甘露醇治疗颅内高压症36例临床分析

本文收集36例各种病因引起的颅内高压病例，依据脑CT提示脑出血量及脑积水程度，脑脊液压力及患者生命体征的特征，分为经、中、重三种类型进行脱水治疗。治愈率86％，病死率13．8％。治疗中应注意防止肾衰、糖尿病以及低颅内压综合征的出现。     

47例骨髓穿刺干抽的临床和病理分析

分析４７例骨髓穿刺干抽的临床和病理改变，干抽占同期１３１９例骨穿的３．６％。根据骨髓细胞的密度和间质纤维增殖的程度，把干抽的原因分为４类：高细胞伴间质细胞增多者１９例（４２．２％）；间质细胞增多者１４例（３１．１％）；高细胞者８例（１７．８％）及低细胞者４例（８．９％）。主要疾病为：急性淋巴细胞白血病（２５．５％），急性非淋巴细胞白血病（１７．０％），慢性白血病（１４．９％），骨髓转移瘤（１０．６     

Asteroid bodies and calcium oxalate crystals: two infrequent findings in fine-needle aspirates of parotid sarcoidosis.

We have studied 3 cases of sarcoidosis involving the parotid gland by means of fine-needle aspiration cytology (FNAC). The main findings were noncaseating granulomas, multinucleated giant cells (MGCs), and lymphocytes. In one case MGCs contained asteroid bodies and in another case we observed calcium oxalate crystals (COCs) over both stromal fragments and MGCs. Although nonpathognomonic for sarcoidosis, these 2 findings may help in the diagnosis of this condition. However, both are easily overlooked and must be borne in mind when viewing noncaseating granulomas. Sarcoid granulomas displaying COC must be differentiated from foreign-body granulomas. The aforementioned cytological findings must be assessed in conjunction with clinical findings. Nevertheless, in most cases the diagnosis of sarcoidosis is made by exclusion.     

Aspiration cytology of ameloblastic fibroma: a diagnostic challenge

Ameloblastic fibroma of the jaw is a rare, benign mixed odontogenic tumor, having little tendency for local invasion and a low recurrence rate. Cytologic distinction from ameloblastoma, ameloblastic fibrosarcoma, and intraosseous adenoid cystic carcinoma is necessary, in view of the different biologic behavior. A painful, slow-growing swelling of the jaw in a 5-yr-old child clinicoradiologically considered as a benign cystic lesion was aspirated. Sheets of small monomorphic epithelial cells with peripheral palisading by columnar cells were seen on cytology smears. The striking feature was central hyaline globules in some tubules. A cytologic possibility of adenomatoid odontogenic tumor was suggested. Histopathology, however, confirmed it to be an ameloblastic fibroma.     

Fine-needle aspiration biopsy of multiple myeloma in a patient with renal-cell carcinoma: A case report

A case of multiple myeloma diagnosed by fine-needle aspiration (FNA) biopsy and confirmed by laboratory studies in a patient with a history of renal-cell carcinoma is presented. The patient was diagnosed with renal-cell carcinoma of the right kidney and a radical nephrectomy was performed. Eighteen months after this diagnosis was made, the patient developed chest wall pain and was found to have osteolytic bone lesions of the ribs and vertebral bodies. FNA of an osteolytic rib lesion disclosed multiple myeloma. Additional laboratory studies confirmed the diagnosis of multiple myeloma. This case report demonstrates the value of FNA as a diagnostic tool for the follow-up of cancer patients, the subsequent discrimination between metatastic lesions and a second primary malignancy, and the cytology of multiple myeloma.     

Tophaceous pseudogout: a pitfall in the diagnosis of chondrosarcoma

Tumoral calcium pyrophosphate dihydrate deposition disease (TCPPD, tumoral or tophaceous pseudogout) is a rare nonneoplastic entity which mimics soft-tissue or skeletal malignancy. We present here the fine-needle aspiration cytology findings of a unique case of TCPPD in a 76-yr-old woman, with a large paraischial soft-tissue mass diagnosed as a malignant neoplasm. The difficulty in diagnosing such lesions by fine-needle aspirates is discussed and reviewed in the context of known cases from the literature.     

The utility of ancillary studies in pediatric FNA cytology.

