Objective: To observe the value of preoperative multi-slice spiral CT angiography (MSCTA) and intraoperative assisted ultrasound in application of laparoscopic kidney-preserving surgery for treating small renal cancer (tumor diameter ≤4 cm). Methods: A total of 85 patients with small kidney cancer underwent retroperitoneal laparoscopic nephron-sparing surgery, including 43 underwent preoperative MSCTA and intraoperative assisted ultrasound (observe group) and 42 underwent preoperative routine renal ultrasound and CT examination (control group). The relevant indicators were compared between the two groups. Results: Preoperative MSCTA findings of observe group were consistent with intraoperative findings. The operative time, intraoperative heat ischemia time, intraoperative blood loss and postoperative hospital stay in observe group were all less than those in control group (all P<0.05). In observe group, microcarcinoma was found in 1 case with ultrasound during operation, no positive resection margin nor urine leakage occurred after operation. In control group, postoperative urine leakage occurred in 2 patients (cured after conservative treatment with D-J tube implantation) and positive resection margin in 2 patients (recurred in the follow-up, 1 underwent retroperitoneal laparoscopic radical nephrectomy, and 1 underwent nephron sparing open surgery). There was no statistical difference of preoperative nor postoperative levels of serum creatinine, urea nitrogen and glomerular filtration rate (GFR) of affected kidney between the two groups (all P>0.05), while the postoperative GFR of control group was lower than that before surgery (P=0.040). Conclusion: Preoperative MSCTA and intraoperative auxiliary ultrasound during retroperitoneal laparoscopic nephron-sparing surgery for patients with small renal carcinoma can reduce intraoperative blood loss and positive rate of resection margin, reserve as much nephrons as possible to promote the recovery of renal function.

By summarizing and analyzing the clinical diagnosis and treatment experience of 17 cases of adrenal lymphangioma, the imaging characteristics and pathological types of the disease were discussed. The results showed that the imaging of adrenal lymphangioma was non-specific, and the appearance was similar to that of general cysts.Howerer, the density of the cyst was slightly higher than that of simple cysts. Some cases showed calcification on the cyst wall, and a few showed adenoma-like appearance. The diagnosis mainly depends on pathological examination. For those patients with tumors ≥4.0 cm, endocrine function, suspected malignancy, or obvious clinical symptoms, surgery is recommended.

Objective To study the clinicopathological and immunohistochemical features, histogenesis and biological behavior of solid pseudopapillary tumor of the pancreas ( SPT ). Methods Routine HE and immunohistochemical ( SP) methods were used in 20 cases of SPT. Results There were 18 females and 2 males, age ranging from 13 to 48 years with mean age of 25. 3 years. Abdominal pain and palpable mass were among the main complains. Seventeen cases were followed-up from 9 to 120 monthes. Fourteen cases were alive. Tumors were encapsulated, mixed with solid and cystic tissues. Histological features were psudopapillary structure with a fibrovascular core. Immunohistogically, the tumors were positive for a-1-AT ( 17 cases) , vimentin ( 14 cases) , synaptophysin ( 10 cases) , CgA (5 cases) ,CK and insulin (2 cases) ,glucagon and S-100 (1 case) ,PR (14 cases) , ER (1 case) ,pS2 (6 cases) , but all were negative for CEA and gastrin. Conclusion SPT is of low-graded malignancy and a distinct clinicopathologic entity in young female patients with both exocrine as well as endocrine differentiation. The tumor is closely related with sex hormone receptors.

A patient with adrenal enteric cyst was reported. The patient was admitted to the hospital for physical examination and found adrenal glands. The preoperative diagnosis considered simple adrenal cysts and underwent complete surgical resection. Postoperative pathological returns were adrenal enteric cysts. There was no recurrence at 1 year postoperative follow-up and recovery was good. The clinical symptoms of the disease are not typical. The imaging and laboratory indicators are not specific. Pathological diagnosis is required, and surgical resection is the best treatment plan.