The Diagnosis and Differential Diagnosis of Umteral Fibroepithelial Polyps

OBJECTIVE To study the clinical pathologic characteristics and differential diagnosis of ureteral fibroepithelial polyps. METHODS One case of ureteral fibroepithelial polyps was studied by clinical data analysis and light microscopy. RESULTS The tumor was located in the lower ureter. Histologically, the polyp was composed of expanded blood vessels and fibrous connective tissue under normal or proliferous transitional epithelium. CONCLUSION Benign ureteral fibroepithelial polyps are extremely rare, recognition of it＇s precise histological features can facilitate its correct diagnosis.     

细针吸取细胞学对甲状腺肿瘤的诊断与鉴别诊断

本文通过甲状腺肿瘤细针吸取细胞学涂片观察和结合文献，对甲状腺癌细胞中出现的某些特征：核内包涵体、核沟细胞、毛玻璃样核、乳头状结核作了详细的描述。研究显示：核内包涵体在乳头状癌中多见，可作为诊断乳头状癌的重要指标；核沟细胞在滤泡癌和乳头状癌中均可见到，但数量少，对诊断癌有一定价值；甲状腺癌细胞中罕见上述癌之特征。研究还发现，甲状腺癌细胞核普遍增大至１０～１２μｍ以上，并具备其它恶性指征。文章对甲状腺良恶性肿瘤细胞诊断和鉴别亦作了概括。     

原发性输尿管癌(附26例报告)

目的　提高原发性输尿管癌的诊治水平。方法　对 1980年～ 2 0 0 1年收治的 2 6例原发性输尿管癌患者的诊断、治疗经验进行总结。结果　 2 4例行IVU ,6例示输尿管充盈缺损或狭窄。 2 2例膀胱镜检 ,3例见肿瘤自输尿管口脱出 ,5例患侧输尿管口喷血。 16例逆行肾盂造影 ,11例输尿管充盈缺损或狭窄。 2 1例获随访 ,时间 6个月～ 12年。 5年生存率为 42 9%。结论　肉眼血尿、腰痛为主要症状。逆行肾盂造影及膀胱镜检查为主要手段。肾输尿管全长及膀胱部分切除为主要术式。预后与肿瘤分期分级有关     

Diagnosis and Differential Diagnosis of Rhabdoid Meningioma:One Case Report and Literature Review

Introduction Rhabdoid meningioma (RM) is a special type of meningioma. The pathologic features of RM include sheets of rhabdoid tumor cells with or without the findings typical of conventional meningiomas.     

原发性输尿管癌诊治体会11例分析

[目的]探讨原发性输尿管癌的诊治方法.[方法]11例原发性输尿管癌中10例经输尿管镜及活检明确,1例膀胱镜及活检明确.9例行半尿路切除,1例行输尿管下段及膀胱袖口状切除、输尿管膀胱再植术,未手术1例.[结果]全部患者获随访,手术患者已生存半年至五年半,未手术者半年后死亡.[结论]输尿管镜检可提高原发性输尿管癌的诊断正确率,半尿路切除是治疗输尿管癌的有效方法,术后膀胱灌注化疗是必要的.     

血清和腹水肿瘤标志物对良、恶性腹水的鉴别诊断价值

目的 探讨血清和腹水AFP、CEA、CA125、CA19-9对良、恶性腹水鉴别诊断的价值.方法 70例腹水患者根据病因分为良性组和恶性组,比较2组患者血清和腹水肿瘤标志物的水平.结果 恶性组血清和腹水中AFP、CEA、CA19-9水平均高于良性组(P均＜0.05).血清AFP、CEA、CA19-9联合检测的敏感性、特异性和准确性分别为61.90％、82.14％和70.00％,腹水AFP、CEA、CA19-9联合检测的敏感性、特异性和准确性分别为57.14％、88.46％和67.14％.结论 血清和腹水AFP、CEA、CA19-9的检测有助于良、恶性腹水的鉴别,血清或腹水AFP、CEA、CA19-9联合检测可提高恶性腹水诊断的敏感性和准确性.     

CT在甲状腺滤泡性结节病变诊断和鉴别诊断中的价值

[目的]探讨CT在甲状腺滤泡性结节病变诊断和鉴别诊断中的价值.[方法]搜集经病理证实的122例135枚甲状腺滤泡性结节病变的CT资料,其中包括92例105枚腺瘤性甲状腺肿(ANG),17例17枚腺瘤(FA),13例13枚滤泡细胞癌(FC).分别对ANG与FA、ANG和FA (ANG-FA)与FC在病变形态、平扫密度、强化程度、增强后边界、坏死及钙化状态进行统计分析,并对ANG-FA与FC的环状钙化进行分析.[结果]平扫密度在ANG和FA诊断中具有统计学差异(P＜0.05),形态、强化程度、增强后边界及环状钙化在ANG-FA和FC间具有统计学差异(P＜0.05),而病变强化程度、增强后边界、坏死、钙化在ANG与FA诊断中无统计学差异(P＞0.05),病变平扫密度、坏死、钙化状态在ANG-FA与FC组中无统计学差异(P＞0.05).[结论] CT在滤泡性结节病变的诊断中具有重要价值,平扫密度均匀倾向于FA的诊断,强化程度高于周围甲状腺有助于ANG或FA的诊断,而形态不规则、强化程度低于周围甲状腺、增强后边界较平扫清晰及环状钙化有助于FC的诊断.     

