Single-port thoracoscopic resection of a posterior mediastinal Mullerian cyst in a woman

Mullerian cysts are benign tumors that are very rare in the posterior mediastinum. It is necessary to distinguish Mullerian cysts from benign tumors or other types of cyst in the posterior mediastinum. A 42-year-old woman visited our hospital for a routine check-up, and a mediastinal mass was identified on chest computed tomography (CT). Contrast-enhanced chest magnetic resonance imaging (MRI) revealed a 4.0 × 2.6 × 2.8-cm mass, and a neurogenic tumor or esophageal cyst was suspected. Single-port thoracoscopic surgery was performed for cyst removal. Histopathological examination of the resected tissue revealed that the cyst wall was covered with a single layer of ciliated columnar epithelium. Immunohistochemical staining revealed positivity for paired box gene 8 (PAX8), Wilms tumor protein 1 (WT-1), estrogen receptor (ER), and progesterone receptor (PR). Therefore, a diagnosis of mediastinal Mullerian cyst was made. Mediastinal Mullerian cysts should be included in the differential diagnosis of posterior mediastinal cysts. Cystic lesions in the posterior mediastinum should be removed surgically and undergo immunohistochemical examination.     

A rare case of pelvic bronchogenic cyst treated by laparoscopic surgery

A 31‐year‐old man with pain in his thigh was diagnosed with a benign presacral cystic mass. We performed laparoscopic subtotal resection of the cyst utilizing mobilization of a total mesorectal excision procedure used in low anterior resection for rectal cancer. Histopathological findings showed that the cystic lumen of the specimen was lined with pseudostratified columnar ciliated epithelium and had glandular structures and smooth muscle in its wall, leading to a diagnosis of bronchogenic cyst. The postoperative course was uneventful, and as of 6 months after surgery, the patient was doing well with no evidence of recurrence.     

Ileal bronchogenic cyst: A case report and review of literature

We herein report a rare case of ileal bronchogenic cyst that was found in a 39-year-old Chinese man. He had no symptoms and the physical examination was normal. Tumor markers were within the normal range. Abdominopelvic enhanced computed tomography showed a mass in the lower abdominal cavity and the tumor had a complete capsule. Diagnostic laparoscopy was then performed, which showed that a spheroid mass with a complete capsule was located at the antimesenteric border of the distal ileum 20 cm from the ileocecal valve, measuring 6.0 cm × 6.0 cm × 5.0 cm. Considering that the malignancy of the tumor cannot be ruled out, and there is a risk of rupture during laparoscopic surgery, the patient was converted to an open surgery. Partial resection of the ileum with the tumor was performed, followed by a side-to-side anastomosis. The tumor was gray-red in color, filled with grayish yellow mucus and had no septum. The postoperative pathology revealed that the cystic wall was lined by pseudostratified ciliated columnar epithelium without cellular atypia. The wall consisted of bronchial mucous glands and smooth muscle fibers, and no abnormalities were found in adjacent ileum tissues. Thus, a diagnosis of bronchogenic cyst of the ileum was made.     

肝内胆管囊腺瘤及囊腺癌的螺旋CT表现与病理对照

目的:对照分析肝内胆管囊腺瘤及囊腺癌的螺旋CT表现与病理结果,旨在提高其影像诊断水平。方法:回顾性分析8例肝内胆管囊腺瘤及囊腺癌病例的病理资料及螺旋CT表现,其中囊腺癌3例,囊腺瘤5例,所有病例均经手术病理证实。8例均行CT平扫及动脉期、门静脉、延时期三期增强扫描。结果:8例患者的病灶均呈薄壁囊性肿物,圆形、类圆形分叶状或趋于分叶状,外缘光滑7例,1例伴发感染而外缘模糊。3例囊腺癌中,囊内出血1例,囊液密度均匀2例;多房伴分隔2例;伴细小囊壁钙化1例,粗大壁结节3例。5例囊腺瘤中,多囊伴分隔4例,分隔菲薄均匀;囊液密度均匀5例;伴细小壁结节3例;增强后病灶囊壁、分隔及壁结节均呈持续强化改变。病理上,大体所见与影像学所见相似,为类圆形、边界清楚囊性病灶;镜下,囊壁内衬单层上皮,上皮下为致密纤细的梭形间质细胞增生,肿瘤间质血管较少。结论:肝内胆管囊腺瘤及囊腺癌的螺旋CT表现具有一定特征性,CT平扫和动态增强能较好地反映其病理学特点,有助于该疾病的诊断。     

