后纵隔巨大甲状腺乳头状癌一例

患者女,48岁。两年前无明显诱因出现轻微进食梗噎感,抬头时加重,未予治疗。近半年,梗噎感加重,并出现胸闷、咳嗽,痰中带血,遂来我院就诊。胸部CT显示:左后纵隔食管后方见一长条形低密度影,密度不均,其上方见环形斑     

Deep Granuloma Annulare (Pseudorheumatoid Nodule) in Children: Clinicopathologic Study of 35 Cases

Deep granuloma annulare (DGA) is one of several lesions of skin and superficial soft tissues whose histologic character is a palisading granuloma with a small central focus of necrosis or necrobiosis. Unlike the other palisading necrobiotic lesions, DGA has a predilection for children in the first 5 to 6 years of life. A painless subcutaneous nodule(s) in the lower anterior tibial region or foot and the scalp, typically in the occiput, was the most common presenting feature in this study of 35 cases. Additional or recurrent lesions were reported in approximately 70% of cases with clinical follow-up. All lesions showed the presence of necrobiosis; however, one of the characteristic features was the multinodular character of the predominantly mononuclear cellular aggregates. The presence of vascular spaces at the periphery of the nodular profiles served as a clue to the diagnosis of DGA. The palisading arrangement of the mononuclear cells was evident only in those foci with central necrobiosis. A histiocytic disorder or fibrohistiocytic process was a common consideration in the differential diagnosis, especially in those cases with less apparent foci of necrosis. Palisading histiocytes with prominent eosinophilic cytoplasm and some nuclear atypism were problematic with regard to possible epithelioid sarcoma. Our study failed to identify any underlying or predisposing factors in the development of DGA. Despite the fact that DGA is a well-documented lesion in children, it occurs sufficiently infrequently that it is often not considered clinically when it presents as a subcutaneous mass or masses in a child. Its recognition by the pathologist is especially important as the occurrence of additional lesions in a high proportion of children can be anticipated without undue concern. Received June 16, 1997; accepted October 28, 1997.     

Quantitative study of the morphological changes in the thyroid gland following IR laser radiation

The morphological changes produced in the thyroid glands of albino rats following radiation with a 904 nm infrared laser were studied. Two different levels of radiation were applied: 46.8 J/cm² and 140.4 J/cm². Evaluation of the changes in the densities of the epithelial, colloidal and follicular volumes and of the activation index revealed that the laser beam produced changes in the thyroid parenchyma. It was observed that there was a direct relationship between the severity of the lesion and the radiation energy applied.     

Detection and characterization of small hepatocellular carcinoma

Abstract   Early detection and characterization of small hepatocellular carcinoma (HCC) by imaging is possible with high confidence, and is important for the improvement of the prognosis of the patient with liver cirrhosis. In this lecture, screening of HCC and its characterization by imaging, with special reference to imaging features of human multi step hepato carcinogenesis will be discussed.     

Thyroid storm as a cause of loss of consciousness following anaesthesia for emergency Caesarean section

A previously undiagnosed thyrotoxic patient was anaesthetised for an emergency Caesarean section. The recovery period was complicated by an acute thyroid crisis resulting in loss of consciousness following an apparently normal recovery from general anaesthesia.     

血清保存方法对促甲状腺激素结果的影响观察

目的 :观察血清保存方法对促甲状腺激素 (TSH)结果的影响。方法 :将甲状腺功能正常、异常患者共 10份血清 ,采用不同血清量、不同条件分组保存后测定 TSH。结果 :保存方法对 TSH结果有一定的影响。结论 :用于 TSH血清的保存量要多、要密封管口、低温保存。     

