Molecular diagnosis and direct quantification of cereal cyst nematode(Heterodera filipjevi) from field soil using TaqMan real-time PCR

Heterodera filipjevi continues to be a major threat to wheat production worldwide.Rapid detection and quantification of cyst nematodes are essential for more effective control against this nematode disease.In the present study,a TaqManminor groove binder(TaqMan-MGB)probe-based fluorescence quantitative real-time PCR(qPCR)was successfully developed and used for quantifying H.filipjevi from DNA extracts of soil.The primers and probe designed from the obtained RAPD-SCAR marker fragments of H.filipjevi showed high specificity to H.filipjevi using DNA from isolatesconfirmed species of 23 Heterodera spp.,1 Globodera spp.and 3 Pratylenchus spp.The qPCR assay is highly sensitive and provides improved H.filipjevi detection sensitivity of as low as 4^(-3) single second-stage juvenile(J2)DNAs,10^(-3) female DNAs,and 0.01μgμL^(-1) genomic DNAs.A standard curve relating to the threshold cycle and log values of nematode numbers was generated and validated from artificially infested soils and was used to quantify H.filipjevi in naturally infested field soils.There was a high correlation between the H.filipjevi numbers estimated from 32 naturally infested field soils by both conventional methods and the numbers quantified using the qPCR assay.qPCR potentially provides a useful platform for the efficient detection and quantification of H.filipjevi directly from field soils and to quantify this species directly from DNA extracts of field soils.

Diagnosis and treatment of congenital choledochal cyst: 20 years' experience in China

AIM To summarize the experience of diagnosis and treatment of congenital choledochal cyst in the past 20years ( 1980 2000).``METHODS The clinical data of 108 patients admitted from 1980 to 2000 were analyzed retrospectively.RESULTS Abdominal pain, jaundice and abdominal mass were presented in most child cases. Clinical symptoms in adult cases were non-specific, resulting in delayed diagnosis frequently. Fifty-seven patients (52.7%) had coexistent pancreatiobiliary disease. Carcinoma of the biliary duct occurred in 18 patients (16.6%). Ultrasonic examination was undertaken in 94 cases, ERCP performed in 46 cases and CT in 71 cases. All of the cases were correctly diagnosed before operation. Abnormal pancreatobiliary duct junction was found in .39 patients.Before 1985 the diagnosis and classification of congenital choledochal cyst were established by ultrasonography preoperatively and confirmed during operation, the main procedures were internal drainage by cyst enterostomy.After 1985, the diagnosis was established by ERCP and CT. and cystectomy with Roux-en-Y hepaticojejunostomy was the conventional procedures. In 1994, we reported a new and simplified operative procedure in order to reduce the risk of choledochal cyst malignancy. Postoperative complication was mainly retrograde infection of biliary tract, which could be controlled by the administration of antibiotics, there was no perioperative mortality.``CONCLUSION The concept in diagnosis and treatment of congenital choledochal cyst has obviously been changed greatly. CT and ERCP were of great help in the classification of the disease. Currently, cystectomy with Roux-en-Y hepaticojejunostomy is strongly recommended as the choice for patients with type I and type Ⅳ cysts.Piggyback orthotopic liver transplantation is indicated in type \ cysts (Carolis disease) with frequently recurrent cholangitis.

