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891.
Zhen-Xing Wang Liang-Liang Yang Zhe-Nan Xu Pei-Yun Lv Yue Wang 《World Journal of Clinical Cases》2021,9(11):2655-2661
BACKGROUNDAzygos vein aneurysms are extremely rare, and their pathogenesis is not clear. The overwhelming majority of patients have no obvious clinical symptoms and are found to have the disease by physical examination or by chance. There are few reports on the diagnosis of and treatment strategy for this disease. Moreover, the choice of therapeutic schedule and the treatment window are controversial.CASE SUMMARYWe report a case of azygos vein arch aneurysm in a 53-year-old woman. The patient had symptoms of back pain, chest tightness, and choking. Enhanced chest computed tomography showed a soft-tissue mass in the right posterior mediastinum, which was connected to the superior vena cava. The enhancement degree in the venous phase was the same as that of the superior vena cava. The patient received video-assisted thoracoscopic surgery. After the operation, her back pain disappeared, and her dysphagia and chest tightness were also significantly relieved. The postoperative pathology confirmed hemangioma. The patient was discharged on the seventh day after surgery without any comp-lications.CONCLUSIONSome patients with hemangioma of the azygos vein arch may experience dysphagia and chest tightness caused by the tumor compressing the esophagus and trachea. Enhanced computed tomography scanning is vital for the diagnosis of azygos vein aneurysms. In addition, despite the difficulty and risk of surgery, thoracoscopic surgery for azygos vein aneurysms is completely feasible. 相似文献
892.
王琦 《中国医学影像技术》2008,24(5):781-784
目的探讨^18F-FDG PET/CT对纵隔淋巴结的鉴别诊断价值。方法对^18F-FDG异常摄取的纵隔淋巴结最终确诊为良性病变者9例(50枚)和恶性病变者13例(35枚)的淋巴结进行比较分析。结果良性组和恶性组淋巴结的大小、CT值、SUV值分别为1.30cm、85.54HU、5.70和2.03cm、37.03HU、7.46,两组之间有统计学差异(P〈0.01)。延迟显像前、后良性组和恶性组淋巴结SUV值分别为4.81、4.71和7.61、7.92,均无统计学意义(P〉0.05)。良性组4L(22%)、11(20%)、4R(16%)和10R(14%)为好发部位;恶性组2R(17%)、4R(17%)、4L(14%)、7(11%)和10L(11%)部位多见。良、恶性组淋巴结在PET/CT图像上有不同的表现特征。结论淋巴结大小、CT值、SUV值在良?恶性鉴别诊断中有一定参考作用;延迟显像帮助不大;掌握PET/CT影像学特征,结合病史和其他实验室检查等综合分析对纵隔18F-FDG阳性淋巴结的鉴别诊断起重要作用。 相似文献
893.
《European journal of surgical oncology》2022,48(1):253-260
BackgroundRoutine lymphadenectomy during metastasectomy for pulmonary metastases of colorectal cancer has been recommended by several recent expert consensus meetings. However, evidence supporting lymphadenectomy is limited. The aim of this study was to perform a systematic review of the literature on the impact of simultaneous lymph node metastases on patient survival during metastasectomy for colorectal pulmonary metastases (CRPM).MethodsA systematic review was conducted according to the PRISMA guidelines of studies on lymphadenectomy during pulmonary metastasectomy for CRPM. Articles published between 2000 and 2020 were identified from Medline, Embase and the Cochrane Library without language restriction. Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the risk of bias and applicability of included studies. Survival rates were assessed and compared for the presence and level of nodal involvement.ResultsFollowing review of 8054 studies by paper and abstract, 27 studies comprising 3619 patients were included in the analysis. All patients included in these studies underwent lymphadenectomy during pulmonary metastasectomy for CRPM. A total of 690 patients (19.1%) had simultaneous lymph node metastases. Five-year overall survival for patients with and without lymph node metastases was 18.2% and 51.3%, respectively (p < .001). Median survival for patients with lymph node metastases was 27.9 months compared to 58.9 months in patients without lymph node metastases (p < .001). Five-year overall survival for patients with N1 and N2 lymph node metastases was 40.7% and 10.9%, respectively (p = .064).ConclusionSimultaneous lymph node metastases of CRPM have a detrimental impact on survival and this is most apparent for mediastinal lymph node metastases. Therefore, lymphadenectomy during pulmonary metastasectomy for CRPM can be advised to obtain important prognostic value. 相似文献
894.
We report a case of blunt chest trauma, where findings on repeated conventional chest radiographs were compatible with pneumothorax developing CT showed that the appearance was due to a detachment after 2 days of mechanical high-pressure ventilation. of the parietal pleura along the lateral, mediastinal and diaphragmatic boundaries of the lungs, imitating a pneumothorax. The widespread pleural detachment was caused by the extra-mediastinal interstitial spread of mediastinal emphysema caused by a small tear in the left main bronchus, which had initially escaped bronchoscopic detection.
