左腰部肿物

1.病例简介：患者女,46岁.左腰部肿物术后左髋部疼痛、麻木,逐渐加重3年,于2003年11月10日入院.继往史：40年前无明显诱因出现左腰部肿物,无不适感,手术切除;约20年前左腰部再次出现肿物,予以切除;3年前出现肿物,切除后左髋部疼痛、麻木,逐渐加重,于当地穿刺病理诊断为纤维肉瘤.体检：左髋部感觉减退.     

左胫骨中上段肿物

一、病历摘要患者男，22岁。因左小腿不适于1991年9月就诊。X线示左胫骨上段局限性溶骨性改变，当地医院病理活检诊断为非骨化性纤维瘤。行刮除植骨术，术后局部复发，未予治疗。1993年11月27日该患者不甚摔倒致左胫骨中上段病理性骨折入院，X线检查示左胫骨中上段5cm×4cm×2．5cm溶骨性缺损，皮质变薄，无骨膜反应（图1）。于1993年12月8日手术，术中冰冻诊断为胜骨釉质瘤，行股骨中下段截肢术。二、病理检查送检标本为切除之左下肢，由膝上15cm处离断。胜前骸骨下方10cm处局部软组织肿胀。剔除软组织后见距膝关节11cm，距踝关节16cm处髓…     

乳腺癌改良根治术后胸壁新发良性肿物的超声特征

目的探讨乳腺癌改良根治术后胸壁新发良性肿物的超声表现特点。方法回顾性分析19例乳腺癌改良根治术后胸壁新发肿物并被病理证实为良性患者的超声表现及临床病理特征。结果 19例患者乳腺癌改良根治术后3个月~10年胸壁新发良性肿物,其中73.7%(14/19)集中于术后2年内,24个病灶大小4.0~45.0 mm,术后病理诊断证实:45.8%(11/24)为脂肪坏死,33.3%(8/24)为炎性反应伴异物巨细胞反应,其他20.9%(5/24)。24个胸壁病灶术前超声正确提示11个(11/24,45.8%)为良性病变可能,其中脂肪坏死4个,超声表现:2个低或无回声,形态规则,边界清,未见血流;2个低回声,形态不规则,边界不清,内可见中高回声或钙化,未见血流。炎性反应伴异物巨细胞反应5个均为多发病灶,超声表现:3个伴显著后方回声衰减,2个呈中高回声,少或未见血流。1个脂肪瘤及1个纤维脂肪组织急性及慢性炎性反应均表现为中高回声。结论乳腺癌改良根治术后患者胸壁新发良性肿物的时间多在手术后2年内,病理类型复杂,多见脂肪坏死或炎性反应伴异物巨细胞反应,超声表现多样,需依靠病理明确诊断。     

子宫肿物

1.病例简介:患者女,33岁.因经最增多,阴道不规则流血于2007年12月在外院行B超检查发现官腔内占位,随后在官腔镜下行肿块活检术,送检切片为官腔内活检组织.     

颅前窝肿物

1.病例简介:患者女,35岁.因头痛并逐渐加重3个月,近1个月有时恶心呕吐,于2006年2月18日收住院.体检:意识清楚,痛苦面容.面部无肿胀,眼球无外突,无复视.     

椎体肿物

1.病例简介:患者女,30岁.主因"胸背部疼痛1个月,加重1周"于2006年11月20日入住本院.1个月前无明显诱因出现胸背部疼痛,近1周症状逐渐加重,下床活动疼痛明显,卧床后可缓解,在外院就诊,行相关辅助检查后发现T12椎体病变,随后来我院住院诊治.胸椎CT检查:T12,椎体病变:右侧横突、双侧椎板、棘突等可见骨质破坏(图1).骨扫描:T12椎体异常浓聚.遂行手术治疗,手术中见:T11右侧附件、T12双侧附件及T12右侧方被肿物侵犯,向右侧方延伸包绕肋骨形成10 cm×6 cm大小软组织肿块,肿块质韧,色黄.行前后联合T12肿瘤切除,内固定术.术后随访2年无复发及转移征象.     

卵巢肿物

1.病例简介:患者女,26岁.5年前发现左侧卵巢肿物,伴腹痛2 h,手术切除肿物;2007年10月,体检时B超发现右侧卵巢肿物,直径5 cm,无其他不适.患者除体毛较明显外,无其他男性化体征.     

子宫肿物

1.病例简介:患者女,59岁.因"绝经后5年,阴道出血2次"于2006年12月入院检查.B超检查提示"子宫大,官腔内不均回声,性质待查",为进一步诊治收入院.     

