AIM:To evaluate the relationship between gene polymorphism(BclI,ER22/23EK,N363S)and the occurrence,progression and sensitivity to glucocorticoid of lacrimal gland benign lymphoepithelial lesion(LGBLEL).METHODS:Clinica...AIM:To evaluate the relationship between gene polymorphism(BclI,ER22/23EK,N363S)and the occurrence,progression and sensitivity to glucocorticoid of lacrimal gland benign lymphoepithelial lesion(LGBLEL).METHODS:Clinical peripheral blood samples of 52 LGBLEL patients and 10 normal volunteers were collected for DNA extraction and polymerase chain reaction sequencing to analyze single nucleotide polymorphism(SNP)genotypes.The lacrimal tissues of LGBLEL were surgically removed and made into paraffin sections for subsequent hematoxylin-eosin(HE)and Masson staining analysis.The duration of disease and hormone use of LGBLEL patients from diagnosis to surgery were also analyzed.The Meta-analysis follows PRISMA guidelines to conducted a systematic review of human studies investigating the relationship between the NR3C1 BclI polymorphism and glucocorticoids(GCs)sensitivity.RESULTS:There was no association between ER22/23EK or N363S and the occurrence of LGBLEL or GCs sensitivity(P>0.05);BclI GC genotype was closely related to GCs resistance(P=0.03)as is the minor allele C(P=0.0017).The HE staining and Masson staining showed that the GC genotype of BclI remarkably slowed down the disease progression and reduced fibrosis(P<0.05),especially for GCs-dependent patients(P<0.0001).Meta-analysis showed that BclI was not significantly associated with GCs responsiveness.CONCLUSION:The LGBLEL patients who carry the NR3C1 BclI allele C may be more sensitive to GCs and associated with lower fibrosis and slower disease progression.The results may guide the clinical treatment strategy for the LGBLEL patients.展开更多
The treatment of pathological fractures of the femoral neck and trochanteric region secondary to benignlesions can be a challenge for orthopaedic surgeons because of the size and nature of the lesions, the resulting ...The treatment of pathological fractures of the femoral neck and trochanteric region secondary to benignlesions can be a challenge for orthopaedic surgeons because of the size and nature of the lesions, the resulting bony defect, the risk of recurrence, the possible associated deformities, and the risk of osteonecrosis. Numerous treatment modalities have been reported for the management of pathological fractures of the proximal femur secondary to benign lesions. An unsatisfactory outcome in 25% of patients and a complication rate of 45% have been observed.展开更多
PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 ...PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 was in 11 was 85.7%,展开更多
BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but th...BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young patients.AIM To describe TEM outcomes in patients under 50 years of age.METHODS We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.RESULTS During the study period,a total of 26 patients under the age of 50 years underwent TEM procedures.Their mean age was 43.3 years.Eleven(42.0%)were male.The mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 cm.No major intraoperative or postoperative complications were recorded.The median length of stay was 2 d.Seven(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other pathologies.Surgical margins were negative in all cases.Local recurrence was detected in one patient 33 mo following surgery.CONCLUSION Among young adult patients,TEM for benign rectal lesions has excellent outcomes.It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer.In some cases,it may be considered an alternative to radical surgery.展开更多
Objective To explore the influence factors in hematoma formation after removing benign breast lesions with an ultrasound-guided vacuum-assisted system.Methods A total of 232 females with 312 benign breast masses recei...Objective To explore the influence factors in hematoma formation after removing benign breast lesions with an ultrasound-guided vacuum-assisted system.Methods A total of 232 females with 312 benign breast masses received excisional biopsy with ultrasoundguided vacuum-assisted system.The pathology of patients,results of hematoma development and outcome,influence factors for hematoma occurrence(nodule size,nodule location,number of nodule,breast shape,menstrual period,efficacy time of bandage,and application of hemostatic agents during the procedure) were recorded.Results Pathologic examination revealed fibroadenomas in 138 lesions,fibroadenosis in 127 lesions,intraductal papillomas in 39 lesions,inflammatory change in 4 lesions,retention cyst of the breast in 3 lesions,and benign phyllodes tumor in 1 lesion.Thirty hematomas were observed in patients(9.6%).Finally,97.0%hematomas were absorbed completely within 6 months follow-up.The incidence rates of hematoma were increased by 24.7%,10.0%,63.2%,13.9%in the nodule diameter larger or equal to 25 mm group,removal of larger or equal to two nodules once time from one patient group,menstrual period group,and larger and loose breast group,respectively(all P<0.05).However,the incidences were decreased by 60.6%in the bandage performed for 12-24 hours or beyond 24 hours group(P<0.05).The multiple logistic regression models revealed that nodule size(x^2=15.227,P<0.001),number of nodule(x^2=7.767,P=0.005),menstrual period(x^2=24.530,P<0.001),and breast shape(x^2=9.559,P=0.002) were independent risk factors associated with hematoma occurrence,but efficacy time of bandage was a protective factor associated with hematoma occurrence.Conclusion The occurrence of hematoma after the minimally invasive operation was associated with nodule size,number of nodule,menstrual period,breast shape,and efficacy time of bandage.展开更多
AIM:To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions.METHODS:A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 t...AIM:To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions.METHODS:A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 to December 2005 in the Chinese PLA General Hospital were investigated retrospectively according to their medical documentation.RESULTS:The effect of operative and perioperative factors on the outcome of patients were analyzed.Of the 827 cases undergoing hepatectomy for more than 3 liver segments accounted for 22.1%,316(38.21%) required transfusion of blood products during operation.The average operating time was 220.59 ± 109.13 min,the average hospital stay after operation was 13.55 ± 9.38 d.Child-Pugh A accounted for 98.13%.The postoperative complication rate was 13.54% and the in-hospital mortality rate was 0.24%.Multivariate analysis showed that operating time(P = 0.004,OR = 1.003) and albumin value(P = 0.040,OR = 0.938) were the independent predictors of morbidity and indicated that operating time,blood transfusion,complication rate,and LOS had a trend to decrease.CONCLUSION:Hepatectomy for benign hepatic lesions can be performed safely with a low morbidity and mortality,provided that it is carried out with optimized perioperative management and an innovative surgical technique.展开更多
