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1.
卵巢转移癌的超声图像特征分析   总被引:1,自引:0,他引:1  
目的:探讨卵巢转移癌的超声图像特征,以提高疾病诊断的准确性。方法选择2008年1月~2012年12月收治的51例卵巢转移癌患者纳入研究,将其作为观察组,并将同期收治的49例卵巢癌患者(A组)、65例卵巢囊腺瘤患者(B组)、50例卵巢交界性肿瘤患者(C组)作为对照组,通过超声图像分析,比较各组患者的图像特征。结果转移癌多为囊实性,边界多清晰,一般囊区≤3个,呈类圆形且内无乳头或实性回声、壁光整。卵巢癌囊性或实性,边界多不清,一般囊区>3个,囊壁不光整或呈不规则形。囊腺瘤与交界性肿瘤也属于类圆形囊区,但囊中实性成份较多。观察组的血流频谱获及率明显高于B、C两组,RI平均值明显低于B、C两组,伴腹水率明显高于B、C两组,组间差异有统计学意义(P<0.05)。结论卵巢转移癌具有特征性的超声图像表现,这是与卵巢癌、囊腺瘤、交界性肿瘤等疾病鉴别的重要指标。  相似文献   

2.
腹膜上皮样间皮瘤和广泛腹膜转移的浆液性癌通过组织学形态鉴别往往比较困难,但如果使用免疫组织化学及电镜方法则会比较容易诊断。D2-40和podoplanin是最近认识的淋巴管内皮标记,它们在正常间皮细胞和间皮瘤中都可以表达。为了比较这两种抗体同以往使用的间皮标记在鉴别间皮瘤  相似文献   

3.
目的:总结18例肝细胞癌胆管转移的影像学特征,探讨超声诊断本病的依据及与胆管癌的鉴别诊断。方法:回顾性收集749例阻塞性黄疸的临床资料,对其中18例经手术、病理证实为肝细胞癌胆管转移的影像资料进行分析。结果:18例肝细胞癌胆管转移约占全部阻塞性黄疸病例的2.4%,超声诊断本病的符合率约66.7%(12/18)。主要超声表现为:肝实质回声增强增粗,分布欠均匀,部分(10/18)肝内可见边界模糊、形态不规则的强回声斑块;胆总管上段及肝内胆管明显扩张,在扩张的胆管下端可见较规则的实性肿块,以椭园形等回声居多(11/18);肿块与胆管壁的界限大多清楚(15/18),胆管壁无增厚及回声增强,胆管腔无鼠尾状狭窄。结论:肝细胞癌胆管转移有其特征性图像,有别于胆管癌,若结合CDFI或介入穿刺细胞学检查可提高诊断的符合率。  相似文献   

4.
将解放军总医院病理科电镜室开始应用于病理诊断从1984年至1991年中每年的活检例数、电镜检查总例数、活检电镜诊断例数进行统计分析,8年中总活检为92 264例,总电镜检查数是6814例,活检诊断电镜数2183例,占活捡总数的2.37%。2183例中前5位的标本是神经组织、消化道、肺、软组织和泌尿生殖道。从已经总结出来的光镜诊断与电镜诊断比较结果看,233例中电镜更正诊断117例,占50.2%。我们认为,在我国目前病理诊断现状中,应努力使电镜诊断提高到活检总数的3%,同时密切与光镜诊断结合,以提高病理诊断水平。  相似文献   

5.
上皮样间皮瘤,特别是那些呈乳头状和管状乳头状生长的间皮瘤,与原发性或转移性浆液性乳头状癌弥漫累及腹膜者很难鉴别。1998年一个研究报道有16种标记在间皮瘤的诊断中有一定的价值,该项研究认为,calretinin、thrombomodulin和CK5/6是间皮瘤最好的诊断指标,MOC-31、B72.3、Ber—EP4、CA19—9和Leu—M1(CD15)在间皮瘤中表达阴性,可用于区分腹膜上皮样恶性间皮瘤和乳头状浆液性癌弥漫累及腹膜。D2-40和podoplanin是2个最近认识的淋巴管内皮细胞标记物,它们也表达于正常间皮细胞和间皮瘤。为了比较这两种新的间皮细胞标记和以前其他用于间皮瘤和浆液性癌鉴别诊断的标记的特异性,  相似文献   

