胆囊黏液性纤维肉瘤1例

1临床资料患者,女性,64岁。因“反复中上腹疼痛2年余,加重1月”入院。患者2年前开始出现进食后中上腹胀痛不适,无恶心、呕吐、寒战及发热,无后背部疼痛及右肩部牵拉痛,外院B超示:“胆管增粗,胆管炎”,服胆宁片及对症支持治疗后症状改善。体检:全身皮肤黏膜无黄染,腹平软,未触及     

瘤体切除韧带重建治疗黏液性纤维肉瘤1例

<正>患者,女,左小腿近端肿物5年余,于2018年4月8日入院。患者5年前发现左小腿前内侧一包块,无明显压痛,局部皮温正常,5年来肿物逐渐增大。左小腿外侧见一5 cm×10 cm大小包块,活动度不佳,压痛,局部静脉扩张,皮温正常,见图1A。X线检查:左胫骨近端软组织包块,骨质未见明显异常。外院B超检查:左小腿肿物,局部血运良好。CT检查:左侧胫腓骨近端外侧见一大小约为12 cm×5 cm的软组织包块,边界尚清晰,形态欠规则,CT值40 Hu,     

黏液纤维肉瘤1例

1病例资料患者,男,44岁。困“右腹股沟肿物6个月”入院。入院查体：浅表淋巴结尤肿大。     

髂骨低度恶性纤维黏液样肉瘤1例

1病例资料 患者,男,28岁,因左臀中肌神经鞘黏液瘤切除术后5年,复发6个月入院。患者曾于2005年1月因无明显诱因出现左臀部包块就诊我院,诊断为＂左臀中肌神经鞘黏液瘤＂,并在院行病灶切除术,术后伤口愈合出院。     

乳腺间质肉瘤的超声表现

目的观察乳腺间质肉瘤的超声特征。方法回顾性分析11例乳腺间质肉瘤的超声特征,其临床、超声、病理各项资料齐全,病理组织学诊断均由手术切除标本获得。结果 11例乳腺间质肉瘤中,纤维肉瘤3例,成骨肉瘤3例,血管肉瘤2例,平滑肌肉瘤、横纹肌肉瘤、多形性肉瘤各1例。超声测量肿瘤最大径2.3~3.8cm。7例位于右乳,4例位于左乳。超声表现:实性或囊实性,低或混合回声,形态不规则或分叶状,边界不清,血流丰富(n=6);实性,低回声,形态规则,边界清,血流少或丰富(n=3);实性,低回声,形态规则,边界清、内见多个粗大钙化伴后方声影,血流无或少(n=2)。结论乳腺间质肉瘤的术前诊断困难,对于术后复发、生长快、血流丰富的实性或囊实性乳腺肿块应考虑到乳腺间质肉瘤。     

乳腺黏液癌常规超声和超声造影表现

目的观察乳腺黏液癌的常规超声和超声造影(CEUS)表现。方法回顾性分析16例经手术病理确诊的乳腺黏液癌患者(17个病灶),术前均接受常规超声及CEUS检查;以常规超声观察并记录病灶位置、大小、形态、内部回声、钙化、后方回声及血流特点等,CEUS观察病灶增强程度及增强方式等。结果 17个病灶中,常规超声显示16个(16/17, 94.12%)呈低回声、1个为等回声;15个(15/17, 88.24%)形态不规则或呈分叶状,14个(14/17, 82.35%)边界不清或有毛刺;10个(10/17, 58.82%)内部回声不均匀;3个(3/17, 17.65%)内部可见局灶性液化区,9个(9/17, 52.94%)可见砂砾样钙化;11个(11/17, 64.71%)内部可探及血流信号,其中8个可探及动脉频谱。CEUS表现为低增强15个、高增强2个;不均匀增强16个、均匀增强1个;16个病灶内见持续性无增强区;13个结节被膜呈稍高增强、4个无被膜高增强。结论乳腺黏液癌超声表现有一定特征性,对诊断该病具有一定临床价值。     

乳腺黏液样脂肪肉瘤1例

<正>1病例资料患者女,47岁,2019年5月于外院行左乳肿块切除术,术后常规病理示符合低度恶性纤维性肿瘤。2020年9月无意中于原手术刀口下方触及肿块,并逐渐增大。2021年9月于山东大学齐鲁医院复查乳腺彩超示左乳原手术刀口下方探及3.2×1.6cm实性低回声结节,边界尚清,形态欠规则,     

