肝原发性平滑肌肉瘤（附三例报告及免疫组化分析）

本文报告了３例肝原发性平滑肌肉瘤，男性１例，女性２例，平均年龄３８．７岁，占同期肝恶性肿瘤检出率的０．６８％，占同期肝癌检出率的２５％，临床表现为上腹痛，右上腹包块，肝大。本组病例还进行了Ｍａｓｓｏｎ三色染色及免疫组化染色。本文结合文献对肝原发性平滑肌肉瘤的组织发生，临床病理特点及参数，鉴别诊断进行了讨论。     

肝原发性血管肉瘤（附三例报告）

本文报告了３例肝原发性血管瘤，男性２例，女性１例，平均年龄３２．７岁，占同期肝脏恶性肿瘤检出率的０．６８％（３／４３６），临床表现为上腹痛及包块，血清ＨＢｓＡｇ及ＡＦＰ阴性，本组资料还进行了网状纤维染色及免疫组织化学标记，本文讨论肝血管肉瘤的临床病理特点，诊断及鉴别诊断。     

肝原发性血管肉瘤（附三例报告）

本文报告了３例肝原发性血管瘤，男性２例，女性１例，平均年龄３２．７岁，占同期肝脏恶性肿瘤检出率的０．６８％（３／４３６），临床表现为上腹痛及包块，血清ＨＢｓＡｇ及ＡＦＰ阴性，本组资料还进行了网状纤维染色及免疫组织化学标记，本文讨论肝血管肉瘤的临床病理特点，诊断及鉴别诊断。     

胃肠道平滑肌肉瘤的临床病理及免疫组化研究

胃肠道平滑肌肉瘤（ＬＳ）５１例，其中食管２例、胃１８例、小肠２２例、大肠９例。临床症状缺乏特征性。核分裂数均≥１个／１０ＨＰＦ，过半数的ＬＳ可见到边缘浸润、瘤巨细胞及幼稚瘤细胞。Ｖｉｍｅｎｔｉｎ及Ｆｉｂｒｏｎｅｃｔｉｎ阳性纺１００％，Ｄｅｓｍｉｎ２２％Ｃ，Ｃｙｔｏｒｅｒａｔｉｎ全部阴性，Ｓ－１００３／８阳性，Ｐ＾５３阳性率４４％。Ｐ＾５３蛋白的表达在生存组与死亡组之间有显著差异，在ＬＳＩ级与Ⅱ、Ⅲ     

原发性肝脏平滑肌肉瘤1例

原发性肝脏平滑肌肉瘤十分罕见,我院经手术病理证实1例,报告如下:女性,53岁,主因间断性右上腹痛7个月于1986年5月5日入院。患者在入院前无明显诱因间断性右上腹绞痛发作2～4小时后自然缓解,疼痛时不伴有发烧及黄染。患病以来食欲减少,消瘦10余斤,无呕吐、腹泻及便血史。查体:发育正常,营养中等,全身皮肤巩膜无黄染及出血点,     

原发性阴囊皮下平滑肌肉瘤(附2例报告)

目的:结合文献探讨原发性阴囊皮下平滑肌肉瘤的临床特点及诊断、治疗方法.方法:对2例原发性阴囊皮下平滑肌肉瘤的临床资料进行分析.结果:2例均行根治性切除术,病理诊断为平滑肌肉瘤.分别随访11及8个月,未见复发及转移.结论:原发性阴囊皮下平滑肌肉瘤少见.好发于中老年人.诊断主要依靠病理诊断.治疗需以根治性手术为主,需跟踪随访,早期预后效果较好.     

