腹膜后纤维化的多层螺旋CT诊断

目的探讨腹膜后纤维化（RPF）的多层螺旋CT（MSCT）的表现和诊断价值。方法对19例经临床病理证实的腹膜后纤维化的MSCT影像表现及临床资料作回顾性分析。结果腹膜后纤维化的MSCT表现为腹膜后弥漫型肿块及腹膜后脏器的浸润及与周围组织的包裹。19例中13例为肿块型,6例为弥漫型。CT平扫为腹膜后密度较均匀或不均匀的软组织肿块。增强扫描病灶呈不同程度强化。本组11例行MPR多平面重建,可进一步明确病变与周围组织的关系。结论 MSCT检查可明确病变的范围、部位、形态、密度及强化特征,对腹膜后纤维化的诊断有重要临床价值。     

腹膜外途径腹腔镜前列腺癌根治术(附2例报告)

目的 报告腹膜外途径腹腔镜前列腺癌根治术的初步体会。方法 分别于2005年4月、12月，经腹膜外途径进行腹腔镜前列腺癌根治术2例。结果 2例均获成功，首例手术时间为7小时20分钟，第2例为3小时20分钟。术中分别输红细胞悬液3单位、2单位。首例术后出现尿漏12d，术后23d带导尿管出院，半月后膀胱造影提示无尿漏后拔导尿管，站立后有尿失禁，术后4个月后尿失禁完全消失；第2例患者术后未出现尿漏，于术后10d拔除导尿管，拔管后即无尿失禁，术后15d出院。结论 腹膜外途径腹腔镜前列腺癌根治术是安全、可行的，较传统的经耻骨后径路的开放性手术及经腹腔途径的腹腔镜前列腺癌根治术均有一定的优势。     

Mature cystic teratoma involving adrenal gland

A mature cystic teratoma presented as an adrenal mass in a 57-yr-old woman. The tumor was found to be predominantly paraadrenal but focally interrupted the adrenal cortex so that an intraadrenal origin could not be ruled out. Similar lesions have been reported extremely rarely and should be considered in the differential diagnosis of hormonally silent adrenal tumors. The findings of rimlike calcification and fatty density on computed tomography may be helpful diagnostically.     

Myoepithelioma of the Retroperitoneum

An abdominal mass detected in a 36-year-old man was thought from radiologic studies to be a renal neoplasm, but at surgery the kidney was found to be uninvolved. The 9.5-cm retroperitoneal tumor was resected totally and found to be encapsulated, and it appeared to be benign by light microscopy. The pattern of the spindle cells throughout the tumor suggested a cellular schwannoma, but immunocytochemical and ultrastructural studies did not support schwannian differentiation and instead revealed epithelial and smooth muscle features compatible with a myoepithelioma.     

Fetus in fetu. Rare cause of a lump in an adult’s abdomen

Fetus in fetu is a rare entity. The patient usually presents in childhood. A case in which the patient presented in adulthood, with a lump in the abdomen, is reported. Computed tomography findings were diagnostic of this condition and a prospective diagnosis could be made. Computed tomography also helped to differentiate it from mature teratoma.     

后腹腔镜与开放性肾囊肿去顶术的疗效比较

目的:评价经后腹腔镜与开放性肾囊肿去顶术的治疗效果,探讨术中进入后腹腔的方法。方法:14例单纯性肾囊肿行后腹腔镜手术,其中11例采用直接闭合式方法进入后腹腔,21例行开放性手术。对两种术式的临床疗效、术后恢复等进行对比研究。结果:两种手术方式均能达到良好的肾囊肿去顶效果,后腹腔镜手术在术中出血,术后下床活动时间,术后住院天数,术后镇痛药使用情况方面优于开放性手术(P<0.05)。后腹腔镜手术1例中转开放性手术。结论:后腹腔镜肾囊肿去顶术疗效可靠,手术创伤小,术后恢复快。采用直接闭合式方法进入后腹腔,操作更简便。     

Lipoma-like tumor mass probably arising in the retroperitoneal heterotopic pancreas: a previously undescribed lesion

Heterotopic pancreatic tissue is found in several locations of the body. However, to the best of our knowledge, there have been no reports on heterotopic pancreas in the retroperitoneum. A case of retroperitoneal lipoma-like large tumor mass probably arising in the heterotopic pancreas is reported. A 45-year-old Japanese woman was admitted to hospital because of back pain. Imaging modalities showed an abnormal mass in the retroperitoneum separate from the surrounding organs, including the pancreas and kidney. Histologically, the mass consisted of mature adipose tissue and scattered ductal and acinar elements. Although there was no islet tissue in this fatty mass, the epithelial elements suggested heterotopic pancreatic tissue in origin. The present case is very unusual; however, heterotopic pancreas should be considered in the differential diagnosis of retroperitoneal tumors.     

眼眶原发性脂肪肉瘤的临床特点及病理观察(英文)

目的:探讨眼眶原发性脂肪肉瘤的临床和病理特点。方法:收集2例眼眶原发性脂肪肉瘤和6例腹膜后原发性脂肪肉瘤的临床资料,病理标本光镜取材切片观察,免疫组织化学作CK(AE1/AE3), Desmin, MyoD1,S100-protein, Melanoma标记。眼眶原发性脂肪肉瘤的例2作透射电镜观察。结果:原发性眼眶脂肪肉瘤的患者年青,原发性腹膜后脂肪肉瘤的患者年龄以40岁以上者为主(5/6)。原发性眼眶患者症状显著但肿瘤小,原发性腹膜后患者症状轻,但肿瘤巨大。两组在组织学上分布于脂肪肉瘤的各型。肿瘤易复发,但无转移。结论:眼眶原发性脂肪肉瘤易复发,诊断依靠光镜和电镜观察以及免疫组织化学染色。     

后腹膜腔人工CO2气腹对兔肝、肾功能的影响

目的 探讨后腹膜腔人工CO2气腹对兔肝、肾功能的影响。方法 新西兰白兔20只，随机分为2kPa 1h组、2kPa 2h组、4kPa 1h组、4kPa 2h组；建立后腹膜腔后应用气腹机自动完成气腹。测定气腹前、气腹后1、3、5d肝、肾功能，应用统计学方法分析指标动态变化规律。结果 气腹后1d可出现不同程度的肝、肾功能减退，气腹后3d开始好转，第5天恢复至气腹前水平，这种改变与气腹压力、气腹持续时间相关。结论 后腹膜腔人工CO2气腹可以引起肝、肾功能改变，后腹腔镜手术应注意气腹压力和持续时间。