Ｔｈｉｒｔｅｅｎ ｃａｓｅｓ ｏｆ ｐａｎｃｒｅａｔｉｃ ｃｙｓｔ ｗｅｒｅ ａｎａｌｙｓｅｄ，ｉｎｃｌｕｄｉｎｇ ６ ｃａｓｅｓ ｏｆ ｒｅｔｅｎｔｉｏｎ ｃｙｓｔ，４ ｃａｓｅｓ ｏｆ ｃｙｓｔａｄｅｎｏｍａ ａｎｄ ３ ｃａｓｅｓ ｏｆ ｃｙｓｔａｄｅｎｏｃａｒｃｉｎｏｍａ．Ｔｈｅ ｄｉｓｅａｓｅ ｈａｓ ｎｏ ｓｐｅｃｉａｌｉｔｙ ｉｎ ｃｌｉｎｉｃａｌ ｓｙｍｐｔｏｍｓ ｕｌｔｒａｓｏｎｏｇｒａｐｈｙ ａｎｄ ＣＴ ｈａｖｅ ｈｉｇｈ ｖａｌｉｄｉｔｙ ｉｎ ｌｏｃａｔｉｎｇ ｔｈｅ ｃｙｓｔ，ｂｕｔ ｎｏ ｖａｌｕｅ ｉｎ ｄｅｔｅｒｍｉｎｇ ｉｔｓ ｐａｔｈｏｌｏｇｉｃａｌ ｎａｔｕｒｅ．Ｍｕｌｔｉｐｌｅ ｃｏｍｐａｒｔｍｅｎｔ ｏｆ ｔｈｅ ｃｙｓｔ ｗｅｒｅ ｏｆｔｅｎ ｓｅｅｎ．Ｓｅｒｏｕｓ ｆｌｕｉｄ ａｎｄ ｆｌａｔ ｅｐｉｔｈｅｌｉａｌ ｃｅｌｌ ｅｘｉｓｔｅｄ ｍａｉｎｌｙ ｉｎ ｒｅｔｅｎｔｉｏｎ ｃｙｓｔ．Ｍｕｃｉｎｏｕｓ ｆｌｕｉｄ ａｎｄ ｃｕｂｉｃ／ｃｏｌｕｍｎ ｅｐｉｔｈｅｌｉａｌ ｃｅｌｌｓ ｗｅｒｅ ａｌｗａｙｓ ｓｅｅｎ ｉｎ ｃｙｓｔａｄｅｎｏｍａ ａｎｄ ｃｙｓｔａｄｅｎｏｃａｒｃｉｎｏｍａ．Ｃｙｓｔｅｃｔｏｍｙ ｉｓ ａｎ ａｐｐｒｏｐｒｉａｔｅ ｏｐｅｒａｔｉｏｎ ｆｏｒ ｔｈｅ ｄｉｓｅａｓｅ．
目的 探讨胰腺囊腺瘤和囊腺癌的临床病理特点及其诊治。 方法 回顾性分析山东省菏泽市立医院及曹县人民医院1996年6月至2007年3月共收治的17例患者的临床病理资料。结果 本病临床表现无特征性。B超和CT检查能发现囊肿但不能确定类型。浆液性囊腺瘤7例均行肿瘤局部切除； 黏液性囊腺瘤6例，行胰十二指肠切除1例，胰体尾切除5例； 囊腺癌4例，行胰十二指肠切除加淋巴结清扫1例，胰体尾切除术2例，胰体尾加脾切除1例。光镜下浆液性囊腺瘤囊壁由扁平或立方上皮细胞组成； 黏液性囊腺瘤囊壁由高柱状上皮细胞组成，可见乳头状突起； 囊腺癌囊壁细胞核异形明显，可见核分裂象及间质浸润。15例获得B超随访，中位随访时间为42个月（1～129个月），除1例行胰体尾切除加脾切除的老年囊腺癌患者术后6个月死于营养衰竭和 1例胰十二指肠切除患者并发糖尿病外，其余患者生存满意，未见肿瘤复发。结论 B超和CT是本病的主要影像检查方法。加强对本病临床病理特征的认识是提高诊治率的关键。手术切除治疗本病疗效满意。
ObjectiveTo study the clinical features,pathogenesis and differential diagnosis,and explore the imaging characteristics of congenital cystic adenomatoid malformation of the lung (CCAM) in children,in order to improve the knowledge of imaging findings of the disease. MethodsWe retrospectively analyzed the clinical data and imaging characteristics of three patients proven to have CCAM of the lung both by surgery and pathology between March 2011 and March 2013.Related literature was also reviewed,and two out of the three patients were followed up for two years. ResultsAll CCAM lesions in this study involved unilateral lower lobe,including two left lung and one right.Two patients had multiple large cysts containing gas,and one had multiple honeycomb-shaped vesicles.Histopathological examination showed that two cases were classified as Stocker type I and one as type Ⅱ,without type Ⅲ cases.Surgeries proved that the malformation was unilateral in all patients without connection with the bronchia.All patients with CCAM got complete cure by operation.The two-year postoperative follow-up showed an excellent recovery in all the patients. ConclusionImaging examination is the main basis for discovery and diagnosis of CCAM.The CT manifestations of CCAM are featured,and according to CT examination,pathological subtypes of the disease can be predicted.Being familiar with these characteristics is helpful for its diagnosis.
目的总结胰腺浆液性囊腺瘤的临床特点、诊治及预后情况。 方法对我院2003年6月至2013年6月期间收治的19例胰腺浆液性囊腺瘤患者的临床资料进行回顾性分析。 结果胰腺浆液性囊腺瘤好发于中老年女性（本组男女比例为1:3.75，发病平均年龄56.7岁）。患者首发症状：腹部疼痛不适12例，发现腹部包块2例，无特殊症状因体检发现5例。肿瘤部位：胰头及胰颈部8例，胰体部6例，胰尾部5例。肿瘤平均直径5.4 cm。CT及MRI术前诊断率分别为60.0%（9/15）、80.0%（8/10）。19例患者均成功手术并行病理检查，其中浆液性微囊性腺瘤15例，浆液性寡囊性腺瘤4例。有4例患者术后出现胰漏，其中1例合并腹腔感染，经内科治疗后痊愈。术后随访4～124个月，平均55个月，未见肿瘤复发。 结论胰腺浆液性囊腺瘤的临床表现无特异性，CT及MRI术前诊断价值较高。手术为最有效的治疗方法，预后良好。
ObjectiveTo evaluate the clinical manifestation, diagnosis, and treatment of intrahepatic biliary cystadenoma (IBCA). MethodsThe clinical date of 12 patients with IBCA from January 2004 to December 2013 in our hospital were retrospectively analyzed. ResultsOf the total 10 patients were female and 2 were male. The average age was 49.0 years old (16-77 49.0 years old). The course of disease were 1 month-3years (average:7 months). The clinical symptoms were right upper abdominal fullness with a sense of pain in 6 patients, right upper abdominal mass in 1 case, jaundice in 1 case, and no symptoms in 4 cases. Enhanced CT examination showed that the tumor complete capsule and there were internal septations in 11 cases, the density of internal septations was different. There was mild enhancement of cyst wall and internal septations in 9 cases. All of 12 cases received surgical resection. Only 1 case showed recurrence in 2 years after operation, the remaining 11 patients had no recurrence. ConclusionsIBCA often occurs in middle-aged women. The main clinical symptoms are abdominal fullness with a sense of pain, right upper abdominal mass or jaundice. Enhanced CT is the main method of diagnosis before operation. Radical resection of IBCA is the best treatment, and can prevent recurrence effectively.