Objective: The aim of the study was to analyze the CT morphology features of pulmonary sclerosing hemangiomas (PSHs) and improve the diagnosis ability of this disease.Methods: The 18 cases of pulmonary sclerosing hema...Objective: The aim of the study was to analyze the CT morphology features of pulmonary sclerosing hemangiomas (PSHs) and improve the diagnosis ability of this disease.Methods: The 18 cases of pulmonary sclerosing hemangioma (PSH) confirmed by operation and histopathology from August 2002 to May 2009 were collected,including 17 females and 2 males,aged from 19 to 60 years old,with an average age of 43 years.All the cases underwent plain CT scan,among them,16 cases received enhanced CT scan.Results: The 18 cases had isolated mass.Mean long-axis diameter of these lesions was (2.7 ± 1.3) cm (range,1.9–4.2 cm).Of all cases,5 cases (27.8%) were round in shape,9 cases (50%) were oval,4 cases (22.2%) were lobulated,and 14 cases (77.8%) were smooth margin.The air meniscus sign was in 2 cases (11.1%),and the halo sign in 3 cases (16.7%).Two cases (11.1%) contained small nodular calcification,the remaining 16 cases (70%) were homogeneous density,the CT density of the masses ranged from 24–47 HU,and the mean value was 35 HU.Sixteen cases received enhanced scan,the welt vessel sign was in 8 cases (44.4%),1 case showed less enhancement,5 cases showed marked homogeneous enhancement and 10 cases showed intense and patchy heterogeneous enhanced.The CT density of the enhancing masses ranged from 60–110 HU,the mean value was 35 HU,and the net enhancement value was 14–80 HU,the mean value was 55 HU.Conclusion: PSH should be considered in middle-aged female whose CT found that single round or oval pulmonary nodules,with smooth margin,or associated with the air meniscus sign,the halo sign,or the marked enhancement.展开更多
Objective： To investigate the histogenesis and differential diagnosis of pulmonary sclerosing hemangioma （PSH）. Methods： Thyroid transcription factor-1 （TTF-1）, surfactant proteins A, B （SP-A, SP-B）, epithelia...Objective： To investigate the histogenesis and differential diagnosis of pulmonary sclerosing hemangioma （PSH）. Methods： Thyroid transcription factor-1 （TTF-1）, surfactant proteins A, B （SP-A, SP-B）, epithelial membrane antigen （EMA）, vimentin, pancytokeratin, cytokeratin7 （CK7）, CK5/6, calretinin, S-100, neurospecific enolase （NSE）, synaptophysin （Syn）, chromogranin A （CgA）, CD34, factor-Ⅷ-related antigen （F-Ⅷ） and smooth muscle actin （SMA）in 55 patients with PSH were examined with immunohistochemistry, while samples from 19 patients were also observed by electron microscope. Follow-up information were reviewed. Results： Pathologically, PSH mainly consisted of both surface lining cuboidal cells and pale polygonal cells. Immunohistochemitry revealed that coexpression of TTF-1, EMA and vimentin in both cuboidal and polygonal cells was 94.5 % （52/55）, 90.5% （50/55） and 58.2% （32/55）, respectively. In cuboidal cells, the expression of SP-A and SP-B was 92.7% （51/55） and 81.8 % （45/55）, respectively. Whereas pancytokeratin and CK7 immunostained the cuboidal cells in all cases. The polygonal cells were difussed immunostained with Syn in 13 PSHs （24%） and NSE in 8 PSHs （15%）, while immunoreactions with S-100 and CgA were separated detected in 7 PSHs （13%）. There was no significant difference of TTF-1 and EMA expression between these two cells （χ^2 value was 1.371 and 3.352, respectively. P 〉 0.05）. In contrast, there was a significant difference of vimentin between them （χ^2 value was 17.720, P 〈 0.001）. Electron microcopy observation showed that ultrastructure may not differ from each other sometime. The follow-up was obtained for 49 cases ranged from 3 months to 14 years. 48 of them had no recurrence or metastasis except one case had recurrence. Conclusion： PSH may origin from the primitive respiratory epithelial. Polygonal and cuboidal cells are all parenchymal neoplasm cells. The concomitant examination of TTF-1, SPA, SP-B, EMA, virnentin and pancytokeratin may favor the diagnosis and differential diagnosis of PSH.展开更多
Sclerosing cholangitis(SC)is a rarely reported morbidity secondary to transcatheter arterial chemoembolization(TACE)with bleomycin-iodinated oil(BIO)for liver cavernous hemangioma(LCH).This report retrospectively eval...Sclerosing cholangitis(SC)is a rarely reported morbidity secondary to transcatheter arterial chemoembolization(TACE)with bleomycin-iodinated oil(BIO)for liver cavernous hemangioma(LCH).This report retrospectively evaluated the diagnostic and therapeutic course of a patient with LDH who presented obstructive jaundice 6 years after TACE with BIO.Preoperative imaging identified a suspected malignant biliary stricture located at the convergence of the left and right hepatic ducts.Operative exploration demonstrated a full-thickness sclerosis of the hilar bile duct with right hepatic duct stricture and right lobe atrophy.Radical hepatic hilar resection with right-side hemihepatectomy and Roux-en-Y hepaticojejunostomy was performed because hilar cancer could not be excluded on frozen biopsy.Pathological results showed chronic pyogenic inflammation of the common and right hepatic ducts with SC in the portal area.Secondary SC is a long-term complication that may occur in LCH patients after TACE with BIO and must be differentiated from hilar malignancy.Hepatic duct plasty is a definitive but technically challenging treatment modality for secondary SC.展开更多
