Objective To investigate clinical significance of serum VEGF-C level and C-erbB-2 protein expression in patients with breast cancer. Methods Sixty-two female patients with breast invasive ductal cancer and breast benign lesion were respectively selected. Serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA) before operation and at one month after operation, and C-erbB-2 protein expression in tissues of breast cancer was detected by immunohistochemistry. Then, the relationship between serum VEGF-C level and clinicopathologic characteristics and C-erbB-2 protein expressions wereas analyzed. Results The serum VEGF-C level before operation in breast cancer patients〔(279.65±17.34) pg/ml〕 was significantly higher than that in breast benign lesions patients 〔(167.26±12.15) pg/ml〕, P＜0.01. In breast cancer patients, the serum VEGF-C level before operation was higher than that at one month after operation 〔(209.45±15.23) pg/ml〕, P＜0.01. The serum VEGF level was related to tumor stage (P＜0.05) but not to patient age, tumor size, menopause status , lymph node metastasis or not and ER and PR expression (Pgt;0.05). The positive expression rate of C-erbB-2 protein in breast cancer patients (54.84%, 34/62) was significantly higher than that in breast benign lesion patients (11.29%, 7/62), P＜0.01. Moreover, the positive expression rate of C-erbB-2 protein in breast cancer patients with axilla lymph node metastasis (69.44%) was significantly higher than that without axilla lymph node metastases (34.62%), P＜0.05. The serum VEGF level increased with increasing expression intensity of C-erbB-2 protein and there was positive correlation between them (r=0.813，P＜0.05). Conclusions The serum VEGF-C level in breast cancer may be conducted as an assisted marker to differential diagnosis of breast tumor. C-erbB-2 is related to lymph node metastasis of breast cancer patients. There is synergistic effect between VEGF-C and C-erbB-2 in the lymph node metastasis way of breast cancer.
目的：探讨喉巨细胞瘤的临床病理学特征及诊断、鉴别诊断要点.方法：报道1例喉巨细胞瘤，结合文献对其临床表现、影像学情况、病理形态学特点及鉴别诊断进行分析和探讨。结果：巨细胞瘤好发于长骨末端，约5%累及扁骨，不足5%的病例累及手足部的短管状骨，2%发生于头颈部。喉巨细胞瘤极罕见，发病平均年龄为42.4岁，男性多见。本例34岁，男性，左侧声门下3 cm×2 cm×2 cm肿块。镜下表现为圆形、卵圆形单核细胞及均匀分布其间的破骨细胞样巨细胞混合组成。结论：喉巨细胞瘤罕见，临床易误诊为恶性肿瘤，其病理学检查有特征性形态改变，结合影像学改变，可以确诊。
摘要:目的:研究胸腺瘤与前纵隔(血管前间隙)淋巴瘤的MSCT表现,提高对二者的诊断与鉴别诊断能力。方法:回顾性分析经手术病理证实的30例胸腺瘤与18例血管前间隙淋巴瘤MSCT表现,着重观察肿瘤的密度、形态及其与周围结构的关系。结果:30例胸腺瘤中,24例良性胸腺瘤与邻近大血管分界清晰,肿块表现 “D”字或反“D”字状,平扫CT值16~59 Hu,增强CT值20~110 Hu;6例侵袭性胸腺瘤边界不清,呈分叶状、不规则形,密度不均,平扫CT值23~42 Hu,增强CT值23~60 Hu。18例淋巴瘤中,单发于前上纵隔者6例,其余12例呈多结节、肿块状,侵入血管间隙生长,致大血管受压,增强扫描呈轻度强化,常伴有其它部位淋巴结增大。结论:MSCT能清晰显示胸腺瘤与前纵隔淋巴瘤的影像学表现特征,并能有效提高对二者的鉴别诊断。Abstract: Objective: To diagnosis and differentiate thymoma and malignant lymphoma in the anterior mediastinum on the basis of multislice CT (MSCT) imaging features. Methods:We retrospectively reviewed 30 cases with thymoma and 18 cases with malignant lymphoma proven by surgery and pathology.More attention was put on the density, morphology and relation with the surrounding structures of the tumors. Results: The CT manifestations of 30 cases of thymoma were shown as: For 24 cases of benign thymoma, the boundaries were clear, the shapes were “D” signs or contra“D” signs, CT attenuation value were 1659Hu and 20110Hu on unenhanced and contrastenhanced scanning. For 6 cases of malignant thymoma, the boundaries were unclear, the shapes were lobulated or irregular, the density was heterogeneous, CT attenuation value were 2342Hu and 2360Hu on unenhanced and contrastenhanced scanning. For 18 cases of malignant lymphoma, 6 cases were located at anterior mediastinum, 12 cases were nodes or multiple mass, enveloped the neighboring vessel structures, mildly enhanced on contrastenhanced scanning, and associated with enlargement of lymph nodes in other place. Conclusion: MSCT can display the imaging features of thymoma and anterior mediastinal lymphoma, and effectively differentiate thymoma and mediastinal lymphoma.
