8年来门诊手术体表良性肿物术后复发率统计分析

体表肿物来源于皮肤、皮肤附件、皮下组织等浅表组织的肿物[1].随着医疗水平的不断提高,门诊手术室的改善以及门诊手术档案制度的建立,此类浅表肿物完全可以在门诊进行.现将2002年4月至2010年5月8年来本院门诊手术体表良性肿物6100例患者资料,重点复发率作一统计分析.     

如何诊断和治疗体表肿物

所谓体表肿物,一般是指肉眼可以直接看到,或者通过简单触诊就能摸到的身体表面的肿物。皮脂腺囊肿、植入性囊肿、脂肪瘤、纤维瘤、血管瘤、黑痣、腱鞘囊肿等等,都是常见的体表肿物。由于这类肿物的发病率非常高,而且许多患者常常为这些普通的肿块而担忧,所以,医务工作者有责任对这些肿物作出     

四肢体表肿物四例误诊分析

目的 探讨四肢体表肿物误诊误治的原因及治疗对策.方法 回顾分析2008-2010年4例体表肿物临床资料,分析其误诊、误治的原因.结果 4例分别因右拇指肿物半年、右肘肿物伴麻木半月、右股肿物1个月、左外踝肿物3年入院,分别误诊为纤维瘤2例,滑膜瘤、外踝肿瘤各1例.经手术后病理确诊为右拇指间关节结核、右肘淋巴结梅毒、右股平滑肌肉瘤、左外踝色素沉着绒毛结节性滑膜炎.结论 四肢体表肿瘤虽然诊断相对较容易,但因组织类型众多误诊时有发生,手术切除的任何组织均要病理检查,避免贻误病情.     

自制简易自动拉钩在浅表手术中的应用

体表肿物尽管表浅,但均有一定深度,因此浅表肿物切除术往往需要有一个助手在术中帮助用拉钩显露肿物。在人员不足的情况下,手术往往很难进行。目前的自动拉钩多数为腹腔、胸腔、阴道、直肠等深部手术设计,不适合浅表手术[1-3]。尽管     

超声引导下经体表植入125I粒子治疗晚期恶性肿瘤

目的评价超声引导经体表放射性粒子植入治疗恶性肿瘤的疗效.方法我院共进行超声引导下经体表粒子植入8例,11人次,29个病灶.应用超声测量病灶肿物的体积大小来判断疗效.结果肿物治疗前为216～4.3 cm3,平均30.8 cm3.治疗后肿物为67.2～1 cm3,平均19.7 cm3.两者之间的差异有统计学意义(P=0.000).结论超声引导下经体表粒子植入125I方法安全,疗效可靠.     

美容缝合技术在体表肿物切除手术中的临床应用

目的 观察美容缝合技术在体表肿物切除手术中的临床应用效果。方法 选取烧伤整形科收治的158例体表肿物患者作为治疗组,选取同期普通外科收治的体表肿物传统手术治疗者149例作为对照组。治疗组患者体表肿物切除手术中均应用美容缝合技术。术后2周及6个月后进行随访,比较2组患者手术切口愈合情况。采用视觉模拟评分法(VAS)评估2组患者手术治疗满意度;采用温哥华瘢痕评分量表(VSS)评估2组术后瘢痕情况,比较2组瘢痕宽度。结果 术后2周,治疗组切口甲级愈合率为96.8%(153/158),高于对照组的91.3%(136/149),差异有统计学意义(P<0.05)。术后6个月,治疗组VSS评分、VAS评分低于观察组,差异有统计学意义(P<0.01)。治疗组患者瘢痕平均宽度为(1.72±0.86) mm,小于对照组的(4.55±2.38) mm,差异有统计学意义(P<0.01)。结论 美容缝合技术应用于体表肿物切除手术可显著减轻组织损伤和切口瘢痕,改善患者术区外形,并提高患者的手术满意度。     

超声引导下经体表植入地^125I粒子治疗晚期恶性肿瘤

目的评价超声引导经体表放射性粒子植入治疗恶性肿瘤的疗效。方法我院共进行超声引导下经体表粒子植入8例，11人次，29个病灶。应用超声测量病灶肿物的体积大小来判断疗效。结果肿物治疗前为216-4．3cm^3，平均30．8cm^3。治疗后肿物为67．2～1cm^3，平均19．7cm^3。两者之间的差异有统计学意义（P=0．000）。结论超声引导下经体表粒子植入^125I方法安全，疗效可靠。     

常见体表肿物的诊治：第9讲 面颊部肿物

1涎腺肿大 1．1腮腺区肿物 腮腺部位除炎症、肿瘤外,在临床上经常遇到腮腺和腮腺区肿大,在体表肿瘤的鉴别中,应当注意。     

基层常用诊疗和护理技术（2）

13．1概念 临床工作中经常遇到某些体表肿物，通过物理或影像学等其他检查很难正确作出诊断，为了明确诊断、制定合理的治疗方案，因而常需切除少许肿物进行病理检查，为选择正确的治疗方案提供科学依据。     

