ObjectiveTo explore the clinical efficacy of transcatheter arterial embolization or transcatheter arterial embolization combined with percutaneous transhepatic sclerotherapy injection for hepatic cavernous hemangioma with different blood supply. MethodsEighty-six patients with hepatic cavernous hemangioma with different blood supply received femoral artery pingyangmycin iodized oil embolization or transcatheter arterial embolization combined with percutaneous transhepatic injection of pingyangmycin iodized oil embolization from February 2004 to April 2013. ResultsForty-five cases (52.3%) of tumor decreased by over 50%; 26 (30.2%) decreased by about 20% to 50%; 11 (12.8%) decreased by less than 20%; and 4 (4.7%) had no significant change in the tumor diameter. Patients did not have serious complications. ConclusionThe effect of individualized intervention for hepatic cavernous hemangioma with different blood supply is obvious, and it is a safe and effective therapeutic method.
【摘要】 目的 总结原发性乳腺淋巴瘤（primary breast lymphoma，PBL）的临床病理学、免疫组织化学特征、综合治疗及复发情况。 方法 对2010年11月入院手术切除的PBL术后同侧乳头复发的1例患者的临床资料进行回顾分析，病理常规切片及免疫组织化学观察。 结果 光学显微镜检查低倍镜下肿瘤细胞弥漫性浸润破坏乳头组织，导致乳头结构紊乱，肿块乳管结构紊乱；高倍镜下显示瘤细胞成分多样，以中等大小细胞和大细胞为主，肿瘤细胞弥漫侵犯小血管。免疫组织化学结果显示Ki-67（gt;90%），CD20（+），bcl-6（+），MUM1（+），CD43（灶+），CD3（-），CD10（-）。符合恶性非霍奇金淋巴瘤。 结论 PBL是一种少见的结外淋巴瘤，临床表现缺乏特异性，术前很难与乳腺其他良、恶性病变区分，其诊断主要依靠术后病理。目前单纯肿块切除术+放射治疗联合全身化学疗法是治疗PBL临床共识，肿瘤复发可能与Ki-67高度表达存在相关性。【Abstract】 Objective To investigate the clinical pathology, immunohistochemical features, comprehensive treatment, recurrence and prognosis of primary breast lymphoma (PBL). Methods We retrospectively analyzed the clinical data including general information and pathological and immnohistochemical examinations of one patient with recurrent PBL in nipple of the same side after surgery who was admitted into our hospital in November 2010. Results Under low-power optical microscope lens, we found that the tumor cells diffused and infiltrated the nipple tissue which looked quite disorganized. Under high-power lens, we observed various tumor cells, especially the medium-and large-sized tumor cells which infiltrated small vessels. The results of immunohistochemical tests were as follows: Ki-67 (gt;90%), CD20 (+), bcl-6 (+), MUM1 (+), CD43 (nidus+), CD3 (-), and CD10 (-). All these indexes indicated malignant non-Hodgkin’s lymphoma. Conclusions PBL is a kind of extremely rare extra-nodal lymphoma with low-specificity clinical manifestations, and it is hard to distinguish from other mammary abnormalities. Its diagnosis mainly depends on pathological examinations. At present, lumpectomy followed by chemotherapy and radiotherapy is the best treatment method. Its recurrence may be related to the high expression of Ki-67.
ObjectiveTo study the clinical value of digital technology assisted minimally invasive surgery in diagnosis and treatment of hepatolithiasis. MethodsThe image data of 64-slice spiral CT scanning were obtained from five patients of complicated hepatolithiasis and introduced into medical image three-dimensional visualization system (MI-3DVS) for three-dimensional reconstruction. On the basis of the data of three-dimensional reconstruction, minimally invasive surgical planning of preoperation was made to obtain reasonable hepatectomy and cholangiojejunostomy, and then preoperative emulational surgery was carried out to minimize the extent of tissue damage and provide guidance to actual operation. ResultsLiver, biliary system, stone, blood vessel, and epigastric visceral organ were successfully reconstructed by MI-3DVS, which showed clearly size, number, shape, and space distribution of stone, and location, degree, length, and space distribution of biliary stricture, and anatomical relationship of ducts and vessels. The results of three-dimensional reconstruction were successfully confirmed by actual operation, which was in accordance with emulational surgery. There was no operative complication. No retained stone in internal and external bile duct was found by Ttube or other supporting tube cholangiography on one month after operation. ConclusionThree-dimensional digitizing reconstruction and individual emulational surgery have important significance in diagnosis and treatment of complicated hepatolithiasis by minimally invasive technique.