histopathological examination

组织病理学检查
  • 文章类型: Case Reports
    胎盘早剥可能是灾难性事件,与不良的母体和胎儿结局高度相关。我们介绍了一个在妊娠30周时在年轻无症状母亲中发生的大量胎盘早剥的病例。尽管电子胎儿监护和超声检查可以迅速诊断8×5cm胎盘后血肿,胎儿在紧急剖宫产时死亡。胎儿被插管,但无法复苏。胎盘的组织学检查记录了变薄和堆叠的高毛细血管化绒毛,在母体和胎儿两侧均存在透明条纹的情况下,有合胞芽和纤维蛋白样坏死灶。
    Abruptio placenta can be a catastrophic event with a high association with adverse maternal and fetal outcomes. We present a case of massive abruptio placenta occurring in a young asymptomatic mother at 30 weeks\' gestation. Although electronic fetal monitoring and ultrasound allowed a prompt diagnosis of an 8 × 5 cm retroplacental hematoma, the fetus died at the time of emergency cesarean section. The fetus was intubated, but could not be resuscitated. Histologic examination of the placenta documented thinning and stacked hypercapillarized villi, with syncytial buds and foci of fibrinoid necrosis in the presence of hyaline streaks on both the maternal and fetal sides.
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  • 文章类型: Case Reports
    该病例报告介绍了一名64岁的男性,其右侧腰部背阔肌肌内巨大的肌内脂肪瘤。患者出现无痛肿胀,在六年内逐渐增加。磁共振成像(MRI)证实了脂肪瘤的存在,提示手术干预。手术包括细致的解剖和完全切除肿瘤。组织病理学检查证实了诊断。与类似病例的比较分析强调了手术方法的差异以及治疗肌内脂肪瘤的挑战。此病例强调了在软组织质量差异中考虑肌内脂肪瘤的重要性,以及综合管理策略对最佳患者预后的重要性。
    This case report presents a 64-year-old male with a giant intramuscular lipoma on the right lumbar region\'s latissimus dorsi muscle. The patient presented with painless swelling, which gradually increased over six years. Magnetic resonance imaging (MRI) confirmed the presence of the lipoma, prompting surgical intervention. The surgical procedure involved meticulous dissection and complete excision of the tumor. Histopathological examination validated the diagnosis. Comparative analyses with similar cases highlighted variations in surgical approaches and the challenges in managing intramuscular lipomas. This case emphasizes the importance of considering intramuscular lipomas in soft tissue mass differentials and the significance of comprehensive management strategies for optimal patient outcomes.
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  • 文章类型: Case Reports
    脂肪瘤是常见的良性软组织肿瘤,通常表现为无痛,生长缓慢的成熟脂肪组织。然而,在肛周区域很少发生带蒂病变。我们介绍了一个70岁的男性,有20年的无痛史,美容上涉及肛周区域的质量。临床检查和超声检查结果与带蒂脂肪瘤一致。手术切除成功,组织病理学检查证实诊断为脂肪纤维瘤。此病例强调了在肛周肿块的鉴别诊断中考虑脂肪瘤异常表现的重要性。它强调了手术切除对症状性或美容性病变的作用。长期随访对于监测复发和确保最佳患者预后至关重要。
    Lipomas are common benign soft tissue tumors, typically presenting as painless, slow-growing masses of mature adipose tissue. However, their occurrence as pedunculated lesions in the perianal region is rare. We present a case of a 70-year-old male with a 20-year history of a painless, cosmetically concerning mass in the perianal region. Clinical examination and ultrasonographic findings were consistent with a pedunculated lipoma. Surgical excision was performed successfully, and histopathological examination confirmed the diagnosis of lipofibroma. This case highlights the importance of considering unusual presentations of lipomas in the differential diagnosis of perianal masses. It emphasizes the role of surgical excision for symptomatic or cosmetically concerning lesions. Long-term follow-up is essential to monitor for recurrence and ensure optimal patient outcomes.