Endosonography in the diagnosis and management of pancreatic cysts

Rapid advances in radiologic technology and increased cross-sectional imaging have led to a sharp rise in incidental discoveries of pancreatic cystic lesions. These cystic lesions include non-neoplastic cysts with no risk of malignancy, neoplastic non-mucinous serous cystadenomas with little or no risk of malignancy, as well as neoplastic mucinous cysts and solid pseudopapillary neoplasms both with varying riskof malignancy. Accurate diagnosis is imperative as management is guided by symptoms and risk of malignancy. Endoscopic ultrasound(EUS) allows high resolution evaluation of cyst morphology and precise guidance for fine needle aspiration(FNA) of cyst fluid for cytological, chemical and molecular analysis. Initially, clinical evaluation and radiologic imaging, preferably with magnetic resonance imaging of the pancreas and magnetic resonance cholangiopancreatography, are performed. In asymptomatic patients where diagnosis is unclear and malignant risk is indeterminate, EUSFNA should be used to confirm the presence or absence of high-risk features, differentiate mucinous from non-mucinous lesions, and diagnose malignancy. After analyzing the cyst fluid for viscosity, cyst fluid carcinoembryonic antigen, amylase, and cyst wall cytology should be obtained. DNA analysis may add useful information in diagnosing mucinous cysts when the previous studies are indeterminate. New molecular biomarkers are being investigated to improve diagnostic capabilities and management decisions in these challenging cystic lesions. Current guidelines recommend surgical pancreatic resection as the standard of care for symptomatic cysts and those with high-risk features associated with malignancy. EUSguided cyst ablation is a promising minimally invasive, relatively low-risk alternative to both surgery and surveillance.

Management of Ovarian Cystic Tumor: Diagnosis, Management, and Its Follow-Up-Case Presentation of Three Patients and Literature Review

The diagnosis and management of ovarian cystic tumor is sometimes difficult. In this manuscript, we wish to summarize this issue by showing three cases. Ultrasound and Color Doppler are very useful to diagnose the presence of this tumor but also to distinguish between benign and malignant. Pelvic MRI is also a strong tool and is sometimes mandatory. HE4 and CA125 are often useful as a serum diagnostic marker of malignancy, but not always so. Recently, laparoscopic management has gained popularity;however, great caution should be exercised during laparoscopic operative procedures, as this may lead to intraperitoneal malignant cell spreading/proliferation when the tumor is malignant. During the surgery of malignant tumor, irrespective of laparoscopic or laparotomic, intraperitoneal rupture should be avoided. Since the final diagnosis must be made by histological examination, the patient must always be informed of this possibility.

Radiological Mimics of Popliteal Cysts: An Algorithmic Approach Using US and MRI to Identify the Potentially Malignant Lesions: Case Series

Background: Popliteal cysts are common and present as asymptomatic lumps in the medial popliteal fossa. Some have complex internal characteristics such as septa and loose-bodies. However, not all are popliteal cysts and can be aggressive. These lesions need to be differentiated by the absence of the communicating neck with the joint on ultrasound. Presence of Doppler flow of non-communicating cysts requires further evaluation on MRI, prior to performing a biopsy. Using a case series, we propose an algorithmic approach that is simple and will help identify the malignant lesions and institute appropriate management. Case-Presentation: Popliteal Cyst: On ultrasound: characteristic neck communicating with knee joint. Synovial Sarcoma: Gadolinium enhancement, with areas of low-, iso- and hyper-intense signal to fat on T2. Synovial-Osteochondromatosis: Non-mineralized: T1-low/intermediate intensity;T2-high intensity. Mineralized type: low intensity on T1 & T2. Thrombosed Popliteal Aneurysm: Lamellated appearance-high/low signal intensity on T2. Myxoid-Liposarcomas: Inhomogeneous appearance;homogenous with gadolinium. Usually require a biopsy for diagnosis. Conclusion: The cystic lesions in the medial aspect of the popliteal fossa can be misdiagnosed. Our article reiterates the importance of the communicating neck that separates popliteal cysts from other mimics. We have proposed an algorithm to identify these mimics.

