1.Children's OSAHS caused by the huge fibrolipoma in pharynx nasalis: a case report.
Siwen XIA ; Xiaomiao LI ; Qiongfan MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(15):1394-1395
We reported a case of children's OSAHS caused by the huge fibrolipoma in pharynx nasalis. The patient was a 10-years-old child who went to the hospital with the chief complaint of "Snoring and mouth breathing during sleep for 10 years". Imaging tests found one huge tumor in pharynx nasalis before the operation. The tumor was resected totally. The postoperative pathological diagnosis was fibrolipoma. No recurrence was noted during the follow-up visit one year postoperatively. The clinical features, diagnosis, treatment, pathology and prognosis were reviewed herein.
Child
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Humans
;
Lipoma
;
complications
;
surgery
;
Neoplasm Recurrence, Local
;
Pharynx
;
pathology
;
Prognosis
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Sleep Apnea, Obstructive
;
etiology
;
Snoring
2.Clinical management strategies of pulsatile tinnitus with transverse sinus stenosis.
Jing XIE ; Yan Jing HAN ; Peng Fei ZHAO ; Na ZENG ; Shu Sheng GONG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(7):704-712
Objective: To study the clinical diagnosis and treatment strategies for vein-related pulsatile tinnitus patients with transverse sinus stenosis. Methods: The clinical data of patients with vein-related pulsatile tinnitus, from January 2015 to August 2019, were collected,whose digital subtraction angiography showing transverse sinus stenosis. Taking December 2019 as the last follow-up time, we analyzed the clinical characteristics, CT angiography and digital subtraction angiography results, lumbar puncture pressure and cerebrospinal fluid composition, and other auxiliary examination results (pure tone audiometry, fundus examination of papilledema, carotid ultrasonography, bone density screening, endocrinous test), as well as tinnitus handicap inventory, treatment options and follow-up results. Results: 83 patients were enrolled with female of 89.2% (74/83) and male of 10.8%(9/83); 65.1% (54/83) with right tinnitus, 31.3% (26/83) with left tinnitus, and 3.6% (3/83) with bilateral tinnitus; 67.5% (56/83) with right dominant sinus, 19.3% (16/83) with left dominant sinus, 13.3% (11/83) with bilateral equalization; Bilateral and ipsilateral stenosis accounted for 55.4% and 44.6% respectively; BMI was overweight or obese in 41 cases (49.4%, 41/83). Patients with tinnitus handicap inventory level three or above accounted for 79.5% (66/83). Eventually, 33 patients chose conservative observation (39.8%, 33/83), 40 patients (48.2%), 8 patients (9.6%) and 2 patients (2.4%) received sigmoid sinus-related surgery, interventional surgery, or emissary vein occlusion respectively. The mean follow-up time of 74 patients was 26.2 months. The data of 48 surgery patients showed that the pressure differences of venous sinus among the recurrent patients were more obvious; Interventional surgery with simultaneous stenting placement was effective. Tinnitus did not decrease in two patients with emissary vein occlusion. Analysis of 26 patients with lumbar puncture revealed eight cases of normal cranial pressure and 18 cases of high cranial pressure. The sinus pressure difference between the two groups was different (P=0.025), but the difference of age of onset, concomitant symptoms, BMI, proportion of empty sella or papilledema was not statistically significant (P>0.05). Conclusions: The evaluation of patients with vein-related pulsatile tinnitus requires a standardized procedure. Papilledema cannot be used as a sensitive indicator in patients with early intracranial hypertension. Venous sinus pressure difference may be one of the indicators of intracranial hypertension, and the lumbar puncture is the gold standard for the diagnosis. Weight loss can be used as a conservative treatment during the observation period. Significant sinus stenosis is a risk factor for recurrence in patients undergoing sigmoid sinus surgery. Interventional stenting is an effective treatment for tinnitus secondary to transverse sinus stenosis.
