肾上腺髓样脂肪瘤50例报告

目的 探讨肾上腺髓样脂肪瘤的临床表现、实验室检查、影像学及病理学特点与诊治方法.方法 回顾性分析50例肾上腺髓样脂肪瘤患者的临床资料,并结合文献复习,分析其特点.结果 50例患者均经手术切除肿瘤,并经病理检查证实为肾上腺髓样脂肪瘤,随访6~66个月未见复发.结论 肾上腺髓样脂肪瘤术前诊断主要依据超声、CT和MRI等影像学检查,确诊需经病理学检查证实.对于无明显症状、肿瘤体积较小的肾上腺髓样脂肪瘤患者,短期内可随访观察,但手术切除仍是其最有效的治疗方法.     

肾上腺髓样脂肪瘤3例报告并文献复习

目的探讨肾上腺髓样脂肪瘤的临床、影像学及病理特点。方法回顾性分析2000年1月～2011年12月3例肾上腺髓样脂肪瘤患者的临床资料并复习相关文献。患者年龄分别为53、67、73岁,平均64岁,男性1例,女性2例,左侧2例,右侧1例,肿瘤直径2.5～11cm。结果 2例患者经后腹腔镜肾上腺肿瘤切除,1例经腹开放手术切除,术后病理检查均证实为肾上腺髓样脂肪瘤。随访6个月至2年未见复发。结论肾上腺髓样脂肪瘤的诊断主要依靠B超、CT和MRI,确诊需经病理学检查证实。手术切除是主要的治疗方法,症状明显或瘤体直径〉4cm者应尽早手术。     

甲状腺髓样癌20例临床分析

目的 探讨甲状腺髓样癌临床特点、诊断要点及治疗原则.方法 回顾性分析2005年1月至2012年12月20例甲状腺髓样癌患者的临床资料,全组病例均经病理证实为甲状腺髓样癌,颈淋巴结转移9例,远处转移1例,总颈部淋巴结转移率达50％.20例均行手术治疗,至少行患侧腺叶及峡部切除16例,占80％ （16/20）,其中行甲状腺全切除9例.结果 术后常规监测血清降钙素,复发2例.术后随访17例,超过5年者9例,5年生存率达77.8％.结论 甲状腺髓样癌术前诊断困难,多数依赖组织病理学检查确诊,强调细针穿刺细胞学检查的重要性,治疗以根治性手术为主,术后监测降钙素能及早发现局部复发和转移.     

肾上腺髓样脂肪瘤17例分析

目的 提高肾上腺髓样脂肪瘤的诊断和治疗水平。方法 回顾性分析17例肾上腺髓样脂肪瘤患者的诊断和治疗经验。结果 肿瘤均经手术完整切除，并经病理检查证实为肾上腺髓样脂肪瘤。术后患者经内分泌检查均在正常范围。结论 肾上腺髓样脂肪瘤的诊断主要依靠B超、CT、MRI和生化检查，确诊需经病理检查证实；手术是有效的治疗方法．后腹腔镜是手术的金标准。     

肾上腺髓样脂肪瘤23例报告

目的：提高肾上腺髓样脂肪瘤的诊断和治疗水平。方法：回顾性分析２３例肾上腺髓样脂肪瘤患者的诊断和治疗经验。结果：肿瘤无经手术完整切除,并经病理检查证实为肾上腺髓样脂肪瘤。术后患者经内分泌检查均在正常范围。结论：肾上腺髓样脂肪瘤的诊断主要依靠Ｂ超,ＣＴ和ＭＲＩ,确诊需经病理检查证实,手术是有效的治疗方法。     

骨样骨瘤的诊断及手术治疗

目的：探讨骨样骨瘤的临床特点及手术方法。方法：9例经X线或CT检查诊断为骨样骨瘤,均采用手术切除治疗。结果：8例局部疼痛症状均消失;1例第1次手术未能切除瘤巢,局部疼痛症状不减,再次手术切除瘤巢后疼痛消失。结论：骨样骨瘤的术前诊断主要依靠影像学的检查,彻底切除瘤巢是有效手术治疗的关键。     

色素沉着绒毛结节性滑膜炎诊治进展

色素沉着绒毛结节性滑膜炎(PVNS)是一种罕见的滑膜组织瘤样增生性疾病,根据病变损害范围分为局限性PVNS(LPVNS)和弥漫性PVNS(DPVNS)。该疾病主要临床症状为缓慢进行性肿胀、疼痛及功能受限,MRI检查对PVNS诊断有重要作用,其特征性表现为T2 WI低信号,病理学检查可明确诊断。PVNS主要治疗方法是手术切除病变滑膜,LPVNS手术治疗效果好,而DPVNS由于广泛侵蚀滑膜组织,复发率较高,术后辅助放疗可降低DPVNS复发率。生物靶向治疗为难治性PVNS提供了新的治疗思路。该文就PVNS诊治进展作一综述。     

