Objective: The aim of this study was to investigate the imaging findings of intrathoracic solitary fibrous tumor (SFT), so as to improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pat...Objective: The aim of this study was to investigate the imaging findings of intrathoracic solitary fibrous tumor (SFT), so as to improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pathological data of three intrathoracic SFTs confirmed by surgical pathology were analyzed retrospectively. There three cases all received spiral CT plain scan and enhanced scan, among which two multi-planar reformation (MPR) and one MR plain scan. And literatures were reviewed to investigate the imaging findings of intrathoracic SFT. Results: The three intrathoracic SFT located at intra-pulmonary, oblique fissure pleura and posterior chest wall visceral pleura, respectively. All were solitary masses. One case was a peripheral lung mass at dorsal segment of left lower lobe which CT plain scan showed as a soft tissue mass well circumscribed, enhanced scan showed that there were enhanced clustered, lineal small vascular signs in the mass during arterial phase, delayed scanning displayed that the mass showed heterogeneous enhancement and parts of solid content showed gradual enhancement, and there were shorter T1 signals on MRI T1WI, map-like high-low mixed signals on T2WI, mainly with short T2 signals. One case was an oblique fissure mass which plain scan showed as a homogeneous soft tissue mass with oval in shape and smooth edge, and enhanced scan showed moderate homogeneous enhancement. One case was a mass localized at posterior chest wall visceral pleura which CT plain scan showed as a heterogeneous mass, and enhanced scan showed that there was slight ring-like enhancement, large non-enhancing necrosis area in the mass and facing vessels in the vicinity region. All these three cases had no hilar and mediastinal lymphadenectasis. Operation and pathology results showed that the mass was well circumscribed, with capsule or false capsule. Under microscope, tumor cells were long fusiform, presenting bundle, turbulence or irregular arrangement. Hypocellular and hypercellular area appeared alternately, with interspersed coarse scar-like collagen fibers with hyalinization. There were hemangiopericytoma-like structures under parts of visual fields. There were bronchiole and alveolar epithelium in the legion at dorsal segment of left lower lobe in one case. The results of immunohistochemistry showed that the expressions of CD34 or CD99, Bcl-2 and vimentin were all strong positive. Conclusion: Intrathoracic SFT might be rare, which imaging findings could have relative characteristic features and diagnosis must depend on histopathology and immunohistochemistry examination.展开更多
This paper reports a case of testicular synovial sarcoma with molecular genetic analysis. A 24-year-old male presented with painless scrotal mass. Ultrasonography showed a heterogeneous mass of 66 mm × 34 mm in s...This paper reports a case of testicular synovial sarcoma with molecular genetic analysis. A 24-year-old male presented with painless scrotal mass. Ultrasonography showed a heterogeneous mass of 66 mm × 34 mm in size involving the inguinal region. Histological examination of a surgical biopsy showed a grade III monophasic growth pattern of spindle cell proliferation. Immunohistochemical analyses indicated positive staining for pancytokeratine and epithelial membrane antigen. Cytogenetic analysis showed the presence of CYT-SSX1 mutation, and CT scan showed non-specific pleural micro-nodules with a size of 7.5 mm. The patient had an extended left orchidectomy but was lost to follow-up for 1 year. A local recurrent scrotal mass of 32 mm ~ 25 ram, multiple inguinal lymph nodes, and increased pleural nodules, which were confirmed by histological examination, were treated with three cycles of adriamycine and ifosfamide chemotherapy, surgical resection, and radiotherapy with complete response. After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxeL The patient had dyspnea at the time of this writing and chest pain, and is under third-line chemotherapy based on Deticene after 30 months of following up. This patient died on November 16, 2012 after a resperatory failure and malignant plural effusion. Synovial sarcoma should be considered in the differential diagnosis of soft tissue tumor and it should be aggressively treated to improve prognosis. Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.展开更多
The current various proposals at the International Maritime Organisation （IMO） for the s factor （probability of surviving a given flooding） make no reference to survival time. The paper shows a direct link of the ...The current various proposals at the International Maritime Organisation （IMO） for the s factor （probability of surviving a given flooding） make no reference to survival time. The paper shows a direct link of the ＂prime＂ s factor with the time to capsize and shows how to utilise experimental data from 30-minute test runs for the s factor based on longer duration of tests. Unexpectedly, the extension of tests has a modest effect on the survival factor, and hence-modest effect on subdivision index A. Much more important is improving a deficient formulation for the required index R, as flooding cases with si = 1 have an infinite survival time.展开更多
Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomogr...Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen.We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy.Histopathological analysis showed spindleshaped cells with scanty cytoplasm and hyperchromatic nuclei,confirming a primary pancreatic NEC.One month after the surgery,the patient experienced leg swelling.Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg,and the leg was amputated.Histopathological analysis confirmed metastasis of pancreatic NEC.The patient was followed up and received chemotherapy(etoposide and cisplatin).One month after amputation,the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion.The patient suffered from unbearable pain and we treated him with odynolysis.Four months postoperatively,the patient died of respiratory failure.展开更多