侵袭性血管黏液瘤一例

患者女,36岁,14年前发现左侧臀部肿物,直径约2cm,突出于皮面,无红肿热痛表现,于13年前在外院行体表肿物切除术后,考虑为纤维血管瘤。切除后肿物复发并逐渐增大,3年前CT检查提示阴道占位。发病后大便次数增多,无发热腹痛。     

体表肿块细针吸取细胞学检查诊断价值的探讨(附 387 例分析)

目的　探讨细针吸取细胞学 (fineneedleaspirationcytology ,FNAC)检查对体表肿块的诊断价值。方法　采用“友谊式细针穿刺器对” 3 87例体表肿块行FNAC检查。结果　在 3 87例FNAC检查中 ,确诊结核 91例 ,疑似结核 3 8例 ;确诊恶性肿瘤 2 9例 ,可疑恶性肿瘤 6例 ;其他病变 2 2 3例。结论　FNAC是体表肿块 (包括淋巴结结核 )病理诊断的有效方法之一 ,但也存在一定的局限性 ,可以通过病理活检或其他方法解决。     

1035例乳腺肿物细针吸取细胞学的分析

目的：分析乳腺肿物细针吸取细胞学（FNAC）对乳腺恶性肿瘤诊断的敏感性。方法：复习乳腺肿物FNAC检查1035例,与其中手术后获病理组织学诊断502例做对照比较。结果：乳腺肿物FNAC对乳腺恶性肿瘤诊断的敏感性为98.9％,特异性为85.7％。细胞学诊断为阳性者（IV、V级）,术后除1例（IV级）外,均证实为恶性。结论：FNAC诊断乳腺癌较为敏感。     

B超引导下细针吸取细胞学涂片对肾癌的诊断价值

目的探讨细针穿刺细胞学涂片对肾癌的诊断价值。方法选取有病理组织学对照的59例肾癌病例。每一病例术前均行细针穿刺细胞学涂片（FNAC）,分析细胞学涂片对肾癌诊断的准确率。结果FNAC诊断准确率为83．1％（49／59）。对恶性肿瘤分型中,FNAC诊断准确率为66．1％（39／59）,差异显著（P〈0．05）。结论细针吸取细胞学对。刖嘉的诊断准确性较高,但对组织分型诊断特异性较差。     

Fine-needle aspiration cytology of an intrathyroidal nodule diagnosed as squamous cell carcinoma: A case report

BACKGROUNDBoth squamous cell carcinoma (SCC) and papillary thyroid carcinoma (PTC) are common malignant tumors in the neck. However, seldom has SCC of the thyroid been diagnosed. Further, cytological features of SCC and PTC have rarely been reported. The significance of fine-needle aspiration cytology (FNAC) in the diagnosis of neck masses has been established. Herein, we present an exceedingly rare case of an intrathyroidal SCC diagnosed using FNAC, along with its cytological features.CASE SUMMARYA 66-year-old man presented with a left-sided neck mass. Ultrasound examination showed an ill-defined nodule. The appearance was hypoechoic with a few hyperechoic spots. FNAC of the left thyroid nodule was performed. A cellular smear was obtained, and it showed a large number of neoplastic cells with rich cytoplasm and poor cell adhesion. Tumor cell nuclei showed coarse nuclear chromatin and a few enlarged prominent nucleoli. An increased nuclear/cytoplasm ratio was observed. Thus, malignancy was diagnosed without a confirmed tumor type. Percutaneous tumor biopsy was performed to make a definite diagnosis. The tumor cells showed typical squamous cell characteristics.CONCLUSIONHead and neck SCC and PTC have different cytologies. Measures are needed to ensure accurate diagnosis using FNAC.     

乳腺肿物细针吸取细胞学2938例诊断和误诊因素分析

目的　探讨细针吸取细胞学诊断乳腺肿物的作用及临床意义 ,并对容易误诊的因素进行分析。方法　分析2 938例乳腺肿物细针吸取细胞学 (FNAC)的诊断结果 ,与 784例经手术获组织病理学诊断的结果进行比较。结果　FNAC对乳腺恶性肿瘤诊断的敏感性为 95 .9% ;对乳腺良性肿瘤的诊断符合率为 96 .3% ;对乳腺恶性肿瘤的诊断符合率为 99.3% ;假阴性率和假阳性率分别为 3.8%和 0 .7%。结论　FNAC对乳腺肿物诊断具安全、可靠、阳性率高等优点 ,可作为乳腺肿物常规检查手段 ,值得推广应用     

