Vulvar Paget's disease. Clinicopathological review of 14 cases

The clinicopathological course of 14 cases of vulvar Paget's disease is presented. Clinical presentation, age at diagnosis, duration of symptoms, associated and underlying malignancies, treatment and follow-up are reviewed. Survival by invasiveness and surgical management are compared. The use of conservative therapy where appropriate is advocated.     

咽后脓肿14例临床回顾

目的:探讨咽后脓肿的临床特点,提高对该病的诊治水平。方法:直接喉镜引导下经口行咽后脓肿切开引流术,术后辅以全身抗炎治疗。结果:13例痊愈,1例放弃治疗,自动出院,无严重并发症发生。结论:对咽后脓肿应做到早期诊断,全身应用有效抗生素,及时切开引流,以提高治愈率,减少并发症的出现。     

Leiomyosarcoma of uterus: a review of 14 cases

A detailed clinicopathologic study of 14 patients with leiomyosarcoms of the uterus was made. Twelve of 14 patients were followed up for 2 or more years. The median age was 49, the youngest patient was 20, and the oldest was 68. The predominant symptoms were abnormal vaginal bleeding and abdominal pain. The preoperative dilation and curettage established the correct diagnosis was 2 of 6 patients (33%). The predominant method of treatment was total abdominal hysterectomy (TAH). Five patients had adjuvant chemotherapy, 4 had adjuvant radiotherapy, 2 patients had chemotherapy and radiotherapy for adjuvant treatment, and one had adjuvant hormonal therapy. The overall cumulative probability of survival rate at 5 years was 29.6%. The mitotic count, margin type, tumor size, and the presence of necrosis did not affect the prognosis. Favorable prognostic features are low pleomorphism, lower staging, and aggressive management.     

胰头肿块型胰腺炎14例误诊分析

1临床资料1984-07/2004-03,我院收治慢性胰腺炎138例,其中肿块型49例,14例误诊为胰头癌而行手术治疗.男11例,女3例,年龄38~49(平均42)岁.     

儿童胰腺囊实性瘤的诊断与治疗

目的 探讨儿童胰腺囊实性瘤的诊断和治疗特点。方法 回顾性总结北京儿童医院16年间收治的14例病例,并结合文献分析此病的临床表现、影像学检查、病理特点、手术治疗方法和疗效。结果 1985年11月至2002年3月经手术和病理诊断14例胰腺囊实性瘤,男1例,女13例,年龄9－14岁,平均11．4岁。就诊原因：腹痛9例（64．3％）,腹部包块7例（50％）,黄疸3例（21．4％）。术前检查血清神经元特异性烯醇化酶（NSE）升高2例（267．4及124．0μg/ml,正常值0．0－15．2μg/ml)和雌激素（E240．3ng/ml及42.7ng/ml),余12例未查。B超和CT示胰腺占位性病变：边界清,囊实性,有的有少许钙化。肿瘤部位：胰头9例,胰体3例,胰尾2例。肿瘤直径3－15cm。治疗：手术局部切除2例;根治性切除12例,其中伴脾切除4例,部分脾切除1例。组织学特点：肿瘤局限,暗红色,包膜完整,剖面囊实性病变交织,瘤组织有片状出血,坏死和囊性变。光镜下为数层瘤细胞围绕纤维血管排列成乳头状结构,乳头状结构和实性区相互交替,瘤细胞核分裂少见。仅1例周围组织器官镜下见肿瘤细胞浸润。随诊1个月至16年。患儿全部存活,未见复发和转移。2例NSE术后降至正常（9．5和8．7μg/ml),E2下降50％以上（17．5和20．7ng/ml)。结论 儿童胰腺囊实性瘤多发生于青春期的女孩,是低度恶性或交界性肿瘤,术前可以诊断,根治性手术可获得良好的治疗效果。肿瘤复发时间晚,应长期随诊。     

爱滋病14例报道并文献综述

爱滋病是人类T淋巴源型病毒Ⅲ型感染所引起的特殊细胞内免疫缺陷病,无有效疗法,病死率高,有超级癌症之称。本文报道14例爱滋病,并对其传播途径、临床表现、诊断、处理、预后及预防结合文献加以讨论。     

14例胸内Castleman病临床病理学特征分析

目的探讨胸内Castleman病(CD)的临床病理学特征.方法回顾分析经病理检查确诊的14例胸内Castleman病的组织病理切片与临床资料.结果临床分型,局限型11例,表现为局部淋巴结肿大,多中心型3例,表现为多部位淋巴结肿大.组织病理学分型,透明血管型(HV)9例、浆细胞型(PC)2例,混合型(Mix)3例.所有病例术后均生存,其中11例局限型和2例多中心型CD术后无复发.1例多中心Mix型患者于术后第4年、第9年各复发1次,均再次手术治疗.结论 CD临床诊断很困难,最后诊断依赖组织病理学检查.胸内局限型CD和部分多中心型CD经彻底手术可获治愈;部分胸内多中心型CD手术治疗效果不佳,应辅助其他综合治疗.