鼻内窥镜在鼻腔鼻窦内翻性乳头状瘤切除术中的应用

目的 探讨经鼻内窥镜鼻腔鼻窦内翻性乳头状瘤切除术和鼻内镜联合鼻侧切开鼻腔鼻窦内翻性乳头状瘤切除术的疗效。方法 13例鼻腔鼻窦内翻性乳头状瘤病例中经鼻内窥镜鼻腔鼻窦内翻性乳头状瘤切除术10例，鼻内镜联合鼻侧切开鼻腔鼻窦内翻性乳头状瘤切除术3例。结果 术后随访13—61个月。平均21个月，13例中12例未复发，治愈率92．3％，1例术后复发，病理检查证实为内翻性乳头状瘤恶变，给予放射治疗。结论 经鼻内窥镜鼻腔鼻窦内翻性乳头状瘤切除术适用于较局限的病变；而对广泛病变则应采用鼻内镜联合鼻侧切开术。术后鼻内镜定期复查可早期发现肿瘤复发并处理。     

鼻内窥镜技术在鼻腔鼻窦内翻性乳头状瘤治疗的探讨

目的 鼻内窥镜技术在鼻腔鼻窦内翻性乳头状瘤治疗的探讨.方法 病理和临床诊断为内翻性乳头状瘤21例,术前做鼻内窥镜检查及鼻窦CT扫描,全麻鼻内窥镜下鼻腔鼻窦内翻性乳头状瘤切除.术后随访1年到2年.结果 21例患者术后复发两例.结论 此方法对治疗早期的鼻腔鼻窦内翻性乳头状瘤有一定的优越性.     

鼻内窥镜外科技术治疗鼻内翻性乳头状瘤17例

目的：探讨鼻内窥镜下鼻内翻性乳头状瘤切除术手术方法和疗效。方法：回顾分析我院1995年8月至2002年8月间鼻内窥镜下鼻内翻性乳头状瘤切除术17例。结果：经鼻内窥镜治疗鼻腔鼻窦内翻性乳头状瘤17例，术后随访15例，失访2例，随访时间12～36个月。术后复发1例，复发部位为前筛顶、额隐窝，再次手术，随诊12个月无复发。本组手术无眶眼、颅底并发症。结论：鼻内窥镜外科技术治疗鼻内翻性乳头状瘤，手术视野清晰，能够准确彻底切除瘤体，降低了术后复发率；同时避免了鼻侧切开等人为手术人路创伤，术后面部无切口瘢痕。     

内窥镜下鼻腔鼻窦内翻性乳头状瘤切除术的护理

探讨内窥镜下鼻腔鼻窦内翻性乳头状瘤切除术的护理。对13例内翻性乳头状瘤患者施行鼻内窥镜手术前认真评估，针对性的予以心理护理，充分术前准备，木后加强观察，鼻腔换药，详细的出院指导，术后随访，除1例复发，12例均取得满意效果。     

鼻内镜下手术切除鼻腔鼻窦内翻性乳头状瘤

目的探讨鼻内镜下手术切除鼻腔鼻窦内翻性乳头状瘤的方法及疗效。方法对32例鼻腔鼻窦内翻性乳头状瘤患者,以彻底切除为原则,根据肿瘤不同部位,确定鼻内镜下手术切除范围,术后定期复查。结果术后随访12～36个月治愈28例,复发4例。结论鼻内镜下手术切除鼻腔鼻窦内翻性乳头状瘤,只要掌握好手术适应证,术后定期随访,疗效确切。对侵及上颌窦者联合柯陆经路可有效预防复发。     

膀胱内翻性乳头状瘤10例的诊断与治疗

目的：探讨膀胱内翻性乳头状瘤的诊断与治疗。方法：回顾性分析10例膀胱内翻性乳头状瘤的临床资料。10例术前均行B超和膀胱镜检查，7例行静脉尿路造影检查，5例行尿脱落细胞学检查，8例术前行膀胱镜活检。在治疗上，8例行经尿道膀胱肿瘤电切术，2例行膀胱部分切除术。结果：10例术后病理诊断均为膀胱内翻性乳头状瘤，其中1例伴上皮异型增生，此例术后予以膀胱内丝裂霉素灌注化疗2年。所有病例术后随访6个月至11年，未见肿瘤复发。结论：膀胱内翻性乳头状瘤是一种良性肿瘤，好发于膀胱颈和三角区。诊断主要依赖于膀胱镜检查和术后病理。经尿道膀胱肿瘤电切术是首选的治疗方法。术后不需常规进行膀胱内灌注化疗，但为预防肿瘤复发，仍需随访与复查。     