BACKGROUND R2^(*)estimation reflects the paramagnetism of the tumor tissue,which may be used to differentiate between benign and malignant liver lesions when contrast agents are contraindicated.AIM To investigate whet...BACKGROUND R2^(*)estimation reflects the paramagnetism of the tumor tissue,which may be used to differentiate between benign and malignant liver lesions when contrast agents are contraindicated.AIM To investigate whether R2^(*)derived from multi-echo Dixon imaging can aid differentiating benign from malignant focal liver lesions(FLLs)and the impact of 2D region of interest(2D-ROI)and volume of interest(VOI)on the outcomes.METHODS We retrospectively enrolled 73 patients with 108 benign or malignant FLLs.All patients underwent conventional abdominal magnetic resonance imaging and multi-echo Dixon imaging.Two radiologists independently measured the mean R2^(*)values of lesions using 2D-ROI and VOI approaches.The Bland-Altman plot was used to determine the interobserver agreement between R2^(*)measurements.Intraclass correlation coefficient(ICC)was used to determine the reliability between the two readers.Mean R2^(*)values were compared between benign and malignant FFLs using the nonparametric Mann-Whitney test.Receiver operating characteristic curve analysis was used to determine the diagnostic performance of R2^(*)in differentiation between benign and malignant FFLs.We compared the diagnostic performance of R2^(*)measured by 2D-ROI and VOI approaches.RESULTS This study included 30 benign and 78 malignant FLLs.The interobserver reproducibility of R2^(*)measurements was excellent for the 2D-ROI(ICC=0.994)and VOI(ICC=0.998)methods.Bland-Altman analysis also demonstrated excellent agreement.Mean R2^(*)was significantly higher for malignant than benign FFLs as measured by 2D-ROI(P<0.001)and VOI(P<0.001).The area under the curve(AUC)of R2^(*)measured by 2D-ROI was 0.884 at a cut-off of 25.2/s,with a sensitivity of 84.6%and specificity of 80.0%for differentiating benign from malignant FFLs.R2^(*)measured by VOI yielded an AUC of 0.875 at a cut-off of 26.7/s in distinguishing benign from malignant FFLs,with a sensitivity of 85.9%and specificity of 76.7%.The AUCs of R2^(*)were not significantly different between the 2D-ROI and VOI methods.CONCLUSION R2^(*)derived from multi-echo Dixon imaging whether by 2D-ROI or VOI can aid in differentiation between benign and malignant FLLs.展开更多
·AIM: To identify the association of the T cell receptor(TCR) signaling with the development of benign lymphoepithelial lesions(BLEL) of the lacrimal gland.· METHODS: We collected affected lacrimal gland tis...·AIM: To identify the association of the T cell receptor(TCR) signaling with the development of benign lymphoepithelial lesions(BLEL) of the lacrimal gland.· METHODS: We collected affected lacrimal gland tissues from 9 patients who underwent dacryoadenectomy in the Capital Medical University Beijing Tongren Hospital Eye Center between August2010 and March 2013 and were confirmed to have lacrimal gland BLEL by histopathological analysis. Tumor tissues from 9 patients with orbital cavernous hemangioma were also collected and used as control.Whole genome gene expression microarray was used to compare gene expression profiles of affected lacrimal gland tissues from patients with lacrimal gland BLEL to those from of orbital cavernous hemangiomas.Differential expression of TCR pathway genes between these tissues was confirmed by polymerase chain reaction(PCR) and immunohistochemistry.·RESULTS: Microarray analysis showed that in lacrimal glands with BLEL, 32 signaling pathways were enriched in the upregulated genes, while 25 signaling pathways were enriched in the downregulated genes. In-depth analysis of the microarray data showed that the expression of 27 genes of the TCR signaling pathway increased significantly. To verify the differential expression of three of these genes, CD3, CD4, and interleukin(IL)-10, reverse transcription-PCR(RT-PCR)and immunohistochemistry assays were performed. RT-PCR analysis showed that CD3 and CD4 were expressed in the lacrimal glands with BLEL, but IL-10 was not expressed. Immunohistochemistry confirmed that CD3 and CD4 proteins were also present, but IL-10 protein was not. CD3, CD4, or IL-10 expression was not found in the orbital cavernous hemangiomas with either RT-PCR or immunohistochemistry.· CONCLUSION: TCR signaling pathway might be involved in the pathogenesis of lacrimal gland BLEL.展开更多
BACKGROUND Fracture risk assessment in children with benign bone lesions of long bones remains poorly investigated.AIM To investigate the risk factors for pathological fracture in children with benign bone lesions and...BACKGROUND Fracture risk assessment in children with benign bone lesions of long bones remains poorly investigated.AIM To investigate the risk factors for pathological fracture in children with benign bone lesions and to propose a modified scoring system for quantitative analysis of the pathologic fracture risk.METHODS We retrospectively reviewed 96 pediatric patients with benign bone lesions.We compared radiographic and clinical features between 40 patients who had fractures through a benign bone lesion and 56 who had no fracture.Information including histological diagnosis,anatomical site,radiographic appearance,severity of pain,and lesion size was recorded for the patients.A modified scoring system was proposed to predict the risk of fracture.RESULTS The univariate comparisons showed a significant difference between the fracture and non-fracture groups in terms of lesion type,pain,lesion-to-bone width,and axial cortical involvement of the patients(P<0.05).Lesion type,pain,lesion-tobone width,and axial cortical involvement were independently correlated with an increased risk of fracture.The mean score of the fracture group was 7.89,whereas the mean score of the non-fracture group was 6.01.The optimum cut-off value of the score to predict pathological fracture was 7.The scoring system had a sensitivity of 70%and a specificity of 80%for detecting patients with fractures.The Youden index was 0.5,which was the maximum value.The area under the receiver operator characteristic was 0.814.CONCLUSION Lesion type,pain,lesion-to-bone width,and axial cortical involvement are risk factors for pathological fracture.The modified scoring system can provide evidence for clinical decision-making in children with benign bone lesions.A bone lesion with a total score>7 indicates a high risk of a pathologic fracture and is an indication for prophylactic internal fixation.展开更多
·AIM:To analyze the differences in immune indicators and prognosis between Ig G4-positive and negative lacrimal gland benign lymphoepithelial lesion(LGBLEL).·METHODS:This was a single-center retrospective cl...·AIM:To analyze the differences in immune indicators and prognosis between Ig G4-positive and negative lacrimal gland benign lymphoepithelial lesion(LGBLEL).·METHODS:This was a single-center retrospective clinical study including 105 cases of Ig G4-positive LGBLEL and 41 cases of Ig G4-negative LGBLEL.Basic information,related indicators of peripheral venous blood samples using immunoscattering turbidimetry,treatment(partial surgical excision and glucocorticoid therapy)and prognosis(recurrence and death)were collected.Survival curves for recurrence were created using the Kaplan-Meier analysis.Univariate analysis and multivariate regression analysis were used to analyze prognostic factors.·RESULTS:The mean age was 50.10±14.23y and 44.76±11.43y(P=0.033)in Ig G4-positive and negative group respectively.The serum C3 and C4 was lower in Ig G4-positive group(P=0.005,P=0.002),while the serum Ig G and Ig G2 was higher in Ig G4-positive group(P=0.000 and P=0.008).Twenty-one cases had recurrence in Ig G4-positive group and 3 cases recurrence in Ig G4-negative group.The 5-year recurrence-free cumulative percentages of Ig G4-positive group was 81.85%,and 83.46%in the Ig G-negative group(P=0.216).The history of preoperative glucocorticoid therapy,serum C4,Ig G1 and Ig G2 were the factors affecting recurrence in Ig G4-positive group,while serum C4,and Ig G1 were the factors affecting recurrence of LGBLEL.·CONCLUSION:Serum C4 and Ig G1 are the factors affecting recurrence of LGBLEL,while the Ig G4 does not affect recurrence of LGBLEL.展开更多
