BACKGROUND Turner syndrome(TS)with leukemia is a complicated clinical condition.The clinical course and outcome of these patients are poor,so the treatment and prognosis of TS with hematological malignancies deserve o...BACKGROUND Turner syndrome(TS)with leukemia is a complicated clinical condition.The clinical course and outcome of these patients are poor,so the treatment and prognosis of TS with hematological malignancies deserve our attention.CASE SUMMARY Here,we report a case of a 20-year-old woman diagnosed with TS,primary myelofibrosis(PMF),cirrhosis,and an ovarian cystic mass.This is the first report on the coexistence of TS and PMF with the MPL and SH2B3 mutations.The patient was diagnosed with cirrhosis of unknown cause,splenomegaly and severe gastroesophageal varices.Additionally,an ovarian cystic mass caused the patient to appear pregnant.The patient was treated with the JAK2 inhibitor-ruxolitinib according to peripheral blood cells,although myelofibrosis was improved,the splenomegaly did not reduce.Moreover,hematemesis and melena occasionally occurred.CONCLUSION Ruxolitinib may clearly reduce splenomegaly.Though myelofibrosis was improved,cirrhosis and splenomegaly in this case continued to worsen.Effective treatment should be discussed.展开更多
Cystic lesions are very commonly encountered entities in the breast. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><spa...Cystic lesions are very commonly encountered entities in the breast. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Among</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> these, Complex Cystic Breast Masses (CCBM</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">), which contain both anechoic </span><span style="font-family:Verdana;">and echogenic components, can result in a variety of imaging appearances.</span><span style="font-family:Verdana;"> These include cystic lesions with thick walls and/or internal septa, intracystic nodular lesions, and solid-cystic masses of varying com</span><span style="font-family:Verdana;">positions. Ultrasound is the mainstay for evaluating cystic lesions, and thus recognizing the imaging features appropriately and suggesting suitable interventional procedures are </span><span style="font-family:Verdana;">included in their management. In this pictorial essay, we describe the</span><span style="font-family:Verdana;"> wide</span><span style="font-family:Verdana;"> range of ultrasound appearances of CCBMs with a number of clinically encountered examples from our institution. This article would enhance the understanding of readers in possible differentials to be included in their clinical </span><span style="font-family:Verdana;">practice and to suggest appropriate further intervention, when deemed ne</span><span style="font-family:Verdana;">cessary.展开更多
We present a case report of a parathyroid adenoma, which presented as a giant cystic neck mass while providing thorough reviews of the pathophysiology of parathyroid adenomas and the differential diagnosis for large, ...We present a case report of a parathyroid adenoma, which presented as a giant cystic neck mass while providing thorough reviews of the pathophysiology of parathyroid adenomas and the differential diagnosis for large, cystic neck masses in adults. A 72 year old female presented to a tertiary academic medical center with a complicated past medical history and was found to have an asymptomatic central neck mass which measured 10.5 × 7.7 × 4.1 cm on ultrasound and extended from the retropharyngeal space with mass effect on the hypopharynx, esophagus, trachea, and right carotid space structures as well as the superior mediastinum. She had elevated calcium and parathyroid hormone (PTH) levels. She underwent surgical excision of this mass and had an uneventful postoperative period. Large cystic neck masses generate a wide differential diagnosis. In adults, it is important to consider the rare possibility of parathyroid adenoma, especially in patients who may not be able to communicate vague symptoms of hypercalcemia. This particular parathyroid adenoma is several orders of magnitude larger than an average parathyroid adenoma and its massive size served as a distraction for the proper diagnosis as large, cystic neck masses in adults are to be considered cancer until proven otherwise.展开更多