Constriction, Pathologic/complications*
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Cranial Sinuses
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Female
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Humans
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Male
;
Neoplasm Recurrence, Local
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Stents
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Tinnitus/etiology*
3.A case of selective embolization in treatment of advanced tonsillar cancer hemorrhage.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(17):1359-1360
This paper reports a case of recurrence of tonsillar cancer on the right 6 months after radiotherapy with pharyngeal hemorrhage for 4 days and aggravation in the next day. The pharyngeal hemorrhage was severe in the case and the maximum of single amount of bleeding was approximately 200 ml. The examination showed active bleeding on the ulcer with a diameter of 2 cm in the right tonsil and the depth of 1 cm. After repeated compression hemostasis proved to be invalid, selective embolization was applied on the patient and the symtoms of pharyngeal hemorrhage disappeared without complications. The patient was discharged after 2 weeks of observation without any recurrence of hemorrhage.
Embolization, Therapeutic
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methods
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Hemorrhage
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etiology
;
therapy
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Hemostasis
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Humans
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Neoplasm Recurrence, Local
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Palatine Tonsil
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Pharyngeal Diseases
;
etiology
;
therapy
;
Recurrence
;
Tonsillar Neoplasms
;
complications
4.Benefits of Recurrent Colonic Stent Insertion in a Patient with Advanced Gastric Cancer with Carcinomatosis Causing Colonic Obstruction.
Semi PARK ; Sang Joon SHIN ; Joong Bae AHN ; Hei Cheul JEUNG ; Sun Young RHA ; Sang Kil LEE ; Hyun Cheol CHUNG
Yonsei Medical Journal 2009;50(2):296-299
Malignant obstruction develops frequently in advanced gastric cancer. Although it is primarily the gastric outlet that is obstructed, there are occasional reports of colonic obstruction. Treating intestinal obstruction usually requires emergency surgery or stent insertion. There are several kinds of complications with stent insertion, such as bowel perforation, stent migration, bleeding, abdominal pain and reobstruction. Nevertheless, endoscopic stent insertion could be a better treatment than emergency surgery in cases of malignant bowel obstruction in cancer patients with poor performance status. We report a case of advanced gastric cancer with carcinomatosis in which a recurrent colonic stent was inserted at the same site because of cancer growth into the stent. The patient maintained a good condition for chemotherapy, thus improving their chances for survival.
Aged
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Female
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Humans
;
Intestinal Obstruction/etiology/radiography/*surgery
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Neoplasm Recurrence, Local
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Prosthesis Implantation/*methods
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*Stents
;
Stomach Neoplasms
5.Epidemiological characteristics and inducing factors of gastric stump cancer.
Chinese Journal of Gastrointestinal Surgery 2018;21(5):498-501
Gastric stump cancer was initially defined as a carcinoma of the stomach occurring more than 5 years after surgery for gastric or duodenal benign disease. In recent years, as the number of total gastrectomy for benign disease has gradually decreased and the gastric cancer detection and operation rate have annually increased, residual recurrence of primary gastric cancer more than 10 years after gastric cancer surgery has also been considered as gastric stump cancer. The incidence of gastric stump cancer is increasing annually. The epidemiological characteristics of this form of cancer are also developing, and they show a higher incidence in males compared to females. The incidence has been affected following digestive tract reconstruction, and the risk increases in patients who undergo Billroth II( reconstruction. The interval of onset is related to the benign and malignant condition of primary disease, and the incidence increases after 10 years of early gastric cancer surgery. Lymph node metastasis pattern in gastric stump cancer is different from that in primary gastric cancer as the primary operation may destroy normal lymph flow. Many factors are known to cause gastric stump cancer, mainly duodenal gastric reflux, Helicobacter pylori infection, and gastric mucosal barrier dysfunction; however, the mechanism is not clear. It is expected to reduce the incidence of gastric stump cancer by taking precautionary measures against different inducements, which also has some guiding significance for the treatment and prognosis of gastric cancer.
Female
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Gastrectomy
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Gastric Stump
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pathology
;
surgery
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Gastroenterostomy
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Humans
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Incidence
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Male
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Neoplasm Recurrence, Local
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Risk Factors
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Stomach Neoplasms
;
epidemiology
;
etiology
;
surgery
6.Persistent chest pain for 4 months and progressive lower limb weakness for 2 months in a boy.