肺硬化性血管瘤（sclerosing hemangioma of the lung, SHL）曾被认为是炎性假瘤的亚型之一,现已证明它是一个独立的疾病。本病由Liebow在1956年首次报道7例,此后世界各地均有散在报道。现将我科诊断的1例右下肺SHL患者资料结合文献报...肺硬化性血管瘤（sclerosing hemangioma of the lung, SHL）曾被认为是炎性假瘤的亚型之一,现已证明它是一个独立的疾病。本病由Liebow在1956年首次报道7例,此后世界各地均有散在报道。现将我科诊断的1例右下肺SHL患者资料结合文献报道如下。展开更多
文摘Objective: The aim of the study was to analyze the CT morphology features of pulmonary sclerosing hemangiomas (PSHs) and improve the diagnosis ability of this disease.Methods: The 18 cases of pulmonary sclerosing hemangioma (PSH) confirmed by operation and histopathology from August 2002 to May 2009 were collected,including 17 females and 2 males,aged from 19 to 60 years old,with an average age of 43 years.All the cases underwent plain CT scan,among them,16 cases received enhanced CT scan.Results: The 18 cases had isolated mass.Mean long-axis diameter of these lesions was (2.7 ± 1.3) cm (range,1.9–4.2 cm).Of all cases,5 cases (27.8%) were round in shape,9 cases (50%) were oval,4 cases (22.2%) were lobulated,and 14 cases (77.8%) were smooth margin.The air meniscus sign was in 2 cases (11.1%),and the halo sign in 3 cases (16.7%).Two cases (11.1%) contained small nodular calcification,the remaining 16 cases (70%) were homogeneous density,the CT density of the masses ranged from 24–47 HU,and the mean value was 35 HU.Sixteen cases received enhanced scan,the welt vessel sign was in 8 cases (44.4%),1 case showed less enhancement,5 cases showed marked homogeneous enhancement and 10 cases showed intense and patchy heterogeneous enhanced.The CT density of the enhancing masses ranged from 60–110 HU,the mean value was 35 HU,and the net enhancement value was 14–80 HU,the mean value was 55 HU.Conclusion: PSH should be considered in middle-aged female whose CT found that single round or oval pulmonary nodules,with smooth margin,or associated with the air meniscus sign,the halo sign,or the marked enhancement.
文摘Objective： To investigate the histogenesis and differential diagnosis of pulmonary sclerosing hemangioma （PSH）. Methods： Thyroid transcription factor-1 （TTF-1）, surfactant proteins A, B （SP-A, SP-B）, epithelial membrane antigen （EMA）, vimentin, pancytokeratin, cytokeratin7 （CK7）, CK5/6, calretinin, S-100, neurospecific enolase （NSE）, synaptophysin （Syn）, chromogranin A （CgA）, CD34, factor-Ⅷ-related antigen （F-Ⅷ） and smooth muscle actin （SMA）in 55 patients with PSH were examined with immunohistochemistry, while samples from 19 patients were also observed by electron microscope. Follow-up information were reviewed. Results： Pathologically, PSH mainly consisted of both surface lining cuboidal cells and pale polygonal cells. Immunohistochemitry revealed that coexpression of TTF-1, EMA and vimentin in both cuboidal and polygonal cells was 94.5 % （52/55）, 90.5% （50/55） and 58.2% （32/55）, respectively. In cuboidal cells, the expression of SP-A and SP-B was 92.7% （51/55） and 81.8 % （45/55）, respectively. Whereas pancytokeratin and CK7 immunostained the cuboidal cells in all cases. The polygonal cells were difussed immunostained with Syn in 13 PSHs （24%） and NSE in 8 PSHs （15%）, while immunoreactions with S-100 and CgA were separated detected in 7 PSHs （13%）. There was no significant difference of TTF-1 and EMA expression between these two cells （χ^2 value was 1.371 and 3.352, respectively. P 〉 0.05）. In contrast, there was a significant difference of vimentin between them （χ^2 value was 17.720, P 〈 0.001）. Electron microcopy observation showed that ultrastructure may not differ from each other sometime. The follow-up was obtained for 49 cases ranged from 3 months to 14 years. 48 of them had no recurrence or metastasis except one case had recurrence. Conclusion： PSH may origin from the primitive respiratory epithelial. Polygonal and cuboidal cells are all parenchymal neoplasm cells. The concomitant examination of TTF-1, SPA, SP-B, EMA, virnentin and pancytokeratin may favor the diagnosis and differential diagnosis of PSH.
文摘Sclerosing cholangitis(SC)is a rarely reported morbidity secondary to transcatheter arterial chemoembolization(TACE)with bleomycin-iodinated oil(BIO)for liver cavernous hemangioma(LCH).This report retrospectively evaluated the diagnostic and therapeutic course of a patient with LDH who presented obstructive jaundice 6 years after TACE with BIO.Preoperative imaging identified a suspected malignant biliary stricture located at the convergence of the left and right hepatic ducts.Operative exploration demonstrated a full-thickness sclerosis of the hilar bile duct with right hepatic duct stricture and right lobe atrophy.Radical hepatic hilar resection with right-side hemihepatectomy and Roux-en-Y hepaticojejunostomy was performed because hilar cancer could not be excluded on frozen biopsy.Pathological results showed chronic pyogenic inflammation of the common and right hepatic ducts with SC in the portal area.Secondary SC is a long-term complication that may occur in LCH patients after TACE with BIO and must be differentiated from hilar malignancy.Hepatic duct plasty is a definitive but technically challenging treatment modality for secondary SC.
