肾肌周细胞瘤1例报告并文献复习

目的:探讨肾肌周细胞瘤的临床病理特点及诊疗方法。方法:回顾性分析1例罕见肾肌周细胞瘤的临床表现、影像学及术后病理学资料,并结合相关文献,总结其临床表现、病理特征及诊疗方法。结果:肾肌周细胞瘤无典型临床表现,彩超和CT检查缺乏特异性。患者行后腹腔镜左肾部分切除术,病理检查报告为肌周细胞瘤。免疫组织化学检查显示SMA+,Vim+,CD34+。术后随访25个月未见肿瘤复发和转移。结论:肾肌周细胞瘤为极其罕见的良性肿瘤,不易复发和转移;诊断主要依靠病理检查;手术切除肿瘤是目前唯一有效的治疗方法。     

肝脏血管周上皮样细胞瘤1例报告并文献复习

目的：探讨肝脏血管周上皮样细胞瘤的临床病理特征。
方法：报告1例肝脏血管周上皮样细胞瘤,结合文献分析其临床表现、病理特征和免疫组化表达。
结果：该例肝脏血管周上皮样细胞瘤无临床症状,辅助检查无特征性阳性,术前难以确诊。组织学上由单一的上皮样细胞构成,无厚壁血管及脂肪成分,瘤细胞特征性表达HMB-45。
结论：肝脏血管周上皮样细胞瘤十分罕见,确诊依靠病理检查,手术完整切除是目前主要的治疗方法。该肿瘤生物学行为不确定,术后需要密切随访。     

膀胱血管周细胞瘤1例报告并文献复习

目的探讨膀胱血管周细胞瘤的临床特点及诊疗方法。方法分析1例膀胱血管周细胞瘤的临床资料并结合文献进行复习。结果患者行经尿道膀胱肿瘤电切术,术后1周痊愈出院,病检结果为膀胱血管周细胞肿瘤（中间型）。随访3个月未见肿瘤复发。结论膀胱血管周细胞瘤极为罕见,术前诊断困难,需经病理证实才能确诊,治疗上应按照恶性肿瘤进行切除,术后需长期随访。     

家族性嗜铬细胞瘤一家系诊疗及文献复习

目的探讨家族性嗜铬细胞瘤的遗传特征、临床表现及治疗方法。方法结合文献回顾性分析一家系家族性嗜铬细胞瘤患者的临床资料。结果该家系两代人中有4例肾上腺嗜铬细胞瘤患者,均在青少年期发病,其中1例为双侧发病。采用肾上腺肿瘤切除术治疗。病理诊断为良性嗜铬细胞瘤,随访6个月至28年无复发。结论家族性嗜铬细胞瘤符合常染色体显性遗传特点,多在青少年期发病。目前尚无预防手段,早期诊断和长期随访是提高治愈率的唯一方法。     

嗜铬细胞瘤合并肾上腺节细胞神经瘤 1 例

目的：分析嗜铬细胞瘤合并肾上腺节细胞神经瘤的临床特点及诊治思路。方法：总结分析 1 例嗜铬细胞瘤合并肾上腺节细胞神经瘤的诊断与治疗经过。结果：该例患者临床症状不明显,影像学检查提示神经鞘瘤可能,肿瘤性质不明, 考虑神经鞘瘤可能,行后腹腔镜下肾上腺肿瘤切除术后,术后病理学检查回复示混合性嗜铬细胞瘤和肾上腺节细胞神经瘤。结论：嗜铬细胞瘤合并肾上腺节细胞神经瘤是一种罕见的良性肿瘤,如临床症状不典型者,可通过实验室及影像学初步判断, 并借助病理结果进一步确诊,其主要的治疗方法为手术切除。     