Correspondence to: C. Rozeik 相似文献
895.
896.
目的:探讨纵隔恶性生殖细胞瘤(malignant germ cell tumors,MGCT)的临床特点、治疗和预后。方法:32例纵隔MGCT患者,精原细胞瘤18例,非精原细胞瘤14例。所有患者均采用手术和(或)放疗和(或)化疗等多学科综合治疗的方法。结果:非精原细胞瘤患者中位生存期(OS)32.4个月,中位无进展生存期(PFS)18个月,5年无复发生存率和总生存率均为28.6%。精原细胞瘤患者5年无复发生存率和总生存率分别为83.3%和85.6%,中位OS和PFS均未到达。精原细胞瘤患者OS和PFS均明显好于非精原细胞瘤患者,P值分别为0.001 4和0.000 7。结论:纵隔精原细胞瘤采用多学科综合治疗方法能取得较好的治疗效果,本研究的结果与文献报道相符。纵隔非精原细胞瘤的治疗效果有待进一步提高。非精原细胞瘤是影响纵隔恶性生殖细胞瘤预后的重要因素。 相似文献
897.
肺癌纵隔淋巴结转移规律的分析 总被引:6,自引:1,他引:6
目的:探讨肺癌纵隔淋巴结转移的规律与特点。方法:对358例肺癌行肺切除加淋巴结廓清术,对其中132例N2肺癌病例的281组转移性纵隔淋巴结进行临床病理分析。结果:两组以上N2转移占62.1%,跳跃式转移占12.1%,左侧肺癌N2转移发生率较高的依次为5,7,6组淋巴结,右侧肺癌N2转移发生率较高的依次为4,7,3组淋巴结;瘤体越大N2转移发生率越高,肺癌分化程度越差,N2转移发生率越高,病理类型不同,N2转移发生率分别为,小细胞癌80.0%,腺癌45.1%,大细胞癌33.3%,鳞癌24.0%,结论:对N2肺癌行广泛,全面的纵隔淋巴结清扫是十分必要的。 相似文献
898.
Ma K Chang D He B Gong M Tian F Hu X Ji Z Wang T 《Journal of cancer research and clinical oncology》2008,134(12):1289-1295
Purpose To explore the appropriate method of mediastinal lymph node dissection for selected clinical stage IA (cIA) non-small cell
lung cancer (NSCLC).
Methods From 1998 through 2002, the curative-intent surgery was performed to 105 patients with cIA NSCLC who had been postoperatively
identified as pathologic-stage T1. According to the method of intraoperative medistinal lymph node dissection, they were divided
into radical systematic mediastinal lymphadenectomy (LA) group (n = 42) and mediastinal lymph-node sampling (LS) group (n = 63). The effects of LS and LA on morbidity, N staging, overall survival (OS) and disease-free survival (DFS) were investigated.
Also, associations between clinicopathological parameters and survival were analyzed.
Results The mean numbers of dissected lymph nodes per patient in the LA group was significantly greater than that in the LS group
(15.59 ± 3.08 vs. 6.46 ± 2.21, P < 0.001), and the postoperative overall morbidity rate was higher in the LA group than that in the LS group (26.2 vs. 11.1%,
P = 0.045). There were no significant difference in migration of N staging, OS and DFS between two groups. However, for patients
with lesions between 2 and 3 cm, the 5-year OS in LA group was significantly higher than that in LS group (81.6 vs. 55.8%,
P = 0.041), and the 5-year DFS was also higher (77.9 vs. 52.5%, P = 0.038). For patients with lesions of 2 cm or less, 5-year OS and DFS were similar in both groups. Multivariate analysis
showed that lymph node metastasis was the unique unfavorable prognostic factor (P < 0.001).
Conclusions After being intraoperatively identified as stage T1, patients with lesions between 2 and 3 cm in cIA NSCLC should be performed
with LA to get a potentially better survival, and patients with lesions of 2 cm or less should be performed with LS to decrease
invasion. 相似文献
899.
900.
急性感染性纵隔炎的诊断和治疗(25例报告) 总被引:10,自引:0,他引:10
1980年1月~1991年12月我们治疗25例急性感染性纵隔炎,包括食管、气管穿孔后11例,食管手术后8例,胸骨劈开心脏手术后5例,胸部外伤感染蔓延者1例。诊断要注重食管外伤和手术史。X线胸片和食管造影对诊断和治疗有重要意义。本组治愈率60%,成功的关键是去除原发病因和进行有效的纵隔引流。 相似文献