Angioleiomyoma

血管平滑肌瘤
  • 文章类型: Journal Article
    背景:血管平滑肌瘤,由平滑肌细胞和厚壁血管组成的良性肿瘤,预计在女性生殖道中非常罕见。本研究旨在描述女性生殖道血管平滑肌瘤的临床病理特征和治疗结果。
    方法:回顾性分析2008年7月至2023年10月在中南大学湘雅三医院治疗的89例生殖道血管平滑肌瘤患者。症状缓解率是该研究的主要结果。
    结果:血管平滑肌瘤占女性生殖道平滑肌瘤的0.6%。89名妇女的平均年龄为41.8±8.7岁。70名妇女(78.7%)有子宫手术史,其中两名患者通过腹腔镜子宫肌瘤切除术切除了子宫血管肌瘤。61例(68.5%)女性血管平滑肌瘤位于子宫体,17(19.1%)在阔韧带,宫颈10(11.2%),阴道仅1(1.1%)。异常子宫出血是位于子宫体或子宫颈的血管平滑肌瘤的主要临床表现,而宽韧带血管平滑肌瘤的主要临床表现是盆腔肿块。89名女性中,59人接受了保留子宫的手术,30例接受了全子宫切除术或次全子宫切除术。6名妇女的术中失血量超过500ml(700-4,500ml)。术后症状缓解率为100%。在59名子宫保留的妇女中,8在随访期间显示多发性子宫平滑肌瘤,但是很难确定它们是否是血管平滑肌瘤。一名接受全子宫切除术的妇女血管平滑肌瘤复发。
    结论:血管平滑肌瘤在女性生殖道罕见,患者可能会出现不同的症状,这与肿瘤的位置有关。子宫切除术和子宫肌瘤切除术都是有效的治疗方法,但是对于多发病变和直径较大的病变,应认识到术中出血的风险.一些患者可能出现复发。
    BACKGROUND: Angioleiomyoma, a benign tumour composed of smooth muscle cells and thick-walled vessels, is expected to be very rare in the female genital tract. This study aimed to describe the clinicopathological features and treatment outcomes of angioleiomyoma in the female genital tract.
    METHODS: We retrospectively reviewed 89 women with angioleiomyoma in the genital tract who were treated at Third Xiangya Hospital of Central South University between July 2008 and October 2023. Symptom remission rate was the primary outcome of the study.
    RESULTS: Angioleiomyomas accounted for 0.6% of leiomyomas of the female genital tract. The average age of the 89 women was 41.8 ± 8.7 years. Seventy women (78.7%) had a history of uterine surgery, of whom two patients had removed uterine angioleiomyoma by laparoscopic myomectomy. The angioleiomyomas of 61 (68.5%) women were located in the uterine corpus, 17 (19.1%) in the broad ligament, 10 (11.2%) in the cervix and only 1 (1.1%) in the vagina. Abnormal uterine bleeding was the main clinical manifestation of angioleiomyomas located in the uterine corpus or cervix, whereas the main clinical manifestation of angioleiomyomas in the broad ligaments was pelvic mass. Of the 89 women, 59 underwent surgery to preserve the uterus, and 30 underwent total hysterectomy or subtotal hysterectomy. The intraoperative blood loss was more than 500 ml (700-4,500 ml) in six women. The symptom remission rate was 100% after surgery. Among the 59 women with preserved uterus, 8 showed multiple uterine leiomyomas during follow-up, but it was difficult to determine whether they were angioleiomyomas. Angioleiomyomas recurred in one women who underwent total hysterectomy.
    CONCLUSIONS: Angioleiomyoma is rare in the female reproductive tract, and patients may present with diverse symptoms, which are related to the location of the tumour. Hysterectomy and myomectomy are both effective treatment methods, but the risk of intraoperative bleeding should be recognised for multiple lesions and those with large diameters. Relapse may occur in some patients.
