CT诊断胸壁错构瘤1例

患者男,46岁,体检时发现右胸壁肿物半月余。CT:右侧胸壁约平右侧第7后肋不规则软组织密度影,约5cm×3cm×3cm,CT值-48～253HU,边界欠清,病灶内部密度不均匀,可见斑片状脂性密度影及钙化灶,邻近肋骨骨质密度尚均匀,未见明确骨质破坏(图1),考虑为错构瘤。行     

胸壁错构瘤的MSCT表现

目的 探讨胸壁错构癌的MSCT征象.方法 收集5例经手术病理证实的胸壁错构瘤患儿资料,结合文献分析其病理起源、临床特点与MSCT表现.结果 4例为单发病变,1例为双发病变.共6处病变,其中位于左后胸壁3处,位于左前胸壁、右后胸壁、右侧胸壁各1处,均起源于肋骨.CT均表现为肋骨膨胀性改变,局部形成凸向胸腔内或胸腔外的不均匀密度肿块,边界清楚,内见高密度骨化或钙化影,增强后肿块部分呈轻-中度强化.结论 胸壁错构瘤的MSCT表现具有一定特征性,可很好地显示病变起源、大小、受累肋骨的数量及邻近组织结构情况.     

婴幼儿巨大肺错构瘤1例

病例女,50天,4天前无明显诱因下出现咳嗽,咳嗽逐渐加重,呈阵发性连声咳。出生史:第二胎第二产,36周顺产。既往史:无异常。血常规:Hb103g/L,WBC4.8×10NL,体征:无气急,两肺呼吸音粗。常规X线胸片检查(图1):正位;胸廓尚对称。左肺上野见片状密度增高影,内见泡性充气影;左肺中野见大片密度!a!b#③a①a①b增高影,中央见较大囊泡状透亮影;左心缘受压,心影、纵隔略向右偏移。左侧位片:相当于左肺上叶舌段部位见大囊肿样影,壁略厚、模糊,左上叶上部见多个小囊状影,数量较多。两膈面光整,肋膈角锐利。诊断:①支气管肺炎。②左肺上叶(包括舌段)多…     

软腭错构瘤1例

患儿女,出生后12h,以"呼吸困难9 h"入院.患儿生后3h出现呼吸困难,侧卧可缓解.查体:全身皮肤青紫,口唇略发绀,前囟平坦,三凹征及鼻煽(+),咽后壁略膨隆,上腭可见散在破溃.CT:软腭末端见赘生肿物,约2.8 cm×2.5 cm×2.0 cm,边缘光滑,轮廓清晰,表面不光整,有蒂与软腭相连,堵塞大部分口咽腔,肿块密度不均匀,大部分呈脂肪密度,CT值-76 HU(图1).术中见口腔前庭类圆形质软新生物,带蒂,活动,基底位于左侧软腭背面,约3.0 cm×2.7 cm×2.5 cm,表面光滑,颜色淡黄,切开后见内容物呈淡粉色,类似疏松结缔组织.病理:肿物切面淡黄,组织被覆鳞状上皮,皮肤附属器增生,上皮下见纤维脂肪组织增生,血管不规则扩张充血.病理诊断:(软腭)错构瘤(图2).     

Kartagener综合征1例并文献复习

病例男,32岁,因“反复咳嗽、咳痰10+年,再发加重1周”就诊于我院呼吸科,患者自诉自幼体质较弱,反复出现咳嗽、咳浓痰、间断咯血等症状,病程中反复发作性头痛、头昏,伴鼻塞、流脓性鼻涕,嗅觉差,未婚未育。曾于外院多次诊断“支气管扩张并感染”。体格检查:双侧鼻腔黏膜充血,可见少许分泌物,鼻窦区压痛。胸部对称,外形正常,肋间隙正常,双侧乳头正常对称。双侧呼吸运动对称,双下肺呼吸音减低,可闻及散在哮鸣音及下肺湿罗音。触诊未触及胸膜摩擦感,语音震颤对称。心前区无隆起,心界不大。心尖搏动位于第5肋间右锁骨中线内侧缘约0.5 cm处,心率75次/分,律齐。腹平软,肝肋缘下未触及,脾未触及,肠鸣音正常。     

