。     

结核瘤与周围型肺癌的影像学对比分析

目的进一步认识结核瘤与周围型肺癌的不同影像学表现，探讨影像检查在二者鉴剐诊断中的应用价值。方法对经临床或病理证实的结核瘤及周围型肺癌各30例患者进行回顾性分析，结合临床，分析其影像学改变。结果结核瘤与周围型肺癌的X线平片及CT征象的表现具有某些各自的特异性征象，有助于二者的鉴别：①结核瘤的特异性X线征象包括卫星病灶、边缘清晰锐利部分有浅分叶征等；②而深分叶征或脐凹征、毛刺征、支气管充气征或空泡征、胸膜凹陷征夏血管集束征为周围型肺癌的基本征象；③对病灶的定性诊断CT优于X线普通摄影。结论胸部X线检查是发现病变的基本首选方法，发现病变后进行CT扫描，根据其特异性的影像表现结合临床综合分析，是对二者进行准确鉴别诊断的关键。     

乳癖和癥瘕的关系

从乳房和胞宫的生理病理,乳癖与癥瘕的病因病机、临床表现和治疗等方面阐述了乳癖和症瘕的关系.     

玻片法与血块法检测红斑狼疮细胞的比较

临床上检查红斑狼疮细胞(LEC)方法有多种,目前省内医院多采用血块法,本文采用玻片法检测34例,阳性率为73％,与血块法阳性率比较差异显著(P<0.05)。该法采用末梢血为标本,操作简单,阳性率高,值得推广。     

235例乳腺肿块针吸细胞学检查结果分析

本文总结有病理组织学证实的乳腺肿物针吸细胞学检查235例,结果表明本组乳癌细胞学诊断阳性率为80%,假阴性14．5%,无假阳性报告。结合涂片观察,本文提出了乳腺肿块针吸细胞学的良恶性鉴别标准,讨论了导致假阳性和假阴性的原因。