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  • 文章类型: Journal Article
    血管平滑肌瘤(ALM)是一种以血管和平滑肌细胞为特征的良性肿瘤,通常位于皮下或深层真皮层内。它在翼腭窝的表现很少见,从而在其诊断和与同一解剖部位内的其他良性肿瘤区分方面存在困难。在本案例研究中,我们对一名44岁女性患者右侧翼腭窝的ALM进行了调查.患者接受了血管平滑肌瘤的手术干预,并且在术后监测期间没有发现复发。
    Angioleiomyoma (ALM) is a benign neoplasm marked by the presence of blood vessels and smooth muscle cells, commonly located within the subcutaneous or deep dermal layers. Its manifestation in the pterygopalatine fossa is infrequent, thereby posing difficulties in its diagnosis and distinction from other benign tumors within the same anatomical site. In the present case study, an ALM originating in the right pterygopalatine fossa of a 44-year-old female patient was investigated. The patient underwent surgical intervention for the vascular smooth muscle tumor, and there has been no recurrence noted during the postoperative monitoring period.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    血管平滑肌瘤是一种具有良性生物学行为的周细胞肿瘤。它通常以血管周围成熟的血管周围平滑肌细胞增殖为特征。血管平滑肌瘤可分为实性,海绵状或静脉亚型。通常,它发生在真皮或皮下组织中,而罕见的海绵状亚型在上肢最常见。迄今为止,仅报道了位于纵隔的少数血管平滑肌瘤病例。此外,有描述为海绵状组织病理学亚型的纵隔血管平滑肌瘤的报道很少。本研究报告了一例纵隔血管平滑肌瘤,表现为不寻常的海绵状组织病理学亚型。组织病理学和免疫组织化学特征,据此诊断为海绵状血管平滑肌瘤,梭形肿瘤细胞中的脱肌动蛋白和平滑肌肌动蛋白阳性表达,以及ETS相关基因(ERG)和CD31在血管内皮细胞中的阳性表达。纵隔的海绵状血管平滑肌瘤在临床上很少发生,但应视为纵隔肿瘤的鉴别诊断。
    Angioleiomyoma is a type of pericyte tumor with a benign biological behavior. It typically features proliferation of mature perivascular smooth muscle cells around blood vessels. Angioleiomyoma may be categorized into solid, cavernous or venous subtypes. Usually, it occurs in the dermis or subcutaneous tissue, while the rare cavernous subtype is most common in the upper extremities. Only a small number of cases of angioleiomyoma located in the mediastinum have been reported to date. In addition, there are few reports of mediastinal angioleiomyoma described as a cavernous histopathological subtype. The present study reported a case of mediastinal angioleiomyoma presenting as an unusual cavernous histopathological subtype. The histopathological and immunohistochemical features, based on which a diagnosis of cavernous angioleiomyoma was confirmed, were desmin- and smooth muscle actin-positive expression in spindle tumor cells, as well as ETS-related gene (ERG)- and CD31-positive expression in vascular endothelial cells. Cavernous angioleiomyoma of the mediastinum rarely occurs in the clinical setting but should be considered as a differential diagnosis of mediastinal tumors.
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  • 文章类型: Journal Article
    我们描述了一个喉血管平滑肌瘤的病例,讨论其特点和管理,并提供文献综述,提高临床诊断和治疗水平。我们报告了迄今为止年龄最大的喉血管平滑肌瘤患者,并分析了文献中报道的临床病理特征。据我们所知,英文和中文医学文献中描述了总共36例病例(包括我们的病例).男女比例为5:1,平均年龄为53.89岁。最常见的喉部部位是声门上区(23例;63.89%),其次是声门下区(8例;22.22%),声门5例(13.89%)。最常见和严重的术中和术后并发症是大出血。血管平滑肌瘤是一种良性肿瘤,很少发生在喉部。不应进行该病变的活检;完整的手术切除是最好的治疗方法。复发和恶性转化极为罕见。
    We describe a case of laryngeal angioleiomyoma, discuss its characteristic features and management, and provide a review of the literature, to improve clinical diagnosis and treatment. We report the oldest patient with a laryngeal angioleiomyoma to date and analyze the clinicopathological features reported in the literature. To the best of our knowledge, a total of 36 cases have been described in the English and Chinese medical literature (including our case). The male-to-female ratio was 5:1 and the mean age was 53.89 years. The most common laryngeal site was the supraglottic region (23 cases; 63.89%), followed by the subglottic region (8 cases; 22.22%), and glottis (5 cases; 13.89%). The most common and serious intra- and postoperative complication was massive bleeding. Angioleiomyoma is a benign tumor that rarely occurs in the larynx. Biopsy of this lesion should not be performed; complete surgical resection is the best treatment. Recurrence and malignant transformation are extremely rare.
