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1.
目的总结甲状腺滤泡癌样肾细胞癌(TFCLTK)的临床、病理及免疫学特征,对TFCLTK的诊疗进行探讨。方法报告1例甲状腺滤泡癌样肾细胞癌,结合文献检索到的11例,分析此类肿瘤的临床特征、影像学、病理学及免疫表型特点,治疗及预后。结果肉眼观察见肾表面呈结节状,切面可见一巨大肿块,于肾下极并向肾盂内生长,肿块约8.0cm×4.3cm×5.0cm,与肾实质分界不清,切面灰白色,实性,可见散在灰褐色坏死区及灰色出血区,小囊腔形成。镜下观察见肿瘤细胞排列成甲状腺滤泡样,滤泡腔内可见红染胶体样物,肾门旁淋巴结未查见转移地肿瘤细胞。免疫组化结果:Vimentin(+),EMA(+),CK(+),CK7灶(+),NSE(+)。CK34BE12(-),Syn(-),CK20(-),CD56(-),CD56(-),CD10(-),WT-1(-),CD34(-),CD57(-),P53(-),CD99(-),TTF-1(-),CD15(-),Tg(-),Ki-67LI 30%(+)。结论甲状腺滤泡癌样肾细胞癌是具有一定侵袭性的低度恶性的肾源性肿瘤。目前已明确病理学及免疫表型特点为细胞形态学类似甲状腺滤泡癌细胞,但TTF-1和TG蛋白表达阴性。可行根治性肾切除术,预后较好。 相似文献
2.
阑尾滤泡树突状细胞肉瘤的临床与病理 总被引:2,自引:0,他引:2
目的 探讨阑尾滤泡树突状细胞肉瘤(follicular dendritic cell sarcoma,FDCS)的生物学行为特征,诊断要点和临床治疗.方法 对1例阑尾FDCS术后8个月腹腔内复发患者的手术标本进行病理形态学观察、免疫组化检测.结果 两次手术切除的肿瘤的组织病理学形态一致.免疫组化:CD21、CD35、S-100、Vimentin、CD68和FN呈阳性反应;CD117、CD34、SMA、Actin、NSE和CK呈阴性反应.病理学诊断:阑尾FDCS,腹腔内复发.结论 FDCS是一种非常罕见的肿瘤,大多发生于淋巴结,少数可见于淋巴结外.手术切除是治疗FDCS的主要方法. 相似文献
3.
目的探讨肝滤泡树突细胞肉瘤(hepatic follicular dendritic cell sarcoma,HFDCS)的临床表现、影像学特点、病理特征、诊断与鉴别诊断、治疗与预后及其与EB病毒的关系。方法2010年2月诊治1例HFDCS,并通过检索国内外相关文献,检索到16例HFDCS,对其进行回顾性综合分析。结果HFDCS的临床表现不典型,甲胎蛋白检测结果阴性,CT表现多为单发型低密度灶,边界模糊。动脉期边缘轻度强化。免疫学检查:特异性滤泡树突状细胞(FDC)标志物CD21、CD35、R4/23、Ki-FDC1p、Ki-M4等表达阳性,而上皮性标志物CD18、上皮膜抗原(EMA)等阴性。利用EB病毒寡核苷酸探针(EBER)原位杂交法检测EB病毒阳性率为80%。17例中15例接受手术治疗,复发率与5年生存率均为30%。结论HFDCS十分罕见,其病因可能与EB病毒感染密切相关;目前,HFDCS的诊断与鉴别诊断主要依靠免疫组织化学检测;该病复发率很高,但预后相对较好。 相似文献
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目的 探讨炎性假瘤样滤泡树突细胞肿瘤的临床病理特征及生物学行为.方法 收集中国医科大学附属盛京医院病理科2001-2010年诊断为肝脏炎性假瘤样滤泡树突细胞肿瘤(1例)、肝脏和脾脏炎性假瘤病例(13例)资料、复查HE切片、进行免疫组化染色、EB病毒编码的核RNA(Epstein-Barr virus encoded nuclear RNA,EBER)原位杂交,并追踪患者预后.结果 免疫组化染色和EBER原位杂交证实,13例肝脏和脾脏炎性假瘤中有1例为脾脏炎性假瘤样滤泡树突细胞肿瘤,有特殊的组织学形态;1例肝脏炎性假瘤样滤泡树突细胞肿瘤则经进一步检查证实,其组织形态与文献报道一致.2例患者均为女性,术后分别随访2.5年、6年均健在.结论 炎性假瘤样滤泡树突细胞肿瘤应从炎性假瘤中分离出来,此病非常少见.该肿瘤主要发生于肝脏和脾脏,确诊依赖组织形态和免疫组化.其生物学行为相对惰性,属于低度恶性肿瘤,手术彻底切除是根本的治疗方法.本文2例为炎性假瘤样滤泡树突细胞肿瘤的相对惰性的生物学行为提供了进一步的证据. 相似文献
