喉鳞状细胞癌伴甲状腺乳头状癌1例

患者,男,55岁。因发现颈部肿物2年,声音嘶哑2个月,呼吸困难1个月于2009年10月22日入院。吸烟、饮酒史20年。否认放射物质接触史及甲状腺癌家族史。入院体检:颈前偏右可触及一大小约3cm×3cm×2cm的肿物,无压痛,质韧,表面光滑,可移动。甲状腺右叶可触及一肿物,大小     

左面部嗜伊红增多性淋巴肉芽肿1例报告

病人,男,53岁,因左面部肿物2年,于2004年3月 10日入院。病人2年前无意中发现左面部有一肿物,约花生 米大小,无疼痛、发热,肿物生长缓慢,未曾治疗。3个月前左 面部肿物生长加快,约鸡蛋大小。检查:一般情况可,心、肺、 腹部检查未见异常。左面部耳垂前可触及一肿物,约 4cm×3cm×     

四重癌一例

患者女，76岁。声嘶及咽喉异物感半年，近20天来声嘶加重，并出现呼吸困难，不能平卧。于1993年10月3日急诊入院。间接喉镜检查发现咽部粘膜充血，喉部入口处可见约2．0cm×2．0cm×1．5cm大小之圆形肿物，暗灰色，表面光滑，边缘清楚，有蒂附着在右侧构区内侧缘，随呼吸上下活动。急诊行气管切开术，给予补液及消炎治疗。于10月20日全身麻醉下行支撑喉镜下喉肿物切除术，肿物约2．1cm×2．0cm×1.5cm大小，术后呼吸、发音正常。病理诊断：喉鳞状细胞乳头状癌（图1）。住院15天后行局部放疗，发声改善。患者过去曾三次在全身不同部位发现癌…     

咽旁间隙迷走神经副神经节瘤1例

患者,女,28岁,主因右颈部肿物3年,声嘶1年余入院。肿物开始约1.0cm×1.5cm大小,渐进性增大,常伴有右颈部疼痛,不伴呼吸困难及呛咳。家族中无类似病例发生。体检:右上颈、下颌角下可触及约2.0cm×3.0cm大小肿物,质硬,活动度差,表面皮肤正常,触之患者咳嗽明显。右咽侧壁隆起,表面     

鼻翼及鼻小柱神经鞘瘤1例

患者,女,2 8岁。因发现鼻翼部新生物2年余入院。无局部疼痛麻木等不适感,全身检查未见异常体征。左侧鼻翼部可见大小约0 .6cm×1 .0cm肿物,侵及鼻尖部,肿物表面光滑,颜色与鼻部正常皮肤相同,表面可见少量小血管,其边界清,质软,不活动,无压痛。双侧鼻前庭无红肿及糜烂,左侧鼻前庭内侧可见绿豆大小白色隆起。鼻腔未见异常。CT示:左侧鼻翼见0 .4cm×1 .0cm大小类圆形软组织影,CT值约43.4Hu ,边界尚清楚;鼻腔、鼻窦无异常。术中见鼻翼部及鼻小柱多发圆形或圆柱形边界清楚有完整包膜的肿物,其中0 .2cm×0 .2cm大小1 0余个,0 .3cm×0 .8cm大小1…     

颈淋巴清扫术后双侧乳糜胸一例

患者女,42岁,因左颈前肿物10年增大1年于2007年12月18日入院,伴有颈前压迫感,进食略有梗阻感.否认家族肿瘤病史及其他疾病史.入院查体:左颈前触及4 cm×5 cm大小肿物,左上颈触及肿大淋巴结3 cm×3 cm大小,均质硬、活动欠佳.辅助检查:B超示甲状腺左叶内见39 mm×38 mm实质性团块,右叶中部见10 mm×6 mm低回声结节,双颈多发肿大淋巴结.CT示左甲状腺肿瘤伴双颈部多发肿大淋巴结.胸部X线检查心、肺、纵隔未见异常.     

颈部横纹肌肉瘤1例

患儿,女,6岁。因发现颈前无痛性肿物10d,于2004年7月12日入院。体检:全身情况良好,颈部正中甲状软骨、环状软骨前可触及一大小约3cm×2cm×2cm肿物,表面光滑,质硬,界限清,与皮肤无粘连,随吞咽上下移动,舌骨下方未触及条索状物,甲状腺不大,颈部两侧未触及肿大淋巴结。彩色超声检查示:颈部实性肿物,被膜完整、规则,与甲状腺峡部关系密切,甲状腺左右叶大小、回声正常。颈部CT检查示:颈前实性肿物,周围脂肪间隙清晰,肿物与左侧甲状腺分界不清。入院诊断为颈部肿物,于入院第2天在全身麻醉下行颈部肿物切除术。术中见肿物位于带状肌深面,包膜完整…     