椎体肿物

1.病例简介:患者女,30岁.主因"胸背部疼痛1个月,加重1周"于2006年11月20日入住本院.1个月前无明显诱因出现胸背部疼痛,近1周症状逐渐加重,下床活动疼痛明显,卧床后可缓解,在外院就诊,行相关辅助检查后发现T12椎体病变,随后来我院住院诊治.胸椎CT检查:T12,椎体病变:右侧横突、双侧椎板、棘突等可见骨质破坏(图1).骨扫描:T12椎体异常浓聚.遂行手术治疗,手术中见:T11右侧附件、T12双侧附件及T12右侧方被肿物侵犯,向右侧方延伸包绕肋骨形成10 cm×6 cm大小软组织肿块,肿块质韧,色黄.行前后联合T12肿瘤切除,内固定术.术后随访2年无复发及转移征象.     

侧脑室肿物

1.病例简介：患者男,31岁,间断性头痛3年,不伴有恶心、头晕,休息后可缓解。近3个月来,出现记忆力不降,睡眠差,心情烦躁,1d前突然出现剧烈头痛,言语不流利,并出现呕吐,继而出现意识不清,于2004年1月4日入院。专科体检：嗜睡,言语尚流利,对答切题,不能回忆起发病时情节。双侧视乳头水肿,右下肢Babinski征阳性,余无阳性体征。     

Cytomorphology of a solitary left chest wall mass: an unusual presentation from unknown primary hepatocellular carcinoma

Hepatocellular carcinoma (HCC) may present in various ways, but only very rarely with symptoms of distant metastases or evolve from ectopic liver tissue. This report describes a case of a 62-year-old white man who was admitted for hemoptysis and a large left chest wall mass that was growing for about a year. The patient underwent Fine-needle aspiration (FNA) of the mass that revealed poorly differentiated large-cell carcinoma. A lung primary was suspected initially; however, further workup of this patient showed an elevated serum alpha-fetoprotein (AFP) level of 16,425 ng/ml. A computerized tomography (CT) scan of the abdomen showed cirrhotic liver, evidence of esophageal varices, but no evidence of a liver mass. The FNA findings were reviewed and ancillary studies were performed, including pan cytokeratin (AE1/3), Hepatocyte Paraffin 1 (HepPar-1), AFP, CD10, CD34, and polyclonal CEA. The results confirmed the diagnoses of HCC probably from occult primary or from ectopic liver tissue. The former was suggested, since serum AFP was dropped to 6,640 ng/ml following resection of the tumor. We concluded that HCC should be considered in the list of differential diagnosis of chest wall mass. HCC may present as metastatic disease from a clinically and radiologically unrecognized liver mass. FNA, coupled with ancillary studies, provides a rapid and accurate diagnostic tool in challenging cases.     

Fine-needle aspiration cytology of soft-tissue calcinosis presenting as an enlarging mass in the chest wall

Calcinosis cutis is an uncommon condition, and calcific deposits in patients with end-stage renal disease are now somewhat rare, due to improvement in management. Since calcific deposits may clinically resemble a tumor, it is feasible to investigate them by fine-needle aspiration cytology (FNAC). A 52-yr-old male with a history of end-stage renal failure presented with a 2-cm mass in the left chest wall. Within 6 mo the mass enlarged to nearly four times its original size. In view of clinical suspicion of malignancy, FNAC was performed. Cytopreparations showed abundant calcium, indicative of soft-tissue calcinosis. The case is interesting, since the known history of end-stage renal failure enabled the FNAC diagnosis of soft-tissue calcinosis. Diagn. Cytopathol. 1998;19:465–467. © 1998 Wiley-Liss, Inc.     

Angiosarcoma in irradiated post-mastectomy chest wall

A 61-year-old woman developed an angiosarcoma in the irradiated chest wall 2 1/2 and 4 years after mastectomy for a carcinoma of breast. The two sets of tumours were morphologically distinct and differed immunohistochemically. The short interval between post-operative irradiation and presentation of the angiosarcoma is unusual. The case is discussed in relation to others of allied type.     

Isolation of Wolinella recta and Actinomyces viscosus from an actinomycotic chest wall mass.

In this Note we describe a patient with an actinomycotic chest wall mass from which large numbers of Wolinella recta and Actinomyces viscosus organisms were isolated. This is the first reported association of W. recta with extraoral infection and the tenth report of lung infection by A. viscosus.