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目的 探讨胸内甲状腺肿的诊断方法及手术方式。方法 收集1958－2000年间经病理证实为胸内甲状腺肿65例。结果 主要依靠临床症状、X线、同位素扫描、CT检查诊断。肿物下极在主动脉弓上缘水平以上者41例（63．1％），在此水平以下者24例（36．9％）。均行手术治疗，手术径路分为颈部领式切口41例（63．1％），低位领式切口加胸骨正中切开11例（17．0％），开胸18例（12．3％），颈胸联合切口3例（4．6％），胸骨正中切开2例（3．0％）。术后并发症发生率15．4％，其中喉返神经损伤发生率7．7％；死亡率为1．5％。结论 手术切除是胸内甲状腺肿的首选治疗方法，喉返神经务是术后主要并发症，应注意预防其发生。并依据肿物不同情况采取不同的手术径路，宜先行衣领式切口，估计操作困难，病变达主动脉弓下者，应行胸骨切开或开胸处理。     

Nodular Lymphocyte Predominant Hodgkin Lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare subtype of HL with unique clinicopathologic features. The hallmark histologic feature is the presence of malignant LP cells, unusual CD20⁺CD15^?CD30^? variants of Reed‐Sternberg cells, embedded within a nodular pattern of infiltrating lymphocytes. Compared with classical HL, NLPHL shows a slightly older median age at presentation (30–40 years), greater male predominance (3:1), less mediastinal involvement (<15%), and lower occurrence of classical HL risk factors. The differential diagnosis includes progressive transformation of germinal centers, lymphocyte‐rich classical HL, and T‐cell/histiocyte‐rich large B‐cell lymphoma, the latter of which may share a common biologic relationship. The vast majority of patients present with limited stage disease (70%–80%), the standard treatment for which is involved field radiotherapy at 30–36 Gy. Response rates to primary therapy exceed 90%, although relapses are common and may occur years after the initial diagnosis. Secondary malignancies, particularly non‐Hodgkin lymphoma, may also occur at a frequency similar to that of relapsed NLPHL. Patients with advanced stage disease may have lower response rates and overall survival times than those with limited stage disease. For relapsed disease, treatment options include the salvage therapies used in classical HL, and rituximab.     

Inhibitory effect of Kangjia Pill (抗甲丸) on thyrocyte proliferation in rat goiter model

Objective:To investigate the inhibitory effects of Kangjia Pill(抗甲丸,KJP)on the cell proliferation in rat goiter model induced by methimazole(MMI).Methods:Fifty-six Wistar rats were randomly divided into four groups:the normal group,MMI model group(MMI),low dose of KJP group(LKJP),and high dose of KJP(HKJP). Except the normal group(20 rats),the other groups(12 rats in each)were given 0.04%(w/v)MMI through the drinking water until the end of the experiment.One week later,the rats in the LKJP and HKJP group...     

Pulmonary and thymic lymphoid hyperplasia in primary Sjögren’s syndrome

Pulmonary and thymic lymphoid hyperplasia with characteristic clinicoradiological manifestations were seen in a 71-year-old woman who was diagnosed with primary Sjögren’s syndrome. A hazy opacity 12 mm in diameter and an anterior mediastinal nodule 20 mm in diameter were incidentally detected on computed tomography. Thoracoscopic biopsy revealed lymphoid hyperplasia in the lung accompanying thymic lymphoid hyperplasia. Immunohistochemically, the pulmonary lesion was considered to be nodular lymphoid hyperplasia (NLH), not lymphoma. A previously undescribed finding in the NLH was the hazy opacity containing an air bronchiologram, not a solid nodule. This finding might suggest a common causal relation for NLH, thymic hyperplasia, and primary Sjögren’s syndrome.     

Bleeding esophageal varices caused by Graves' hypervascular cervical goiter

A 65-year-old woman presented with an episode of hematemesis and a recurrent cervical goiter due to Graves' disease. The angiogram revealed bleeding esophageal varices which had developed through a drainage vein of the vascular goiter. Total thyroidectomy resulted in eradication of the esophageal varices.     

