肺鳞状细胞癌脾转移一例

患者　男性 ,70岁。入院前 5个月因左上肺肿物行左上肺叶切除术。术后病理结果 :肺鳞状细胞癌。给予卡铂、ＶＰ 16常规化疗 1个疗程。 2个月前 ,患者自觉左上腹胀痛不适 ,Ｂ超检查发现脾脏肿物。入院后查体未触及脾脏。Ｂ超检查 :脾脏上极内侧可见 5 5ｃｍ× 4 6ｃｍ无回声反射区 ,边界清楚 ,形状欠规则 ,肿物内壁欠光滑 ,呈低弱回声反射 ,周边型分布。ＣＴ检查 :脾上极局部外突型肿物 ,其内低衰灶直径约 4 0ｃｍ× 5 0ｃｍ ,ＣＴ值 10 0～ 18 5Ｈｕ。以“脾脏肿物”进行手术探查。术中发现脾上极肿物大小约 6 0ｃｍ× 3 5ｃｍ× 4 0ｃ…     

肺鳞状细胞癌小肠转移致肠梗阻一例

患者 男，72岁，因腹胀，腹痛，呕吐8d，于2003年9月3日入院，患者发病后曾就诊于当地县医院，诊断为“胰腺炎”给予消炎治疗并行CT检查发现右侧肺门占位性病变，治疗4d病情无缓解而来我院。患者明显咳嗽，咳痰，胸闷，气短等症状。既往有吸烟史30年。查体：体温36.2℃，血压114/72mm Hg(1mm Hg=0.133kPa).全身浅表淋巴     

肺癌伴甲状腺鳞状细胞转移癌一例

正病人,男,62岁。2019年1月11日因颈部不适行甲状腺彩超检查,提示甲状腺弥漫性回声不均,实质性占位(可疑),双侧颈部异常淋巴结肿大。3日后入院。术前全胸片检查提示两肺多发小结节;气管颈7水平变窄。甲状腺CT检查提示:多发甲状腺癌,并双侧颈部多发淋巴结转移可能性大(图1)。术前诊断:(1)甲状腺肿瘤;(2)肺结节。1月16日在全麻下行双侧甲状腺癌根治术、双侧颈区淋巴结清扫术、双侧喉返神经探查术。术后病理检查:甲状腺双侧叶中均可见恶性肿     

胆囊鳞状细胞癌一例临床病理分析

目的 分析胆囊鳞状细胞癌的临床病理、免疫组化、诊断要点、治疗及预后.方法 对1例胆囊单纯性鳞状细胞癌进行临床病理及免疫组织化学特征进行观察分析,并结合相关文献复习.结果 本例行胆囊肿瘤切除术.镜下见肿瘤细胞巢团状浸润性生长,癌细胞宽大、多角形,可见细胞间桥,胞浆丰富,细胞核类圆形,癌巢中央角化珠形成.全部切片未见腺管成分.免疫组化上皮样细胞表达AE1/AE3、34βE12、CK5/6、P40（△Np63）,Ki67指数＜1％,未表达CK19、CK20、CK7、CK8/18、CDX2、MUC2.术后随访半年无复发转移证据.结论 发生在胆囊的单纯性鳞状细胞癌少见,临床表现无明显特异性,血鳞状细胞癌相关抗原（SCCA）有一定参考价值,诊断主要根据病理学检查,尤其是全面的标本取材,辅以免疫组化检测,排除腺鳞癌,治疗以彻底的原发灶手术切除为主.     