左心室先天性支气管囊肿1例报告并文献复习

目的：探讨心脏先天性支气管囊肿的临床和病理特征。方法：病例报告和文献复习。结果：1例罕见的左心室壁先天性支气管囊肿，术前未获明确诊断，但经左前外侧切口进行了完整切除，病理检查提示囊肿内壁通常由假复层柱状纤毛上皮覆盖，周围含有软骨和支气管黏膜腺体。结论：心脏先天性支气管囊肿属于罕见的心脏肿瘤，由于现有诊断技术在术前对于肿瘤部位和比邻关系难于完全明确，手术径路最好采用胸骨正中切口，必要时可以建立体外循环。     

Mullerian cyst of the uterus misdiagnosed as ovarian cyst on pelvic sonography

Mullerian cyst of the uterus, also known as endosalpingiosis, is rare and often can be misdiagnosed as adnexal cyst on pelvic sonography. A 47‐year‐old woman was referred for an incidental finding of a right adnexal mass on pelvic sonography, suspected to be an ovarian cyst. During laparoscopy, a pedunculated cystic mass arising from the right anterior uterine wall was seen. The mass was resected laparoscopically and histologic examination showed a benign Mullerian cyst of the uterus. Diagnosis of Mullerian cyst of the uterus can be challenging. However, with increased awareness, preoperative diagnosis of this condition should be possible sonographically. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42 :183–184, 2014     

高频超声对甲状舌管囊肿的分型及诊断价值

目的 探讨高频超声检查对甲状舌管囊肿(TDC)的临床诊断价值.方法 应用高频超声检查41例TDC,观察病变的位置、边界、形态、内部回声及其与舌骨的关系,并应用彩色多普勒血流显像观察肿物边缘与内部的血流信号.超声检查结果 与手术病理诊断对照,将所有资料按照病理类型分组并分别与声像图表现对比.结果 全部病例均经手术病理证实为TDC,其中9例TDC内衬纤毛柱状上皮,19例内衬复层鳞状上皮,另13例TDC为两种上皮共同存在.高频超声检查显示不同病理类型的TDC超声表现不同,本组77.8%(7/9)内衬柱状上皮的TDC内部表现为无回声,而84.2%(16/19)内衬鳞状上皮的TDC为类实性回声,两种上皮并存的TDC则多表现为类实性和多房囊肿回声类型(P<0.01).本组资料同时显示80.5%(33/41)TDC病变周围可测及清晰的舌骨强回声,41例TDC内部均未见明显血流信号,仅于5例病变囊壁边缘见少许点状血流信号.高频超声检查对TDC的诊断符合率高达95.1%(39/41).结论 高频超声检查能清晰显示肿物的位置、边界、形态、内部回声及其与舌骨的关系,对TDC的诊断和鉴别诊断有重要作用.     

苗勒氏管源性囊肿3例诊治报告并文献复习

目的探讨苗勒氏管源性囊肿的诊断与治疗方法。方法 2010年3～9月收治3例盆腔囊肿患者。回顾3例患者的诊治过程,结合文献复习讨论其临床、影像表现及治疗方法。结果 1例盆腔、会阴部巨大囊肿在全麻下行会阴部囊肿切除联合盆腔囊肿切除,术中见肿块呈多房囊性,囊肿血供丰富。1例行腹腔镜下囊肿切除。2例术后病理诊断均为＂苗勒氏管源性囊肿＂,术后随访6～11个月未见囊肿复发。另1例经影像检查诊断,予随访观察。结论 B超、CT、MRI检查均可发现盆腔苗勒氏管源性囊肿包块,确诊依赖病理学检查,手术切除安全有效。     

Hepatic cyst with intracystic bleeding: contrast-enhanced sonographic findings

Intracystic bleeding is a relatively rare complication of hepatic cysts, which is very difficult to diagnose by conventional sonography (US). Hence, a new US technique has been sought for this purpose. We present the case of a hepatic cyst with intracystic bleeding in which contrast-enhanced US showed microbubbles oozing from the cyst wall into the cystic cavity. Contrast-enhanced US is now an important diagnostic tool for diagnosing liver tumors, but contrast-enhanced US findings relating to intracystic bleeding have not been reported. Our observations suggest that this technique may be a useful new diagnostic tool for this purpose.     

