Magnetic resonance imaging features of a solitary fibrous tumor of the vulva: a case report

Solitary fibrous tumors (SFTs) are commonly seen in the pleura. SFT involvement of the vulva is rare, and clinical diagnosis is mainly based on histopathological and immunohistochemical analyses. We herein describe the imaging features of a 69-year-old woman with an SFT of the vulva. The SFT was hypointense on T1-weighted images, similar to muscle; however, it showed inhomogeneous hyperintensity predominantly on fat-suppressed T2-weighted images. An area of low signal intensity was evident on T2-weighted images, and the tumor showed progressive enhancement in delayed phases. The tumor also displayed heterogeneous and prolonged, persistent enhancement, and serpentine vessels were present in the peritumoral area as signal voids. Pathological examination confirmed that the lesion was an atypical SFT originating from the vulva, and it was composed of spindle cells and perivascular and stromal hyalinization. This case reveals the characteristic imaging findings of vulvar SFT and their association with the relevant pathological findings, thus contributing to the primary diagnosis and preoperative evaluation of this potentially aggressive tumor.     

Cellular solitary fibrous tumor in the mental area: a case report and literature review

Solitary fibrous tumors (SFTs) are rare benign mesenchymal tumors that occur mainly in the pleura. We herein report the first case of a cellular SFT located in the mental region of the head and neck in a 46-year-old woman. Facial computed tomography revealed a mass measuring 0.8 cm with clear boundaries in the right mental region. After excision of the mass, expert pathologists diagnosed a cellular SFT. To our knowledge, this is the first case of a cellular SFT identified in the subcutaneous tissue of the mental region of the head and neck. Because the postsurgical prognosis of SFTs is unpredictable, long-term follow-up and further studies are necessary to determine the characteristics of cellular SFTs in the head and neck region.     

Malignant solitary fibrous tumor of the greater omentum: A case report and review of literature

BACKGROUNDMalignant solitary fibrous tumors (SFTs) account for 15%-20% of all SFTs, and malignant SFTs arising from the greater omentum are extremely rare. Most malignant SFTs of the greater omentum are diagnosed via pathological examinations after surgery. In this study, we report a case of malignant omental SFT and review the published literature on this rare malignancy.CASE SUMMARYA 64-year-old female presented with an abdominal mass, and underwent exploratory surgery, during which a huge tumor originating from the greater omentum and intraperitoneal implants were identified and resected. The results of the pathological examination, immunohistochemistry staining, and gene sequencing led to the diagnosis of malignant SFT of the greater omentum. The patient died one and a half years later due to tumor recurrence and metastasis.CONCLUSIONThis is the first report of the application of gene sequencing in the diagnosis of malignant SFTs of the greater omentum.     

颈部孤立性纤维性肿瘤的超声诊断价值

目的 对10例颈部孤立性纤维性肿瘤(SFT)的超声特征进行回顾性分析.方法 收集颈部SFT患者10例,男4例,女6例,年龄3～65岁.所有患者均行超声检查,其中2例行超声造影检查.对其临床、超声特征进行分析,并进行文献学习,所有病例均经术后病理证实及电话随访.结果 共计发现肿块10个,最大直径1.7～8.5 cm,高频...     

Diagnosis of solitary fibrous tumor in the submandibular gland: Case report and literature review

Solitary fibrous tumors (SFTs) rarely occur in the head and neck area. Imaging findings are nonspecific, and immunohistochemical (IHC) analysis is necessary for a definitive diagnosis. We report the case of a patient with a mass in the submandibular region that was initially diagnosed as basal cell adenoma. After excision and IHC examinations, a SFT was diagnosed.     