SAPHO综合征SPECT/CT显像1例报道并文献复习

SAPHO综合征即滑膜炎、痤疮、脓疱疮、骨肥厚和骨炎综合征,是一种少见疾病,通常同时伴发皮肤及骨关节改变,部分患者皮肤改变不明显,仅有骨关节改变时很少有医生考虑此综合征的诊断.本文旨在回顾性分析1例SAPHO综合征患者的临床、SPECT/CT图像及病理资料,同时复习国内外相关报道,加深影像科医生对此病的认识,从而提高此病的诊治水平. 病例 男,50岁,半年前无诱因出现前胸壁疼痛,未予特殊诊治,近1周自觉前胸壁疼痛加重,偶有咳嗽咳痰,无发热及乏力盗汗,体质量无明显变化.查体:胸骨角及双侧第一肋软骨处可见隆起性肿物,无压痛,无活动性,硬度与周围骨组织无明显区别.血钙镁磷结果依次为2.06、0.75、0.95.     

胆管错构瘤的CT表现(附5例报告)

目的 探讨胆管错构瘤的CT表现,旨在提高对本病的认识.方法 回顾性分析经穿刺活检病理证实的5例胆管错构瘤患者的CT表现,并结合文献,对本病的病理、临床以及CT表现特点进行讨论.结果 CT平扫显示病灶呈多发低密度,大小不等,形态各异,边缘部分清楚,部分不清,增强扫描后无强化.其中1例行MRI平扫,病灶呈长T1、长T2信号.MRCP显示肝内多发类囊状高信号病变,与胆管树不相通,肝内胆管树分支未见异常.结论 正确认识胆管错构瘤的CT表现特点,对本病的诊断以及鉴别诊断有较大的帮助,最终确诊有赖于采取活体组织进行病理学检查.     

支气管内型错构瘤1例

病例 女,73岁,因“反复咳嗽、咳痰2年伴发热、咯血10天”入院.患者无明显诱因下突然出现发热、最高体温39.3℃,抗感染治疗症状无明显改善,遂来本院就诊.入院体检:T 38.5℃,BP 120/80 mmHg(1 mmHg=0.133 kPa),两肺呼吸音粗,可闻及少许干湿罗音. 胸部CT(图1,2):左肺上叶见大片状密度增高影,边缘模糊,内见支气管充气征,左上叶支气管腔局部狭窄,见有小结节样影突向腔内,CT值为26.33 HU,增强后CT值44.24 HU,轻度强化,结节边缘见小钙化点.     

肺乳头状腺瘤1例并文献复习

<正>肺乳头状腺瘤是一种罕见的肿瘤,这种肿瘤细胞缺乏明显的异型、有丝分裂以及Ki-67的高表达,所以通常被认为是一种良性的肿瘤,且不伴有复发及肺内转移。本例旨在应用影像学、组织学、免疫组织化学,对1例右肺中叶伴左肺转移的乳头状腺瘤进行报道和文献复习。     

无钙化及脂肪密度的肺错构瘤的CT诊断

目的:探讨无钙化及脂肪密度的肺错构瘤的CT特征。材料与方法:26例经手术病理证实的无钙化及脂肪密度的肺错构瘤,19例行普通CT扫描,7例行动态增强CT扫描。结果:肿瘤形态规整,呈圆形或椭圆形,边缘清楚,8例见分叶征象,4例病灶周围可见血管影聚集,3例邻近胸膜的肿瘤有胸膜增厚。动态增强后,平均最大强化值为(20.4±13.2)Hu。5例强化值小于20Hu。2例强化值大于20Hu的错构瘤在3~4min达到峰值。病理对照表明强化不明显者,其组织成分以软骨样组织为主,强化显著者均具有丰富的血管结构。结论:无钙化及脂肪密度的肺错构瘤平扫形态上有一定特征,动态增强CT扫描对其鉴别诊断有一定价值。     

婴儿鼻腔软骨间叶性错构瘤1例及文献复习

目的报告1例婴儿鼻腔发生的极其罕见的病例，总结其病变特点。方法应用组织学方法，HE染色进行观察。结果肿瘤由梭形细胞、胶原纤维及不规则的骨和软骨岛组成。病理性核分裂象罕见。结论婴幼儿鼻腔软骨间叶性错构瘤具有良性的生物学行为，手术完整切除即可治愈。形态学上需要与间叶性软骨肉瘤鉴别。     

5例获得性血友病A的诊断及其体会

目的：通过系列的实验检测和文献复习，探讨获得性血友病A（AH-A）的规范化诊断方法。方法：应用临床诊断、一般凝血检测、活化部分凝血活酶时间（APTT）温育纠正试验、稀释试验、Nijmegen法、Bethesda法测定因子Ⅷ抗体（FⅧAb）和排除试验等，诊断5例AH-A患者。结果：应用系列诊断方法检测5例AH-A患者，均获得准确的AH-A诊断。结论：所使用的系列诊断流程，对AH-A患者的诊断有临床实用价值。     

Intramural esophageal hamartoma: A report of two cases and review of the literature

Intramural esophageal hamartoma is an unusual cause of distal esophageal obstruction in childhood. Two cases are reported with a review of the literature.     