AIM: To identify the association of the macrophage migration inhibitory factor (MIF) gene polymorphism with the susceptibility of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. METHODS: A total o...AIM: To identify the association of the macrophage migration inhibitory factor (MIF) gene polymorphism with the susceptibility of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. METHODS: A total of 40 BLEL of lacrimal gland cases were matched with 40 healthy subjects (HS). Extraction the plasma and whole blood DNA of patients of lacrimal gland BLEL and HS. Elisa and polymerase chain reaction was used to determine in plasma contents of MIF and MIF gene SNP-173G〉C and STR -794 CATT(8) polymorphism, respectively. RESULTS: The MIF levels in plasma were significantly higher in patients with lacrimal gland BI.EL versus HS (P〈0.001). The -173 G〉C MIF polymorphism was significantly associated with lacrimal gland BLEL, with a significantly higher frequency of the C allele in lacrimal gland BLEL patients compared with HS (OR=2.38, 95% C1=1.07-5.31, P=0.032), and the -173 C/x is more frequent in patients than in HS, P=0.037. Besides, we found that the carriage rate of the MIF -173C/x is associated with higher plasma levels of MIF in the BLEI. of lacrimal gland. CONCLUSION: MIF -173G/C variants play an insidious role in susceptibility of BLEL of lacrimal gland. Otherwise,there is no statistically significant correlation exists between MIF-794 CATT () and BLEL of lacrimal gland.展开更多
BACKGROUND Habitual khat(Catha edulis) chewing has been proven to cause numerous oral tissue changes. However, oral melanoacanthoma triggered by chronic khat chewing is rare. Oral melanoacanthoma is an uncommon, sudde...BACKGROUND Habitual khat(Catha edulis) chewing has been proven to cause numerous oral tissue changes. However, oral melanoacanthoma triggered by chronic khat chewing is rare. Oral melanoacanthoma is an uncommon, sudden, asymptomatic, benign pigmentation of the oral cavity. Under the microscope, the epithelial layer of the oral mucosa showed dendritic melanocyte proliferation and acanthosis. The study aimed to highlight chronic khat chewing as a trigger for oral melanoacanthoma.CASE SUMMARY In the current study, we report a case of a 26-year-old male patient with a rare presentation of oral melanoacanthoma triggered by regular khat chewing. Many intrinsic and extrinsic factors can cause oral pigmentation. Chewing khat is an extrinsic factor that can cause several diseases, including oral pigmentation. In this case, the definitive diagnosis was oral melanoacanthoma. This diagnosis was made based on the patient’s history, clinical lesion presentation, and microscopic biopsy results.CONCLUSION Habitual khat(Catha edulis) chewing causes many oral tissue changes including oral melanoacanthoma. The study aimed to highlight chronic khat chewing as a trigger for oral melanoacanthoma.展开更多
BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosi...BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosis is often in the advanced stage,which ultimately leads to a poor 5-year survival outcome.Tumor markers including carbohydrate antigen 19-9(CA 19-9),carcinoembryonic antigen(CEA),CA 125,CA 242,and alpha fetoprotein are used as indicators in the diagnosis and prognosis of GBC.AIM To compare tumor marker levels between GBC and benign GB diseases(GBDs)and to assess the combined use of tumor markers to increase the diagnostic accuracy for GBC.METHODS Patients of either sex aged≥18 years,with suspected GBC(GB polyp,irregular thick GB wall,GB mass,porcelain GB)on the basis of radiological imaging were included in this study.GB wall thickness using ultrasonography and tumor markers CEA,CA 125,CA 19-9,and CA 242 in all patients were recorded.All cases after surgical intervention were divided into two groups,GBC and benign GBD,according to histopathological examination findings.The cases were followed up and clinical findings,radiological findings,and levels of tumor markers were assessed.RESULTS A total of 200 patients were included in this study,of whom 80 patients had GBC and 120 patients had benign GBD.The median(interquartile range)age was 52.0(41.0-60.0)years and the majority of patients(132,66.0%)were women.Tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly elevated in patients with GBC(P<0.001).There was a significant reduction in tumor markers at 3 and 6 mo from baseline(P<0.001).The mean survival of patients with normal and elevated levels of tumor markers CA 125,CA 19-9,and CEA was comparable;however lymph node metastasis and CA 242 expression level were independent prognostic factors.CONCLUSION Serum levels of tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly associated with GBC.However,no significant association was observed between the presence of elevated levels of any tumor marker with respect to survival.Tumor marker assessment during follow-up may represent a treatment response.展开更多
Background:Benign lymphoepithelial lesion (BLEL) is characterized by symmetric bilateral swelling of the lacrimal and salivary glands and considered a subtype of immunoglobulin G4 (IgG4)-related sclerosing diseas...Background:Benign lymphoepithelial lesion (BLEL) is characterized by symmetric bilateral swelling of the lacrimal and salivary glands and considered a subtype of immunoglobulin G4 (IgG4)-related sclerosing disease,the etiology and pathogenesis of which has not been determined.The purpose of the present study was to analyze the clinical features of BLEL in the lacrimal gland and the relationship between the serum level of IgG4 and BLEL.Methods:Twenty consecutive patients with BLEL diagnosed in Department of Ophthalmology at Beijing Tongren Hospital,Capital Medical University between January 2012 and December 2013 were observed.The clinical features,imaging findings,laboratory tests,treatments and follow-up status of these 20 consecutive patients were analyzed.Results:In all 20 patients,the ratio of male to female was 1:4,the ages ranged from 28 to 57 years,the ratio of unilateral to bilateral eyes involvement was 1:4,and painless uncongested symmetrical swelling of the upper eyelid was the main clinical manifestation.Orbital magnetic resonance imaging (MRI) showed that all patients involved lacrimal gland,which were obviously enlarged with equal signals in T1W images and T2W images and obvious enhancement on contrast MRI.Extraocular muscles were involved in 5 patients,salivary gland in 8 patients,and frontal nerve in 3 patients.Serum IgG4 concentration was elevated in 18 patients.The treatment strategy mainly included surgery and steroid administration.Three patients were lost to follow-up,17 patients reached complete response,and no recurrence was observed.Conclusions:Eyelid swelling is the typical symptom of BLEL.Most of the patients involved bilateral lacrimal glands.High serum IgG4 level and abundant IgG4-positive plasma cell infiltration are the important features,which can be found in most of BLEL patients.Surgery combined with glucocorticoids is an efficient treatment strategy.展开更多
