儿童巨大胸腺增生误诊畸胎瘤1例

病例:女,3岁.因咳嗽、咳痰半月收入院.查体:呼吸促,口周无发绀,胸廓对称,肋间隙无增宽及狭窄,双肺呼吸音粗,右肺呼吸音低.血常规:白细胞10.93×109/L,血红蛋白137 g/L,中性粒细胞44％,淋巴细胞55％,单核细胞6.7％.影像学检查:胸部平片示右侧胸腔内大片状高密度影,密度不均匀(图1a).胸部CT示右...     

胸腺瘤与畸胎瘤的临床分析

胸腺瘤和畸胎瘤是两种最常见的前中上纵隔肿瘤,临床上有许多相似的征象,鉴别诊断较困难。现综合分析我院自1973年6月～1994年6月收治的胸腺瘤及畸胎瘤的临床特点,为临床诊治提供依据。     

阴茎畸胎瘤1例

患者男,49岁,因排尿困难,尿流细5年余,近日加重就诊,临床疑前列腺病变,要求超声检查.超声检查:膀胱前列腺未见明显异常.阴茎中段背侧可见一 0.8 cm×0.5 cm杂乱高回声团,边界清楚,外形不规则,后方有声影(图1),CDFI示其内未见明显血流信号显示.插入导尿管时其处感觉阻力增大,但可以通过.导出尿中无红细胞及其他异常.手术切除肿物,病理诊断为畸胎瘤.     

肝脏畸胎瘤1例

患者女,18岁。以“右上腹腹胀腹痛3个月”为主诉就诊。该患3个月前无明显诱因右上腹持续性腹胀腹痛,无放射痛,病来无发热寒战,无恶心呕吐,皮肤巩膜无黄染,大小便正常。查体:右上腹部膨隆,饱满,未触及包块,无压痛及反跳痛。实验室检查未见异常。CT所见:肝右叶见椭圆形囊实性肿块,大小约17.5cm×15.2cm×11.5cm,边缘清楚,光滑锐利,突出向肝外生长,邻近组织受压移位。肿块内密度混杂,囊内大部分呈脂肪密度,内见多房状囊性成分,有完整包膜,CT值18Hu,旁可见实质成分,CT值45Hu,囊内散在多发条状、点状高密度钙化骨化影(图1),增强扫描实质成分…     

会厌畸胎瘤1例

患儿男,14岁,4年前无诱因出现声音嘶哑、发音含混不清,此后症状逐渐加重。1天前出现咽部不适伴吞咽困难入院。间接喉镜下可见会厌处红色囊肿,约有乒乓球大小,触诊为囊性,无明显压痛,初步诊断会厌囊肿。CT扫描(图1、2):会厌处可见欠规则结节影,边界清晰,最大层面约33.3mm×18.6m     

颈部畸胎瘤1例

1 病例报告 女,40岁.体检发现颈部肿物2d入院.查体见右颈前下部位略隆起,可扪及肿物,边界欠清,表面不光滑,质中等偏硬,无触痛,不随吞咽移动,周围未触及肿大淋巴结.核磁提示右颈部肿物,性质待定.超声检查:高频(10MHz)探头扫查见甲状腺大小形态正常,回声均,内未见结节回声.     

椎管内畸胎瘤1例

病例男 ,３５岁 ,腰及双下肢不适６～７年 ,日前症状明显加重 ,腰部剧痛以夜间痛明显、双下肢麻木、排尿困难、大便干燥。查体 :腰 ２～５ 棘突叩压痛 ,向双下肢放射 ,马鞍区浅感觉迟钝 ,巴宾斯基征（ -） ,直腿抬高试验３０°（ ）。Ｘ线表现 :腰椎正侧位片 :正位显示腰３ 左侧椎弓根结构不清晰 ,周围骨质密度减低 ,骨小梁模糊不清 ;侧位片示腰 ３ 左侧椎板骨质呈局限性椭圆形低密度影 ,内见点状密度增高影 ,病灶周围骨质明显硬化形成斑环状致密影。拟诊 :腰椎部畸胎瘤。手术所见 :腰 ３ -５ 硬膜外脂肪消失 ,椎板增厚约０ ５ｃｍ ,打开硬…     

胎盘畸胎瘤1例

患者女性，20岁。孕0产1，孕40W羊水少胎儿窘迫行剖宫产术，产下-2．9kg女婴，婴儿无畸形。 病理检查巨检：胎盘一个，21cm×17cm×6cm大小，胎盘小叶完整，于胎儿面见有一长6cm的血管与直径7cm的肿瘤相连，肿瘤似儿头，肿瘤表面见皮肤及胎毛，切面实性，灰黄、灰白色，并见有骨及软骨组织。[第一段]     

