共查询到19条相似文献,搜索用时 93 毫秒
1.
2.
3.
4.
5.
6.
8.
9.
外科诊治原发性气管腺样囊性癌11例 总被引:7,自引:0,他引:7
目的 探讨原发性气管腺样囊性癌的临床特征、诊断及治疗方法。方法 11例原发性气管腺样囊性癌患,年龄30~49岁。病灶位于气管上1/3段7例,其中2例侵及喉,1例侵及环状软骨;气管中、下段各2例。11例患均采取手术治疗,行气管袖状切除端端吻合术5例,其中环状软骨部分切除、气管环状软骨端端吻合1例;气管肿瘤局部刮除术4例;颈段气管及全喉切除气管造口术2例。结果 11例患无手术死亡,术后均痊愈出院,远期并发症有气管造口狭窄1例,复发1例。结论 对原发性气管腺样囊性癌患应力争早期诊断,积极手术治疗。 相似文献
10.
11.
Introduction:The relationship between chronic empyema and malignant tumors, most of which are lymphoma, has been recognized for many decades. Sarcomatoid carcinoma associated with chronic empyema is extremely rare, may metastasize to other organs in the early stage, and rapidly progresses to death. As far as we know, this was the first case report on sarcomatoid carcinoma associated chronic empyema.The patient''s main concerns and important clinical findings:A 59-year-old man presented to our hospital with a 9-year history of chronic empyema and a chief complaint of left chest wall pain for 5 months. The diagnostic contrast-enhanced computed tomography (CT) showed a large irregular soft tissue mass located on the left lower hemithorax at the margin of the empyema cavity extending to the adjacent chest wall and lung parenchyma. In addition, CT revealed pleural and pulmonary metastases surrounded by ground glass opacity.The main diagnosis, therapeutics interventions, and outcomes:The patient underwent CT guided percutaneous core needle biopsy (PCNB). The histopathological evaluation showed carcinomatous proliferation of pleomorphic spindle cells with extensive necrosis. Immunohistochemically, tumor cells were positive for cytokeratin and vimentin. The final histopathological diagnosis was sarcomatoid carcinoma underlying chronic empyema. The tumors showed rapid progression on serial simple radiography. Palliative treatments were performed, but the patient still developed severe dyspnea and died shortly after on day 16.Conclusion:Sarcomatoid carcinoma can occur very rarely as a complication of chronic empyema, and is more aggressive than usual. Early detection of developing malignancy during the follow-up of chronic empyema is an important factor for patient prognosis. 相似文献
12.
1病例资料患者男性,63岁,因体检发现上腹部肝左叶占位,考虑恶性肿瘤,于2018年10月23日收入南通大学附属医院肝胆外科。患者自诉有慢性HBV病史30余年,未正规治疗,否认家族性肝癌病史。查体:全腹未及肿块,肝区无叩痛,肝脾肋下未触及。肿瘤指标:癌胚抗原16.7 ng/ml,血清铁蛋白>2000 ng/ml,CA19-97289.8 U/ml,AFP 3.57 ng/ml,CA72-41.10 U/ml。异常凝血酶原(PIVKA-Ⅱ)46.00 mAU/ml。HBV核酸定量<1000拷贝/ml。HBsAg阳性(48.80 ng/ml),抗-HBe阳性(>6.00 PEIU/ml),抗-HBc阳性(6.52 PEIU/ml)。胸苷激酶1测定:细胞质胸苷激酶0.49 PM。上腹部增强CT示:肝占位,考虑肝内胆管细胞癌(图1)。 相似文献
13.
14.
随着影像学技术的提高,胰腺囊性肿瘤的诊断率明显提高,然而各种类型之间的鉴别诊断仍比较困难。对于胰腺囊性肿瘤的处理应根据患者的身体状况、肿瘤大小、在胰腺所处的位置、患者意愿等综合考虑,做到个体化治疗。虽然胰腺囊性肿瘤的手术病死率很低,但并发症发生率较高。因此,必须严格制订治疗方案。 相似文献
15.
16.
