腮腺Warthin瘤的CT诊断及误诊分析

目的 总结腮腺Warthin瘤的CT影像特征及其与腮腺混合瘤的鉴别要点,以提高影像定性诊断与病理符合率.方法 收集有完整手术或穿刺病理记录的17例患者的资料,其中14例为腮腺Warthin瘤,3例影像报告Warthin瘤但病理证实为混合瘤病例.患者均采用常规平扫加多期动态增强扫描,观察病灶数目、形态特征、密度、强化特征...     

Malignant non-Hodgkin's lymphoma mimicking a benign parotid tumor: sonographic findings.

We report the case of an extranodal non-Hodgkin's lymphoma mimicking a benign tumor in the left parotid gland of a 71-year-old woman. The clinical presentation of the painless, mobile mass was suggestive of a benign parotid tumor such as an adenoma. The intraglandular tumor appeared sonographically as a well-circumscribed, hypoechoic, homogeneous, lobulated mass with mild distal sound enhancement. Power Doppler sonography showed marked intratumoral vascularization. The tumor was resected by lateral lobectomy of the parotid gland and was found histopathologically to be a diffuse large B-cell lymphoma.     

超声造影对腮腺多形性腺瘤与腺淋巴瘤的鉴别诊断价值

目的 分析腮腺多形性腺瘤与腺淋巴瘤的超声造影特征及超声造影参数差异,探讨超声造影在腮腺多形性腺瘤与腺淋巴瘤鉴别诊断中的价值.方法 25例腮腺多形性腺瘤患者为多形性腺瘤组,34例腺淋巴瘤患者为腺淋巴瘤组,均行超声造影检查.记录2组造影特征;对2组肿块进行时间-强度曲线分析,获得定量分析参数包括达峰时间、峰值强度、峰值半降...     

腮腺多形性腺瘤与腺淋巴瘤的CT特征及鉴别诊断

目的 探讨腮腺多形性腺瘤与腺淋巴瘤的CT特征及鉴别诊断.方法 选取2017年3月12日至2020年2月18日收治的65例疑似腮腺多形性腺瘤患者,设为多形性腺瘤组;选取同期65例疑似腺淋巴瘤患者,设为腺淋巴瘤组.两组患者均进行CT检查及病理活检检查.以病理检查结果为金标准,分析CT检查对腮腺多形性腺瘤、腺淋巴瘤的诊断价值...     

Ultrasound of the parotid gland.

Five cases of parotid gland masses were studied by ultrasound. Only retention cysts and true cysts of the parotid gland appear sonolucent at low and high gain settings. Benign and malignant tumor present as solid masses except for the Warthin's tumor which is sonolucent at lower gain settings but has a lattice of internal echoes at higher gain settings.     

腮腺腺淋巴瘤的CT诊断

目的：探讨腮腺腺淋巴瘤的临床及CT表现，以提高其诊断率。方法：回顾性分析经手术及穿刺活检病理证实的12例腮腺腺淋巴瘤的CT表现。结果：12例腮腺腺淋巴瘤中，单侧发病11例，双侧发病1例，共13侧发病；男10例（83.3％），女2例（16.7%）；单发9例（75%，9/12），多发3例（25％，3/12），共16个病灶，9个（56.3％，9/16）病灶位于腮腺后下方。CT表现病灶呈圆形、椭圆形及分叶状软组织肿块，边缘清晰，密度均匀10个，坏死囊变致密度不均匀6个；增强扫描除囊变区外，病灶呈早期均匀强化，以中度强化为主，囊变区不强化。结论：根据腮腺腺淋巴瘤的发病性别、年龄、部位及影像学表现，有助于诊断和鉴别诊断。     

Tuberculosis of the parotid gland: sonographic manifestations and sonographically guided aspiration.