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  • 文章类型: Case Reports
    子宫内膜腺癌是绝经后妇女中普遍存在的恶性肿瘤,常表现为异常阴道出血和盆腔疼痛等症状。我们介绍了一个60岁的绝经后女性,其表现出异常阴道出血三个月,伴有盆腔疼痛和无意的体重减轻。临床评价,包括体检,影像学检查,和组织病理学检查,导致高分化子宫内膜腺癌的诊断。患者接受了腹部子宫切除术和双侧附件卵巢切除术,组织病理学分析证实浸润性肿瘤累及子宫下段和子宫颈。最终的病理肿瘤,节点,转移(TNM)分期报告为pT1b无Mx,FIGO(国际妇产科联合会)第二阶段。该病例强调了在绝经后出血的鉴别诊断中考虑子宫内膜腺癌的重要性,并强调了及时诊断和多学科管理对优化患者预后的重要性。
    Endometrial adenocarcinoma is a prevalent malignancy among postmenopausal women, often presenting with symptoms such as abnormal vaginal bleeding and pelvic pain. We present a case of a 60-year-old postmenopausal female who exhibited abnormal vaginal bleeding for three months, accompanied by pelvic pain and unintentional weight loss. Clinical evaluation, including physical examination, imaging studies, and histopathological examination, led to the diagnosis of well-differentiated endometrial adenocarcinoma. The patient underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy, and histopathological analysis confirmed invasive tumor involvement in the lower uterine segment and cervix. The final pathological tumor, node, and metastasis (TNM) staging was reported as pT1b No Mx, FIGO (International Federation of Gynecology and Obstetrics) stage II. This case underscores the importance of considering endometrial adenocarcinoma in the differential diagnosis of postmenopausal bleeding and highlights the significance of timely diagnosis and multidisciplinary management for optimizing patient outcomes.
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  • 文章类型: Journal Article
    良性恶性颈淋巴结病(CLA)的术前分化对于确定是否需要手术干预至关重要。本研究旨在评估超声(US)的诊断性能,细针穿刺细胞学(FNAC),以及它们与CLA术后组织病理学诊断的结合。
    在2021年4月至2023年5月的一项回顾性研究中,对214例CLA患者进行了术前US和FNAC评估。形态学参数,包括组织边缘,血管,和脂肪肺门回声,进行回顾性收集和分析。美国的诊断效力,FNAC,并将其联合使用与术后组织病理学结果进行比较。
    在最后的组织病理学检查中,185例(86.4%)为良性,29例(13.6%)被确定为恶性。美国的特点,脂肪的门,回声,血管分布模式在表征CLA模式方面具有最高的诊断准确性,值为88.3%,85.5%,85.0%,分别。受试者工作特征(ROC)曲线显示,联合使用所有US参数的曲线下面积(AUC)值为0.883(95%CI:0.832-0.923;P<0.0001),与单个参数相比,具有更好的灵敏度(93.10%)和特异性(68.65%)。整体灵敏度,特异性,FNAC的准确率为97.3%,82.8%,和95.3%,分别。此外,US参数和FNAC一起显示出明显更高的AUC值0.924(95%CI:0.880-0.956;P<0.0001),并实现了86.21%的灵敏度和88.65%的特异性。
    US和FNAC的结合使用提供了高灵敏度,特异性,以及表征CLA模式的诊断准确性。在有限资源设置中,这种方法是可行的,侵入性较小,并且具有成本效益,从而使明确的管理策略和避免额外的手术干预。
    UNASSIGNED: The preoperative differentiation of benign form malignant cervical lymphadenopathy (CLA) is crucial in determining the need for surgical intervention. This study aims to assess the diagnostic performance of ultrasonography (US), fine-needle aspiration cytology (FNAC), and their combination with the postoperative histopathological diagnoses of CLA.
    UNASSIGNED: In a retrospective study between April 2021 and May 2023, 214 patients with CLA were assessed with preoperative US and FNAC. The morphological parameters, including tissue margins, vascularity, and fatty hilum echogenicity, were collected and analyzed retrospectively. The diagnostic efficacies of US, FNAC, and their combined use were compared to the postoperative histopathological findings.
    UNASSIGNED: In the final histopathological examination, 185 cases (86.4%) were found to be benign, while 29 cases (13.6%) were determined to be malignant. The US features of fatty hilum, echogenicity, and vascularity pattern had the highest diagnostic accuracy in characterizing CLA patterns, with values of 88.3%, 85.5%, and 85.0%, respectively. The receiver operating characteristic (ROC) curve showed a significantly higher area under the curve (AUC) value of 0.883 (95% CI: 0.832-0.923; P<0.0001) for the combined use of all US parameters with better sensitivity (93.10%) and specificity (68.65%) than individual parameters. The overall sensitivity, specificity, and accuracy of FNAC were 97.3%, 82.8%, and 95.3%, respectively. Additionally, US parameters and FNAC together showed a significantly higher AUC value of 0.924 (95% CI: 0.880-0.956; P<0.0001) and achieved a sensitivity of 86.21% and specificity of 88.65%.
    UNASSIGNED: The combined use of US and FNAC provides high sensitivity, specificity, and diagnostic accuracy in characterizing CLA patterns. In limited-resources settings, this approach is feasible, less invasive, and cost-effective, thereby enabling clear management strategies and avoiding additional surgical interventions.
