Penoscrotal reconstruction using groin and bilateral superomedial thigh flaps: a case of penile vaselinoma causing Fournier's gangrene

Penile augmentation by the injection of mineral oil provokes many serious, undesirable effects. Although there are reports of complications such as deformity, ulceration, necrosis, and erectile dysfunction, Fournier's gangrene resulting from the injection of petroleum jelly into the penis has not been reported. Here, we present a 42-year-old man with penile vaselinoma causing Fournier's gangrene which was treated successfully with aggressive surgical debridement, followed by penoscrotal reconstruction using groin and bilateral superomedial thigh flaps.     

阴股沟皮瓣修复男性会阴部皮肤软组织缺损及文献复习

目的观察利用阴股沟皮瓣修复男性会阴部皮肤软组织缺损的效果。方法 2005年1月至2009年12月间应用阴股沟皮瓣修复男性会阴部皮肤软组织缺损8例,皮瓣面积为5cm×6cm～9cm×15cm,修复创面面积为4cm×5cm～12cm×14cm。并对PubMed收录相关文献进行检索。结果 8例皮瓣成活良好,效果满意,仅1例患者皮瓣远端形成水泡,局部表皮坏死,经换药愈合。PubMed中收集到文献6篇,其中英文文献5篇,中文文献1篇,共计54例病例,其中英文病例31例,中文病例23例,对病例进行回顾分析。结论阴股沟皮瓣血运丰富,抗感染能力强,术后外观良好,是修复男性会阴部皮肤软组织缺损的良好方法 。     

大腿球血管肌瘤一例

患者女,24岁。因左大腿反复疼痛4年于2006年6月7日入院。体检：左大腿中下段前内侧触及一肿物,大小约2am×3am×1am,质软,有压痛,可活动。B超示：左大腿皮下脂肪与肌层间见低回声区,性质待查。CT示：左股骨下端皮下脂肪与股内侧肌之间异常信号,海绵状血管瘤可能大。临床以左大腿肿块性质待查行手术切除。     

浅表宫颈阴道肌纤维母细胞瘤的临床病理学观察

目的探讨浅表宫颈阴道肌纤维母细胞瘤（superficial cervicovaginal myofibrohlastoma,SCVM）的临床病理学特点、免疫表型、超微结构和鉴别诊断。方法对1例发生于阴道和穹隆部的SCVM进行组织学观察、免疫组化标记和电镜检测。结果患者,63岁,因阴道分泌物增多1个月并扪及有肿物自阴道口突出就诊。妇检于阴道右前壁上方和阴道左上穹隆处可见直径分别为3cm和1．1cm的带蒂肿块。大体上,肿块均呈椭圆形,边界清晰。低倍镜下,肿瘤位于黏膜下,呈卵圆形,与周围组织分界清楚,但无包膜。位于肿瘤浅表或周边区域内的瘤细胞成分相对稀疏,间质呈黏液样或水肿样;位于中心区域内的瘤细胞相对密集,细胞之间可见纤细、致密的胶原纤维。高倍镜下,瘤细胞由形态基本一致、淡嗜伊红染的梭形细胞和星状细胞组成,瘤细胞无明显的异型性,核分裂象罕见（〈2个／50HPF）。在瘤细胞稀疏、问质呈黏液样的区域内,瘤细胞多呈短条束状、网格状、花边状或筛孔状排列,或排列紊乱,偶见多核性细胞;在瘤细胞密集、间质富含胶原纤维的区域内,瘤细胞多呈条柬状或波浪状排列,并与胶原纤维的走向一致。肿瘤内含有散在分布的薄壁血管,间质内可见丰富的肥大细胞,并见少量的慢性炎细胞浸润。免疫组化标记显示,瘤细胞强阳性表达vimentin、desmin、ER和PR,灶性表达CD34,不表达EMA、α-SMA、MSA、hcaldesmon、NF、S-100蛋白、CD57和calretinin等。电镜检测显示瘤细胞部分具肌纤维母细胞分化。结论SCVM是一种起自于女性阴道和宫颈黏膜下浅表基质的良性间叶性肿瘤,其独特的组织学形态提示SCVM可被视为一种新的病种。免疫表型和超微结构均显示瘤细胞具肌纤维母细胞分化。SCVM应注意与同样好发于女性下生殖道的一些间叶性病变相鉴别。     

Malignant chondroid syringoma of the thigh. Report of a case with electron microscopy of the tumour.

A case of malignant chondroid syringoma occurring in a 52-year-old female is reported. The tumour presented as a large, cystic lesion of the thigh. Local recurrence and secondary deposits in the inguinal region occurred at an early stage. The rarity of these malignant tumours and metastasising sweat gland tumours in general is emphasised.     

Internal carotid artery agenesis with stenosed intercavernous anastomosis:a case report

We report a rare case of internal carotid artery agenesis with stenosed intercavernous anastomosis.A 59-yearold male patient presented with a new infarction in the left basal ganglia.Magnetic resonance angiography and cerebral angiography showed that the right internal carotid artery disappeared from the origin to the foramen lacerum segment,and there was an anastomotic artery with severe stenosis passed through the floor of the sella and in front of the cavernous sinus.The right A1 segment of the anterior cerebral artery was absent and A2 segment was supplied by the normal contralateral internal carotid artery via the anterior communicating artery.     