原发性肾上腺节细胞神经瘤的诊治特点及影像学病理学分析

目的总结肾上腺节细胞神经瘤影像学、病理学特点及后腹腔镜手术治疗经验。方法回顾性分析寿光人民医院收治的12例行后腹腔镜手术切除的肾上腺节细胞神经瘤的影像学、病理学特点及临床经验。结果所有患者经后腹腔镜手术治疗,除1例中转开放外均获成功,影像学CT特征呈渐进性轻度延时强化,术后病理证实为肾上腺节细胞神经瘤,其中1例合并肾上腺皮质部分增生性改变,术后随访未见复发和转移。结论肾上腺节细胞神经瘤影像学CT检查有其特征性表现,结合病理学特点来进行影像学读片,可提高术前确诊率;后腹腔镜手术切除肾上腺节细胞神经瘤安全可行,可作为治疗的首选方法。     

血管内乳头状内皮细胞增生（马松瘤）的诊断与治疗进展

血管内乳头状内皮细胞增生(Intravascular papillary endothelial hyperplasia,IPEH)是一种罕见的血管良性病变，又称为马松瘤。IPEH表现为反应性血管内皮细胞乳头状增生，与血栓形成密切相关。超声和MRI是其主要影像学检查，但是其最终的诊断需要进行病理学及免疫组织化学检查。目前普遍认为手术切除是治疗的首选方法，切除不彻底将导致病变复发。本文对IPEH诊断与治疗的相关文献进行回顾总结，以期为临床IPEH的诊断及治疗提供帮助。     

肾上腺神经鞘瘤(附三例报告)

目的 根据３例肾上腺神经鞘瘤。方法 回顾性分析３例肾上腺神经鞘瘤病人的临床资料。结合文献讨论此病的发病情况,病理学特征以及诊治方法。结果 ３例肿瘤均经手术切除,病理学证实良性２例,恶性１例,随访３～５年未见复发,结论 肾上腺神经鞘瘤的术前诊断困难。确诊需经病学检查。手术切除是最佳治疗方法,恶性神经鞘瘤可辅以放疗。     

磁共振成像对椎管内肿瘤与肿瘤样病变的诊断价值

目的：分析椎管内肿瘤的MRI表现特征，探讨MRI对椎管内肿瘤与肿瘤样病变的诊断价值。方法：33例经手术和病理证实的椎管内肿瘤与肿瘤样病变患者，术前均行MRI平扫与增强扫描，分析其MRI影像特征。结果：髓内肿瘤3例；髓外硬膜下肿瘤20例；其它椎管内病变10例。髓外硬膜下肿瘤中脊膜瘤与神经类肿瘤的发生部位与信号有一定的特异性。脊膜瘤好发于上胸及下颈段，神经类肿瘤则以上颈及下胸段居多。脊膜瘤信号多均匀，而神经类肿瘤多不均匀，易发生囊变是较为特征性的表现，有囊变病灶中又以神经鞘瘤居多。结论：MRI检查可以对椎管内肿瘤进行明确的髓内与髓外定位诊断，在此定位诊断的基础上，结合肿瘤的好发部位，信号是否均匀、增强扫描上所见有助于其术前定性诊断。     

单孔腹腔镜手术探查并诊治子宫切除术后盆腔包块53例临床分析

目的:总结单孔腹腔镜手术诊治子宫切除术后盆腔包块的应用价值及手术方法。方法:回顾分析5年间采用单孔腹腔镜手术诊治53例子宫切除术后盆腔包块患者的临床资料。结果:53例中10例患者行术中冰冻;38例患者获得标本,行常规病理检查。结合探查及病理47例诊断为卵巢瘤样病变,5例为卵巢良性肿瘤(1例畸胎瘤,2例浆液性囊腺瘤,2例粘液性囊腺瘤),1例为恶性肿瘤。41例直接行单孔腹腔镜手术,11例因腹腔粘连严重中转三孔法腹腔镜手术,1例恶性肿瘤患者中转开腹。结论:单孔腹腔镜探查术对子宫切除术后盆腔包块的诊治具有较高的临床应用价值。     

滑膜软骨瘤病13例临床分析

目的 探讨滑膜软骨瘤病外科诊断和治疗经验。方法 对１９８６－１９９７年期间经治的１３骨膜罗骨瘤病的诊断、治疗及其病理进行总结、分析。结果 滑膜软骨瘤病临床多表现为间歇性关节疼痛、肿长、功能受限,活动时关节有弹响声或磨擦感,少数有关节交锁有的可及活动性人;Ｘ线片显示关节内游离体数目往往秒于关节内游离体的实际数目;术中肉眼可见病变滑膜充血、增厚、表面粗糙;镜下风 管增生、淋巴细胞聚集、滑膜囊层细胞及纤     

Hyperplasia of the thymic gland in a patient with Graves' disease.

A tumor-like lesion in the anterior mediastinum was recognized in a 21-year-old female patient with Graves' disease. A CT examination and MRI suggested a thymoma. A subtotal thyroidectomy and a total thymectomy were therefore performed simultaneously. A pathological study of the thymic mass showed thymic hyperplasia. These findings suggest that an enlarged anterior mediastinal mass in a Graves' disease could thus sometimes turn out to be thymic hyperplasia and not a thymoma.     