Hong-Ling WEI ; Shan LU ; Yan-Mei CHANG
Chinese Journal of Contemporary Pediatrics 2019;21(8):820-823
A boy, aged 5 years, was admitted due to chest pain for 4 months, right lower limb weakness for 2 months, and weakness of both lower limbs for 10 days. There were no symptoms of defecation/urination disorders or disturbance of consciousness, and the boy had upper motor neuron paralysis in both lower limbs, without cranial nerve involvement or sensory disorder. Spine magnetic resonance imaging revealed tumor in the spinal canal between cervical vertebra 6 and thoracic vertebra 2, which put pressure on the spinal cord. He was transferred to the department of neurosurgery for surgical treatment and fully recovered after tumor resection, and no recurrence was observed after 6 years of follow-up. The pathological diagnosis was clear cell meningioma (WHO grade II). For children with chest pain and dyskinesia, spinal meningioma should be considered.
Chest Pain
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etiology
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Child, Preschool
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Humans
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Lower Extremity
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Magnetic Resonance Imaging
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Male
;
Meningeal Neoplasms
;
complications
;
Meningioma
;
complications
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Neoplasm Recurrence, Local
7.Influence of different thyroidectomy on perioperative blood calcium concentration.
Yi LAI ; Mengjia FEI ; Jiadong WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(23):1873-1876
OBJECTIVE:
lo discuss the inmtluence of different thyroidectomy on perioperative blood calcium concentration.
METHOD:
Total number of patients was 240. These patients of thyroid tumors were recruited. Clinical and follow-up datum were retrospective analyzed.
RESULT:
Patients were divided into four groups by different operative methods. Group one was patients taken one-side thyroidectomy, group two taken one-side lymph node dissection plus, group three taken two-sides thyroidectomy,and group four taken one or two sides lymph node dissection plus. Group two was easier to become hypocalcemia and their calcium concentration decreased more remarkably, compared with group one. Patients taken two-sides thyroidectomy had the familiar outcome.
CONCLUSION
Patients taken lymph node dissection were easier to become hypocalcemia, compared with patients only taken thyroidectomy.
Calcium
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blood
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Humans
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Hypocalcemia
;
etiology
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Lymph Node Excision
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Neoplasm Recurrence, Local
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Retrospective Studies
;
Thyroid Neoplasms
;
Thyroidectomy
;
adverse effects
8.Clinicopathological analysis of mucosa associated lymphoid tissue lymphoma secondary to Sjögren' s syndrome in salivary gland.
Yan Ting CHI ; Yan Ping ZHANG ; Qiu Lu ZHANG ; Cui Ling LIU ; Bin Bin LI
Journal of Peking University(Health Sciences) 2020;53(1):40-45
OBJECTIVE:
To analyze the clinicopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphoma secondary to Sjögren' s syndrome (SS) (SS-MALT lymphoma) in salivary gland and to explore the value of the combined application of histopathological morphology, protein expression and molecular phenotype in pathological diagnosis and prognostic evaluation of SS-MALT lymphoma.
METHODS:
Sixteen patients with SS-MALT lymphoma were collected from 260 patients who were diagnosed with SS in Peking University School and Hospital of Stomatology from January 1997 to December 2016. Twelve patients with non-MALT lymphoma secondary to SS (non-SS-MALT lymphoma) in salivary gland were selected as controls. The clinical data of the patients were retrospectively reviewed and analyzed. All the patients were followed up until December 20, 2019. Hematoxylin-eosin staining, immunohistochemistry, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) techniques were used to observe the histologic characteristics and to detect the manifestations of light chain restrictive expression, immunoglobulin (Ig) gene clonal rearrangement, chromosome translocation and gene abnormality, so as to evaluate their values in pathological diagnosis and prognostic evaluation.
