透明细胞软骨肉瘤误诊1例

患者男,41岁,因摔伤左髋骶部致疼痛不适1个月,活动后加剧。实验室检查未见异常。X线平片(图1):左股骨颈见一约为7.0cm×4.8cm的囊状低密度区,内见分隔,囊内未见钙化,边缘清楚,未见软组织肿胀及骨膜反应。MRI(图2、3):T2W呈高信号,T1W为等低信号,信号不均,内见囊状分房,有多个液-液平面,部分房内T1W为均匀略高信号,T2W为高或等信号,提示囊内有出血,边缘尚清,未见骨膜反应;增强扫描为轻度强化。影像诊断:动脉瘤样骨囊肿。手术所见:左股骨颈部髓腔中有一大小约4cm×3cm×5cm不规则囊状包块,呈膨胀性生长,侵袭肿块周缘骨皮质,骨皮质明显变…     

软组织透明细胞肉瘤6例报道

软组织透明细胞肉瘤(clear cell sarcoma of softtissues,CCS)是一种患病率较低的软组织肿瘤,占软组织肉瘤的1%。WHO(2002)软组织肿瘤分类将其归类于分化不确定的肿瘤,因其肿瘤细胞具有黑色素细胞分化特点,将其归入恶性黑色瘤中的一种亚型。CCS的部分病例HE染色可见黑色素颗粒,也有文献称其为软组织恶性黑色素瘤(malignant melanoma of soft parts,MMSP)[1]。由于CCS临床表现多无特异性,易导致误诊、误治,为提高对其的认识,本文收集6例CCS临床病理资料,并结合有关     

臀部富含色素性软组织透明细胞肉瘤1例

患者男性,40岁。发现右臀部包块半年入院。2年前行右臀部肿块切除术,当地医院病理诊断:纤维肉瘤。体检:右臀部触及一质硬包块,压痛,边界欠清楚,活动度差,表面无溃疡、波动感,腹股沟区未触及肿大淋巴结。盆腔CT示右侧臀大肌肿胀并肿块,肌间隙模糊,累及皮下脂肪层,未侵及皮肤。行肿瘤切除+臀大肌部分切除术,术中见包块约10     

多发性软组织透明细胞肉瘤一例误诊报告

目的:探讨多发性软组织透明细胞肉瘤的误诊原因.方法:分析1例多发性软组织透明细胞肉瘤病例资料.结果:患者表现为进行性加重的头晕、头痛、呕吐,MRI提示多发性脑肿瘤,手术病理诊断为胶质母细胞瘤.因右下肢多发肿块再次入院,2次手术病理诊断为软组织神经外胚叶肿瘤.后经病理会诊,诊断为多发性软组织透明细胞肉瘤伴脑及肺转移.结论:多发性软组织透明细胞肉瘤临床罕见,应加强认识,并注意与其他疾病的鉴别诊断.     

透明细胞肉瘤1例

1病例报告患者,女,54岁,因右大腿后侧渐增性包块8月余于2004年3月12日入院。入院查体:右大腿后侧中下1/3处皮下可见一7 cm×6 cm大小的隆起性病变,皮肤无红肿、破溃及水肿,肌肉深面可扪及一6 cm×5 cm×4 cm大小的包块,质硬,界限不清,活动度差,轻微压痛。右下肢无活动障碍,右腹     

肾透明细胞肉瘤2例

例1女,11岁,发现右下腹包块10个月,体检右下腹可触及8ｃｍ×8ｃｍ长圆形肿块,质韧,不能移动。例2男,7个月,发现茶色尿9天,伴发热。体检左上腹可触及4ｃｍ×3ｃｍ肿块,质硬,界清,表面光滑,不能移动。病理检查　巨检:例1肾脏及肿瘤组织14ｃｍ×13ｃｍ×45ｃｍ,灰红色,切面肾皮质处见一肿块12ｃｍ×10ｃｍ×4ｃｍ,灰白色,实质性,边界较清(图1)。例2肾脏及肿瘤组织9ｃｍ×7ｃｍ×5ｃｍ,切面肾皮质处见一肿块65ｃｍ×55ｃｍ×4ｃｍ,灰白色,实质性,边界较清。镜检:肿瘤细胞丰富,细胞排列成片,细胞呈多边形,胞浆淡染,透明状,细胞核圆形、卵圆形,染…     