58例阴茎鳞状细胞癌治疗的临床分析

目的:提高阴茎鳞状细胞癌的治疗水平,寻求鳞状细胞癌合理有效的治疗方法。方法:回顾分析58例病理活检证实阴茎鳞状细胞癌治疗的临床资料。结果:按照Jackson分期,Ⅰ期25例,Ⅱ期18例,Ⅲ期11例,Ⅳ期4例。53例行手术治疗;行阴茎肿瘤局部切除及阴茎癌部分切除43例;阴茎全切除并尿道会阴部造口术及髂腹股沟淋巴清扫术10例(腹股沟淋巴结均阳性,髂淋巴结阳性1例)。术前新辅助治疗(热疗加化疗)联合术后化疗37例,仅术后化疗12例,单纯手术治疗4例;5例未手术治疗患者行化疗和/或放疗。48例随访2~5年,4例行阴茎部分切除者2年内复发,4例2年内死亡,7例2~5年内死亡,2年生存率为91.7%,5年生存率为77.1%,10例失访或随访期未满2~5年。结论:外科手术治疗、术前新辅助治疗联合术后化疗是目前治疗阴茎鳞状细胞癌的有效方法,淋巴结的清扫根据临床分级具体处理,手术联合术前新辅助治疗及术后化、放疗是否可减少复发及提高生存率,还需进一步研究。     

肾盂鳞状细胞癌临床特点分析

目的 探讨肾盂鳞状细胞癌的诊治特点.方法 回顾性分析1991年10月至2009年5月收治8例肾盂鳞状细胞癌患者资料.临床表现血尿8例,腰痛7例,腹部包块1例.B超检查8例,IVU检查8例,CT检查4例.术前诊断为肿瘤3例,诊断为肾结石5例,结石术中发现肿瘤并经冰冻病理确诊2例.8例患者均经手术治疗,行根治性肾输尿管切除4例、单纯性肾切除3例、姑息性切除术1例.结果 8例病理诊断均为鳞状细胞癌.中分化6例,高分化和低分化各1例;pT1 1例,pT2 1例,pT3 3例,pT4 3例;淋巴结转移2例.获随访7例,失访1例.术后生存时间2～42个月,中位时间6个月,患者均死于肿瘤复发及转移.结论 肾盂鳞状细胞癌恶性程度高,常合并结石,术前诊断困难,确诊时多为中晚期,术后短期内易复发转移,预后极差.

Abstract：

Objective To review the diagnosis and treatment of squamous cell carcinoma of renal pelvis. Methods The clinical data from October 1991 to May 2009 of eight cases of squamous cell carcinoma of renal pelvis were reviewed and analyzed retrospectively. The symptoms of the patients were hematuria (eight cases), pain (seven cases) and abdominal mass (one case). All patients underwent B-ultrasound and IVU examination and four cases underwent CT scan. Three cases were diagnosed as having a tumor before surgery. Five cases were diagnosed as renal calculus, two of the five cases were diagnosed by intraoperative frozen section. Radical nephroureterectomy were performed in four cases, nephrectomy in three cases and palliative resection in one case. Results Histological classification revealed that six cases were moderately differentiated, one case was well differentiated and one case was poorly differentiated. Two cases had stage pT1/pT2 and six cases had stage pT3/pT4. 2 cases had regional lymph nodes metastasis. Seven cases were followed-up. All patients died of tumor recurrence or metastasis. The median tumor specific survive time was six months (range from two months to 42 months). Conclusions Squamous cell carcinoma of renal pelvis is often occurs concurrently with urolithiasis which could lead to difficulty in diagnose before operation. As the most of the patients were diagnosed with advanced stage disease, squamous cell carcinoma of renal pelvis tended to early recurrence and metastasis and the prognosis was very poor.     

结肠鳞状细胞癌4例报告

结肠鳞状细胞癌４例报告天津市肿瘤医院腹科（３０００６０）张汝鹏潘亚文１）崔青皓王殿昌结肠鳞状细胞癌罕见，其发病机理不明。我院于１９８５年９月至１９９４年６月收治４例，均经病理证实，现分析报告如下。１病例报告例１．女，５０岁。以发现右下腹肿物伴疼痛２个...     

