ObjectiveTo summarize the clinicopathological features of microencapsulated/reticular schwannoma.MethodsTwo cases of microencapsulated/reticular schwannoma treated in West China Hospital of Sichuan University were retrospectively collected. The histological and immunohistochemical features were summarized, and the related literatures were reviewed.ResultsTwo cases of microcystic/reticular neurilemmoma diagnosed and treated in West China Hospital of Sichuan University were male. The clinical manifestations were “dull pain in the right lower abdomen” and “mass of left index finger”. Microscopically, the characteristic reticular or cribriform structures were found in all cases, and lymphocytic sheath was seen in 1 case. Immunohistochemical staining showed S-100, glial fibrillary acidic protein (GFAP) and calretinin positive. By February 2020, only 41 cases were reported in the literatures （there were no cases of this group),there was no significant gender difference, the median age was 55 years (11–93 years), and the median size of the lesion was 2.1 cm (0.4–13.0 cm). Most of them were found by accident, without obvious symptoms and signs, and no history of neurofibromatosis type 1 or 2. Microencapsulated/reticular schwannoma in this patients mainly occurs in the viscera, especially in the gastrointestinal tract (mostly in the the colorectal of lower gastrointestinal tract ), most of them were solitary nodular masses without capsule. Microscopically, the boundary was clear, and the characteristic microcapsules and reticular structures were seen. The tumor cells were diffusely expressing S-100 protein, and GFAP and calretinin were expressed in varying degrees. Electron microscopy showed the characteristics of Schwann cells.ConclusionsMicrocystic/reticular schwannoma is a rare subtype of schwannoma, which needs to be differ-entiated from multiple benign and malignant neoplasms. The diagnosis of the tumor is a challenge for the pathologist.
Objective To summarize the research progress in the diagnosis and treatment of pancreatic cystic neoplasms (PCNs). Method The guidelines and literatures related to the diagnosis and treatment of PCNs were collected and reviewed. Results At present, there was still no clear method to distinguish the types of PCNs and their benign and malignant, and there was still a dispute between domestic and foreign guidelines on the diagnosis and treatment of PCNs. Conclusion Clinical researchers still need to carry out more research, provide higher quality evidence, resolve the disputes existing in different guidelines, standardize the diagnosis and treatment process of PCNs, thus, PCNs can be identified early, diagnosed accurately and intervened in time.
ObjectiveTo investigate diagnosis and treatment of rupture of pancreatic cystic disease. MethodThe clinical data of 20 patients who were diagnosed as pancreatic cystic disease combined with rupture in the First Affiliated Hospital of Harbin Medical University from June 2011 to December 2015 were analyzed retrospectively. Results① For the 5 patients with pancreatic cystic tumor, 3 patients of them received distal pancreatectomy and 2 patients of them received Whipple procedure. For the 15 patients with pancreatic pseudocyst, 2 patients received ultrasound-guided cyst puncture and drainage, 2 patients received endoscopic retrograde pancreatic drainage (ERPD), 2 patients received ERPD plus ultrasound-guided cyst puncture and drainage, 1 patient received pancreatic external drainage, 3 patients received pancreatic cyst-gastric anastomosis, 5 patients received pancreatic cyst-jejunal Roux-en-Y anastomosis. ② Pancreatic fistula occurred in 3 patients (Grade A 2 cases, Grade B 1 case), delayed gastric emptying was found in 1 patient, peritoneal effusion occurred in 1 patient. ③ Eighteen of them were followed up from 3 to 60 months with an average 25.6 months, 2 patients recurred and non-surgical treatments were taken. ConclusionsHow to correctly identify pancreatic cystic tumor with pancreatic pseudocyst is premise of treatment. Pancreatic cystic disease combined with rupture requires urgent therapy. Based on clinical manifestations, optimal selection might achieve a better prognosis.