AIM:To retrospectively analyze the imaging features of hepatic focal nodular hyperplasia(FNH) in children on dynamic contrast-enhanced multi-slice computed tomography(MSCT) and computed tomography angiography(CTA) ima...AIM:To retrospectively analyze the imaging features of hepatic focal nodular hyperplasia(FNH) in children on dynamic contrast-enhanced multi-slice computed tomography(MSCT) and computed tomography angiography(CTA) images.METHODS:From September 1999 to April 2012,a total of 218 cases of hepatic FNH were confirmed by either surgical resection or biopsy in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and the Cancer center of Sun Yat-sen University,including 12 cases(5.5%) of FNH in children(age ≤ 18 years old).All the 12 pediatric patients underwent MSCT.We retrospectively analyzed the imaging features of FNH lesions,including the number,location,size,margin,density of FNH demonstrated on pre-contrast and contrastenhanced computed tomography(CT) scanning,central scar,fibrous septa,pseudocapsule,the morphology of the feeding arteries and the presence of draining vessels(portal vein or hepatic vein).RESULTS:All the 12 pediatric cases of FNH had solitary lesion.The maximum diameter of the lesions was 4.0-12.9 cm,with an average diameter of 5.5 ± 2.5 cm.The majority of the FNH lesions(10/12,83.3%) had well-defined margins.Central scar(10/12,83.3%) and fibrous septa(11/12,91.7%) were commonly found in children with FNH.Central scar was either isodense(n = 7) or hypodense(n = 3) on pre-contrast CT images and showed progressive enhancement in 8 cases in the equilibrium phase.Fibrous septa were linear hypodense areas in the arterial phase and isodense in the portal and equilibrium phases.Pseudocapsule was very rare(1/12,8.3%) in pediatric FNH.With the exception of central scars and fibrous septa within the lesions,all 12 cases of pediatric FNH were homogenously enhanced on the contrast-enhanced CT images,significantly hyperdense in the arterial phase(12/12,100.0%),and isodense in the portal venous phase(7/12,58.3%) and equilibrium phase(11/12,91.7%).Central feeding arteries inside the tumors were observed on CTA images for all 12 cases of FNH,whereas no neovascularization of malignant tumors was noted.In 9 cases(75.0%),there was a spoke-wheel shaped centrifugal blood supply inside the tumors.The draining hepatic vein was detected in 8 cases of pediatric FNH.However,the draining vessels in the other 4 cases could not be detected.No associated hepatic adenoma or hemangioma was observed in the livers of the 12 pediatric cases.CONCLUSION:The characteristic imaging appearances of MSCT and CTA may reflect the pathological and hemodynamic features of pediatric FNH.Dynamic multi-phase MSCT and CTA imaging is an effective method for diagnosing FNH in children.展开更多
BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a...BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a large cystic-solid PH and provides a literature review of the imaging features,formation mechanism and histopathological basis of PHs.CASE SUMMARY A 53-year-old woman with no clinical symptoms underwent a chest computed tomography(CT)examination at our hospital.Nonenhanced CT images revealed a large,flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor;the solid part of the tumor showed abundant fat and lamellar soft tissue components.Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images.Given the large size of the lesion,the patient elected to undergo surgery.Histological examination revealed PH.A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe,which was a clue to its lung tissue histological origin.According to immunohistochemical staining,the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.CONCLUSION This case shows the imaging manifestations of a large PH.Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.展开更多
BACKGROUND Skin bronchogenic cysts are extremely rare congenital bronchocystic changes caused by the abnormal development of the trachea,bronchial trees or lung buds during the embryonic period.The first case of skin ...BACKGROUND Skin bronchogenic cysts are extremely rare congenital bronchocystic changes caused by the abnormal development of the trachea,bronchial trees or lung buds during the embryonic period.The first case of skin bronchogenic cysts was reported in 1945.Since then,this disease has attracted increasing attention,but due to the low incidence,its pathogenesis is still not clear.CASE SUMMARY Here,we report another case of skin bronchogenic cysts with infection in a 64-year-old female patient.The patient had no symptoms for more than 60 years until her chest wall was recently found to be swollen,and she felt pain and discomfort.At the same time,secretions were found on the surface of the swelling.Color Doppler ultrasound examination showed abnormal echoes in the soft tissue under the frontal chest wall,suggesting the presence of cysts.Cytological puncture resulted in about 2 mL of pus and showed the presence of more acute inflammatory cells.The final clinical diagnosis was skin cyst with infection,and surgery was carried out.The pathological results obtained after surgery showed that the cystic wall was covered with column-like cilia epithelial cells,and the interstitial structure was partially inundated with inflammatory cells.After a variety of examinations and clinical diagnoses,we finally confirmed that the patient was suffering from bronchogenic cyst.CONCLUSION This article not only describes the case of an elderly patient with rare skin bronchogenic cysts with infection but also provides a detailed and correct diagnosis and a successful treatment process,which is of great value for the diagnosis and treatment of the disease.展开更多
87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were...87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were then confirmed by展开更多
Objective To investgate the value of various parameters obtained from monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the differential diagnosis of breast lesions.Methods A...Objective To investgate the value of various parameters obtained from monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the differential diagnosis of breast lesions.Methods A retrospective study was performed in 54 patients with pathologically confirmed malignant tumors(n=30),benign lesions(n=34)and normal fibroglandular展开更多
Using a computer database,the author investigated the histopathology of 10000 consecutive gastric specimens,taken in the last 12 years(2002-2013)at the pathology laboratory of a Japanese hospital.Re-observation of the...Using a computer database,the author investigated the histopathology of 10000 consecutive gastric specimens,taken in the last 12 years(2002-2013)at the pathology laboratory of a Japanese hospital.Re-observation of the already examined histological sections was done when the histological diagnosis and findings on the computer data base were not very obvious.The gastric specimens were identified as 8579 benign conditions and 1421 malignant lesions.The 8579 benign conditions were comprised almost normal stomach in 74 cases(0.9%),chronic gastritis in 4374(51.0%),benign gastric peptic ulcer in 2195(25.6%),foveolar hyperplastic polyp in 1004(11.7%),fundic gland polyp in 421(4.9%),adenoma in 487(5.6%),heterotopic pancreas in 9(0.1%),pancreatic acinar metaplasia(PAM)in 8(0.1%),and amyloidosis in 7(0.1%).Chronic gastritis showed lymphocytic infiltration and frequently showed erosions and intestinal metaplasia.Gastric peptic ulcer showed exudate,necrosis,active inflammation,and regenerative atypia of the epithelium.Foveolar hyperplastic polyp revealed 23 malignant changes and frequently showed dysplastic glands and intestinal metaplasia.Fundic gland polyp demonstrated cystic dilations of fundic gland ducts.Gastric adenoma showed adenomatous proliferation in the superficial mucosa and cystic dilation of the epitheliumunder the adenoma.Heterotopic pancreas was located in the submucosa and consisted of acinar cells,ducts,and occasionally islets.PAM was a tiny lesion in the mucosa and consisted of only pancreatic acinar cells.Amyloidosis was primary amyloidosis with positive reaction with Congo-red stain.展开更多
基金Supported by Natural Science Foundation of Beijing(No.7222025)Beijing Hospitals Authority’Ascent Plan(No.DFL20190201)Natural Science Foundation of Beijing Projects(No.81602408).