6.
Tornos  C  Soslow  R  Chen  S  黄文斌 《临床与实验病理学杂志》2005,21(6):742-742
乳腺癌患者的长期生存率正在逐渐增加,其中部分病人在生存期内有可能发生其它肿瘤。乳腺癌患者发生卵巢恶性肿瘤呈上升趋势,对于这些病人来说,鉴别是卵巢原发性恶性肿瘤还是乳腺癌转移至卵巢非常重要,因为二者的治疗和预后是不一样的。由于ER和PR在卵巢癌和乳腺癌中都有较高的阳性率,因此它们在二者的鉴别诊断中没有价值。WT1和CA125虽然是卵巢癌的一个可能的指标,但在乳腺癌转移至卵巢和卵巢原发性癌中的比较还没有报道。作者应用免疫组化方法研究了39例乳腺癌转移至卵巢、36例原发性乳腺癌和42例原发性卵巢癌中WT1、CA125、CEA、MUC2、MUC1和GCDFP的表达。  相似文献   

7.
患者女,45岁。左侧卵巢肿瘤切除术后8年,月经量增多2年。临床检查:子宫增大至10cm×9cm×7cm,质地较硬,活动受限,盆腔可触及一个直径约4cm肿物,质地中等,表面光滑。手术所见:子宫4cm×16cm×10cm,可触及2个肿物;左侧卵巢缺如,右...  相似文献   

8.
粘附分子CD44与妇癌转移相关性的临床探讨   总被引:2,自引:0,他引:2  
本文应用分子生物学技术流式细胞分析法进行卵巢癌与术后复发者实体瘤组织、外周血粘附分子CD44的含量测定。结果表明:正常人与良性肿瘤外周血CD44含量分别为4.83%、7.62%,明显低于卵巢癌27.01%与复发转移者38.1%(P<0.01)有显著差异,且CD44含量于恶性肿瘤的外周血、腹水、实体组织中均呈高水平表达、其间无明显差异。提示CD44粘附分子与癌转移密切相关。进而文章对CD44在癌转移的作用进行讨论。临床验证认为外周血CD44含量检测可做为患者术后监测疗效观察及癌转移早期诊断指标  相似文献   

9.
223例肿瘤的电镜诊断研究   总被引:4,自引:0,他引:4  
223 neoplasms were submitted to electron microscopic (EM) study and diagnosis during a three-year period. It was demonstrated that EM provided a more precise pathologic diagnosis in 135 cases (60%), corrected the original diagnosis by light microscopy (LM) in 11 cases (5%) and confirmed diagnosis made by LM in 62 cases (28%). Anyhow, EM failed to give a good turn to the diagnosis in 15 cases (7%), because of unsatisfactory specimen provided or improperly processed. EM contributes greatly to the diagnosis of neuroendocrine tumors and the neoplasms from skin and soft tissue. The study verified that EM is of significant diagnostic value, for its capability of more accurately defining the histogenesis of certain tumors.  相似文献   

10.
患者女,44岁。2001年1月起无明显诱因出现下腹部不适感15个月后下腹部疼痛加剧伴停经,在当地医院B超检查示“盆腔多发性肿物,考虑来源于卵巢并腹腔转移”。于2001年6月14日转我院诊治。发病以来,患者精神尚好,无恶心、呕吐,无腹泻、排黑便,无阴道流血,体重减轻约6kg。体检:皮肤、巩膜无黄染,腹胀,肝脾未触及,全腹无压  相似文献   

11.
Metastatic ovarian carcinoma to the breast is rare. It represents a diagnostic challenge to the cytologist. It usually signifies a progressive widespread metastatic ovarian tumor with a poor prognosis. This report evaluates the breast fine-needle aspiration (FNA) cytomorphologic features of six cases of metastatic ovarian carcinoma and compares them to those reported in the literature. The cytologic features included hypercellularity, abundant papillary fragments, and necrotic background. The tumor cells showed high nuclear/cytoplasmic ratio, anisonucleosis, prominent nucleoli, and psammoma bodies in cases of serous papillary carcinoma. In addition, the clear-cell carcinoma had prominent finely vacuolated and clear cytoplasm, multinucleated giant cells, and papillary fragments with hobnail nuclei. Recognition of these unusual patterns in a breast FNA cytology should raise the suspicion of a metastatic ovarian tumor. Direct comparison between the breast FNA cytology and the original primary ovarian tumor should confirm the diagnosis. The proper diagnosis of metastatic ovarian cancer to the breast will prevent unnecessary surgical treatment and ensure the appropriate therapy. Diagn Cytopathol 1996;15:1–6. © 1996 Wiley-Liss, Inc.  相似文献   