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  • 文章类型: Journal Article
    背景:机械血栓切除术已成为急性缺血性卒中的主要血管内治疗方法。许多研究已经调查了血栓组成与因素之间的关系,例如药物溶栓,卒中病因,机械血栓切除术,和放射成像。然而,有限的研究探讨了血栓成分与临床结局之间的关联.
    方法:这项回顾性分析检查了2020年5月至2023年5月期间50例急性缺血性卒中患者的血栓的组织病理学检查。使用HE染色定量红细胞的比例来评估取回的血栓的组成。白细胞,血小板,和纤维蛋白.根据血栓的主要成分,患者分为富含红细胞和富含纤维蛋白的两组.人口统计,临床特征,回顾性收集美国国立卫生研究院卒中量表(NIHSS)评分和改良Rankin量表(mRS)评分评估的临床结局.
    结果:在50名患者中,23人被归类为红细胞丰富组,和27被归类为富含纤维蛋白组。两组在年龄方面无显著差异,性别,中风亚型,高血压和糖尿病史,血栓位置,NIHSS得分,MRS入学成绩,从症状发作到住院和再灌注的时间间隔,或再灌注成功率。然而,富含红细胞的血栓与从穿刺到再灌注的较短时间间隔有关。大动脉粥样硬化和心脏栓塞之间的红细胞分数和纤维蛋白/血小板分数没有发现显着差异。在90天的随访中,与富含纤维蛋白的血栓患者相比,富含红细胞的血栓患者的NIHSS评分更低,功能结局更有利(mRS评分为0~2).
    结论:富含红细胞的血栓与急性缺血性卒中患者从穿刺到再灌注的较短的时间间隔和良好的临床结局有关。血栓的组成可能会影响血管内治疗的血栓切除策略。
    BACKGROUND: Mechanical thrombectomy has emerged as the primary endovascular treatment for acute ischemic stroke. Numerous studies have investigated the relationship between thrombus composition and factors such as pharmacological thrombolysis, stroke etiology, mechanical thrombectomy, and radiological imaging. However, limited research has explored the association between thrombus composition and clinical outcomes.
    METHODS: This retrospective analysis examined the histopathological examination of thrombi retrieved from 50 patients with acute ischemic stroke between May 2020 and May 2023. The composition of the retrieved thrombi was assessed using HE staining to quantify the proportions of red blood cells, white blood cells, platelets, and fibrin. Based on the predominant composition of the thrombus, the patients were divided into two groups: erythrocyte-rich and fibrin-rich. Demographics, clinical characteristics, and clinical outcomes assessed by the National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin Scale (mRS) scores were collected retrospectively.
    RESULTS: Of the 50 patients, 23 were classified in the erythrocyte-rich group, and 27 were classified in the fibrin-rich group. There were no significant differences between the two groups in terms of age, sex, stroke subtype, history of hypertension and diabetes, thrombus location, NIHSS scores, mRS scores on admission, the time interval from symptom onset to hospitalization and reperfusion, or the rate of successful reperfusion. However, erythrocyte-rich thrombi were associated with a shorter time interval from puncture to reperfusion. No significant differences were found in the red blood cell fraction and fibrin/platelet fraction between large artery atherosclerosis and cardioembolism. At the 90-day follow-up, patients with erythrocyte-rich thrombi exhibited lower NIHSS scores and more favorable functional outcomes (mRS scores of 0-2) compared to those with fibrin-rich thrombi.
    CONCLUSIONS: Erythrocyte-rich thrombi were linked to shorter time intervals from puncture to reperfusion and favorable clinical outcomes in patients with acute ischemic stroke. The composition of the thrombus may influence the thrombectomy strategy for endovascular therapy.
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  • 文章类型: Case Reports
    背景:心脏血管瘤是非常罕见的良性原发肿瘤。它们通常优先位于右心房,而在房间隔中的位置极为罕见。
    方法:我们报告一例41岁因中风入院的患者。经胸超声心动图显示右心房有大量肿块粘附在房间隔上。怀疑是心房粘液瘤,进行了手术干预,确认肿块在房间隔的厚度内延伸,伸入右心房腔.组织学报告证实为血管瘤。
    结论:心脏血管瘤是罕见的原发肿瘤,常被误诊为其他心脏肿瘤。组织病理学检查对于明确诊断至关重要。
    BACKGROUND: Cardiac hemangiomas are very uncommon benign primary tumors. They are usually located preferentially in the right atrium and their location in the interatrial septum is extremely rare.
