bcl-2蛋白在子宫腺肌病组织中的表达

目的　探讨bcl 2蛋白表达在子宫腺肌病发生中的病理生理作用及其临床意义。方法　应用免疫组织化学法 ,检测 16例正常子宫及 32例子宫腺肌病患者子宫组织中bcl 2基因蛋白的组织定位和表达强度 ,对比其差异。结果　增殖期 ,bcl 2在正常子宫内膜及子宫腺肌病患者子宫在位、异位子宫内膜腺体中的表达强度分别为 (2 .0± 0 .3)、(2 .5± 0 .1)和 (3.0± 0 .1)分 ( x±s x,下同 ) (P <0 .0 5 ) ,在间质中的表达强度分别为 (0 .4± 0 .1)、(1.1± 0 .2 )和 (1.0± 0 .2 )分 (P <0 .0 5 ) ;分泌期 ,bcl 2在正常子宫及子宫腺肌病患者在位、异位子宫内膜腺体中的表达强度分别为 (0 .9± 0 .2 )、(1.3± 0 .2 )和 (1.7± 0 .2 )分 (P <0 .0 5 ) ,在间质中的表达强度分别为 (1.1± 0 .2 )、(0 .9± 0 .2 )和 (1.0± 0 .2 )分 (P >0 .0 5 )。在平滑肌中表达强度无明显变化。结论　bcl 2基因在子宫腺肌病子宫内膜中过度表达所致的细胞凋亡减弱 ,可能是子宫腺肌病发生的机理之一     

Adenomyotic Cyst in a 25-Year-Old Woman: Case Report

Adenomyotic cysts are uncommon findings, usually in the context of diffuse adenomyosis and <5 mm in diameter. Herein we report a 4.5-cm adenomyotic cyst in a 25-year-old nulliparous woman with severe dysmenorrhea and pelvic pain. Transvaginal ultrasonography and magnetic resonance imaging revealed a well-circumscribed hypoechogenic mass in the posterior uterine wall, well separated from the uterine cavity. Pathologic analysis demonstrated that the cyst was lined with endometrial epithelium and stroma and was surrounded by smooth muscle hyperplasia. In the literature, we found 30 reports of cysts with similar characteristics. Because this cyst has not been clearly defined, it has been called by various names including adenomyotic cyst, cystic adenomyosis, and cystic adenomyoma. We believe this lesion should not be called an adenomyoma, but is more correctly called an adenomyotic cyst or, depending on age at onset, a juvenile adenomyotic cyst.     

Adenomyoma of the stomach

Summary A case of adenomyoma of the prepyloric antrum and a review of the previous reported in the literature are presented. The tumor is composed of cysts and glandular structures lined by cuboidal-to-columnar epithelium surrounded by hypertrophic smooth muscle bundles. Furthermore, glands resembling Brunner's and/or heterotopic pancreatic tissue are present in some patients. The endoscopic characteristics of the lesion are discussed, as well as the diagnostic and therapeutic approaches.     

Simultaneous appearance of an adenomyoma and pancreatic heterotopia of the stomach

Adenomyomas of the stomach are rare tumours characterised by duct/gland-like structures embedded within a smooth muscle stroma. Although the histogenesis of adenomyomas remains unclear, the histological appearance has justified the assumption that these are abortive forms of pancreatic heterotopia. We report an unusual case with simultaneous and independent appearance of both adenomyoma and pancreatic heterotopia of the stomach including immunohistochemical characterisation, supporting the concept of a common histiogenetic origin of both lesions. Received: 31 May 1999 / Accepted: 9 September 1999     

腹壁腺肌瘤超声表现1例

患者女,28岁,主因“下腹闷痛、腹壁触痛数月”就诊.查体:下腹壁皮肤未见红肿,但触痛显著,可扪及肿块,底部较宽,挤压不移动.体温正常.血常规、心电图均正常,无腹腔手术史.超声检查:下腹前壁探及4.51 cm×1.82 cm的低回声区,边界清楚,呈椭圆形,无包膜回声显示,内部回声不均匀,无回声及低回声相间,后方回声无明显变化,包块前壁距皮肤表面约1 cm,与肠道无明显关联;彩色多普勒检查低回声区及其周围未见明显彩色血流;子宫及双侧卵巢大小、形态正常,未见明显异常回声(图1).超声提示:前腹壁混合性肿瘤,性质待定.     