Metastatic lobular mammary carcinoma diagnosed in cervicovaginal smears: a case report

Lobular carcinoma of the breast uncommonly metastasizes to the cervix. We report a case of lobular carcinoma of the breast with an abnormal cervicovaginal smear caused by metastasis in the cervix. We also discuss the differential diagnosis of primary genital and secondary adenocarcinomas in abnormal cervicovaginal smears.     

Dorsal pancreas agenesis: computed tomography appearance with three-dimensional volume rendering reconstruction

We report a case of a very rare congenital variant consisting in a dorsal (or left) pancreas agenesis due to the lack of development of the dorsal embryonic bud of the gland. This variant is characterized using helical computed tomography (CT). Three-dimensional (3D) computed tomography reconstruction, especially using the volume rendering technique, is very helpful for assessing this entity, which it is important to recognize due to its potential clinical implication (diabetes mellitus). Associated variants of abdominal vessels were also clearly seen in our patient with this technique, including a hepatomesenteric trunk and left retro-aortic renal vein.     

Arias-Stella reaction in a cervicovaginal smear of a woman undergoing infertility treatment: a case report

Arias-Stella reaction commonly is seen in gestational endometrium, but rarely is described outside the endometrium, particularly in nonpregnant women. Although the cytological diagnoses of Arias-Stella reaction by cervical Papanicolaou (Pap) smears in pregnant, postpartum, and postabortal women are documented, to our knowledge, this is the first report of Arias-Stella reaction in a cervicovaginal smear of a nonpregnant woman undergoing infertility treatment with clomiphene and beta-human chorionic gonadotropin (beta-HCG). The cytological features observed in this case were characteristic of Arias-Stella reaction but mimic malignancy leading to initial misinterpretation. It is of paramount importance to recognize this phenomenon in cervical Pap smears, especially in women receiving ovulation-inducing agents and exogenous hormonal treatment to avoid this potential cytological pitfall.     

Unilateral autosomal dominant polycystic kidney disease with contralateral renal agenesis: a case report

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease. There are some reports in the literature concerning unilateral ADPKD. However, in adults, only a few cases of unilateral ADPKD with agenesis of contralateral kidney have been reported. We present a case of unilateral ADPKD with agenesis of contralateral kidney in a 66-yr-old man. Radiographic images showed the enlarged right kidney with multiple variable-sized cysts and the absence of the left kidney. The diagnosis of ADPKD was confirmed by the family screening. The patient received maintenance hemodialysis for endstage renal disease. We report a case of unilateral ADPKD associated with contralateral renal agenesis in a 66-yr-old male patient with a literature review.     

Styloid chain ossification: Report of a case with articulations

A bilateral ossified stylohyoid ligament was observed in a cadaver specimen. On the left side, the stylohyoid chain was markedly enlarged. The stylohyoid ligament was completely ossified into two segments separated by a diarthrodial-like joint. An articulation was also observed between the enlarged styloid process and the ossified ligament. On the right side, the styloid process had a normal appearance. The middle part of the stylohyoid ligament was ossified and it was attached to the styloid process and to the hyoid bone by a fibrous band. Proposed theories to account for the ossification oaf this ligament are discussed. Since the presence of an enlarged and ossified stylohyoid chain can cause much discomfort and pain, a greater understanding of the causative factors responsible for this anomaly is needed to provide for more effective diagnosis and treatment. © 1995 WiIey-Liss, Inc.     

MicroPET reconstruction with random coincidence correction via a joint Poisson model

Positron emission tomography (PET) can provide in vivo, quantitative and functional information for diagnosis; however, PET image quality depends highly on a reconstruction algorithm. Iterative algorithms, such as the maximum likelihood expectation maximization (MLEM) algorithm, are rapidly becoming the standards for image reconstruction in emission-computed tomography. The conventional MLEM algorithm utilized the Poisson model in its system matrix, which is no longer valid for delay-subtraction of randomly corrected data. The aim of this study is to overcome this problem. The maximum likelihood estimation using the expectation maximum algorithm (MLE-EM) is adopted and modified to reconstruct microPET images using random correction from joint prompt and delay sinograms; this reconstruction method is called PDEM. The proposed joint Poisson model preserves Poisson properties without increasing the variance (noise) associated with random correction. The work here is an initial application/demonstration without applied normalization, scattering, attenuation, and arc correction. The coefficients of variation (CV) and full width at half-maximum (FWHM) values were utilized to compare the quality of reconstructed microPET images of physical phantoms acquired by filtered backprojection (FBP), ordered subsets-expected maximum (OSEM) and PDEM approaches. Experimental and simulated results demonstrate that the proposed PDEM produces better image quality than the FBP and OSEM approaches.     

Adrenal gland hypertrophy in a case of homolateral renal agenesis: case report with special emphasis on adrenal blood supply

Hypertrophic suprarenal gland is an anomaly which can lead to serious complications during adrenalectomy under endoscopy because of abnormal veins of the retroperitoneum. The authors report a rare dissection of a male which presented with this anomaly in a case of homolateral renal agenesis, highlighting this left pseudorenal vein. No abnormality of the genital tract was found. The anatomic features, associated syndromes, implications for endoscopic surgery are outlined and embryologic considerations and discussed.