文摘AIM:To evaluate the relationship between gene polymorphism(BclI,ER22/23EK,N363S)and the occurrence,progression and sensitivity to glucocorticoid of lacrimal gland benign lymphoepithelial lesion(LGBLEL).METHODS:Clinical peripheral blood samples of 52 LGBLEL patients and 10 normal volunteers were collected for DNA extraction and polymerase chain reaction sequencing to analyze single nucleotide polymorphism(SNP)genotypes.The lacrimal tissues of LGBLEL were surgically removed and made into paraffin sections for subsequent hematoxylin-eosin(HE)and Masson staining analysis.The duration of disease and hormone use of LGBLEL patients from diagnosis to surgery were also analyzed.The Meta-analysis follows PRISMA guidelines to conducted a systematic review of human studies investigating the relationship between the NR3C1 BclI polymorphism and glucocorticoids(GCs)sensitivity.RESULTS:There was no association between ER22/23EK or N363S and the occurrence of LGBLEL or GCs sensitivity(P>0.05);BclI GC genotype was closely related to GCs resistance(P=0.03)as is the minor allele C(P=0.0017).The HE staining and Masson staining showed that the GC genotype of BclI remarkably slowed down the disease progression and reduced fibrosis(P<0.05),especially for GCs-dependent patients(P<0.0001).Meta-analysis showed that BclI was not significantly associated with GCs responsiveness.CONCLUSION:The LGBLEL patients who carry the NR3C1 BclI allele C may be more sensitive to GCs and associated with lower fibrosis and slower disease progression.The results may guide the clinical treatment strategy for the LGBLEL patients.
文摘The treatment of pathological fractures of the femoral neck and trochanteric region secondary to benignlesions can be a challenge for orthopaedic surgeons because of the size and nature of the lesions, the resulting bony defect, the risk of recurrence, the possible associated deformities, and the risk of osteonecrosis. Numerous treatment modalities have been reported for the management of pathological fractures of the proximal femur secondary to benign lesions. An unsatisfactory outcome in 25% of patients and a complication rate of 45% have been observed.
文摘PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 was in 11 was 85.7%,
文摘BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young patients.AIM To describe TEM outcomes in patients under 50 years of age.METHODS We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.RESULTS During the study period,a total of 26 patients under the age of 50 years underwent TEM procedures.Their mean age was 43.3 years.Eleven(42.0%)were male.The mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 cm.No major intraoperative or postoperative complications were recorded.The median length of stay was 2 d.Seven(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other pathologies.Surgical margins were negative in all cases.Local recurrence was detected in one patient 33 mo following surgery.CONCLUSION Among young adult patients,TEM for benign rectal lesions has excellent outcomes.It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer.In some cases,it may be considered an alternative to radical surgery.
基金Supported by the National Major Scientific Equipment Special Project(2012YQ16020304)
文摘Objective To explore the influence factors in hematoma formation after removing benign breast lesions with an ultrasound-guided vacuum-assisted system.Methods A total of 232 females with 312 benign breast masses received excisional biopsy with ultrasoundguided vacuum-assisted system.The pathology of patients,results of hematoma development and outcome,influence factors for hematoma occurrence(nodule size,nodule location,number of nodule,breast shape,menstrual period,efficacy time of bandage,and application of hemostatic agents during the procedure) were recorded.Results Pathologic examination revealed fibroadenomas in 138 lesions,fibroadenosis in 127 lesions,intraductal papillomas in 39 lesions,inflammatory change in 4 lesions,retention cyst of the breast in 3 lesions,and benign phyllodes tumor in 1 lesion.Thirty hematomas were observed in patients(9.6%).Finally,97.0%hematomas were absorbed completely within 6 months follow-up.The incidence rates of hematoma were increased by 24.7%,10.0%,63.2%,13.9%in the nodule diameter larger or equal to 25 mm group,removal of larger or equal to two nodules once time from one patient group,menstrual period group,and larger and loose breast group,respectively(all P<0.05).However,the incidences were decreased by 60.6%in the bandage performed for 12-24 hours or beyond 24 hours group(P<0.05).The multiple logistic regression models revealed that nodule size(x^2=15.227,P<0.001),number of nodule(x^2=7.767,P=0.005),menstrual period(x^2=24.530,P<0.001),and breast shape(x^2=9.559,P=0.002) were independent risk factors associated with hematoma occurrence,but efficacy time of bandage was a protective factor associated with hematoma occurrence.Conclusion The occurrence of hematoma after the minimally invasive operation was associated with nodule size,number of nodule,menstrual period,breast shape,and efficacy time of bandage.
文摘AIM:To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions.METHODS:A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 to December 2005 in the Chinese PLA General Hospital were investigated retrospectively according to their medical documentation.RESULTS:The effect of operative and perioperative factors on the outcome of patients were analyzed.Of the 827 cases undergoing hepatectomy for more than 3 liver segments accounted for 22.1%,316(38.21%) required transfusion of blood products during operation.The average operating time was 220.59 ± 109.13 min,the average hospital stay after operation was 13.55 ± 9.38 d.Child-Pugh A accounted for 98.13%.The postoperative complication rate was 13.54% and the in-hospital mortality rate was 0.24%.Multivariate analysis showed that operating time(P = 0.004,OR = 1.003) and albumin value(P = 0.040,OR = 0.938) were the independent predictors of morbidity and indicated that operating time,blood transfusion,complication rate,and LOS had a trend to decrease.CONCLUSION:Hepatectomy for benign hepatic lesions can be performed safely with a low morbidity and mortality,provided that it is carried out with optimized perioperative management and an innovative surgical technique.
