糖尿病足坏疽38例临床分析

糖尿病足（DF）是糖尿病常见的慢性并发症之一，是导致下肢截肢的重要原因，也是严重障碍病人生活质量的，顽固而不易愈合的难冶的疮，其发生的原因常是在糖尿病未能很好治疗的基础上，发生下肢血管病变、神经病变和外伤感染等共同作用的结果。现把近几年收治的38例糖尿病足患者。临床分析如下：     

Small bowel schwannoma with diffuse subcutaneous lipomatosis. Case report and literature review

A case of a small-bowel schwannoma with diffuse familiar lipomatosis is described. This case underlines the rarity of the neoplasm and its probably chance association with subcutaneous lipomatosis. The intestinal neoplasm was diagnosed preoperatively by upper gastrointestinal endoscopy and a small-bowel enema; computed tomography scan confirmed the intestinal lesion. Attention is focused on the morphological features of intestinal schwannomas and their biological behaviour.     

Atypical mediastinal lipomatosis

We present an elderly, non-obese male with no significant medical history who presented with dyspnea on exertion. Chest radiography showed an enlarged cardiac silhouette with a retrocardiac shadow of increased lucency, resulting in a "double contour" effect. Transthoracic echocardiography raised the suspicion of a diffuse fatty infiltration in the pericardium severely distorting the left atrium. This was later confirmed on computed tomography of the chest by measuring radiodensity in Hounsfield units. The serum cortisol level ordered later was normal. To the authors' knowledge, this is only the second reported case of mediastinal lipomatosis that occurred in the absence of endogenous or exogenous steroid excess or obesity, with diffuse fatty infiltration, suspected on chest radiography and transthoracic echocardiography and confirmed by computed tomography of the chest.     

Diffuse locally invasive lipomatosis of the pericardium

The chest radiographic, echocardiographic (transthoracic and transesophageal), MRI, CT and cardiac catheterization findings in a 72-year-old patient with extensive pericardial lipomatosis are presented. Diastolic pressures in the left heart were elevated. The massive lipomatous mass was partially resected surgically with good symptomatic relief. Histologically the neoplasm consisted of mature non-malignant adipose tissue. Cushing's Syndrome was absent.     

Lipohyperplasia or intestinal lipomatosis

Lipohyperplasia or intestinal lipomatosis is an infrequent disease characterised by anomalous infiltration of adipose tissue in the intestinal submucosa. Localised forms are generally asymptomatic, whereas diffuse forms may lead to intestinal subocclusion, digestive hemorrhage or diarrhoea. Although benign, the differential diagnosis of intestinal lipomatosis with malignant pathologies of the colon or appendix often prompts the need for surgical exploration and the histological analysis of biopsy material. Surgical exeresis of the lesion is generally associated with the normalisation of clinical symptoms. The authors report the onset and clinical evolution of two cases of intestinal lipomatosis referred to their attention.     

Endomyocardial diagnosis of cardiac lipomatosis

A patient with severe isolated right-sided cardiac failure of unknown origin is presented in whom three right ventricular endomyocardial biopsies obtained in different bioptome positions disclosed a yellowish material which was confirmed at histological examination as fat. At operation, a complete replacement of atrial and ventricular myocardium by fat was noted. this previously unreported use of endomyocardial biopsy is emphasized, especially when the differential diagnosis of isolated right-sided heart failure is considered.