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目的 探讨骨嗜酸性肉芽肿的临床病例特点及鉴别诊断。方法 收集26例骨嗜酸性肉芽肿,行组织病理学观察和免疫组化染色,并复习相关文献。结果 骨嗜酸性肉芽肿患者多为青年人,受累骨组织见朗格汉斯细胞和组织细胞不同程度增生,伴嗜酸性细胞、淋巴细胞等,免疫组化检测肿瘤细胞S - 100 (+) 、CDlα(+)、Vitnentin(+),CD68 (-)、Syn(-)。结论 骨嗜酸性肉芽肿组织病理学具有一定特点,需与多种疾病鉴别,免疫组化染色对其确诊有帮助。 相似文献
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《中华肝胆外科杂志》2022,(6)
炎性假瘤样滤泡树突细胞肉瘤是一种罕见的低度恶性肿瘤, 具有复发倾向, 最常见的发生部位是腹腔内脏器, 以肝脏、脾脏多见。本文报道了1例湖南师范大学附属第一医院收治的肝炎性假瘤样滤泡树突细胞肉瘤患者的临床资料, 以期为临床诊疗提供一定参考。 相似文献
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烧伤并发内毒素血症早期肝损害与TNF—αmRNA表达的实验研究 总被引:4,自引:0,他引:4
目的 观察TNF-αmRNA及其蛋白的组织分布和细胞定位,探讨烧伤并发内毒素血症早期肝损害的发生机理。方法 选用20%Ⅲ度TBSA烧伤大鼠合并腹腔内毒素(LPS)注射造成烧伤复合内毒素血症肝损害模型,采用光镜,电镜及免疫组化原位杂交染色观察产肝脏的形态功能变化、血清TNF-α含量变化、肝组织TNF-α和TNF-α mRNA的细胞定位及其分布。结果 烧伤复合内毒素血症组,光镜下主要表现肝窦反应,枯否细胞(KCs)激活与增生以及肝细胞(HCs)变性坏死等;电镜下主要表现肝窦内血小板聚集、纤维素沉积与中性粒细胞(PMNs)扣押以及KCs、肝细胞退变溶解等。血清丙氨酸氨基转氨酶(ALT)显著升高(P<0.01)和白蛋白(ALB)轻度下降。组织TNF-α主要定位于肝窦内皮细胞(SECs)、KCs。TNF-αmRNA主要定位于KCs、PMNs、巨噬细胞(MPs)。而在单因素组主要特点为病变程度轻,肝功能损害不明显,血清TNF-α峰值滞后以及组织TNF-α和TNF-αmRNA表达相对较弱等。结论 TNF-α是参与烧伤复合内毒素血症早期肝脏损害的重要细胞因子。 相似文献
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目的:探讨皮肤上皮样肉瘤的临床病理特点,免疫组化表型及生物学行为.方法:收集5例皮肤ES患者的资料,运用显微镜观察、免疫组化等方法观察和分析其临床、细胞学涂片和病理学组织学特征.结果:本组肿瘤全部原发于皮肤,肿瘤呈结节状浸润性生长,瘤细胞又由两种细胞组成,大部分为多角形或卵圆形,胞浆丰富,嗜酸性,少部分呈胖梭形,象纤维母细胞样,常围绕在结节周围,结节中央常有坏死.免疫组化示:上皮膜抗原(EMA),细胞角蛋白(CK),波形蛋白(Vimentin)均强阳性,CD34及CD68弱阳性,其余多项免疫组化结果均呈阴性.结论:ES少见且形态复杂多变,只凭光镜容易误诊,肿瘤细胞学对其诊断无特异性,需结合免疫组化结果才能做出正确的诊断.ES预后差,患者常需行肿物扩大甚至根治术. 相似文献
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目的:探讨前列腺滑膜肉瘤的影像学特点、临床病理和诊治方法。方法:对1例原发性前列腺滑膜肉瘤的临床诊治资料进行回顾性分析。该例患者行超声、CT、MRI检查。手术后病理证实(免疫组化)。结果:该患者行前列腺肿瘤根治性切除术。病理:镜下所见异型性细胞片状分布,免疫组化:CK34(+),CD99(+),Ki67(+),MYOD1(+/-),Actin(+),CD117(+),dog-1(+/-),Vimentin(+)。诊断原发性前列腺滑膜肉瘤随访6个月,患者存活。结论:原发性前列腺滑模肉瘤临床罕见,确诊依赖病理及免疫组化检查。应与梭形细胞肿瘤、恶性神经鞘瘤、横纹肌肉瘤、间质肉瘤鉴别。治疗以手术为主,需根据肿瘤分级分期决定手术方案及术后是否需行辅助治疗。 相似文献
10.