Hemiclamshell incision in the treatment of mediastinal goiter

Background  The thyroid disease can appear in 0.16–3.3% of cases as mediastinal goiter. The treatment is difficult and requires a mediastinal approach. Materials and methods  We have analyzed our experience from September 1995 to September 2007 among 2,439 thyroidectomies conducted for thyroid disease; 16 cases required a sternotomy, in seven patients conducted as hemiclamshell approach (median sternotomy associated to a fourth intercostals space incision). Preoperative evaluation included otorhinolaryngology evaluation and computed tomography. All the cases were followed up to 12 months. Results  For seven cases treated trough hemiclamshell, the mean age was 57.8 years; hospital stay is 5.2 days. All the patients were discharged after respiratory evaluation; two patients required a pneumological admittance to physio-kinesi-respiratory. There were no cases of hemorrhage, nerve injury, permanent hypocalcemia, and chylothorax. There was no mortality at 30 days. Conclusions  The hemiclamshell is a safe procedure to treat mediastinal goiter and permit a good exposure of subclavian vessels and mediastinal nodes.     

结节性甲状腺肿的超声图像与病理对照分析

目的 分析结节性甲状腺肿的二维超声图像特征，提高诊断符合率。方法 回顾分析已获得病理诊断的51例结节性甲状腺肿的声像图。结果 51例结节性甲状腺肿术前超声仅提示24例，27例误为甲状腺腺瘤、囊腺瘤、桥本甲状腺炎、亚急性甲状腺炎、甲状腺乳头癌。结论 结节性甲状腺肿声像图复杂多样，应注意鉴别诊断。     

Case report: benign liver tumor with central necrosis.

A 38 year old previously well woman had sudden onset of upper abdominal pain and fever. Ultrasound examination revealed a necrotizing lesion in the liver. Arteriography revealed findings consistent with an adenoma or focal nodular hyperplasia. A right lobectomy and wedge resection of a similar lesion in the left lobe were done. Microscopy of both lesions indicated focal nodular hyperplasia. Adenoma is said to be related to the contraceptive oral hormone; focal nodular hyperplasia not. But it is possible that both may have an increased incidence of bleeding in the users of the oral contraceptive hormones.     

超声成像在结节性甲状腺肿并发腺瘤中的应用评价

目的评价超声在结节性甲状腺肿并发腺瘤中的诊断价值，提高对甲状腺疾病多源性的认识。方法对40例甲状腺中的结节逐一进行仔细观察，评价二维图像和彩色多普勒血流图(CDFI)的表现。结果40例甲状腺病变共检出157个结节，其中腺瘤结节42个，结节性甲状腺肿结节115个。实质性及囊实性腺瘤结节表现为包膜完整，周边有晕环并有环状包绕的血流信号。实质性及囊实性结节性甲状腺肿的结节表现为无包膜或包膜不完整，周边无血流或有短杆状血流显示。囊性腺瘤与囊性结节性甲状腺肿的鉴别诊断主要依据二维图像。结论超声对提高甲状腺疾病多源性的认识，提高超声正确诊断率有重要的意义。     

软组织结节性筋膜炎的细针吸取细胞学诊断

目的 对13例结节性筋膜炎进行细针吸取细胞学检查，并结合病史分析不同时期的细胞学形态特点，以取得诊断与鉴别诊断的经验。方法 13例均有术后病理组织学对照，光镜观察其细胞学特点及形态表现，与组织学对比分析；并与黏液性脂肪肉瘤、恶性纤维组织细胞瘤、皮肤转移腺癌及炎性肌纤维母细胞瘤等的细胞学特点相对照。结果 13例中男性8例，女性5例；发生于上肢6例，胸壁1例，颈部1例，背部2例，下肢3例。在疾病不同的发展阶段可见不同的细胞学构象，但基本图像以从幼稚到较成熟的纤维母细胞增生为主，病变的不同阶段纤维母细胞以不同比例混杂出现，可见核分裂，但无病理性核分裂及凝固性坏死是其与各种肉瘤区分的要点。结论 细胞学穿刺对结节性筋膜炎的中、晚期改变诊断较准确，但在早期病变中误诊率较高，需密切结合病史及部位。