Laparoscopy-assisted spleen-preserving pancreatic resection for epidermoid cyst in an intrapancreatic accessory spleen

A rare case of an epidermoid cyst originating in an intrapancreatic accessory spleen in a 50-year-old Japanese female is reported. A hypoechoic cystic tumor was detected incidentally by abdominal ultrasonography. It appeared to be a single cyst in the pancreatic tail with a contrasted mass lesion beside it. Laparoscopy-assisted spleen-preserving pancreatic tail resection was performed. Microscopic examination revealed that the cyst was surrounded by fibrous tissue and a thin layer of splenic tissue, adjacent to normal pancreatic parenchyma. The inner surface of the cyst was lined with non-keratinizing squamous epithelium. The diagnosis of an epidermoid cyst occurring in an intrapancreatic accessory spleen was confirmed. Laparoscopy-assisted spleen-preserving pancreatic resection is a safe and effective procedure for benign or low-grade malignant cystic diseases in the pancreas.     

三维超声在卵巢囊肿穿刺治疗中的应用价值

目的　本文应用三维超声引导下穿刺治疗卵巢囊肿 2 0 0例 ,探讨三维超声在卵巢囊肿治疗中的应用价值。方法　采用常规超声引导穿刺方法 ,对囊肿治疗术前、术中及术后进行二维和三维超声对比观察。结果　 2 0 0例穿刺抽吸和治疗顺利 ,成功率 10 0 % ,治愈率 95 %以上。三维超声对囊内细小分隔、后壁分隔及囊壁增厚有良好的鉴别。结论　三维超声引导下穿刺治疗卵巢囊肿 ,具有信息量大 ,多平面显示囊内微细结构及与周围脏器的空间位置关系 ,可有效提高治疗成功率。     

超声显像在颌骨囊性病变中的临床应用

目的：探讨超声显像在颌骨囊性病变中的特征及诊断价值,方法：29例颌骨囊性病变的患者,术前均经超检查,术后病理对照。结果：1．超声能显法颌骨骨皮质破坏的范围,最小病变检出范围为0．3cm;2．超声能显示含牙囊肿有光点密集的特点,可见囊内含牙声像;3．超声能显示囊内不均质的变化;4．超声不能显示颌骨囊壁 破坏及牙根吸收的特点。论：超声显像在颌骨囊性病变诊断中有重要的临床价值。     

Gastric bronchogenic cyst diagnosed by endosonographically guided fine needle aspiration biopsy

We report a case of a gastric bronchogenic cyst diagnosed via endosonographically guided fine-needle aspiration (EUS-FNA) biopsy. A 60-year-old woman was referred to our hospital for an endoscopic ultrasound (EUS) examination because of a gastric subepithelial lesion detected by upper gastrointestinal endoscopy. EUS examination revealed a lesion that appeared to originate from the gastric submucosa but seemed to extend beyond the gastric wall. The latter finding raised concerns that the lesion might represent a cystic neoplasm rather than a simple cyst. Subsequently, EUS-FNA was performed to establish a definitive diagnosis and to guide further management. Cytologic evaluation of aspirated material revealed the presence of benign-appearing ciliated columnar epithelial cells within a mucinous background. Based on imaging and EUS-FNA findings, a diagnosis of gastric bronchogenic cyst was made and surgical resection was avoided.     

Papillary intracystic carcinoma of the female breast--role of ultrasonography

We report on a 76-year-old patient with papillary intracystic breast carcinoma. Papillary intracystic carcinomas represent a rare entity. Among all malignant breast tumors, this lesion has an incidence of 0.5-2%. Palpation is not sufficient to distinguish benign from malignant findings. The same applies to mammography, unless the tumor infiltrates the cyst wall. The method of pneumocystography has become obsolete. Sonography is the preferred diagnostic modality to distinguish cystic from solid lesions and to differentiate simple cysts from cysts with intracystic growth. In this respect, Doppler and power Doppler sonography can be instrumental. It is feasible to obtain preoperative ultrasound guided FNAC or core biopsies of the cystic and solid components for cytological or histological verification. Complete excision of the cyst which should include the intracystic growth is considered the treatment of choice.     

