儿童前上纵隔巨大未成熟畸胎瘤一例

患者,男,14岁。因反复发热、咳嗽咳痰20d入院。入院后胸部CT（图1）提示左前纵隔占位,考虑畸胎瘤,肿瘤压迫左上肺,致部分肺不张。左肺内少许感染。     

纵隔畸胎瘤破入肺内1例

患者女性24岁，两年前突然出现刺激性咳嗽、咯痰，痰中带有鲜红色血丝，伴右侧胸痛。无畏寒、发热和潮热、盗汗。胸片和CT检查均诊断为肺结核，经正规抗结核治疗后上述症状好转。但胸片复查无明显改变。2002年6月1日，因咳嗽、咯痰、痰中带血，门诊以右上肺结核收入住院。入院检查：体温36．4℃，脉搏78次／     

肺内畸胎瘤1例

性腺和前纵隔是畸胎瘤的好发部位,肺内畸胎瘤罕见.我院胸外科近三十年肺肿瘤切除术中仅发现1例,患者术后治愈出院.现报告如下.     

卵巢成熟性畸胎瘤恶变为腺癌1例

卵巢成熟性畸胎瘤恶变为腺癌十分罕见,确诊主要依赖病理检查及免疫组化,治疗以手术治疗为主,辅以化疗或放疗,临床Ⅰ期预后相对较好.本文回顾性分析1例卵巢成熟性畸胎瘤恶变为腺癌病例的临床特点及诊治方法,并结合相关文献进行总结报道,以提高对这类疾病的认识.     

纵隔畸胎瘤穿入肺引起大咯血二例

1991年 1月～ 2 0 0 0年 1月我院收治纵隔畸胎瘤穿入肺引起大咯血患者 2例。报道如下。1　病例报告例 1:患者男 ,42岁 ,因咳嗽、吐痰 2 0ｄ并大咯血 2ｄ来诊 ,入院前 1ｄ咯血 30 0ｍＬ。查体 :Ｔ 37 0℃ ,Ｐ 88次 /ｍｉｎ ,Ｒ 2 1次/ｍｉｎ ,Ｂｐ 10 5 /71 3ｍｍＨｇ ;气管居中 ,右肺上部可闻及少许干湿罗音 ,呼吸音减低 ;胸片示 :右肺上野中内带片状模糊影 ,密度不均 ,侧位片示病变位于右肺上叶前段。左肺无明显异常。查Ｈｂ 90ｇ/Ｌ ,ＷＢＣ 8 9× 10 9/Ｌ ,Ｎ 0 78;痰结核菌 (-)。入院后 ,经止血芳酸、安络血、止血敏、脑垂体后叶素及激…     

纵隔畸胎瘤破入肺内既往卵巢畸胎瘤1例

多部位畸胎瘤较少见,而胸部畸胎瘤破裂导致肺内严重感染在临床上治疗比较棘手.因畸胎瘤破裂而导致的手术前后患者出现高热等严重的感染症状,往往使病情难以控制.本科室收治1例卵巢畸胎瘤术后2年发现纵隔畸胎瘤破裂入肺的病例,现分析如下. 患者女性,30岁,2013年5月16日快速奔跑后突然感到胸前区剧烈疼痛,伴呼吸困难,向背部放射.行胸CT提示上纵隔占位,回家休养.2013年5月18日淋大雨后发热,达38℃,急诊入外院.患者于2年前本院彩超示晚期妊娠,母体子宫右侧附件区9.5 cm×8.2 cm囊性肿物.妊娠38周终止妊娠,2011年7月20日行剖宫产及右侧附件区切除术.病理诊断为右卵巢囊性成熟型畸胎瘤.2013年5月20日入本院后,胸部CT双侧胸腔后部见弧形影,左侧明显,左肺下叶致密片影,肺门影不大.气管及双肺叶段支气管通畅.双侧胸腔积液,左侧较多.左纵隔增宽,可见囊实混杂密度肿块,胸廓入口水平至左心房上方水平,最大横面约6.6 cm×6.8 cm,病变与纵隔结构分界不清.各层面未见肿大淋巴结.     

以咯血和胸痛为表现的儿童纵隔畸胎瘤1例

儿童纵隔畸胎瘤(mediastinal teratoma)临床少见,症状缺乏特异性,早期诊断困难,常导致误诊和漏诊.当瘤体增大压迫周围组织和器官可出现咳嗽、喘息、咯血、胸痛等症状.现将我们遇到的1 例典型病例进行报道,提高对该病的认识水平,减少误诊误治.     

原发性纵隔精原细胞瘤2例报告

例1:患者男性,34岁,工人.住院号:873086。主因:无明显原因突发性胸部针刺样剧烈疼痛,X光片示右上纵隔前方块影8cm×6cm,拟诊为“胸腺瘤”.于87年6月25日手术切除,术中见肿瘤8cm×6cm×5cm与胸腺、右肺上叶粘连.术后病检为;右上纵隔精原细胞瘤(生殖细胞癌)。术后40天补充放疗,体查.双侧睾丸、阴束、腹股沟未触及异常改变。采用10M.V.X线全纵隔外照射,肿瘤量5900CGy/60天,至今6年无不适反应,正常工作。     

左肺中叶综合征

本文介绍我院1986年10月至1992年10月对13例右肺中叶综合征施行手术治疗,其中男9例、女4例,年龄46岁～63岁.患者最常见的症状是咳嗽、咳痰、痰中带血、发热及呼吸困难.恶性肿瘤8例(62%),肺结核2例,炎性假瘤2例,肺纤维化1例.值得注意的是恶性肿瘤是引起中叶不张的主要病因.     