文摘Objective: The aim of this study was to investigate the imaging findings of intrathoracic solitary fibrous tumor (SFT), so as to improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pathological data of three intrathoracic SFTs confirmed by surgical pathology were analyzed retrospectively. There three cases all received spiral CT plain scan and enhanced scan, among which two multi-planar reformation (MPR) and one MR plain scan. And literatures were reviewed to investigate the imaging findings of intrathoracic SFT. Results: The three intrathoracic SFT located at intra-pulmonary, oblique fissure pleura and posterior chest wall visceral pleura, respectively. All were solitary masses. One case was a peripheral lung mass at dorsal segment of left lower lobe which CT plain scan showed as a soft tissue mass well circumscribed, enhanced scan showed that there were enhanced clustered, lineal small vascular signs in the mass during arterial phase, delayed scanning displayed that the mass showed heterogeneous enhancement and parts of solid content showed gradual enhancement, and there were shorter T1 signals on MRI T1WI, map-like high-low mixed signals on T2WI, mainly with short T2 signals. One case was an oblique fissure mass which plain scan showed as a homogeneous soft tissue mass with oval in shape and smooth edge, and enhanced scan showed moderate homogeneous enhancement. One case was a mass localized at posterior chest wall visceral pleura which CT plain scan showed as a heterogeneous mass, and enhanced scan showed that there was slight ring-like enhancement, large non-enhancing necrosis area in the mass and facing vessels in the vicinity region. All these three cases had no hilar and mediastinal lymphadenectasis. Operation and pathology results showed that the mass was well circumscribed, with capsule or false capsule. Under microscope, tumor cells were long fusiform, presenting bundle, turbulence or irregular arrangement. Hypocellular and hypercellular area appeared alternately, with interspersed coarse scar-like collagen fibers with hyalinization. There were hemangiopericytoma-like structures under parts of visual fields. There were bronchiole and alveolar epithelium in the legion at dorsal segment of left lower lobe in one case. The results of immunohistochemistry showed that the expressions of CD34 or CD99, Bcl-2 and vimentin were all strong positive. Conclusion: Intrathoracic SFT might be rare, which imaging findings could have relative characteristic features and diagnosis must depend on histopathology and immunohistochemistry examination.
文摘This paper reports a case of testicular synovial sarcoma with molecular genetic analysis. A 24-year-old male presented with painless scrotal mass. Ultrasonography showed a heterogeneous mass of 66 mm × 34 mm in size involving the inguinal region. Histological examination of a surgical biopsy showed a grade III monophasic growth pattern of spindle cell proliferation. Immunohistochemical analyses indicated positive staining for pancytokeratine and epithelial membrane antigen. Cytogenetic analysis showed the presence of CYT-SSX1 mutation, and CT scan showed non-specific pleural micro-nodules with a size of 7.5 mm. The patient had an extended left orchidectomy but was lost to follow-up for 1 year. A local recurrent scrotal mass of 32 mm ~ 25 ram, multiple inguinal lymph nodes, and increased pleural nodules, which were confirmed by histological examination, were treated with three cycles of adriamycine and ifosfamide chemotherapy, surgical resection, and radiotherapy with complete response. After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxeL The patient had dyspnea at the time of this writing and chest pain, and is under third-line chemotherapy based on Deticene after 30 months of following up. This patient died on November 16, 2012 after a resperatory failure and malignant plural effusion. Synovial sarcoma should be considered in the differential diagnosis of soft tissue tumor and it should be aggressively treated to improve prognosis. Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.
文摘The current various proposals at the International Maritime Organisation （IMO） for the s factor （probability of surviving a given flooding） make no reference to survival time. The paper shows a direct link of the ＂prime＂ s factor with the time to capsize and shows how to utilise experimental data from 30-minute test runs for the s factor based on longer duration of tests. Unexpectedly, the extension of tests has a modest effect on the survival factor, and hence-modest effect on subdivision index A. Much more important is improving a deficient formulation for the required index R, as flooding cases with si = 1 have an infinite survival time.
文摘Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen.We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy.Histopathological analysis showed spindleshaped cells with scanty cytoplasm and hyperchromatic nuclei,confirming a primary pancreatic NEC.One month after the surgery,the patient experienced leg swelling.Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg,and the leg was amputated.Histopathological analysis confirmed metastasis of pancreatic NEC.The patient was followed up and received chemotherapy(etoposide and cisplatin).One month after amputation,the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion.The patient suffered from unbearable pain and we treated him with odynolysis.Four months postoperatively,the patient died of respiratory failure.
