Benign metastasizing leiomyoma of the lung with malignant transformation mimicking mediastinal tumor

We report a rare case of benign metastasizing leiomyomas (BMLs) showing malignant transformation in one of them. A 65-year-old woman had a fever. Computed tomography (CT) revealed a mass on the left side of the anterior mediastinum and multiple nodules in bilateral lungs. The masses proved to be leiomyomas and a leiomyosarcoma. The latter showed heterogeneous contrast enhancement on CT and high heterogeneous uptake of ¹⁸F-fluorodeoxyglucose (FDG) on positron emission tomography (PET)-CT. This case suggested the potential usefulness of PET-CT for differentiating these entities.     

丹参注射液联合消瘤颗粒对子宫肌瘤大鼠激素水平的影响及机制研究

目的 探讨丹参注射液联合消瘤颗粒对子宫肌瘤大鼠激素水平的影响,并分析其机制.方法 以30只成年雌性未孕无特定病原体级SD大鼠为研究对象,采用苯甲酸雌二醇联合黄体酮肌注建立子宫肌瘤模型,并按照随机数字表法分为4组:模型对照组(n=7),腹腔注射和灌胃等量0.9％氯化钠溶液)、治疗A组(n=7),腹腔注射1 mL丹参注射液...     

Differential levels of soluble angiopoietin-2 and Tie-2 in patients with haematological malignancies

The system involving angiopoietin-2 (Ang-2) and its receptor, Tie-2, appears to play an important role not only in tumor angiogenesis, but also in the biology of haematological and non-haematological malignancies. In the present study we evaluated the serum levels of soluble Ang-2 (sAng-2) and soluble Tie-2 (sTie-2) in patients with haematological malignancies. Measurements were carried out in 15 patients with chronic myeloid leukaemia (CML), 25 with essential thrombocythemia (ET), 24 with multiple myeloma (MM) and six with monoclonal gammopathy of undetermined significance (MGUS). In addition, we correlated the levels of angiopoietins with known prognostic factors. sAng-2 and sTie-2 were quantified with enzyme-linked immunosorbent assay (ELISA). In patients with CML and MM the levels of sAng-2 were significantly higher (1686.53 +/- 936.41 pg/mL and 1917.82 +/- 1427 pg/mL, respectively) than in controls (n = 15; 996.096 +/- 414.65 pg/mL) (P < 0.01). In patients with MM sAng-2 levels were significantly increased with increasing stage of disease, from stage I to stage III (P < 0.03) and presented a trend of correlation with Beta2-microglobulin levels (r = 0.317) and grade of bone involvement. Furthermore, the levels of sAng-2 determined after 6 months of chemotherapy in CML patients were significantly lower than at diagnosis in the patients who achieved haematological remission. Circulating sTie-2 levels were increased in patients with ET (17.5 +/- 9.2 vs 9 +/- 3.5 ng/mL; P < 0.01) and in those with CML (16.29 +/- 8.7 ng/mL; P < 0.04). In conclusion, abnormal levels of sAng-2 and sTie-2 are present in some haematological malignancies. These markers may play a role in the pathophysiology of these conditions and their progression.     

Portal vein thrombosis is a common complication following splenectomy in patients with malignant haematological diseases

BACKGROUND: Elective laparoscopic splenectomy (LS) is performed with increasing frequency rather than open splenectomy (OS) because of reduced morbidity. LS is feasible also in patients with haematological diseases with splenomegaly, a group that is subject to more postoperative complications, such as bleeding, infections and portal vein thrombosis (PVT). METHOD: We retrospectively reviewed the medical records of 69 patients splenectomised for haematological diseases during a 5-yr period at a single centre with the aim of comparing the results and complications after LS and OS. RESULTS: Thirty-nine patients underwent LS and 30 OS. The median durations of surgery were 138 and 115 min (ns) in the LS and OS groups respectively. Three conversions (7.7%) from laparoscopic surgery to open surgery were necessary because of bleeding and/or splenomegaly. Thromboembolic complications occurred in totally seven of 69 patients. PVT was diagnosed in five of 37 (13.5%) patients with haematological malignancies (three with indolent lymphoma and two with myeloproliferative disease), one after LS and four after OS. All patients with PVT had splenomegaly and had received thromboembolic prophylaxis with low-molecular-weight heparin of short duration. Two patients were diagnosed with deep vein thromboses in the lower leg. Both had idiopathic thrombocytopenic purpura (ITP) and LS. CONCLUSIONS: Patients with malignant haematological diseases and splenomegaly seem to have a high risk of developing PVT after splenectomy why careful observation and prolonged thromboprophylaxis is recommended for these patients. Ultrasonography or computerised tomography should be considered in all patients with abdominal symptoms after splenectomy.     

