Merkel细胞瘤一例

患者　女 ,4 4岁。曾于 1999年 7月初因后枕部肿物 6个月就诊省肿瘤医院。ＣＴ片显示后颈部一肿物 ,枕骨可见破坏。小脑内似可见一不规则肿物影 ,边界不清 (图 1)。针吸找到生长活跃的瘤细胞 ,行肿物切除术 ,术中见肿物大小为5ｃｍ× 5ｃｍ× 4ｃｍ ,边界不清 ,质中 ,血运丰富 ,侵及骨膜 ,颅骨外板尚完整。病理报告为皮肤Ｍｅｒｋｅｌ细胞瘤。术后予以放疗。家族中无类似病例。此次因头痛 13ｄ ,伴呕吐 1ｄ ,于 2 0 0 1年 3月 31日入院。于 13ｄ前无明显原因出现头痛 ,自认为“感冒” ,服用相应药物无效。头痛逐渐加重 ,主要位于后部。入院…     

皮肤Merkel细胞癌超微结构观察

皮肤Merkel细胞癌,又称皮肤神经内分泌癌,因为罕见,给肿瘤患者早期诊断和治疗带来困难,为了提高对该肿瘤的认识,我们对1例皮肤Merkel细胞癌进行了免疫组织化学和超微结构观察研究.     

人体皮肤Merkel细胞原代培养与鉴定

目的探索人体皮肤Merkel细胞体外培养方法,为进一步研究银屑病发病中Merkel细胞的神经内分泌调节作用积累基础资料。方法获取正常人皮肤组织,采用酶消化法分离细胞。设计专门的细胞体外培养系统,观察Merkel细胞在3种不同培养液中贴壁和增殖情况。采用Merkel细胞特异性标记抗体CK20标记Merkel细胞,采用免疫组化和流式细胞仪进行鉴定。结果人体皮肤Merkel细胞在3种培养液中均能顺利贴壁和增殖,并具有内分泌功能,但1号培养液[ Hamˊs-F12＋胎牛血清（10/100 ml）＋bFGF（20 ng/ml）]更有利于Merkel细胞生长。经流式细胞仪鉴定,Merkel细胞纯度可达90.11%。结论在本培养系统中,人体皮肤Merkel细胞能成功进行体外培养,并可获得较高纯度的Merkel细胞。     

皮肤Merkel细胞癌1例并文献复习

目的 探讨皮肤Merkel细胞癌(MCC)的影像特征,以提高对该肿瘤的认识。方法 回顾性分析1例经病理证实的皮肤MCC的MRI表现及病理资料,并复习相关文献。结果 MRI平扫显示右大腿中下段内侧皮下分叶状肿块,T1WI呈低信号,T1WI脂肪抑制(FS)序列呈高信号,质子密度加权成像(PDWI)FS序列呈高信号,信号不均匀,内部见分支样低信号影。MRI可见病灶邻近皮肤增厚,皮下脂肪见网格样影。MRI增强检查显示病变呈明显不均匀强化。结论 皮肤MCC的影像表现具有特征性,MRI上病灶内分支样低信号影可能对早期诊断具有特异性。     

Merkel细胞癌术后放疗可提高局部区域控制率

Merkel细胞癌为皮肤神经内分泌肿瘤。有关该瘤放疗的报道甚少。作者1980～1990年间共收治11例(均经病理诊断)。其中术后放疗8例,单纯放疗3例,前者术后均无大体残瘤,后者均有区域淋巴结转移。放疗剂量:深部X线,30Gy/15次/18天～50Gy/15次/20天;高能X线或电子束,32.4Gy/18次/22天～60Gy/30次/43天。随访6～64个月时,术后放疗照射瘤床和淋巴引流区的6例都获     

《请您诊断》病例148答案:Merkel细胞癌

病例资料患者,男,20岁,因右侧胸部疼痛5月余入院.患者5个月前无明显诱因出现右侧胸背部疼痛不适,呈间断性胀痛,无咳嗽、咳痰,无呼吸困难,5个月来胸部胀痛无缓解.实验室检查:乙肝表面抗原及乙肝e抗原阳性,HIV阴性,血清碱性磷酸酶128 U/L(正常范围40～500 U/L),男性不明原因肿瘤标记物阴性.查体:右侧胸壁...     

