1.Clinical treatment of 100 patients with subacute thyroiditis
Shunbin LI ; Wei QIU ; Shuying ZHENG ; Wanchun SHI ; Wenhua WANG
Chinese Journal of General Practitioners 2013;12(11):909-910
A total of 100 patients with subacute thyroiditis hospitalized from January 2011 to October 2012 were recruited.Each received glucocorticoid treatment for 8 weeks and there was a 2-month follow-up period after drug withdrawal.After treatment,the short-term recurrence rate was 34% (34/100).If thyroid ultrasound was abnormal,the recurrence rate was 52% (30/58).And it was significantly higher than 10% recurrence rate for those with normal thyroid ultrasound (4/42,x2 =9.67,P < 0.01).The recurrence rate of different erythrocyte sedimentation rate groups of 40-100 mm/1 h and > 100 mm/1 h was 37% (22/60) and 30% (12/40) respectively (P > 0.05).
2.Imaging diagnosis of prostatic hyperplasia and prostate cancer
Aijun SHI ; Kaihang JIANG ; Jinye CHEN ; Wanchun GAO ; Jiafei CHEN
Journal of Regional Anatomy and Operative Surgery 2017;26(9):682-686
Objective To explore the methods of improving diagnosis correctness between the patients with prostate cancer and benign prostatic hyperplasia.Methods Totally 87 patients with benign prostatic hyperplasia or prostate cancer which confirmed by MRI and prostate biopsy for the PSA significantly increased in our hospital from July 2013 to March 2016 were collected.By using the three methods of the PI-RADS V2 score,the T2WI+DWI/ADC+DCE-MRI+MRS and PI-RADS V2 score+MRS to diagnose,and comparing with the pathology results,the diagnostic consistency of the two physicians were analyzed.The sensitivity,accuracy and specificity of three ways were compared,and the correlation between PI-RADS V2 score and Gleason score were calculated.Results The diagnostic consistency of the two physicians:PI-RADS V2 score,K=0.951;T2WI+DWI/ADC+DCE-MRI+MRS score,K=0.838;PI-RADS V2+MRSI score,K=0.937.The correlation between PI-RADS V2 score and Gleason score,r=0.871,P=0.001 4;diagnostic sensitivity,specificity and accuracy of PI-RADS V2 score were 77.3%,74.4%,75.9%;diagnostic sensitivity,specificity and accuracy of T2WI+DWI/ADC+DCE-MRI+MRS were 88.6%,76.7%,82.8%;diagnostic sensitivity,specificity and accuracy of PI-RADS V2+MRSI score were 86.4%,81.4%,83.9%,respectively.Conclusion Compared with the traditional diagnostic methods,the combination of new prostate report and data system and MRSI can improve the diagnostic accuracy of prostate cancer and benign prostatic hyperplasia.The PI-RADS V2 score is more objective and accurate in the description of the lesion,but the low signal of benign hyperplastic nodules in transitional zone should be dialogued carefully through a variety of image parameters.
3.Ovarian small cell carcinoma hypercalcemic type with acute renal dysfunction
Yingchun SHUI ; Jianjun WANG ; Qun GUAN ; Hai WANG ; Wanchun LI ; Jiandong WANG ; Qi LIU ; Qunli SHI
Chinese Journal of Clinical and Experimental Pathology 2015;(5):492-496
Purpose To investigate the clinicopathlogical characteristics, diagnosis and differential diagnosis of ovarian small cell car-cinoma hypercalcemic type ( OSCCHT) associated with acute renal dysfunction. Methods A case of OSCCHT associated with acute renal dysfunction was reported. The clinical and pathologic data, treatment and pathological examinations were analyzed and the related literatures were reviewed. Results A 29-year-olds women was presented to hospital with inappetence and significant weight loss for 2 months. The laboratory examination showed abnormal renal function, and pelvic cavity mass, possibly coming from adnexa of the uterus was seen by radiography. Serum levels showed significantly increased serum calcium with acute renal dysfunction. An emergency opera-tion was performed just after renal function partially recovered by 2 times hemodialysis. During surgery, right ovary tumor with a size of 12 cm × 10 cm × 10 cm was inspected. Microscopically, the tumor cells were arranged in a diffuse solid pattern, mutiple nodules were separated by fibrous tissue. some small folliculars and pseudoglandular cavities with acidophilia secretion within nodules could been ob-served. Tumor cells were medium to large with eosinophilic cytoplasm, round or oval vesicular nucleus, increased karyoplasmic ratio and pathologic mitosis. Immunohistochemistry revealed that the tumor cells expressed EMA, CKpan, C-erbB-2 ( +) , CA125 ( focal+) and Ki-67 proliferation index was about 60%, while ER, PR, Syn, CgA, PTH, Inhibin, CD99, AFP, PLAP, CD30 and CD20 were not expressed. Conclusion Ovarian small cell carcinoma hypercalcemic type with acute renal dysfunction is a very rare with a rapidly progressive and highly malignant tumor. The final diagnosis mainly lies on clinical information ( hypercalcaemia) , morphology and immunohistochemistry, combined with electron microscopy and molecular biological detection when necessary.
4.Misdiagnosis of cervical lymph node lesions by fine-needle aspiration cytology
Leilei LIU ; Hui CHEN ; Wanchun LI ; Pin TU ; Hongai JI ; Qunli SHI
Journal of Medical Postgraduates 2015;(1):58-60
Objective Cervical lymph node enlargement may be attributed to inflammation or tumors .This study was to analyze the pitfalls in fine-needle aspiration cytology ( FNAC) of cervical lymph nodes and the measures for avoiding misdiagnosis of cervical lymph node lesions . Methods We retrospectively analyzed the data about 435 cases of FNAC in comparison with the results of corre-sponding tissue biopsies in cervical lymph nodes . Results Among the 435 cases, 7 showed disagreement between the results of cytolog-ic and histologic diagnoses, which included 5 males and 2 females, at the age of 41 to 71 (58.4 ±8.9) years.Six of the cases presented with local lymph node enlargement and 1 with generalized lymphadenopathy, all with enlarged lymph nodes palpable 1-4 cm in diameter . Based on the results of FNAC, 1 case of malignant lymphoma was misdiagnosed as lowly differentiated adenocarcinoma, 1 case of lympho-ma misdiagnosed as poorly differentiated metastatic carcinoma, 2 cases of lymphoma diagnosed as lymphoproliferation and recommended for biopsy, 1 case suggestive of malignant tumor without further classification, and 2 cases microscopically characterized and recommended for lymph node biopsy.Compared with the results of the biopsy, FNAC achieved a 99.3%coincidence rate of qualitative diagnosis (432/425), with a misdiagnosis rate of 1.6%(7/435). Conclusion FNAC plays a very important role in the initial identification of the nature of lymph node lesions and the type of tumors.Practiced puncture skills and intimate knowledge about the histopathological features, diagnostic criteria, and differential diagnosis of the lymphatic system disorders are essential for improving the diagnostic accuracy of FNAC .