DIAGNOSIS AND TREATMENT OF MEDIASTINAL ENTEROGENOUS CYSTS IN CHILDREN

Objective To investigate the diagnosis and therapy of mediastinal enterogenous cysts in children. Methods Clinical data of 17 cases with mediastinal enterogenous cysts within 19 years in our hospital were retrospectively analyzed. Results One case was intramural esophageal cyst and 16 cases were enteric cysts, two among which were complicated with abdominal enteric duplications. Most cases presented with symptoms of respiratory distress. Twelve cases were complicated with vertebral anomalies. Ultrasound of 12 cases and magnetic resonance imaging of 4 cases were helpful in confirming the cystic nature of these lesions. Eight cases had technetium-99m pertechnetate scintigraphy of posterior mediastinum.Conclusions Most patients present with symptoms of respiratory distress, complicated with vertebral anomalies. Ultrasonography and magnetic resonance imaging may be helpful in confirming the cystic nature of these lesions. Technetium-99m pertechnetate scintigraphy is the most effective method for differentiation of the disease from other mediastinal cysts.

Prenatal diagnosis of choledochal cyst using magnetic resonance imaging: A case report

Choledochal cysts are congenital anomalies of the biliary ducts, characterized by cystic dilatation of the ducts.Prenatal diagnosis of this anomaly using ultrasonography (US) has been well documented. Magnetic resonance imaging (MRI) has recently become an important complement to US in prenatal diagnosis of fetal anomalies. We herein report a patient in whom at 24 wk' gestation US suggested a right upper quadrant abdominal cyst and in whom at 26 wk' gestation MRI more clearly delineated the cyst and its surrounding structures and suggested a choledochal cyst, which was confirmed at postnatal surgery and histopathology.

Clinicopathological characteristics and typing of multilocular cystic renal neoplasm of low malignant potential

BACKGROUND Up until now,no research has been reported on the association between the cli-nical growth rate of multilocular cystic renal neoplasm of low malignant potential(MCRNLMP)and computed tomography(CT)imaging characteristics.Our study sought to examine the correlation between them,with the objective of distin-guishing unique features of MCRNLMP from renal cysts and exploring effective management strategies.AIM To investigate optimal management strategies of MCRNLMP.METHODS We retrospectively collected and analyzed data from 1520 patients,comprising 1444 with renal cysts and 76 with MCRNLMP,who underwent renal cyst decom-pression,radical nephrectomy,or nephron-sparing surgery for renal cystic disease between January 2013 and December 2021 at our institution.Detection of MC-RNLMP utilized the Bosniak classification for imaging and the 2016 World Health Organization criteria for clinical pathology.RESULTS Our meticulous exploration has revealed compelling findings on the occurrence of MCRNLMP.Precisely,it comprises 1.48%of all cases involving simple renal cysts,5.26%of those with complex renal cysts,and a noteworthy 12.11%of renal tumors coexisting with renal cysts,indicating a statistically significant difference(P=0.001).Moreover,MCRNLMP constituted a significant 22.37%of the patient po-pulation whose cysts demonstrated a rapid growth rate of≥2.0 cm/year,whereas it only represented 0.66%among those with a growth rate below 2.0 cm/year.Of the 76 MCRNLMP cases studied,none of the nine patients who underwent subsequent nephron-sparing surgery or radical nephrectomy following renal cyst decompression experienced recurrence or metastasis.In the remaining 67 patients,who were actively monitored over a 3-year postoperative period,only one showed suspicious recurrence on CT scans.CONCLUSION MCRNLMP can be tentatively identified and categorized into three types based on CT scanning and growth rate indicators.In treating MCRNLMP,partial nephrectomy is preferred,while radical nephrectomy should be minimi-zed.After surgery,active monitoring is advisable to prevent unnecessary nephrectomy.

Efficacy of Ultrasound-Guided Unidirectional Valve Enlargement in Treatment of Popliteal Cysts

Purpose: To investigate the effect of ultrasound-guided unidirectional valve cleft enlargement in the treatment of popliteal cysts. Methods: Forty-eight patients with popliteal cysts who met the inclusion criteria and were admitted to our hospital from December 2018 to June 2020 were randomly divided into group A (24 cases) and group B (24 cases). Group A was treated with a central venous catheter dilator, and group B was treated with traditional open surgery to remove the popliteal cyst. Visual analogue scale (VAS) was used to evaluate discomfort. The VAS, Lysholm score of knee joint and Rauschning-Lindgren grade 0~I improvement rate were compared at 6 months after operation. Results: The postoperative VAS in group A was significantly better than that in group B (P < 0.05), and the postoperative Lysholm score and Rauschning-Lindgren grade 0~I in group A were higher than those in group B (P < 0.05). There was no recurrence or other complications in either group. Conclusions: Ultrasound-guided central venous catheter dilator is more effective than traditional surgical resection of popliteal cysts.

