目的 总结原发性腹膜后脂肪肉瘤（primary retroperitoneal liposarcoma，PRL）的临床病理特征、诊断及治疗方法。 方法 回顾性分析经手术和活检证实的23例PRL患者的临床病理资料。结果 首发症状及体征表现为腹部肿块（91.3%，21/23），腹胀（56.5%，13/23）及腹痛（30.4%，7/23）。B超及CT的定位诊断准确率分别为66.7%（12/18）和85.7%（12/14）。首次手术肿瘤完整切除16例（69.6%），其中8例联合脏器切除； 部分切除3例（13.0%）； 仅行活检4例（17.4%）。PRL肿瘤完整切除术后复发率为75.0%（12/16）,该12例中再次手术8例（66.7%）可完全切除肿瘤。结论 CT是诊断PRL的重要手段，优于B超； 手术以完整切除肿瘤为主，对侵犯脏器者采用累及脏器一并切除； 术后复发者可再次手术。
ObjectiveTo investigate the clinical value of real-time elastosonography in diagnosis of thyroid nodules. MethodsThe clinical date of 168 patients with thyroid nodules, admitted to our hospital from June 2009 to December, were retrospectively analyzed with pathological findings as the reference standard． The findings on elastography were classified into five grades: grade 0 to Ⅳ. The nodules with grade less than Ⅱ were diagnosed as benign, otherwise more than Ⅲ were diagnosed as malignancy. ResultsThere were 208 nodules in 168 patients: nodular goiter was in 125 cases, thyroid adenoma in 36 cases, thyroid malignant tumor in 41 cases including 39 cases for thyroid papillary carcinoma, 1 case for thyroid medullary carcinoma, 1 case for thyroid non-Hodgkin lymphoma. Other nodules were in 6 cases, including diffuse toxic goiter in 1 case, local lymphocytic thyroiditis in 3 cases, and subacute granulomatous thyroiditis in 2 cases. There were 148 thyroid nodules in grade 0-Ⅱ and 60 nodules in grade Ⅲ-Ⅳ. According to the pathological findings, 97.3%(144/148) thyroid nodules of grade 0-Ⅱ were benign, however, 38.3% (23/60) of grade Ⅲ-Ⅳ were benign. Furthermore, 2.7% (4/148) thyroid nodules of grade 0-Ⅱ were malignancy, while 61.7% (37/60) of grade Ⅲ-Ⅳ were malignancy. The sensitivity， specificity, and accuracy of the real-time elastosonography in diagnosis of thyroid nodules was 90.2%(37/41), 86.2%(144/167), and 87.0%(181/208), respectively. ConclusionReal-time elastosonography can reflect the relative hardness of thyroid nodules and provide useful information for diagnosis, which is helpful in differentiating benign and malignant thyroid nodules.
ObjectiveTo evaluate the risk factors for central lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) of cN0 staging. MethodsClinical data of 94 patients with cN0 PTC in Guangdong General Hospital who underwent thyroidectomy with prophylactic central node dissection (pCND) from March to July in 2014 were collected to analyze the risk factors of CLNM by using univariate and multivariate analysis methods. ResultsCLNM was found in 43 patients (45.7%). Multivariate analysis results showed that, the CLNM rate of patients with age < 45 years, tumor located in front of lobe by ultrasound, diameter of tumor > 2 cm, capsular invasion, and total number of central lymph node dissected > 3 were significantly higher (P < 0.05). ConclusionAge < 45 years, tumor located in front of lobe by ultrasound, and diameter of tumor > 2 cm are the risk factors of CLNM in patients with cN0 PTC, pCND should be performed for patients with some of the above risk factors.