RESULTS:
The malignant transformation rate of SS to MALT lymphoma was about 6.15%, ranged from 3 to 240 months, during which 2 patients died due to high-level deterioration. Microscopically, the acini of the glandular tissue were atrophied and destroyed. The tumor cells dominated by central cell-like lymphocytes grew diffusely, destroying the epithelial islands. All SS-MALT lymphoma cases were positive in CD20 and Pax5. Half of them had the Ki-67 proliferation index of 10% or less, and half greater than 10%. 93.75% cases expressed AE1/AE3 protein, which showed the residual glandular epithelium. All the tumor cells were negative in CD3ε, and the plasma cells were detected by CD138 antigen. The light chain restrictive expression of κ and λ was 37.5% in SS-MALT lymphoma group. The positive detection rates of immunoglobulin heavy chain (IgH)-FR1, IgH-FR2, IgH-FR3, immunoglobulin kappa chain (IgK)-A, and IgK-B in SS-MALT lymphoma group were 33.3%, 53.3%, 33.3%, 20.0%, and 26.7%, respectively, and 93.3% when together used with IgH and IgK. The positive rates of the MALT1, IGH and BCL6 genes with dual color break-apart probes were 36.4%, 27.3% and 27.3%, and the detection rate of chromosome translocation and gene abnormality by applying the three probes was 72.7%.
CONCLUSION
There are no specific histological characteristics and protein phenotypes in the histologic diagnosis of SS-MALT lymphoma in salivary gland. The combined application of histopathological manifestations, immunohistochemistry, PCR and FISH techniques helps the accurate pathologic diagnosis of the disease. Although SS-MALT lymphoma is considered as an indolent lymphoma with a relatively favorable prognosis, the regular return visit and long-term follow-up should be conducted to detect the clues of recurrence and advanced deterioration.
Humans
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In Situ Hybridization, Fluorescence
;
Lymphoma, B-Cell, Marginal Zone/etiology*
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Neoplasm Recurrence, Local
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Retrospective Studies
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Salivary Glands
9.Influence of postoperative complications on prognosis of gastric cancer-The manifestation of gastric surgeon's skill, responsibility and empathy.
Chinese Journal of Gastrointestinal Surgery 2023;26(2):126-131
Radical gastrectomy combined with perioperative comprehensive treatment is the main curable strategy for gastric cancer patients, and postoperative complications are the issue that gastric surgeons have to face. Complications not only affect the short-term postoperative recovery, but also facilitate tumor recurrence or metastasis, thus resulting in poor prognosis. Therefore, unifying the diagnostic criteria for postoperative complications, bringing the surgeons' attention to complications, and understanding the potential mechanism of complications undermining long-term survival, will be helpful to the future improvement of the clinical diagnosis and treatment as well as prognosis for gastric cancer patients in China. Meanwhile, surgeons should constantly hone their operative skills, improve their sense of responsibility and empathy, and administer individualized perioperative management based on patients' general conditions, so as to minimize the occurrence of postoperative complications and their influence on prognosis.
Humans
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Stomach Neoplasms/pathology*
;
Empathy
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Neoplasm Recurrence, Local/surgery*
;
Prognosis
;
Gastrectomy/methods*
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Postoperative Complications/etiology*
;
Surgeons
;
Retrospective Studies
10.Isolated Extramedullary Relapse of Acute Myelogenous Leukemia as a Uterine Granulocytic Sarcoma in an Allogeneic Hematopoietic Stem Cell Transplantation Recipient.
Hoyoung MAENG ; June Won CHEONG ; Seung Tae LEE ; Woo Ick YANG ; Jee Sook HAHN ; Yun Woong KO ; Yoo Hong MIN
Yonsei Medical Journal 2004;45(2):330-333
We report an unusual case of acute myelogenous leukemia in a patient who showed an extramedullary relapse in her uterus, without bone marrow recurrence, two years after an allogeneic bone marrow transplant. She complained of irregular vaginal spotting, and magnetic resonance imaging demonstrated a uterine mass. A biopsy revealed a massive infiltration of immature myeloid cells. A variable number of tandem repeats (VNTR) based on an examination of peripheral blood cells showed full donor chimerism. After receiving chemotherapy, her uterine mass had completely resolved. She has remained in complete remission for more than 6 months. This case suggests that physicians should be aware of the possibility of a uterine relapse in female bone marrow transplant recipients with acute myelogenous leukemia.
Adult
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Female
;
Hematopoietic Stem Cell Transplantation/*adverse effects
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Human
;
Leukemia, Myelocytic, Acute/*pathology/*therapy
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Neoplasm Recurrence, Local
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Sarcoma, Granulocytic/etiology/*pathology
;
Uterine Neoplasms/etiology/*pathology