文摘BACKGROUND R2^(*)estimation reflects the paramagnetism of the tumor tissue,which may be used to differentiate between benign and malignant liver lesions when contrast agents are contraindicated.AIM To investigate whether R2^(*)derived from multi-echo Dixon imaging can aid differentiating benign from malignant focal liver lesions(FLLs)and the impact of 2D region of interest(2D-ROI)and volume of interest(VOI)on the outcomes.METHODS We retrospectively enrolled 73 patients with 108 benign or malignant FLLs.All patients underwent conventional abdominal magnetic resonance imaging and multi-echo Dixon imaging.Two radiologists independently measured the mean R2^(*)values of lesions using 2D-ROI and VOI approaches.The Bland-Altman plot was used to determine the interobserver agreement between R2^(*)measurements.Intraclass correlation coefficient(ICC)was used to determine the reliability between the two readers.Mean R2^(*)values were compared between benign and malignant FFLs using the nonparametric Mann-Whitney test.Receiver operating characteristic curve analysis was used to determine the diagnostic performance of R2^(*)in differentiation between benign and malignant FFLs.We compared the diagnostic performance of R2^(*)measured by 2D-ROI and VOI approaches.RESULTS This study included 30 benign and 78 malignant FLLs.The interobserver reproducibility of R2^(*)measurements was excellent for the 2D-ROI(ICC=0.994)and VOI(ICC=0.998)methods.Bland-Altman analysis also demonstrated excellent agreement.Mean R2^(*)was significantly higher for malignant than benign FFLs as measured by 2D-ROI(P<0.001)and VOI(P<0.001).The area under the curve(AUC)of R2^(*)measured by 2D-ROI was 0.884 at a cut-off of 25.2/s,with a sensitivity of 84.6%and specificity of 80.0%for differentiating benign from malignant FFLs.R2^(*)measured by VOI yielded an AUC of 0.875 at a cut-off of 26.7/s in distinguishing benign from malignant FFLs,with a sensitivity of 85.9%and specificity of 76.7%.The AUCs of R2^(*)were not significantly different between the 2D-ROI and VOI methods.CONCLUSION R2^(*)derived from multi-echo Dixon imaging whether by 2D-ROI or VOI can aid in differentiation between benign and malignant FLLs.
基金Supported by National Natural Science Foundation of China(No.81371052)
文摘·AIM: To identify the association of the T cell receptor(TCR) signaling with the development of benign lymphoepithelial lesions(BLEL) of the lacrimal gland.· METHODS: We collected affected lacrimal gland tissues from 9 patients who underwent dacryoadenectomy in the Capital Medical University Beijing Tongren Hospital Eye Center between August2010 and March 2013 and were confirmed to have lacrimal gland BLEL by histopathological analysis. Tumor tissues from 9 patients with orbital cavernous hemangioma were also collected and used as control.Whole genome gene expression microarray was used to compare gene expression profiles of affected lacrimal gland tissues from patients with lacrimal gland BLEL to those from of orbital cavernous hemangiomas.Differential expression of TCR pathway genes between these tissues was confirmed by polymerase chain reaction(PCR) and immunohistochemistry.·RESULTS: Microarray analysis showed that in lacrimal glands with BLEL, 32 signaling pathways were enriched in the upregulated genes, while 25 signaling pathways were enriched in the downregulated genes. In-depth analysis of the microarray data showed that the expression of 27 genes of the TCR signaling pathway increased significantly. To verify the differential expression of three of these genes, CD3, CD4, and interleukin(IL)-10, reverse transcription-PCR(RT-PCR)and immunohistochemistry assays were performed. RT-PCR analysis showed that CD3 and CD4 were expressed in the lacrimal glands with BLEL, but IL-10 was not expressed. Immunohistochemistry confirmed that CD3 and CD4 proteins were also present, but IL-10 protein was not. CD3, CD4, or IL-10 expression was not found in the orbital cavernous hemangiomas with either RT-PCR or immunohistochemistry.· CONCLUSION: TCR signaling pathway might be involved in the pathogenesis of lacrimal gland BLEL.
基金Natural Science Foundation of Zhejiang Province,No.LY20H060001.
文摘BACKGROUND Fracture risk assessment in children with benign bone lesions of long bones remains poorly investigated.AIM To investigate the risk factors for pathological fracture in children with benign bone lesions and to propose a modified scoring system for quantitative analysis of the pathologic fracture risk.METHODS We retrospectively reviewed 96 pediatric patients with benign bone lesions.We compared radiographic and clinical features between 40 patients who had fractures through a benign bone lesion and 56 who had no fracture.Information including histological diagnosis,anatomical site,radiographic appearance,severity of pain,and lesion size was recorded for the patients.A modified scoring system was proposed to predict the risk of fracture.RESULTS The univariate comparisons showed a significant difference between the fracture and non-fracture groups in terms of lesion type,pain,lesion-to-bone width,and axial cortical involvement of the patients(P<0.05).Lesion type,pain,lesion-tobone width,and axial cortical involvement were independently correlated with an increased risk of fracture.The mean score of the fracture group was 7.89,whereas the mean score of the non-fracture group was 6.01.The optimum cut-off value of the score to predict pathological fracture was 7.The scoring system had a sensitivity of 70%and a specificity of 80%for detecting patients with fractures.The Youden index was 0.5,which was the maximum value.The area under the receiver operator characteristic was 0.814.CONCLUSION Lesion type,pain,lesion-to-bone width,and axial cortical involvement are risk factors for pathological fracture.The modified scoring system can provide evidence for clinical decision-making in children with benign bone lesions.A bone lesion with a total score>7 indicates a high risk of a pathologic fracture and is an indication for prophylactic internal fixation.