妊娠合并嗜铬细胞瘤的诊断与处理

目的 探讨妊娠合并嗜铬细胞瘤的诊断与处理方法.方法 妊娠合并嗜铬细胞瘤病例3例.年龄分别为41、28、32岁,均为妊娠期间出现高血压,并伴有头痛、心悸、多汗等症状,分别于妊娠27周+1,12周+4,14周+3就诊.24 h尿儿茶酚胺明显升高;肿瘤位于右肾上腺2例,双侧肾上腺1例,肿瘤直径4.5～10.0 cm,术前诊断"妊娠合并嗜铬细胞瘤".结果 例1于孕32周行全麻下剖宫产术,顺利分娩一健康女婴,同时行后腹腔镜下右肾上腺肿瘤切除术,切除7.0 cm肿瘤1枚.例2及例3均选择流产.例2行后腹腔镜下右肾上腺肿瘤切除术,切除右肾上腺4.5 cm肿瘤1枚.例3拒绝进一步治疗.例1及例2术后病理均证实为嗜铬细胞瘤.结论 对于妊娠早期出现高血压、典型发作性高血压或伴有头痛、心悸、大汗三联征,分娩后高血压仍未恢复正常的孕妇,应考虑嗜铬细胞瘤;及时诊断可显著降低母亲及胎儿死亡率;处理上应根据妊娠所处的时期及嗜铬细胞瘤的功能状态选择恰当的方式.妊娠中期是较理想的手术治疗时机.腹腔镜手术治疗妊娠嗜铬细胞瘤安全、有效.     

妊娠合并嗜铬细胞瘤的诊断与处理

目的 探讨妊娠合并嗜铬细胞瘤的诊断与处理方法.方法 妊娠合并嗜铬细胞瘤病例3例.年龄分别为41、28、32岁,均为妊娠期间出现高血压,并伴有头痛、心悸、多汗等症状,分别于妊娠27周+1,12周+4,14周+3就诊.24 h尿儿茶酚胺明显升高;肿瘤位于右肾上腺2例,双侧肾上腺1例,肿瘤直径4.5～10.0 cm,术前诊断"妊娠合并嗜铬细胞瘤".结果 例1于孕32周行全麻下剖宫产术,顺利分娩一健康女婴,同时行后腹腔镜下右肾上腺肿瘤切除术,切除7.0 cm肿瘤1枚.例2及例3均选择流产.例2行后腹腔镜下右肾上腺肿瘤切除术,切除右肾上腺4.5 cm肿瘤1枚.例3拒绝进一步治疗.例1及例2术后病理均证实为嗜铬细胞瘤.结论 对于妊娠早期出现高血压、典型发作性高血压或伴有头痛、心悸、大汗三联征,分娩后高血压仍未恢复正常的孕妇,应考虑嗜铬细胞瘤;及时诊断可显著降低母亲及胎儿死亡率;处理上应根据妊娠所处的时期及嗜铬细胞瘤的功能状态选择恰当的方式.妊娠中期是较理想的手术治疗时机.腹腔镜手术治疗妊娠嗜铬细胞瘤安全、有效.     

胰腺恶性纤维组织细胞瘤的诊治（附1例报道并文献复习）

目的 探讨胰腺恶性纤维组织细胞瘤的诊断及治疗.方法 对兰州大学第一医院收治的1例胰腺恶性纤维组织细胞瘤患者,结合国、内外文献对其临床特点,影像学、病理学及免疫组化特征、治疗和预后进行分析.结果 行胰腺肿瘤切除,术后医用直线加速器采取三维适形精确放疗,随访9个月,未见肿瘤复发.结论 胰腺恶性纤维组织细胞瘤恶性度高,易复发、转移,生存率低,诊断主要依靠病理和免疫组化检查.外科手术联合放射治疗可延长生存时间和延缓肿瘤的复发.     

����Ѫ������Ƥ��ϸ����1�����沢���׸�ϰ

目的 分析肝脏血管周上皮样细胞瘤的临床特点.方法 2007年10月首都医科大学附属北京友谊医院普外科诊治1例肝脏血管周上皮样细胞瘤,对其临床、影像、病理学特点进行分析及相关文献复习.结果 肝脏血管周上皮样细胞瘤无临床症状,无特征性影像学表现,术前难于确诊.组织学上由单一上皮样细胞构成,不合血管及脂肪成分,免疫组化呈特征性黑色素生成(HMB-45)阳性.目前文献报道肝脏血管周上皮样细胞瘤发生在肝脏者尚不足10例.结论 肝脏血管周上皮样细胞瘤是一种非常罕见的间叶组织来源肿瘤.主要依靠病理进行诊断.肝脏血管周上皮样细胞瘤生物学行为不确定,建议术后长期随访.     

