附睾横纹肌肉瘤1例

附睾横纹肌肉瘤很少见,恶性程度高。2000年我院收治1例,现报告如下。 患者,16岁。1996年偶然发现左阴囊内肿块,无疼痛、发热。4年来肿块呈进行性增大。2000年在当地医院诊断为“左附睾结节”,于同年5月行左     

肾上腺血管肉瘤1例并文献复习

血管肉瘤是一组不同的软组织肉瘤,起源于血液和淋巴管,好发于老年人以及既往有放疗或淋巴水肿患者,发生在肾上腺的血管肉瘤非常罕见。肾上腺血管肉瘤源自肾上腺皮质,病因因素和生物学行为仍然不清楚。本文报告1例肾上腺血管肉瘤患者,行腹腔镜下肾上腺病损切除术,术后病理检查及免疫组化结果确诊为肾上腺血管肉瘤。结合该病例,本文复习国内外有关资料对其诊疗进行相关总结。     

上臂横纹肌肉瘤并发肱骨病理性骨折一例报道及文献复习

1临床资料 患者,男,35岁,因＂骑车摔倒后右上臂疼痛伴右手麻木无力4小时＂急诊入院。入院查体：患者右上臂中段局部肿胀,皮温稍高,压痛明显,右肩关节活动明显受限,右手垂腕,背伸无力,右手拇指、食指、中指及环指桡侧麻木;辅助检查：右上臂X线片提示右肱骨中段粉碎骨折（不除外病理性骨折）（图3）;     

横纹肌肉瘤乳腺转移一例

患者女性 ,16岁 ,因右乳腺包块 2周入院 ,无发热、疼痛及其它不适。查体 :右乳腺可触及 1个约 1 5ｃｍ× 1 2ｃｍ大小包块 ,质中等 ,表面光滑 ,边界清 ,无压痛 ,考虑为右乳腺纤维腺瘤 ,即于门诊行右乳腺包块切除。病理报告 :肿物由小圆细胞组成 ,作弥漫排列 ,细胞核大深染 ,有明显异形性。病理诊断 :右乳腺小细胞恶性肿瘤 ,组织来源不清。入院后 1周患者突然出现第 8胸髓平面以下截瘫 ,ＭＲＩ诊断Ｔ7 9椎管内硬膜外神经纤维瘤。手术探查 :肿瘤位于Ｔ7 9椎管内、硬脊膜外 ,大小约 5 5ｃｍ× 3 0ｃｍ× 1 5ｃｍ ,暗红色 ,质中等 ,边界清 ,即…     

成人膀胱横纹肌肉瘤2例报告及文献复习

目的 探讨成人膀胱横纹肌肉瘤的临床特征及诊疗特点.方法 回顾性分析2例成人膀胱横纹肌肉瘤患者的临床资料并进行文献复习.结果 1例行膀胱部分切除术,术后给予VAC方案化疗4周期及放疗,随诊24个月,未见复发;1例行膀胱全切,术后拒绝放、化疗,8个月后死于远处转移.术后病理诊断为膀胱横纹肌肉瘤.结论 成人膀胱横纹肌肉瘤罕见,需病理确诊,治疗需手术结合放化疗.     

成人膀胱横纹肌肉瘤2例报告及文献复习

目的 探讨成人膀胱横纹肌肉瘤的临床特征及诊疗特点.方法 回顾性分析2例成人膀胱横纹肌肉瘤患者的临床资料并进行文献复习.结果 1例行膀胱部分切除术,术后给予VAC方案化疗4周期及放疗,随诊24个月,未见复发;1例行膀胱全切,术后拒绝放、化疗,8个月后死于远处转移.术后病理诊断为膀胱横纹肌肉瘤.结论 成人膀胱横纹肌肉瘤罕见,需病理确诊,治疗需手术结合放化疗.     