CT和MRI对鼻腔鼻窦内翻性乳头状瘤的诊断价值

目的:观察分析MRI和CT在鼻腔鼻窦内翻性乳头状瘤中的诊断价值。方法:回顾性分析经病理分析证实为鼻腔鼻窦内翻性乳头状瘤的46例患者的临床资料,分析并总结患者的CT和MRI影像图结果,对比术中、术后病理及随访结果。结果:SNIP患者的CT影像图表现为鼻窦形态存在不规则的软组织阴影,密度不均,并呈膨胀性生长。或有锥状骨质增生和斑块状骨质增生。MRI信号多呈等信号或高信号。结论:对鼻腔鼻窦内翻性乳头状瘤患者采用CT和MRI相结合的方式进行诊断,可明确判断鼻腔鼻窦内翻性乳头状瘤的起源、病变范围、是否有合并恶性病变。     

鼻内镜治疗鼻腔鼻窦内翻性乳头状瘤

目的：探讨应用鼻内镜治疗鼻腔鼻窦内翻性乳头状瘤方法及疗效。方法：回顾性分析3年来6例应用鼻内镜治疗鼻腔鼻窦内翻性乳头状瘤的疗效及体会。结果：6例经鼻内翻性乳头状瘤手术乳头状瘤患者，经1-3年随访，均未见肿瘤复发。结论：经鼻内镜手术治疗鼻腔、鼻窦内翻性乳头状瘤疗效显著方法可行。     

经鼻内镜对鼻腔鼻窦内翻性乳头状瘤深层次处理的疗效分析

目的分析经鼻内镜对鼻腔鼻窦内翻性乳头状瘤深层次处理手术方式的疗效。方法将2016年1月—2018年12月收治的68例鼻腔鼻窦内翻性乳头状瘤患者纳入观察组,采用经鼻内镜对鼻腔鼻窦内翻性乳头状瘤根基部深层次处理的手术方式治疗;将2013年8月—2015年12月收治的68例鼻腔鼻窦乳头状瘤患者纳入对照组,采用鼻内镜手术治疗。术后随访,比较2组手术相关指标、临床疗效及术后复发情况。结果观察组术中出血量少于对照组,术腔黏膜上皮化时间、住院时间短于对照组,差异有统计学意义(P 0.05); 2组手术时间差异无统计学意义(P0.05);观察组复发率为7.4%,低于对照组的26.5%,且观察组复发时间晚于对照组,差异有统计学意义(P 0.05)。2组均无手术相关严重并发症发生。结论经鼻内镜对鼻腔鼻窦内翻性乳头状瘤深层次处理的手术方式具有损伤小、恢复快、住院时间短等优点,可有效降低鼻腔鼻窦内翻性乳头状瘤术后复发率,且具有良好的治疗效果。     

经鼻内窥镜鼻腔、鼻窦内翻性乳头状瘤切除术19例

目的 探讨经鼻内窥镜鼻腔、鼻窦内翻性乳头状瘤切除术的疗效.方法 24例鼻腔、鼻窦内翻性乳头状瘤患者经鼻内窥镜切除术19例,鼻内窥镜联合鼻侧切开术5例.结果 术后随访6～48个月,平均18个月.5例复发,复发率为20.8%.结论 经鼻内窥镜手术治疗鼻腔、鼻窦内翻性乳头状瘤具有微创、视野清晰、术后不留瘢痕、复发率低等特点,对病变广泛者加用鼻侧切开术.     

Recurrent inverted papilloma coexisted with skull base lymphoma: A case report

BACKGROUNDInverted papilloma is an uncommon neoplasm in the nasal cavity. It is a histologically benign tumor, but has a high recurrence and local invasion rate. In addition, nasal or skull base lymphoma is another rare neoplasm. The coexistence of these two tumors in one case makes the diagnosis and related treatment difficult.CASE SUMMARYWe report a case of an immunocompetent patient, who had a history of inverted papilloma 20 years ago. The patient presented with an infiltrated mass lesion in the nasal cavity with extension to the frontal base. The repeated biopsies revealed inverted papilloma without any malignant transformation. After the patient underwent a frontobasal craniotomy with total tumor excision, the final pathological examination revealed nasal inverted papilloma coexisting with diffuse large B-cell lymphoma of the skull base.CONCLUSIONBased on this case report, while managing a case of an aggressive recurrent inverted papilloma, not only squamous cell carcinoma transformation, but also other invasive malignancy, such as lymphoma, should be considered.     

