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目的:探讨肾上腺皮质癌临床诊疗过程中的特征,以期提高对该病的认识。方法:回顾性分析我院两例肾上腺皮质癌患者的临床资料,并检索中国知网、万方、Pubmed等数据库,对相关文献进行系统性分析,归纳其临床特点。结果:本组患者1例行肾上腺肿物开放手术,术后一个月行放疗,行骨扫描,提示多发骨转移,给予抗骨转移治疗,术后5个月复查,提示肾周多发转移,以密妥坦口服抗肿瘤治疗,术后2年患者死亡;1例行腹腔镜肾上腺肿物切除术,术后病理提示伴肝转移,术后三个月复查:肝区占位,考虑肝转移,以密妥坦口服抗肿瘤治疗,随访5个月,疾病未进一步进展。结论:肾上腺皮质癌是一种罕见的泌尿系肿瘤,有些无特异临床表现。肾上腺皮质癌的诊断应该结合临床表现,肾上腺内分泌检查,如雄激素和皮质醇等,再同时结合影像学资料,金标准依靠病理学。治疗应以手术切除为首选,对于难以切除的肾上腺皮质癌可行辅助化疗、放疗、免疫治疗、靶向治疗等治疗。 相似文献
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肾嗜酸细胞瘤2例报告并文献复习 总被引:1,自引:0,他引:1
目的提高对肾嗜酸细胞瘤的认识,探讨肾嗜酸细胞瘤的治疗方法。方法报告2例肾嗜酸细胞瘤并复习国内外文献。结果本组例1术前疑诊为肾嗜酸细胞瘤,并为术中快速冰冻切片证实,行保留肾脏的腹腔镜肿瘤剜除术,术后随访2年,一般情况良好,无复发,无转移。例2术前诊为肾癌,行腹腔镜左肾根治性切除术,术后随访3年,无复发,无转移,肝、肾功能均正常。结论肾嗜酸细胞瘤的诊断要点:(1)肿瘤无明显症状,多为偶然发现,肿瘤生长缓慢,无周围浸润或远处转移,多为单发;(2)肿瘤突出于肾轮廓之外,呈外突性生长;(3)肿瘤切面呈棕褐色;(4)CT示肿块密度均匀,无出血、坏死,有完整包膜;(5)病理检查:光镜下肿瘤由单一的嗜酸细胞构成,电镜下细胞富含线粒体。一旦确诊,应尽可能行保留肾脏的手术,避免行根治性肾切除术。 相似文献
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Three cases of angiosarcoma in the stomach, small bowel, and colon, respectively, are reported. The gastric lesion occurred many years after historic evidence of cutaneous Kaposi's sarcoma. Two of the three lesions exhibited multifocality, and all demonstrated aggressive biologic courses. The varied histologic features of angiosarcoma make this diagnosis difficult to establish in an unusual location such as the gastrointestinal tract. The use of immunohistochemistry for a panel of antibodies, particularly the successful reaction with Factor VIII-related antigen, is important in evaluating light microscopically unusual tumors. A delicate framework of collagen type IV was elicited in each case, but ultrastructurally correlated with short segments of basal lamina in one case. This suggests that the absence of the traditional morphologic expression of basal lamina does not preclude its presence and emphasizes the sensitivity of immunohistochemistry. The lack of previously reported cases of gastrointestinal angiosarcoma may be because the tumor is underrecognized or because it is truly a rare occurrence. 相似文献
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以低钠血症为首发症状的肺癌三例临床分析 总被引:2,自引:0,他引:2
回顾分析3例以低钠血症为首发表现的肺癌患者临床资料,并进行文献复习.3例患者临床确诊为抗利尿激素分泌不适当综合征(syndrome of inappropriate secretion of antidiuretic hormone,sIADH),其中2例误诊为胃炎及药源性,病理确诊2例为小细胞肺癌,1例为鳞癌.回顾分析结果提示,对临床上低钠血症表现的患者应考虑到SIADH的可能,它是副癌综合征的表现之一,多为小细胞肺癌;治疗上以去除原发病为主,辅以限水和利尿等措施,可提高本病的疗效. 相似文献
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S S Givens N A Ellerbroek J J Butler H I Libshitz G N Hortobagyi M D McNeese 《Cancer》1989,64(11):2214-2216
The authors discuss an angiosarcoma that developed in a 50-year-old woman's breast 10 years after she underwent conventional postoperative irradiation with cobalt 60 teletherapy. Although angiosarcoma developing in a lymphedematous arm after radical mastectomy is a well-known phenomenon, and several cases of angiosarcoma are known to have occurred in the chest wall after mastectomy with or without irradiation, only one other case of angiosarcoma in an irradiated breast has been reported. The possible role of therapeutic irradiation in inducing this malignancy is discussed. 相似文献
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原发性肾脏滑膜肉瘤诊疗分析 总被引:1,自引:0,他引:1
目的探讨原发性肾脏滑膜肉瘤的临床及病理特点,提高对其诊断、治疗及预后的认识。方法回顾性分析我院2例原发性肾脏滑膜肉瘤的诊治资料并复习国内外文献。结果2例患者均行根治性肾切除术。经镜下检查及免疫组化染色后,病理诊断均考虑为原发性肾脏滑膜肉瘤,进一步应用RT-PCR方法检测出SYT-SSX融合基因mRNA表达,确诊为原发性肾脏滑膜肉瘤。例1术后予以辅助化疗,术后随访14个月未见复发转移。例2术后随访4个月,患者死于肺转移。结论原发性肾脏滑膜肉瘤临床罕见,免疫组化染色对诊断有重要价值,确诊需行分子遗传学检测SYT-SSX融合基因的表达。临床治疗上首选根治性肾切除术辅以化疗,预后极差。 相似文献
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目的:探讨低级别中央型骨肉瘤(Low grade central osteosarcoma)的临床、影像学和病理学特点。方法:应用光镜观察2例成人低级别中央型骨肉瘤的病理组织学特点,结合临床、影像学资料分析和国内外文献回顾,讨论低级别中央型骨肉瘤的临床、影像和病理学特点以及诊断和鉴别诊断要点。结果:低级别中央型骨肉瘤发病年龄较普通型骨肉瘤稍大,多为青壮年,病史较长;病变多位于长骨干骺端,特别是股骨远端和胫骨近端,最好发于股骨;影像学检查可见程度不等的骨质破坏;组织学改变没有特征性,类似于良性骨肿瘤或瘤样病变,但有明确的瘤组织浸润,替代骨小梁间的骨髓脂肪组织。常误诊为纤维结构不良等良性病变,骨皮质破坏和软组织肿块是重要的鉴别诊断线索。结论:低级别中央型骨肉瘤的诊断强调组织病理学结合临床和影像学,可以避免误诊。 相似文献