乳腺肿块细针吸取物的细胞学诊断价值

目的 探讨细针吸取对乳腺肿块的细胞学诊断价值.方法 分析术后病理学诊断对照的333例乳腺肿块细针吸取物的细胞学诊断资料.结果 127例乳腺恶性肿块细针吸取的细胞学诊断为恶性102例,可疑10例,良性15例;206例乳腺良性肿块细针吸取物的细胞学诊断为良性201例,可疑5例;采用国际通用细胞学诊断准确性统计方法 (Frabl,1989)统计,本组敏感性80.3%,特异性97.6%,假阴性率11.8%,准确率91%,且部分乳腺肿块细胞学与病理学诊断完全一致.结论 细针吸取的细胞学诊断可以结合临床确诊绝大多数乳腺肿块的良恶性,而且可以作为确诊部分乳腺良性肿块的组织学类型的一种方法 .     

Cysticercosis presenting as cervical lymphadenopathy: a rare presentation in two cases with review of literature

Lymphadenopathy is a rare mode of presentation of cysticercus infestation. Hence, in endemic areas, cysticercosis must be included in the differential diagnosis of superficial palpable swellings in the neck region. We report two cases of cervical lymphadenopathy which were clinically suspected to be of tuberculous etiology. However, fine-needle aspiration cytology (FNAC) revealed features of parasitic lymphadenitis consistent with cysticercosis. Our cases highlight the importance of FNAC as an initial and rapid diagnostic modality for detecting parasitic lesions manifesting as lymphadenitis. Diagnosis by the minimally invasive FNA technique prompted an early therapeutic intervention with good response in our patients.     

B超引导下细针穿刺细胞块对胰腺占位性病变的诊断价值

目的 探讨术前细针穿刺细胞块对胰腺占位性病变的诊断价值。方法回顾分析本院2005年1月至2010年6月收治的胰腺占位性病变83例,术前均行B超引导下穿刺作细胞学涂片及细胞块检查,并与最终病理诊断作对比研究。结果细胞学涂片和细胞块切片的准确性分别为89．2％、97．6％,两者比较差异显著（P〈0．05）。细胞块诊断实性假乳头状瘤和胰腺内分泌肿瘤的准确性均为100％。结论术前穿刺细胞块检查可提高诊断的准确性。细胞块结合免疫组化分析,有助于提高胰腺肿物的分型,尤其是实性假乳头状瘤和胰腺内分泌肿瘤的检出率,减少漏诊和误诊。     

Correct diagnosis of Warthin tumor in the parotid gland with dynamic MRI

Warthin tumor (WT) is a benign tumor of the salivary gland primarily affecting middle-aged men. WT is almost exclusively located in the parotid gland and tend to grow slowly without symptoms. Although fine needle aspiration cytology (FNAC) often correctly diagnoses these tumors, they are occasionally misdiagnosed as malignant. Our study sought to distinguish between WT and non-WT using dynamic MRI. In dynamic MRI, a series of images are taken over time measuring the intensity of gadolinium uptake by the parotid. We examined two patients for this study. The first was a 53-year old male, heavy smoker, experiencing manic-depressive episodes. He received a brain MRI at which time his parotid tumor was discovered. Parotid FNAC indicated a squamous cell carcinoma. The second patient was a 76-year old male, moderate smoker and drinker, who had been complaining about swelling in the neck. FNAC of the parotid indicated acinic cell carcinoma and gadolinium-enhanced MRI suggested the tumor was malignant. Prior to surgically extracting of these masses, we performed dynamic MRI on each patient. Both tumors exhibited a pattern consisting of rapid enhancement and rapid attenuation, the pattern of which is characteristic of WT. The surgical specimens confirmed that both were WTs without malignant transformation. Our findings indicate that dynamic MRI is a useful tool for preoperative diagnosis of WT, where other examinations indicate malignancy. Early and correct diagnosis of WT can minimize the use of invasive procedures, and eliminate the stress placed on the patient from a diagnosis of cancer.     

口腔颌面部肿物FNAC与组织学对照研究

目的 探讨口腔颌面部肿物针吸细胞学诊断的准确性。方法 109例口腔颌面部肿物针吸细胞学与其手术标本组织病理学诊断对照。结果 109例中组织病理学诊断良性病变46例,针吸细胞学诊断的符合率为91.3%,其特异性在90％以上。组织病理学诊断恶性肿瘤63例,针吸细胞学诊断符合率为74.6%,其敏感性在75％左右。结论 针吸细胞学对口面部良性肿瘤及非肿瘤性病变的诊断准确性较高,可减少一些不必要的手术治疗;而对口面部恶性肿瘤的诊断准确率偏低,这与某些肿瘤仅凭形态不能判断良恶性有关。