82例阴茎鳞状细胞癌临床诊断与治疗

目的：提高阴茎鳞状细胞癌的诊断和治疗水平。方法：回顾性分析1980-2005年82例阴茎鳞状细胞癌患者临床资料,结合文献复习进行讨论。结果：77例病例行手术治疗,其中阴茎部分切除术64例,阴茎全切术13例。阴茎切除加髂腹股沟淋巴结清扫14例（腹股沟淋巴结均为阳性,髂淋巴结均为阴性）。放疗3例,化疗1例,放化疗联合治疗1例。71例患者随访1～10年,5例1年内死亡,17例2～5年内死亡,49例生存5年以上,占69％,其中34例生存10年,占48％,11例失访。结论：包茎、包皮过长是阴茎鳞状细胞癌的重要诱因;HPV感染可能与阴茎鳞状细胞癌发生有关。外科手术治疗是目前治疗阴茎鳞状细胞癌的有效方法;淋巴结清扫范围应采用由浅至深逐级切除的方式;放、化疗及联合治疗疗效尚不确切。     

原发性甲状腺鳞状细胞癌七例分析

目的 提高对原发性甲状腺鳞状细胞的认识。方法 结合文献对我院收治的7例患者进行分析讨论。结果 原发性甲状腺鳞状细胞癌主要临床表现为甲状腺结节短期内迅速增大,伴有声音嘶哑、呼吸困难、体重下降等。肿瘤质硬,固定,边界不清,侵犯喉周围组织及血管,在就诊时已均属晚期且对放、化疗无效。7例患者均于姑息性手术后4个月内死亡。结论 甲状腺鳞癌与甲状腺鳞状细胞化生有着密切的关系,失去手术根治机会者预后极差。因此早期发现和治疗是提高生存率的关键。     

足趾间皮肤鳞状细胞癌1例

成功治疗足趾间皮肤鳞状细胞癌患者1例,报告如下。 1临床资料 患者男性,38岁,10年前出现右足第3、4趾间皮肤溃烂,在多家医院诊断为真菌感染,间断外用达克宁、肤炎宁,口服斯皮仁诺等药物治疗,无好转。2010年6月19日经组织病理活检诊断为右足趾间高分化鳞状细胞癌,     

Testicular metastasis from squamous cell carcinoma of the lung

We present a case of squamous cell carcinoma of the testis that metastasized from lung cancer. The patient, who had received left pneumonectomy 2 years earlier for squamous cell carcinoma (SCC) of the lung, developed pulmonary metastasis, which was treated with chemotherapy. Although the recurrence regressed after treatment, the testicular tumor progressed gradually. Left radical orchiectomy was performed. Pathological examination revealed metastatic SCC. Testicular metastasis from lung cancer is a very rare disease.     

Basal cell carcinoma with lung metastasis

A forty-seven year-old man had a small ulceration on his left cheek. The ulcer had a repeated crust formation following removal, for ten years. The patient found a hard tumor in the deep site of the ulcer and the tumor was resected. The pathological diagnosis was basal cell carcinoma. The metastases to the regional lymph nodes developed one year later and these lymph nodes were resected. The histological picture was the same as seen in the primary tumor. Lung metastasis occurred three years later. The tumor was resected and the pathological diagnosis was basal cell carcinoma. Multiple lung metastases developed one year later and massive hemoptysis led to a sudden death two years after the thoracotomy. Thirty-seven cases of basal cell carcinoma with lung metastases were reported in the literature. This case is the thirty-eighth case and the third occurrence in a Japanese.     