OBJECTIVE: Involvement of the parotid gland by tuberculosis (TB) is rare. If treated properly, the prognosis of TB of the parotid gland is good. In this retrospective study, we report our experience with sonography and sonographically guided aspiration in the diagnosis of parotid TB. METHODS: Over 12 years, 9 adults (mean age, 48 years) with parotid gland TB had been examined with high-resolution sonography and color Doppler sonography for their clinical problems of swelling on the mandibular angle. Sonographically guided fine-needle aspiration was done for cytologic study, stains for acid-fast bacilli, and cultures for mycobacterium. RESULTS: The sonographic patterns were classified as chiefly the parenchymal type (4 patients) and chiefly the periparotid type (5 patients). The parenchymal type appeared as a diffusely enlarged, comparatively hypoechoic gland (compared with the contralateral asymptomatic gland), with or without focal intraparotid nearly anechoic zones, which might have a cavity or cavities within it. The periparotid type appeared as hypoechoic nodules located in the peripheral zone of the hyperechoic parotid gland, consistent with enlarged periglandular lymph nodes. The diagnosis of parotid TB was made in 8 of 9 patients on the basis of sonographically guided aspiration for acid-fast bacilli stains, cytologic study, and cultures for mycobacterium. CONCLUSIONS: Sonographic examination contributes substantially in the diagnosis of parotid TB infection. In the presence of diffuse parotid echo pattern changes with periparotid lymphadenopathy, and with or without focal hypoechoic zones, TB infection should be differentiated. Sonographically guided fine-needle aspiration may provide further diagnostic information by means of stains, cultures, and cytologic study.     

腮腺肿瘤伴高血压患者的围手术期护理

目的探讨对伴高血压的腮腺肿瘤患者进行围手术期护理干预的临床疗效。方法对32例伴高血压的腮腺肿瘤患者进行术前用药指导、心理护理、专科护理、术创观察、饮食管理、并发症处理等多个环节进行观察分析。结果通过对伴高血压腮腺肿瘤患者进行有针对性的特殊护理,使手术危险性显著降低,术后并发症明显减少。结论对伴有高血压腮腺肿瘤患者围手术期的一系列特殊护理,是提高手术成功率、促进康复、减少术后并发症的非常重要的一环。     

Ultrasound-guided piezoelectric extracorporeal shock wave lithotripsy of parotid gland calculi

PURPOSE: The introduction of piezoelectric extracorporeal shock wave lithotripsy (ESWL) has changed therapy for salivary calculi. This method seems especially suitable for treating calculi in the parotid gland. The purpose of this study was to evaluate ESWL in patients with such calculi. METHODS: From November 1990 to November 1999, all patients with sialolithiasis of the parotid gland were treated with piezoelectric ESWL. Three different lithotriptors were used over the 9-year study period. Results were analyzed according to both the patients' clinical status and follow-up sonograms. RESULTS: In total, 42 patients (21 women, 21 men; mean age, 59 years) were treated with ESWL. The mean follow-up period for all patients was 63 months (range, 7-96 months). After ESWL had been performed, 71% of the patients were completely free of symptoms, and 21% had marked improvement of their symptoms. Sixty-seven percent were completely free of calculi, and 27% had a marked reduction in the size of their calculi. Adverse effects of ESWL included temporary glandular swelling (4 patients), blood-tinged salivary secretions (9 patients), petechiae on the skin surface (3 patients), and parotid abscess (1 patient). CONCLUSIONS: ESWL is an outpatient procedure that can be performed without anesthesia and with scarcely any discomfort for patients. Conventional surgical procedures such as subtotal parotidectomy may be almost entirely replaced by ESWL because of the excellent treatment results and a very low rate of complications associated with ESWL. ESWL should be considered the treatment of choice for parotid calculi.     