    METHODS: We report the case of a 41-year-old patient who was admitted due to a stroke. The transthoracic echocardiogram revealed a large mass in the right atrium adhered to the interatrial septum. Suspecting an atrial myxoma, surgical intervention was performed confirming that the mass extended within the thickness of the interatrial septum, protruding into the right atrial cavity. The histologic report confirmed a hemangioma.
    CONCLUSIONS: Cardiac hemangiomas are rare primary tumors and are usually misdiagnosed as other cardiac tumors. Histopathological examination is essential for a definitive diagnosis.
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  • 文章类型: Journal Article
    淋巴血管侵犯(LVI)是前列腺癌(PCa)的关键组织病理学参数,持有显著的预后影响。我们的研究追求双重目标:首先,为了确定与LVI相关的术前因素,旨在揭示在术后检查期间有助于识别易发生LVI的患者的标志物;其次,评估与LVI相关的术后结局。
    我们回顾性分析了861例接受根治性前列腺切除术(RP)的非转移性PCa患者,调查术前因素和术后结果。按照既定的指南处理手术标本。统计分析使用非参数检验来评估LVI与术前和术后因素之间的关联。此外,逻辑回归分析用于开发模型,旨在识别LVI和pN1状态的最重要预测因子,分别。
    许多术前因素与LVI有显著相关性,提供有价值的临床见解。Logistic回归确定基于磁共振成像(MRI)的临床肿瘤分期(cT)3-4,活检Gleason分级组(GGG)3-5,术前前列腺特异性抗原(PSA)≥20和阳性活检核心百分比(PPBC)≥50%是LVI的最强术前预测因子。此外,该研究揭示了LVI与术后结局之间的关联,包括术后PSA(p值<0.001),囊外延伸(ECE)(<0.001),手术切缘阳性(PSM)(<0.001),神经周浸润(PNI)(<0.001),病理肿瘤分期(pT)(<0.001),病理淋巴结状态(pN)(<0.001),术后GGG(<0.001),和手术时间(0.023)。值得注意的是,在单因素分析中,该研究揭示了LVI与pN+患者淋巴结阳性数量增加之间的新的实质性关联(<0.001).此外,我们在逻辑回归分析中发现LVI和pN1状态之间存在关联(比值比[OR]=23.905;p<0.001).
    我们的发现强调了LVI在影响前列腺癌(PCa)预后中的关键作用。该研究承认与术前LVI评估相关的挑战,并强调未来研究需要揭示与这一组织病理学发现相关的因素。重要的是,我们的研究是第一个,据我们所知,揭示pN+患者LVI与阳性淋巴结数量之间的关联。
    UNASSIGNED: Lymphovascular invasion (LVI) is a pivotal histopathological parameter in prostate cancer (PCa), holding significant prognostic implications. Our study pursued a dual objective: firstly, to identify preoperative factors associated with LVI, aiming to unveil markers facilitating the recognition of patients prone to LVI during postoperative examination; and secondly, to assess postoperative outcomes correlated with LVI.
    UNASSIGNED: We retrospectively analyzed 861 nonmetastatic PCa patients who underwent radical prostatectomy (RP), investigating preoperative factors and postoperative outcomes. Surgical specimens were processed following established guidelines. Statistical analyses utilized non-parametric tests to assess the association between LVI and both pre- and postoperative factors. Furthermore, logistic regression analyses were utilized to develop models aimed at identifying the most significant predictors of LVI and pN1 status, respectively.
    UNASSIGNED: Numerous preoperative factors exhibited significant correlations with LVI, offering valuable clinical insights. Logistic regression identified magnetic resonance imaging (MRI)-based clinical tumor stage (cT) 3-4, biopsy Gleason Grading Group (GGG) 3-5, preoperative prostate specific antigen (PSA) ≥20 and percentage of positive biopsy cores (PPBC) ≥50% as the strongest preoperative predictors of LVI. Additionally, the study uncovered an association between LVI and postoperative outcomes, including postoperative PSA (p value <0.001), extracapsular extension (ECE) (<0.001), positive surgical margins (PSM) (<0.001), perineural invasion (PNI) (<0.001), pathological tumor stage (pT) (<0.001), pathological lymph node status (pN) (<0.001), postoperative GGG (<0.001), and operative time (0.023). Notably, the study revealed a novel and substantial association between LVI and an increased number of positive lymph nodes in pN+ patients in the univariate analysis (<0.001). Furthermore, we have found an association between LVI and pN1 status in the logistic regression analysis (odds ratio [OR] = 23.905; p <0.001).
