卵巢放线菌病1例

卵巢放线菌病１例周力患者女，２３岁，汉族，未婚。因右下腹痛６余天，近日持续性胀痛伴阵发性加重入院。查体：腹部平坦，肝脾未扪及，移动性浊音（－），下腹部肌紧张，右侧附件区可触及一１２ｃｍ×１０ｃｍ包块，质硬，有明显压痛，活动度差。临床诊断为右侧卵巢肿瘤...     

卵巢放线菌病一例

患者女,39岁,发现盆腔包块1年余,近20天出现下腹胀痛于2005年6月13日入院。     

软组织动脉瘤样囊肿一例

患者女 ,9岁。咽部疼痛 2 0ｄ ,发现右侧颈部肿块 7ｄ ,右侧咽后壁肿块 4ｄ于 2 0 0 1年 3月 8日入院。体检 :右颈深上部有一 1 5ｃｍ× 2 0ｃｍ肿块 ,活动 ,质中 ,轻度压痛 ,右侧咽柱被推向前内 ,鼻咽部向右后方膨起 ,右侧扁桃体被推向前方。ＣＴ示鼻咽右后方见一软组织块影 ,约 10 0ｃｍ× 4 0ｃｍ× 2 0ｃｍ ,周围带有不均匀强化 ,中心为低密度影 ,肿块周围软组织肿胀 ,肌间隙不清 ,右侧颈血管鞘向外推移 ,咽腔变窄 ,邻近骨质无破坏。术中见肿块从鼻咽右后壁舌根平面的咽侧壁膨起 ,质硬 ,无波动感 ,切开见咽后右侧间隙中多个淋巴样组…     

Werdnig-Hoffmann病一例报告及文献复习

Ｗｅｒｄｉｎｇ Ｈｏｆｆｍａｎｎ病 ,即急性婴儿进行性脊髓性肌萎缩 ,又称婴儿型脊肌性萎缩综合征、ＨｏｆｆｍａｎｎⅠ型综合征、Ｗｅｒｄｎｉｇ Ｈｏｆｆｍａｎ麻痹 (型 )等[1] ,本病少见 ,发病率仅 0 1～1/ 10万[2 ,3 ] ,现将新近所收治的 1例报告如下。图　Ｗｅｒｄｉｎｇ Ｈｏｆｆｍａｎｎ病患儿病例 :　患儿 ,男 ,1岁。因进行性无力 8个月 ,咳嗽 10天 ,发热 3天入院。患儿系Ｇ1、Ｐ1、孕 37+ 6周 ,羊水早破顺产 ,无窒息、抢救史及黄疸史 ,母乳喂养 ;因“右侧腹股沟斜疝”3个月时在本院手术治疗 ,同时能抬头 ,4个月时四肢活动减少 ,…     

皮肤型奴卡菌病二例并文献分析

目的探讨皮肤型奴卡菌感染的临床表现、诊断、治疗及预后,提高对奴卡菌的认识。 方法选取2016年6月至2017年5月解放军总医院第四医学中心烧伤整形科收治的皮肤型奴卡菌病患者2例,患者入院后积极进行外科清创,清创术后行负压封闭引流治疗,细菌培养结果明确为奴卡菌后,使用敏感抗生素结合口服复方磺胺甲口恶唑治疗。分析患者的临床资料、治疗过程,并结合检索、查阅奴卡菌相关文献,对奴卡菌病进行系统性陈述。 结果2例患者最终均治愈。皮肤型奴卡菌病临床表现及影像学检查无特异性,易误诊。 结论皮肤型奴卡菌病少见,病原菌培养为奴卡菌是诊断本病的主要依据,伴有脓肿需行外科手术切开引流,并结合磺胺类药物治疗。     

软组织网状神经束膜瘤1例报道并文献复习

目的 探讨软组织网状神经束膜瘤的临床病理特点和鉴别诊断。方法 对1例网状神经束膜瘤进行光镜、免疫组化和电镜观察。结果 肿瘤位于左尺骨远端软组织。长而纤细的肿瘤细胞突起网状、格子样、吻合状生长，排列于黏液水肿性、纤维性和胶原化的背景中，细胞纺锤状，胞质弱嗜酸性，核星形，无核分裂象。免疫表型：肿瘤细胞EMA和Vim阳性。电镜：肿瘤细胞可见长形的纤细的胞质突起，突起上有较多的吞饮小泡。结论网状神经束膜瘤是软组织神经束膜瘤的富有特征性的亚型，预后良好，诊断主要依靠常规病理、免疫组化和超微结构的综合观察。     

软组织恶性混合瘤/肌上皮癌1例并文献复习

目的 探讨软组织恶性混合瘤/肌上皮癌(malignant mixed tumor/myopeithelia carcinoma,MMTMC)的临床病理特征、免疫表型、鉴别诊断及预后.方法 对1例原发于大腿的软组织MMTMC进行HE和免疫组化染色,并复习相关文献.结果 患者男性,75岁,3个月前发现右大腿后部占位,进行性...     