Differential diagnosis and treatment of foot drop caused by an extraneural ganglion cyst above the knee:A case report

BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common peroneal neuropathy by intraneural ganglion cysts and synovial cysts.Compression of the peroneal nerve by extraneural ganglion cysts is rare.We report a rare case of compressive common peroneal neuropathy by an extraneural ganglion cyst.CASE SUMMARY A 46-year-old man was hospitalized after he reported a right foot drop for 1 mo.Manual muscle testing revealed scores of 1/5 on dorsiflexion of the right ankle.Hypoesthesia and paresthesia on the right lateral leg and foot dorsum were noted.He was diagnosed with a popliteal cyst by using electrophysiologic study and popliteal ultrasound(US).To facilitate common peroneal nerve(CPN)decompression,2 cc of sticky gelatinous material was aspirated from the cyst under US guidance.Electrical stimulation and passive and assisted active ROM exercises of the right ankle and strengthening exercises for weak muscles using elastic band were prescribed based on the change of muscle power.A posterior leaf spring ankle-foot orthosis was prescribed to assist the weak dorsiflexion of the ankle.Follow-up US revealed that the cystic lesion was growing and magnetic resonance imaging demonstrated compression of the CPN by the cystic mass.The cyst was resected to prevent impending compression of the CPN.CONCLUSION Precise diagnosis and immediate treatment are important in cases of compressive common peroneal neuropathy caused by an extraneural cyst.

Treatment of Popliteal Cyst through Radiofrequency Thermocoagulation under Ultrasound Guidance

Objective: The purpose of this study was to explore the clinical efficacy and security of the treatment of popliteal cyst through radiofrequency thermocoagulation (RFT) under ultrasound guidance. Methods: The clinical data of 35 patients with popliteal cyst, who were treated by RFT under ultrasound guidance from June 2019 to June 2020, were retrospectively analyzed. The Visual Analogue Scores (VAS) and the size of cyst before and after treatment were recorded at the first month, the third month, the sixth month. After six months, the recovery rate of Rauschning and Lindgren classification (R-L classification) level 0, 0 - I were counted. All the complications of the patients were observed. Results: 32 patients were followed up for six months. The scores and cyst sizes of each patient before and after the treatment were on a normal distribution curve. There was no significant difference in VAS scores before and after the treatment (P > 0.05). However, there was a significant difference in cyst sizes before and after the treatment (P < 0.05). Moreover, there was no significant difference in VAS scores and cyst sizes in each period after treatment (P > 0.05). According to the R-L classification in 6 months after treatment: the recovery rate of class 0 was 62.5% and class 0 - I level was 87.5%. There were no serious complications in the process. Conclusion: Treatment of popliteal cyst through RFT under ultrasound guidance is a simple, easy, reliable method that is worthy of clinical promotion.

Management and Diagnosis Challenges in Cystic Meningioma. A Case Report and Review of Literature

Background: Cystic meningioma is a rare variety of meningioma. It represents 4% to 7% of all meningiomas. The authors report a case of intracranial cystic meningioma with a review of literature. Case Report: A 59-year-old female presented with a history of headache followed by left side hemiplegia. CT scan and MRI of the brain showed a right parietal tumor with double solid and cystic components thought to be pilocytic astrocytoma or metastasis preoperatively. At surgery, the extraaxial solid and cystic lesion had a well defined capsule that could be easily separated from the perilesional cortical surface. The tumor was totally removed and the cyst was punctioned. The histological study showed a cystic meningioma WHO Grade I. A follow-up at 10 months after surgery, the patient was going well and recovered from the hemiplegiaa. Conclusion: Cystic meningioma is an uncommon tumor that should be considered in the differential diagnosis of brain tumors with a cystic component. The preoperative diagnosis and management could be in some cases challenging.

