腹阴联合超声在带环异位妊娠中的诊断价值

目的探讨腹阴联合超声在带环异位妊娠中的诊断价值,旨在提高早期异位妊娠的诊断水平。方法 65例经手术病理证实为带环异位妊娠的患者,术前均进行经腹部及经阴道超声检查,比较两种检查方法的诊断符合率及联合应用的诊断效果。结果经阴道超声检查及经腹超声检查诊断符合率为分别为92.3%、61.5%,两者联合应用诊断符合率为100%。结论腹阴联合超声检查与单独应用经阴道超声检查或经腹超声检查相比有明显优势,可提高带环异位妊娠诊断符合率,具有重要的临床价值。     

经阴道彩超检测子宫内膜厚度及阻力指数对异位妊娠的诊断价值

目的探讨经阴道彩超(TVCD)检测子宫内膜厚度(ET)及阻力指数(RI)对异位妊娠(EP)的诊断价值。方法选择疑似EP患者186例,在早孕阶段应用TVCD检测了ET及RI,同时测定β-人绒毛膜促性腺激素(β-HCG)、孕酮(PRG)、肌酸激酶(CK)水平。结果经过随访,最终筛选出诊断明确的异位妊娠63例(A组),自然流产45例(B组),宫内妊娠38例(C组)。1A、B组ET显著低于C组(t=43.251,39.133,P0.01),A组和B组ET比较差异未见统计学意义(t=1.5583,P0.05)。2A、B组RI显著高于C组(t=32.446,34.042,P0.01),A、B组间RI比较差异未见统计学意义(t=1.1110,P0.05)。3A组β-HCG水平低于B、C组(t=3.6206,10.939,P0.01),B组β-HCG水平低于C组(t=6.5034,P0.01)。4A、B组PRG水平低于C组(t=18.254,14.098,P0.01),A、B组间PRG水平比较差异未见统计学意义(t=0.8818,P0.05)。5A组CK水平高于B、C组(t=7.1253,9.2792,P0.01),B、C组间CK水平比较差异未见统计学意义(t=1.2656,P0.05)。结论用阴道彩超检测子宫内膜厚度及其阻力指数,并结合血β-HCG、PRG、CK水平检测,能提高诊断正确率。     

Ectopic liver tissue in stomach paries: a case report

Ectopic liver (EL) tissue is a rare entity which is reported to occur in several organs such as the gallbladder, pancreas and some other places. The EL tissue is usually detected incidentally during laparoscopy or autopsy, and several potential mechanisms may explain the development of liver ectopia. Although ectopic liver tissue is usually asymptomatic, it develops the same pathologic conditions as orthotopic liver. Although incidental ectopic livers rarely existing and do not have clinical importance, they should be looked for during electron microscope scan and histopathological examination should be carried out to rule out pathological changes since development of hepatocellular carcinoma is a possible issue. In this article, we presented an EL tissue in stomach of which only two cases were reported previously and this is the first reported case of a laparoscopically treated EL which lies to the bottom submucosal of the stomach. It would seem sensible to resect the ectopic tissue under endoscopic and the patient was well when seen for follow-up three months later.     

Ectopic hamartomatous thymoma: report of a case and review of literature

Ectopic hamartomatous thymoma (EHT) is an exceedingly rare lesion that usually arises in the lower neck and mainly affects adult men. We present the clinicopathological features of a case of EHT in a 28-year-old Chinese male, together with a literature review. Ultrasound imaging and a computed tomography (CT) scan of the neck demonstrated a 3.0-cm well-defined nodule of heterogeneous density located within the left sternocleidomastoid muscle. The patient underwent a gross total resection of the tumor. Grossly, the well-demarcated, encapsulated mass had a predominantly solid and gray-white appearance admixed with microcystic foci filled with serous content and yellowish regions. The lesion consisted of an irregular admixture of spindle cells, epithelium, and mature adipose tissue. Immunohistochemistry showed that both the spindle cell and epithelial components were diffuse and had intense nuclear positivity for p63 and cytoplasmic reactivity for pan-cytokeratin, CK7, and CK19. The patient was followed for 18 months without any evidence of metastasis or recurrence.     