巨大颈动脉体瘤切除一例

患者男 ,5 0岁 ,于 2 0 0 0年 4月 2 0日因右面颈肿块 2 4年 ,伴呼吸、吞咽困难 1年收入院。 10余年前曾就诊外院行面颈肿物探查术 ,术中发现瘤体巨大、血供丰富而中止手术 ,术后诊断 :海绵状血管瘤。入院查体见右软腭膨隆 ,可触及 6cm× 4cm肿物 ,右面颈部可触及 10cm× 16cm肿物 ,质实 ,皮温高 ,颈部轴位CT示右咽旁富血供占位约 8 6cm× 7 0cm(图1)。数字减影血管造影提示瘤体与颈部大血管关系不密切。因曾有手术探查史及伴吞咽呼吸困难 ,不能平卧 ,未行颈动脉压迫训练。于 2 0 0 0年 5月 10日在全身麻醉下行右颈部肿物切除术。术中先行…     

颈部脂肪瘤累及颌下腺及腮腺1例

患者,女,24岁。因左颌下肿块3年余收入院。患者3年前无意中发现左颌下肿块,约樱桃大小,间断性疼痛且反复发作,外院曾行相关抗炎对症处理（具体不详）,效果不佳。体查：左颈部胸锁乳突肌前缘可触及2．5cm×2．0cm×1．5cm大小肿块,质软,活动度尚可,无压痛,颈软。心肺腹等均未见明显异常。     

头皮畸胎瘤1例

患者,女,27岁,以"发现头皮肿物10年,增大半年"为主诉入院。10年前出现右颞侧头皮肿物,初约黄豆大小,无明显增大,入院前半年来肿物增大明显,现约有鸽蛋大小,无伴有头晕,头痛、视物模糊,呕吐等不适。体检:右颞侧近耳部一半球形肿物,大小约3cm×4cm×3cm,触之表面光滑,有囊性感,无压痛,基底部无明显移动,未触及颅骨缺损。入院后初步诊断:头皮囊肿,脂肪瘤可能。在局部麻醉下行头皮肿物切除术,术中见肿物位于皮     

肾透明细胞癌甲状腺及腮腺转移1例

患者,女,58岁,8年前因右肾透明细胞癌（Ⅲ期）行右肾癌根治术,术后病理免疫组织化学结果示：     

双囊甲状舌管囊肿1例

患儿,男,5岁,以＂发现颈前肿物5年＂为主诉于2013年4月8日入院。患儿出生后家长发现其颈前上部一蚕豆大小的肿物,局部无红肿、疼痛、吞咽受限及咽部异物感,未治疗。肿物随患儿年龄增长逐渐增大至约鸡蛋黄大小,为明确诊治,遂来我院,门诊以甲状舌管囊肿收入。体检：颈前正中甲状软骨上方可触及一类圆形肿物,约2.0cm×0.5cm大小,边界清楚,质软,可随吞咽上下运动,皮色、皮温正常,无压痛。彩超检查示：颈前区见大小约2.3cm×1.0cm的囊性包块,距体表0.3cm,     

Nuchale Schwellung

In the unusual case of a 68-year-old woman with one-sided painless lateral neck swelling, the ENT examination showed a firm nuchal mass (4 × 4 cm) on the right side with no other pathological findings. Angio-MRI confirmed a solid, sharply demarcated tumor with arterial hyperperfusion. Core needle aspiration biopsy was performed, revealing well-circumscribed tufts showing the typical "cannonball" aspect. After preoperative embolisation we performed extirpation of the mass. Histological examination showed an acquired tufted angioma. Clinical as well as radiological follow-up examination detected neither local relapse nor metastases.     

鼻中隔后端巨大囊肿1例

患者,男,17岁,双鼻塞半年伴张口呼吸,持续性进行性加重,偶有头部胀痛,无耳部症状。体检：鼻中隔左偏,双鼻腔下鼻甲肥大,双鼻腔通畅。纤维鼻咽镜：巨大球形光滑淡红色新生物位于鼻咽顶后壁及鼻腔后端,大小约3．5cm×2．5cm,堵塞整个后鼻孔,新生物与双侧圆枕相贴（图1）。     

Pleomorphic adenoma of nasal septum

The pleomorphic adenoma is the most common benign tumour of the major and minor salivary glands. We report a 40-year-old female patient, who presented with progressive swelling and deformity of the left side of her nose for last 2 years. On a lateral rhinotomy a mass (4 cm X3 cm in size) was found to be arising from the cartilaginous part of the nasal septum. The mass was emicleated from its capsule and the walls excised. The histopathological examination revealed it to be pleomorphic adenoma.     

Internal jugular vein vascular malformation presenting as mass at root of neck: a case report

Background

We report a case of vascular malformation arising from internal jugular vein presenting as mass at root of neck with no clinical stigmata which to the best of our knowledge is the first reported case of an intrinsic vascular malformation arising from the internal jugular vein. Magnetic resonance imaging features of this new entity have been described.