Duplicated mullerian duct remnants associated with unilateral renal agenesis

A case of duplicated Mullerian duct remnants associated with unilateral renal agenesis in a male patient is described. This association is not uncommon in females, but is rarely recognized in male patients. The possibility of Mullerian duct cyst or enlarged prostatic utricle should be considered in the differential diagnosis of a pelvic cyst in a male patient with unilateral renal agenesis.     

Adrenal endothelial cyst with massive central calcification

A 55-year-old woman was treated for a rare case of adrenal endothelial cyst that was detected incidentally during management of abdominal pain. Computed tomography of the tumor displayed massive central calcification and a fluid–fluid level by intracystic hemorrhage. Magnetic resonance imaging showed an intracystic papillary part with calcification. After surgery, the tumor was diagnosed as an angiomatous type of adrenal endothelial cyst. Received: 4 December 1998/Accepted: 13 January 1999     

卵巢子宫内膜异位囊肿超声分型及其临床价值

目的 分型认识卵巢子宫内膜异位囊肿的复杂声像图,以求提高超声对本病的诊断符合率。方法 回顾性分析131例卵巢子宫内膜异位囊肿患者共139个肿块的声像图特点,分型观察,计算各型诊断符合率。结果依据肿块声像特点共分7种类型。囊内均匀光点型的符合率最高（88．3％）,单纯囊肿型符合率最低（12．0％）。易误诊为单纯囊肿、囊腺瘤、炎性包块、畸胎瘤、子宫肌瘤、卵巢癌等。结论 分型可使子宫内膜异位囊肿复杂的声像简单化,鉴别重点更明确,有助于提高对本病的认识。     

经阴道彩色多普勒超声对胎囊型输卵管妊娠的诊断价值

目的　探讨经阴道彩色多普勒超声对胎囊型输卵管妊娠的诊断价值。方法　对经阴道超声诊断的 3 2例胎囊型输卵管妊娠的二维及彩色多普勒声像图改变进行总结分析。结果　 3 2例异位胎囊的特征为 :单侧附件区厚壁型囊性物 ,囊壁厚度均匀一致 ,约 2 .5～ 4.0mm ,回声强而均匀 ,囊内为液性暗区。与卵巢分界清。CDFI:囊性物周围血流丰富 ,似“花环样”包绕胎囊。PD :“花环样”血流处可录及低阻型滋养动脉频谱 ,舒张期血流丰富 ,RI平均为 0 .45± 0 .0 4。结论　经阴道彩色多普勒超声在诊断胎囊型输卵管妊娠中具有较强优势 ,结合血尿妊娠试验能为临床早期治疗提供可靠的诊断依据。     

卵巢甲状腺肿的MR诊断与病理对照

目的 探讨卵巢甲状腺肿（SO）的 MRI 表现和病理学特征.方法 回顾性分析7例手术病理证实为SO的临床资料及MRI表现,与病理学所见进行对照分析.结果 7例均为单侧卵巢发病,肿块3.2～13.3 cm,平均7.8 cm.囊实性 5 例,囊性 2 例,有分隔,分隔及囊壁增厚,不同囊腔信号可不均等.实性部分呈等T1、等或稍高T2信号;囊性部分呈长T1、长T2信号,或稍短T1、长T2信号,其中 5 例囊内见非压脂 T2WI极低信号、T1WI等信号区;囊壁及分隔呈等T1、等T2信号.增强扫描实性部分明显强化,囊壁及分隔中度强化,囊性部分无强化.镜下肿瘤实质大部分由甲状腺组织组成,其中 3 例合并有皮脂腺、钙化等成分.肿瘤内衬单层柱状或扁平上皮,见成熟甲状腺滤泡,大小不一,腔内可见红染的胶冻样物质,无异形性.结论 卵巢甲状腺肿MRI表现有一定的特征性（囊内出现非压脂T2WI极低信号、T1WI等信号改变）,MRI平扫加增强扫描是诊断卵巢甲状腺肿有价值的方法.