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  • 文章类型: Journal Article
    背景:格林-巴利综合征(GBS)是外周神经系统中常见的自身免疫性疾病。本研究旨在阐明IL-27基因多态性在老年人GBS中的作用。
    方法:共纳入395名健康受试者和422名GBS患者,平均年龄为63岁。收集外周血样品。IL-27的2个单核苷酸多态性(SNP),即使用PCR方法分析GBS患者的rs153109和rs785575,并与健康对照进行比较。IL-27SNP与疾病严重程度的相关性,疾病结果,抗GM1抗体水平,评估空肠弯曲杆菌感染。使用酶联免疫吸附试验分析健康受试者和GBS患者的血清IL-27水平。
    结果:在GBS和健康受试者之间没有观察到rs785575SNP频率的显着差异。在分析rs153109SNP时,发现G等位基因在GBS患者中更为普遍(p=0.012).更多的等位基因在GBS患者中显示GG基因型(p=0.023)。-964A>G等位基因在严重受影响的和抗GM1-Ab阳性的GBS患者中具有较高的患病率。具有rs153109SNP的GBS患者的临床结果比没有rs153109SNP的患者差(p=0.012)。GBS患者的血清IL-27水平高于健康受试者(p<0.001)。IL-27水平在GBS患者中也较高,基因型为AG和GG,GG基因型的IL-27水平最高。
    结论:rs153109SNP在具有GG和G等位基因的GBS患者中更为普遍,并且与严重的GBS相关,较差的临床结果,和更高的IL-27水平。
    BACKGROUND: Guillain-Barré syndrome (GBS) is a common autoimmune disease in the peripheral nervous system. This study aimed to elucidate the role of IL-27 gene polymorphisms in elderly people with GBS.
    METHODS: A total of 395 healthy subjects and 422 GBS patients with an average age of 63 years old were included in this study. Peripheral blood samples were collected. The 2 single-nucleotide polymorphisms (SNPs) of IL-27, namely, rs153109 and rs785575, of GBS patients were analyzed using the PCR method and compared with those of the healthy controls. The correlations of IL-27 SNPs with disease severity, disease outcome, level of anti-GM1 antibodies, and Campylobacter jejuni infection were assessed. Serum levels of IL-27 of healthy subjects and GBS patients were analyzed using enzyme-linked immunosorbent assay.
    RESULTS: No significant differences in the frequencies of rs785575 SNPs between GBS and healthy subjects were observed. In analyzing rs153109 SNPs, the G allele was found to be more prevalent in the GBS patients (p = 0.012). More alleles show GG genotype in GBS patients (p = 0.023). The -964A>G allele has a higher prevalence in severely affected and anti-GM1-Ab-positive GBS patients. GBS patients with the rs153109 SNP showed a poor clinical outcome than those without rs153109 SNP (p = 0.012). GBS patients showed higher serum IL-27 levels than healthy subjects (p < 0.001). The levels of IL-27 were also higher in GBS patients with genotypes of AG and GG, and those with GG genotypes showed the highest IL-27 levels.
    CONCLUSIONS: The rs153109 SNP is more prevalent in GBS patients with the GG and G allele and is associated with severer GBS, poorer clinical outcomes, and higher IL-27 levels.
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  • 文章类型: Case Reports
    血管平滑肌瘤是一种孤立的平滑肌细胞肿瘤,起源于动脉和静脉的膜介质。它起源于骶骨是罕见的,迄今为止,文献中只记录了一个案例,但是骨骼破坏的病例更罕见。我们介绍了一个49岁的女性腰骶部疼痛,步态不稳定和右下肢疼痛持续两年,伴有辐射疼痛。通过普通电影,计算机断层扫描(CT)和磁共振成像(MRI)检查,我们诊断为巨大骶骨神经鞘瘤(GSS)。手术后,经病理证实为血管平滑肌瘤。血管平滑肌瘤的诊断不应仅基于影像学。它需要结合免疫染色的组织病理学检查。应作为骶骨肿瘤的鉴别诊断之一。
    Angioleiomyoma is a solitary smooth muscle cell tumor that originates from the tunical media of arteries and veins. Its origin in the sacrum is rare, only one case has been recorded in the literature to date, but cases with bone destruction are even rarer. We present a 49-year-old woman with lumbosacral pain, unsteady gait and right lower extremity pain for two years, accompanied by radiation pain. Through plain film, Computerized tomography (CT) and Magnetic resonance imaging (MRI) examination, we diagnosed this case as giant sacral schwannoma(GSS). After an operation, it was pathologically confirmed as angioleiomyoma. The diagnosis of angioleiomyoma should not be based on imaging alone. It requires histopathological examination combined with immunostaining. It should be considered as one of the differential diagnosis of sacral tumors.