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S Katayama M Ikeuchi Y Kanazawa Y Akanuma K Kosaka T Takeuchi T Nakayama 《Cancer》1981,48(11):2499-2502
A case of hyperamylasemia with lung cancer is described. Macroamylasemia was excluded by a normal amylase/creatinine clearance ratio and by a sedimentation constant obtained by sucrose density gradient centrifugation. Positive immunofluorescent staining of tumor cells with a specific antibody against human salivary amylase and significant amylase activity in the primary tumor and metastases support the hypothesis of independent production of amylase by the lung tumor. Cellulose--acetate membrane electrophoresis demonstrated three bands of amylase activity. The major component corresponded to normal salivary amylase in electrophoretic mobility, isoelectric point and molecular size. The minor bands, one of which occupied about 10% of the total amylase activity in serum, urine and tissue homogenates, demonstrated a lower electrophoretic mobility and a more acidic isoelectric point. Gel filtration and electrophoresis disclosed that these minor bands were derived from an amylase isozyme with a larger molecular size than that of normal salivary amylase. The results suggest ectopic tumor production of heterogenous amylase isozymes, with the larger form being secreted into the circulation. 相似文献
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目的探讨前列腺叶状肿瘤(PT)的临床病理特点。方法2例前列腺PT,结合文献分析其临床表现、病理特征和免疫组化表达。结果前列腺PT由上皮和间叶成分组成,上皮细胞增生,无异型性,由上皮细胞形成的囊腔被增多的间质成分挤压形成类似叶状的裂隙。例1,间质细胞轻-中度异型,核分裂1~2/10HPF,无坏死;例2,间质细胞异型性明显,核分裂〉5/10HPF,有坏死。免疫组化染色上皮细胞CK、EMA、PSA均(+),间质细胞Vim(+),PR(+),部分间质细胞SMA(+)。例1患者术后1年复发。结论前列腺PT罕见,可分为良性、交界性、恶性三种类型。该肿瘤易复发和转移,恶性者预后差。 相似文献
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Y Bobin D Dolbeau C Besnard H Mignotte M Rivoire P Zlatoff 《Bulletin du cancer》1991,78(11):1037-1044
Four cases of angiosarcoma of the breast were treated at Centre Léon-Bérard in Lyon. It is a rare malignant vascular tumor, constituting < 1% of all primary breast lesions. Radical local surgery is the treatment of choice; however, local recurrences and metastases are frequently observed. The 3-year disease-free survival rate is < 15%. The role of irradiation and adjuvant chemotherapy remains to be evaluated. Doxorubicin-ifosfamide-GM CSD gave a positive response in one case with metastases. 相似文献
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T A Jennings L Peterson C A Axiotis G E Friedlaender R A Cooke J Rosai 《Cancer》1988,62(11):2436-2444
The production of tumors through solid-state mechanisms has been demonstrated in experimental animals, but foreign body tumorigenesis has not been proven definitively in man. The authors report three patients with angiosarcoma that occurred in intimate association with foreign material retained for prolonged periods. Although several etiologic factors have been defined in angiosarcoma, foreign bodies generally are not appreciated to have this potential. Review of the literature disclosed six cases of angiosarcoma and 40 cases of sarcomas of other histologic types associated with foreign material, with latency periods of from 4 months to 63 years. Implanted foreign material thus should be considered capable of inducing virtually any form of sarcoma in humans. 相似文献
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目的:探讨巨球蛋白血症的临床表现、诊断、鉴别诊断和治疗。方法:分析我科收治的3例巨球蛋白血症患者的临床资料及诊治过程,并复习相关文献。结果:本文3例患者发病时均出现不同程度贫血、单克隆IgM及骨髓浆细胞样淋巴细胞浸润,例1及例3可见高黏滞综合征所致鼻出血或牙龈出血。其中例1及例2接受苯丁酸氮芥联合强的松方案治疗,例3未接受治疗。例1目前病情平稳,例2死亡,例3失访。结论:巨球蛋白血症的诊断与鉴别诊断有赖于形态学及免疫表型检查。烷化剂、嘌呤类似物及利妥昔单抗是WM一线治疗药物。 相似文献