基金Supported by Beijing Hospitals Authority’ Ascent Plan (No.DFL20190201)Natural Science Foundation of Beijing (No.7222025)Beijing Science and Technology Rising Star Program-Cross-cooperation (No.20220484218)。
文摘·AIM:To analyze the differences in immune indicators and prognosis between Ig G4-positive and negative lacrimal gland benign lymphoepithelial lesion(LGBLEL).·METHODS:This was a single-center retrospective clinical study including 105 cases of Ig G4-positive LGBLEL and 41 cases of Ig G4-negative LGBLEL.Basic information,related indicators of peripheral venous blood samples using immunoscattering turbidimetry,treatment(partial surgical excision and glucocorticoid therapy)and prognosis(recurrence and death)were collected.Survival curves for recurrence were created using the Kaplan-Meier analysis.Univariate analysis and multivariate regression analysis were used to analyze prognostic factors.·RESULTS:The mean age was 50.10±14.23y and 44.76±11.43y(P=0.033)in Ig G4-positive and negative group respectively.The serum C3 and C4 was lower in Ig G4-positive group(P=0.005,P=0.002),while the serum Ig G and Ig G2 was higher in Ig G4-positive group(P=0.000 and P=0.008).Twenty-one cases had recurrence in Ig G4-positive group and 3 cases recurrence in Ig G4-negative group.The 5-year recurrence-free cumulative percentages of Ig G4-positive group was 81.85%,and 83.46%in the Ig G-negative group(P=0.216).The history of preoperative glucocorticoid therapy,serum C4,Ig G1 and Ig G2 were the factors affecting recurrence in Ig G4-positive group,while serum C4,and Ig G1 were the factors affecting recurrence of LGBLEL.·CONCLUSION:Serum C4 and Ig G1 are the factors affecting recurrence of LGBLEL,while the Ig G4 does not affect recurrence of LGBLEL.
基金Supported by the National Natural Science Foundation of China(No.81602408No.81371052)
文摘AIM: To identify the association of the macrophage migration inhibitory factor (MIF) gene polymorphism with the susceptibility of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. METHODS: A total of 40 BLEL of lacrimal gland cases were matched with 40 healthy subjects (HS). Extraction the plasma and whole blood DNA of patients of lacrimal gland BLEL and HS. Elisa and polymerase chain reaction was used to determine in plasma contents of MIF and MIF gene SNP-173G〉C and STR -794 CATT(8) polymorphism, respectively. RESULTS: The MIF levels in plasma were significantly higher in patients with lacrimal gland BI.EL versus HS (P〈0.001). The -173 G〉C MIF polymorphism was significantly associated with lacrimal gland BLEL, with a significantly higher frequency of the C allele in lacrimal gland BLEL patients compared with HS (OR=2.38, 95% C1=1.07-5.31, P=0.032), and the -173 C/x is more frequent in patients than in HS, P=0.037. Besides, we found that the carriage rate of the MIF -173C/x is associated with higher plasma levels of MIF in the BLEI. of lacrimal gland. CONCLUSION: MIF -173G/C variants play an insidious role in susceptibility of BLEL of lacrimal gland. Otherwise,there is no statistically significant correlation exists between MIF-794 CATT () and BLEL of lacrimal gland.
文摘BACKGROUND Habitual khat(Catha edulis) chewing has been proven to cause numerous oral tissue changes. However, oral melanoacanthoma triggered by chronic khat chewing is rare. Oral melanoacanthoma is an uncommon, sudden, asymptomatic, benign pigmentation of the oral cavity. Under the microscope, the epithelial layer of the oral mucosa showed dendritic melanocyte proliferation and acanthosis. The study aimed to highlight chronic khat chewing as a trigger for oral melanoacanthoma.CASE SUMMARY In the current study, we report a case of a 26-year-old male patient with a rare presentation of oral melanoacanthoma triggered by regular khat chewing. Many intrinsic and extrinsic factors can cause oral pigmentation. Chewing khat is an extrinsic factor that can cause several diseases, including oral pigmentation. In this case, the definitive diagnosis was oral melanoacanthoma. This diagnosis was made based on the patient’s history, clinical lesion presentation, and microscopic biopsy results.CONCLUSION Habitual khat(Catha edulis) chewing causes many oral tissue changes including oral melanoacanthoma. The study aimed to highlight chronic khat chewing as a trigger for oral melanoacanthoma.
文摘BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosis is often in the advanced stage,which ultimately leads to a poor 5-year survival outcome.Tumor markers including carbohydrate antigen 19-9(CA 19-9),carcinoembryonic antigen(CEA),CA 125,CA 242,and alpha fetoprotein are used as indicators in the diagnosis and prognosis of GBC.AIM To compare tumor marker levels between GBC and benign GB diseases(GBDs)and to assess the combined use of tumor markers to increase the diagnostic accuracy for GBC.METHODS Patients of either sex aged≥18 years,with suspected GBC(GB polyp,irregular thick GB wall,GB mass,porcelain GB)on the basis of radiological imaging were included in this study.GB wall thickness using ultrasonography and tumor markers CEA,CA 125,CA 19-9,and CA 242 in all patients were recorded.All cases after surgical intervention were divided into two groups,GBC and benign GBD,according to histopathological examination findings.The cases were followed up and clinical findings,radiological findings,and levels of tumor markers were assessed.RESULTS A total of 200 patients were included in this study,of whom 80 patients had GBC and 120 patients had benign GBD.The median(interquartile range)age was 52.0(41.0-60.0)years and the majority of patients(132,66.0%)were women.Tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly elevated in patients with GBC(P<0.001).There was a significant reduction in tumor markers at 3 and 6 mo from baseline(P<0.001).The mean survival of patients with normal and elevated levels of tumor markers CA 125,CA 19-9,and CEA was comparable;however lymph node metastasis and CA 242 expression level were independent prognostic factors.CONCLUSION Serum levels of tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly associated with GBC.However,no significant association was observed between the presence of elevated levels of any tumor marker with respect to survival.Tumor marker assessment during follow-up may represent a treatment response.
基金This study was supported by two grants from National Natural Science Foundation of China
文摘Background:Benign lymphoepithelial lesion (BLEL) is characterized by symmetric bilateral swelling of the lacrimal and salivary glands and considered a subtype of immunoglobulin G4 (IgG4)-related sclerosing disease,the etiology and pathogenesis of which has not been determined.The purpose of the present study was to analyze the clinical features of BLEL in the lacrimal gland and the relationship between the serum level of IgG4 and BLEL.Methods:Twenty consecutive patients with BLEL diagnosed in Department of Ophthalmology at Beijing Tongren Hospital,Capital Medical University between January 2012 and December 2013 were observed.The clinical features,imaging findings,laboratory tests,treatments and follow-up status of these 20 consecutive patients were analyzed.Results:In all 20 patients,the ratio of male to female was 1:4,the ages ranged from 28 to 57 years,the ratio of unilateral to bilateral eyes involvement was 1:4,and painless uncongested symmetrical swelling of the upper eyelid was the main clinical manifestation.Orbital magnetic resonance imaging (MRI) showed that all patients involved lacrimal gland,which were obviously enlarged with equal signals in T1W images and T2W images and obvious enhancement on contrast MRI.Extraocular muscles were involved in 5 patients,salivary gland in 8 patients,and frontal nerve in 3 patients.Serum IgG4 concentration was elevated in 18 patients.The treatment strategy mainly included surgery and steroid administration.Three patients were lost to follow-up,17 patients reached complete response,and no recurrence was observed.Conclusions:Eyelid swelling is the typical symptom of BLEL.Most of the patients involved bilateral lacrimal glands.High serum IgG4 level and abundant IgG4-positive plasma cell infiltration are the important features,which can be found in most of BLEL patients.Surgery combined with glucocorticoids is an efficient treatment strategy.