腋窝巨大透明细胞肉瘤1例

1　病例报告男 ,35岁。因右腋窝肿物 0 .5 a入院。 0 .5 a前无意当中发现右腋窝一核桃大小的肿物 ,呈逐渐增大 ,在院外按淋巴瘤治疗 ,肿物未见缩小 ,转诊我院。查体 :右腋下见 13cm× 12 cm大小的肿物 ,表面皮肤略呈紫色 ,皮肤温度不高 ,活动度差 ,无压痛 ,肾脏超声检查未见异常 ,临床拟诊淋巴瘤 ,予以手术切除。术中切开皮肤及皮下组织见肿物表面不光滑 ,质硬 ,血运丰富。病理检查 :送检标本为带皮肤之组织块 ,体积 17cm× 12 cm×12 cm,皮肤面积 11cm× 5 cm,皮下见直径约 10 cm之圆形肿物 ,肉眼观察肿物与周围组织界限清楚 ,包膜不完整 ,…     

透明细胞肉瘤1例

患者男性 ,2 8岁 ,因左腋下肿块逐渐增大 3个月入院。 3个月前发现左腋下蚕豆大肿块一个 ,无不适症状 ,抗生素治疗无效 ,肿块逐渐增大。入院查体 :左腋下可扪及 3 5ｃｍ×2 5ｃｍ大小肿块 1枚 ,表面光滑 ,质硬 ,可推动 ,与周围组织界限清楚 ,无压痛。左上肢活动轻度受限 ,实验室检查 :ＷＢＣ6 6 4× 10 12 /Ｌ ,Ｎ 6 5 % ,Ｌ 33%。行左腋下肿块切除术 ,切除不同大小 4个肿块 ,2 5ｃｍ× 2 5ｃｍ至 0 3ｃｍ× 0 3ｃｍ不等。病理检查　巨检 :结节状组织 1块 ,3ｃｍ× 2 2ｃｍ×1 5ｃｍ ,表面灰红色 ,有包膜 ,切面灰红灰白色 ,有灰黄色…     

足部软组织透明细胞肉瘤2例并文献复习

<正>软组织透明细胞肉瘤(soft tissue clear sarcoma, CCS)是起源于神经嵴细胞的一种软组织恶性肿瘤,发病率非常低,约占所有软组织肉瘤的1%^[1],好发于青少年和年轻成人的肌腱和腱膜^[2]。其形态学及免疫表型与恶性黑色素瘤(malignant melanoma, MM)相似[3],但具有独特的遗传学特征,即由t(12;22)(q13;q12)染色体易位导致的EWSR1-ATF1基因融合。软组织透明细胞肉瘤恶性程度高,     

透明细胞软骨肉瘤1例报道

透明细胞软骨肉瘤(CCCS)为罕见的骨肿瘤,约占所有软骨肉瘤的1%～2%,男女之比约为2∶1[1]。自1976年Unni等[2]首次报道以来,英文文献报道有100余例,国内仅有20余例。CCCS属于低度恶性肿瘤,临床、病理、影像都极     

左足部腺泡状软组织肉瘤误诊１例

腺泡状软组织肉瘤是一种少见的软组织肿瘤,临床容易误诊漏诊．现报道1例如下。病例女,25岁,左足部内侧肿胀半年,逐渐加重伴疼痛半月就诊。半年前出现左足背内侧肿痛,漫认为脚扭伤未予正规检查治疗。近半月上述症状加重,伴活动受限遂就诊。左足部DR片：左足背内侧肿胀明显,第l跖骨及内侧侧楔骨骨肉瘤或骨结核。随后转院至北京积水潭医院治疗,最后经活检及病理诊断楔骨溶骨性骨质破坏,边界不清（图1,2）。胸部DR片未见明显肺转移征象。初步诊断为左足第1跖骨及内为左足部腺泡状软组织肉瘤,累及第l跖骨及内侧楔骨。给予ACDD方案化疗。1年后复查,左足部DR片见足部软组织肿胀明显加重,第1-5跖骨及内中外侧楔骨、舟状骨均有不同程度骨质破坏,骨质破坏范围较前明显扩大（图3,4）,同时复查胸部DR片见双肺转移（图5,6）。1月后患者又因脑、脊柱、肝等多器官转移．出现恶病质而死亡。     