Preoperative Diagnosis of Thyroglossal Duct Cancer: A Case Report and Literature Review

Objective: To clarify the preoperative diagnostic rate and elucidate the morphological features of thyroglossal duct cancer through a literature search on cases reported in Japan. Methods: A search of a medical database (Japan Medical Abstracts Society) identified 40 studies on thyroglossal duct cancer in Japanese patients between 1976 and 2014. A total of 47 cases, including the present case, are summarized herein. Patient characteristics, preoperative diagnosis, and morphological features were reviewed and analyzed. Morphological features of the internal portions in the cystic lesions were classified using the previously reported Yokosuka Kyosai Hospital criteria for ultrasonography findings of thyroid cystic tumors. Results: Preoperative diagnosis was described for 43 of the 47 cases. Malignancy was suspected in 18 (41.9%) of the 43 cases on the basis of fine needle aspiration (FNA) cytology (presence of suspected papillary carcinoma cells) and imaging studies (presence of calcifications), 12 and 6 cases, respectively. Preoperative FNA was performed in 24 cases with a correct diagnosis obtained in only 12 (50%) cases. Morphological features were evaluated by preoperative imaging studies and/or postoperative histopathology. We found 6 cases (15%) with solid lesions, 32 cases (80%) with cystic lesions containing a solid part, and 2 cases (5%) with solo cystic lesions, respectively. Calcification was observed in 28 (72.5%) cases. We further examined the internal morphology of 32 cases with cystic lesions according to the criteria for ultrasonography findings of thyroid cystic tumors described in Methods. Of the 32 cases, 25 (62.5%) and 7 (17.5%) were classified as “eccentric acute angle type (Ea)” and “multiseptate type (M)”, respectively. The boundary between the solid part and the cystic part was irregular in all 7 “M” cases. No “eccentric and blunt angle type (Eb)” or “concentric type (C)” lesions were observed. Conclusions: The preoperative diagnostic rate for thyroglossal duct cancer using FNA is low, and it is important that diagnosis be performed in conjunction with imaging findings. The presence of solid parts or calcified lesions classified as “Ea” or “M with irregular boundaries” on the basis of imaging findings is suggestive of malignancy.

Hydatid Cyst of the Liver: About a Case at the Digestive and General Surgery Department of the University Hospital of Bouaké(Côte d’Ivoire)

Hydatid cyst of the liver (KHF) is a parasitic condition caused by the development of the larval form of the dog tapenia Echinococcus granulosus. In sub-Saharan Africa, few writings are interested in this pathology, which remains common and constitutes a public health problem in highly endemic countries [1] [2]. We report the observation of a 61-year-old hypertensive patient owner of a dog admitted for abdominal pain without abdominal mass. In whom ultrasound and computed tomography have made it possible to make the diagnosis of hydatid cyst of the liver (KHF). The patient underwent surgery. We performed an associated conservative treatment post-operative albendazole. The post-operative follow-up was simple. In our patient the evolution was good after a setback of more than 2 months. Through this observation and a review of the literature, we insist on the contribution of imaging in diagnosis and treatment, which is essentially surgical.