We evaluated the diagnostic contribution of adjunct studies performed on aspirated material in the work-up of pediatric fine-needle aspiration (FNA) biopsies. Ancillary studies were performed on 54 of 136 (39.7%) pediatric FNA biopsies during a 5-year period. In 23 (16.9%) cases, immunocytochemical (ICC) studies, consisting of immunoperoxidase staining of direct smears and/or cell blocks or flow cytometric immunophenotyping, were performed. The studies were adequate in 14 cases (60.9%), suboptimal in five cases (21.7%), and inadequate in four cases (17.4%). Of the adequate and suboptimal cases, the ICC data helped to narrow the differential diagnosis or classify the disease process in eight cases (42.1%), confirmed cytologic impression in nine cases (47.4%), and gave contradictory results in two cases (10.5%). Adequate material for electron microscopy (EM) was obtained in 14/19 cases (73.7%). Ultrastructural studies were diagnostic, or helped classify the disease process in five cases (35.7%), confirmed the cytologic impression in four cases (28.6%), helped exclude diagnostic considerations in three cases (21.4%), and were judged to be non-contributory in two cases (14.3%). Cytogenetic studies revealed six of seven cases (all neoplasms) to have abnormal karyotypes. Special stains for organisms performed on smears from 25 cases including Ziehl-Neelsen, Gomori methenamine silver (GMS), Gram, and Warthin-Starry (WS) were negative except for 1/16 GMS and 4/9 Gram stains. In summary, we found that with appropriate case selection, ancillary studies performed on aspirated material can provide useful information in pediatric FNA cytology.     

Two unusual benign lesions of the neck masquerading as malignancy on fine-needle aspiration cytology

Two cases of unusual benign tumors of the neck are described, both of which were initially misdiagnosed on cytology as carcinomas. Fine-needle aspiration findings in each case demonstrated a pleomorphic population of cells including bizarre multi-nucleated giant cells, the latter raising the false impression of malignancy. However, on review the cytological appearances of the tumors, a pleomorphic lipoma and a carotid body tumor, were characteristic. the correct diagnosis in each case would have been made or suggested if the pathologist had been familiar with the cytologic features characteristic of the lesion and the differential diagnosis of the head and neck tumors. in addition, the point is made that adequate clinical information is essential for the pathologist if all relevant conditions are not to be missed in the differential diagnosis.     

原发性脑淋巴瘤的MRI表现特点与诊断

目的：分析颅内原发性淋巴瘤的MRI表现特点，为临床诊断与治疗提供资料。方法：回顾分析28例经病理证实颅内原发性淋巴瘤的MRI资料，所有病例均行平扫及增强扫描。结果：病灶单发6例，多发22例，分布于幕上14例，幕下4例，幕上幕下同时存在10例，大多位于深部脑白质，病灶多呈圆形或不规则形，T1WI呈低信号，T2WI呈等或高信号，瘤周水肿较轻，增强扫描病灶均呈团块状显著强化。结论：颅内淋巴瘤的MRI表现缺乏特异性，需手术或活检才可作出定性诊断。     

Fine-needle aspiration biopsy of the pancreas: a study of 61 cases

Eighty-six fine-needle aspirates (FNAs) of pancreas from 74 patients were reviewed. Histological confirmation or clinical follow-up of the final diagnosis was available in 61 aspirates from 49 patients. Of 42 proven malignant cases, FNAs were diagnosed as positive in 21 (50%), suspicious in 4 (9.5%), negative in 12 (28.6%), and unsatisfactory in 5 (11.9%). Of 19 proven benign cases, FNAs were diagnosed as negative in 15 (78.9%) and unsatisfactory in 4 (21%). This resulted in a 50% sensitivity, a 100% specificity, a diagnostic efficiency of 59%, a predictive value of a positive test of 100%, and a predictive value of a negative test of 55.6%. Thirty-six primary pancreatic adenocarcinomas and six metastatic tumors to the pancreas were encountered. Benign cases were attributed to anatomical pancreatic variants, acute pancreatitis, abscess, chronic pancreatitis, and pseudocysts. Pancreatic FNA was safe, accurate, and relatively inexpensive, but it was relatively insensitive in the diagnosis of malignancy.