Terminal Transferase Expression in the Differential Diagnosis of Acute Leukemias

While the clinical significance of terminal transferase (TdT) detection in acute lymphoblastic leukemia (ALL) is uncontested, conflicting evidence exists for the prognostic relevance of this enzyme in blast cells from patients with acute myeloid leukemia (AML). The technical challenge of determining TdT in myeloid blast cells may be primarily responsible for those discrepancies in the literature. We present here the relative values of various standard approaches to the detection of TdT in ALL versus AML, including the slide staining technique, which served as the reference method, flow cytometry, and the biochemical enzyme assay.     

彩色多普勒超声鉴别诊断甲状腺良恶性肿块

目的：探讨彩色多普勒超声在甲状腺肿块中的诊断与鉴别诊断价值。方法：对120例甲状腺肿患者观察二维及彩色多普勒血流（CDFI）的特点,结果：结节性甲状腺肿67例,超声诊断符合率94．0％,甲状腺炎25例,超声诊断符合率92．0％,甲状腺良性肿瘤18例,超声诊断符合率100％,甲状腺恶性肿瘤10例,超声诊断符合率80．0％,结论：甲状腺良性肿块之间及良,恶性肿块在超声声像图及血流上有鉴别意义。     

胃肠道炎性纤维性息肉的病理诊断分析

目的　探讨病理对胃肠道炎性纤维性息肉 (IFP)的诊断及其价值。方法　观察 5例IFP临床、病理学特点及免疫组织化学(ABC)标记。结果　 5例均表现为胃肠道粘膜下息肉样肿块 ,向腔内突出炎性生长 ,病变由小的薄壁血管周围环绕具有长的胞浆突起的梭形细胞构成 ,这些细胞在较大的血管周围呈洋葱皮排列。有慢性炎细胞浸润 ,常以嗜酸细胞为主 ,ABC结果病变组织为纤维及肌纤维母细胞标记。Vimentin( 5 / 5 )、SMA( 3/ 5 )。结论　确诊胃肠炎性纤维性息肉诊断首选病理。     

Clinicopathologic Features of Colorectal Polyps in Shahid Beheshti University of Medical Sciences (SBMU)

Aim: This study was designed to report epidemiologic findings of polyps in Iranian patients, and predict histology of polyp regarding to demographic and colonoscopic findings. Background: Classification of colorectal polyps had been revised in the past two decades and there is a need for polyp categorization in the Iranian Health System. Patients and methods: In this retrospective study, the medical records of patients with colonoscopic diagnosis of polyp in pathology departments of SBMU affiliated teaching hospitals were reviewed. Patient’s slides evaluated and demographics findings were assessed. The anatomical location, macroscopic appearance including size and histological assessment of all polyps were recorded. Results: From total number of 1106 polyps (detected in 862 patients), adenomatous polyps (638 [57.7%]) were the most prevalent findings, followed by colon mucosal tag (184[16.6%]), hyperplastic and serrated polyps (122[11%]), inflammatory polyps (110[9.9%]), hamartomatous (21[1.9%]), and malignant lesions (13[1.2%]). Multivariate logistic regression showed age (each one year increasing age; odds ratio [OR] = 1.026, 95%confidence interval [CI] = 1.016–1.036, p < 0.0001), location of polyp (right colon; OR = 1.905, 95%CI = 1.366–2.656, p < 0.0001), and polyp size of 5-10 mm (OR = 1.662, 95%CI = 1.214–2.276, p = 0.002), and polyp size of >10 mm (OR = 2.778, 95%CI = 1.750–4.411, p< 0.0001) were independently associated with neoplastic polyps. Also, polyp size of >10 mm (OR= 2.613, 95%CI= 1.083-6.307, p=0.033), tubulovillous pattern of polyp (OR= 3.508, 95%CI= 1.666-7.387, p=0.001) and villous pattern of polyp (OR= 10.444, 95%CI= 4.211-25.905, p     

99mTc-EC显像用于原发输尿管癌手术定位及肾功能初步评价

目的：探讨核素^99mTc—EC显像在原发输尿管癌手术定位及肾功能评价方面的应用，为手术决策提供依据。方法：就诊病例10例，静脉注射^99mTc—EC后采集图像，根据影像资料判断梗阻位置，利用计算机处理所得肾图曲线获得两肾功能。结果：10例患者中，患侧输尿管显影6例，其中伴对侧输尿管显影1例，肾图曲线示双肾功能受损3例，总肾功受损5例，患肾排泄不良2例，患侧肾功能受损2例，患侧肾及输尿管未显影5例：与MRI及IVP比较，MRI阳性9例患者中，ECT阳性6例，IVP阳性2例(另l例过敏)，IVP阴性7例患者中有4例ECT阳性。结论：核素^99mTc—EC显像可从形态与功能两方面提供受试者泌尿系的动态情况，与其它诊断手段互相补充，为受检者术前提供必要的决策依据。     

Diagnosis and differential diagnosis of rhabdoid meningioma: One case report and literature review

Introduction Rhabdoid meningioma （RM） is a special type of meningioma, The pathologic features of RM include sheets of rhabdoid tumor cells with or without the findings typical of conventional meningiomas. Since the disease is rare, and the histologic structure similar to that of other tumors, misdiagnosis and failure to include the entity in the differentiation can occur from time to time. In this article, the pathologic features and immunophenotype of RM are analyzed, in combination with analysis of a case treated at our institution and a review of the literature.     