恶性嗜铬细胞瘤的临床特点（附6例报告）

我院经手术治疗的嗜铬细胞瘤４０例，其中出现转移病变并经手术及病理确诊为恶性嗜铬细胞瘤者６例，占１５％。２例为肾上腺嗜铬细胞瘤，４例为肾上腺外嗜铬细胞瘤，本文就恶性嗜铬细胞瘤的发病率、诊断依据及临床特点进行了讨论。     

Multiple myopericytoma of the face and parotid gland

Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely. A 40-year-old woman noticed multiple enlarging, painless, round-shaped masses on her left cheek. The patient had experienced a similar lesion of the same area 8 years earlier which was completely excised and the pathological diagnosis was spindle cell type myoepithelioma. On a computed tomographic image, one mass involved the superficial parotid gland and was well encapsulated. Excision of the facial masses and superficial parotidectomy with facial nerve preservation were performed. A diagnosis of myopericytoma was established in light of the immunohistochemical pattern with the histopathological findings. Over the 4-year follow-up period, there was no evidence of recurrence. As many perivascular myoid neoplasms share common morphologic features with myopericytoma, we should consider the differential diagnosis, and confirm the histological findings with appropriate immunohistochemical staining. After identifying myopericytoma, it should be treated with wide surgical excision to prevent local recurrence.     

Myopericytoma of the oral cavity

BACKGROUND: Myopericytoma is a rare mesenchymal neoplasm of pericytic cells demonstrating myoid differentiation. The lesion typically arises within the subcutaneous tissue of the extremities. We report a case that, to the best of our knowledge, is the first case of myopericytoma involving the soft tissue of the oral cavity. METHODS: A 36-year-old woman had a 5-mm sessile, whitish-pink, firm tongue nodule. The patient underwent excisional biopsy, and histopathologic examination as well as immunohistochemical analysis were performed. RESULTS: The differential diagnosis by histologic analysis included solitary fibrous tumor, myofibroma, glomus tumor, and myopericytoma. The results of immunohistochemical analysis, when combined with the histologic features, led to a diagnosis of myopericytoma. CONCLUSIONS: Applying strict morphologic criteria and appropriately selective immunohistochemical markers will help to distinguish myopericytoma in the oral cavity.     

Myopericytoma in right inguinal region: A rare case report from Nepal

IntroductionMyopericytoma is a rare mesenchymal soft tissue tumor that originates from perivascular myoid cells and mostly benign in nature. With a slight male predisposition, it occurs more commonly in the lower extremities with an insidious and painless presentation. Contrary to the usual, our patient was with a rare presentation in the inguinal region with a dull aching pain.Case presentationWe herein report a case of a 64-year-old female patient with myopericytoma, the first of its kind reported in Nepal, present in the right inguinal region and surgically removed. The mass was single with dull aching pain, non-tender, globular, smooth, mobile, covered with skin and, had been slowly growing for 1 year and had started bleeding for 4 days. On complete surgical excision and subsequent biopsy, a nodule with thin-walled blood vessels and spindle-shaped cells having indistinct cell border, eosinophilic cytoplasm, and oval to spindle-shaped nucleus was observed, features consistent with those of myopericytoma.DiscussionMyopericytoma can occur in different sites in the body. Its differential diagnoses in the inguinal region include inguinal hernia, lipoma, or an inguinal lymphangioma. Histopathological analysis and immunohistochemistry (IHC) staining are used for diagnosis and confirmation.ConclusionMyopericytomas are rare and have a substantial propensity to be misdiagnosed as other soft tissue tumors such as sarcomas due to significant overlap in their presentation and histological features. Complete surgical excision of mass is the curative therapy.     