前列腺胚胎性横纹肌肉瘤1例报告并文献复习

目的探讨前列腺胚胎性横纹肌肉瘤的诊治方法。方法分析1例前列腺胚胎性横纹肌肉瘤患者的临床资料,并结合文献进行复习。结果患者在前列腺根治性切除术后行异环磷酰胺、阿霉素化疗加用泌尿系统保护剂美司那。术后1年发现膀胱转移瘤,施行膀胱根治性切除术,随访15个月未见病灶复发或扩散,患者无瘤存活。结论前列腺胚胎性横纹肌肉瘤CT检查表现为软组织肿块,密度近似于正常肌肉,仅能提示前列腺稍大,对早期诊断价值不大,需经病理检查才能确诊。治疗以根治性手术为主,辅以化疔。我们采用异环磷酰胺、阿霉素化疗加关司那疗效较好,值得临床进一步证实。     

成人肝脏腺泡状横纹肌肉瘤1例并文献复习

背景与目的：横纹肌肉瘤（RMS）是具有横纹肌分化特征的恶性肿瘤,是儿童和青少年最常见的软组织肉瘤,在成年人中罕见。本文回顾1例成人肝脏腺泡状横纹肌肉瘤（ARMS）诊治经过,结合既往文献对本病特点进行复习,以期为临床工作提供经验借鉴。方法：回顾中国人民解放军联勤保障部队第九二〇医院病理科会诊的1例肝脏ARMS,分析该患者的临床资料、病理组织形态以及免疫组织化学染色结果,结合前期文献资料进行总结。结果：患者,男,43岁。因肝脏占位就诊于当地医院肝胆外科,术前腹部CT示肝S8段占位性病变并肝门区、腹膜后及腹主动脉旁多发淋巴结转移,于外院行中肝肿瘤及腹腔结节切除术。镜下见肿瘤细胞排列成巢状、实性片状,部分为腺泡状结构,腺泡间为纤维血管间隔。瘤细胞圆形或卵圆形,大小较一致,胞质较少,核深染,部分瘤细胞具有纤细的空泡状染色质和小的核仁,核分裂象易见。免疫组化结果显示瘤细胞表达myogenin、MyoD1、desmin。病理诊断为ARMS,术后患者未接受辅助放化疗,术后7个月因肝脏ARMS复发并出现输尿管、脊柱及全身多发淋巴结转移死亡。结论：在临床诊疗过程中,若发现影像学和甲胎蛋白水平不能完全符合肝...     

小儿生殖道横纹肌肉瘤3例并文献复习

目的探讨小儿生殖道横纹肌肉瘤的临床特征、治疗方法及预后情况。方法对我院1985年11月至2008年7月间收治的小儿生殖道横纹肌肉瘤(RMS)患者进行回顾性分析,并复习相关文献。结果小儿生殖道RMS患者3例,占同期小儿妇科恶性肿瘤的5.4%(3/56)。年龄1～5岁。阴道RMS 2例,盆腔RMS 1例;按国际横纹肌肉瘤协会(IRS)分期均为Ⅲ期。初期均进行保守性手术,并联合化疗,均达到完全缓解。2例阴道RMS分别随诊30、13个月无复发。1例盆腔RMS初期治疗停化疗1年复发,予复发病灶切除,并行联合化疗,完全缓解6个月,6个月后出现肺转移,放弃治疗后死亡。结论生殖道是小儿RMS的常见部位,阴道RMS最为常见,强调综合治疗,保守性手术是可行的。预后取决于肿瘤的组织学亚型、大小、病变范围、初始部位、治疗后残留病灶情况及年龄。     

睾旁胚胎型横纹肌肉瘤1例报告并文献复习

<正>横纹肌肉瘤临床少见,而发生于睾旁横纹肌肉瘤更罕见。近期我院收治1例阴囊鞘膜胚胎型横纹肌肉瘤患者,结合文献复习如下。1病例资料患者,男性,19岁,主因发现左侧阴囊肿物1个月入院。1个月前,患者无意间触及左侧阴囊内约2 cm×1 cm×1 cm实性肿物,无触痛,无发热,亦无阴囊皮肤红肿,患者未行特殊诊治。此后患者左侧阴囊肿物逐渐增大,但无疼痛及发热等。查体:双侧阴囊、睾丸及附睾未触及异常,于左侧阴囊内可触及     

Primary Rhabdomyosarcoma of the Diaphragm: Case Report and Review of the Literature

Background

Diaphragmatic sarcomas are extremely rare and mostly described in children. We present the case of an adult with rhabdomyosarcoma of the diaphragm.