Case presentation

A 27 year male presented with a gradually enlarging, asymptomatic swelling on left supraclavicular region with normal overlying skin. A soft mass, about 7 × 7 cm with restricted mobility was found with normal cranial nerve function. Fine needle aspiration cytology showed a hemorrhagic aspirate. Doppler showed a mass displacing left carotid artery posteriorly while left internal jugular vein was not visualized. Magnetic resonance imaging showed a well defined mass isointense to hypointense on T1 weighted and hyperintense on T2 weighted and STIR images with fluid-fluid levels. On exploration, a vascular mass arising from left internal jugular vein was found with good tissue planes, which was excised after ligating the patent internal jugular vein above and below the lesion. Histopathologic examination confirmed the diagnosis of vascular malformation.

Conclusion

The diagnosis of intrinsic vascular malformation arising from internal jugular vein should be kept in differential while dealing with masses at root of neck and magnetic resonance imaging features may help in the pre-operative diagnosis of this entity.     

Objective measurements differ for perception of left and right nasal obstruction

Objective

Nasal obstruction is one of the most common sensation complaints of nasal disease in clinical practice. It is a subjective sensation of nasal airflow. Objective assessment of nasal patency and nasal physiology includes the use of rhinomanometry and acoustic rhinometry. The perception of nasal obstruction changes as the alternating of nasal airway resistance and nasal airflow. However, there were limited studies reported whether the perceptions of the left and right nostrils are similar. We examined the relationship between subjective and objective parameters of the nasal airway in the left and right nostrils.

Methods

A prospective study of 101 patients with a deviated nasal septum and chronic hypertrophic rhinitis was conducted for subjective and objective nasal airway evaluation. Patients were then divided into three groups based on the visual analog scale. Associations between measures were evaluated with analysis of variance, f tests and simple regression.

Results

Among three patient groups with different subjective sensations of nasal obstruction, there were significant differences among three patient groups according to the objective measurements of airflow resistance on the right side (p = 0.0002 for inspiration right mean resistance; p = 0.0049 for expiration right mean resistance), and for the minimal cross-sectional area (p = 0.030) and nasal cavity volume (p = 0.028 for 0–3.3 cm left nostril; p = 0.047 for 2–4 cm left nostril) on the left side. This indicates that nasal flow resistance is an important determinant for right side nasal obstruction. Nasal minimal cross-sectional area and nasal cavity volume are an important determinant for left side nasal obstruction.

Conclusion

Our study indicates the important role of rhinomanometry in objective measurement of right side nasal obstruction and acoustic rhinometry in objective measurement of left side nasal obstruction. Thus, human perception of right and left nostrils may be different and requires further study.     

Giant cell tumor of the mandible

A 53-year-old woman presented with left mandibular area pain, trismus, and facial numbness that had persisted for 4 years. Physical examination revealed a 3×5 cm, hard, non-tender, and round mass on the left mandibular area. Computed tomography and magnetic resonance imaging revealed an expansile tumor involving the left mandibular ramus and temporomandibular joint area with bone destruction, extending to the base of middle cranial fossa and left zygomatic bone. The mass at the segment of left mandible and zygomatic bone, and base of middle cranial fossa was removed. Pathological examination of the mass revealed a giant cell tumor. The defect was reconstructed with iliac bone for the mandible and temporal bone and fascia for the cranial bone and dura. The case is described along with a review of the literature.     

以颈部淋巴结肿大为首发症状的局灶型Castleman病诊治体会

目的 总结颈部Castleman病的临床特征与诊治体会.方法 回顾性分析2000年5月至2008年10月期间8例以颈部淋巴结肿大为首发症状的Castleman病患者临床资料.肿物位于颈部Ⅰ区1例,Ⅱ区3例,Ⅲ区3例,Ⅳ区1例.8例病例均行常规CT检查表现为类圆形软组织肿块影,其中4例增强扫描后周围可见环性增强区.8例血常规检查大致正常,其中6例患者轻度贫血.结果 本组病例均为局灶型Castleman病,手术完整切除肿大淋巴结,肿大淋巴结呈椭圆形,大小约(2 cm×2 cm×3 cm)～(4 cm×3 cm×2 cm),界限清楚,与周围组织无明显粘连.病理类型为透明血管型.术后随访7～30个月未见复发.结论 局灶型Castleman病表现为单一部位的淋巴结肿大,CT等影像榆查可以提示诊断,手术切除疗效好.     

Synchronous bilateral carotid body tumor and vagal paraganglioma: a case report and review of literature

We present a case of synchronous bilateral carotid body tumor and vagal paraganglioma in a 49-year-old man who presented with 3 months history of tenderness and palpable neck masses bilaterally. An encapsulated mass which was thought to be a carotid body tumor and an incidental 3 cm x 2 cm, 5 cm x 1 cm, 5 cm mass which seemed to be originated from vagus nerve were dissected from the left side. Pathology revealed carotid body tumor and vagal paraganglioma. Six months after the first operation, the carotid body tumor on the right side was totally excised. A discussion of this case is followed by a review of the literature surrounding this rare clinic and pathological entity.