长骨骨化性纤维瘤的临床分析

１２例长骨骨化性纤维瘤，１１例经手术切除病灶及其硬化边缘，应用５０％氯化锌涂抹骨腔杀灭残存的瘤细胞，自体骨或加入少量人工骨植骨；１例行病变骨段切除。结果表明，随访３～１４年，２例复发，经再次手术后５～１４年未复发。本组病例复发率低，疗效满意，切除肿瘤硬化边缘能有效地防止复发。     

经腋前线单切口腔镜切除乳腺纤维瘤手术分析

目的分析经腋前线单切口腔镜辅助乳腺手术(VABS)在乳腺纤维瘤患者中的可行性及安全性。 方法选取2014年5月至2015年5月在广东省东莞市常平医院接受治疗的乳腺纤维瘤患者71例,按照患者的意愿,分为观察组(38例)和对照组(33例)。观察组进行经腋前线VABS,对照组进行常规的经乳晕切口手术治疗。比较两组的手术时间、术中出血量、切口长度、切口-病灶远端距离、住院时间、手术并发症的发生率,以观察组手术时间作为应变量并以观察组病灶大小和切口-病灶远端距离为自变量进行多元相关分析。 结果观察组的术中出血量、切口-病灶远端距离与对照组比较,差异有统计学意义(P<0.05);两组的手术时间、切口长度和住院时间比较,差异无统计学意义(P>0.05);两组均未发生皮下瘀斑、血肿、皮下积液和切口红肿等并发症,多元相关分析显示手术时间与病灶大小和切口-病灶远端距离呈正相关(R²＝0.821,P<0.05)。 结论经腋前线VABS治疗乳腺纤维腺瘤患者安全可靠,其手术难度与病灶大小和切口-病灶远端距离有关,值得在临床上推广应用。     

Clinical and computed tomography features of adult abdominopelvic desmoplastic small round cell tumor

To investigate the clinical and computed tomography(CT)features of desmoplastic small round cell tumor(DSRCT),we retrospectively analyzed the clinical presentations,treatment and outcome,as well as CT manifestations of four cases of DSRCT confirmed by surgery and pathology.The CT manifestations of DSRCT were as follows:(1)multiple soft-tissue masses or diffuse peritoneal thickening in the abdomen and pelvis,with the dominant mass usually located in the pelvic cavity;(2)masses without an apparent organbased primary site;(3)mild to moderate homogeneous or heterogeneous enhancement in solid area on enhanced CT;and(4)secondary manifestations,such as ascites,hepatic metastases,lymphadenopathy,hydronephrosis and hydroureter.The prognosis and overall survival rates were generally poor.Commonly used treatment strategies including aggressive tumor resection,polychemotherapy,and radiotherapy,showed various therapeutic effects.CT of DSRCT shows characteristic features that are helpful in diagnosis.Early discovery and complete resection,coupled with postoperative adjuvant chemotherapy,are important for prognosis of DSRCT.Whole abdominopelvic rather than locoregional radiotherapy is more effective for unresectable DSRCT.     

肋骨骨化性纤维瘤的CT诊断

骨化性纤维瘤是一种骨组织的良性肿瘤,常见于青少年,颅面骨及四肢骨为其好发部位,发生于肋骨的骨化性纤维瘤较罕见,近年仅见个案报道~([1]).本文报道我院近4年经手术病理证实的肋骨骨化性纤维瘤7例,并结合文献进行分析.     

骨促结缔组织增生性纤维瘤的临床病理观察

目的:了解骨促结缔组织增生性纤维瘤的临床病理.方法:收集骨促结缔组织增生性纤维瘤1例和6例腹壁外韧带样纤维瘤病的临床资料.手术切除组织HE染色光镜观察.涂胶切片做Vimentin,Desmin,NF,S100蛋白的单克隆标记.结果:骨促结缔组织增生性纤维瘤的组织学改变和免疫组织化学标记与腹壁外韧带样纤维瘤病相似,临床症状和影像学改变与骨样骨瘤相似.结论:骨促结缔组织增生性纤维瘤易发生于青年男性,病理才能将其确诊,有复发的可能.     

股骨促结缔组织增生性纤维瘤1例

患者男,16岁,左大腿下段反复疼痛一年余,逐渐加重,活动后加剧,膝关节无明显活动受限.查体:大腿下段内侧可触及一肿块,质硬,活动度差,轻度压痛.实验室检查无异常.     

Proptosis in a young child

We encountered an extremely unusual presentation of proptosis in a 7-yr-old boy due to psammomatoid juvenile ossifying fibroma of frontoethmoidal region. The tumor also led to development of mucocele in the frontal sinus not yet fully developed as on opposite side.     

Fine-needle aspiration of intra-abdominal desmoplastic small cell tumor

The cytologic features of four cases of histologically confirmed intra-abdominal desmoplastic small cell tumor (DSCT) that occurred in males between 18-27 yr of age are presented. Smears showed small cells with scant cytoplasm which were primarily arranged in loosely cohesive clusters. Nuclei were oval to round with evenly distributed, finely granular chromatin and inconspicuous nucleoli. As is typical of DSCT, the cells strongly expressed keratin and desmin in all cases. In the one case studied by electron microscopy, it was demonstrated that the cells were joined by small junctions and contained paranuclear aggregates of intermediate filaments. The absence of the characteristic desmoplastic stroma in DSCT aspirates and the nonspecific cytologic features of this small round-cell tumor (SRCT) made cytologic interpretation difficult. Cytopathologists should be aware of this entity so that DSCT is included in the differential diagnosis of SRCTs that occur in intra-abdominal sites. A panel of markers that includes keratin and desmin should be used to assist in the identification of DSCT.     

非骨化性纤维瘤的影像学诊断

目的分析非骨化性纤维瘤的CR、CT及MRI表现及诊断价值,旨在提高诊断水平。方法回顾分析19例非骨化性纤维瘤的CR、CT及MRI表现,全部经穿刺或手术病理证实。结果非骨化纤维瘤发生在股骨8例,胫骨6例,腓骨与肱骨各2例,髂骨1例。CR及CT表现为囊状骨质缺损,边缘有硬化,内含软组织密度,无钙化。MRI表现为T1WI稍低或低信号,T2WI低信号,少部分T2WI为稍高信号,无软组织肿块。结论CR CT与MRI三者综合分析,对非骨化性纤维瘤有较高诊断价值。