良恶性胸腔积液的鉴别诊断

胸腔积液是一个常见的临床表现,其良恶性的判断治疗和与预后密切相关.许多方法和指标都曾尝试用于恶性胸腔积液的诊断,各有利弊.随着分子生物学和实验技术的迅速发展,新的诊断指标和检测方法不断涌现.本文综述了近年来相关的临床研究结果,对各种诊断方法进行了客观评价.     

Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

Background: Colorectal cancer is the third most common type of cancer in males and the second in femalesin Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor forcolorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. Aim: The object of thisstudy was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients andto investigate the variation between our populations with other populations. Materials and Methods: A total of167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013and specimens were taken through polypectomy and transferred to pathology. All data in patient files includingpathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of< 0.05 was considered significant. Results: Mean age of participants was 57±15. Some 84 were females (50.3%)and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) werein females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%)with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followedby 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, databeing missing in two cases. Conclusions: Recto sigmoid was site of most of the polyps. The most prevalent typeof lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70(31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screeningplans to prevent further healthcare problems with colorectal cancer in the Iranian population.     

Ureteral metastasis as the first and sole manifestation of gastric cancer dissemination

Background

Isolated ureteral metastasis from gastric cancer is extremely rare.

Case report

We describe a 50 year old man with a history of subtotal gastrectomy who presented 4 years later with an ureteral metastasis. He was asymptomatic and diagnostic tests were performed due to the elevated creatinine level disclosed incidentally. The partial resection of distal right ureter as well as the resection of the right ureterovesical junction was performed with the implantation of double J stent. Histopathology revealed a metastasis of the adenocarcinoma that matched perfectly a tumour specimen from the gastric cancer surgery. It was first and isolated manifestation of gastric cancer dissemination.

Conclusions

Although rare, the ureteral metastasis from gastric cancer can be the first, sole and asymptomatic manifestation of gastric cancer dissemination after a period of time.     

低度恶性中心型骨肉瘤的诊断及鉴别诊断

目的：探讨低度恶性中心型骨肉瘤的临床病理学特征、影像学特征。方法：对低度恶性中心型骨肉瘤的临床资料、影像学、病理形态学进行观察，并结合相关文献加以分析。结果：低度恶性中心型骨肉瘤组织学上由纤维组织和不规则的相互吻合的肿瘤性骨小梁混合组成，似纤维结构不良或骨旁骨肉瘤。细胞异型性小，少见病理性核分裂象。结论：低度恶性中心型骨肉瘤的诊断及鉴别诊断比较困难，确诊有赖于影像学资料和详细的组织学检查。     

C-myc在结直肠癌和息肉中的表达及其意义

[目的]探讨c-myc在结直肠癌发生、发展中的作用及其与临床病理特征的相关性。[方法]采用免疫组织化学SP法检测60例结直肠癌组织、60例结直肠息肉组织、30例结直肠癌旁组织中c-myc蛋白表达。[结果]结直肠癌、结直肠腺瘤性息肉组织中c-myc蛋白表达阳性率明显高于结直肠增生性息肉及癌旁黏膜组织。c-myc蛋白高表达与结肠癌发病部位、肿瘤分化程度、Dukes分期、淋巴结转移有关（P均〈0.05）。c-myc蛋白高表达与结直肠腺瘤性息肉大小以及息肉有蒂或无蒂相关（P〈0.05）。[结论]c-myc表达与结直肠癌发生、发展有关。主题词：结直肠息肉;结直肠肿瘤;c-myc;免疫组织化学     

前列腺增生与肿瘤的CT诊断与鉴别诊断

目的 :对比研究前列腺增生与肿瘤的CT表现 ,提高早期诊断符合率。方法 :回顾分析经病理及临床证实的 2 1例前列腺增生和 16例前列腺肿瘤的CT表现及其他检查资料。结果 :前列腺增生与肿瘤在前列腺形态、大小、密度、边缘及毗邻关系间存在明显差异。CT表现为体积增大、密度均匀、边缘光滑清晰 ,多见于前列腺增生 ;CT表现为不规则增大、密度不均、边缘模糊呈结节状隆起、膀胱精囊角变钝或消失 ,多见于前列腺肿瘤。结论 :CT平扫加增强扫描在前列腺增生与前列腺中晚期肿瘤的诊断与鉴别诊断中有重要作用。