Primary clear cell sarcoma of soft tissue in the posterior cervical spine invading the medulla oblongata: A case report

BACKGROUNDClear cell sarcoma (CCS) is a rare and highly malignant soft tissue tumor, usually occurring in the deep soft tissues of the distal tendons and aponeurosis of the extremities, especially the feet and knees. CCS originating in the head and neck is extremely rare. The clinical manifestations of CCS in the head and neck are not typical, and the imaging manifestations have certain characteristics, but the diagnosis still depends on pathological examination and genetic testing.CASE SUMMARYA 33-year-old male patient had paroxysmal headache for more than 4 years, accompanied by nausea and vomiting, which could be relieved after rest. Computed tomography angiography showed a left paraspinal soft tissue mass. Contrast-enhanced imaging showed obvious uneven enhancement with adjacent bone lytic destruction. Magnetic resonance imaging examination showed isosignal on T₁-weighted images, slightly high signal on T₂-weighted images (T₂WI), high signal on Tirm fat suppression sequence, significantly high signal on diffusion weighted imaging, and obvious and uneven enhancement. The lesion invaded the anterior medulla oblongata through the left atlantoaxial foramen and compressed the cervical spinal cord on T₂WI. Primary CCS of soft tissue was diagnosed by pathology and genetic examination.CONCLUSIONCCS should be considered in the differential diagnosis of soft tissue tumors of the head and neck, and their diagnosis depends on pathological examination and genetic testing.     

肺透明细胞瘤1例报道

肺透明细胞瘤是一种较罕见的肿瘤,1963年由Liebow和Castleman[1]首次描述。病理诊断易与肺部其他恶性肿瘤相混淆。本文报告1例,并结合文献复习讨论该肿瘤的诊断及鉴别诊断。     

面部巨大血管外皮肉瘤1例

病例 女,65岁.左面部肿块15年,近3年来肿块迅速长大并间断伴有肿块表面少量出血而入院.左侧面部可见一15cmx12cmx12cm大小肿块,质软、饱满、皮温高,肿块表面可见增粗迂曲血管,呈蚯蚓状,未扪及波动感.体位移动试验( ).透光试验(一).     

Clear cell myoepithelial carcinoma of the breast: a case report

Primary clear cell myoepithelial carcinoma (CCMC) is extremely rare. During the past twenty years, only one CCMC case has been reported. Here, a case of CCMC is reported. A 30-year-old woman became aware of an abnormal mass on the left breast, and quadrantectomy was performed. Microscopically, it consisted of tumor cells that had clear cytoplasm and showed an invasive growth pattern. Immunohistochemically, the tumor was positive for alpha-smooth muscle actin, S-100, partly positive for vimentin and epithelial membranous antigen. From these findings, the tumor was diagnosed as CCMC. Most of the clear cell myoepithelial tumors are probably misclassified in other examples. It is expected that the numbers of CCMC may be increased by routinely performing special stains and immunohistochemical stains, even without ultrastructual study.     

Management of soft tissue sarcoma

Sarcomas are rare and unusual neoplasms that can be found in any tissue and can have life-threatening outcomes. Caring for these patients can be a great challenge and requires a multidisciplinary team.     

右侧冈下肌腺泡状软组织肉瘤伴右侧肩胛骨转移1例

病例男,27岁,右肩部疼痛8月余,加重1个月,无明确外伤史。查体：右肩关节活动自如,肩胛盂处轻度压痛,冈下肌处触及一质地较硬实质性软组织肿块,移动度小,皮肤完整,无红肿,皮温正常。CT检查示右肩胛关节盂内下方肩胛颈可见类似哑铃状骨质吸收破坏区,未见明显骨膜反应,