Current Status of Hematopoietic Cell Transplantation for Adult Patients with Hematologic Diseases and Solid Tumors in Japan

A nationwide survey of hematopoietic cell transplantation (HCT) was started in Japan in 1991, and the analyzed survey data have been presented as the annual report of the Japan Society for Hematopoietic Cell Transplantation. The 10-year overall survival (OS) rates after HCT for each disease are as follows: acute myelogenous leukemia, 44.2%; acute lymphocytic leukemia, 33.7%; adult T-cell leukemia, 24.6%; chronic myelogenous leukemia, 53.3%; myelodysplastic syndrome, 37.3%; non-Hodgkin's lymphoma, 41.5%; Hodgkin's lymphoma, 50.8%; aplastic anemia, 72.5%; breast cancer, 37.1%; germ cell tumor, 52.6%; and ovarian cancer, 44.2%. The 5-year OS rates for multiple myeloma and lung cancer were 40.6% and 23.6%, respectively. Except in cord blood transplantation, engraftment was accomplished in more than 90% of patients. The respective frequencies of acute graft-versus-host disease (GVHD) and chronic GVHD were 41.1% and 34.9% for related bone marrow transplantation (BMT), 66.8% and 34.5% for unrelated BMT, 52.9% and 36.0% for allogeneic peripheral blood stem cell transplantation, and 53.3% and 32.1% for allogeneic cord blood transplantation. OS for each disease was analyzed by patient age, stem cell source, donor type, disease status, and disease type. These data provide objective and valuable information for hematologists as well as for patients who need HCT.     

老年妇女宫腔占位性病变超声及宫腔镜手术的研究

目的探讨老年妇女宫腔占位性病变特点及超声和宫腔镜检查在诊断中的价值。方法对妇产科医院2009年1月～2009年5月间135例宫腔占位性病变老年妇女的临床资料进行回顾性分析。结果以病理诊断为金标准,超声诊断子宫内膜息肉、子宫黏膜下肌瘤、子宫内膜炎、子宫内膜癌、子宫内膜增殖症的符合率分别为93．1％（81／87）、64．0％（16／25）、30．0％（3／10）、25．0％（2／8）、0．0％（0／1）,官腔镜诊断的符合率分别为97．7％（85／87）、68．0％（17／25）、80．0％（8／10）、100％（8／8）、0．0％（0／1）。宫腔镜诊断与病理诊断总的符合率为88．06％（118／134）,明显高于超声诊断与病理诊断的符合率76．12％（102／134）,（χ^2=6．497,P=0．011）。结论老年妇女的官腔占位性病变中,子宫内膜炎和子宫内膜癌的宫腔镜诊断符合率明显高于超声检查;子宫内膜息肉及子宫黏膜下肌瘤的诊断准确性两者无显著差异,但由于宫腔镜兼具治疗作用,仍为较佳处理方法。     

绝经后妇女宫颈癌筛查的价值及方法的研究

目的探讨绝经后妇女宫颈癌筛查的价值和筛查方法的研究。方法对1278名研究对象进行醋酸肉眼直接观察（VIA）、随机巴氏涂片或液基细胞学检查（TCT）、随机人乳头瘤病毒（HPV）检测（HC—II方法）。按诊断标准结果阳性者行阴道镜检查与定位活检,筛查阴性者如自愿活检亦予以对照活检。结果病理检出CINⅠ9人,CINⅡ6人,CINⅢ5人。各种筛查方法灵敏度、阳性预测值、阴性预测值比较无统计学意义（P〉0．05）;特异度比较：VIA低于其余几项,巴氏涂片和TCT最高（两者间差异无统计学意义）,TCT、VIA联合巴氏涂片、HPV之间差异无统计学意义。结论开展对绝经后妇女宫颈癌的筛查十分有必要。应高度重视绝经后妇女HPV感染。VIA联合巴氏涂片适于在基层单位用于绝经后妇女宫颈癌的筛查。     

改良B-Lynch缝合术在剖宫产术中大出血的应用观察

目的：评价改良B-Lynch缝合术在治疗剖宫产术中大出血的应用价值及有效性。方法：将本院2005年1月～2009年12月行剖宫产术中产后出血的46例患者,随机分为改良B-Lynch缝合组和宫腔纱条填塞组,比较两组治疗效果。结果：两组的有效率、手术时间差异有统计学意义（P〈0.05）;两组的出血量、术后再出血差异无统计学意义（P〉0.05）。结论：改良B-Lynch缝合术操作简便、并发症少,能有效治疗剖宫产大出血,值得临床应用。