原发性肺平滑肌肉瘤8例诊治分析并文献复习

目的探讨原发性肺平滑肌肉瘤的临床、病理特点,诊断和治疗,提高其诊治效果。方法总结分析我院收治的8例原发性肺平滑肌肉瘤患者的诊治及预后情况。结果无手术死亡,8例患者均恢复出院,术后随访死亡2例,其余仍健在。结论原发性肺平滑肌肉瘤是一种少见的肺部恶性肿瘤,早期无特殊症状,极易误诊。手术切除是治疗原发性肺平滑肌肉瘤的有效方法,肿瘤的大小、局部受侵程度、癌细胞分化程度与预后明显相关。     

肺平滑肌肉瘤(附3例报告并文献复习)

肺平滑肌肉瘤是一种罕见的肺部恶性肿瘤，本文报告我院自1991年以来收治的3例肺平滑肌肉瘤，并结合文献对本病的特点进行讨论。我们认为肺平滑肌肉瘤同支气管肺病相比具有以下特点：1）肺内阴影边界清晰，密度均匀，生长快，但不论肿块大小，多不伴有肺门或纵隔淋巴结肿大，2）术前不易获得病理或细胞学的诊断，3）病理学上不易与肺的未分化癌相区别。结论：详细了解病史，注意X线特征和早期手术是对这种罕见的肺部肿瘤唯一有效的诊断和治疗方法。     

原发性肺平滑肌肉瘤1例

患者，杨某，男，56岁，因“右侧背痛2月，查体发现右肺占位5d”入院。入院查体：一般情况可，仅右肺呼吸音略粗，余无阳性体征。胸部X线：右肺中叶团块状影，约5cm×5cm大小，密度均匀，边缘欠光滑。CT：右肺中叶约5cm×5cm×4cm软组织团块影，形态不规则，呈分叶状，密度欠均匀，CT值20～25HU。纤维支气管镜检查：右下叶基底段支气管口被黄色光滑肿块堵塞。入院后在全麻下行右肺切除术，术中探查：右肺中叶一约6cm×5cm×5cm大小质硬肿块。与肺上下叶关系紧密，与右主支气管、肺动静脉无粘连，[第一段]     

心脏原发性平滑肌肉瘤1例

1病案摘要患者,女,29岁,因“活动后心悸、胸闷、气促1周”于2004年10月15日入院。查体:心界向左稍大,心率126次/m in,律齐,心尖区可闻及Ⅲ/6级收缩期吹风样杂音及舒张期隆隆样杂音,向腋下传导。B超示:双侧胸腔积液。超声心动图示:左房、右室增大,左房内可见大小约8.4 cm×4.3 c     

肺肉瘤样癌2例并文献复习

目的提高对肺肉瘤样癌（lung sarcomatoid carcinoma,LSC）的诊断、治疗及预后方面的认识。方法通过对2例LSC患者的诊治进行分析,结合相关文献复习。结果患者表现为咳嗽、咯血、胸痛,其症状与其它类型肺癌相似,增强CT示环形强化为其特征。肺组织活检确诊肺肉瘤样癌（病理及免疫组化）。手术联合化/放疗可延长患者生存时间。结论肺肉瘤样癌罕见,较一般肺癌更具侵袭性,预后差。本病缺乏特异性临床表征,增强CT扫描示环形强化为其特征,但诊断主要依靠手术病理。手术是LSC的首选治疗方法。     

原发性肺滑膜肉瘤诊断与治疗附1例报告及文献复习

目的 通过探讨原发性肺滑膜肉瘤的临床症状、影像学表现、病理学及免疫组化,提高对本病的认识.方法 报告近期呼吸科确诊1例原发性肺滑膜肉瘤患者,同时对既往报道18例患者进行回顾性研究,分析其临床表现、影像学表现、病理学特征及免疫组化特点.结果 临床表现为咳嗽、咳痰或胸痛、胸闷等,影像学表现为肺部肿块影,边缘清楚或呈分叶状,病灶密度不均匀,增强扫描呈不均匀强化,可伴纵隔淋巴结肿大及胸腔积液,病理学检查提示为梭形细胞恶性肿瘤,瘤细胞呈流水状排列,核分裂象易见,免疫组化EMA、Bcl-2、Vimentin等阳性.结论 原发性肺滑膜肉瘤临床表现及影像学表现上无特异性,不易与其他肺或胸膜原发性肉瘤相鉴别,需要结合病理及免疫组化结果进行诊断.     