锁骨上畸胎瘤1例

患者女，27岁，因无意间扪及颈部肿块来院就诊，肿块约鸽蛋大小，吞咽时感颈部牵拉不适，无呼吸、吞咽困难，无明显怕热、多汗、心悸乏力等症状。外科颈部检查：颈软，无压痛，颈部前方偏左侧可扪及一肿块，直径约3．0cm，质中等，边界清楚，表面光滑，移动度可，肿块可随吞咽上下移动。甲状腺功能检查：TSH 1．65μIU／ml（正常值范围0．27～4．8μIU／ml），     

畸胎瘤漏诊1例

患者女 ,32岁。自述右下腹隐痛不适一年余 ,加腹压时疼痛明显。有习惯性便秘史。妇检 :子宫前位 ,大小正常 ,右附件区可触及“兵乓球”样大小的包块 ,质硬、表面光滑、边界清、无压痛 ,左侧附件未及明显异常。经腹部Ｂ超显示 :子宫大小 5 7ｍｍ× 35ｍｍ× 5 1ｍｍ ,宫内回声均     

异位胸腺3例

本文收集我院2008年-2009年经外科手术病理确诊的1例异位胸腺瘤、2例异位正常胸腺组织患者的完整影像学及临床资料,并进行分析,旨在提高对异位正常胸腺或继发肿瘤的认识.     

Postoperative radiotherapy for thymus salivary gland carcinoma: A case report

BACKGROUNDSalivary gland cancer is a rare disease in which cancer cells form in the tissues of the salivary glands. It mostly occurs in the glands that have secretion functions, such as the parotid gland, sublingual gland and submandibular gland. This is very rare when it occurs in other nonsecreting glands. Here, we report one case of salivary gland carcinoma occurring in the thymus and discuss related diagnoses and treatment progress.CASE SUMMARYOne 33-year-old middle-aged man presented with a thymus mass without any clinical symptoms when he underwent regular physical examination. Later, the patient was admitted to the hospital for further examination. Computed tomography (CT) showed that there was a mass of 3 cm × 2.8 cm × 1.5 cm in the thymus area. The patient had no symptom of discomfort or tumor- related medical history before. After completing the preoperative examinations, it was confirmed that the patient had indications for surgery. The surgeon performed a transthoracoscope thymectomy + pleural mucostomy for him. During the operation, the tumor tissue was quickly frozen, and the symptomatic section showed a malignant tumor. The final pathological result suggested thymus salivary gland carcinoma- mucoepidermoid carcinoma (MEC). In the second month after surgery, we performed local area radiotherapy for the patient, with a total radiation dose of 50.4 Gy/28Fx. After 12 mo of surgery, the patient underwent positron emission tomography-CT examination, which indicated that there was no sign of tumor recurrence or metastasis. After 16 mo of operation, CT scan re-examination showed that there was no sign of tumor recurrence or metastasis. As of the time of publication, the patient was followed up for one and a half years. He had no sign of tumor recurrence and continued to survive.CONCLUSIONThe incidence of MEC in the thymus is low, and its diagnosis needs to be combined with clinical features and imaging methods. Histopathological analysis plays a key role in the diagnosis of the disease. Patients with early-stage disease have a good prognosis and long survival period. In contrast, patients with advanced-stage disease have a poor prognosis and short survival period. Combining radiotherapy and chemotherapy in inoperable patients may prolong survival.     

超声诊断儿童肾上腺神经母细胞瘤1例

患者男,13岁,高烧39 ℃两周不退,贫血面容,经血生化检验发现血红蛋白减低,其余指标正常.彩超检查肝脏、胆囊、脾脏、胰腺、右区肾及膀胱均未见异常回声.而于左肾上极肾上腺区可探及一个大小为4.9 cm×6.0 cm的低回声,轮廓不规则,其内有不均匀的点样强回声及不规则的无回声区(见图).     

