OBJECTIVE To enhance the understanding of Castleman’s disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were ret...OBJECTIVE To enhance the understanding of Castleman’s disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed. RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situa-tions in the 14 cases, with a lack of specificity. They were previously misdiag-nosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.展开更多
AIM: To study the clinicopathological characteristics of unsuspected gallbladder carcinoma (UGC). METHODS: We retrospectively studied 23 cases of UGC in Tongji Hospital, and compared their clinicopathological char...AIM: To study the clinicopathological characteristics of unsuspected gallbladder carcinoma (UGC). METHODS: We retrospectively studied 23 cases of UGC in Tongji Hospital, and compared their clinicopathological characteristics with 33 cases of preoperatively diagnosed gallbladder carcinoma (PDGC). RESULTS: The proportion of UGC coexisting with cholecystolithiasis was significantly higher than that of PDGC (x^2 = 13.53, P 〈 0.01). The infection rate of hepatitis B virus was 21.74% (5/23) in UGC and 30.30% (10/33) in PDGC. Nine (39.13%) of 23 patients with UGC and 8/33 (24.24) PDGC had contact with schistosome pestilent water. The rate of multiple pregnancies was 56.52% (13/23) in the patients with UGC and 42.42% (14/33) in PDGC. The primary location of the UGC was mostly in the neck and body of the gallbladder, and that of the PDGC was often in the body and bottom. The incidence of Nevin stage I and 11 UGC was significantly higher than that of PDGC (x^2 = 4.44, P 〈 0.05 and 2 = 4.96, P 〈 0.05) while that of Nevin stage V UGC was significantly lower than that of PDGC (x^2 = 7.59, P 〈 0.01). According to the grading of carcinoma, the incidence of well-differentiated UGC was significantly higher than that of PDGC (2 = 4.16, P 〈 0.05), and that of poorlydifferentiated UGC was significantly lower than that of PDGC (x^2 = 4.48, P 〈 0.05).CONCLUSION: There are different characteristics between UGC and PDGC, such as in primary location, malignant degree and incidence of coexistence with cholecystolithiasis. Cholecystolithiasis, hepatitis B, schistosome and multiple pregnancies were high risk factors for gallbladder carcinoma.展开更多
To get a better understanding of the location,pathophysiology,etiology and prognosis of multiple malignant tumors (MPMT),we evaluated the medical records of 22 patients with MPMT.Our results suggested that radiotherap...To get a better understanding of the location,pathophysiology,etiology and prognosis of multiple malignant tumors (MPMT),we evaluated the medical records of 22 patients with MPMT.Our results suggested that radiotherapy and chemotherapy might play an important role in the pathogenesis of MPMT and follow up is important in detecting a secondary primary malignant tumor (PMT) at an early stage.Surgical removal of tumors is the first choice therapy for MPMT.展开更多
A 58-year-old male patient, complaining of dysuresia, which increased over a period of 2 months, had a history of urine retention that did not respond to treatment administered in an outpatient clinic. Upon admission ...A 58-year-old male patient, complaining of dysuresia, which increased over a period of 2 months, had a history of urine retention that did not respond to treatment administered in an outpatient clinic. Upon admission to the hospital on August 2, 2005, examination showed that his prostate was midrange size by rectal palpation, and without pain or prostate nodus. An ultrasound examination indicated the prostate size was 6.1 cm×4.7 cm×3.6 cm, without an occupying lesion in the prostate.展开更多
Objective: To investigate the features of hepatic abscess by dynamic contrast-enhanced CT. Methods : CT films of 62 cases of hepatic abscesses were reviewed retrospectively. All the patients underwent both plain and e...Objective: To investigate the features of hepatic abscess by dynamic contrast-enhanced CT. Methods : CT films of 62 cases of hepatic abscesses were reviewed retrospectively. All the patients underwent both plain and enhanced CT scanning, and 23 of them received dynamic CT examination. Results: The dynamic CT appearance of hepatic abscesses was characterized by: ① In the early phase (30 s), abscess membrane enhanced obviously and the liver parenchyma surrounding the abscesses enhanced transiently; ② In the late phase (60-90 s) , the enhancement patterns of the abscesses varied from the ring enhancement of the abscess membrane to the irregular enhancement of the abscess; ③ In the delayed phase, the enhancement of abscess diminished in which the hypodense ring enhanced and became isodense, or the abscess enhanced diffusely and became smaller, the colliquative necrosis area more obvious. Conclusion: Contrast enhanced CT should be used routinely in the evaluation of hepatic abscesses. The dynamic and delayed scan is necessary to diagnose atypical hepatic abscesses.展开更多
文摘OBJECTIVE To enhance the understanding of Castleman’s disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed. RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situa-tions in the 14 cases, with a lack of specificity. They were previously misdiag-nosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.
