分泌血清素的恶性胰腺内分泌肿瘤1例及文献复习

目的：探讨分泌血清素的恶性胰腺内分泌肿瘤的临床病理特点，诊断和预后，方法：对1例分泌血清素的恶性胰腺内分泌肿瘤进行光镜，免疫组化观察并结合文献进行分析。结果：肿瘤细胞大小一致，圆形或多边形，呈实性成片状，巢索状排列，未见核分型，胞质嗜酸性，向周围浸润，侵犯神经，淋巴结内见癌转移，NSE，CgA,Syn和serotonin阳性，结论：分泌血清素的恶性胰腺内分泌肿瘤来源于外分泌导管或腺泡上皮的Kultschitsky细胞，具有典型的神经内分泌肿瘤的组织学特征，常伴有类癌综合征，属低度恶性，病理诊断依赖于组织学，免疫组化并结合临床特征。     

胰腺浆液性微囊性囊腺瘤1例报道并文献复习

目的探讨胰腺浆液性微囊性囊腺瘤的临床病理学特征及诊断、鉴别诊断要点。方法对1例胰腺浆液性微囊性囊腺瘤进行临床病理分析及免疫组化研究。结果胰腺浆液性微囊性囊腺瘤临床上可以表现为消瘦、乏力而体格检查阴性；镜下肿瘤由大小不等的囊腔组成，囊壁内衬单层立方上皮，胞质清亮，核小而圆、居中，核分裂象极少见，细胞无异型性，囊腔之间可见粗大的纤维结缔组织分隔。免疫组化瘤细胞keratin和EMA( )，S-100、vjmentir、actin、CGA、Syn、CEA、desmin和Ⅷ因子(-)。结论胰腺浆液性微囊性囊腺瘤是一种罕见肿瘤，其诊断和鉴别诊断主要依靠病理组织学和免疫组化，部分肿瘤的良恶性很难确定，需进行随访。     

肾髓质癌1例并文献复习

目的 探讨肾髓质癌的临床病理特征。方法 对1例肾髓质癌进行临床，病理组织学和免疫组织化学观察，并结合文献探讨其临床表现，病理形态及鉴别诊断。结果 本病好发于中青年，肿瘤呈不规则实性，生长于肾髓制裁内；瘤细胞呈片块状弥漫分布，少数呈网状或巢状排列，细胞以圆形，卵圆形或不规则形居多，胞浆嗜酸，泡状核，核仁明显；间质纤维组织增生，多量中性粒细胞，嗜酸性粒细胞浸润，肿瘤细胞vimentin、CK（ ），EMA、desmin、Syn及S-100（-）。结论 肾髓质癌是一种罕见的起源于肾盏上皮的高度恶性肿瘤，预后差。     

肺错构瘤的临床诊断

目的：肺错构瘤是肺内最常见的良性肿瘤，但因临床表现无特异性而容易误诊。为提高地本病的诊治水平，我们从临床表现、胸部Ｘ线、手术及病理等方面探讨肺错构瘤的诊断与鉴别诊断。方法与结果：采用呃生资料分析发现，本组肺错构瘤肺内型１５例，腔内型１２例；平均年龄４９．９岁，男女比例为１．６７：１。临床症状少而轻。Ｘ线表现为圆形、类圆形阴影，肺块直径≤４ｃｍ者占８７．５％，位于肺周边部位才占７５％。结论：肺错构瘤     

乳腺错构瘤1例

患者女性 ,2 8岁。因左乳无痛性肿块 3年入院。查体 :左乳外上象限可触及一肿块 ,体积 3ｃｍ× 3ｃｍ× 3ｃｍ ,与皮肤无粘连。肿块表面光滑 ,质地软 ,边界清楚 ,活动 ,无压痛。Ｂ超示乳腺内实质性肿块 ,有包膜 ,内部回声不规则。术中冷冻报告为错构瘤 ,行肿瘤单纯切除。病理检查　巨检 :椭圆形肿块一个 ,体积 2 5ｃｍ× 2 5ｃｍ× 2 0ｃｍ ,表面光滑 ,包膜完整 ,切面淡黄色质软区与灰白色质韧区成分大致相等 ,彼此交叉。镜检 :淡黄色区主要分布于外周 ,为大量成熟脂肪组织、少量平滑肌束及纤维组织 ;灰白色区主要分布在中央 ,为不规则分…     

胰腺类癌1例报告并文献复习

目的：探讨胰腺类癌临床病理特点及治疗。方法：报告我院10a间消化道类癌中l例胰腺类癌病例，结合国内外文献资料，对胰腺类癌的临床病理特点、诊断、鉴别诊断及治疗进行分析。结果：胰腺类癌极为少见．约占全部消化道内分泌肿瘤的1．4％。临床表现多样性．可有不典型类癌综合征表现。肿瘤细胞表达NSE．嗜铬索A（CgA），突触索及5-羟色胺等内分泌肿瘤细胞标志。胰腺类癌转移率高．5a生存率低。结论：病理形态及免疫组化检查是胰腺类癌确诊的关键．治疗上应以根治性手术及彻底的淋巴结清扫为主。     

