Clinicopathologic correlations in pseudocapsule formation after breast augmentation

In 2,000 patients who underwent augmentation mammoplasties with different types of prostheses, the thickness of the pseudocapsules around gel-filled implants was greater than that of the pseudocapsules forming around inflatable implants. This observation was corroborated by an independent histologic study. Deposition of liquid silicone into the pseudocapsules as well as the adjacent brest tissue and migration into capillaries was demonstrated. Until an impermeable shell or a non-transgressive gel can be manufactured, gel-filled implants should not be used.     

Tumor–parenchyma interface and long-term oncologic outcomes after robotic tumor enucleation for sporadic renal cell carcinoma

Objective

Tumor enucleation has been shown to be oncologically safe for elective treatment of renal cell carcinoma (RCC); yet, evidence on long-term oncologic outcomes after robotic tumor enucleation is lacking.In this study we provide a detailed histopathological analysis of tumor–parenchyma interface and the long-term oncologic outcomes after robotic tumor enucleation for sporadic RCC in a high-volume referral center.

中医药论治肝癌的思考

目的:临床观察中医药复方辨证、辨病单用或协助治疗肝癌的疗效。方法:采用回顾性、追溯性的临床观察方法,对25例原发性、继发性肝癌患者在手术或放化疗等治疗前后、同时采用中医辨证、辨病论治,健脾补肾、益气养阴、活血除癥、软肝散结等,主方为鳖甲煎丸合逍遥散加减治疗,采用WHO实体瘤治疗客观疗效判定标准、生活质量评定标准卡式评分法,已评定其治疗效果。结果:在治疗的25例患者中,完全缓解7例(28.0%),部分缓解6例(24.0%),稳定6例(24.0%),进展6例(24.0%),缓解率52.0%,总有效率达76.0%。生命质量改善卡式评定,完全缓解组的分值增加30～50分;部分缓解者增20～30分间;稳定者增20分左右;进展者在10～20分间。生活质量提高改善的23例,稳定者2例。5年生存期36%,平均生存期37.24个月。结论:中药复方可治愈肝癌,中医药辨证论治的阶段性、序贯治疗,是对肿瘤形成的不同环节、不同阶段的多部位、多靶点、多层次的调整和治疗,是对癌症患者机体内环境的根本性治疗。使机体细胞避开了异常增殖和分裂的因素,或异常增殖的细胞走向凋亡。中医药治疗后还有一个显著的局部病灶周围的"假包膜"改变,也是临床上治疗过程中所追求的。中药治疗肝癌依从性好才有效;中药健脾养阴、活血除癥、软坚散结,是治疗肝癌的主要论治法则。中医药在肝癌的防止复发、转移上有着特殊作用;中医药能显著提高肝癌患者的生活质量和延长寿命;医生与患者的心理互动是肝癌治疗过程中必不可少的环节。     

MR appearance of the pseudocapsule of renal cell carcinoma and its pathologic basis

The pseudocapsule of renal cell carcinoma (RCC) appears as a low-intensity band or rim on magnetic resonance (MR) images. The frequency of its appearance differed on T1- and T2-weighted images. In our group of 19 RCC (in 18 patients), it appeared on 26.3% of T1-weighted images and on 57% of T2-weighted images. The pathology of the pseudocapsule on MR is its thickness and composition. On T1-weighted images, the appearance of the pseudocapsule is mainly related to the fibrous element, and on T2-weighted images to the fibrous element and compressed renal parenchyma.     

肾细胞癌假包膜的超声研究进展

假包膜是肾癌(肾细胞癌)的重要特征,超声发现假包膜对于肾癌的鉴别诊断及术前评估具有重要价值.本文就超声检查肾癌假包膜的研究进展做一综述.     

A prospective,multicenter analysis of pseudocapsule characteristics: Do all stages of renal cell carcinoma have complete pseudocapsules?

Objectives

To assess the characteristics of pseudocapsule (PC) in localized renal cell carcinoma (RCC) by analyzing the rates of completeness of PC and pseudocapsular invasion and clinical and pathological risk factors of it.

Surgical removal of growth hormone-secreting pituitary adenomas with intensive microsurgical pseudocapsule resection results in complete remission of acromegaly

Although some investigators recommended surgical removal of the borders between pituitary adenoma and the surrounding normal pituitary gland, there is so far little documentation of how intensive dissection of the border zone affects the actual clinical remission rate of pituitary adenomas. We investigated the precise histological characteristics of the boundary, using surgical specimens from patients who underwent intensive resection of microsurgical pseudocapsule of growth hormone (GH)-secreting pituitary adenomas. Furthermore, we compared the remission rate of acromegaly between subjects with (Group 1) and without (Group 2) intensive resection of microsurgical pseudocapsule in order to correlate the histological complete resection and endocrinological remission. Histologically, most adenomas were in direct contact with normal pituitary gland that formed an increased fibrous component facing the adenoma, without a true histological pseudocapsule. It was impossible to dissect the tumor at exactly the tumor–normal pituitary interface for the whole extent of the pituitary adenoma during surgery, and complete removal of the tumor inevitably included a portion of normal tissue (microsurgical pseudocapsule). The biochemical remission rate was significantly higher in Group 1 than in Group 2 (90.0 vs 61.1%), and Group 1 showed no additional postoperative pituitary hypofunction. The present results suggested that intensive resection of the microsurgical pseudocapsule is essential to accomplish histological and endocrinological total resection of the GH-secreting pituitary adenomas for remission of acromegaly.     

垂体腺瘤假包膜囊外切除术的临床研究

目的 探讨垂体腺瘤行假包膜囊外切除术的临床意义.方法 选取2015年4月~2016年7月行经蝶窦入路切除垂体腺瘤的173例患者,根据假包膜囊外及囊内切除进行分组,对比其全切率、生物学治愈率及并发症情况.结果 173例患者中,90例发现假包膜(52.0%),其中无功能型和生长激素型垂体腺瘤假包膜发现率较高.囊外切除组肿瘤全切率(95.6%)高于囊内切除组(88.0%),但差异无统计学意义;功能型腺瘤中囊外切除组生物学治愈率亦较高(89.7%比71.4%),差异有统计学意义(χ2=4.279,P<0.05);术中脑脊液漏发生率分别为47.8%和41.0%,术后脑脊液漏发生率为0;术后病理学证实假包膜有肿瘤细胞浸润.结论 垂体腺瘤假包膜囊外切除能够提高肿瘤全切率及功能型垂体腺瘤的生物学治愈率,且不增加术后并发症,是一种安全、有效的切除方式.     

侵袭性在垂体腺瘤术后残留再生长与复发中的评价及临床现状

垂体腺瘤是颅内肿瘤中较常见的一种,约占颅内肿瘤的10%。垂体腺瘤虽然为良性肿瘤,但由于肿瘤侵袭性生长特性、设备条件和手术者技术有限等因素影响,使得肿瘤镜下全切和复发问题仍然较突出,复发垂体腺瘤比例逐年升高,治疗难度也随之增大。本文旨在总结本中心的侵袭性或复发性垂体腺瘤的病例资料,对复发性垂体腺瘤的诊治,包括再次经蝶手术适应证、手术技巧以及术后并发症的预防和处理等进行述评,为临床医师提供参考。