隐匿性肿瘤与中风

中风的病因可概括为动脉的损害、血液流变学异常、血液动力学异常、血液成分异常及一些继发因素等。肿瘤患者的凝血活性增加、血管壁损伤和血管阻塞、血小板异常、纤溶系统异常和抗凝活性减弱等病理变化使患者机体处于易发血栓状态,而致中风。肿瘤早期多隐匿,症状不明显,可以血栓性疾病为首发疾病,临床中尚有部分中风病因不明确。明确隐匿性肿瘤形成静脉血栓的机制,结合中风的病因,可指导临床对无明显诱因中风的病因进行深入的研究,对无明显诱因的中风患者可考虑是否由隐匿性肿瘤所致。     

Transportational thrombocytopenia

Transportational delay in performing a routine CBC may result in platelet clumping and a false thrombocytopenia referred to as transportational thrombocytopenia.     

Occult Carcinoma of the Bronchus

The term “occult carcinoma” is applied to those patients with carcinoma of the bronchus at an in situ or early invasive stage who have carcinoma cells in their sputum but have no recognizable evidence of tumour in the chest radiograph. In eight such patients at the Toronto General Hospital, the lesion was localized and treatment instituted. Our experience with these eight patients can be compared with that of 27 patients described in two similar studies. The lesions were commonly symptomatic. Localization, although sometimes difficult, was accomplished using information obtained during bronchoscopy and bronchography. The prognosis following adequate resection appeared excellent. No patient died of carcinoma during the post-treatment follow-up period, which was continued for a minimum of 18 months. Pathological evidence indicates that bronchial carcinoma at this occult stage can be diagnosed cytologically, is rarely multifocal and, as a localized neoplasm, is amenable to curative therapy.     

隐匿性骨折的CT诊断

回顾分析了1463例骨折病人的X线平片和CT表现，其中隐匿性骨折37例（2．5％），均为CT扫描所发现。CT对隐匿性骨折的诊断具有特异性，它可以克服平片重叠影的影响以及患者体位所限不易显示骨折的缺点。对有外伤史、临床疑有骨折而平片显示阴性时应进行CT扫描。     

隐匿性骨折的MRI分析

目的:探讨隐匿性骨折的MRI表现,提高对隐匿性骨折的认识。方法:回顾性分析31例X线片阴性患者的MRI及其他影像学资料。结果:31例患者中,常规X线片均未见明显异常改变,其中有11例作CT检查亦未提示异常,进一步作MPR重建后,有7例提示可疑异常。31例行MRI检查均出现异常信号改变,而诊断为隐匿性骨折。结论:对于外伤患者,临床怀疑有隐匿骨折患者,MRI应作为首选手段,且具有较高的敏感性。     

Sulfasalazine-induced immune thrombocytopenia

Sulfasalazine is a well established disease-modifying anti-rheumatic drug commonly used in the treatment of rheumatic disorders and inflammatory bowel disease. Sulfasalazine was generally well tolerated in clinical trials, the most frequently reported adverse effects being adverse gastrointestinal effects, headache, dizziness and rash; myelosuppression can also occur. We are now reporting the first case of autoimmune thrombocytosis following sulfasalazine treatment.