软组织软骨瘤一例

患者女，２６岁，因右腕疼痛２年余，于１９９８年２月１６日来院就诊。体检：于右腕部桡骨远段近腕关节处可触及一肿物，大小２ｃｍ×４ｃｍ，单结节半球形稍隆起，界清。Ｘ线显示于右腕屈侧软组织内见一球形阴影，密度较低，无明显钙化，未侵及骨组织，骨质无破坏。临床...     

下颌骨腺泡状软组织肉瘤一例

患者男 ,2 1岁。左下颌骨无痛性肿块渐进性增大 2年 ,近 3个月肿块生长加速、左下后牙松动并在当地医院拔除 ,病情无好转并出现下唇麻木 ,于 1998年 1月 14日入院。体检 :左下颌骨 |3至下颌角区可触及一约 5ｃｍ× 4ｃｍ大小肿块 ,粘膜正常 ,张口受限 ,|4 8区颊侧骨性膨隆、骨质变薄、触之有乒乓感、无压痛 ,|7缺失。未发现其他异常。Ｘ线检查 :左下颌体见 5ｃｍ× 4ｃｍ密度减低影 ,其内可见骨间隔。 |6根尖吸收。临床诊断 :左下颌骨成釉细胞瘤。行左下颌骨切除加髂骨移植术。病理检查 :送检为 |2至同侧升支之下颌骨切除标本 ,于|3至同侧…     

Kartagener综合征一例并文献复习

目的探讨Kartagener综合征的临床特点、诊断标准,以提高对Kartagener综合征认识。方法 Kartagener综合征1例。患儿,女,10岁余。因反复咳嗽1年,咯血4次入院。回顾性分析该患儿临床资料,检索国内外文献,进行总结分析。结果患儿隐匿起病,主要表现为反复咳嗽,咳脓痰,伴咯血。CT示双肺支扩伴感染,全内脏反位,鼻窦炎。经抗感染对症治疗1周后,临床症状消失出院。检索国内外文献发现,Kartagener综合征以全内脏反位,支气管扩张,副鼻窦炎三联征为诊断标准。治疗以对症治疗为主。结论 Kartagener综合征是一种罕见的常染色体隐性遗传病,加强对该病的认识,有利于提高对该病的诊断率,减少误诊率。对该病的致病基因、机制的进一步研究,可能提供更好的诊断和治疗方法。     

Capillary hemangioblastoma of soft tissue: report of a case and review of the literature

Capillary hemangioblastoma (CH) is a tumor of unknown histogenesis that arises primarily in the posterior cranial fossa, either as a sporadic event or in association with von Hippel-Lindau disease. To date, only 6 examples of a tumor with morphological features of CH arising in the somatic soft tissues have been documented in case reports and small series, and 3 of these tumors were associated with a peripheral nerve. Herein, we report a case of CH arising in the gastrocnemius muscle and not associated with a peripheral nerve in a 53-year-old woman with no clinical stigmata or family history of von Hippel-Lindau disease.     

浅表肢端纤维黏液瘤的临床病理特征

目的 探讨浅表肢端纤维黏液瘤(SAF)的临床病理学特点、免疫表型和鉴别诊断.方法 对1例发生于左手中指末端SAF的临床表现、组织形态和免疫学表型进行回顾性分析,并复习文献.结果 患者男,62岁.因左手中指背侧末端肿块伴疼痛就诊,曾有外伤史.术中见肿块近甲床,并深达骨膜.大体观察,肿块周界不清,直径约2 cm,切面呈灰白色,实性,质韧.镜下观察,肿瘤位于真皮层内,略呈分叶状.瘤细胞由梭形至星形纤维母细胞样细胞组成,呈杂乱状分布于黏液样基质内,局部区域可呈条束状或疏松的席纹状排列.黏液样基质内含有丰富的纤细血管,并可见较多散在的肥大细胞.瘤细胞异型性不明显或仅显示轻度的异型性,核分裂象罕见.肿瘤内也未见坏死.免疫组织化学标记显示,梭形和星形细胞表达波形蛋白、CD34和CD99,灶性表达CD10,不表达上皮细胞膜抗原、肌动蛋白、结蛋白和S-100蛋白.结论 SAF好发于成年人指趾末端.熟悉其临床病理特点则有助于与其他发生于指趾的软组织黏液性肿瘤相鉴别.临床上宜将SAF作完整性切除,以预防局部复发.     

