深部软组织平滑肌瘤1例

<正>深部软组织平滑肌瘤临床少见,文献报道很少。我院最近诊治1例,现报道如下。临床资料:女,16岁,发现左大腿包块3d来院就诊。查体发现左大腿上方内侧软组织内突出包块,位置较深,质硬固定,无压痛,其他无异常。X线平片(图1)、CT扫描(图2,3)见左股骨内、上方肌间隙内大小约4.7cm×5.4cm×9.2cm类圆形混杂密度占位性病变,边界清晰,其内及边缘示明显片絮状钙化,与周围肌肉界限清晰,邻近骨质结构正     

肾脏平滑肌瘤1例

患者男，62岁。患2型糖尿病多年，近期因多饮多尿而住院治疗。超声检查：发现右肾中上极类圆形低回声团块，回声不均匀，其内未见血流信号。诊断：①肾癌？②肾结核球？     

胃血管球瘤2例

胃血管球瘤临床少见,笔者遇到2例,报告如下。例1患者,女,28岁。上腹隐痛1年,加重1个月。无贫血,未触及包块。实验室检查未见异常。胃镜检查:胃窦大弯侧见一半球形隆起,大小约3.0cm×3.0cm,表面光滑,充血,质硬。诊断:胃窦粘膜下肿物,间质瘤可能性大。CT表现:胃后壁边界清楚的球形肿块,平扫CT值约50HU(图1),增强扫描动脉期病灶边缘明显斑点状强化(图2),静脉期及平衡期强化范围增大,强化程度稍减低(图3)。CT诊断:胃后壁富血供良性病变。手术所见:肿物位于胃窦粘膜下大弯侧,约3.0cm×3·0cm大小,质韧,光滑,有搏动。免疫组化染色:Actin( )、C…     

巨大肺平滑肌瘤1例

患者女,26岁.胸闷、呼吸困难1月余,加重1周就诊,无咯血、发热及盗汗等.体检发现左上肺呼吸音明显减弱,实验室常规检查未见异常.     

腹腔腹壁下平滑肌瘤1例

患者女,75岁。因“记忆力减退1年余,乏力纳差3天”入院。查体无特殊阳性体征。实验室检查为阴性。全腹部CT增强检查:胃窦部胃壁不规则增厚,管腔狭窄,增强扫描不均匀强化,周围脂肪间隙模糊,见多发肿大淋巴结,环形强化,大网膜浑浊(图1A~1D);盆腔前腹壁下团块影,大小约7.4 cm×3.8 cm,与前腹壁分界不清,CT值约47 HU,内密度欠均匀,见少许斑片状低密度区(CT值-35 HU),增强扫描呈轻度较均匀强化(图1E~1H)。     

子宫角血管平滑肌瘤CT误诊1例

患者女,25岁。因停经40天来院就诊,行超声检查发现盆腔内实性占位。体检:于下腹部触及一质硬包块,边界不清,活动度差,无压痛,接近平脐。影像检查:超声示子宫体大小约5.5cm×4.3cm×5.3cm,形态正常,实质回声均匀,     

胃间质瘤的CT诊断

胃间质瘤（gastric stromal tumor,GST）是一种独立起源于原始间叶组织的非定向分化的肿瘤,属于消化道间叶性肿瘤[1~3],术前CT定性诊断困难,随着免疫组织化学、电镜及分子生物学技术不断发展和应用,人们对其研究不断深入,本文对1997年1月~2006年4月在本院经手术病理证实的12例GST的临床及CT征象作一分析,以期提高该肿瘤的认识。1材料与方法1.1临床资料本组病例12例,男性7例,女性5例,年龄38~72岁,平均54岁。所有病例均有CT和胃镜检查资料,主要临床表现为上腹疼痛或饱胀不适伴乏力、纳差、消瘦、黑便、贫血、恶心返酸、嗳气、体检腹部包块10例,2例由查体钡餐发现。实验室检查：粪潜血（＋）7例、血红蛋白、红细胞、红细胞压积均有不同程度降低,12例均经手术病理证实。1.2检查方法所有病例术前均行CT平扫和增强扫描,然后再行胃镜检查,超声检查。     

胃间质瘤的CT诊断

目的 分析胃间质瘤(GST)的CT表现特征,探讨CT对其诊断价值.资料与方法 回顾性分析经手术及病理证实的10例GST患者的CT资料,并将大体病理所见与CT表现相对照.结果 10例中黏膜下型2例,肌壁间型7例,浆膜下型1例;肿瘤主体位于胃内4例,位于胃外6例;胃大弯侧6例,胃小弯侧4例.10例中恶性6例,良性3例,不能定性者1例.CT表现为外生性或内生性肿块,肿块最大径约3.1～17.3 cm,＜5 cm者3例,≥5cm者7例.肿块密度不均匀,呈囊实性,实性部分轻至中度强化,瘤内点状钙化灶2例,6例高度恶性肿物表现边缘强化,中心大片低密度.结论 GST的CT表现具有一定特点,CT检查有助于GST的定位,以及观察肿瘤与周围组织结构关系.     

