纵隔支气管囊肿1例

患者女,51岁,发现纵隔肿块6年,近1周出现颜面部水肿。胸部CT：上腔静脉后、气管右侧可见类圆形稍高密度肿块影．大小约3．7cm×4．7cm,内部密度不均,CT值63HU,边缘见弧形钙化影,与邻近组织分界尚清（图1）;增强扫描肿块未见明显强化．上腔静脉轻度受压、管腔变窄。气管、纵隔位置居中,胸骨后可见残余胸腺影,心脏大小、形态未见明显异常,两侧胸膜腔内未见积液征象,脾脏见多发结节状钙化影（图2）。     

后纵隔支气管囊肿1例

患者女,27岁,常规体检透视时发现心影后圆形高密度影,无不适感。食管吞钡造影发现食管下段向右侧移位,局部受压,受压处左侧可见6.5cm×5.0cm圆形实变影（图1A）。胸部CT示后纵隔内7.1cm×5.3cm囊性病变,边界清楚,密度较均匀,CT值约5HU,囊壁局部见少许钙化影。增强CT示囊内液性病灶无明显强化,囊壁轻度强化（图1B）。     

纵隔内原发性绒毛膜癌1例

正患者男,24岁,因"反复胸痛20天,发热伴咳嗽、痰中带血10天"入院,查体:左下肺呼吸音弱。实验室检查:谷丙转氨酶93.67U/L,谷草转氨酶53.71U/L,血清白蛋白33.37g/L,白蛋白/球蛋白0.91,谷氨酰转移酶221.39 U/L,碱性磷酸酶171.13U/L,聚酰胺120.93mg/L,乳酸脱氢酶703.11U/L,人绒毛膜促性腺激素(human chorionic gonadotropin, HCG)31 026.00U/L,甲胎蛋白(alpha fetoprotein,AFP)1.08ng/ml,红细胞沉降率24mm/h。胸部CT检查:双肺多发类圆形结节影,边界清晰,最大约4.4cm×3.3cm,增强扫描呈轻度强化(图     

胃壁支气管源性囊肿1例

病人女性,71岁。查体发现上腹部囊性占位病变10d。于2007-04-07入院。腹部彩超检查发现上腹部囊性占位病变,胃小弯后内侧有一10 cm×6 cm囊性包块。CT示胃小弯内后方10 cm×6 cm×4 cm囊性包块,边界清晰(图1)。无腹痛、腹泻,无畏寒、发热。腹部平坦,无压痛及反跳痛。上腹部包块     

超声诊断胎儿支气管囊肿1例

<正>孕妇26岁,孕1产0,既往体健,本次怀孕无药物接触史,妊娠初期有感冒史。孕32周胎儿超声检查:胎儿双顶径7.81cm,股骨长5.32cm,羊水指数12.03cm,肝、胃、肾脏、膀胱及四肢正常;超声心动图于胎儿右心室流出道切面动脉导管与左肺动脉间探及2.22cm×1.73cm囊性包块,壁薄、边界清晰、内部透声良好(图1A),CDFI未见明显血流信号(图1B);气管-左右主支气管冠状切面扫查示囊性包块位于气管隆突下,主动脉弓切面扫查示囊性包块位于主动脉弓下(图1C)。超声诊     

纵隔支气管囊肿的外科治疗

纵隔支气管囊肿较少见 ,我科 1970年～ 2 0 0 0年经手术和病理证实的 3 9例 ,现就其诊治特点报告如下。1.临床资料 :本组男 2 3例 ,女 16例。年龄 12～ 60岁 ,平均 49岁 ;病程在3个月～ 10 0年之间 ,平均 2 5年。出现咳嗽、咳痰症状者 2例 ,轻度呼吸困难 11例 ,中度呼吸困难 13例 ,咯血 1例 ,胸疼4例 ,吞咽困难 1例 ,呛咳 5例。所有患者Ｘ线胸片显示 :纵隔相应部位均匀、致密、边缘光滑的圆形或类圆形阴影 ,5例囊肿内伴有液平。其中 13例可见气管被压现象。支气管碘油造影显示 :4例造影剂进入囊腔。食道钡餐透视显示 :8例肿物影压迫食道 ,…     

纵隔镜支气管囊肿摘除1例

病人　女 ,2 9岁。间断咳嗽、气短 ,发现纵隔肿物 1年。查体未见明显异常。胸部Ｘ线及ＣＴ示右上纵隔肿物 ,约4ｃｍ× 3ｃｍ× 2ｃｍ大小 ,位于主气管右前方 ,边界清楚 ,密度均匀 ,ＣＴ值 2 5Ｈｕ ,初步诊断为纵隔囊肿。为进一步明确诊断及治疗 ,于 2 0 0 1年 4月全麻下行颈部纵隔镜手术。术中以食指分离气管前颈纵隔隧道。探查肿物呈囊性、张力不大 ,位于主气管右前方 ,向下至隆凸水平。用注射器穿刺抽得约5ｍｌ淡黄色浆液性液体 ,同时刺破囊肿 ,使囊肿完全萎陷 ,用抓钳提起囊壁 ,以电凝吸引器钝性分离囊肿 ,完整切除之。术后病理报告为支…     