端粒酶在大鼠肝卵圆细胞中表达的意义

目的 检测大鼠肝卵圆细胞端粒酶活性,探讨端粒酶表达与卵圆细胞增殖分化的关系.方法 采用2-AAF/PH模型诱导大鼠卵圆细胞增殖,改良的胶原酶灌注结合密度梯度离心法分离,用细胞免疫荧光和电镜鉴定卵圆细胞.采用免疫组织化学、RT-PCR、荧光定量PCR等方法检测卵圆细胞端粒酶的表达,组间比较采用t检验分析其意义.结果 采用2-AAF/PH模型成功诱导大鼠卵圆细胞增殖.分离的卵圆细胞核大,卵圆形,胞质少,呈铺路石样生长.电镜发现细胞核质比大,胞质内细胞器少且发育不成熟.细胞免疫荧光结果表达OV-6、AFP、CK-19、albumin、c-kit.端粒酶逆转录酶(TERT)表达在门静脉周围增殖的卵圆细胞核内,随着卵圆细胞逐渐向肝细胞方向分化,TERT阳性细胞数逐渐减少.大鼠正常肝组织TERT mRNA表达水平最高,为LE-6卵圆细胞的2.27倍;分离的卵圆细胞TERT mRNA表达水平为LE.6卵圆细胞的1.26倍;采用2μg和4μg细胞提取物分析细胞的端粒酶活性,随着LE-6卵圆细胞传代次数的增加,由24代传至40代,端粒酶活性由△A=1.05、1.15降低到△A=0.25、0.45(t=17.74,12.38,P<0.05).结论 卵圆细胞具有端粒酶活性,端粒酶可能是卵圆细胞维持其增殖能力和多分化潜能的一个必要条件.     

大鼠肝干细胞定位及形态学特征研究

目的 研究大鼠肝干细胞在肝脏的定位及其形态学特征。方法采用3’-甲基-4-二甲基偶氮苯诱癌建立大鼠肝癌模型,于造模第4周取肝脏组织进行免疫组织化学染色定位,同时分离干细胞,采用相差显微镜摄像、透射和扫描电镜摄像对分离的细胞进行形态学观察。结果 组织免疫化学发现细胞角蛋白(CK)18、19、CD_(34)、c-kit阳性。从成体大鼠肝脏分离的肝干细胞体积小、外形及胞核为圆形或椭圆形,可以稳定传代,细胞形态不发生改变;结论 成体大鼠肝干细胞位于汇管区,肝干细胞的成功培养为研究肝干细胞的生物学特性和临床应用提供了理论依据。     

Foot soft tissue myopericytoma: Case-report and review

IntroductionMyopericytoma is a rare tumor of deep soft tissues, originating from pericytes and characterized by numerous thin walled blood vessels.Case reportWe report a case of myopericytoma found at the level of the second toe of the right foot.A patient came to the Endocrinology Surgery Department of Catania Polyclinic because of a presence of a small swelling in the plantar region, between the 2nd and 3rd toe of the right foot. At the anatomopathological examination, the escalated lesion showed a neoformation of 0.6 cm in diameter, well circumscribed, capsulated, with myopericytoma diagnosis.DiscussionIts histopathological appearance is similar to myofibromatic lesions from glomic and angiomyoma tumors. It is a rare tumor that affects all ages with a peak after 50 years 3. The most frequent localization is at the lower extremities, particularly in soft subcutaneous tissues, but can rarely occur in other sites.ConclusionAt the anatomopathological evaluation, the immunohistochemical examination for the correct formulation of the diagnosis is essential and an adequate surgical excision is important.     

Myopericytoma of the Foot: A Case Report

Myopericytoma is a rare soft tissue tumor found in the subcutaneous and superficial soft tissues in the extremities. The present study reports a unique case of myopericytomas found in the first and second toes of a patient. The masses were surgically excised, and on pathologic and immunohistochemical examination, the diagnosis of myopericytoma was made. At the follow-up visit, the patient had no recurrence of the soft tissue tumor.     

成体小鼠肝脏卵圆细胞的分离及培养

目的:建立一种稳定的成体小鼠卵圆细胞的分离和培养方法。方法:采用喂饲2-乙酰氨基芴（AAF）加2/3肝切除方法诱导肝脏卵圆细胞的增殖。经门静脉灌注消化法和等密度离心法分离卵圆细胞，并在体外进行长期培养。免疫荧光和免疫双标法对培养的卵圆细胞加以鉴定。结果:体外培养的卵圆细胞呈集落样生长，稳定传代并已培养至3个月。免疫荧光和免疫双标法证实培养的细胞为卵圆细胞，并显示该细胞具有分化潜能。结论:该方法是一种稳定的成体小鼠卵圆细胞的分离和培养方法，为肝脏干细胞的相关研究和应用奠定基础。     

Myopericytoma of skin and soft tissues: clinicopathologic and immunohistochemical study of 54 cases