贲门癌肉瘤病理形态学与免疫组化(附一例报告及文献复习)

目的　探讨贲门癌肉瘤病理组织学特点 ,诊断与鉴别。方法　应用光镜、免疫组化染色对 1例贲门癌肉瘤手术切除标本进行组织学研究。结果　癌与肉瘤成份相间混杂 ,但无移行过渡 ,免疫组化染色上皮与间叶成份各自表达相应抗体 ,排除肉瘤样癌。其肿瘤生长方式多呈息肉样 ,且少转移。结论　贲门癌肉瘤是一种罕见肿瘤 ,根据组织学特点 ,结合免疫组化染色 ,可以作出明确的病理诊断。     

外阴平滑肌肉瘤1例

1临床资料 患者,女性,60岁,2年前无意发现右側会阴部一长条索状枣仁大小包块,质地中等,不规则,界限不清,活动欠佳,伴肛门坠胀,无溃烂.查体:腹股沟区淋巴结不肿大,外阴约1.5 cm×2.5 cm包块,阴道无出血,白带少许,无臭味.     

Leiomyosarcoma of the scrotum

A case of leiomyosarcoma arising from the dartos muscle of the scrotum is described. Review of the literature reveals only eight other cases, and aspects of management of these and our case are discussed.     

肝癌的病因及预防研究新进展

目前已确定肝癌的主要病因为乙型肝炎病毒和黄曲霉毒素 ,丙型肝炎病毒、遗传病因及饮水污染问题也得到重视 ;激素、糖尿病等因素备受关注。围绕主要病因开展人群干预已取得较大进展 ,化学预防研究中采用补硒、吡噻硫酮和叶绿酸等业已证明有良好的效果 ,癌前期患者的诊治对肝癌的预防有重要的意义。     

Leiomyosarcoma of the female breast

Leiomyosarcomas of the breast are rare tumors. Less than 15 such cases have been reported in the literature so far. In this paper authors describe a case of leiomyosarcoma of a female breast presenting as a firm lobulated mass, mimicking a phylloid tumor radiographically. By fine needle aspiration biopsy, on the smears discohesive malignant looking cells were conclusive to a poorly differentiated invasive ductal carcinoma of the breast. The mastectomy specimen contained a lobulated mass, microscopically showing a partly epithelioid spindle cell tumor, immunoreactive for vimentin, desmin, smooth muscle actin antibodies, and negative for epithelial markers, hormone and growth factor receptors. Axillary lymph nodes were free of tumor. A primary leiomyosarcoma of the breast was diagnosed.     

Treatment of Rupture of a Liver Metastasis from Esophageal Leiomyosarcoma

We describe a case of rupture of a liver metastasis from esophagealleiomyosarcoma which was treated successfully by hepatic arterialembolization, thus facilitating hepatectomy. A 59-yearold womanwho had previously undergone esophagectomy for leiomyosarcomawas admitted in a state of hypovolemic shock. Ultrasonographyrevealed multiple tumors in the left lobe of the liver and massiveintraperitoneal hemorrhage, confirmed by paracentesis, possiblydue to spontaneous rupture. Subsequent hepatic angiography showedextravasation from the tumor, and embolization of the feedingleft hepatic artery was performed. After achieving hemostasis,a left hepatic lobectomy was carried out just beneath the reconstructedstomach tube. The patient made an uneventful recovery and remainswell after one year. Emergency arterial embolization followedby hepatectomy is an appropriate treatment for patients withspontaneous rupture of liver metastases.     

肝移植治疗原发性肝细胞癌的进展

肝移植已经成为治疗肝癌的重要手段.选择合适的病人是一个重要的问题,国际通行的是米兰标准,我国一般公认的适应证主要包括:合并有肝硬变失代偿、不能接受肝切除治疗的小肝癌患者和肿瘤多发且波及左右两叶、肝功能严重损害、行切除术后肿瘤容易复发或出现肝功能衰竭者.血管侵犯,细胞分化程度等因素可以影响治疗的预后.围手术期辅助治疗(经皮肝动脉化学栓塞、经皮无水酒精瘤内注射、射频消融,氩氦刀治疗)对于提高肝移植的疗效有一定的意义.     