胃支气管源性囊肿1例报告

<正>胃支气管源性囊肿极其罕见,笔者医院2014年收治1例胃后壁来源支气管源性囊肿,治疗效果良好。现报告如下。1病历简介病人女性,49岁。因"中上腹阵发性疼痛不适1个月"于2014-08-13入院。病人疼痛时不伴恶心呕吐,无寒战发热,无腹泻便秘,1周前在当地医院诊断为急性胰腺炎,经过抑酶、抗炎、止痛后症状缓解。查体:神志清楚,皮肤巩膜无黄染,中上腹轻压痛,无反跳痛,无肌紧张,肝脾肋缘     

前纵隔内孤立性淀粉样瘤1例

正患者女,42岁,因头晕、头痛1天入院,既往有干燥综合征病史4年余。查体:神清,无明显脱发,牙齿片状脱落,舌干裂,舌苔消失,皮肤遇光变红。CT:平扫示前纵隔肿块,边缘光整,最大截面约8.1cm×4.5cm,其内密度不均,可见点状钙化及大小不等低密度区,CT值40～76HU(图1A),增强扫描病     

小儿纵隔恶性孤立性纤维瘤侵及右肺1例

正患儿男,13岁,咳嗽、咳痰3月余,偶伴发热;既往无特殊病史。查体:右上肺叩诊浊音。实验室检查:白细胞12.20×109/L,血小板503×109/L,中性粒细胞7.09×109/L,单核细胞1.23×109/L,嗜酸性粒细胞0.74×109/L,D-二聚体0.402mg/L,纤维蛋白原5.72 g/L,肿瘤异常糖链蛋白176.821μ。胸部X线片:双肺纹理增多,右中上肺野见团块状高密度影,外缘及下缘尚清,内缘与纵隔重叠,     

Bronchogenic cyst.

Two recent patients with bronchogenic cysts, presenting in an atypical manner, stimulated our review of this subject. Twenty patients with bronchogenic cysts have been treated at the Boston Floating Hospital over the past 20 yr. Of these patients, 19 out of 20 were symptomatic, the most common symptom being fever (6 out of 20). Half of our patients had no respiratory symptoms but only one was found to have an asymptomatic mass on chest x-ray. The majority of theses cysts were found within the pulmonary parenchyma, the right lung being affected three times more commonly than the left. These facts are at odds with the reports in the literature. Three were found in the neck. Bronchogenic cysts are generally thought to be small, solitary, and limited in area. However, a significant number in our series (8 out of 20) were large, multiple or multicystic, and involved segments, lobes, multiple lobes, and, on one occasion, an entire lung. The correct pre-operative diagnosis was made in only 30% of the cases. The fact that the diagnosis was often missed led to long delays in treatment resulting in recurrent infectious complications and repeated hospitalizations. The most common cause of error in diagnosis was failure to follow a pneumonia to complete resolution. Despite the frequent delays in diagnosis, surgical treatment was curative in all patients.     

Bronchogenic cyst imitating chronic asthma

This case report demonstrates the dangers of assuming the accuracy of a neonatal diagnosis of asthma, that is not responsive to medical therapy, and highlights the value of CT imaging.     

前上纵隔透明血管型Castleman病误诊为胸腺瘤1例

患者女,52岁,1年前无明显诱因出现胸憋,偶有刺激性咳嗽,无发热,近20天症状加重,咳黄痰、双下肢无力。CT平扫示前上纵隔软组织肿块影,约3.8cm×2.8cm×1.8cm,边缘光滑,密度均匀,CT值约31HU(图1A),增强扫描结节明显均匀强化,值约,与邻近主动脉弓及肺动脉干分界清     

Cervico-Mediastinal Bronchogenic Cyst Occurring in the Prenatal Period: Report of a Case

We experienced a case of cervico-mediastinal bronchogenic cyst in which a cervical cystic mass was detected by prenatal ultrasonography. On prenatal ultrasound, a unilocular, well-defined and hypoechoic mass was detected in the fetal neck. The baby was born by a normal vaginal delivery at 40 weeks of gestation, and had no respiratory distress. Radiological investigations demonstrated a cyst in the cervico-mediastinal region, which displaced the trachea to the left. At the age of 32 days, an elective resection was easily performed through a right inferior collar incision after first aspirating the contents of the cyst. Prenatal sonography showing abnormal findings is effective for identifying cysts in the perinatal period and allows for the timely resection of such cysts before respiratory distress occurs. Received: October 22, 1999 / Accepted: May 30, 2000     

Gastric Bronchogenic Cyst Histologically Diagnosed After Laparoscopic Excision: Report of a Case

Abdominal computed tomography of a 71-year-old man revealed a 3-cm mass in gastric cardia. Although the mass was widely attached to the gastric wall, no clear contrast enhancement was observed. Abdominal magnetic resonance imaging revealed the mass to have homogenous high intensity on T2W1 images and isointensity on T1W1 images. On diffusion-weighted imaging, no high intensity was observed. However, the mass had a smooth surface and was widely attached to the gastric wall, consistent with computed tomography findings. A gastric submucosal tumor was suspected. Laparoscopic tumor resection was performed. Histopathologic diagnosis of the mass was a bronchogenic cyst derived from the respiratory primordium originating in the foregut of the primitive intestine. Such cysts are mostly found in the mediastinum or thoracic cavity; their occurrence on the gastric wall is extremely rare. Despite this, we think that bronchogenic cysts should be considered in the differential diagnosis of abdominal unilocular cystic diseases.     

SAPHO综合征1例

患者女,33岁,主冈“间断双手掌、双足脓疱2年,颈部及双肩疼痛1年半”就诊。体格检查：双手掌可见脓疱。右颈肩部明显肿胀．压痛阳性,右肩上举及外展困难。