腮腺混合瘤97例临床分析

腮腺混合瘤是腮腺中发病率最高的良性肿瘤,约占腮腺肿瘤的60%~70%[1],临床多见。本文对我科1999年10月至2005年10月6年间,经组织病理学确诊的97例混合瘤患者的手术及术后并发症等进行了分析及探讨。1临床资料1.1性别与年龄本组97例,男性47例,女性50例,年龄16~86岁,平均年龄41.2     

Endosonographic appearances of Brunner's gland hamartomas

Brunner's gland hamartoma is an uncommon intestinal tumor, most frequently located in the duodenal bulb. We report the endoscopic sonographic (EUS) appearances in 2 cases of Brunner's gland hamartoma. In 1 case, EUS revealed a heterogeneous hypoechoic pedunculated mass, 1.7 cm in diameter, arising from the mucosal and submucosal layers of the wall of the duodenal bulb. Multiple anechoic large and small cystic areas were demonstrated in the tumor. In the other case, EUS revealed a 1.4- x 0.9-cm pedunculated mass with an echogenicity higher than that of the muscular layer and lower than that of the mucosa, arising from the submucosal layer of the duodenal bulb wall. Multiple small anechoic areas were demonstrated in the tumor. We believe that both EUS patterns are typical for Brunner's gland hamartomas.     

Cranial sonographic findings in Joubert's syndrome

The striking clinical picture of periodic hyperpnea and apnea, hypotonia, ataxia, mental retardation, retinal dystrophy, and oculomotor abnormalities found in association with radiologic evidence of agenesis of the cerebellar vermis characterizes Joubert's syndrome. We describe the cranial sonographic findings in 2 children with Joubert's syndrome from 2 families. Two children in the first family and 6 children in the second family were affected by Joubert's syndrome. To our knowledge, cranial sonographic findings in this syndrome have not been described before. © 1999 John Wiley & Sons, Inc. J Clin Ultrasound 27:41–44, 1999.     

Intussusception induced by villous tumor of the colon: sonographic findings.

We report a case of intussusception caused by a villous tumor of the ascending colon in an 82-year-old man. Abdominal sonography showed intussusception in the ascending colon, with a transverse scan demonstrating a multiple concentric ring sign. Color Doppler sonography showed blood flow signals in a mass, which was considered to be the lead point of the intussusception. A spontaneous reduction of the intussusception occurred during the examination; sonography then showed a mildly echogenic, mass. The graded compression method revealed that the mass was soft and immobile. Colonoscopy confirmed the diagnosis of villous tumor. Sonography helped to make an early diagnosis, allowing successful conservative management of the tumor and the intussusception.     

同侧腮腺Warthin瘤合并腺泡细胞癌临床病理观察

目的提高对唾腺多发肿瘤的认识和警惕性，探讨Warthin瘤和腺泡细胞癌的起源。方法采用HE染色和免疫组化染色，观察1例同侧腮腺Warthin瘤合并腺泡细胞癌的病理形态及CK7、CK19、34βE12和Ki-67等的表达，并结合文献进行复习讨论。结果腮腺深部肿瘤最大径2．7cm，为典型的Warthin瘤组织结构；同侧腮腺浅叶内结节最大径0．8cm，组织学为腺泡细胞癌；Warthin瘤上皮成分和腺泡细胞癌CK7、CK19和34βE12均（＋），但前者分布有规律，后者分布紊乱，其表达与正常腮腺组织的小导管和闰管上皮相似。结论同侧腮腺同时发生Warthin瘤和腺泡细胞癌十分罕见，免疫组化支持腮腺Warthin瘤和腺泡细胞癌起源于未梢导管细胞或“多潜能”储备细胞的观点。     

腮腺腺淋巴瘤的CT表现

目的 探讨腮腺腺淋巴瘤的CT和临床特点.方法 回顾性分析经手术及病理证实的15例腮腺腺淋巴瘤的CT表现.结果 15例腮腺腺淋巴瘤中,男12例,女3例,其中50岁以上13例（86.7%）,有吸烟史13例（86.7%）.单发13例,多发2例,共21个病灶,其中17个（81.0%）病灶位于腮腺浅叶下极;病灶呈圆形、椭圆形及分叶状软组织肿块,边缘光整,密度均匀或不均匀,动脉早期中度强化或明显强化,其中13个（61.9%）病灶内见小血管通过或周围见贴边血管影.结论 根据发病年龄、性别、部位及影像学表现,有助于提高腮腺腺淋巴瘤的CT诊断水平.     