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  • 文章类型: Journal Article
    原发性颅内血管平滑肌瘤(ALM)非常罕见,青少年的ALM甚至更罕见。迄今为止,仅报告了三例青少年病例。
    我们仔细介绍了青少年颅内ALM的新位置。临床,本文对颅内ALM的病理和影像学特征进行了详细的描述,并对已发表的文献进行了综述。
    据我们所知,我们介绍了青少年的第四例原发性颅内ALM和右额颅底的第一个ALM,颅内和颅外连通。我们不仅总结了ALM的一般性,而且说明了成人和青少年ALM在性别和年龄优势方面的差异,病因学,常见的位置和病理亚型。
    我们报道了一个预后良好的青少年的右额叶颅底的第一个ALM,颅内和颅外连通。我们还总结了ALM的一般性,并说明了成人和青少年ALM之间的差异。成人和青少年ALM都需要对大型患者队列进行对照研究的未来调查,以比较它们之间的差异。
    UNASSIGNED: Primary intracranial angioleiomyoma (ALM) is quite rare and ALM of the adolescent is even rarer. To date, only three cases of adolescents have been reported.
    UNASSIGNED: We carefully introduced a new location of intracranial ALM in an adolescent. The clinical, pathological and imaging features of intracranial ALM were described in detail and published literature was reviewed.
    UNASSIGNED: To our best knowledge, we presented the fourth primary intracranial ALM of adolescent and the first ALM of the right frontal cranial base with intracranial and extracranial communication. We not only summarize the generalities of ALM but also illustrate the difference between adult and adolescent ALM in the aspects of gender and age predominance, etiology, common location and pathologic subtype.
    UNASSIGNED: We reported the first ALM of the right frontal cranial base with intracranial and extracranial communication of an adolescent with a good prognosis. We also summarize the generalities of ALM and illustrate the difference between adult and adolescent ALM. Future investigation of control study with large patient cohorts is needed for both adult and adolescent ALM to compare the difference between them.
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  • 文章类型: Case Reports
    背景:肺动脉血管平滑肌瘤在文献中很少见,很少有研究报道。在这里,我们介绍了一例罕见的年轻患者由肺动脉引起的血管平滑肌瘤。
    方法:一名27岁的男性患者因偶然发现肺下叶的结节而出现在我们的诊所,与上一年相比没有变化。术前CT扫描显示,右前基底动脉(RA8b)的基底分支穿透了一个界限清晰的软组织密度结节。在术前三维重建的指导下进行单端口视频辅助RS8节段切除术,以对肿瘤进行组织学确认。肿瘤表现为具有血管内皮的管状结构的实体瘤,由梭形平滑肌细胞组成,缺乏核异型和均匀的红色染料物质。梭形细胞对平滑肌肌动蛋白(SMA)的免疫染色呈阳性,结蛋白和Ki-67,对Dog-1,HMB45和Melan-A的免疫染色均为阴性。最终对肺动脉原发性血管平滑肌瘤进行了病理诊断。
    结论:该报告提醒胸外科医师,血管平滑肌瘤应包括在肺肿瘤的鉴别诊断中。特别是CT显示的肺血管穿透的软组织密度肿块。对这种罕见实体的认识可能会防止诊断不足和手术治疗不当。
    BACKGROUND: Angioleiomyoma of the pulmonary artery is rare in the literature and few studies have been reported. Here we present a rare case of angioleiomyoma arising from the pulmonary artery in a young patient.
    METHODS: A 27-year-old male patient presented to our clinic due to the incidental finding of a nodule in the right lower lobe of the lung, which was unchanged from the prior year. Preoperative CT scans showed a well-demarcated nodule of soft tissue density penetrated by the basal branch of the right anterior basilar artery (RA8b). Single-port video-assisted RS8 segmentectomy was performed under the guidance of preoperative 3-dimensional reconstruction for histologic confirmation of the tumour. The tumour appeared as a solid tumour of a tube-like structure with vascular endothelium, composed of spindle-shaped smooth muscle cells lacking nuclear atypia and homogenous red-dye substances. The spindle cells were positive for immunostaining for smooth muscle actin (SMA), desmin and Ki-67 and were negative for immunostaining for Dog-1, HMB45, and Melan-A. A pathological diagnosis of primary angioleiomyoma of the pulmonary artery was finally made.
    CONCLUSIONS: This report is a reminder for thoracic surgeons that angioleiomyoma should be included in the differential diagnosis of lung neoplasms, especially for the mass of soft tissue density penetrated by pulmonary blood vessels shown by CT. Awareness of this rare entity should potentially prevent underdiagnosis and improper surgical treatment.
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