实时超声弹性成像技术鉴别诊断子宫肌瘤和子宫腺肌瘤

目的 探讨实时超声弹性成像鉴别诊断子宫肌层病变的价值。方法 40例子宫肌瘤患者和20例子宫腺肌瘤患者均在术前接受常规超声检查及实时超声弹性成像,分析子宫肌瘤和子宫腺肌瘤的弹性图像特征及应变力比值(SR)。计算组内相关系数(ICC)评估SR多次测量的重复性。结果 子宫肌瘤患者的正常肌壁与病变的SR为1.52±0.69;子宫腺肌瘤患者正常肌壁与病变的SR为0.91±0.28,差异有统计学意义(t=3.79,P=0.013)。实时超声弹性成像示子宫腺肌瘤以红与绿色为主;子宫肌瘤以较均匀一致的蓝色为主。结论 实时超声弹性成像是鉴别诊断子宫肌瘤和子宫腺肌瘤的有效方法。     

子宫肌瘤和局限型腺肌病超声弹性图像特征分析

目的探讨经阴道超声弹性成像应用于子宫肌瘤和局限型腺肌病诊断中的可行性及其价值。方法回顾性分析经手术后病理证实的50例子宫肌瘤患者(60枚肌瘤)和15例子宫局限型腺肌病患者(15处腺肌病病灶)的经阴道超声弹性图像,以及病灶与正常肌层间的顺应性比值(B/A)。结果 60枚肌瘤与正常肌层的B/A为1.05~10.40,平均3.13±1.80;15处局限型腺肌病病灶与周围正常肌层的B/A为0.32~0.83,平均0.52±0.15。肌瘤与正常肌层B/A、局限型腺肌病病灶与正常肌层B/A比较差异有统计学意义(P=0.00)。结论经阴道超声弹性成像能较准确地反映子宫常见疾病的硬度变化,肌瘤硬度大于正常肌层,腺肌病的硬度小于正常肌层,在子宫疾病的鉴别诊断中有一定的应用前景。     

存在Razavi-Ⅰ型子宫动脉-卵巢动脉吻合时子宫动脉栓塞术的栓塞终点选择

目的探讨子宫动脉栓塞（UAE）治疗子宫肌瘤或腺肌瘤在有Razavi-Ⅰ型子宫动脉-卵巢动脉吻合（UA-OAa）时的栓塞终点。方法回顾性分析UAE治疗在栓塞前后子宫动脉造影（UAG）明确显示有UA-OAa的子宫肌瘤或腺肌瘤病例。结果在1056例UAE病例中显示68例共有47侧左卵巢动脉和57侧右卵巢动脉存在Razavi-Ⅰ型UA-OAa。20例左侧子宫动脉和27例右侧子宫动脉达到肌瘤动脉栓塞,而UA-OAa保持。68例UAE全部达到技术成功和临床成功,无肌瘤复发和卵巢衰竭病例。结论对有Razavi-Ⅰ型UA-OAa的病例进行UAE治疗,采用肌瘤动脉栓塞作为血管造影栓塞终点是一种有意义的选择。     

Myoepithelial hamartoma causing small-bowel intussusception: a case report and literature review

We report an unusual case of a 5-month-old girl who suffered an ileo-ileal intussusception that was not reduced by hydrostatic reduction. Surgical treatment revealed that the leading point was a tumor 1.5 cm in diameter. Myoepithelial hamartoma was diagnosed histopathologically. The literature indicates that MEH rarely causes small-bowel intussusception in childhood.