肾错构瘤的超声鉴别诊断

目的：研究肾错构瘤的声像特征，提高肾错构瘤的诊断水平。方法：以声像表现结合临床资料进行分析。结果：B超诊断肾错构瘤8例，对照手术及病理结果定位及肿瘤大小基本符合8例，定性符合7例，误诊1例。结论：B超检查诊断小的肾错构瘤准确性较高，诊断大的错构瘤准确性稍低。     

胰腺实性假乳头状肿瘤32例特点及文献复习

目的:探讨胰腺实性假乳头状肿瘤(SPN)的临床病理特点及预后.方法:对32例胰腺实性假乳头肿瘤进行组织学检查及免疫组化染色,并观察其临床特点及预后情况.结果:32例病例中男6例,女26例,男女比约1:4.3,平均年龄约31.6岁(9～ 68岁),发生在胰头6例,胰颈3例,胰体尾23例.患者多无明显临床症状,腹痛及腹部肿块为常见表现.肿瘤平均直径约5.8 cm(2 ～ 16 cm),镜下特点是肿瘤细胞围绕纤维血管轴心松散排列成乳头样结构,细胞形态温和,核分裂罕见.23例可见肿瘤细胞浸润胰腺实质,3例可见细胞明显异型性及多核巨细胞形成,2例可见血管内瘤栓及神经束侵犯.免疫组化显示β-Catenin(核阳性)、Vimentin均为阳性,CD10、CD56阳性25例,PR阳性24例,CK阳性8例,CgA阳性3例.24例病例随访3～51个月,均未复发或转移(包括2例细胞明显异型及2例血管和神经束侵犯).结论:胰腺实性假乳头状肿瘤是常发生在年轻女性的一种低度恶性肿瘤,手术切除预后良好,侵袭性组织学特点与预后无直接相关性,因此所有病例均需术后密切随访.     

乳腺肌纤维母细胞瘤1例及文献复习

乳腺肌纤维母细胞瘤是乳腺肿瘤中极少见的类型 ,文献报道多发生于老年男性。本文报道中年女性患者 1例。1　材料与方法1 1　临床资料　患者女性 ,44岁。发现左乳腺肿块 3个月。查体 :乳腺内向限可触及一个直径约 2ｃｍ结节 ,表面光滑 ,边界清 ,有轻度压痛。细针穿刺细胞病理学提示纤维腺瘤 ,未发现恶性肿瘤细胞。遂行乳腺肿物切除术。1 2　方法　瘤组织经 1 0 %福尔马林固定 ,常规石蜡包埋 ,4μｍ切片 ,ＨＥ染色。免疫组织化学试剂Ｖｉｍ、Ｓ 1 0 0、ＳＭＡ、ＭＳＡ、ｃｙｔｏｋｅｒａｔｉｎｓ、ＣＤ34、ｄｅｓｍｉｎｅ和ＣＤ68均为美国Ｄ…     

Adult pancreatoblastoma: a case report

Pancreatoblastoma (PB) is a rare epithelial malignancy usually occurring in the paediatric population. Adult PB is rare, and its imaging findings are similar to those of other tumours, making preoperative diagnosis a considerable challenge. We report correlative ultrasound, contrast-enhanced ultrasonography, contrast-enhanced magnetic resonance imaging, and positron emission tomography-computed tomography findings in a 60-year-old woman with PB. PB often presents with uncommon imaging features and should be considered in the differential diagnosis of pancreatic masses. It is important for clinicians to be aware of these differences to provide effective treatment.     

婴儿鼻腔软骨间叶性错构瘤1例及文献复习

目的报告1例婴儿鼻腔发生的极其罕见的病例，总结其病变特点。方法应用组织学方法，HE染色进行观察。结果肿瘤由梭形细胞、胶原纤维及不规则的骨和软骨岛组成。病理性核分裂象罕见。结论婴幼儿鼻腔软骨间叶性错构瘤具有良性的生物学行为，手术完整切除即可治愈。形态学上需要与间叶性软骨肉瘤鉴别。     

Gastric metastasis from pancreatic cancer characterized by mucosal erosion: a case report and literature review

Pancreatic cancer with gastrointestinal tract metastasis is a fairly rare occurrence, and gastric metastasis in such cases has been seldom reported. We herein present a case of gastric involvement secondary to pancreatic cancer in a 74-year-old woman in whom the metastatic lesion only presented as mucosal erosion in the stomach. The patient had a 1-month history of progressive right upper quadrant pain before admission. Computed tomography and endoscopic examinations revealed a solid and hypo-enhancing mass in the head of the pancreas. The patient underwent conventional upper endoscopy before pancreatic biopsy, and mucosal erosion was observed in the gastric pylorus. We obtained gastric and pancreatic biopsies by gastroscopy and endoscopic ultrasound-guided fine needle aspiration, respectively. Pathologically, the biopsies taken from the area of gastric erosion showed poorly differentiated invasive adenocarcinoma that was morphologically consistent with the pancreatic specimens. Moreover, the gastric section showed tumor thrombi within the vessels. Hence, the suspected diagnosis was unresectable pancreatic cancer with gastric metastasis. The patient immediately underwent two courses of chemotherapy, but her condition rapidly deteriorated and she died 2 months later.     