隆突性皮肤纤维肉瘤影像学表现

目的探讨隆突性皮肤纤维肉瘤(DFSP)的影像学表现。方法回顾性分析9例DFSP患者的影像资料,结合病理分析其影像学特点。结果 9例患者均为单发病灶,均发生于皮肤或皮肤下,其中四肢4例、躯干5例。8例表现为皮下软组织肿块,6例呈圆形或类圆形,边缘较清晰,2例呈分叶状肿块,并沿周围肌肉间隙生长,1例大部分边界模糊;1例悬吊于皮肤外,呈分叶状。2例CT平扫病灶呈中等略低密度,多均匀或略不均匀;MRI示7例病灶呈较均匀等或稍长T1信号,1例呈不均匀稍短T1信号,6例呈不均匀稍长T2信号,可伴小斑片状、条索状稍短T2信号或小斑片状长T2信号,2例呈长T2信号,1例伴环状稍短T2信号;5例增强后明显强化,其中4例强化不均匀。结论 DFSP的影像学表现具有一定特征性,尤其MRI对定性诊断及术前评估有重要的临床应用价值。     

右手小指低度恶性纤维黏液肉瘤1例

1病例资料 患者,女,45岁,主因右手小指肿物5年,疼痛半年入院。查体：右手小指末节肿胀、畸形,无红肿、压痛,远端指间关节活动受限。血常规正常,血沉35 mm/h。CR示：考虑右手小指内生软骨瘤（见图1）。入院后在臂丛麻醉下行右手小指远端截指术,术中见：大部分骨质破坏,     

左前臂粘液纤维肉瘤1例报告

粘液纤维肉瘤（Myxofibrosarcoma, MFS）是纤维组织的一种低度恶性肿瘤,国内报道不多,我科近日收治一例,现报道如下。     

静脉内平滑肌瘤病的超声表现

目的观察静脉内平滑肌瘤病（IVL）的超声特征。方法回顾性分析4例经超声诊断并经手术病理证实的IVL患者的临床资料与超声声像图表现。结果4例IVL患者中,3例曾因子宫肌瘤而接受子宫切除术;3例病变累及髂静脉,其中2例出现下腔静脉受累;2例累及右心。2例于术后6个月接受随访,发现盆腔低回声结节。结论密切结合病史,熟悉超声图像特征,有助于诊断IVL。超声为IVL术后随访的首选检查方法。     

胸壁软组织间叶来源恶性肿瘤超声表现1例

正患者女,59岁,因"无明显诱因右侧肩锁关节处疼痛1年余,伴进行性加重2个月"就诊,无外伤史,发病期间患者体质量无明显变化。查体:神志清,心肺听诊无异常,肝脾未触及,右侧锁骨周围触及约4 cm×3 cm×3 cm质软肿物,触痛明显,活动时疼痛加重,皮肤表面肿胀、凸起、溃烂,伴右上肢神经分布区域广泛放射痛,右侧上肢麻木、肿胀,门诊以"前斜角肌综合征"收入院。CT:右侧锁骨上下窝软组织影,右侧锁骨骨质破坏。超声:右侧锁骨周围胸壁下探及约5.3     

Ultrasonic lithotripsy and soft tissue

Summary It has been suggested that ultrasonic lithotripsy causes soft tissue damage by cavitation processes, by DNA alterations at subcavitational ultrasound levels, by thermic and mechanical trauma from the probe and from metal fragments splintered off the sonotrode. These issues were investigated in vitro and in vivo in the leporine bladder. Ultrasound intensity levels measured at the tips of sonotrodes never exceeded the cavitation threshold, so that cavitation processes are not involved in ultrasonic lithotripsy. The incidence of sister chromatid exchange in growing human lymphocytes was not altered, so that mutagenic effects appear unlikely. Thermic damage by the sonotrode is reliably prevented by irrigation cooling with 20 ml/min saline (20°C); higher flow rates are necessary for adequate vision in clinical practice. In spite of vibration amplitudes of up to 50 , the sonotrode causes only mucosal abrasion and submucosal hemorrhage; lesions of deeper layers of the bladder wall were never observed. Metal fragments are splintered off the sonotrode and nephroscope by contact, and this can largely be prevented by teflon coating of the wands. The fragments were washed out of leporine bladders within 24 h when instilled into the bladder cavity, and within 7 days when rubbed into the mucosa. In conclusion, significant soft tissue damage by ultrasonic lithotripsy was not observed. This corresponds to clinical experience with technique in 518 kidneys.     