乳腺转移性肿瘤的影像表现（附5例报告及文献复习）

目的：探讨乳腺转移性肿瘤的影像特征。方法：回顾分析5例经病理证实的乳腺转移性肿瘤的钼靶X线、CT资料,并结合文献对照分析。结果：表现为多发边界清楚的结节2例,乳腺腺体致密模糊、皮肤广泛增厚2例,巨大肿块1例。结论：乳腺转移性肿瘤的影像表现有一定的特点,且可能与转移方式相关。     

宫腔镜诊治子宫颈蓝痣(附1例报道及文献复习)

蓝痣又称真皮良性黑色素瘤，多发生在四肢、手腕、背部、臀部和面部等处皮肤，皮肤蓝痣以外的部位可发生于口腔黏膜、子宫颈、前列腺、阴道、尿道及淋巴结等区域，子宫颈比较罕见，国内外文献仅见少数报道。现将我院诊治的1例报道如下，并复习文献，对其临床表现、病理特征及处理方案进行讨论。     

Splenic hamartoma: A case report and review of the literature

Splenic hamartoma is a rare benign malformation, composed of an anomalous mixture of normal splenic elements, often found incidentally while working up other complaints or at autopsy. A splenic mass was incidentally found while evaluating the effects of a traffic accident in a 63-year-old woman. Abdominal computed tomography revealed a well-defined splenic mass with rim enhancement. The patient underwent splenectomy. The resected spleen contained a well-defined mass lesion measuring 3.5 cm × 3.0 cm. Microscopic examination revealed disorganized slit-like vascular channels lined by plump endothelial cells without atypia. The cells lining the vascular channels were positive for CD8, CD31, CD34 and vimentin. Endothelial cells that are positive for CD8 are a key feature that differentiates hamartoma from other vascular lesions of the spleen. Although this tumor is very rare, it must be included in the differential diagnosis of splenic mass-forming lesions.     

支气管色素沉着纤维化与结核感染(3例报道并文献复习)

近年来陆续有文献报道无暴露于煤尘环境和吸烟史的女性患者,在支气管镜检查中,其支气管镜特点为支气管黏膜,在支气管镜检查中,其支气管狭窄或闭塞,而胸部CT有纵隔或肺门淋巴结肿大或钙化[1-3],并与结核感染有关.     

Multi-modality imaging findings of splenic hamartoma: a report of nine cases and review of the literature

Purpose

To investigate the presentation of splenic hamartomas (SHs) on ultrasonography (US), CT and MRI.

Methods

Nine patients (5 males and 4 females, mean age, 52.8 years) with pathologically proven SHs were included in this study. US, CT and MRI images were analyzed retrospectively, and imaging features were correlated with pathological findings.

Results

SHs appeared solitary lesion (n = 8) and multiple lesions (n = 1) in the present study. (1) In 8 cases of solitary lesion, the lesions appeared as solid nodules or masses with well-defined margins and varying echogenicity (hyperecho = 5, hypoecho = 2, strong echo = 1) on ultrasound. The lesions showed iso-attenuation (n = 3) or slightly hypo-attenuation (n = 4) on unenhanced CT, and calcification were revealed in 3 lesions. MRI showed isointensity (n = 3) or hypointensity (n = 2) on the T1-weighted image, and heterogeneous hypointensity (n = 2), slightly hyperintensity (n = 2) and hyperintensity (n = 1) on the T2-weighted image. The enhanced patterns of SHs showed mild diffuse heterogeneous enhancement (n = 6) and prominent enhancement (n = 1) during arterial phase and above 7 lesions were demonstrated progressive enhancement at delayed phase on enhanced CT. One lesion without any enhancement was revealed in another patient. (2) One case of multiple lesions included 1 cystic lesion with irregular calcification and 7 solid lesions with progressive enhancement on CT images.

Conclusions

Combination of a variety of imaging modalities could more fully reflect the pathological characteristics and contribute to the diagnosis of SH.