Multiple epithelial cysts of the spleen and on the splenic capsule, and high serum levels of CA19-9, CA125 and soluble IL-2 receptor

An 18-year-old woman with abdominal pain was diagnosed as having splenic cysts by computed tomography scan. She had high serum levels of CA19-9 (2886.8 U/mL; normal value, <35 U/mL), CA125 (131.1 U/mL; normal value, <35 U/mL) and soluble IL-2 receptor (1490 U/mL; normal range, 220-530 U/mL). The resected spleen weighed 1050 g, was 14 x 28 cm, and had more than 10 macroscopic cysts up to 10.3 x 9.5 cm. There were numerous microscopic cysts in the spleen and several on the splenic capsule. The levels of CA19-9 and CA125 in the cyst fluid were 2165550 U/mL and 160400 U/mL, respectively. After the surgery, the serum levels of the tumor markers decreased gradually. The inside of the largest cyst was mainly covered by granulation tissue with a focal lining of epithelial cells, and the other macroscopic cysts had stratified squamous epithelium. The microscopic splenic cysts and cysts on the splenic capsule were lined by either attenuated single-layered or multilayered epithelial cells. The lining epithelial cells of these cysts were positive for epithelial membrane antigen and cytokeratins. CA19-9 and CA125 were detected in the lining cells of the splenic cysts. In the present case, it is suspected that the splenic cysts were derived from the capsular lining cells that showed migration from the capsule or formed microcysts on the splenic capsule, as in the case of ovarian inclusion cysts.     

经皮穿刺囊内注射消痔灵治疗肝囊肿

目的 观察经皮穿刺囊内注射消痔灵治疗肝囊肿的疗效。方法 回顾性分析58例肝囊肿患者（男18例，女40例；年龄16-78岁，平均39.5岁），行B超引导下经皮穿刺肝囊肿内注射消痔灵注射液的临床疗效。结果 58例随访10个月，总治愈率94.8％（55／58），显效率5.2％（3／58），总有效率100％。未出现感染、发热等。结论 B超引导下穿刺囊肿内注射消痔灵治疗肝囊肿疗效好，方法安全、简便、实用，患者易于接受。     

Diagnostic difficulties in the interpretation of needle aspiration material from large renal cysts

In recent years, fine-needle-aspiration biopsies (FNA) have been widely used in the evaluation of renal masses, with false-positive FNA data being very uncommon. We present a case report of a 76-yr-old man with a 16-cm renal cyst and what was interpreted as an isolated calcified mural nodule. Following drainage of the main cyst fluid, FNA biopsy showed atypical cell clusters thought to be positive for malignancy. Subsequent surgery failed to disclose either a residual mural nodule or evidence of malignancy. Immunoperoxidase studies performed on both the cell block and actual cyst wall suggested that the abnormal cells were histiocytes. The diagnostic pitfalls of this case, along with a review of pertinent literature, are discussed. Diagn Cytopathol 1994; 11:380–384. © 1994 Wiley-Liss, Inc.     

Treatment of supratentorial primary arachnoid cysts

Summary Twenty-four cases of supratentorial primary arachnoid cysts operated with different techniques are reviewed: both cyst shunting or extirpation may lead to a good early clinical result, but the former is less dangerous and more indicated in a particular group of patients; late results are better in the shunted patients. CT scan is almost always diagnostic and is mandatory postoperatively to assess the late results.     

Applications of CT-adapted stereotaxis for the diagnosis and treatment of intracranial lesions

Summary Two hundred twenty five patients with intracranial lesions underwent diagnostic and therapeutic stereotactic surgery during the period 1978–1985. In the first 98 cases target coordinates were determined by transferring the information from the CT images to the standard stereotactic films. In the remainder, a simple, CT adapted stereotactic system has been used. Operations were as a rule performed under local anaesthesia. Positive histological diagnosis using paraffin embedding was achieved in 96% of the patients (biopsy success rate). Therapeutic procedures included abscess and cyst aspiration, cyst shunting, interstitial (Ir 192) or intracavitary (Y 90) irradiation and ventriculocisternostomy. Stereotactic surgery implied a refinement of the eventual therapeutic management in 90% of the cases. Transient neurological deficit occurred in 5.7% of the patients and there were three deaths (mortality rate 1.3%). Infection or other complications were not seen. The rationale and indications for non-functional stereotaxis are discussed.     