Methods

We performed a literature review, highlighted possible diagnostic pitfalls, and discussed multidisciplinary treatment options.     

Rapid Growth of a Retroperitoneal Rhabdomyosarcoma Following Right Hemicolectomy for Ascending Colon Cancer: Report of a Case

(Received for publication on Feb. 2, 1999; accepted on Nov. 11, 1999)     

Rhabdomyosarcoma in the region of the sella turcica

Summary Intracranial extension of rhabdomyosarcoma from the face, nasopharynx or middle ear is rare.A 16-year-old boy presented with deterioration of vision and headache. CT scan revealed a soft tissue mass occupying the sphenoid and ethmoid sinuses, extending to the suprasellar fossa and impinging on the optic chiasm. The tumour, mimicking pituitary carcinoma, was removed by transsphenoidal craniotomy. Morphologic studies, including immunohistochemistry and electron microscopy, revealed that the tumour was a rhabdomyosarcoma. This case stresses the value of immunohistochemical and ultrastructural studies in the diagnosis of tumours occurring in the region of the sella turcica. The origin of this tumour was thought to be the sphenoid or ethmoid sinus. The pituitary gland appeared intact.     

Sclerosing Rhabdomyosarcoma: Presentation of a Rare Sarcoma Mimicking Myoepithelial Carcinoma of the Parotid Gland and Review of the Literature

Sclerosing rhabdomyosarcoma (SRMS), a recently characterized variant of rhabdomyosarcoma, can pose a significant diagnostic challenge given its rarity and its histological similarity to other malignancies. SRMS is characterized by dense hyalinized or sclerosing collagenous matrix and a pseudovascular pattern of growth. SRMS shares histologic similarities with several mesenchymal tumors including: leiomyosarcoma, osteosarcoma, chondrosarcoma, angiosarcoma, and sclerosing epithelioid fibrosarcoma. We herein report a case of SRMS mimicking a myoepithelial carcinoma of the parotid gland. The tumor contained small, spindled, and epithelioid tumor cells lining pseudovascular spaces within a dense hyalinized stroma. Initial stains for keratins, S100 and p63 were negative. However the tumor cells showed desmin and myogenin positivity. The tumor was negative for FKHR gene rearrangements and showed no MDM2 gene amplification. This is the second case of SRMS to be diagnosed in the parotid gland highlighting the potential for misdiagnosis as a primary salivary gland epithelial malignancy.     

阴茎原发性外周T细胞淋巴瘤(附1例报道及文献复习)

目的:报道1例阴茎原发性外周T细胞淋巴瘤并文献复习。方法:运用组织学、细胞化学和免疫组织化学技术对1例阴茎外周T细胞淋巴瘤进行光镜观察和免疫标记并结合文献就该类肿瘤的临床病理特征进行探讨。结果:患者为老年男性,临床上以阴茎肿胀为首发症状,并龟头糜烂溃疡和腹股沟淋巴结肿大。病理组织学表现为表皮溃疡,肿瘤细胞血管呈浸润性生长伴肿瘤性坏死,肿瘤细胞多形性,核分裂多见,并血管增生。免疫组织化学显示肿瘤细胞CD43和CD3强阳性,CKpan,CD20,CD79 a,CD30、CD56和CD34阴性。临床按外周T细胞淋巴瘤行化疗有效。结论:阴茎原发性外周T细胞淋巴瘤是一种罕见的恶性肿瘤,诊断依赖于病理检查和免疫组化标记,并需要与低分化鳞状细胞癌和其他类型淋巴瘤鉴别。     