12.
Urothelial carcinoma (UC) is the most common malignant neoplasm of the urinary tract. Metastases of UC are most common in the regional lymph nodes, lungs, liver, bone, and adrenal glands. Fine-needle aspiration cytology diagnosis of such metastases can be difficult, particularly in the setting of incomplete clinical history or when multiple primary neoplasms may be present. This review focuses on the cytologic features helpful in differentiating UC from its potential mimics, as well as ancillary studies that may be helpful in the distinction.  相似文献   

13.
Carcinoma of the prostate is predominantly a disease of older men. Men younger than 50 years of age account for approximately 1% of all patients diagnosed with prostate cancer. Patients generally present with urinary symptoms and rarely with metastatic disease. Lymphatic spread typically occurs to the obturator and internal iliac nodes. We report a case of an aggressive prostate adenocarcinoma in a 47-year-old white male who presented with nausea, vomiting, and enlarged inguinal lymph nodes for 1 month. A fine needle aspiration biopsy (FNAB) and immunohistochemical stains performed on the FNAB revealed metastatic prostatic adenocarcinoma. The initial clinical presentation of inguinal lymphadenopathy, the age of the patient and the cytologic features made this an unusual case.  相似文献   

14.
To test the possibility of immunohistochemical differentiation of cytostatically treatable metastatic breast carcinomas from other metastatic adenocarcinomas of unknown primary site, we studied a total of 328 metastatic adenocarcinomas including 35 bronchogenic, 26 pancreatic, 25 colonic, 39 gastric, 45 renal, 29 ovarian and 129 breast carcinomas with a panel of 13 commercially available monoclonal antibodies. The expression of gross cystic disease fluid protein 15 and/or oestrogen or progesterone receptors had a sensitivity of 0.83, a specificity of 0.93 and a predictive accuracy of 0.92 for carcinomas of the breast against all other carcinomas. Excluding ovarian carcinomas, this combination had a sensitivity, specificity and predictive accuracy for mammary carcinomas of 0.83, 0.98 and 0.98, respectively. Carcinoembryonic antigen and/or cytokeratin 20 identified bronchogenic, gastric, pancreatic and colorectal carcinomas versus breast carcinomas lacking gross cystic disease fluid protein 15 and oestrogen or progesterone receptors with a sensitivity, specificity and predictive accuracy of 0.82, 0.99 and 0.95, respectively. Vimentin differentiates renal cell carcinomas from gross cystic disease fluid protein 15 and oestrogen or progesterone receptor negative breast carcinomas with a sensitivity, specificity and predictive accuracy of 0.93, 0.82 and 0.84. Thus, it should be possible to differentiate most metastatic mammary carcinomas from metastatic adenocarcinomas of other common primary sites, even if the former lack expression of gross cystic disease fluid protein 15 and oestrogen or progesterone receptors.  相似文献   

15.
Secondary (metastatic) neoplasms to the ovary often cause diagnostic problems, especially those tumors that produce large, symptomatic ovarian tumors that masquerade clinically and pathologically as primary ovarian tumors of surface epithelial type. Most of these tumors arise from organs of the digestive system. Except for typical Krukenberg tumors, which usually originate in the stomach and generally are easily recognized, the most diagnostically problematic secondary ovarian tumors are those that originate in the large intestine, appendix, and pancreas. Metastases from these sites typically produce histologic patterns resembling primary ovarian endometrioid carcinoma or mucinous epithelial neoplasms of borderline and malignant types. This review focuses on the diagnostic challenge of distinguishing these secondary ovarian tumors from primary ovarian neoplasms. Studies on useful or potentially applicable immunohistochemical stains are also detailed.  相似文献   