CD70在肾癌中的表达及意义 总被引:1,自引:0,他引:1
肾细胞癌(RCC)的发生和进展机制目前仍不完全清楚。肾癌细胞对放疗、化疗和生物治疗均不敏感,并且有高转移率及转移后的低生存率的特点。目前肾癌术后预后评估的方法主要依靠临床和病理学表现,尚无敏感的标记物来预测肿瘤的复发或转移。Ⅱ型跨膜糖蛋白CD70是肿瘤坏死因子家族成员,主要表达于抗原提呈细胞(APCs),如B细胞,DC细胞;少量的T淋巴细胞和多种肿瘤细胞。CD70在肾癌细胞内的特异高表达及在正常肾组织内不表达,这为肾癌的诊断,治疗和预后判断提供了理想的途径。本文对CD70的研究现状和其临床应用前景综述如下。 相似文献
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??Hepatic ollicular dentritic cell sarcoma: a case report and review of the literature LIU Jun??ZHANG Zhong-tao??LI Jian-she, et al. Department of General Surgery, Beijng Friendship Hospital, Capital Medical University, Beijing 100050,China Corresponding author: ZHANG Zhong-tao , E-mail: zhangzht@medmail.com.cn Abstract Objective To explore the hepatic follicular dendritic cell sarcoma (FDCS) of the histopathological and immunohistochemical characteristics. Methods One case of hepatic FDCS was diagnosed and treated in June 2008 at Beijng Friendship Hospital of Capital Medical University. Histopathological and immunohistochemical characteristics of hepatic FDCS and related literature review were analyzed and summarized. Results The hepatic FDCS hadn’t special symptoms nor characterized imaging features, and was difficult to make correct diagnosis before operation. A large single mass in liver was showed in CT scan. Microscopically, the neoplastic cells were in ovoid or spindle and some of them had indistinct cell borders. Neoplastic cells were positive for CD35, but negative for CD21, CD23, S-100, ALK, EBER in immunohistochemical analysis. Conclusion The FDCS is a rare low-grade malignant tumor. Its diagnosis should mainly rely on histopathological and immunohistochemical findings. Complete excision is the main therapeutic method for it. 相似文献
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治疗效果同治疗方式及理念的规范化密切相关,治疗的规范化带来了治疗效果和预后的改善。从全直肠系膜切除(TME)的理念提出和广泛应用,到肿瘤相关系膜切除(TSME)概念对TME进行完善和补充,直到近年完整结肠系膜切除(CME)理念的提出,胃肠外科医师对规范结直肠癌外科治疗的努力从未停止过。 相似文献
13.
肿瘤局部复发是直肠癌病人手术后最为重大的生存风险之一。因此,降低直肠癌根治术后的局部复发率一直是结直肠外科的主要挑战。降低吻合口复发率以及局部复发率,重点在于预防,在于原发肿瘤手术时的安全切缘以及全直肠系膜切除标本的完整性,在于围手术期肿瘤综合治疗策略的执行力度。吻合口复发以及局部复发的治疗,需要手术结合多学科综合治疗协作组(MDT)模式治疗方式。从低位前切除术(LAR)到腹会阴联合切除术(APE)手术,甚至后盆腔器官切除、全盆腔器官切除,如果能够达到R0切除,都是可选择的再次手术切除方式。如何改善病人的术后生活质量,目前尚存争议。 相似文献
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微创时代复杂胆道结石的处理 总被引:2,自引:0,他引:2
随着纤维十二指肠镜、胆道镜以及腹腔镜技术的广泛应用,多镜联合治疗胆管结石已经日趋成熟,成为传统治疗技术的有益补充。拟采用微创技术治疗的病人,更应对其病情进行全面的了解,准确进行术前评估。无论采用何种治疗方式,都必须严格遵守“祛除病灶、解除梗阻、取尽结石、通畅引流”的治疗原则。每一位外科医生都应该努力掌握微创技术,以便统览全局,为病人制定出有效、微创的“个体化”治疗方案。在遇到无法解决的困难时,术者应及时改变治疗策略,甚至中转开腹手术,避免胆道损伤。 相似文献
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�� ΰ�������� 《中国实用外科杂志》2009,29(7):563-565
??Treatment of complicated cholelithiasis in Era of minimally invasive Surgery GUO Wei,ZHANG Zhong-tao. Department of General Surgery, Beijing Friendship Hospital,Capital Medical University , Beijing100050,China Corresponding author: ZHANG Zhong-tao??E-mail??zhangzht@medmail.com.cn Abstract With the maturity of fiber duodenoscope, choledochoscope and laparoscopic technique, the hybrid minimally invasive surgery has been more and more popular in the therapy of bile duct stone, and became useful alternative procedure to the treatment. For the patients to be treated by the minimally invasive technique, the preoperatively accuate assessment and comprecensive planning are very important. No matter what procedure would be used, it must obey the following principles: eliminating lesions, relieving obstruction, clearing stones and expediting drainage. Every surgeon should master the all these techniques, in order to plan an effective, minimally invasive and individualized treatment, meanwhile to try to avoid iatrogenic bile duct injure. 相似文献
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������a���� ��b��������b�����ab����ʤ��b���� ��b��������a��������a�������a���� ��a���� ��a����ɺɺa���� ��a 《中国实用外科杂志》2011,31(12):1127-1129
??Influences on quality of life of patients with breast cancer undergone different styles of operations LI Pei-xin*, QU Xiang, ZHANG Zhong-tao, et al.*Department of Lomprohensive Surgery, Medical and Healthy Center, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050,China