Malignant solitary fibrous tumor of the pancreas with systemic metastasis: A case report and review of the literature

BACKGROUND Pancreatic solitary fibrous tumor(SFT) is a rare neoplasm of intermediate biological potential. So far, only 22 cases have been reported since 1999. All the cases, except one, exhibited benign features. Here, we report the first case of malignant pancreatic SFT with typical Doege-Potter syndrome, along with the clinical and pathologic evidence of its systemic metastasis.CASE SUMMARY The patient was a 48-year-old man with a 1-year history of pancreatic and liver masses and refractory hypoglycemia. Increased uptake of the tracer fluorodeoxyglucose(FDG) was found in the liver and bones by fluorine-18 FDG positron emission tomography/computed tomography. After multidisciplinary discussion, a distal pancreatectomy procedure was performed, and histological examination showed a lesion composed of abundant heterogeneous spindle cells with localized necrosis. On immunohistochemistry evaluation, STAT6 was found to be diffusely expressed in the tumor. Based on the overall evidence, the patient was diagnosed with malignant pancreatic SFT with liver and bone metastases.CONCLUSION The diagnosis of malignant SFT requires comprehensive evidence including clinical, immunohistochemistry, and histological features. This case may be presented as a reference for diagnoses and management of malignant pancreatic SFTs with systemic metastasis.     

Dumbbell-shaped solitary fibrous tumor in the parapharyngeal space: A case report

BACKGROUNDSolitary fibrous tumors (SFTs) occurring in the parapharyngeal space are rare, and their final diagnosis depends on pathological and immunohistochemical analyses. Once the tumor is diagnosed, complete resection and regular postoperative follow-up are required.CASE SUMMARYA 40-year-old male patient with a right parotid gland mass discovered 8 years ago was admitted to hospital. The mass showed no tenderness or local skin redness. Imaging was carried out as the patient had stable vital signs and showed that the mass was a dumbbell-shaped tumor comprising a superficial tumor approximately 5 cm long and 3 cm wide in size that compressed the right parotid gland and a deep tumor located in the right parapharyngeal space approximately 4.5 cm long and 2.5 cm wide in size. Both tumors were connected in the middle. Prior to surgery, the tumors were considered to be parapharyngeal schwannomas. During surgical dissection, the tumors were found to be smooth and tough, without obvious adhesion to the surrounding tissues. The tumors were revealed to be a SFT following postoperative pathological analysis.CONCLUSIONSFTs in the parapharyngeal space are rarely reported, and complete resection of such tumor is recommended. Adjuvant chemoradiotherapy is used in patients with extensive tumor invasion to lower the recurrence rate. Postoperative long-term follow-up is required.     

颅内孤立性纤维瘤/血管外皮瘤与脑膜瘤的临床和MRI对比分析

目的 探讨颅内孤立性纤维瘤（SFT）/血管外皮瘤（HPC）MRI影像征象,并与脑膜瘤进行对比分析。方法 分析经手术和病理证实的SFT/HPC患者28例（SFT/HPC组）和脑膜瘤患者68例（脑膜瘤组）的临床及MRI征象,并比较各观察指标。结果 肿瘤形态、信号均匀性、瘤内血管流空信号、瘤内短T2信号强化结节、瘤内囊变坏死情况、脑膜尾征、骨质改变、性别、Ki-67%水平、术中出血量在两组间差异均有统计学意义（P均<0.05）。结论 SFT/HPC及脑膜瘤临床及MRI表现存在一定差异,对比分析两者的影像征象有助于两者的鉴别诊断。     

Might within the madness: solution-focused therapy and thought-disordered clients

Nurses working with thought-disordered clients in inpatient psychiatric settings may find that much of their role is defined by the administration and monitoring of antipsychotic medications. Therefore, a challenge for these nurses can be to find other nursing interventions for these clients that are effective, efficient, and clearly and uniquely within the scope of nursing. In response to this challenge, this article presents the use of solution-focused therapy (SFT) to help thought-disordered clients better cope with some of their negative experiences and symptomatology. The article provides an overview of SFT, with a focus on how these techniques might be used on an inpatient psychiatry setting with clients experiencing thought disorders. The authors include three case studies demonstrating the use of SFT with clients experiencing thought disorders, and conclude with some of the lessons they have learned using SFT techniques with these kinds of clients in inpatient psychiatric settings.     