感觉神经植入术后Merkel氏细胞轴突复合体的溃变与再生

目的：研究神经植入对失神经皮肤中Merkel氏细胞轴突复合体再生的影响。方法：利用猴失神经手指模型,将感觉神经全程植入失神经皮肤的手指,于术后1,3,5,8和12个月对实验猴手指指腹标本进行免疫组化染色和光、电镜观察。结果：Merkel氏细胞轴突复合体随失神经时间延长逐步减少,直至完全消失;神经植入后3个月,失神经皮肤内的Merkel氏细胞轴突复合体停止溃变,且与植入的神经建立了联系。结论：感觉神经的植入能延缓神经的溃变,使Merkel氏细胞轴突复合体获得神经再支配,是一项有效的周围神经修复方法。     

125I粒子植入局部治疗晚期Merkel细胞癌患者1例并文献复习

Merkel细胞癌（MCC）是一种原发于皮肤、罕见的、具有高度侵袭性的神经内分泌恶性肿瘤。笔者报道了1例经125I粒子植入局部治疗的晚期MCC患者,通过治疗前后的18F-FDG PET/CT显像评估其疗效,分别从临床症状、影像表现、治疗经过并结合相关文献报道分析MCC的特点,旨在加深临床医师对MCC的认识并为125I粒子植入局部治疗晚期MCC患者提供依据。     

不同病期银屑病皮损组织中Merkel细胞超微结构变化和表达CK20的研究

目的探索不同病期银屑病患者皮损组织中Merkel细胞超微结构变化和表达CK20的情况,研究银屑病Merkel细胞结构和功能的变化规律。方法选择经过不正规治疗、新老皮损同时存在的银屑病患者25例,获取皮损旁的正常皮肤组织（相当于发病前期）、皮损组织（相当于进展期）和皮损修复后的病灶皮肤组织（相当于治愈期）,电子显微镜观察Merkel细胞的超微结构,免疫组化法检测皮损中CK20的表达情况。结果进展期皮损组织中Merkel细胞核相对于发病前期和治愈期无明显变化,但皮损组织Merkel细胞质中神经内分泌颗粒数量进展期组高于另两组（P〈0．05）,而另两组间差异无显著性意义（P〉0．05）。进展期皮损组织CK20表达高于发病前期和治愈期（P〈0．05）;治愈期皮损组织CK20表达与发病前期相当（P〉0．05）。结论银屑病发病与Merkel细胞结构无关,与Merkel细胞数量或表达CK20的高低可能有一定相关性。     

Bemerkung zu der Arbeit von Merkel: über das Zustandekommen von Mund- und Rachenverletzungen bei Neugeborenen

Ohne ZusammenfassungMit dieser Entgegnung ist die Erörterung der Streitfrage in dieser Zeitschrift bis zur Beibringung neuer Tatsachen geschlossen.     

ACR–ABS–ACNM–ASTRO–SIR–SNMMI practice parameter for selective internal radiation therapy or radioembolization for treatment of liver malignancies

PurposeThe American College of Radiology (ACR), American Brachytherapy Society (ABS), American College of Nuclear Medicine (ACNM), American Society for Radiation Oncology (ASTRO), Society of Interventional Radiology (SIR), and Society of Nuclear Medicine and Molecular Imaging (SNMMI) have jointly developed a practice parameter on selective internal radiation therapy (SIRT) or radioembolization for treatment of liver malignancies. Radioembolization is the embolization of the hepatic arterial supply of hepatic primary tumors or metastases with a microsphere yttrium-90 brachytherapy device.Materials and MethodsThe ACR -ABS -ACNM -ASTRO -SIR -SNMMI practice parameter for SIRT or radioembolization for treatment of liver malignancies was revised in accordance with the process described on the ACR website (https://www.acr.org/ClinicalResources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters—Interventional and Cardiovascular Radiology of the ACR Commission on Interventional and Cardiovascular, Committee on Practice Parameters and Technical Standards—Nuclear Medicine and Molecular Imaging of the ACR Commission on Nuclear Medicine and Molecular Imaging and the Committee on Practice Parameters—Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with ABS, ACNM, ASTRO, SIR, and SNMMI.ResultsThis practice parameter is developed to serve as a tool in the appropriate application of radioembolization in the care of patients with conditions where indicated. It addresses clinical implementation of radioembolization including personnel qualifications, quality assurance standards, indications, and suggested documentation.ConclusionsThis practice parameter is a tool to guide clinical use of radioembolization. It focuses on the best practices and principles to consider when using radioemboliozation effectively. The clinical benefit and medical necessity of the treatment should be tailored to each individual patient.     

Mass spectrometric differentiation of the isomers of mono-methoxyethylamphetamines and mono-methoxydimethylamphetamines by GC–EI–MS–MS

Mass spectrometric differentiation of the six isomers of mono-methoxyethylamphetamines (MeO-EAs) and mono-methoxydimethylamphetamines (MeO-DMAs) by gas chromatography–electron ionization–tandem mass spectrometry (GC–EI–MS–MS) was investigated. Based on their EI-mass spectra, the fragment ions at m/z 121 and 72 were selected as precursor ions for their regioisomeric and structurally isomeric differentiation, respectively. Collision-induced dissociation provides intensity differences in product ions among the isomers, enabling mass spectrometric differentiation of the isomers. Furthermore, high reproducibility of the product ion spectra at the optimized collision energy was confirmed, demonstrating the reliability of the method. To our knowledge, this is the first report on mass spectrometric differentiation of the six isomers of MeO-EAs and MeO-DMAs by GC–EI–MS–MS. Isomeric differentiation by GC–EI–MS–MS has a high potential to discriminate isomers of newly encountered designer drugs, making GC–MS–MS a powerful tool in the forensic toxicology field.