Corresponding author: QU Xiang, E-mail??cqx3968@sina.com
Abstract Objective To explore influences on quality of life of patients with breast cancer undergone different styles of operations. Methods During January 2008 and May 2010, 48 patients undergone breast reserved mastectomy, 57 patients undergone modified radical mastectomy and 50 normal persons admitted in Beijing Friendship Hospital Affiliated to Capital Medical University were included in the research, in which GQOLI-74 was used to assess the quality of life. Results The study showed that patients with breast caner had a lower point than normal persons in physical function, psychological function and social function. Patients undergone modified radical mastectomy had lower points than those undergone breast reserved mastectomy. Conclusion The quality of life of the patients with breast cancer is obviously lower than normal persons. The quality of life of the patients undergone breast reserved mastectomy is higher than those undergone modified radical mastectomy. 相似文献
Corresponding author: QU Xiang, E-mail??cqx3968@sina.com
Abstract Objective To explore influences on quality of life of patients with breast cancer undergone different styles of operations. Methods During January 2008 and May 2010, 48 patients undergone breast reserved mastectomy, 57 patients undergone modified radical mastectomy and 50 normal persons admitted in Beijing Friendship Hospital Affiliated to Capital Medical University were included in the research, in which GQOLI-74 was used to assess the quality of life. Results The study showed that patients with breast caner had a lower point than normal persons in physical function, psychological function and social function. Patients undergone modified radical mastectomy had lower points than those undergone breast reserved mastectomy. Conclusion The quality of life of the patients with breast cancer is obviously lower than normal persons. The quality of life of the patients undergone breast reserved mastectomy is higher than those undergone modified radical mastectomy. 相似文献
17.
全直肠系膜切除(TME)规范了低位直肠癌手术的切除范围,是低位直肠癌手术治疗的金标准。结直肠外科医生需要在做好规范化的TME手术基础上,综合考量直肠癌治疗策略,降低局部复发风险,保护病人肛门功能、性功能、排尿功能以及提升生活质量,并且考虑如何减少手术创伤。目前,直肠癌诊治领域的研究热点转向如何更好地保护功能以及进一步降低局部复发风险,其中新辅助放化疗后临床完全缓解的“等待观察”策略、侧方淋巴结清扫以及经肛全直肠系膜切除(TaTME)等是目前临床研究的热点问题。 相似文献
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��ӯ�࣬�� ᰣ������� 《中国实用外科杂志》2015,35(8):850-856
??Pure transanal total mesorectal excision:A report of 8 cases YANG Ying-chi, JIN Lan, ZHANG Zhong-tao. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University??National Clinical Research Center for Digestive Diseases,Beijing100050,China
Correspondence author??ZHANG Zhong-tao. E-mail: zhangzht@medmail.com.cn
Abstract Objective Discussed feasibility and perioperative safety of pure transanal TME. Methods 8 patients with mid-or low rectal tumors were selected to undergo pure transanal TME using the SILS port platform in Department of General Surgery, Beijing Friendship Hospital from May to July, 2015. Perioperative clinical data and histological parameters were reviewed and analyzed. Results 8 patients were successfully completed pure transanal TME. No case was laparoscopic assisted operation and laparotomy. The quality of specimens, including the specimen length (15~29 cm) and the distal margin (1.5~3.0 cm), are satisfied. The average length of hospital stay was 4.8 days (3~7 days). One case occurred postoperation uroschesis. The average operative duration was 219 minutes (160~300 minutes). Conclusion pure transanal TME is a new direction in the surgical treatment of distal rectal cancer. But larger, randomized controlled trials with longterm follow-up are warranted. 相似文献
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�����Σ��� ΰ 《中国实用外科杂志》2011,31(1):29-31
经自然孔道内镜外科(natural orifice transluminal endoscopic surgery,NOTES)经过近10年的研究,已经由一个理想中的概念走向初步的临床应用.由于其尚存在诸多较难克服的技术瓶颈,现阶段仍无法广泛开展.经脐单孔腔镜手术是目前最现实可行的"无瘢痕"技术.该技术近年来在国内外进... 相似文献