ObjectiveTo summarize the clinical features of infection with Staphylococcus intermedius and its differential diagnosis. MethodsA clinical case of Staphylococcus intermedius infection was analyzed and Chinese literatures about Staphylococcus intermedius infection were reviewed.The literatures were derived from domestic medical journals in CNKI Digital Library and Wanfang Databases from 1998 to 2015. ResultsThe patient was a 35-year-old male.The chief complaints were cough and sputum associated with fever for three days.Chest CT scan showed cuneate and flocculent shadow with high density and unclear margin in the posterior segment of the right upper lobe and aerated bronchus sign was seen.Fuzzy shadow under the pleural was observed in the right lower lobe; On the right side of the chest, a little curved liquid density was seen.Sputum culture in Columbia blood agar plate and chocolate agar plate was done and Staphylococcus intermedius was identified.The final diagnosis of this patient was pneumonia caused by Staphylococcus intermedius.Fleroxacin 0.4 g per day was given by intravenous drip.Two weeks later, chest CT scan showed cuneate and flocculent shadow in the right upper lobe decreased obviously.Fuzzy shadow under the pleural the right lower lobe and pleural effusion on the right side of the chest disappeared.Four cases with Staphylococcus intermedius infection were reported and 3 were children.Two patients had open wound with infection.The involved organs included brain, joints, lungs, and one patient developed septicemia.Staphylococcus intermedius was identified from blood, sputum, cerebrospinal fluid, and pus from the open wound.By treatment with sensitive antibiotics three patients were cured but one patient with meningoencephalitis died of circulatory failure. ConclusionsStaphylococcus intermedius infection can occur in many organs and its clinical manifestations are dependent on the infected location.Specimen culture for pathogen is necessary and blood, sputum, cerebrospinal fluid, and pus from the open wound are optional candidates.Cultivation of Staphylococcus intermedius is similar to that of Staphylococcus aureus and should be differentiated carefully.Early treatment with high sensitive antibiotics is effective with good prognosis.
Hepatic angiomyolipoma (HAML) is a rare benign mesenchymal tumor of the liver, which has highly variable imaging appearances, often leads to missed diagnosis and misdiagnosis. The images of 2 patients with HAML confirmed by pathology were presented in this study, and the typical imaging features of the HAML, the underlying pathophysiological mechanism, and the differential diagnosis were briefly summarized so as to deepen the understanding of HAML and to improve the diagnosis and differential diagnosis abilities of HAML, then reduce the rates of missed diagnosis and misdiagnosis of the HAML.
【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
Objective To determine feasibility of texture analysis of CT images for the discrimination of hepatic epithelioid hemangioendothelioma (HEHE) and liver metastases of colon cancer. Methods CT images of 9 patients with 19 pathologically proved HEHEs and 18 patients with 38 liver metastases of colon cancer who received treatment in West China Hospital of Sichuan University from July 2012 to August 2016 were retrospectively analyzed. Results Thirty best texture parameters were automatically selected by the combination of Fisher coefficient (Fisher)+classification error probability combined with average correlation coefficients (PA)+mutual information (MI). The 30 texture parameters of arterial phase (AP) CT images were distributed in co-occurrence matrix (22 parameters), run-length matrix (1 parameter), histogram (4 parameters), gradient (1 parameter), and autoregressive model (2 parameters). The distribution of parameters in portal venous phase (PVP) were co-occurrence matrix (18 parameters), run-length matrix (2 parameters), histogram (7 parameters), gradient (2 parameters), and autoregressive model (1 parameter). In AP, the misclassification rates of raw data analysis (RDA)/K nearest neighbor classification (KNN), principal component analysis (PCA)/KNN, linear discriminant analysis (LDA)/KNN, and nonlinear discriminant analysis, and nonlinear discriminant analysis (NDA)/artificial neural network (ANN) was 38.60% (22/57), 42.11% (24/57), 8.77% (5/57), and 7.02% (4/57), respectively. In PVP, the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN was 26.32% (15/57), 28.07% (16/57), 15.79% (9/57), and 10.53% (6/57), respectively. The misclassification rates of AP and PVP images had no statistical significance on the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN between AP and PVP (P>0.05). Conclusion The texture analysis of CT images is feasible to identify HEHE and liver metastases of colon cancer.
目的 探讨胰腺淋巴瘤和胰腺癌的鉴别诊断及治疗。方法 回顾性分析我院2000年1月至2008年4月期间经病理确诊的5例胰腺淋巴瘤患者的临床资料。结果 本组5例患者临床症状以腹痛、发热、黄疸为主，除1例外血浆CA19-9均正常，临床表现无法区分胰腺淋巴瘤和胰腺癌，CT等影像学有助于鉴别诊断。胰腺淋巴瘤CT增强扫描后均见强化表现，胰管不粗，和周围大血管关系紧密，邻近血管结构被推移，但无浸润、包绕现象。治疗以化疗为主，除1例失访外，其余4例分别存活24、14、14、13个月。结论 胰腺淋巴瘤是一种罕见的疾病，临床症状缺乏特异性，极易与胰腺癌混淆，治疗和预后却与胰腺癌不尽相同，临床上应该尽量通过CT或超声下穿刺明确诊断，以避免不必要的手术。