鼻腔鼻窦内翻性乳头状瘤恶变7例临床分析

【目的】鼻腔鼻窦内翻性乳头状瘤是一类少见的良性肿瘤,少部分病例可以发生恶变。迄今为止,有关该病恶变的临床报道甚少。本文旨在总结分析7例鼻腔鼻窦内翻性乳头状瘤恶变病例的临床特点、治疗及疗效。【方法】回顾性分析2000年1月至2008年6月在本院治疗的鼻腔鼻窦内翻性乳头状瘤及恶变患者的临床资料。【结果】7例恶变病例占我院同期鼻腔鼻窦内翻性乳头状瘤的22．6％（7／31）。7例肿瘤恶变患者均为单侧发病;年龄45～70岁;男女比例为2：5;2例接受了鼻内镜肿瘤切除术,2例鼻侧切开肿瘤切除术,1例面中部掀翻术,1例上颌骨次全切除术,1例颅面联合手术,其中手术后给予辅助放射治疗3例;除1例失随访,2例死亡肿瘤复发外,余4例患者均无瘤生存至今。3年、5年生存率分别为80％、40％。【结论】鼻腔鼻窦内翻性乳头状瘤恶变患者应采取积极彻底的手术切除,必要时辅以放、化疗。     

成人喉乳头状瘤癌变15例临床分析

目的探讨成人喉乳头状瘤癌变的病因、临床特征、病理特点及治疗效果。方法对本院1987～2000年收治的15例成人喉乳头状瘤癌变病例的临床术资料进行回顾性分析。结果所有患者均得到手术治疗及术后放疗。喉裂开及喉部分切除术3例中,1例术后2年死于复发及远处转移。半喉切除术6例中,2例术后分别于18个月、3年死于复发及远处转移。全喉切除术6例,其中3例亦于术后1～2年死于远处转移。5年生存率60％。结论临床早期诊断及时治疗甚为重要,反复活检是术前确诊的重要方法,彻底的手术切除是治疗的重要手段。     

A case of solitary intraductal papilloma of the breast coexisting with ductal carcinoma in situ (DCIS)

A 54-year-old woman was referred to this institution because of spontaneous bloody discharge from the nipple of her left breast in July 2003. Physical examination revealed no mass, but minimal pressure on the mammary gland exuded a bloody discharge from the nipple. No lymph node swelling was recognized in the axillary or subclavicular regions. Mammography and magnetic resonance imaging revealed mastopathy. Ultrasonography on the immersion method demonstrated a dilated duct with an irregular, solid, hypoechoic mass immediately behind the nipple. Fine-needle aspiration cytology showed the mass to be an intraductal tumor. Carcinoembryonic antigen (CEA) concentration of the nipple discharge was 400 ng/ml. Preoperatively, she was diagnosed as intraductal solitary papilloma, and endoscope-assisted microdochectomy was carried out under general anesthesia. The tumor was 10.5–10.6 mm in diameter and had developed from the posterior wall of the duct adjacent to the nipple. The tumor contained a small solid area in which a two-cell layer of epithelium was missing, and thus solitary papilloma coexisting with ductal carcinoma in situ (DCIS) was diagnosed. Solitary intraductal papilloma coexisting with carcinoma is rare; cases of DCIS are exceptionally rare. Follow-up for 3 years has revealed no evidence of recurrence.     

Diagnosis and management of glandular papilloma of lung: A case report

BACKGROUND Solitary respiratory papilloma is a rare epithelial tumor that can be categorizedinto multiple subtypes depending on tumor location,histological presentationand number.The glandular type is the rarest,with only 30 cases available withinthe field.Hence,information on its identification and treatment is limited.In thisreport,we discuss the diagnostic strategy and management of glandularpapilloma,along with a review of the literature.CASE SUMMARY We describe a male 44-year-old nonsmoker who presented with a persistentcough and recurrent pneumonia,which he had experienced for over 2 years.Asolitary pulmonary nodule with an endobronchial lesion was found via computedtomography of the chest.After a biopsy was obtained,no definite diagnosiscould be made.Glandular papilloma of the lung was confirmed via videoassistedthoracoscopic anatomic resection of the right lower lobe of the lung.Thepatient remained disease-free after 6 mo follow up.CONCLUSION Minimally invasive surgery is feasible for the surgical resection of endobronchialglandular papilloma.Although rare,glandular papilloma should be consideredin patients with infection or endobronchial lesions.     