Nodular Fasciitis of the Face: Aesthetic Considerations

Nodular fasciitis is an uncommon tumor-like fibroblastic proliferation that occurs rarely in the head and neck region. A new case of nodular fasciitis occurring in the cheek of a 56-year-old woman is reported. The case was characterized by dental trauma preceding the appearance of the lesion (extraction of tooth 35). Histologically, the lesion consisted of proliferating fibroblasts and myofibroblasts presenting clinically as a rapidly growing subcutaneous nodule. A conservative surgical excision with curettage is the treatment of choice, and the lesion usually does not exhibit a tendency to recur. The clinical relevance of this condition relies on the fact that both the disorder and its surgical treatment may cause tissue distortion resulting in aesthetic compromise. Furthermore, it needs to be differentiated from malignancy due to its very rapid growth, its rich cellularity, and its high mitotic activity. Both of these aspects, i.e. aesthetic implications and differential diagnosis, have been discussed.     

Mandibular actinomycosis mimicking tumor recurrence

Actinomycosis is a rare disease caused by a microorganism of the normal oral flora. Infection is characterized by swollen tissues and sinuses from which pus drains containing characteristic sulfur granules. Since actinomycosis is a tumorous infection of skin and subcutaneous tissue, this chronic lesion can occasionally mimic neoplasia. A male patient is presented; he had a tumor-like lesion of the left mental region that was initially diagnosed as tumor recurrence, but proved to be an Actinomyces infection on histopathologic examination. Excellent therapeutic response was obtained with a combination of antibiotic therapy, surgical debridement, and mandibular curettage. Vestibuloplasty–commissuroplasty was also performed.     

Bladder mucosa-associated lymphoid tissue lymphoma progressed from chronic cystitis along with a comparative genetic analysis during long-term follow-up: a case report

The pathogenesis of bladder marginal zone/mucosa-associated lymphoid tissue (MALT) lymphoma, which is the most common type of primary bladder lymphoma, has not been clarified. There are no reports that described histological and molecular time course of MALT lymphoma occurring in the bladder and the importance of the score on the Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale during and after radiation therapy (RT). We present a case of MALT lymphoma with long-term comparative genetic analysis. A 77-year-old Japanese woman with hematuria and severe perineal pain was found to have a tumor-like lesion in the bladder trigone. She was diagnosed with cystitis based on the results of pathological examination and immunostaining after transurethral resection of the lesion. The second transurethral resection procedure was performed approximately 4 years after the first procedure because of recurrence of the hematuria and enlargement of a lesion in the left bladder wall. Postoperative pathologic examination confirmed a diagnosis of MALT lymphoma. Genetic analysis of immunoglobulin heavy chain (IGH) gene rearrangements showed more clonal progression from the first biopsy to the second. The patient then underwent RT, during which her perineal pain was exacerbated by radiation cystitis but finally decreased to a level less severe than that before treatment. The PUF patient symptom scale was useful to monitor her pain throughout the clinical course. No recurrence was detected more than 2 years after completion of RT.     

Myositis ossificans: A rare location in the foot. Report of a case and review of literature

BackgroundMyositis ossificans is a benign, tumor-like lesion characterized by heterotopic ossification of soft tissue that usually affects the elbow and thigh. At different stages of maturity, it show similar histologic appearances with sarcomatous lesions or maturing bone. Misdiagnosis can result in unnecessary radical treatment.Case reportA 50-year-old woman with dorsal forefoot soft tissue mass was diagnosed as myositis ossificans after surgical excision and confirmed by a histopathological examination.DiscussionTo our knowledge, myositis ossificans occurrence in the foot is rare and only a few cases have been reported in the literature.SummaryIncreasing awareness on the unusual sites for myositis ossificans occurrence is necessary for differentiating this lesion from a malignant soft- tissue tumors and avoiding diagnostic pitfalls and unnecessary investigations, which can have major consequences and complications for patients.     

La fasciite nodulaire : à propos d’un cas et revue de la littérature

Among soft tissue tumors, nodular fasciitis is a relatively common tumor process, which occurs in the 30 first years of life. Nodular fasciitis is a benign tumor with a rapid proliferation of myofibroblastic cells, which develops at the expense of a muscular fascia in the subcutaneous tissue. Usual localizations are the trunk and upper limbs. Difficulty of diagnosis consists in the need to eliminate many differential diagnoses especially malignant tumor processes. From a clinical point of view, the rapid development of nodular fasciitis (from some days to some weeks) must fear a malignant process. This benign lesion, which does not recur (even if incomplete resection), may regress spontaneously. We report such a tumor located at the cubital fossa confirmed by a pathological examination.     

Ectopic thyroid cancer.

Ectopic thyroid tissue may be encountered anywhere from the foramen caecum to the lower neck. It is rarely seen in the mediastinum. True malignant transformation in ectopic thyroid tissue is extremely rare. Such a malignancy is virtually always diagnosed after surgical excision of the lesion at pathological examination. We report on an extremely rare case of true mediastinal thyroid cancer in a 45-year-old woman. The clinicopathologic features and diagnosis of the lesion, with regard to its mediastinal location are discussed.