盆腔输精管包裹性脓肿1例报告并文献复习

目的:探讨盆腔输精管包裹性脓肿的临床特点、诊断要点、误诊原因以及治疗方法。方法:报告1例盆腔输精管包裹性脓肿患者的临床资料,结合文献复习进行讨论。结果:经腹行盆腔包裹性脓肿切开引流术。术后1d拔除尿管后患者能自行排尿,无排尿困难,术后3d拔除盆腔引流管,术后随诊1年未见脓肿复发,排尿无障碍。结论:盆腔输精管脓肿如形成纤维包裹容易误诊,应详细分析病史、体征以及辅助检查,才能作出正确的诊断。外科治疗是最有效的方法。     

Unusual Clinical Presentation of a Meningeal Melanocytoma with Seizures: Case Report and Review of the Literature

Summary  The 17th case of an intracranial meningeal melanocytoma is presented in a 67-year old man. It is the 6th melanocytoma arising from the cavum Meckeli and the first presenting with seizures. Surgical removal was curative for a follow up period of 32 months. Besides the clinical and neuroradiological presentation, the histological, ultrastructural and immunohistochemical features are described. A review of the literature including cases with malignant transformation is given and differential diagnostic problems are discussed.     

Sclerosing Rhabdomyosarcoma: Report of a Case Arising in the Head and Neck of an Adult and Review of the Literature

Sclerosing rhabdomyosarcoma is a unique rhabdomyosarcoma variant, characterized by a prominent hyalinizing matrix. A notable pitfall is the potential for the unusual matrix and often pseudovascular growth pattern of this lesion to lead to confusion with other sarcoma types, including osteosarcoma, chondrosarcoma, and angiosarcoma. Here we report a case of sclerosing rhabdomyosarcoma arising in a 40-year old male. The tumor was centered in the pterygomaxillary fossa with extensive infiltration into adjacent structures. Fine needle aspiration yielded a preliminary diagnosis of high-grade pleomorphic undifferentiated sarcoma, for which he received neoadjuvant chemotherapy and surgical resection. Microscopic examination showed a malignant spindled to round cell neoplasm with prominent osteoid-like, hyaline stroma. Focal rhabdomyoblastic differentiation and diffuse immunoreactivity for desmin and myogenin aided in diagnosis. Nineteen months status post primary resection, the patient expired with multiple lung and bony metastases. Among 39 cases reported thus far (including the present case), there is a broad age range (0.3–79 years), with an average age at presentation of 27 years. The most commonly involved sites are the extremities (n = 19) and head and neck (n = 15). Most cases have been treated by resection, often combined with radiation and/or chemotherapy. Out of 31 cases with follow-up information provided, 6 patients developed local recurrence, 7 patients developed regional or distant metastasis, and 5 patients died of disease. Herein we discuss the ongoing controversy regarding how sclerosing rhabdomyosarcoma might best fit into existing rhabdomyosarcoma classification schemes, based upon current clinicopathologic and molecular genetic evidence.     

精囊原发性Burkitt淋巴瘤1例报告并文献复习

目的:报告精囊原发性Burkitt淋巴瘤(BL)的临床病理特征。方法:对1例精囊原发性BL的临床特征、组织学、免疫组织化学和原位分子杂交进行观察,并结合文献探讨其病理形态及鉴别诊断。结果:本例临床表现以尿频和排尿困难为特征,发病2个月后出现腹股沟淋巴结肿大。影像学显示病灶精囊呈低密度阴影,组织学呈弥漫单一性中等大小肿瘤细胞浸润性生长伴肿瘤性坏死,核分裂易见并有"星空"图象。免疫标记肿瘤细胞表达CD10、CD20、CD79α和Bcl-6,而CD3、CD5、CD23、MPO、Bcl-2、CyclinD1和TdT缺乏表达,肿瘤细胞Ki-67增殖指数>95%,原位杂交检测肿瘤细胞EBER阳性。结论:精囊原发性BL是一种非常罕见的高度恶性的肿瘤,病程进展快,诊断时应除外精囊外BL累及,确诊依赖病理组织学和实验室检查,并需要与精囊或前列腺发生的弥漫性大B细胞性淋巴瘤、淋巴母细胞淋巴瘤和小细胞癌鉴别。