Endoscopic diagnosis and treatment of a case of respiratory papillomatosis

Respiratory papilloma is a rare lesion that arises in the larynx, trachea and bronchus. We describe a patient with laryngeal papilloma that spread to the trachea and which was effectively treated by Nd-YAG laser. Two years after the initial treatments of the laryngeal and tracheal papillomas, a recurrent lesion (solitary papilloma) was observed on the membranous portion of the trachea. We examined the recurrent lesion by bronchoscopy including bronchoscopic ultrasound (US), helical computed tomography (CT) and tracheal biopsies. Respiratory papillomatosis sometimes shows either malignant transformation or invasion to tracheal wall without displaying cytohistological atypia. Therefore, we concluded that bronchoscopic US and helical CT were useful for deciding on therapeutic strategy in cases of recurrence of tracheal papilloma.     

膀胱内翻性乳头状瘤36例报告

目的提高对膀胱内翻性乳头状瘤（inverted papilloma of the bladder,IPB）的诊治水平。方法回顾分析我科1995年1月至2010年5月收治的具有完整临床和随访结果的36例IPB患者的资料。结果 36例患者均接受手术治疗,其中1例患者同时合并有膀胱尿路上皮细胞癌,1例在内翻性乳头状瘤中合并有尿路上皮细胞癌成分,术后27例行定期膀胱内灌注化疗,9例仅作定期随访,其中1例同时合并有膀胱尿路上皮细胞癌者术后3年复发。结论 IPB是一种预后良好的良性肿瘤,诊断有赖于病理检查,TURBT是治疗该病的标准方法,术后应行膀胱内灌注化疗及定期随访。     

膀胱低度恶性潜能乳头状尿路上皮肿瘤33例临床病理分析

目的探讨膀胱低度恶性潜能乳头状尿路上皮肿瘤（PUNLMP）的临床、病理特征,减少误诊。方法光镜观察33例PUNLMP石蜡切片,并与同期收治的膀胱肿瘤进行对比。结果33例PUNLMP乳头表面被覆尿路上皮形态稍有异型,明显增生,增生细胞层次超过7层。瘤组织结构整齐,细胞大小一致,基底细胞的排列呈栅栏状,细胞的极向几乎没有变化。复发7例,复发率为24.14%。结论PUNLMP的绝大多数病例并不能进展为癌,但是这种肿瘤病人增大了发生新的乳头状肿瘤的危险性,需长期随访。     

Epidermodysplasia verruciformis: response to therapy with dialyzable leukocyte extract (transfer factor) derived from household contacts

Dialyzable leukocyte extracts (DLE) have been used to treat a variety of antigen selective, and broad spectrum immunodeficiency diseases with sometimes encouraging results. We describe here the clinical and laboratory responses to DLE therapy of 2 patients with epidermodysplasia verruciformis (EV), a chronic cutaneous infection with a variety of human papilloma viruses. One patient with longstanding (30 yr) disease and no improvement to previous therapy showed gradual yet definite resolution of extensive verrucae planae, plaque, tinea-versicolor-like, and tumor lesions scattered over his entire integument. Cessation of DLE therapy for a short time resulted in recurrence of partially regressed lesions and also in the development of new tumors in this patient. The second patient, a grandson of the first patient, with minimal disease showed no progression of the disease during DLE prophylaxis. A third subject (brother of patient number 2) received no DLE and served as a control. All 3 subjects demonstrated severely depressed levels of suppressor T cells, a defect in cell-mediated immunity that has not been hitherto reported in patients with EV. Finally, evidence is presented for a possible X-linked recessive mode of inheritance for susceptibility to EV.     

膀胱内翻性乳头状瘤的腔内声像图

膀胱内翻性乳头状瘤是一种较少见的膀胱肿瘤，通过对其经尿道膀胱腔内超声声像图的研究，发现有特征性改变，表现为肿块边缘呈锯齿状强回声，内部呈不均质或均质的低回声或无回声，后方回声衰减不明显，认为它与膀胱移行上皮乳头状癌声像有明显区别，可以作为诊断膀胱内翻性乳头状瘤的一种方法。