超声引导下经皮胸腔细针吸取活检(附68例报告)

目的:探讨在超声引导下经皮胸腔细针吸取活检对肺外周型肿块、肺的弥漫性病变和纵隔肿块细胞学、病理学诊断的临床应用价值.方法:选择68例影像学检查提示肺外周型肿块、肺弥漫性病变或纵隔肿块,而痰细胞学和支气管镜检查阴性的病例.应用ALOKA-SSD 650实时灰阶超声仪.采用日本18G与21G细针活检.68例全部做细胞涂片,40例除做涂片外同时吸取组织块做石蜡切片.计算敏感性,特异性,准确性.结果:经细胞学、组织学两种方法诊断恶性肿瘤43例,仅细胞学诊断为恶性肿瘤40例,良性病变28例,其中3例假阴性.细胞学检查敏感度为93%,特异性100%.细胞学总准确率为95.6%.被检查者无气胸或出血等合并症.结论:该方法简便、迅速、安全且准确.尤其对细支气管肺泡癌的诊断更有帮助.     

Ca15-3在乳腺外Paget病鉴别诊断中的价值

目的：探讨Ｃａ１５３ 在Ｐａｇｅｔ 病鉴别诊断中的价值。方法：对１１ 例阴囊Ｐａｇｅｔ 病回顾性地做Ｃａ１５３、ＥＭＡ、ＣＥＡ和ＨＭＢ４５ 免疫组化染色,并以４ 例Ｂｏｗｅｎ 病和１ 例恶性黑色素瘤做对照。结果：Ｃａ１５３ 、ＥＭＡ 在Ｐａｇｅｔ 病和大、小汗腺及皮脂腺均有较强的表达,４ 例Ｂｏｗｅｎ 病均无Ｃａ１５３ 表达,但其中２ 例有ＥＭＡ 表达。ＣＥＡ 在６ 例（５４．５ ％）Ｐａｇｅｔ 病中有表达。ＨＭＢ４５ 只在恶性黑色素瘤中表达。结论：Ｃａ１５３ 在Ｐａｇｅｔ 细胞的相对特异性表达提示它可作为Ｐａｇｅｔ 病与Ｂｏｗｅｎ 病鉴别诊断的标志物,其对诊断的敏感性与ＥＭＡ 相同,但特异性高于ＥＭＡ。同时还说明Ｐａｇｅｔ 病的发生可能与汗腺有关。     

儿童胰母细胞瘤的临床病理分析

目的通过分析儿童胰母细胞瘤（PB ）的临床表现、病理特点及预后等因素,提高对PB的认识。方法回顾性分析近5年我院PB患儿的临床资料。结果 PB患儿共9例,男5例,女4例,平均年龄5岁（2个月～12岁）;8例因偶然发现腹部包块就诊,1例产前（32周）超声检查提示胰腺占位就诊;腹部超声（n＝6）及CT（n＝7）检查均提示胰腺占位;2例外周血白细胞升高,3例血清甲胎蛋白（AFP）升高;8例行肿瘤切除,1例取瘤组织活检;1例术后第2年和第3年分别发生肝转移;肿瘤累及胰头部6例,体尾部2例,整个胰腺1例;肿瘤最大直径3～18 cm,平均10 cm,结节状,切面灰白色,实性,细腻,部分区域呈囊性,可见明显的出血及坏死;镜下：肿瘤富含细胞,由形态一致的上皮细胞构成,瘤细胞呈实性片巢状排列,混有分化好的腺泡样结构,可见特征性“鳞状上皮小体”;免疫组织化学染色显示有腺泡、内分泌和导管分化的证据,表现为胰酶、内分泌标记和癌胚抗原（CEA）的阳性表达。结论胰母细胞瘤是儿童胰腺最常见的恶性肿瘤,镜下显示有腺泡、内分泌和导管的分化及特征性鳞状小体结构,确诊主要依据病理检查结果,应注意与胰腺其它肿瘤鉴别。首选的治疗方案是肿瘤的完整切除。预后较成人好。     