Lung hamartoma resembling lung cancer: a report of three cases

Pulmonary hamartoma is a benign lung tumor. However, it is difficult to distinguish this lesion from other diseases via imaging. Three patients with pathologically confirmed pulmonary hamartoma in our department were analyzed. We believe it is necessary to combine imaging, pathology, clinical testing, and individual patient assessments to enable an earlier and more definitive diagnosis of pulmonary hamartoma. Therefore, it is necessary to analyze and summarize the clinical manifestations and imaging features of patients with pulmonary hamartoma to improve the early recognition of the disease by clinicians.     

Rare case of granular cell tumor of perianal region: a case report and literature review

Granular cell tumors (GCTs) are rare submucosal neoplasms, with tumors in the oral mucosa accounting for about a third of all cases. In contrast, GCT is a rare anal neoplasm, with fewer than 30 cases of perianal GCT reported in the literature. We report the case of a 36-year-old woman with a perianal lump with no obvious local lesion as the main clinical complaint. The tumor was completely resected and histologically confirmed as a GCT. The patient remained under continuous follow-up. GCT is difficult for surgeons and pathologists to diagnose, and biopsy and immunohistochemical analysis are prerequisites for an accurate diagnosis. An integrated understanding of GCT in terms of its differential diagnosis will contribute to better identification and more appropriate treatment of this disease.     

Lipofibromatous hamartoma of a digital branch of the median nerve: A case report and review of literature

Lipofibromatous hamartoma (LFH) is a benign tumor that causes nerve enlargement due to fatty adipose tissue infiltration around bundles of peripheral nerves. It most commonly occurs at the median nerve with associated macrodactyly. We present an uncommon case of LFH that affected a digital branch of the median nerve without macrodactyly.     

Splenic hamartoma: A case report and review of the literature

Splenic hamartoma is a rare benign malformation, composed of an anomalous mixture of normal splenic elements, often found incidentally while working up other complaints or at autopsy. A splenic mass was incidentally found while evaluating the effects of a traffic accident in a 63-year-old woman. Abdominal computed tomography revealed a well-defined splenic mass with rim enhancement. The patient underwent splenectomy. The resected spleen contained a well-defined mass lesion measuring 3.5 cm × 3.0 cm. Microscopic examination revealed disorganized slit-like vascular channels lined by plump endothelial cells without atypia. The cells lining the vascular channels were positive for CD8, CD31, CD34 and vimentin. Endothelial cells that are positive for CD8 are a key feature that differentiates hamartoma from other vascular lesions of the spleen. Although this tumor is very rare, it must be included in the differential diagnosis of splenic mass-forming lesions.     

家族性噬血细胞性淋巴组织细胞增生症1例并文献复习

目的加强对家族性噬血细胞性淋巴组织细胞增生症（familially hemophagocytic lymphohistiocytosis,FHL）的认识。方法报道确诊为FHL的新病例1例,结合国内外报道的FHL的病例,对该病的临床特点进行汇总分析。结果FHL2常与PRF1基因突变相关,约20%~40%的患者存在穿孔素基因突变。结论对于有阳性家族史,基因诊断明确,应尽早行化疗或者造血干细胞移植。若无家族史,未发现与继发性HLH相关的原发病因,可考虑行基因筛查以明确是否存在FHL的可能。     

Granulomatous orchitis: case report and review of the literature

We report the disease characteristics, diagnosis, and treatment of granulomatous orchitis. A 38-year-old man presented with a history of intermittent swelling, pain, and discomfort in the right testicle of 3 days’ duration. Unenhanced magnetic resonance imaging (MRI) of the testis and scrotum revealed an oval mass in the right testis measuring approximately 17 mm in diameter, with clear borders and a target ring-like appearance from periphery to center. T1-weighted imaging (T1WI) showed uniform low-intensity signals, and T2WI showed mixed high- and low-intensity signals. Diffusion-weighted imaging (DWI) signals were iso-intense, and the outer ring on enhanced scans showed progressive enhancement. We performed radical resection of the right testis under combined spinal–epidural anesthesia. The pathological diagnosis was granulomatous right orchitis. Two months postoperatively, ultrasonography showed no testis and epididymal echo signals in the right scrotum, and no obvious abnormalities; color Doppler blood flow imaging (CDFI) findings were normal. Granulomatous orchitis is rare in clinical practice, and the cause is unknown. The disease involves non-specific inflammation; however, it is currently believed that antibiotics and steroids are ineffective for conservative treatment, and orchiectomy should be actively performed.