原发性肝癌患者肝储备功能的研究

目的 :探讨原发性肝癌患者的肝储备功能。方法 :将 2 37例原发性肝癌患者的ICGR15分别与患者的腹水、血浆白蛋白、胆红素、Child’s分级及术后肝功能损害率进行统计分析。结果 :1)ICGR15与腹水、胆红素、Child分级及术后肝功能损害呈正相关 ,P =0 0 0 ;与血浆白蛋白呈负相关 ,P =0 0 0。 2 )ICGR15 >2 0 %时 ,患者出现腹水、低蛋白血症、黄疸、Child’s分级升高和术后肝功能损害的机率明显增高 ,P =0 0 0。结论 :ICGR15是评估原发性肝癌患者的肝储备功能和肝功能较好的指标。     

"Three-Grade Criteria" of Radical Resection for Primary Liver Cancer

OBJECTIVE The present study was designed to develop the "ThreeGrade Criteria" for radical resection of primary liver cancer (PLC) and to evaluate its clinical significance.METHODS Criteria for radical resection of PLC were summed up to 3 grades based on criterion development. Grade I: complete removal of all gross tumors with no residual tumor at the excision margin. Grade Ⅱ: on or the primary branches of the portal vein, the common hepatic duct or its dition to the above criteria, negative postoperative follow-up result including AFP dropping to a normal level (with positive AFP before surgery)within 2 months after operation, and no residual tumor upon diagnostic imaging.The clinical data from 354 patients with PLC who underwent hepatectomy were reviewed retrospectively. Based on the "Three-Grade Criteria" these patients were divided into 6 groups: Grade Ⅰ radical group,Grade Ⅰ palliative group, Grade Ⅱ radical group, Grade Ⅱ palliative group,Grade Ⅲ radical group, Grade Ⅲ palliative group. The survival rate of each group was calculated by the life-table method and the rates compared among the groups.RESULTS The survival rate of patients receiving radical treatment was better than those receiving palliative treatment (P＜0.01). Survival improved as more criteria were applied. The 5-year survival rate of the patients in Grade Ⅰ, Ⅱ and Ⅲ who underwent radical resection was 43.2%,51.2% and 64.4%, respectively (P＜0.01).CONCLUSION The "Three-Grade Criteria" may be applied for judging the curability of resection therapy for PLC. The stricter the criterion used,the better the survival would be. Adopting high-grade criteria to select cases and guide operations and strengthening postoperative follow-up would improve the results of hepatectomy for PLC.     

羟基喜树碱肝动脉栓塞治疗原发性肝癌疗效观察

[目的]探讨以羟基喜树碱为主化疗药物肝动脉栓塞治疗原发性肝癌的临床疗效.[方法]82例原发性肝癌患者,随机分为常规药物组(A组41例)和羟基喜树碱为主化疗药物组(B组41例),两组均给予经皮肝动脉插管化疗栓塞治疗,至少2个疗程,疗效及毒性判定按照WHO标准.[结果]A组CR 19.51%,PR 21.95%,CR PR 41.46%;B组CR 21.95%,PR 36.59%,CR PR 58.54%,两组之间差异有显著性.毒副反应两组之间差异无显著性.[结论]以羟基喜树碱为主的化疗药物栓塞治疗原发性肝癌有明显疗效.     

Leiomyosarcoma of the great saphenous vein

Peripheral vascular leiomyosarcomas are rare. A case of leiomyosarcoma of the great saphenous vein diagnosed pre‐surgically by MRI and fine‐needle aspiration is presented. Characteristics of the tumour and imaging features are discussed.     

Leiomyosarcoma of the skin: A case report

A middle-aged man presented with an ulcerated nodule of the right posterior thigh that was histologically evaluated as leiomyosarcoma of the skin. A wide excision of the tumor was followed by split-thickness skin grafting. Leiomyosarcomas of the skin and subcutaneous tissue are rare tumors, usually occurring in the proximal lower extremities. The treatment of choice is a wide local excision with a 3- to 5-cm margin including the subcutaneous tissue and fascia. The defect is covered by a split-thickness skin graft.