文摘AIM:To retrospectively analyze the imaging features of hepatic focal nodular hyperplasia(FNH) in children on dynamic contrast-enhanced multi-slice computed tomography(MSCT) and computed tomography angiography(CTA) images.METHODS:From September 1999 to April 2012,a total of 218 cases of hepatic FNH were confirmed by either surgical resection or biopsy in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and the Cancer center of Sun Yat-sen University,including 12 cases(5.5%) of FNH in children(age ≤ 18 years old).All the 12 pediatric patients underwent MSCT.We retrospectively analyzed the imaging features of FNH lesions,including the number,location,size,margin,density of FNH demonstrated on pre-contrast and contrastenhanced computed tomography(CT) scanning,central scar,fibrous septa,pseudocapsule,the morphology of the feeding arteries and the presence of draining vessels(portal vein or hepatic vein).RESULTS:All the 12 pediatric cases of FNH had solitary lesion.The maximum diameter of the lesions was 4.0-12.9 cm,with an average diameter of 5.5 ± 2.5 cm.The majority of the FNH lesions(10/12,83.3%) had well-defined margins.Central scar(10/12,83.3%) and fibrous septa(11/12,91.7%) were commonly found in children with FNH.Central scar was either isodense(n = 7) or hypodense(n = 3) on pre-contrast CT images and showed progressive enhancement in 8 cases in the equilibrium phase.Fibrous septa were linear hypodense areas in the arterial phase and isodense in the portal and equilibrium phases.Pseudocapsule was very rare(1/12,8.3%) in pediatric FNH.With the exception of central scars and fibrous septa within the lesions,all 12 cases of pediatric FNH were homogenously enhanced on the contrast-enhanced CT images,significantly hyperdense in the arterial phase(12/12,100.0%),and isodense in the portal venous phase(7/12,58.3%) and equilibrium phase(11/12,91.7%).Central feeding arteries inside the tumors were observed on CTA images for all 12 cases of FNH,whereas no neovascularization of malignant tumors was noted.In 9 cases(75.0%),there was a spoke-wheel shaped centrifugal blood supply inside the tumors.The draining hepatic vein was detected in 8 cases of pediatric FNH.However,the draining vessels in the other 4 cases could not be detected.No associated hepatic adenoma or hemangioma was observed in the livers of the 12 pediatric cases.CONCLUSION:The characteristic imaging appearances of MSCT and CTA may reflect the pathological and hemodynamic features of pediatric FNH.Dynamic multi-phase MSCT and CTA imaging is an effective method for diagnosing FNH in children.
文摘BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a large cystic-solid PH and provides a literature review of the imaging features,formation mechanism and histopathological basis of PHs.CASE SUMMARY A 53-year-old woman with no clinical symptoms underwent a chest computed tomography(CT)examination at our hospital.Nonenhanced CT images revealed a large,flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor;the solid part of the tumor showed abundant fat and lamellar soft tissue components.Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images.Given the large size of the lesion,the patient elected to undergo surgery.Histological examination revealed PH.A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe,which was a clue to its lung tissue histological origin.According to immunohistochemical staining,the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.CONCLUSION This case shows the imaging manifestations of a large PH.Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.
文摘BACKGROUND Skin bronchogenic cysts are extremely rare congenital bronchocystic changes caused by the abnormal development of the trachea,bronchial trees or lung buds during the embryonic period.The first case of skin bronchogenic cysts was reported in 1945.Since then,this disease has attracted increasing attention,but due to the low incidence,its pathogenesis is still not clear.CASE SUMMARY Here,we report another case of skin bronchogenic cysts with infection in a 64-year-old female patient.The patient had no symptoms for more than 60 years until her chest wall was recently found to be swollen,and she felt pain and discomfort.At the same time,secretions were found on the surface of the swelling.Color Doppler ultrasound examination showed abnormal echoes in the soft tissue under the frontal chest wall,suggesting the presence of cysts.Cytological puncture resulted in about 2 mL of pus and showed the presence of more acute inflammatory cells.The final clinical diagnosis was skin cyst with infection,and surgery was carried out.The pathological results obtained after surgery showed that the cystic wall was covered with column-like cilia epithelial cells,and the interstitial structure was partially inundated with inflammatory cells.After a variety of examinations and clinical diagnoses,we finally confirmed that the patient was suffering from bronchogenic cyst.CONCLUSION This article not only describes the case of an elderly patient with rare skin bronchogenic cysts with infection but also provides a detailed and correct diagnosis and a successful treatment process,which is of great value for the diagnosis and treatment of the disease.
文摘87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were then confirmed by
文摘Objective To investgate the value of various parameters obtained from monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the differential diagnosis of breast lesions.Methods A retrospective study was performed in 54 patients with pathologically confirmed malignant tumors(n=30),benign lesions(n=34)and normal fibroglandular
文摘Using a computer database,the author investigated the histopathology of 10000 consecutive gastric specimens,taken in the last 12 years(2002-2013)at the pathology laboratory of a Japanese hospital.Re-observation of the already examined histological sections was done when the histological diagnosis and findings on the computer data base were not very obvious.The gastric specimens were identified as 8579 benign conditions and 1421 malignant lesions.The 8579 benign conditions were comprised almost normal stomach in 74 cases(0.9%),chronic gastritis in 4374(51.0%),benign gastric peptic ulcer in 2195(25.6%),foveolar hyperplastic polyp in 1004(11.7%),fundic gland polyp in 421(4.9%),adenoma in 487(5.6%),heterotopic pancreas in 9(0.1%),pancreatic acinar metaplasia(PAM)in 8(0.1%),and amyloidosis in 7(0.1%).Chronic gastritis showed lymphocytic infiltration and frequently showed erosions and intestinal metaplasia.Gastric peptic ulcer showed exudate,necrosis,active inflammation,and regenerative atypia of the epithelium.Foveolar hyperplastic polyp revealed 23 malignant changes and frequently showed dysplastic glands and intestinal metaplasia.Fundic gland polyp demonstrated cystic dilations of fundic gland ducts.Gastric adenoma showed adenomatous proliferation in the superficial mucosa and cystic dilation of the epitheliumunder the adenoma.Heterotopic pancreas was located in the submucosa and consisted of acinar cells,ducts,and occasionally islets.PAM was a tiny lesion in the mucosa and consisted of only pancreatic acinar cells.Amyloidosis was primary amyloidosis with positive reaction with Congo-red stain.