原发性心脏平滑肌肉瘤一例

<正>患者,女,45岁,因“活动后胸闷伴下肢水肿1月余”于2022年1月11日就诊于临沂市人民医院心血管内科。患者1个月前无明显诱因出现活动后胸闷,伴乏力、咳嗽咳痰、食欲下降、下肢水肿,无发热、晕厥、黑蒙、腹痛腹泻等不适。曾就诊当地医院,心脏超声提示“左心房血栓、心包积液”,心包穿刺引流液抗酸染色、细菌培养均阴性,脱落细胞学检查未见肿瘤细胞。本院门诊以“心房血栓”收入院。既往体健,无相关遗传家族病史。体格检查：T 36.5 ℃,     

肺原发性滑膜肉瘤二例

肺原发性滑膜肉瘤是一种罕见的肺部恶性肿瘤，占肺原发性恶性肿瘤的0.5%，迄今国内报道61例，现结合经我院诊治的2例，就本病的临床特征，诊断、治疗和预后进行探讨，以期提高对本病的认识。     

肺转移性滑膜肉瘤二例并文献复习

滑膜肉瘤是一种罕见的,具侵袭性的,梭形间叶组织来源的恶性肿瘤,肺是其最常见的转移部位.其临床表现和影像无特异性,极易误诊.国内外关于肺转移性滑膜肉瘤的报道较少,现将苏州大学附属第一医院2例肺转移性滑膜肉瘤并复习的近20年国内外文献报道的9例肺转移性滑膜肉瘤进行分析,以提高对该类疾病的认识.     

原发性脾血管内皮肉瘤—1例报告并文献复习

血管内皮肉瘤(Angiosarcoma)是一罕见病,发生于脾脏者更是少见.发生自发性脾破裂者,国内尚未见报告.最近我院收治1例,现报告如下并综合文献复习.1 病例报告王××,男性,65岁.住院号8579.因持续性左上腹部疼痛半月加重2天于1995年10月27日入院.半月前无诱因出现左上腹疼痛,呈持续性胀痛.近两天疼痛加重难以忍受,伴发热,体温37.5～38.9℃.既往无化学物质接触史.查体:体温37.8℃,脉搏92次/min,急性痛苦面容,心肺正常,肝不大,脾左肋下5cm,触痛明显,移动性浊音阴性.化验:WBC 10.5×10~9/L,Hb 125g/L,RBC 4.25×10~(12)/L,肝功能正常.B超检查肝脏大小形态及回声     

原发性肺隐球菌病例报告及文献复习

目的:探讨肺隐球菌病的临床及病理特点,提高对肺隐球菌病的认识,以减少误诊。方法:回顾性分析1例原发性肺隐球菌病的诊断和治疗经过,分析总结治疗经验,结合文献复习肺隐球菌病的发病机制、临床表现、诊断与治疗要点。结果:患者男性,56岁,有糖尿病史,胸部影像学检查发现右肺内胸膜下多发性片状或团块状阴影,给予抗生素治疗无效,曾怀疑为肺癌行经皮肺活检提示肺隐球菌病,入我院进一步诊治。病理检查提示肉芽肿形成,可见隐球菌孢子,高碘酸希夫染色(PAS)和六胺银染色均阳性,确诊原发性肺隐球菌病。给予氟康唑400 mg/d,静脉滴注,6 w后病灶明显吸收,改为氟康唑口服出院。结论:肺隐球菌病缺乏特异性的临床和影像学表现,容易误诊、误治。临床医生需要提高对肺隐球菌病的认识,尽可能行病理检查结合特殊染色明确诊断。标本来源以创伤小的经皮肺穿刺为首选,治疗前需全面评估病情。     

Crohn's disease with pulmonary manifestations in children: 2 case reports and review of the literature

Crohn's disease (CD) is a chronic granulomatous disease of unknown etiology that affects primarily the gastrointestinal system but can be associated with extraintestinal manifestations. Latent pulmonary involvement in children with CD has been described, but symptomatic pulmonary disease has rarely been reported in children. In this review, we report two pediatric cases, one with pleural effusion at the time of CD diagnosis and the other with bilateral cavitary lesions in a previously diagnosed CD patient. We review the current literature and summarize the diagnosis and management of pulmonary involvement in CD. Awareness of these pulmonary complications of CD in children may lead to more prompt diagnosis, guide appropriate therapy, and decrease morbidity.     