16.
17.
Metastatic renal cell carcinoma of the nasal cavity is very rare. A 76-year-old man presented with epistaxis and admitted to our hospital. His past histories were right radical nephrectomy for renal cell carcinomas at the age of 68 years and brain infarction at the age of 75 years. Laryngoscopic examination revealed a red polyp of the right nasal cavity. Imaging modalities including CT and MRI also revealed a tumor measuring 2 x 3 x 2 cm. Angiography showed that the tumor is very hypervascular. Clinical diagnosis was angiogenic tumors including hemangioma, sinonasal hemangiopericytoma, and paraganglioma. A blood data showed anemia and low platerets, and bone marrow biopsy revealed myelodysplastic syndrome. A coiling embolization of the feeding artery was performed, and the tumor reduced markedly. The tumor was resected almost entirely. Pathologically, the tumor was 2 x 1.5 x 1.5 cm red tumor. The tumor cells had clear cytoplasm, and arranged in a trabecular pattern lined by a layer of endothelial cells. Atypia is mild. Immunohistochemically, the tumor cells were positive for pancytokeratin (AE1/3, CAM5.2), RCC ma, CD10, and Ki-67 (labeling=20%), but negative for CD34, factor-VIII-related antigen, CEA, EMA, melanosome (HMB45), S100 protein, p53, and HepPar-1. The pathological diagnosis was made without knowledge of kidney status. A pathological diagnosis of metastatic renal cell carcinoma of clear cell type (grade 1) was made. The patient is now free from tumor, and palliative chemoradiation is considered.  相似文献   

18.
随着现代肿瘤诊断技术和治疗方法的提高,恶性肿瘤的生存率得到了显著的提高.肿瘤发病率的增长、带瘤生存时间的延长,必然会增多肿瘤全身转移的机会.微创治疗的出现给转移性脊柱肿瘤带来了新的选择,并以创伤小、疗效好、并发症少等优点在脊柱转移性肿瘤领域有广泛的应用前景.对于目前脊柱转移性肿瘤的微创治疗进行综述,对微创治疗最新进展进行比较.认为微创治疗的联合运用是今后脊柱转移性肿瘤治疗的热点. Abstract: With the development of modem tumor diagnostic techniques and therapies, the survival rate of malignant tumor has been remarkably increased. With the increase in survival rate of cancer-beating patients, the chance of tumor metastasis is elevated. Minimally invasive treatment provides a new strategy to the therapy of spinal metastatic carcinoma. Its benefits include smaller surgical wound,, higher efficacy and fewer complications, and thus have a broad application prospects in the field of spinal metastatic tumors. In this article, a general re-view is given on minimally invasive treatments of spinal metastatic carcinoma, as well as the latest progress in the field. It was proposed that the united application of the treatment might be a promising hot spot of tumor therapy.  相似文献   

19.
The identification of a site of origin and direction of differentiation for metastatic neoplasms is clinically important, but is often difficult purely by cytologic analysis of aspirated material. Cytologic separation of metastatic urothelial carcinoma (UC) from other moderate or poorly differentiated epithelial malignancies is difficult, with few cytologic criteria identified in the literature as valuable for this distinction. Several investigators have suggested that "cercariform cells" (CCs) are highly correlated with the presence of metastatic UC. We statistically analyzed the utility of 37 cytomorphologic features for the recognition of urothelial differentiation in a series of 26 metastatic UCs, 10 metastatic squamous cell carcinomas (SCCs), and 15 metastatic adenocarcinomas (ADCs). All specimens had been obtained from metastatic deposits in the lung, liver, lymph nodes, or soft tissues. Stepwise discriminate function analysis with all three diagnoses showed that the strongest discrimination could be made using the findings of waxy metaplastic cytoplasm, with significant increments in prediction added by analysis for (CCs) followed by spindle cells, multiple nucleoli, and columnar-shaped cells. The combination of these five variables accurately predicted 90% of all diagnoses, including 26 accurate diagnoses of UC, 9 accurate diagnoses of SCC, and 11 accurate diagnoses of ADC. CCs were present in highest numbers in UCs and present least frequently in cases of poorly differentiated ADC. While CCs were useful in the identification of UC, CCs occurred in a significant number of SCCs, limiting their diagnostic value as a single variable.  相似文献   

20.
目的 探讨脾原发性恶性肿瘤临床病理特征和手术中无瘤技术原则。方法 结合四例病例报告,回顾性分析脾原发性恶性肿瘤相关临床病理资料,总结出一系列无瘤技术原则和手术方法。结果 本组病例均完成了手术切除,并经病理证实,其中脾恶性纤维组织细胞瘤(MFH)1例,非何杰金氏淋巴瘤(NHL)3例,术后生存最长者4年5个月仍健在。结论 本病治疗的基本术式为脾加胰体尾部切除术;术中操作应严格遵循无瘤术原则。术后辅助性化疗能够对生存率有一定的提高。  相似文献   

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