脊柱骨巨细胞瘤误诊1例

发生于骶骨以上的脊柱骨巨细胞瘤罕见[1],关于其CT表现仅见零星个案报道。我院误诊1例,报告如下。患者男性,20岁。胸背部疼痛2月,加重伴双下肢麻木10天入院。病史中无明显咳嗽、潮热、盗汗现象。外院X线及CT提示第5胸椎体结核伴椎旁冷脓肿形成。专科检查:胸椎活动受限,尤以屈曲位为明显,第5胸椎处叩压痛明显,局部无明显畸形及包块,剑突平面以下痛觉略减退,双下肢踝阵挛阳性,双膝反射、踝反射亢进。实验室检查:肝功、肾功、电解质、CEA、AFP及血、尿常规均无异常,入院时ESR:41mm/h,1周后复查ESR:16mm/h,2周后复查ESR:37mm/h。影像表…     

Mammography using an ultrahigh-strip-density, stationary, focused grid

A 1-mm-thick, stationary, ultrahigh-strip-density, focused grid was evaluated with respect to patient radiation dose and mammographic image quality as it affected the resolution of microcalcifications and masses. Radiographic technique was varied to determine the most useful alteration to improve image quality with the grid. Results from 89 patients demonstrated that no improvement in diagnostic ability was found in women with fatty breasts. As breast density increased, the advantage of the grid technique became more apparent. Grid mammography also often solved the problem of questionable microcalcifications with improved visualization of their number and geometry.     

Outpatient therapy of intra-abdominal abscesses following early discharge from the hospital

Although percutaneous aspiration and drainage of abdominal abscesses will frequently avert an open surgical procedure, patients remain hospitalized during drainage. The authors treated 9 patients for abscesses using percutaneous drainage catheters and sent them home with the catheter in place. All had an uneventful recovery. An average of $12,050 was saved in each case. The authors suggest that outpatient drainage of abdominal abscesses is significantly less expensive than inpatient treatment, yet does not jeopardize patient care.     

Indurative mastopathy: a cause of false-positive mammograms

Indurative mastopathy is a benign, elastotic lesion of the breast characterized by a stellate appearance, with surrounding compressed and distorted ducts causing a pseudo-infiltrative pattern. In previously reported cases of benign sclerosing lesions of the breast there has been no evidence of local recurrence of metastasis following excisional biopsy. The significance of identifying indurative mastopathy lies in recognizing its benign nature despite clinical, radiographic, and gross histologic features that are indistinguishable from malignancy, thereby saving the patient additional surgery or radiotherapy once an excisional biopsy has been performed.     

Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results

Seventy-five patients with hemoptysis were treated with bronchial artery embolization (BAE). The procedure was performed with Hexabrix (sodium methylglucamine ioxaglate), Mikaelson catheters, and Gelfoam particles. Angiographic evaluation of the bronchial artery anatomy revealed ten different configurations, which are described. The embolization attempt failed in three cases (4%); eight additional patients (10.7%) were excluded from the series because of inadequate data. In the remaining 64 patients, 41 underwent BAE alone and 23 underwent either chemotherapy or surgery in addition to embolization. Immediate control of hemoptysis was achieved in 49 of 64 patients (76.6%). Long-term control of hemoptysis was achieved in 46 of the 56 patients included in the long-term follow-up (82.1%). Eight of the 64 patients were lost to follow-up, which ranged from one to 47 months (mean 24.8 months). Hemoptysis recurred in 12 of 56 patients (severe in 10, mild in 2) (21.4%). Twelve patients died (21.4%), five of them due to hemoptysis (8.9%). None of the patients who died of hemoptysis had responded to initial BAE. It is concluded that BAE is an effective treatment for immediate control of life-threatening hemoptysis, allowing long-term control of bleeding in the majority of patients.