文摘AIM: To study the clinicopathological characteristics of unsuspected gallbladder carcinoma (UGC). METHODS: We retrospectively studied 23 cases of UGC in Tongji Hospital, and compared their clinicopathological characteristics with 33 cases of preoperatively diagnosed gallbladder carcinoma (PDGC). RESULTS: The proportion of UGC coexisting with cholecystolithiasis was significantly higher than that of PDGC (x^2 = 13.53, P 〈 0.01). The infection rate of hepatitis B virus was 21.74% (5/23) in UGC and 30.30% (10/33) in PDGC. Nine (39.13%) of 23 patients with UGC and 8/33 (24.24) PDGC had contact with schistosome pestilent water. The rate of multiple pregnancies was 56.52% (13/23) in the patients with UGC and 42.42% (14/33) in PDGC. The primary location of the UGC was mostly in the neck and body of the gallbladder, and that of the PDGC was often in the body and bottom. The incidence of Nevin stage I and 11 UGC was significantly higher than that of PDGC (x^2 = 4.44, P 〈 0.05 and 2 = 4.96, P 〈 0.05) while that of Nevin stage V UGC was significantly lower than that of PDGC (x^2 = 7.59, P 〈 0.01). According to the grading of carcinoma, the incidence of well-differentiated UGC was significantly higher than that of PDGC (2 = 4.16, P 〈 0.05), and that of poorlydifferentiated UGC was significantly lower than that of PDGC (x^2 = 4.48, P 〈 0.05).CONCLUSION: There are different characteristics between UGC and PDGC, such as in primary location, malignant degree and incidence of coexistence with cholecystolithiasis. Cholecystolithiasis, hepatitis B, schistosome and multiple pregnancies were high risk factors for gallbladder carcinoma.
文摘To get a better understanding of the location,pathophysiology,etiology and prognosis of multiple malignant tumors (MPMT),we evaluated the medical records of 22 patients with MPMT.Our results suggested that radiotherapy and chemotherapy might play an important role in the pathogenesis of MPMT and follow up is important in detecting a secondary primary malignant tumor (PMT) at an early stage.Surgical removal of tumors is the first choice therapy for MPMT.
文摘A 58-year-old male patient, complaining of dysuresia, which increased over a period of 2 months, had a history of urine retention that did not respond to treatment administered in an outpatient clinic. Upon admission to the hospital on August 2, 2005, examination showed that his prostate was midrange size by rectal palpation, and without pain or prostate nodus. An ultrasound examination indicated the prostate size was 6.1 cm×4.7 cm×3.6 cm, without an occupying lesion in the prostate.
文摘Objective: To investigate the features of hepatic abscess by dynamic contrast-enhanced CT. Methods : CT films of 62 cases of hepatic abscesses were reviewed retrospectively. All the patients underwent both plain and enhanced CT scanning, and 23 of them received dynamic CT examination. Results: The dynamic CT appearance of hepatic abscesses was characterized by: ① In the early phase (30 s), abscess membrane enhanced obviously and the liver parenchyma surrounding the abscesses enhanced transiently; ② In the late phase (60-90 s) , the enhancement patterns of the abscesses varied from the ring enhancement of the abscess membrane to the irregular enhancement of the abscess; ③ In the delayed phase, the enhancement of abscess diminished in which the hypodense ring enhanced and became isodense, or the abscess enhanced diffusely and became smaller, the colliquative necrosis area more obvious. Conclusion: Contrast enhanced CT should be used routinely in the evaluation of hepatic abscesses. The dynamic and delayed scan is necessary to diagnose atypical hepatic abscesses.