肋骨纤维结构不良误诊为软骨瘤

【病例】男,75岁。因发现右前胸局部隆起无痛性包块2年余,增大半年入院。患者2年前无明显诱因右胸部出现一直径2cm肿块并逐渐增大,近半年增大至直径5cm,病程中无发热、胸闷、呼吸困难、咳嗽、咳痰、咯血,无心悸、体重减轻。平素体健,有烟酒嗜好,无家族遗传病史。查体：一般情况尚好。心、肺及腹部检查未见异常。     

皮肤瘢痕样恶性纤维组织细胞瘤1例报告并文献复习

目的：探讨皮肤瘢痕样恶性纤维组织细胞瘤（malignant fibrous histiocytoma,MFH）的诊断、误诊原因及预防对策。方法：收集1例皮肤瘢痕样MFH的临床资料,光镜和免疫组化观察并复习文献。结果：组织形态学与“席纹状（storiform）”多形性MFH相同。随访15个月因广泛转移而死亡,第一次会诊结果为非典型纤维组织细胞瘤（Atypical fibrous histiocytoma,AFH）,经第二次会诊和后来的病理读片会确诊为皮肤MFH。结论：皮肤瘢痕样MFH非常罕见,临床更凶险,生存期更短。误诊的主要原因是对本病认识不够和鉴别不仔细。     

骨内恶性化学感受器瘤

作者报告３例骨内发生的恶性化学感受器瘤（恶性化感瘤），均发生在股骨内。临床有疼痛，功能障碍，病理性骨折。Ｘ线表现为囊样透亮含淡条影状的骨质破坏区，骨皮质膨胀变薄呈蛋壳状，无骨膜反应及钙化征象。光镜下瘤细胞呈实性巢索状腺泡样或称“器官样”排列，腺泡间由闭锁或扩张成血窦的薄壁血管和少量纤维组织包绕。嗜银染色瘤细胞均在纤维膜外，瘤细胞不产生网状纤维。随访３例于术后１２、１３、１５个月均因广泛转移而死亡。骨内化感瘤虽有细胞分化高低之分，但其生物学行为均表现为恶性。     

原发性胃恶性淋巴瘤的误诊

原发性胃恶性淋巴瘤占胃恶性肿瘤的0.5%～7.6%,由于病史和症状缺乏特殊性,临床诊断十分困难。本文28例术前只确诊1例、怀疑1例,临床误诊率高达92.9%,为吸取教训,对其临床特点和误诊原因加以分析。临床资料本组男15例,女13例。年龄19～66岁,平均38.5岁。出现症状至就诊时间为10天～30     

左下肢大静脉内平滑肌肉瘤1例临床病理观察

Objective To investigate the clinical sings and the pathological diagnosis and the histogenesis of the leiomyosarcoma in the intravenous of great saphenous and profundae femoris. Methods The clinical angiograph and omentopexy grafting and oncotomy were perford. The clinical angiograph and omentopexy grafting and oncotomy were perford. The pathology samples were sectioned routine paraffin and stained with HE, Masson and the immunohistochomical method (ABC) Desmin, Actin ( Smooth muscle) staining and observed with light microscope. Results Obliterdtion of venae profundae femoris was manifest in both time with angiograph. The dilation inflexion venae was finded which clinic operation of for the first time and the tumor situated above, in the great saphenous vein and venae profundae femoris, benind the intravascu of entrance was finded clinic operation of for the second time. The histosections was manifested tumor, consisting of nucleus heterotyical stickal of the spindle cell and discovery pathological karyokinesis nuclear division. Histochemical staining Masson of cytoplasm is erythroid and the immunohistochemical method (ABC) staining Desmin, Actin ( Smooth muscle) were positive. Pathological diagnosis and consultation results were dignosed leiomyosarcoma in the great saphenous vein and venae profundae femoris. Conclusion The leiomyosarcoma is rare in the venae profundae femoris and great saphenous vein genesis at a time. The tumors was generated angitis and thrombosis latter in the clinicopathologic process manifestation.     

心脏韦格纳肉芽肿1例临床病理观察

To investigates the clinical sings and the pathology morphologic changes of the heart tissue of a case with the cardiac Wegener‘ s granulomatosis. Methods The clinical with was examined ECG and laboratory. The pathology samples were sectioned routine paraffin and stained with HE、PAS、AB-PAS and cellulose staining and observed with light microscope. Results The ECG was manifested acute myocardial infarction in the left lateral wall and the blood examination were of the heart, and the blood examination were manifested lift pedigree ferment of myocardium. The pathology sections were manifested necrosis large area perforation wall of the myocardial and became granuloma diffusible. Endocarditis, necrotic vesselitis and thrombus could be found and that the coronary is not embolism. Similar lesions could be found and alike to the heart in the left lung parenchyma and the peripheral zone of trachea and blood vessel. Histochemical examination with PAS and AB-PAS showed cryptococcus negative in the heart and lungs. Cellulose staining was positive reaction in the vascular wall. Antineutrophil cytoplasmic antibody (ANCA) was negative in the blood from the heart. Conclusion Cardiac Wegener‘s granulomatosis is rare. Clinical sings the ever so similar to acute myocardial infarction and that is not all but differentiation and prognosis and unfavorable of the ever cuch.     

T淋巴母细胞性淋巴瘤胸水漏诊1例分析

对T淋巴母细胞性淋巴瘤胸水漏诊1例分析如下。     

第四腰椎骨巨细胞瘤1例

第四腰椎骨巨细胞瘤１例李国建，高罗玉，姚庆端患者，女性，２９岁。因腰痛３月余，伴双下肢麻木，无力，逐渐加重。无外伤及其它病史。体检：脊柱无畸形，皮肤无红肿，活动受限，腰四棘突及左右椎旁压痛明显。无双下肢放射痛，双下肢股前侧皮肤浅感觉减退，深感觉正常。...     

血清肝纤维化指标与肝脏病理改变的关系

近几年来一些反映肝纤维化的血清指标相继应用于临床。本文分析了血清透明质酸（HA）、层粘蛋白（LN）、Ⅳ型前胶原（Ⅳ-C）、Ⅲ型前胶原肽（PⅢC）等血清肝纤维指标与肝组织病理学改变的关系,以进一步评价它们对肝纤维化中的诊断价值。