肝脏局灶性结节状增生的超声表现

目的总结肝脏局灶性结节状增生的超声表现。方法62例肝脏局灶性结节增生患者共70个病灶接受了二维灰阶超声和彩色多普勒超声检查,总结病灶的灰阶超声、彩色多普勒超声特征。结果灰阶超声显示82.9%(5870)的病灶位于肝右叶,17.1%(1270)病灶位于肝左叶。74.3%(5270)的病灶为等或稍低回声,17.1%(1270)的病灶为低回声,8.6%(670)的病灶为高回声;92.9%(6570)的病灶彩色多普勒超声测得动脉血流信号。其中显示Ⅲ级、Ⅱ级及Ⅰ级血供的病灶分别为68.6%(4870)、18.6%(1370)、5.7%(470)。峰值流速14.4～113cms,其均值为46.5±24.2cms,阻力指数为0.4～0.7,其均值为0.55±0.07。结论肝脏局灶性结节状增生具有较特征性的超声表现,了解这些特点有助于诊断与鉴别诊断。     

哈尔滨市3 437例甲状腺癌患者病例回顾性分析

目的调查哈尔滨市2012—2015年甲状腺癌分布特征及合并甲状腺其他疾病的基本情况。方法回顾性分析哈尔滨某三级甲等医院2012—2015年3 437例甲状腺癌患者的病例资料,应用SPSS 17.0软件进行统计学分析。结果 3 437例患者中男性543例,女性2 894例,男女比例为1∶5。乳头状癌患者2 912例,占84.7%。甲状腺癌合并结节性甲状腺肿及合并桥本甲状腺炎呈逐年递增趋势。甲状腺癌合并甲状腺腺瘤无明显变化趋势,只有在2015年略有升高。结论 2012—2015年哈尔滨市甲状腺癌患者逐年上升,女性更为明显。本研究可为区域医疗卫生服务机构对肿瘤的防治提供部分参考依据。     

Nodular hidradenoma arising on the site of a BCG scar

Hidradenomas are tumours that arise from the adnexal structures, both eccrine and apocrine and are histologically benign. The tumours that arise from eccrine differentiation are known as poroid hidradenomas and when they arise from the apocrine glands they are called nodular hidradenomas. In our centre a 13‐year‐old boy presented with a slow‐growing, painless erythematous fungating nodule on the left upper arm over a period of 18 months at the site of the BCG vaccination. The nodule was surgically excised and sent for histopathological examination, leading to a diagnosis of nodular hidradenoma. This case is presented to highlight its rarity, together with its clinical features that were suggestive of malignancy but proved ultimately to be benign.     

Discoid lupus erythematosus

Discoid lupus erythematosus is a manifestation of chronic cutaneous lupus erythematosus with a small risk of systemic involvement. In this review article, the role of predisposing factors such as haplotype, hormones, antibodies and sunlight are discussed. The clinical features, including variants and associations, and management options are presented.     

Primary localized cutaneous nodular amyloidosis successfully treated with cyclophosphamide

Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare subtype of localized cutaneous amyloidosis and can be associated with various connective tissue disorders. It can be difficult to treat and past therapies include surgical excision, dermabrasion, electrodessication and curettage, cryotherapy and laser therapy. We present a case of a middle‐aged woman with PLCNA associated with CREST (calcinosis, Raynaud phenomenon, oesophageal motility disorders, sclerodactyly and telangiectasia) syndrome and Sjögren's syndrome responding to cyclophosphamide with no new amyloid deposits and resolution of skin ulceration after many years of resistance to drug therapy. It is important to monitor these patients for progression into systemic amyloidosis.     

双手背多发结节型环状肉芽肿一例

51岁女性患者,双手背结节逐渐增多伴压痛10年,否认关节痛病史。系统检查无异常。皮损组织病理学示真皮及皮下组织内组织细胞形成的栅栏状肉芽肿,中央可见胶原纤维变性。辅助检查:类风湿因子(RF)及抗溶血性链球菌O (ASO)阴性,血尿酸值正常,结核菌纯蛋白衍生物(PPD)试验阴性,胸部X线片示双肺纹理增多,自身抗体谱阴性。结合临床诊断:结节型环状肉芽肿。给予沙利度胺口服及皮损内曲安奈德注射治疗后皮损大部分消退。     

超顺磁性氧化铁增强MRI诊断肝脏局灶性结节增生

目的 评价超顺磁性氧化铁（SPIO）对肝脏局灶性结节增生（FNH）的诊断价值。资料与方法 回顾性分析7例7个肝脏FNH的平扫、动态增强及SPIO增强MRI资料。结果 病灶在T1WI上呈相对低至等信号，T2WI上呈等至相对高信号，6个病灶可见中心瘢痕。动态增强扫描6个病灶以快速慢出方式强化。SPIO增强扫描6个病灶实质部分信号明显降低，5个中心瘢痕显示更清晰。结论 SPIO增强扫描进一步从组织成分方面为FNH诊断提供依据。     

Clinical significance of focal echogenic liver lesions

During a 4-year period, 53 focal echogenic liver lesions were demonstrated by sonography in 41 patients, in whom there was no evidence of metastatic origin. Most of the lesions were hemangiomas.One of the purposes of this study was to determine the characteristic ultrasound features for liver hemangioma. Small (less than 2 cm), homogeneous, echogenic, well-circumscribed, subcapsular lesions almost prove their hemangiomatous nature. Lesions with a diameter of more than 2 cm are usually more lobulated and heterogeneous. They are located more centrally in the liver and nearly all show a close anatomical relation with 1 of the hepatic veins. Very large lesions (greater than 5 cm) with a heterogeneous and irregular aspect suggest focal nodular hyperplasia, which must be proven by a Tc-isotopic liver scan.     

Fine needle aspiration cytology of nodular fasciitis of the breast

We report a case of nodular fasciitis (NF) of the breast, which was cytologically diagnosed as a spindle cell proliferation with undetermined malignant potential. Owing to small size of the lesion (5.9 × 3.7 × 4.1 mm), only fine needle aspiration (FNA) cytology was performed under ultrasound guidance. The FNA smears were cellular, rich in single/clustered spindle cells but mammary ductal epithelial/myoepithelial cells were absent. These cytologic findings suggested spindle cell growth of mesenchymal origin. Pattern‐less arrangement of spindle cells, heterogeneous composition of the stromal matrix, lack of nuclear/cellular atypia, occasional mitosis but no aberrant mitotic figures, and lymphocyte infiltration indicated reactive rather than neoplastic nature of the lesion. Nonetheless, lumpectomy was conducted because the possibility of neoplasm was not completely ruled out. The histologic diagnosis of the resected nodule was NF. FNA specimens were reviewed thoroughly in an attempt to define the key cytomorphologic features of NF that are important for the correct diagnosis. Differential diagnoses from the lesions that show similar cytologic pictures are discussed in detail. Although NF arising from the breast is rare, cytopathologists should be aware of its clinical and cytopathologic characteristics. Knowledge of the possibility of NF in the breast and its cytologic findings may help cytopathologists to discern its reactive, not neoplastic, characteristics of the lesion. If the referring surgeon is alerted NF as a possibility along with other differential diagnoses, close observation would become a management option. In‐depth discussion of cytologic features and a review of the pertinent literature are also included. Diagn. Cytopathol. 2015;43:222–229. © 2014 Wiley Periodicals, Inc.