硫代葡萄糖甙对碘代谢和甲状腺的影响

猪饲喂８％～１６％英籽饼日粮，平均每日从日粮中摄入９１９．４２～１４１６．０２ｍｇ硫代葡萄糖甙。在连续饲喂１２０天后，其甲状腺肿大，甲状腺滤泡和甲状腺上皮细胞显著增生，细胞质内缺乏分泌颗粒和溶酶体，细胞顶端密集微绒毛；滤泡腔内胶质周边部具有大量吸收空泡，分泌功能旺盛。Ｔ＿４和Ｔ＿４／Ｔ＿３比值明显升高，甲状腺功能亢进。若日粮中增加给碘量和服用解毒剂，猪甲状腺的组织形态学和超微结构接近正常，Ｔ＿４和／Ｔ＿４／Ｔ＿３比值亦趋于正常。     

Ag—NOR计数在区分良恶性甲状腺病变中的意义

随机选择经长期随访证实的滤泡性甲状腺癌和腺瘤各10例,正常甲状腺组织5例作为对照。按Ploton的染色方法和Crocker推荐的计数方法分别计算三组每例各50个细胞的Ag-NOR嗜银颗粒平均数,再算出三组各自的AgNOR均数,经统计学检验三者有极显著性差异。可望成为甲状腺滤泡性肿瘤良恶鉴别的一项辅助指标。     

应用最大似然法鉴别诊断周围型肺癌、肺错构瘤和结核球的初步研究

目的:探讨应用最大似然法鉴别周围性肺癌、肺错构瘤及结核球3种孤立性肺结节(SPN)的诊断价值。方法:对150例经临床和手术病理证实的SPN(周围性肺癌、肺错构瘤、结核球各50例)的HRCT影像学征象进行分类统计分析,运用最大似然判别法,将其各种征象转化为记分值,以数值的大小来判定肺结节所属的类型。结果:最大似然法对周围型肺癌、肺错构瘤及结核球的诊断正确率分别为86%、92%及90%,平均诊断正确率为89.3%,高于常规阅片法的82%,但两组间差异无统计学意义(χ2=2.434,P>0.05)。最能提示为肺癌的征象依次为空泡征、分叶征、支气管充气征和血管集束征;最能提示为肺错构瘤的征象依次为脂肪、边缘清楚及钙化;最能提示为结核球的征象依次为空洞、卫星灶、钙化及胸膜凹陷征。结论:最大似然法对常见SPN的鉴别诊断正确率有所提高,是一种辅助影像学诊断的有价值的方法。     

Fluorine-18 fluorodeoxyglucose positron emission tomography and iodine-131 whole-body scintigraphy in the follow-up of differentiated thyroid cancer

Metastases of differentiated thyroid cancer may show different uptake patterns for fluorine-18 fluorodeoxyglucose and [¹³¹I]NaI. FDG positron emission tomography (PET), iodine-131 whole-body scintigraphy (¹³¹I WBS) and magnetic resonance imaging were performed in 58 unselected patients, and spiral computed tomography (CT) of the lung in 25 patients. Thirty-eight patients presented with papillary carcinomas, 15 patients with follicular carcinomas and five patients with variants of follicular carcinoma. Primary tumour stage (pT) was pT1 in 3, pT2 in 19, pT3 in 11 and pT4 in 25 cases. For the detection of metastases, FDG PET was found to have a sensitivity of 50%, ¹³¹I WBS a sensitivity of 61%, and the two methods combined a sensitivity of 86%. When FDG PET was limited to patients with elevated thyroglobulin (Tg) levels and negative ¹³¹I WBS, the sensitivity of this algorithm was 82%. Of the 21 patients with lymph node metastases, seven presented with FDG uptake but no iodine uptake. In four of them, a second FDG hot spot appeared in a lymph node metastasis of normal size. Five of the seven patients underwent surgery. None of the eight patients with pulmonary metastases smaller than 1 cm exhibited FDG uptake, while five of them had iodine uptake. All had positive results on spiral CT. In conclusion, FDG PET cannot be substituted for ¹³¹I WBS. If the Tg level is elevated and ¹³¹I WBS is negative, FDG PET can be used to detect lymph node metastases and complements anatomical imaging. A spiral CT of the lung is useful to exclude pulmonary metastases before planning a dissection of iodine-negative lymph node metastases. Received 2 May and in revised form 8 July 1997