Primary cutaneous apocrine carcinoma of the scalp: Two case reports and literature review

Rationale:Apocrine carcinoma is a rare malignant sweat gland tumor that has been reported in approximately 200 cases. This tumor usually occurs in the axilla, but in rare cases, it can also develop in the scalp. In the present work, we report 2 cases of cutaneous apocrine carcinoma of the scalp.Patient concerns:Two men visited our outpatient clinic with recurrence of tumor after undergoing surgery for scalp tumor at another hospital.Diagnoses:Brain magnetic resonance imaging of a 56-year old man showed the presence of a 5.0 × 4.5 × 4.4 cm scalp mass in the right parietal region, invading the skull and dura mater and a 2.2 × 2.0 × 0.7 cm bony mass without any skin lesions right next to the scalp mass. Neck magnetic resonance imaging of a 76-year-old man revealed the presence of a well-defined oval mass in the subcutaneous layer of the left occipital scalp and 2 enlarged lymph nodes in the left neck. Definite diagnoses were made postoperatively. The patients were diagnosed with cutaneous apocrine carcinoma. The diagnosis was confirmed through histopathological and immunohistochemical staining tests.Interventions:The tumors were removed with a wide safety margin and reconstructive surgery was performed.Outcomes:Additional radiotherapy or chemotherapy was performed. Follow-up more than 6 months revealed no recurrence or metastasis.Lessons:If accurate diagnosis and treatment had taken place at the initial stages of the primary cutaneous apocrine carcinoma, it would have been possible to prevent recurrence and intracranial invasion. As recurrent primary cutaneous apocrine carcinoma can become aggressive and difficult to treat, even a small mass on the scalp must be evaluated carefully and treated properly.     

Primary pulmonary synovial sarcoma, a rare primary lung neoplasm: two case reports and review of the current literature

Abstract:   This report describes the clinical, histological and immunohistochemical features of two patients with primary pulmonary synovial sarcoma in the context of the literature. Chest pain, cough, haemoptysis and an enlarging pleural-based mass are the main clinical manifestations. Diagnosis depends on identifying epithelioid or spindle cells microscopically and on immunohistochemistry showing positivity for cytokeratin and vimentin and epithelial membrane antigen stains. Surgical excision is the main treatment approach.     

Erythromelalgia: two case reports and literature review

Erythromelalgia is a rare disease of unclear etiology characterized by recurrent erythema, burning pain and warmth of the affected extremities. In this paper we reported 2 cases of primary familial erythromelalgia and difficulties with achieving a significant improvement with the currently available treatment. Moreover, this paper provides a brief update on pathophysiology, prognosis and treatment of erythromelalgia.     

Glutaraldehyde-induced colitis: case reports and literature review

Glutaraldehyde-induced colitis is an uncommon colitis in clinical practice. Because the involvement of colonic segment is determined by the endoscopic part where glutaraldehyde remains, a recent history of endoscopy and a demarcated involvement of colonic segment are the most characteristic signs of glutaraldehyde-induced colitis. The typical clinical scenario is acute onset of lower abdominal pain, fever, and bloody stool. Laboratory data usually show leukocytosis and elevated C-reactive protein. The endoscopic pictures of involved segments are compatible with acute colitis, including hyperemic, edematous, with or without multiple erosions. Acute ischemic colitis and infectious colitis should be differentiated at the outset of the disease. Stool pathogen tests are usually negative. Parenteral empiric antibiotic may be considered if severe transmural edema of the involved segment is observed in computed tomography. Conservative treatment, including bowel rest and parenteral hydration, is able to stabilize the condition in a week. Herein, we present two cases of acute proctocolitis caused by glutaraldehyde after uneventful colonoscopy.     

Primary T-cell pulmonary lymphoma. A case report and review of the literature

Non-Hodgkin's lymphomas rarely involve the pulmonary parenchyma. Most cases described to date involve B-cells. We report the first case of T-cell pulmonary lymphoma in the Spanish literature. The course of disease was rapid and response to treatment was poor. Such cases demonstrate the importance of open biopsy and the study of cell markers for diagnosis. T-cells lymphomas should be included in the differential diagnosis of febrile patients with pulmonary nodules.     

Measles-associated appendicitis: two case reports and literature review

We report 2 cases of appendicitis associated with measles. Four previously reported cases are reviewed. In all 6 patients typical measles rash appeared after removal of the appendix, which showed Warthin-Finkelday giant cells.     

Brevundimonas bacteremia: two case reports and literature review

Brevundimonas spp. are infrequently isolated from clinical samples, including blood. The vast majority of reported cases have underlying diseases. Whether these microorganisms represent true pathogens of human disease in all populations remains to be explored. We present 2 cases of bloodstream infection caused by Brevundimonas sp., with one of these individuals immunocompetent, and discuss the possible role of these organisms in different patient populations.