超微血流成像在新生儿室管膜下疾病的应用

目的探讨超微血流成像技术对新生儿颅脑室管膜下疾病(出血及囊肿)的诊断价值。方法应用超声检查新生儿颅脑,将尾状核头部和丘脑交界处室管膜下出现强回声团或囊性回声标记为阳性指标,将患儿分为三组:正常组、强回声组和囊肿组,分别应用超微血流成像技术观测新生儿尾状核头部和丘脑交界处室管膜区的血流情况,并对病变组(强回声组和囊肿组)进行动态观察以明确诊断并随访。结果观察正常组30例患儿,室管膜下围绕脑室可见星点状及带状血流信号,血流信号丰富程度随侧脑室及脉络丛强回声增多而增丰;强回声组18例,其强回声与脉络丛回声相似,16例(16/18)超微血流成像显示此区域可以见丰富血流信号,其血流信号与脉络丛显示相似,并且其血流在室管膜下与远端脉络丛相连,其中2例(2/18)强回声内部未探及血流信号,后期随访转为囊状回声;囊肿组11例,室管膜下囊肿周边可见丰富血流信号,囊肿周边随强回声团增加其血流显示更丰富,8例(8/17)囊肿内可见血流信号。结论超微血流成像可明确室管膜下区早期病变性质,可以动态观测疾病进展及推测预后,为临床提供更全面的诊断信息,或许此技术的应用将成为室管膜下出血诊断的金标准。

囊壁切除膝关节镜下后内双通道技术治疗腘窝囊肿的效果

目的:探讨囊壁切除膝关节镜下后内双通道技术治疗腘窝囊肿的效果。方法:选取2019年9月—2022年9月吉林省人民医院收治的218例腘窝囊肿患者,根据随机数表法将其分为对照组(n=109)和观察组(n=109)。对照组给予保留囊壁膝关节镜下内引流技术,观察组给予囊壁切除膝关节镜下后内双通道技术。比较两组围手术期指标,术前及术后6个月膝关节功能、疼痛程度及腘窝囊肿程度,并发症及复发。结果:观察组术后首次下地行走时间早于对照组,总住院时间短于对照组,差异有统计学意义(P<0.05)。术后6个月,两组Lysholm评分增加,VAS评分降低,观察组Lysholm评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05)。术后6个月,观察组腘窝囊肿程度分级优于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。观察组复发率低于对照组,差异有统计学意义(χ^(2)=4.317,P<0.05)。结论:囊壁切除膝关节镜下后内双通道技术可更为有效地缓解腘窝囊肿患者的囊肿程度及疼痛,优化膝关节功能,且治疗安全性有保障。

产前诊断胆总管囊肿的临床诊疗进展

胆总管囊肿是儿童发病率较高的先天性胆道畸形,手术是唯一根治的方法。随着产检影像学技术的提高,产前诊断胆总管囊肿逐渐增多,其影像学表现及临床表现复杂多变、实验室检查结果不典型,需出生后进一步手术探查明确诊断。同时,大多数产前诊断胆总管囊肿患儿出生后无症状,随着年龄增长及生后进食,胆道梗阻逐渐加重,术前可发生穿孔、肝纤维化等一系列并发症,其手术干预时机及穿孔后手术方法尚存争议。另外,随着腹腔镜技术的应用、围手术期管理水平的提高以及抗生素的使用与升级,腹腔镜下根治产前诊断胆总管囊肿安全有效。本文从产前诊断胆总管囊肿的临床表现、辅助检查、诊断及鉴别诊断、手术治疗等相关诊疗进展进行综述。