超声在腮腺实性肿瘤诊断中的价值

目的探讨高频超声及彩色多普勒血流显像对腮腺肿瘤性病变的诊断及鉴别诊断的意义。方法回顾分析我院彩超室检出并经手术病理证实的75例腮腺实性肿瘤，其中良性肿瘤49例，恶性26例。应用高频超声观察肿瘤的形态、边缘及内部回声特点，彩色多普勒血流显像（CDFI）观察肿瘤内血流信号特点，频谱多普勒测肿瘤血流信号频谱。结果腮腺良性肿瘤多数形态规则、边缘清楚、内部回声均匀，CDFI显示无血流信号或点状、细线状血流信号；恶性肿瘤则多数边界不清，呈不规则浸润状，内部光点分布不均，CDFI多数可显示条状、树枝状分布血流信号，收缩期峰值血流速度较高。结论高频超声及彩色多普勒对腮腺实性肿瘤具有良好的诊断、鉴别诊断价值。     

Hyalinizing trabecular tumor of the thyroid gland: characteristic features on ultrasonography

We report a case of hyalinizing trabecular tumor of the thyroid gland and describe the characteristic ultrasonographic features of this tumor. This was a rare tumor of follicular cell origin with a trabecular pattern of growth and marked intratrabecular hyalinization. The tumor had an irregular shape, a delicately jagged border, and hypoechoic and heterogeneous internal echoes on B-mode ultrasonography. Very rich intratumoral blood flow, the so-called “tumor inferno” was evident on power Doppler ultrasonography. In the clinical management of thyroid nodules, clinicians should be aware of this peculiar type of thyroid tumor and its characteristic ultrasonographic findings.     

Sonographic appearance of a congenital parotid gland hemangiolymphangioma simulating malignancy in an infant

Congenital hemangiolymphangioma, also called mixed angioma, is a benign tumor that very rarely occurs in the parotid gland. We present a rare case of hemangiolymphangioma of the parotid gland in a 4-month-old boy whose clinical and radiologic presentation simulated malignancy. Gray-scale and color Doppler sonography revealed an enlarged left parotid gland and inhomogeneous hypoechoic and hyperechoic areas scattered throughout the gland. Mild internal vascularity was noted on color Doppler sonographic examination. CT revealed a predominantly fatty mass involving the superficial lobe of the parotid gland. The results of fine-needle aspiration cytology were inconclusive, and total parotidectomy was performed. Histopathologic examination of surgical specimens confirmed a diagnosis of hemangio lymphangioma. The patient recovered well and was free of recurrence at the 6-month follow-up visit. To our knowledge, this case report is the first to describe the findings of congenital hemangiolymphangioma of the parotid gland on sonography and CT. This rare diagnosis should be considered in neonates and infants presenting with a rapidly growing parotid gland tumor suggesting malignancy. Histopathologic examination is necessary to confirm the diagnosis.     

Castleman's disease of the kidney: Sonographic findings

We report a case of rare Castleman's disease of the kidney that mimicked a renal neoplasm with emphasis on the imaging and histologic findings. A 47‐year‐old man presented with dyspeptic symptoms. Ultrasound revealed a vascular, heterogeneous mass in the left kidney. Multiphasic CT scan confirmed an enhancing lesion with enlarged left para‐aortic lymph nodes suspicious for nodal metastases. The provisional diagnosis was renal cell carcinoma. Percutaneous biopsy yielded a diagnosis of Castleman's disease of the hyaline‐vascular type. Despite advancement in imaging modalities, differentiation of hyaline‐vascular variant of Castleman's disease from hypervascular renal neoplasm remains difficult and the final diagnosis requires histopathological confirmation. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :438–442, 2015