Fostering a culture of engagement: a pilot study of the outcomes of training mental health nurses working in two UK acute admission units in brief solution-focused therapy techniques

It is widely acknowledged that there are major concerns about quality of care, ward atmosphere, the nature of nurse–patient interactions and patient outcomes in UK psychiatric acute admission units. Brief solution-focused therapy (SFT) is an approach which aims to shift the focus of interactions in professional care away from the traditional concentration on an individual's problems and weaknesses towards a more proactive identification of their strengths and positive coping mechanisms. This approach relies on a collaborative engagement with patients, in which the nurse or therapist using simple language aims to help the patient construct a plan to ensure their immediate safety while working to identify, focus on and reinforce their strengths and coping mechanisms in the achievement of identified future goals. This paper reports on a pilot study whose principal objective was to determine whether a short training in brief SFT for psychiatric nurses can produce measurable improvements in nurse–patient interactions in two psychiatric acute admission wards. In this study, 36 nurses undertook a 2-day training course in SFT and were followed up 3 months after training. Positive results were obtained on a number of measures indicating that nurses had acquired knowledge and skills and were applying SFT techniques in their clinical work.     

肾脏罕见良性肿瘤的影像学表现与临床病理对照分析

目的 分析肾脏罕见良性肿瘤的影像学表现.方法 回顾性分析15例经手术病理证实的肾脏罕见良性肿瘤的影像学资料,包括肾嗜酸细胞腺瘤5例,上皮样血管平滑肌脂肪瘤3例,孤立型纤维瘤3例,后肾腺瘤、血管瘤、平滑肌瘤和球旁细胞瘤各1例;其中12例接受CT检查,3例接受MR检查.结果 11例CT或MR平扫显示边界清楚的实性肿块.肾嗜酸细胞腺瘤明显不均匀强化,体积较大者可出现中央瘢痕.上皮样血管平滑肌脂肪瘤MR T1WI、T2WI均以低信号为主,内夹杂索条状、斑片状高信号以及流空信号.血管瘤呈渐进性向心性强化,易发生囊变;孤立型纤维瘤T1WI和T2WI均为低信号,增强后延迟强化.后肾腺瘤、平滑肌瘤和球旁细胞瘤缺少特征性影像学表现.结论 肾脏罕见良性肿瘤大多边界清晰,影像学表现多有一定特征性,对术前诊断有所帮助.     

铁转运刺激因子与脑铁代谢

目的为进一步加深铁转运刺激因子(stimulator of Fetransport,FT)对机体铁代谢以及铁代谢异常(缺乏或超载)的理解,综述了国内外对SFT的研究进展,重点讨论了SFT的表达分布与结构、生理功能、表达调控及其表达异常与脑铁代谢疾病关系.资料来源应用计算机检索http//www.ncbi.nlm.nih.gov/PubMed与SFY相关文献,检索词"stimulator of iron transport"和"stimulator of Fe transport",并限定文献语种为英文.同时计算机检索中文CNKI(中国期刊网全文数据库)1997-01/2004-10相关文献,检索词"脑铁代谢,铁转运刺激因子",并限定文献语种为中文.资料选择对资料进行筛选,以关于SFT的结构及其与脑铁代谢疾病相关的文献作为纳入标准.资料提炼共收集到20篇关于SFT及1300篇关于脑铁代谢的文献,1篇文献符合纳入标准.资料综合从入选的21篇文献中,综述了目前对SFT的表达分布与结构、生理功能、表达调控及其表达异常与脑铁代谢疾病关系等方面的研究进展.结论SFT具有刺激细胞表面的非转铁蛋白结合铁或转铁蛋白结合铁的摄取功能,其基因表达存在转录水平和转录后水平两种调控机制,主要受细胞内铁浓度的负向调控.SFT可能在脑铁代谢中具有重要作用.     