目的:探讨多模态超声特征分型在乳腺囊实混合性肿块良恶性鉴别诊断中的价值。方法:回顾性分析106例经病理证实的乳腺囊实混合性肿块(108个),术前行常规超声、萤火虫成像、超微血管三维成像(Smart 3D SMI)及应变弹性成像(SE)。应用多模...目的:探讨多模态超声特征分型在乳腺囊实混合性肿块良恶性鉴别诊断中的价值。方法:回顾性分析106例经病理证实的乳腺囊实混合性肿块(108个),术前行常规超声、萤火虫成像、超微血管三维成像(Smart 3D SMI)及应变弹性成像(SE)。应用多模态超声对肿块特征分型,并对常规超声的乳腺影像报告和数据系统(BI-RADS)分类结果进行校正。以术后病理为金标准,比较分析校正前后的鉴别诊断效能。结果:106例中良性61例(62个病灶),恶性45例(46个病灶)。常规超声BI-RADS分类结果校正后的诊断敏感度、特异度、准确率、阳性预测值、阴性预测值、AUC分别为89.13%、80.65%、84.26%、77.36%、90.91%、0.849,均高于校正前。结论:常规超声BI-RADS分类经多模态超声校正后,可提高对乳腺囊实混合性肿块良恶性的鉴别诊断效能。展开更多
文摘BACKGROUND Turner syndrome(TS)with leukemia is a complicated clinical condition.The clinical course and outcome of these patients are poor,so the treatment and prognosis of TS with hematological malignancies deserve our attention.CASE SUMMARY Here,we report a case of a 20-year-old woman diagnosed with TS,primary myelofibrosis(PMF),cirrhosis,and an ovarian cystic mass.This is the first report on the coexistence of TS and PMF with the MPL and SH2B3 mutations.The patient was diagnosed with cirrhosis of unknown cause,splenomegaly and severe gastroesophageal varices.Additionally,an ovarian cystic mass caused the patient to appear pregnant.The patient was treated with the JAK2 inhibitor-ruxolitinib according to peripheral blood cells,although myelofibrosis was improved,the splenomegaly did not reduce.Moreover,hematemesis and melena occasionally occurred.CONCLUSION Ruxolitinib may clearly reduce splenomegaly.Though myelofibrosis was improved,cirrhosis and splenomegaly in this case continued to worsen.Effective treatment should be discussed.
文摘Cystic lesions are very commonly encountered entities in the breast. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Among</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> these, Complex Cystic Breast Masses (CCBM</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">), which contain both anechoic </span><span style="font-family:Verdana;">and echogenic components, can result in a variety of imaging appearances.</span><span style="font-family:Verdana;"> These include cystic lesions with thick walls and/or internal septa, intracystic nodular lesions, and solid-cystic masses of varying com</span><span style="font-family:Verdana;">positions. Ultrasound is the mainstay for evaluating cystic lesions, and thus recognizing the imaging features appropriately and suggesting suitable interventional procedures are </span><span style="font-family:Verdana;">included in their management. In this pictorial essay, we describe the</span><span style="font-family:Verdana;"> wide</span><span style="font-family:Verdana;"> range of ultrasound appearances of CCBMs with a number of clinically encountered examples from our institution. This article would enhance the understanding of readers in possible differentials to be included in their clinical </span><span style="font-family:Verdana;">practice and to suggest appropriate further intervention, when deemed ne</span><span style="font-family:Verdana;">cessary.
文摘We present a case report of a parathyroid adenoma, which presented as a giant cystic neck mass while providing thorough reviews of the pathophysiology of parathyroid adenomas and the differential diagnosis for large, cystic neck masses in adults. A 72 year old female presented to a tertiary academic medical center with a complicated past medical history and was found to have an asymptomatic central neck mass which measured 10.5 × 7.7 × 4.1 cm on ultrasound and extended from the retropharyngeal space with mass effect on the hypopharynx, esophagus, trachea, and right carotid space structures as well as the superior mediastinum. She had elevated calcium and parathyroid hormone (PTH) levels. She underwent surgical excision of this mass and had an uneventful postoperative period. Large cystic neck masses generate a wide differential diagnosis. In adults, it is important to consider the rare possibility of parathyroid adenoma, especially in patients who may not be able to communicate vague symptoms of hypercalcemia. This particular parathyroid adenoma is several orders of magnitude larger than an average parathyroid adenoma and its massive size served as a distraction for the proper diagnosis as large, cystic neck masses in adults are to be considered cancer until proven otherwise.
文摘目的:探讨多模态超声特征分型在乳腺囊实混合性肿块良恶性鉴别诊断中的价值。方法:回顾性分析106例经病理证实的乳腺囊实混合性肿块(108个),术前行常规超声、萤火虫成像、超微血管三维成像(Smart 3D SMI)及应变弹性成像(SE)。应用多模态超声对肿块特征分型,并对常规超声的乳腺影像报告和数据系统(BI-RADS)分类结果进行校正。以术后病理为金标准,比较分析校正前后的鉴别诊断效能。结果:106例中良性61例(62个病灶),恶性45例(46个病灶)。常规超声BI-RADS分类结果校正后的诊断敏感度、特异度、准确率、阳性预测值、阴性预测值、AUC分别为89.13%、80.65%、84.26%、77.36%、90.91%、0.849,均高于校正前。结论:常规超声BI-RADS分类经多模态超声校正后,可提高对乳腺囊实混合性肿块良恶性的鉴别诊断效能。