Perivascular neoplasms comprise traditionally glomus tumor and hemangiopericytoma (HPC). Whereas glomus tumor represents a well-defined entity, the existence of HPC as a separate entity has been questioned because a number of neoplasms of different lines of differentiation are characterized by a HPC-like vascular growth pattern. Myopericytoma represents a recently delineated entity showing a HPC-like vascular pattern. A large series of myopericytoma of skin and soft tissues has been analyzed to further characterize the clinicopathologic spectrum of this entity. Fifty-four cases of myopericytoma of skin and soft tissues were retrieved and the histology reviewed. Immunohistochemical stainings using alpha-smooth muscle actin (ASMA), desmin, and h-caldesmon antibodies were performed, and clinical data and follow-up information were obtained from referring pathologists. Thirty-four patients were male and 18 were female (gender was unknown in 2 cases). Patient age ranged from 13 to 87 years (median, 52 years). The lower extremities were most commonly affected (26 cases) followed by the upper extremities (16 cases), the head and neck region (4 cases), and the trunk (2 cases); exact location was unknown in 5 cases. In 20 cases, the neoplasms were confined to the dermis, in 6 cases an extension into the subcutis was seen, and 24 as well as 4 cases arose in subcutaneous and deep soft tissue, respectively. Two cases were multicentric; and in 1 of these patients, multiple anatomic regions were involved. Histologically, in all cases, numerous thin-walled vessels and a concentric, perivascular arrangement of ovoid, plump spindled to round myoid tumor cells was seen. However, a broad morphologic spectrum ranging from hypocellular, fibroma-like (3 cases), myofibroma-like (2 cases), angioleiomyoma-like (12 cases), and HPC-like neoplasms (13 cases) to classic myopericytomas (14 cases) and immature, cellular lesions (2 cases) was noted. In addition, 2 neoplasms with focal glomoid features, 5 intravascular, and 1 malignant myopericytomas were found. Prominent cytologic atypia and increased proliferative activity (>3 mitoses/10 high power fields) was seen in 4 and 2 cases, respectively. Immunohistochemically, all cases tested stained positively for ASMA. In addition, 29 of 32 cases tested stained positively for h-caldesmon, whereas desmin was only focally positive in 3 of 33 cases. Follow-up information was available in 46 cases (range, 7-168 months; median, 48 months). Despite marginal or incomplete excision in 23 of 46 cases, only 2 neoplasms (1 malignant and 1 intravascular myopericytoma) recurred locally (within 1 and 4 years, respectively). Despite overlapping morphologic features to angioleiomyoma and myofibroma, myopericytoma represents a distinct perivascular, myoid neoplasm of skin and soft tissues, characterized by a broad morphologic spectrum of concentrically, perivascularly growing myoid tumor cells that stain positively for ASMA and often for h-caldesmon, whereas desmin is usually negative. Most cases of myopericytoma behave in a benign fashion, but local recurrences and rarely metastases may occur in atypical and malignant neoplasms.     

�������˵���Ϻ�����(��15������)

目的 探讨胰腺损伤的诊断与治疗经验.方法 分析自2002年4月至2007年2月间中国医科大学.附属第一医院普通外科收治的15例胰腺损伤的临床资料情况.按美国创伤外科学会(AAST)以及术中探查所见胰腺损伤分级:Ⅰ级2例,Ⅱ7例,Ⅲ级3例.Ⅳ级2例和V级1例.5例行非手术治疗.10例病人经过手术治疗:胰头血肿清创止血、腹腔多管引流1例;胰头颈部破裂缝合修补、胰周引流术4例;胰头侧断端胰管结扎闲镇缝合、胰体尾部切除术3例;胰头侧断端胰管结扎闭锁缝合、体部断端胰空肠Roux-en-Y吻合术2例.结果 12例治愈.其中1例发生创伤性胰腺炎,2例发生胰漏,经引流、胰酶抑制剂、抗炎等治疗治愈.2例好转,腹痛症状较前减轻,血淀粉酶降至正常范围.1例因多发创伤死亡.结论 早期诊断、准确掌握手术时机、必要时果断开腹仔细探查是治疗胰腺损伤的关键.依据胰腺损伤类型选择合理的术式与充分引流,可以有效提高治愈率并减少术后并发症.