胃神经鞘瘤1例

患者 女,56岁.无明显诱因上腹部隐痛不适半年,逐来我院就诊.超声检查:肝左外叶后方腹腔内占位.CT检查:胃体部大弯处胃壁见类圆形软组织密度影,边缘光整,境界清楚,直径约4cm,病变密度均匀,CT值约35HU;增强扫描呈明显渐进性均匀强化,三期的CT值约57HU、80HU、84HU,各期强化程度均低于正常胃粘膜.CT诊断:胃体部大弯侧占位性病变,考虑间质瘤.     

胃间质瘤的CT诊断

胃间质瘤（gastricstromaltumors，GST）是一类来源于胃间叶组织的非定向分化的肿瘤，以往常被误认为平滑肌肿瘤或神经源性肿瘤，随着免疫组织化学电镜及分子生物学技术的发展，人们对其研究不断深入。本文收集两家医院自2006年3月--2008年8月期间手术病理证实的25例胃间质瘤进行回顾性分析，以提高对胃间质瘤的认识。     

Cyst formation in gastric heterotopic pancreas: report of two cases

Cyst formation is an uncommon pathologic finding in heterotopic pancreas. It is sometimes reported in a duodenal location but very rarely in a gastric location and leads to very large lesions of unusual endoscopic and radiographic appearance. Two cases of gastric heterotopic pancreas are described in which cystic zones in the gastric wall were found at preoperative ultrasound or computed tomography.     

胃底种植性异位脾1例

正患者男,68岁。因反复纳差、乏力20余年,并发右上腹胀10余天入院治疗。50年前因"脾肿大"行脾切除术。胃镜发现食管中段中度静脉曲张,慢性浅表性胃炎(II级),慢性糜烂性胃炎(III级)。血肝功能提示总胆红素、直接胆红素、γ-谷氨酰转肽酶升高。CT平扫示胃底部见团块状软组织密度影,边缘清楚,大小约为33mm×49mm,CT值53HU,肿块边缘可见条形钙化     

结节病性关节炎2例

结节病原因未明,可同时或相继侵犯多系统的非干酪坏死性肉芽肿,累及骨关节少见,1%～13%的病人发生[1],常累及手、足.笔者搜集经病理证实2例,报道如下……     

恶性间叶瘤二例

例1 男,63岁.活动后胸闷、气短2个月,弯腰时上腹饱胀及后背痛1个半月于2005年9月12日入院.无吞咽困难及进食梗噎感.体检及实验室检查均无明显异常.     

Unusual acute formed gastric bezoars due to plaster ingestion successfully treated by gastric irrigation: report of two cases

Bezoars usually present as a mass in the stomach. One of the uncommon causes of bezoars is ingestion of plaster in a suicidal attempt. We present here two patients with acute formed gastric bezoars due to plaster ingestion. Their main complaints were abdominal pain, nausea, and vomiting. Clinical examination revealed a slightly distended abdomen and a palpable mass in the epigastric region. Plain abdominal radiograph showed plaster casts in the stomach. They were successfully treated by insertion of a nasogastric tube and gastric irrigation using saline solution over 24 h. Post-treatment abdominal X-ray showed dissolved plaster passing through the small intestines and the colon. The treatment course was uneventful, and finally patients were discharged with good condition and referred to a psychiatric clinic for treatment of underlying psychological disorder.     

家族性石骨症病例报道

石骨症是一种较少见的泛发性骨质硬化性病变．一般认为与遗传有关，以下是本院发现一家族性石骨症病例。     

下颌骨骨软骨瘤2例

例1女27岁.左颞颌关节弹响伴疼痛半年余.查体:张口约4.0cm,左颞颌关节压痛,张闭口时有弹响.颞颌关节体层摄影显示:左下颌骨髁状突前缘有一骨性突起(图1),其内为松质骨,外周环绕骨皮质.X线诊断:下颌骨髁状突骨软骨瘤.手术所见:瘤体约1.0cm×0.8cm大小,基底较宽,与髁状突相连;病理诊断:下颌骨骨软骨瘤.     

Hepatic fascioliasis: report of two cases

Two cases of hepatic fascioliasis with characteristic features in US examinations and CT scans are presented. In both modalities they show tunnel-like branching and clustered areas of low echogenicity/density, which reach subcapsular regions. These cases are presented to recall the imaging features in hepatic fascioliasis especially outside endemic regions. Not only CT but also US is able to detect these characteristic lesions, which may help to make the diagnosis of hepatic fascioliasis in patients with clinical symptoms suggestive of parasitic disease. Received: 4 November 1999; Revised: 30 March 2000; Accepted: 4 April 2000