Ultrasonic diagnosis of soft tissue tumors

Ultrasonography is relatively simple to manage, has no known risks to be patient, and is quickly available, all of which makes it a valuable tool, among the imaging techniques, in the primary diagnosis and initial work-up of soft-tissue tumors. Ultrasonography can reveal the extent of a tumor. Preoperative examination of a tumor in any number of planes gives the clinician a spatial idea of its size. Additionally, the internal architecture and structure of the tumor can be assessed. Sonography can distinguish whether lesions are predominantly cystic, solid, or more complex. Calcium deposits or foreign bodies can be demonstrated in some cases. It is difficult to delineate the margins of a tumor by sonography. Expanding and displacing tumor growth or infiltration cannot be diagnosed with certainty. Perifocal edema can make tumors appear larger than they in fact are. Ab type-specific differences of soft tissue tumors are demonstrable by sonography. Tissue differentiation is not possible.     

肝移植术后肝内及肝周异常的超声表现

目的分析肝移植术后肝内及肝周异常的超声表现。方法回顾性分析114例肝移植术后患者肝内及肝周出现异常的超声声像图。结果114例患者中,96例出现肝周积液,19例见肝周积血或血肿形成,1例肝内血肿,肝段缺血坏死2例,胆漏7例,胆汁瘤3例,移植肝局灶性脂肪浸润3例,肝内实质性肿块6例。结论超声检查对诊断肝移植术后肝内及肝周异常具有较高的应用价值。     

Ultrasonic examination of soft tissue injuries in the shoulder region]

Authors call attention with the demonstration of pictures of a few cases of their own to the significance of the ultrasound examination in cases of shoulder injuries. They stress that beside the demonstration of rotator cuff injuries the examination of the surrounding muscles and the labrum glenoidale should not be forgotten either. The modernization of the ultrasound devices, the improvement of the methods of examination and the obtaining of the necessary practice ensure a more and more important place to echography in the diagnosis of traumas of the motion organs.     

良性前列腺增生临床表现的病理基础

对１０３例无选择性良性前列腺增生病例的临床资料和病理资料进行比较研究。前列腺重量低于２６ｇ者５例，２００ｇ以上的巨大前列腺３例。本研究结果显示患者排尿梗阻症状、国际前列腺症状评分、最大尿流率与前列腺重量无关，而与前列腺病理组织学病变密切相关。排尿刺激症状的病理基础为尿道炎性病变。尿道梗阻症状与前列腺间质增生密切相关，这类前列腺增生结节以基质结节、腺肌型结节为主。以腺体增生为主病例可表现排尿梗阻相对轻微，但常伴有不典型增生。     

软组织恶性纤维组织细胞瘤的超声及MRI影像表现

目的:探讨软组织内恶性纤维组织细胞瘤(malignant-fibrous histiocytoma,MFH)的超声及MRI影像表现。方法:分析2012年1月至2018年8月期间经手术及病理证实的12例软组织内恶性纤维组织细胞瘤患者的超声、MRI影像资料及病理资料,其中男7例,女5例;年龄36～69岁,平均53岁;病程4～49个月,平均28个月。临床表现为软组织肿块和患肢疼痛。术前行超声、MRI平扫及增强检查。对病灶部位、形态、回声/信号特点、彩色血流信号及强化特征进行观察,并与病理结果进行对照。结果:12例MFH中9例为原发病灶,3例为术后复发病灶。双侧大腿7例,小腿2例,上臂1例,臀部1例,后腹膜1例。病灶大小5.1～17.1 cm,平均8.7 cm。超声表现为分叶状或团块状,以低回声为主,5例有包膜,边界清;7例与周围组织分界不清;6例内部见不规则无回声区。CDFI周边均可见较丰富血流信号,内部血流信号多少不等。MRI表现为分叶状、团块状或不规则形,T1WI呈略低信号或等信号,T2WI呈高信号,DWI信号增高;6例内部见混杂信号,7例内部见低信号分隔,5例见假包膜,9例呈浸润生长伴周围水肿。T1WI增强后均呈明显不均匀强化。免疫组化表达Vim、CD68阳性。结论:软组织MFH的发病年龄、部位及影像学表现具有一定特征性。发生在中老年人四肢软组织内的不规则肿块,回声和信号表现均匀或混杂,肿块内见分隔、坏死及囊变区,血流信号丰富、实性成分强化明显时,应考虑到MFH的诊断。