热疗联合化疗与单纯化疗治疗非小细胞肺癌的疗效比较

目的：探讨热疗联合化疗治疗非小细胞肺癌（non—small cell lung carcinoma，NSCLC）的疗效。方法：2003年9月～2006年11月我院对52例NSCLC进行微波热疗联合NP方案化疗联合治疗（热疗联合化疗组），3个周期后评价疗效；并与2006年1～11月16例NSCLC单纯化疗（单纯化疗组）进行对比。结果：热疗联合化疗组近期疗效明显好于单纯化疗组，热疗联合化疗组总有效率（RR）为65．4％（34／52），显著高于单纯化疗组总有效率37．5％（6／16）（Z=-2．419．P=0．016）；热疗联合化疗组结束后疼痛明显改善，单纯化疗组无镇痛作用，差异具有高度统计意义（Z=-6．486，P=0．000）；2组的不良反应主要表现为恶心、粒细胞减少、血小板降低和肝功能异常，差异无显著性（P〉0．05）。结论：热疗联合化疗治疗NSCLC疗效优于单纯化疗治疗NSCLC。     

胆囊鳞癌和腺鳞癌12例临床分析

目的总结原发性胆囊鳞癌和腺鳞癌的诊治经验。方法回顾性分析了解放军总医院肝胆外科1994—2004年收治的胆囊癌12例（鳞癌4例，腺鳞癌8例），男女各6例。结果行根治性手术9例，姑息性手术3例。12例中有11例得到随访，其中2例在1年后死亡，1例在半年后死亡，其余均在半年内死亡。术后中位生存期108d。结论胆囊鳞癌和腺鳞癌恶性程度高，但远处转移较少，有利于手术切除。术后放疗有可能是一个有效的方法。     

胆囊鳞癌和腺鳞癌12例临床分析

目的总结原发性胆囊鳞癌和腺鳞癌的诊治经验。方法回顾性分析了解放军总医院肝胆外科1994-2004年收治的胆囊癌12例(鳞癌4例,腺鳞癌8例),男女各6例。结果行根治性手术9例,姑息性手术3例。12例中有11例得到随访,其中2例在1年后死亡,1例在半年后死亡,其余均在半年内死亡。术后中位生存期108d。结论胆囊鳞癌和腺鳞癌恶性程度高,但远处转移较少,有利于手术切除。术后放疗有可能是一个有效的方法。     

Large cell carcinoma with neuroendocrine morphology of the lung

We experienced a surgical case of large cell carcinoma with neuroendocrine morphology (LCCNM) of the lung. A 76-year-old man was admitted to our hospital because a routine chest X-ray examination had revealed a nodular shadow in the left lung field. 18F-fluorodeoxyglucose positron emission tomography showed accumulation of fluorodeoxyglucose in an area corresponding to the shadow. Transbronchial lung biopsy failed to give a definitive diagnosis, therefore, open lung biopsy was performed because of suspected lung cancer. Needle biopsy was performed, and the tumor was diagnosed as large cell neuroendocrine carcinoma by rapid intraoperative pathological examination. As sampling of hilar lymph nodes revealed no metastasis, left upper segmentectomy was performed for severe obstructive pulmonary disease. Immunohistochemical examination finally diagnosed the tumor as LCCNM. The patient is doing well without recurrence at ten months after surgery.     

Symptomatic renal metastasis 5 years after the management of a squamous cell carcinoma of the lung

A case of solitary renal metastasis five years after the management of a primary squamous cell carcinoma of the lung is presented.     

Single primary lung cancer consisting of three cancer cell types (small cell carcinoma, adenocarcinoma, and squamous cell carcinoma) in which each had metastasized to different lymph nodes

We report a case of a 70-year-old male smoker with a single primary tumor 2.5 x 3.0 cm in size in the right lung lower lobe. A transbronchial lung biopsy revealed squamous cell carcinoma of the lung. We performed right lower lobectomy with lymph node dissection (ND2a). The resected specimen consisted of three different cell types; small cell carcinoma, adenocarcinoma and squamous cell carcinoma (in a ratio of 70: 20: 10). Each cancer cell types had metastasized to different lymph nodes. The final diagnosis was a combined small cell carcinoma in the lung. Combined small cell carcinoma is uncommon, but is nevertheless a well-described diagnostic category in lung cancers.