二维、三维超声技术检测正常胎儿胸腺的研究

目的 建立胎儿胸腺二维各径线和三维体积的正常值,并比较胎儿胸腺的二维、三维超声测量.方法 采集567例正常胎儿胸腺的二维超声测值,包括最大横径、前后径、上下径、最大横截面积及三维超声体积.结果 567例胎儿中541例胎儿满意获得胎儿胸腺的最大横径、前后径、上下径和最大横截面积和体积.胎儿胸腺二维各径线、三维体积均随孕周的增加而增加,与孕周均呈直线相关,三维体积与孕周的相关性明显高于二维超声测值(P＜0.05).结论 本研究建立了胎儿胸腺二维超声面积、周长、直径、横径和三维超声体积的正常参考值.三维超声测量胎儿胸腺体积与孕周相关性更高,提示较二维超声测量更为准确.

Abstract：

Objective To establish the normative data of the 2D and 3D ultrasound (US)measurements of the developing fetal thymus and comparing the 2DUS and 3DUS measurements of the fetal thymus. Methods The normal fetuses' thymus of 567 cases were assessed, and maximum transverse diameter(MTD),antero posterior diameter (APD), suprainferior diameter (SID), maximum transverse area (MTA) were measured by 2DUS,and thymic volume(TV) was measured by 3DUS. Results 2DUS,3DUS assessments of the fetal thymic MTD, APD, SID, MTA and TV were possible in 541 of 567 normal singletons. The fetal thymic 2D diameters/area and 3D volume grow with the gestational age(GA) in linear correlation. The 3D-US TV measurements and GA was significantly higher than that of any individual 2DUS measurements and GA ( P ＜0.05). Conclusions This study presents the normative data of the 2DUS and 3DUS measurements of the developing fetal thymus. 3DUS fetal thymus volume is more significantly correlated to GA than the other 2DUS measurements, which indicates 3DUS measurement of the fetal thymus is more accurate than that of 2DUS.     

Langerhans cell histiocytosis involving only the thymus in an adult: A case report

BACKGROUNDLangerhans cell histiocytosis (LCH) is a rare disease of unknown etiology. LCH involving the thymus is mainly seen in pediatric patients and is extremely rare in adults. In this report, we describe a rare case of LCH originating from the thymus in an adult.CASE SUMMARYA 56-year-old man was admitted in April 2022 with complaints of intermittent dizziness since 2020, which had worsened in the previous 10 d. The physical chest examination was negative, and there was a history of hypertension for > 2 years. Chest computed tomography showed a nodular soft tissue density shadow in the anterior mediastinum measuring approximately 13 mm × 9 mm × 8 mm. Postoperative pathological findings confirmed the diagnosis of LCH.CONCLUSIONIt is challenging to differentiate LCH involving the thymus from thymoma in imaging features. Pathological biopsy remains the gold standard when an anterior mediastinal occupying lesion is found.     

Papillary cystadenoma of the parotid gland: A case report

BACKGROUND Papillary cystadenoma is a rare benign epithelial tumor of the salivary gland,which is characterized by papillary structures and oncocytic cells with rich eosinophilic cytoplasm. We found only one case of papillary cystadenoma in nearly 700 cases of salivary gland tumors. Our case was initially mistaken for a tumor of the right temporomandibular joint(TMJ) capsule rather than of parotid gland origin. Preoperative magnetic resonance imaging(MRI) and computed tomography(CT) should be carefully studied, which allows for appropriate preoperative counseling and operative planning.CASE SUMMARY Here, we report an unusual case of a 54-year-old woman with a parotid gland papillary cystadenoma(PGPC) that was misdiagnosed as a tumor of the right TMJ capsule. She was initially admitted to our hospital due to a mass anterior to her right ear inadvertently found 5 d ago. Preoperative CT and MRI revealed a well circumscribed tumor that was attached to the right TMJ capsule. The patient underwent a resection through an incision for TMJ, but evaluation of an intraoperative frozen section revealed a benign tumor of the parotid gland. Then we removed part of the parotid gland above the temporal facial trunk. The facial nerve was preserved. Postoperative histopathological findings revealed that the tumor was PGPC. No additional treatment was performed. There was no recurrence during a 20-mo follow-up period.CONCLUSION The integrity of the interstitial space around the condyle in MRI or CT should be carefully evaluated for parotid gland or TMJ tumors.     

胸腺海绵状血管瘤1例

患者男,38岁,咳嗽、咳痰2周余。查体未见明显异常。胸部CT:前纵隔内邻近心脏见约7.0cm×5.1cm×6.5cm团块状软组织密度影,边界光整,形态欠规则,病灶内见散在点状钙化影,CT值约35HU(图1A),增强呈轻度强化,动脉期CT值约40HU(图1B),静脉期CT值约48HU(图1C)。考虑为前