Sawomir Mrowiec Beata Jaboska Jan Baron Magdalena Gajda Anna Stelmach Patryk Zema ukasz Liszka 《Medicine》2021,100(2)
Rationale:Biliary cysts (BC) are rare dilatations of various parts of a biliary tract. They account for approximately 1% of all benign biliary diseases. Total cyst excision and Roux-Y hepaticojejunostomy is the treatment method of choice in most patients. In this paper, a novel surgical treatment with the use of internal biliary and pancreatic catheters was presented.Patient concerns:A 21-years-old woman with a giant choledochal cyst of Todani IA type presenting with abdominal pain, nausea, fever and palpable abdominal mass. It had been previously drained as a misdiagnosed pancreatic cyst in another hospital.Diagnosis:A very high amylase level (107140,0 U/l) in drain fluid was noted in laboratory tests. Endoscopic retrograde cholangiopancreatography revealed a biliary cyst located in the distal common bile duct and a pancreaticobiliary anomaly was suggested. A cholangiography per catheter inserted to the biliary cyst showed a large round contrast-filled cyst. A cholangiography following cyst decompression revealed a very long, tortuous bile duct entering the duodenum.Interventions:Cholecystectomy, cyst resection, Roux-Y hepaticojejunostomy, and implantation of catheters into pancreatic and bile duct were performed. The postoperative course was uneventful and she was discharged on 12th day without any complications. Histopathology revealed a cyst wall partially lined with biliary-type and mucinous epithelium, with dysplasia ranging from low to high grade (biliary intraepithelial neoplasia, high grade), without invasion.Outcomes:The biliary and pancreatic catheters were removed during endoscopic retrograde cholangiopancreatography 8 weeks following surgery without any complications. Fourteen months later, the patient reported good health.Lessons:Diagnosis of the abdominal cyst should be very precise in order to avoid misdiagnosis and inadequate management. The early diagnosis and proper treatment of BC are needed in order to avoid serious complications. The cholangiocarcinoma is the most dangerous potential complication of BC due to dysplasia within the cyst wall as in our young female patient. 相似文献
17.
Yukio Oshiro Ryozo Gen Shinji Hashimoto Tatsuya Oda Taiki Sato Nobuhiro Ohkohchi 《World journal of gastroenterology : WJG》2016,22(30):6960-6964
Neuroendocrine carcinoma(NEC) originating from the gastrointestinal hepatobiliary-pancreas is a rare, invasive, and progressive disease, for which the prognosis is extremely poor. The patient was a 72-year-old man referred with complaints of jaundice. He was diagnosed with middle extrahepatic cholangiocarcinoma(cT 4N1M0, c Stage Ⅳ). He underwent a right hepatectomy combined with extrahepatic bile duct and portal vein resection after percutaneous transhepatic portal vein embolization. Microscopic examination showed a large-cell neuroendocrine carcinoma according to the WHO criteria for the clinicopathologic classification of gastroenteropancreatic neuroendocrine tumors. Currently, the patient is receiving combination chemotherapy with cisplatin and etoposide for postoperative multiple liver metastases. Although NEC is difficult to diagnose preoperatively, it should be considered an uncommon alternative diagnosis. 相似文献
18.
Akatsu T Kameyama K Kawachi S Tanabe M Aiura K Wakabayashi G Ueda M Shimazu M Kitajima M 《Journal of gastroenterology》2006,41(1):83-87
Extraskeletal tumors containing multinucleated, osteoclast-like giant cells (OGCs) are uncommon. These neoplasms are most
frequently reported in the breast and pancreas. Recently, some authors have suggested that carcinomas containing OGCs may
represent a distinct clinicopathological entity with a more favorable prognosis. Occurrence in the gallbladder is extremely
rare, with only one previous case. We report here on an additional case of gallbladder carcinoma with an infiltrate of OGCs.
A 72-year-old woman presented with postprandial abdominal pain and was found to have a mass in the body of the gallbladder
with direct liver invasion. Histological examination showed an adenosquamous carcinoma with an infiltrate of benign OGCs.
Immunohistochemical analysis demonstrated that the giant cells were of histiocytic origin. The patient survived for 6 years
without evidence of recurrence. This case adds to a small body of literature on gallbladder carcinoma with OGCs. Further studies
are required to clearly define the prognostic significance of these giant cells in gallbladder cancer and the differences
between adenosquamous carcinoma with OGCs and other gallbladder carcinomas (such as adenocarcinoma and squamous cell carcinoma)
with those cells. 相似文献
19.
目的探讨肝门部胆管癌(HCCA)的早期临床症状及其与临床分型的关系,以期早期诊断。方法采用黄志强建议的在Bismuth分型法基础上的分型方法,根据肿瘤的原发部位分为5型,Ⅰ、Ⅱ型为A组;Ⅲ、Ⅳ、Ⅴ型为B组。对72例病理和临床证实的肝门部胆管癌的主要临床症状、初始症状等临床资料进行分析。结果 72例患者中初始症状表现为无痛性黄疸者仅24例(33.3%);非黄疸者48例(66.7%),主要表现为腹胀并纳差、右上腹部疼痛、尿黄、白陶土样粪便、体重减轻、高热寒战等。A组患者初始症状多表现为无痛性黄疸(53.8%),而B组患者初始症状多表现为非黄疸症状(90.9%)。结论 HACC的临床症状复杂,与病变的临床分型有密切关系。 相似文献