Immunohistochemistry of soft tissue tumours: a review

The diagnosis and classification of soft tissue sarcomas can pose difficult problems for the histopathologist. Many sarcomas are too poorly differentiated to exhibit morphological features specific enough to define their histogenesis. Using the immunoperoxidase technique with commercially available antisera as a routine adjunct to other diagnostic aids, it is possible to arrive at more accurate diagnoses on which treatment protocols can be based. In addition a better understanding of mesenchymal neoplasms and their origins can be obtained by functional immunohistochemical studies.     

Myolipoma of the round ligament: report of a case with a review of the English literature

Tumours consisting of a mixture of mature adipose and smooth muscle tissues, including those designated lipoleiomyomas, fibrolipoleiomyomas and myolipomas, are exceedingly rare, but most often occur in the uterine corpus. We describe here a case of such a tumour arising in the right round ligament of a 44-year-old woman. The tumour, which measured approximately 20×15×10 cm, was well encapsulated and did not involve the intrapelvic organs. Intricate mixtures of adult adipose tissue and bland smooth muscle exhibited no cellular atypia or nuclear mitotic figures, and there was little vascular proliferation. We diagnosed the lesion as a myolipoma of soft tissue with dual differentiation, and have found only 13 cases of this tumour including our own in the English literature. The present tumour is the first reported in the round ligament. Although this tumour is rare, its recognition is important for the avoidance of erroneous diagnoses.     

Papillary thyroid carcinoma presenting as a solitary soft tissue arm metastasis in an elderly hyperthyroid patient. Case report and review of the literature

A case of papillary thyroid carcinoma (PTC) presenting as a solitary metastasis in the right arm muscle is described in an elderly hyperthyroid male patient. A 2-cm nodule in the right bycipites muscle was found to be a papillary carcinoma of thyroid origin and a primary, 3.5-cm tumor was subsequently found in the left lobe of a hyperfunctioning gland due to toxic goiter. Both tumors were well differentiated PTC, follicular variant. No high grade features, nor extrathyroidal spread, nor regional lymph node metastases were found, but histology evidenced intrathyroidal vascular invasion. After radical surgery and radioiodine therapy, the patient is currently disease-free 4 years after diagnosis. This is the third reported case of PTC manifesting as a single soft tissue metastasis and the first associated with hyperthyroidism. Hematogenous spread of differentiated PTC is rare, although less unusual in PTC follicular variant. Histological vascular invasion, hypervascularity and increased blood flow in the hyperfunctioning thyroid gland might have facilitated the dissemination of malignant tumor cells through the bloodstream. Literature data indicate that PTC in elderly patients is increasing and is often clinically aggressive. Radical surgical and radiometabolic treatments are required also in this age group to improve clinical outcome.This work was partially supported by grants from the Italian Ministry of Education and University (ex 60% to MP).     

坏死性软组织感染的诊治

坏死性软组织感染(NSTI)是一类因细菌感染导致的皮肤及皮下软组织大面积坏死的疾病。首先,本文探讨了NSTI的流行病学、病因及其发病机制,并总结了其主要的致病微生物与分型。鉴于NSTI具有进展迅速和局部组织破坏严重的特点,随后本文重点描述了该疾病的临床表现并分析了其诊断要点,以提高临床医师对该疾病的警惕性。最后,本文概述了目前主要的治疗策略,包括彻底清创引流,充分复苏和应用敏感抗生素等。     

The wrinkly skin syndrome: a report of a case and review of the literature

A 2 1/2-year-old boy born of Jewish Moroccan parents is reported with physical findings of wrinkled skin on the dorsum of the hands and feet, with poor skin elasticity, syndactyly, mild kyphosis and poor muscle tone, the diagnosis being the wrinkly skin syndrome. All reported cases of this heritable disorder of connective tissue are reviewed and discussed in terms of genetics, ethnic clustering and differential diagnosis.     

Pleomorphic hyalinizing angiectatic tumor of soft parts: a case report and literature review

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, recently recognized neoplasm occurring predominantly in the subcutaneous tissue of the lower limbs of adults. We report a case of PHAT in an 83-year-old woman who presented with a 5.0 x 5.0 x 2.0 cm mass in the soft part of her left thigh. Histologically, the tumor was well circumscribed by a thin fibrous capsule and predominantly composed of fusiform cells with eosinophilic cytoplasm and round-to-oval or pleomorphic nuclei. The tumor cells resembled those of malignant fibrous histiocytoma, but differed from them by less prominent mitotic figures. Immunohistochemically, the tumor cells were diffusely and strongly positive for CD34; partially positive for vimentin and CD99 (MIC-2); and negative for epithelial and non-epithelial markers. Ultrastructurally, the tumor cells had pleomorphic cytoplasm and nucleus. Intermediate-sized cytoplasmic filaments were observed in a few tumor cells, but neurosecretory-type granule-like intracytoplasmic organelles were not seen. These findings suggest that this tumor is derived from stromal fibroblast, such as solitary fibrous tumors or giant cell angiofibroma.