超声引导下肾囊肿的治疗

目的：通过超声的引导,对肾囊肿采取精确定位穿刺治疗,从而使肾囊肿的治疗更为简便有效。方法：从1995年以来的肾囊肿患者中选取12例单纯性肾囊肿患者,在穿刺探头引导下,对肾囊肿进行穿刺注射无水乙醇治疗,并在术后3－12个月进行随访。结果：治疗后3个月治愈率41．7％,6个月66．7％,12个月治愈率83．3％,有效率100％,无并发症发生,结论：超声引导穿刺治疗肾囊肿方法简便,安全可靠,痛苦小,治愈率高,值得向广大基层医院推广。     

颈部囊肿与瘘管的诊断和治疗

目的：总结颈部囊肿与瘘管的诊治经验。方法：93例行手术治疗,其中鳃裂囊肿15例,鳃裂瘘管10例,皮样囊肿1例,囊状淋巴管瘤4例,甲状舌骨囊肿37例,甲状舌管瘘管25例,癌性淋巴液囊肿1例,随访1－10年。结果：93例中,囊性淋巴管瘤1例复发后失访,另1例行2次手术,癌性淋巴液囊肿1例半年后死于肺转移,鳃裂瘘管2例3次手术,甲状舌管瘘管1例复发,鳃裂瘘管术后1例迟发性面瘫,一次手术治愈,无术后并发症。结论：颈部囊肿与瘘管的诊断除依据术前检查外,主要是依据术中的发现和术后病理检查。B超、CT等是有效的辅助检查.手段治疗上应彻底切除囊壁与瘘管,避免复发。术中应避免损伤颈部的大血管和神经。甲状舌管瘘管须切除舌骨中段2cm,这是防止术后复发的关键。     

Soft tissue aneurysmal bone cyst of left hemithorax with review of literature

Soft tissue aneurysmal bone cysts (STABCs) are extremely rare extraosseous counterpart of aneurysmal bone cyst (ABC), with close resemblance to histo-morphologic characteristics of ABC. Here we would like to report a 13-year-old female patient, who presented with a large mass, occupying the entire left hemithorax. Patient underwent resection of the thoracic mass. On histopathological examination, it was found to be a soft tissue ABC. It is a very rare tumor and until date 28 cases have been reported in English literature, to the best of our knowledge. On review of the literature, we found this to be the first case of STABC reported in thoracic cavity. The objective of this case presentation is to provide information regarding clinical presentation, radiological and pathological features, and course of management for this rare disease. Soft tissue ABCs are a new class of tumors, so more extensive research is required to establish standard guidelines for their diagnosis and management, to yield better prognosis.     

侧脑室室管膜囊肿的MRI诊断及鉴别诊断（附10例报告）

目的探讨侧脑室室管膜囊肿的MRI表现。方法回顾性分析10例侧脑室室管膜囊肿患者的临床及MRI影像学资料。结果10例中有明显症状者3例，其余7例症状不明显。MRI表现为侧脑室三角区和／或体部内单发椭圆形囊样病灶，边界清晰、光滑、锐利，信号均匀，在MRI所有序列上均与脑脊液信号相同，5例增强扫描病灶无增强，邻近的脉络丛受压移位。4例合并同侧颞角轻度扩大，1例合并同侧颞角明显扩大。双侧脑室前角无明显扩大。邻近脑实质无水肿带。结论侧脑室室管膜囊肿MRI表现具有一定特征性，为该病的诊断及鉴别诊断提供重要依据。