颅内血管周细胞瘤与孤立性纤维瘤的影像与病理对照

目的对比分析颅内血管周细胞瘤与孤立性纤维瘤的影像学差异。材料与方法回顾性分析经手术病理证实的颅内血管周细胞瘤18例,孤立性纤维瘤10例,所有病例均行MR平扫及增强扫描,对其影像征象进行对照分析。统计学方法采用单因素分析,计数资料组间比较采用卡方检验。结果血管周细胞瘤与孤立性纤维瘤在与附着硬膜的关系、硬膜尾征征象方面无统计学意义(P＞0.05);在肿瘤形态、T2WI信号、囊变坏死及出血、瘤周水肿、骨质破坏及强化方式方面差异有统计学意义(P＜0.05)。前者肿瘤形态多呈分叶状、不规则形, T2WI等高信号,囊变坏死及出血多见,瘤周水肿较明显,颅骨破坏可见,增强后明显强化;后者肿瘤形态多呈类圆形或椭圆形,T2WI有低信号区,囊变坏死及出血少见,瘤周水肿轻,无颅骨破坏,增强后明显强化,并有延迟强化。结论颅内血管周细胞瘤与孤立性纤维瘤影像表现存在一定差异。     

Construct validity of the Modified Gait Efficacy Scale in older females

There are few well-validated tools that focus on the assessment of walking confidence in older adults. The main objective of this study was to assess construct validity of the 10-item Modified Gait Efficacy Scale (mGES) as a measure of walking confidence in older adults. Twenty-four older females completed the mGES, the 16-item Activities-specific Balance Confidence (ABC-16) scale, and the Senior Fitness Test (SFT). Construct validity of the mGES was evaluated by quantifying relationships between the mGES and the ABC-16 and the SFT, and by examining the ability of the mGES to discriminate between known groups (no/lower fear of falling versus higher fear of falling). There was a strong correlation between mGES and the ABC-16 scale (r_s = 0.85; p < 0.001). The mGES was significantly associated with SFT components that required lower extremity strength, stepping aerobic endurance, and walking agility and dynamic balance (r_s = 0.45 to 0.61; p < 0.05). Relationships between the mGES and number of arm curls in 30 s, chair sit and reach test, and back scratch test were weak (r_s = 0.13–0.25; p > 0.05). Mean mGES score was 91.5% in a no/lower fear of falling group, while it was 81.4% in a higher fear group (p = 0.22). There was a trend toward a significant difference in the unstandardized residuals derived from regression of ranked mGES scores on ranked covariate (age and 8 foot up and go) scores, between the no/lower versus higher fear of falling group (p = 0.095). These results support construct validity of the mGES as a measure of gait self-efficacy in community-dwelling older females.     

Mental health nursing from a solution focused perspective

Solution focused therapy (SFT) is a relatively new and increasingly popular model of brief intervention in mental health care. The central assertion of SFT is that the individual's problem or difficulty (and its cause) need not determine the direction in which the discussion proceeds. Instead the role of the SFT practitioner is to identify what the individual wants to be different and then to explore and elaborate on that difference. This paper outlines the principles of SFT and highlights the compatibility of this approach with the core values of nursing practice. Specific strategies and techniques used in SFT are detailed with clinical examples to illustrate the application of SFT to mental health nursing practice. A summary of current research outcomes and future prospects for SFT in clinical practice and education is also presented.     

不同细胞因子组合对人脐血单个核细胞体外扩增及CD49d和CXCR4表达的影响

为了探讨不同的细胞因子组合对脐血单个核细胞体外的扩增作用及扩增后CD49d和CXCR4的变化，将新鲜脐血标本分离的单个核细胞接种于含有不同细胞因子组合的无血清无基质培养体系中培养7天，在0天，7天检测有核细胞数，CD34^＋细胞数及CD34^＋CXCR4^＋，CD34^＋CD49d^＋的细胞数和集落形成单位（CFU）数．根据不同细胞因子组合实验分组为：对照组；SF组（SCF＋FL）；SFT组（SCF＋FL＋TPO）和SFT6组（SCF＋FL＋TP0＋IL-6）。结果表明，和对照组相比，SF组合仅能低水平支持脐血造血细胞扩增，加入TPO后即SCF／FL／TPO组合能有效的扩增脐血细胞，但SFT和SFT6两组之间差异却无明显发生（P〉0．05）；SF，SFT和SFT63组的细胞因子组合均可提高脐血CD34^＋细胞CD49d，CXCR4的表达，但3组之间差异无显著性（P〉0．05）。结论：SF组合可协同扩增人造血细胞，但协同作用较弱；TPO在脐血造血干／祖细胞体外扩增中起重要调节作用，而IL-6作用不显著；SCF／FL／TPO 3种因子组合不仅可促进脐血造血祖细胞的扩增，而且可上调脐血造血细胞CD49d，CXCR4表达。     

