Three cases of pulmonary leiomyosarcoma were presented.The characteristic clinical features were described with review of literature.In comparison with bronchogenic carcinoma, the leiomyosarcoma has some characteristi...Three cases of pulmonary leiomyosarcoma were presented.The characteristic clinical features were described with review of literature.In comparison with bronchogenic carcinoma, the leiomyosarcoma has some characteristics:1) On chest X-ray,it usually appears as a sharply demarcated, even density round mass,growing rapidly within the lung, it rarely accompanies with hilar or mediastinal lymph node metastasis.2) The preoperative cytological or pathological diagnosis is difficult either by sputum smear or by bronchoscopic biopsy or by fine needle percutaneous aspiration biopsy.31 Pathological differential diagnosis of leiomyosarcoma of lung from anaplastic lung cancer is difficult.In conclusion,the primary pulmonary leiomyosarcoma is a rare malignant tumor,detecting the present illness seriously,paying attention to the chest X-ray films characterize,early surgical resection is the only way to get diagnosis and effective treatment method.展开更多
Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay treatment for bile duct disease. The procedure is difficult per se, especially when a side-viewing duodenoscope is used, and when the p...Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay treatment for bile duct disease. The procedure is difficult per se, especially when a side-viewing duodenoscope is used, and when the patient has altered anatomical features, such as colonic interposition. Currently, there is no consensus on the standard approach for therapeutic ERCP in patients with total esophagectomy and colonic interposition. We describe a novel treatment design that involves the use of a side-viewing duodenoscope to perform therapeutic ERCP in patients with total esophagectomy and colonic interposition. A gastroscope was initially introduced into the interposed colon and a radio-opaque standard guidewire was advanced to a distance beyond the papilla of Vater, before the gastroscope was withdrawn. A sideviewing duodenoscope was then introduced along the guidewire under fluoroscopic guidance. After cannulation into the papilla of Vater, endoscopic retrograde chol-angiography (ERC) revealed a filling defect (maximum diameter: 15 cm) at the distal portion of the common bile duct (CBD). This defect was determined to be a stone, which was successfully retrieved by a Dormia basket after complete sphincterotomy. With this treatment design, it is possible to perform therapeutic ERCP in patients with colonic interposition, thereby precluding the need for percutaneous drainage or surgery.展开更多
文摘Three cases of pulmonary leiomyosarcoma were presented.The characteristic clinical features were described with review of literature.In comparison with bronchogenic carcinoma, the leiomyosarcoma has some characteristics:1) On chest X-ray,it usually appears as a sharply demarcated, even density round mass,growing rapidly within the lung, it rarely accompanies with hilar or mediastinal lymph node metastasis.2) The preoperative cytological or pathological diagnosis is difficult either by sputum smear or by bronchoscopic biopsy or by fine needle percutaneous aspiration biopsy.31 Pathological differential diagnosis of leiomyosarcoma of lung from anaplastic lung cancer is difficult.In conclusion,the primary pulmonary leiomyosarcoma is a rare malignant tumor,detecting the present illness seriously,paying attention to the chest X-ray films characterize,early surgical resection is the only way to get diagnosis and effective treatment method.
文摘Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay treatment for bile duct disease. The procedure is difficult per se, especially when a side-viewing duodenoscope is used, and when the patient has altered anatomical features, such as colonic interposition. Currently, there is no consensus on the standard approach for therapeutic ERCP in patients with total esophagectomy and colonic interposition. We describe a novel treatment design that involves the use of a side-viewing duodenoscope to perform therapeutic ERCP in patients with total esophagectomy and colonic interposition. A gastroscope was initially introduced into the interposed colon and a radio-opaque standard guidewire was advanced to a distance beyond the papilla of Vater, before the gastroscope was withdrawn. A sideviewing duodenoscope was then introduced along the guidewire under fluoroscopic guidance. After cannulation into the papilla of Vater, endoscopic retrograde chol-angiography (ERC) revealed a filling defect (maximum diameter: 15 cm) at the distal portion of the common bile duct (CBD). This defect was determined to be a stone, which was successfully retrieved by a Dormia basket after complete sphincterotomy. With this treatment design, it is possible to perform therapeutic ERCP in patients with colonic interposition, thereby precluding the need for percutaneous drainage or surgery.
