类固醇激素反应性慢性淋巴细胞性炎症伴脑桥血管周围强化症

正类固醇激素反应性慢性淋巴细胞性炎症伴脑桥血管周围强化症(Chronic lymphocytic inflammation with pontineperivascular enhancement responsive to steroid,Clippers)是一种在临床上非常罕见的中枢神经系统性疾病~([1])。在国内由周雁、崔丽英等于2013年首次报道了一例~([2]),这是一种以脑桥、中脑以及小脑血管周围受淋巴细胞浸润为主的疾病,具有特征性影像学改变,对类固醇激素治疗有效的中枢神经系统慢性炎性疾病。由于该病少见,许多临床医生     

表现为多发性淋巴瘤性息肉病的套细胞淋巴瘤临床病理观察

多发性淋巴瘤性息肉病(multiple lymphomatous polyposis,MLP),是一种少见的胃肠道原发的非霍奇金淋巴瘤,占胃肠道淋巴瘤发病的3％,组织学上主要表现为套细胞淋巴瘤(mental cell lymphoma,MCL)[1].母细胞型套细胞淋巴瘤(blastic variant of mant...     

上皮样血管瘤5例临床病理分析

目的 探讨上皮样血管瘤的临床病理学特征、免疫学表型及鉴别诊断.方法 分析和观察5例上皮样血管瘤的临床资料和组织学形态,应用免疫组化EnVision法研究其免疫表型,所用抗体包括CD3、CD3、CD45RO、CD20、CD79á、Ki-67、CD31、CD34、第Ⅷ因子相关抗原(FⅧRAg)、CD68和CK.结果 上皮样血管瘤多见于女性,好发于头颈部,多表现为皮肤单发的小结节或丘疹样病变.病变位于真皮内或皮下,以成簇增生的血管为主;其中3例为毛细血管型,2例为小至中等大的血管型.血管内衬胞质丰富、嗜伊红深染的上皮样内皮细胞.除内衬管腔外,内皮细胞还可在血管腔内生长或在血管周围呈实性片状增生或排列成条索状;部分细胞的胞质内含有空泡,拟形成原始血管腔.2例的间质内可见多少不等的慢性炎症细胞反应,但不见淋巴滤泡形成.免疫组化显示,上皮样血管瘤中的内皮细胞CD31和FⅧRAg等内皮标记强( ).结论 上皮样血管瘤是一种良性的血管瘤,诊断主要靠特征性组织学特点,但应注意与木村病鉴别.     

垂体细胞瘤1例并文献复习

目的 探讨垂体细胞瘤的临床病理学特征.方法 对1例垂体细胞瘤进行临床病理分析,并复习相关文献.结果 患者男性,46岁,临床表现为双眼视力下降,头颅MRI示鞍区占位,大体表现为实性肿瘤,镜下肿瘤由双极梭形细胞构成,呈束状、席纹状或旋涡状排列,肿瘤细胞Vimentin、S-100强阳性,GFAP局灶片状阳性,TTF-1阳性...     

Treatment of chronic lymphocytic leukemia with bendamustine in an HIV‐infected patient on antiretroviral therapy: a case report and review of the literature

Few reports have described the coincidence of chronic lymphocytic leukemia (CLL) and HIV. We administered bendamustine to an HIV‐positive refractory CLL patient and obtained a significant objective response. Our results indicate that bendamustine can be used in HIV‐infected CLL patients. We also reviewed 12 cases of CLL with HIV infection.     

Excellent response of severe aplastic anemia to treatment of gut inflammation: A case report and review of the literature

BACKGROUND Cumulative evidence suggests that the aberrant immune responses in acquired aplastic anemia(AA) are sustained by active chronic infections in genetically susceptible individuals. Recently, the constant source to trigger and sustain the pathophysiology has been proposed to come from the altered gut microbiota and chronic intestinal inflammation. In this case, our serendipitous finding provides convincing evidence that the persistently dysregulated autoimmunity may be generated, at least in a significant proposition of AA patients, by the altered gut microbiota and compromised intestinal epithelium.CASE SUMMARY A 30-year-old Chinese male patient with refractory severe AA experienced a 3-month-long febrile episode, and his fever was refractory to many kinds of injected broad-spectrum antibiotics. When presenting with abdominal cramps, he was prescribed oral mannitol and gentamycin to get rid of the gut infection. This treatment resulted in a quick resolution of the fever. Unanticipatedly, it also produced an excellent hematological response. He had undergone three episodes of recurrence within the one-year treatment, with each recurrence occurring 7-8 wk from the gastrointestinal inflammation eliminating preparations. However,subsequent treatments were able to produce subsequent remissions and consecutive treatments were successful in achieving durative hematological improvements, strongly indicating an etiological association between chronic gut inflammation and the development of AA. Interestingly, comorbid diseases superimposed on this patient(namely, psychiatric disorders, hypertension,insulin resistance, and renal dysfunction) were ameliorated together with the hematological improvements.CONCLUSION Chronic gut inflammation may be responsible for AA pathogenesis. The comorbidities and AA may share a common etiological association.     

Primary testicular neuroendocrine tumor with liver lymph node metastasis: A case report and review of the literature

BACKGROUNDPrimary testicular neuroendocrine tumors (TNETs) are sporadic, accounting for only 0.23% of all testicular tumors. Few cases have been reported in the literature, and no uniform treatment protocol exists. We report a case of a primary TNET with liver lymph node metastasis diagnosed at the age of 24 years and discuss its clinicopathological features, diagnosis, differential diagnosis, treatment, and prognosis.CASE SUMMARYWe report the case of a 24-year-old patient with a primary TNET with liver lymph node metastasis. The patient was found to have a right testicular swelling of about 3 cm × 4 cm in size with unclear borders and no testicular pressure pain seven years ago without any examination or treatment. One month ago, an ultrasound examination was performed for persistent enlargement of the right testis, which showed an occupying lesion of the right testis approximately 110 mm × 102 mm × 82 mm in size. Magnetic resonance imaging scan of the testis (plain scan) showed that the right testis was an occupying lesion with inhomogeneous density and mixed signal, the boundary was still clear, and the possibility of seminoma was considered; chest X-ray and computed tomography did not show any apparent abnormalities. The patient underwent radical orchiectomy, and the pathological examination suggested a right TNET with a typical carcinoid tumor histological type. One month after the surgery, the patient received nine cycles of lanreotide chemotherapy at a dose of 90 mg/mo without adverse effects. No distant lymph node or other organ metastases were detected at follow-up. He is in good physical condition and attends regular follow-up visits.CONCLUSIONNeuroendocrine tumors are rare in clinical practice, and the diagnosis mainly relies on the characteristics of microscopic tumor cells and immunohistochemical features. Treatment involves radical orchiectomy. If it is accompanied by distant lymph node metastasis and the metastatic lesion can be resected, it should be surgically removed; if it cannot be resected, growth inhibitor analog octreotide or lanreotide chemotherapy can be administered to obtain good results, with close postoperative follow-up to prevent recurrence and metastasis.     

Postoperative redislocation of the hip in a patient with congenital insensitivity to pain with anhidrosis: A case report and review of literature

Pelvic osteotomy is commonly used to adjust acetabula dysplasia for congenital dislocation of the hip, whereas congenital insensitivity to pain with anhidrosis (CIPA) is a rare hereditary disease that often has the characteristics of joint development deformity and easy fracture. This article reports the case involving a CIPA patient who was surgically treated by Chiari pelvic osteotomy and proximal femoral rotation osteotomy for congenital dislocation of the left hip joint and was provided long-term follow-up for redislocation and bilateral femoral head absorption.