    UNASSIGNED: Our findings underscore the pivotal role of LVI in influencing the prognosis of prostate cancer (PCa). The study acknowledges the challenges associated with preoperative LVI assessment and emphasizes the need for future research to unravel the factors associated with this histopathological finding. Significantly, our research stands out as the first, to the best of our knowledge, to reveal the association between LVI and the number of positive lymph nodes in pN+ patients.
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  • 文章类型: Journal Article
    背景头颈部肿瘤的发病率正在上升。术中冰冻切片的使用在评估口腔鳞状细胞癌手术患者的切缘状态中起着至关重要的作用。阴性切缘不仅是手术成功的指征,而且还可以减少疾病的复发并提高患者的总体生存率。目的和目的本研究的目的是通过术中冷冻切片评估口腔鳞状细胞癌手术患者切缘的准确性,并将其与常规组织病理学检查进行比较。方法我们的研究方法是对28例诊断为口腔鳞状细胞癌的患者进行的基于医院的前瞻性研究。对所有接受手术的患者进行冷冻切片,并与组织病理学检查进行比较。结果28例手术患者中,男性的发病率高于女性,比例为6:1。肿瘤最常见的部位是左颊粘膜,占28.57%,其次是龈沟占17.85%。在我们的研究中,冻结评估边缘显示58.33%的敏感度,特异性98.76%,和95.25%的准确性。结论冷冻切开术是确认切缘准确性的可靠方法,从而减少了再次手术和疾病复发的机会,并提高了患者的总体生存率。
    Background The incidence of head and neck carcinoma is increasing. The use of an intraoperative frozen section plays a vital role in the evaluation of margin status in patients undergoing surgery for oral squamous cell carcinoma. A negative margin is not only an indication of successful surgery but also decreases the recurrence of disease and improves the overall survival of patients. Aims and objective The aim of this study is to assess the accuracy of margin in patients undergoing surgery for oral squamous cell carcinoma by intraoperative frozen section and compare it with conventional histopathological examination. Methodology The approach of our study was a hospital-based prospective study conducted on 28 patients diagnosed with oral squamous cell carcinoma. A frozen section was done on all patients undergoing surgery and compared with histopathological examination. Results Out of 28 patients undergoing surgery, the incidence of males was more than females, with a ratio of 6:1. The most common site of the tumor was left buccal mucosa comprising 28.57%, followed by gingivobuccal sulcus comprising 17.85%. In our study, the frozen assessed margin showed a sensitivity of 58.33%, specificity of 98.76%, and accuracy of 95.25%. Conclusion Frozen section is a reliable method for confirmation of margin accuracy and thus reduces the chance of re-surgery and recurrence of disease and increases overall patient survival.
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  • 文章类型: Case Reports
    神经节神经瘤是一种罕见的良性神经母细胞瘤,起源于周围神经系统的交感神经节细胞。它通常是在成像研究期间偶然发现的,主要影响儿童和年轻人。
    方法:我们介绍一例21岁女性非霍奇金淋巴瘤患者,在影像学检查中偶然发现腹部肿块,最初在初次诊断的情况下被误认为是淋巴瘤。淋巴瘤化疗后,群众对治疗没有反应,所以手术切除了肿块,组织病理学检查证实了节细胞神经瘤的诊断。患者对淋巴瘤的治疗反应良好,并且保持良好状态,没有复发的迹象。
    据我们所知,这是第一例描述腹内节细胞神经瘤与非霍奇金淋巴瘤之间的关联的病例.
    结论:该病例强调了在评估淋巴瘤患者腹部肿块时,将神经节细胞神经瘤作为鉴别诊断的重要性。
    UNASSIGNED: Ganglioneuroma is a rare benign neuroblastic tumor originating from sympathetic ganglion cells in the peripheral nervous system. It is often incidentally discovered during imaging studies and primarily affects children and young adults.
    METHODS: We present a case report of a 21-year-old female diagnosed with non-Hodgkin lymphoma who had an abdominal mass incidentally detected during imaging, Initially mistaken for lymphoma in the setting of the primary diagnose. After the chemotherapy for the lymphoma, the mass did not response to the treatment, so the mass was surgically excised, and histopathological examination confirmed the diagnosis of ganglioneuroma. The patient responded well to treatment for lymphoma and remains in good condition without signs of recurrence.
    UNASSIGNED: To the best of our knowledge, this is the first case that describes an association between an intraabdominal ganglioneuroma and non-Hodgkin\'s lymphoma.
    CONCLUSIONS: This case highlights the importance of considering ganglioneuroma as a differential diagnosis when evaluating abdominal masses in patients with lymphoma.
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