ObjectiveTo review the current clinical application of Beger procedure and Frey procedure for benign disease or low-grade malignant potential lesion of pancreas. MethodsRelevant literatures about current advance of clinical application of Beger procedure and Frey procedure published recently of domestic and abroad were collected and reviewed. ResultsWith the concept of organ-preserving operations was adopted in recent years, Beger procedure and Frey procedure were applied generally. Beger procedure and Frey procedure were associated with tolerable perioperative risk, postoperative complications, and good outcomes in the aspects of preservation of function and curability in these lesions compared to conventional pancreatectomy, with preservation of the physiological food passage, thus patients gained weight faster, had less pain, and demonstrated better exocrine and endocrine pancreatic function postoperatively and an improvement in the quality of life. Both procedures had reached an international position as a standard operation for the treatment of benign disease or low-grade malignant potential lesion of pancreas. But after long-term following-up early advantages were no longer present. ConclusionsBeger procedure and Frey procedure are safe and effective in providing good outcomes in the aspects of preservation of function and curability in benign disease or low-grade malignant potential lesion of pancreas. Organ-preserving pancreatectomy could become a new organ-preserving standard operation.
目的 探討胰腺囊性腫瘤的診斷及外科治療方法。方法 對我院2003年4月至2012年4月期間收治的19例胰腺囊性腫瘤患者的臨床資料進行回顧性分析。結果 本組19例患者中漿液性囊腺瘤8例，黏液性囊腺瘤5例，導管內乳頭狀黏液瘤4例，實性假乳頭狀瘤1例，囊腺癌1例。行B超或CT發現胰腺占位病變。位于胰頭部5例，胰體部8例，胰尾部6例。行腫瘤摘除術4例，保留脾臟的胰體尾切除術5例，胰體尾＋脾臟切除手術3例，胰十二指腸切除術6例，1例囊腺癌患者因肝臟轉移伴腹腔廣泛轉移、侵犯大血管而腫瘤不能切除僅行胃空腸、膽腸吻合。術后發生胰瘺2例，腹腔感染1例，經保守治療后康復出院。無圍手術期死亡病例。19例患者均進行了隨訪，隨訪時間6～80個月，平均45.2個月。1例囊腺癌合并肝臟轉移患者于術后7個月死亡，其余良性腫瘤患者均未見復發，最長已存活5年。結論 胰腺囊性腫瘤主要靠影像學檢查發現，手術切除是理想的治療方法，選擇合適的術式有助于避免術后并發癥的發生和改善預后。
目的 總結穿刺抽液及無水乙醇局部注射在老年良性甲狀腺囊性疾病患者中的應用方法及效果。方法 回顧性分析2008年1月至2011年6月期間在我院行穿刺抽液及無水乙醇注射治療的老年良性甲狀腺囊性疾病患者的臨床資料。結果 共84例患者接受穿刺抽液及無水乙醇注射，男11例，女73例；年齡（69±6.4）歲（60～82歲）。術前彩超檢查包塊均為囊性，直徑（4.8±1.7） cm。術前所有患者均主訴吞咽或活動時頸部不適感。54例患者注射無水乙醇后出現面色潮紅、局部皮膚發紅等癥狀，在1～2d內消失。無感染、死亡等發生。術前、術后甲狀腺功能比較無變化。術后半年復查彩超，包塊直徑縮小為（1.9±1.2） cm。術后患者主訴頸部不適感癥狀減輕或消失。結論 對于老年良性甲狀腺囊性疾病患者行穿刺抽液及無水乙醇注射安全，可有效緩解患者局部壓迫不適，其遠期療效還有待長期觀察。
目的 探討腹膜后囊性淋巴管瘤的CT診斷價值和治療方法。方法 回顧性分析2004年6月至2010年5月期間我院收治的5例經病理檢查證實的腹膜后囊性淋巴管瘤患者的臨床表現、CT影像特征、手術治療及術后隨訪的資料。結果 5例患者術前CT均診斷為囊性淋巴管瘤，均行手術完整切除腫瘤，術后病理結果均證實為囊性淋巴管瘤。術后7 d順利出院，隨訪3個月～6年均無復發。結論 CT對腹膜后囊性淋巴管瘤的診斷具有重要意義，手術完整切除整個囊壁是治療及預防術后復發的最好方法。