组织细胞性坏死性淋巴结炎的临床病理学研究及其与恶性淋巴瘤的鉴别（附31例报告）

组织细胞性坏死性淋巴结炎（ＨＮＬ）为一种少见的良性疾病。好发于年轻妇女的颈部，引起淋巴结肿大，并常伴有发热及其它全身症状，形成独具一格的临床病理过程。因其组织像具有一定的谱系变化，故对其不熟悉者易造成误诊。据文献记载误诊率竟高达３０％～４０％，特别是在其早期增殖阶段尤甚。作者通过对３１例ＨＮＬ的分析，不仅系统总结了本病的临床病理特征，而且着重阐述了其与淋巴瘤的鉴别要点。尽管目前认为本病属于自限性的良性过程，但在本组病例中也确有２例为系统性红斑狼疮患者，提示两者间可能有某种内在的联系，值得今后进一步探索，包括进行长期随访及了解病人的转归。     

中线外周T细胞淋巴瘤：一类值得重新认识的疾病

Thirty-one cases of midline peripheral T-cell lymphoma (MPTL), treated during the past two years in our hospital, are reported. All were proven by immunohistochemical stain on frozen section, using a panel of antibodies: IIIC4 (CD5), Leu-2, Leu-3, Leu-4, T,p55, T11, Ia, Ki-1, IL2-R, B1/DAKO-CD22, Kappa, Lambda and IgM. Three cases were also stained with LCA, UCHL-1, MT1, MT2, MB1 and MB2 monoclonal antibodies in paraffin sections, and the results conformed with the frozen-sectionmethod. According to our present and previous reports, it is worthy of note that most of the so-called midline malignant reticuloses (MMR) in the past, including necrotic granulomatosis and malignant granulomatosis, are actually MPTL. In view of MPTL being highly malignant and not very rare in this country, it is emphasized that this disease should be paid more attention and recognized anew. More active treatment should be given to improve the results.     

组织细胞性坏死性淋巴结炎的临床病理学研究及其恶性淋巴瘤的…

组织细胞性坏死性淋巴结炎（ＨＮＬ）为一种少见的良性疾病。好发于年轻妇女的颈部，引起淋巴结肿大，并常伴有发热及其它全身症状，形成独具一格的临床病理过程。因其组织像具有一定的谱系变化，故对其不熟悉者易造成误诊。据文献记载误诊率竟高达３０％￣４０％，特别是在其早期增殖阶段尤甚。作者通过对３１例ＨＮＬ的分析，不仅系统总结了本病的临床病理特征，而且着重阐述了其与淋巴瘤的鉴别要点。尽管目前认为本病属于自限性的     

子宫内膜间质肉瘤的命名分类及治疗

From 1958 to 1984, 13 cases were diagnosed as endometrial stromal sarcoma in our hospital, 9 of whom having complete data and been followed for over 5 years were analysed. The results indicated that degree of cellular atypia was a major factor related to prognosis. According to the degree of cellular atypia with consideration of cellular mitotic rate, the tumors were divided into two types: low and high grade malignancies. The former was likely to develop recurrence in the pelvis whereas the latter was prone to distant metastasis. There was no definite relation between the time and initial site of recurrence or metastasis and the stage of the lesion. Operation is the treatment of choice for primary as well as recurrent lesions. The operation should be total hysterectomy and bilateral salpingo-oophorectomy with removal of all visible tumor tissues. In this series, 5 patients received prophylactic postoperative pelvic radiation, none developed local recurrence and 3 of them have survived for 13-19 years free of tumor. Two of 3 treated with postoperative chemotherapy developed recurrence and died 3 months and 4 years after chemotherapy, respectively.     

深在型囊性结肠炎二例报告

深在型囊性结肠炎二例报告严仲瑜贺宪黄艹延庭那加李竞贤深在型囊性结肠炎（ｃｏｌｉｔｉｓｃｙｓｔｉｃａｐｒｏｆｕｎｄａ，ＣＣＰ）是一种少见的炎性病变，我们于１９９４年３月和１９９５年２月收治２例，现报告如下。例１女，６５岁，因腹部隐痛，腹泻伴乏力、消瘦入...     

PRIMARY NEUROENDOCRINE CARCINOMA OF THE SKIN (NERKEL CELL TUMOR)

ＰＲＩＭＡＲＹＮＥＵＲＯＥＮＤＯＣＲＩＮＥＣＡＲＣＩＮＯＭＡＯＦＴＨＥＳＫＩＮ（ＭＥＲＫＥＬＣＥＬＬＴＵＭＯＲ）ＬｕＮｉｎｇ；吕宁；ＬｉＪｉｎｇｘｉａｎ；李竞贤（ＤｅｐａｒｔｍｅｎｔｏｆＰａｔｈｏｌｏｇｙ，ＣａｎｃｅｒＩｎｓｔｉｔｕｔｅ，Ｃｈｉｎｅｓ...