能谱CT平扫图像直方图纹理分析对肾盂旁囊肿与肾盂积水的鉴别价值

目的:探讨能谱CT平扫单能量图像结合直方图纹理分析对肾盂旁囊肿与肾盂积水的鉴别价值。方法:回顾性收集25例肾盂旁囊肿(肾盂旁囊肿组)和18例肾盂积水患者(肾盂积水组)。应用能谱成像分析平台测量2组40~140 keV(以10 keV为间隔)11个不同单能量CT值,并分别行统计学比较。单能量CT值差异有统计学意义的,在AW4.5工作站上重建相应单能量图像,采用GEOmni-Kinetics软件进行直方图纹理分析,选择病灶最大层面勾画ROI,生成基于灰度直方图纹理参数,包括最小值,最大值,均值,标准差,变异度,偏度,峰度,均一性,能量,熵,第5、10、25、50、75、90、95百分位数。采用单因素分析比较2组间参数的差异,基于ROC曲线评价各参数的鉴别价值。采用多因素logistic回归模型进行特征筛选并构建最终的预测模型,绘制最终模型的ROC曲线并分析其价值。结果:40~50 keV条件下,肾盂旁囊肿组的单能量CT值大于肾盂积水组,差异均有统计学意义(均P<0.05),2组60~140 keV单能量CT值差异均无统计学意义(均P>0.05)。40 keV条件下,2组均值,峰度,能量,熵,第5、10、25、50、75百分位数差异均有统计学意义(均P<0.05),余参数差异均无统计学意义(均P>0.05);50 keV条件下,2组均值,第10、25、50百分位数差异均有统计学意义(均P<0.05),余参数差异均无统计学意义(均P>0.05)。ROC曲线分析显示,40 keV图像纹理参数鉴别肾盂旁囊肿与肾盂积水的AUC为0.696~0.756,均大于50 keV图像纹理参数的AUC。多因素logistic回归分析显示,40 keV图像纹理参数的峰度、能量和第25百分位数是肾盂旁囊肿与肾盂积水的独立预测因子,三者联合诊断鉴别肾盂旁囊肿与肾盂积水的AUC为0.915,敏感度为93.3%、特异度为83.3%。结论:基于能谱CT平扫40 keV图像的直方图纹理参数构建的多因素logistic回归模型能有效鉴别肾盂旁囊肿与肾盂积水。

软骨母细胞瘤和原发性动脉瘤样骨囊肿CT三维重建对比分析

目的 探讨软骨母细胞瘤(chondroblastoma,CB)与原发性动脉瘤样骨囊肿(aneurysmal bone cyst,ABC)的三维CT影像表现及鉴别点。方法 回顾性分析经手术、病理及免疫组织化学证实的单纯CB(22例)、CB伴ABC(5例)和原发性ABC(24例)患者的三维CT和临床资料。结果 三组病变三维CT均表现为单发、边界清晰的溶骨性骨质破坏。CB组、CB伴ABC组病灶最大径均小于ABC组(P<0.05)。CB组位于不规则骨(54.5%)、偏心性(86.4%)、钙化(50%)、邻关节面(77.3%)及突破骨皮质(54.5%)发生率高于ABC组(分别为20.8%、29.2%、8.3%、4.2%及25.0%),P<0.05,膨胀性生长(40.9%)和合并病理性骨折(18.2%)发生率低于ABC组(75.0%、45.8%),P<0.05;CB组与ABC组分叶征、边缘硬化、骨嵴和累及骨皮质征象发生率不存在统计学差异(P>0.05)。结论 病变的解剖部位和CT三维征象对CB和ABC的鉴别诊断有重要价值。

动脉瘤样皮肤纤维组织细胞瘤1例并文献复习

目的报道1例动脉瘤样皮肤纤维组织细胞瘤(ADF),并进行文献复习,以提高临床医师对该病的认识。方法归纳上海中医药大学附属市中医医院2021年9月28日收治的1例ADF患者的病历资料,对术中标本进行HE和免疫组化染色,记录并观察HE、免疫组化染色结果、治疗与随访情况。结果巨检显示灰黄组织3块,总直径0.8 cm。镜检显示真皮内结节状、不规则成片或成巢的梭形至卵圆形组织样细胞,内含有含铁血黄素颗粒和多灶性出血性囊腔、无内皮细胞内衬,为假血管性腔隙。免疫组织化学结果:CD34(-)、S-100(-)、Desmin(-)、SMA(-)、β-Catenin(-)、HMB-45(-);Vimentin(+)定位于细胞质和细胞核;CD68(+)定位于细胞膜和细胞质,呈棕黄色;Ki-67(5%+)定位于细胞核,呈棕黄色。患者术后随访1年未复发。结论ADF有一定的复发风险和交界恶性潜能,临床症状缺乏特异性,及时正确的诊断能使患者获益,治疗以尽早手术完整切除为主,后期建议定期随访。