肾原发性孤立性纤维性肿瘤临床病理观察

目的 探讨原发于肾的孤立性纤维性肿瘤的临床病理特点及鉴别诊断要点.方法 复习2例肾孤立性纤维性肿瘤患者的临床资料,并对其进行组织学观察和免疫组化标记.结果 2例肾原发性孤立性纤维性肿瘤患者均为女性,年龄分别为33岁和63岁.临床主要表现为肾区钝痛,无尿频、尿急、尿痛,无血尿.CT检查示肾占位.组织学特征为瘤组织呈束状、波纹状排列,瘤细胞呈梭形,局部富于瘤细胞,间质血管丰富,部分呈血管瘤样或血管外皮瘤样结构,有明显的束状胶原.免疫表型：瘤细胞CD34、CD99和bcl-2（＋）,SMA局灶性（＋）;而HMB45和CD10（-）.结论 孤立性纤维性肿瘤具有低度恶性潜能,发生在肾极少见,以手术治疗为主,预后较好.确诊主要依靠组织病理学,并辅以免疫组化标记.     

Comparability of echographic and tomographic assessments of body fat changes related to the HIV associated adipose redistribution syndrome (HARS) in antiretroviral treated patients

To assess the comparability of ultrasonographic (US) subcutaneous fat thickness (SFT) measurements in comparison with computed tomography (CT) at reference points (RPs) representative of HIV related adipose redistribution syndrome (HARS) in patients treated with antiretrovirals. US and CT measurements were compared in nine patients with clinical reports of HARS. We obtained the best resolution of facial (at deepest point of Bichat pad), brachial (in the dorsal face of arm) and crural SFT (at mid thigh) by means of minimal transducer pressures avoiding potential biases such as stand off pads pressure on the skin and artefacts due to too abundant quantity of gel. CT scans were obtained in the same RP where US measurements were performed such as identified by means of metallic skin markers. Median US measurement of facial SFT was 8.8 mm (95% CI: 3.1 to 13.4), 3.95 mm (95% CI: 2.62 to 5.84) for brachial SFT and 4 mm (95% CI: 3.4 to 9.4) for crural SFT. Median CT assessments of facial SFT was 8.7 mm (95% CI: 3.5 to 13.5), 4.2 mm (95% CI: 2.6 to 5.88) for brachial SFT and 5 mm (95% CI: 3.9 to 10.3) for crural SFT, with no significant difference at each RP. A linear regression showed good CT/US comparability at each RP, with no significant deviation from linearity (p > 0.10). US shows to be highly comparable with CT, excluding invaliding biases as the transducer pressure on the skin. Given the proven efficacy on the HARS assessments, if well standardized, US could be a reliable method, simpler than CT in the management of body fat changes related to HARS.     

巨大壁层胸膜孤立性纤维性肿瘤一例

孤立性纤维性肿瘤（SFT）是一种来源于间叶组织的梭形细胞性肿瘤。该病早期临床症状隐匿,常因肿瘤增大压迫周围组织而被发现,CT和（或）MRI是诊断SFT的常用手段,确诊需行病理活组织检查及免疫组织化学检查。该文报告l例巨大SFT患者,其以大量胸腔积液为首发表现且伴胸闷、呼吸困难等症状。行胸腔引流术后完善胸部CT检查,结果提示为左侧胸腔顶部肿物,由左锁骨下动脉供血,血供较丰富,考虑为壁层胸膜恶性肿瘤。其后行肿瘤血管栓塞术,待肿瘤缩小后行手术将其完全切除,术后病理活组织检查结果为SFT,患者术后恢复良好。由此可见,手术是治疗SFT的首选治疗方法,由于SFT血供常较丰富,故肿瘤较大时可于术前行肿瘤血管栓塞术,待肿瘤缩小后再行手术切除,以降低手术难度及风险,提高手术成功率。