经阴道超声与腹部超声对异位妊娠的诊断价值比较

目的:比较经阴道超声与腹部超声对异位妊娠的诊断价值。方法:选取60例疑似异位妊娠患者作为研究对象,患者均行经阴道超声、腹部超声诊断,以术后病理诊断结果作为诊断金标准,比较经阴道超声及腹部超声对异位妊娠的诊断效能,并分析超声图像特点。结果:经阴道超声诊断异位妊娠检出准确率明显高于腹部超声,且经阴道超声诊断声像图表现优于腹部超声,差异有统计学意义(P<0.05)。结论:经阴道超声诊断异位妊娠具有检出率高,声像图表现好的优势。     

超声造影在子宫瘢痕妊娠疑难病例中的应用价值

目的 探讨经静脉超声造影在诊断子宫剖宫产后瘢痕妊娠疑难病例中的应用价值。 方法 对常规超声显示孕囊与子宫剖宫产瘢痕关系密切,但不能做出明确鉴别诊断的24例患者行经静脉超声造影检查。根据最后的手术病理结果,比较常规超声及超声造影诊断的灵敏度、特异性、阳性预测值、阴性预测值、Youden指数及准确率。结果 所有病例中,常规超声的诊断准确率为75.00%、灵敏度88.24%、特异性85.71%、阳性预测值93.75%、阴性预测值75.00%、Youden指数7395%,而超声造影的诊断准确率为100%。超声造影修正常规超声诊断6例（25.00%）,两种检查方法诊断准确率比较,差异有统计学意义（P＜0.05）。结论 超声造影能够提供更多、更准确的影像学信息,其诊断准确率高于常规超声,具有较好的临床价值。     

Ectopic Primary B Cell Lymphoma of the Thyroid Presenting as an Anterior Mediastinal Mass. A Case Report

Ectopic thyroid tumours arising in the mediastinum without connection to the cervical thyroid gland are very rare. Follicular adenoma, papillary carcinoma and follicular carcinoma in the mediastinum has been reported, but primary ectopic thyroid B cell lymphoma has not been reported previously. We report mediastinal primary ectopic thyroid large B cell lymphoma in an 80-year-old man. Differential diagnosis from primary mediastinal large B cell lymphoma and clinicopathologic features are discussed.     

Solitary gastric Peutz-Jeghers type stomach polyp mimicking a malignant gastric tumor

Most cases of Peutz-Jeghers type polyps of the stomach are associated with mucocutaneous pigmentation and multiple intestinal polyposis. A solitary Peutz-Jeghers type polyp of the stomach is rare. We here report a case of a 71-year-old woman with a solitary Peutz-Jeghers type polyp of the stomach who presented with intolerable epigastric pain and weight loss of 5 kg over the prior two months. During the hospital treatment course for this patient, endoscopic examination revealed a bulging lesion with a central hole, mucosal ulceration, an asymmetrical wall thickness and a narrowing of the gastric lumen. A gastric biopsy further revealed ulceration with moderate dysplasia. The patient received endoscopic ultrasonography which showed a second subepithelial lesion that measured 4 cm × 3 cm. Computed tomography of the abdomen subsequently showed a thickened gastric wall with three visibly enlarged lymph nodes, all greater than 1 cm. The suspected diagnosis was malignant gastric cancer with lymph node metastases. The other lesion, which measured 2 cm × 2 cm × 1 cm was noted in the submucosa of the jejunum during surgery. The patient was treated using a subtotal gastrectomy and partial resection of the jejunal tumor. The final pathological report indicated a gastric Peutz-Jeghers type polyp with proliferation of smooth muscle bundles in the submucosal layer, and hyperplastic glands in the mucosal layer and ectopic pancreas of the jejunum. This is the first reported clinical case of a solitary Peutz-Jeghers type polyp of the stomach accompanying a lymph node enlargement and ectopic pancreas in the jejunum that simulates stomach cancer with lymph node metastases.