环乳晕与传统切11治疗乳腺纤维瘤的临床效果及患者接受性比较

[摘要1目的探讨环乳晕与传统切口治疗乳腺纤维瘤的临床效果及患者的心理接受程度。方法将80例患者均分为两组,观察组40例患者使用环乳晕切口治疗,对照组40例患者使用传统切口治疗,在随访6个月后比较两组患者治疗后对美容效果的满意度,以及所发生的不良反应。结果观察组患者满意度为82．5％,显著高于对照组的27．5％（P〈o．05）,观察组并发症的发生率显著低于对照组（P〈0．05）。结论环乳晕切口治疗乳腺纤维腺瘤几乎不影响术后乳房的美观,而且能促进术后恢复,所以患者较易接受。     

非骨化性纤维瘤21例X线与CT分析

目的 探讨非骨化性纤维瘤的X线及CT表现特点,提高影像诊断准确率.方法 对经手术病理证实的21例非骨化性纤维瘤的临床和影像学资料进行回顾性分析,21例均做X线平片检查,16例拍切线位片,18例做CT平扫检查.结果 21例患者中位于长管状骨的干骺端19例;其中胫骨12例,股骨6例,肱骨1例.另外2例中1例位于坐骨,1例位于肋骨,病灶呈圆形3例,椭圆形11例,椭圆形伴骨皮质缺损3例,分叶状4例.结论 非骨化性纤维瘤皮质型病变具有明显的影像学特征,X线检查多能明确诊断,对于髓腔型病变,易与其它疾病相混淆,X线检查明确诊断较难,CT对其鉴别诊断意义重大.     

骨韧带样纤维瘤的影像学诊断

目的探讨骨韧带样纤维瘤的影像学特点,为临床诊断提供参考。方法回顾、分析经手术病理证实的3例骨韧带样纤维瘤的DR、CT表现。全部病例都曾行普通X线及CT检查。结果病变位置:股骨,胫骨,肱骨各1例。3例病例均呈囊状膨胀性改变,未见钙化和骨膜反应,其中1例可见不规则骨小梁影,2例病灶边缘不同程度硬化病灶内可见囊性改变,合并周围软组织肿胀。结论骨韧带样纤维瘤好发于长骨干骺端,X线及CT表现为膨胀性溶骨性破坏,内呈软组织密度影,多数伴有假骨小梁结构形成,无钙化及骨膜反应。     

Desmoplastic melanoma: A 12-year experience with sentinel lymph node biopsy

Aims

Given the paucity of data regarding nodal involvement in desmoplastic melanoma (DM), we decided to review the incidence of nodal metastasis in our patients with DM to better define guidelines regarding the performance of sentinel lymph node biopsy (SLNB) in this specific melanoma subtype.

Methods

Using a prospectively maintained database, we reviewed all patients who underwent treatment for melanoma at the Yale Melanoma Unit in a twelve-year period (1998–2010), during which 3531 cases were treated. We identified 24 patients (0.7%) diagnosed with DM. These patients' records were studied for clinical and histologic parameters and clinical outcomes.

Results

Twenty-two patients from the DM group had SLNB, of which four (18%) were diagnosed with micro-metastasis. These four patients were all treated with completion lymphadenectomy and none had additional positive nodes in the remainder of the nodes. Patients were followed after surgery for a median of 25 months (range 2–60 months). Two patients (9%) developed local recurrence, two (9%) in-transit recurrence, and six (27%) showed distant metastases (three patients were pure DM and three patients showed mixed morphology). Patients with mixed DM had a higher rate of nodal metastasis (25%) vs those with pure DM (14%).

Conclusions

Other authors have reported that patients diagnosed with pure DM were less likely to have a positive SLN (0–2%) than those patients with the mixed DM subtype (12–16%). Our findings of higher incidence rates of regional lymph node metastases in both the pure and mixed DM subtypes (14% and 25%) compel us to continue to still recommend that SLNB be considered in patients with both subcategories, pure and mixed DM.

Level of evidence

Level IV.     

Sinonasal desmoplastic small round cell tumor

Desmoplastic small round cell tumor (DSRCT) is a rare malignancy with poor prognosis that generally involves the peritoneum. Only rare cases occur outside the abdomen. Its diagnosis can be achieved only by immunohistochemistry and cytogenetic studies. We describe a case of a 61-year-old man referred to our department with a primary sinonasal tumor. The DSRCT diagnosis was confirmed by the presence of a polyphenotypic immunoprofile (positive for cytokeratin, desmin, and neuronspecific enolase) and the characteristic EWS–WT1 gene fusion resulting from the t(11;22)(p13;q12) reciprocal translocation. This reported case of DSRCT draws attention to the importance of including DSRCT in the differential diagnosis of sinonasal tumors.     

Rare diffuse peritoneal malignant neoplasms: CT findings in two cases

In the peritoneal cavity, diffuse serosal replacement by tumor is demonstrated usually by extensive carcinomatous involvement from gastric, colonic, or pancreatic tumors or less frequently by mesothelioma. Primary tumors other than mesothelioma are extremely rare in the peritoneum. The computed tomographic appearances of two cases of rare peritoneal tumors, epithelioid hemangioendothelioma and desmoplastic small round cell tumor, are described.     

Fine needle aspiration cytology in two cases of chondromyxoid fibroma of bone and review of literature

We report the cytological features of two cases of chondromyxoid fibroma (CMF) confirmed by histopathology examination. First case was a 40‐year‐old male who presented with a foot swelling, and the second case was a 16‐year‐old male with a lesion at the angle of jaw. A fine needle aspiration cytology (FNAC) was performed in both the cases. In first case, a correct diagnosis of CMF could be offered on FNAC. In the second case, though the cytology diagnosis was a sarcoma considering the cytological, radiological and clinical features, the histopathological examination confirmed the same to be a CMF. The cases are being discussed to highlight the usefulness of FNAC to diagnose these uncommon benign bone lesions and the potential pitfalls in the cytological diagnosis of chondroid lesions. Diagn. Cytopathol. 2013;41:904–908. © 2012 Wiley Periodicals, Inc.     

Clinical implications and mechanism of histopathological growth pattern in colorectal cancer liver metastases

Liver is the most common site of metastases of colorectal cancer, and liver metastases present with distinct histopathological growth patterns (HGPs), including desmoplastic, pushing and replacement HGPs and two rare HGPs. HGP is a miniature of tumor-host reaction and reflects tumor biology and pathological features as well as host immune dynamics. Many studies have revealed the association of HGPs with carcinogenesis, angiogenesis, and clinical outcomes and indicates HGP functions as bond between microscopic characteristics and clinical implications. These findings make HGP a candidate marker in risk stratification and guiding treatment decision-making, and a target of imaging observation for patient screening. Of note, it is crucial to determine the underlying mechanism shaping HGP, for instance, immune infiltration and extracellular matrix remodeling in desmoplastic HGP, and aggressive characteristics and special vascularization in replacement HGP (rHGP). We highlight the importance of aggressive features, vascularization, host immune and organ structure in formation of HGP, hence propose a novel "advance under camouflage" hypothesis to explain the formation of rHGP.