Amyloidosis Causing Right Middle Lobe Atelectasis

Diffuse tracheobronchial amyloidosis is a rare condition with characteristic bronchoscopic and bronchographic findings. A case in which only the bronchographic findings were characteristic is described.     

Neuroendocrine Tumor Arising within Mature Cystic Teratoma of the Pancreas: Literature Review and Case Report

Cystic teratomas are germ cell tumors most commonly found in the ovaries and testes. The pancreas, however, is very rare as a site of occurrence. Moreover, only two cases of cystic teratoma with concomitant neuroendocrine tumor have been reported to date. We report the case of a 33-year-old female who presented with abdominal pain. Computed tomography and magnetic resonance imaging of the upper abdomen revealed an 85 mm cystic tumor in the head of the pancreas. Cystic teratoma and mucinous cystadenoma were suggested as differential diagnoses. Cytopathologic analysis of endoscopic ultrasound-guided fine needle aspiration was consistent with mucinous cystadenoma. Therefore, the patient underwent surgical resection. Histologic analysis revealed a mature cystic teratoma of the pancreas with a concomitant neuroendocrine tumor. The patient is in great condition at 8 months follow-up. Cystic teratoma of the pancreas with a concomitant neuroendocrine tumor is an extremely rare condition. Surgical resection remains the mainstay of treatment as it provides a definitive diagnosis and no recurrences have been reported to date.     

全内脏反位同时性多原发肺癌行胸腔镜下左肺下叶楔形切除术1例报道CSCD

0引言全内脏转位是指胸腔、腹腔或胸腹腔的脏器位置与正常相反,与健康者呈镜面像。其患者临床中较少见,有文献报道发生率仅1/100000[1],亦有文献报道发生率1/20000~1/50000[2]。资料显示,全内脏转位常合并肺部疾患,如肺结核、肿瘤的报道[3]。而腺癌是目前肺癌中最常见的组织细胞学类型,有文献记录约占肺癌的40%左右,其早期即可侵犯血管及淋巴管,引起症状时常常已发生转移[4].     

Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Coexistent growing teratoma syndrome (GTS) and gliomatosis peritonei (GP) arising during chemotherapy of ovarian immature teratoma (IMT) is extremely rare and can be misdiagnosed as recurrent or progressive disease. We present a 33-year-old woman diagnosed with GTS with synchronous GP during chemotherapy of IMT. She underwent ovarian cystectomy due to ovarian immature teratoma and chemotherapy were administered. The α-fetoprotein (AFP) concentration decreased from 28.7 ng/mL to normal after the second cycle. Four days after the third cycle of chemotherapy, ultrasound and CT revealed an 8-cm mass with negative tumor markers in the pouch of Douglas. An exploratory laparotomy was conducted, and a smooth round cystic-solid 8-cm mass was noted in the pouch of Douglas. Extensive peritoneal seeding glial nodules were also observed on the surface of the uterus, peritoneum, and omentum. The patient underwent a partial omentectomy, intact resection of the tumor, and resection of most of the glial nodules. Postoperative pathology demonstrated a pure mature cystic teratoma component in the mass, as well as diffuse GP involving the uterine serosa, peritoneum, and omentum; this diagnosis of GTS with synchorous GP should be considered in IMT patients with mass newly identified during chemotherapy while tumor markers are normal after treatment.     

肺癌合并肌炎1例临床分析

肺癌是最严重的肺部病变,早期及时治疗可以有治愈的希望。发现早期肺癌尤为重要,肺癌早期症状除外咯血、胸痛、咳嗽等肺部症状以外,多发性肌炎等肺外症状     

肺移植治疗肺癌1例报告并文献复习

背景与目的肺癌被认为是肺移植的相对禁忌症,但随着移植技术的进步,此类非常规疾病也被纳入肺移植适应症.本文通过报道l例双肺移植成功治疗双侧肺癌男性患者的病例,并结合相关文献复习,探讨肺移植治疗肺癌的适应症及疗效.方法2010年l0月21日南京医科大学附属无锡市人民医院肺移植组为1例42岁男性患者成功进行了序贯式双肺移植,该患者术前胸部CT及PET-CT示双肺多发斑片状及团块样浸润阴影,纵隔淋巴结不肿大,其余部位未见转移.术后病理证实为粘液型细支气管肺泡癌,分期T4N0M0,Ⅲb期.结果患者术后予常规三联免疫抑制,抗细菌、真菌、病毒等一系列治疗,并于术后66天恢复良好出院并定期随访,术后6个月随访时肺功能良好,未见明显转移征象.结论对于某些合适的肺癌患者,肺移植是一个有效的治疗方法.     

Growing Teratoma Syndrome in the Setting of Sarcoidosis: A Case Report and Literature Review

Growing teratoma syndrome (GTS) is rare and can mimic disease recurrence in patients with a history of immature teratoma. Benign hypermetabolic lymphadenopathy found on staging and surveillance computed tomography (CT) and positron emission tomography (PET) may lead to the presumption of metastatic malignancy. We report a case of a 38 year old with mixed mature and immature teratomas who developed new peritoneal masses after adjuvant chemotherapy despite a normalization of tumor markers. In addition to low FDG uptake observed in these peritoneal masses, a PET scan showed hypermetabolic lymphadenopathy and pulmonary and spleen lesions suggesting widespread metastases. Subsequent surgical resection confirmed a mixed pathology with GTS and sarcoidosis. We reviewed the current literature evidence of GTS and sarcoidosis as a benign cause of lymphadenopathy in cancer patients. We emphasize the importance of a tissue diagnosis before instituting therapy for presumed cancer recurrence to avoid potentially fatal diagnostic traps and management errors. A multiple disciplinary team approach is imperative in managing patients with suspected recurrent immature teratomas.