ABSTRACT
Objective To evaluate the diagnosis and treatment of duplication of the renal pelvis and ureter. Methods The clinical data of 9 patients with duplication of the renal pelvis and ureter who were treated from May 2014 to January 2018 in the Second People′s Hospital of Lianyungang were retrospectively analyzed. Of the 9 cases, 1 case was male, and 8 cases were female. The age range from 6 to 68(40.4 ± 20.6) years. Three cases of duplex kidneys were on the left side, 4 cases on the right side, and 2 cases on the both side. 6 cases had imcomplete duplex systems and 3 cases had complete duplex systems. The diagnosis rate of ultrasound, intravenous urography (IVU), CT scan, magnetic resonance urography (MRU), retrograde pyelography (RPG) was 3/9, 7/8, 5/9, 0/1 and 2/2 respectively. Results One case with simple urinary tract infection was cured by antimicrobial agents, and 1 case with lower ureteral calculus was cured by lithagogue drugs. One case with renal calculus and pyonephrosis in upper moiety of duplex kidney underwent retroperitoneoscopic nephrectomy, 1 case with ureteropelvic junction obstruction and horseshoe kidney underwent division of the isthmus and pyeloplasty, and 2 cases with ureterocele underwent transurethral incision. The clinical symptoms of patients who underwent surgery were cured in all cases. Three cases without complications underwent conservative treatment, and follow-up observation showed no complications. Conclusions Duplication of the renal pelvis and ureter can be diagnosed properly based on imaging data. IVU has a significant advantage, while RPG has high specificity in difficult cases. Treatment should be individualized according to clinical symptoms, complications and other urinary tract congenital anomaly.
ABSTRACT
Objective To summarize the cytological features of breast carcinoma by fine needle aspiration and differential diagonsis of breast hyperplasia and breast flbroadenoma. Methods Cytological features about 175 cases of breast cancer were analyzed,contrasted with 76 cases of breast hyperplasia and 93 eases of fibroadenoma. And 20 cases of low-diagnosis breast cancer were analyzed, compared with 13 cases of excessive diagnosis. Results The followings were found:disorderly arranged cells in 169 cases of breast cancer, about 96.9% in 175 cases,loose distance between the nucleus in 125 cases of all cases (about 71.4%). The percentage of small groups or scattered cells, medium size cells, round nucleus and irregular border nucleus was 34.3% (60/175) ,81.1% (142/175), 88.6% (155/175) and 28.6% (50/175) respectively. The nucleus/cytoplasm ratio was increased in 105 cases of all (about 60%). The nucleus/cytoplasm ratio was obviously reduced in 15 cases of all (about 8.6%). Big nucleolis were observed in 49 cases of all (about 28%). There was significant difference between nucleus size in 136 cases of all (about 77.7%). There was not myoepithelial cell in 168 cases of all (about 96%). The percentage of visible necrosis, scsttered round nucleus and integrity of cytoplasmic was 13.7% (24/175) ,89.7% (157/175), 66.9% (117/175) respectively. The cases of all above features were significantly more than those of breast hyperplasia and breast fibroadenoma (P <0.05). The percentage of large number of cells was 52.6% in 175 breast cancer cases,higher than 5.3% in 76 breast hyperplasia cases. There was a significant difference(P <0.05) between two groups. In 20 cases of low-diagnosis breast cancer the percentage of round nucleus with integrity of cytoplasmic, special arrangement cells was 70% (14 cases) ,35% (7 cases) ,higher than the cases in 13 excessive diagnosis cases. There was a significant difference(P < 0.05) between two groups. Conclusion The cell morphological characteristics of breast caner by fine needle aspiration are large number of cells, loose distance between the nucleus, disorderly arranged cells, small guoups or scattered cells, integrity of cytoplasmic, increased nuclear, round nuclear, irregular border nucleus,increased or decreased nucleus/cytoplasm ratio, big nucleoli, significant difference in nuclear size, no myoepithelial cell, visible necrosis. Most of breast cancer can be distinguished from breast hyperplasia and breast fibroadenoma by above characteristics. All those cytological characteristics are helpful to identify difficult case.
ABSTRACT
ObjectiveTo explore the value of non-invasive dual-energy CT in the diagnosis of gout and the differential diagnosis of other joint diseases by observing urate crystals surrounding tissues. Methods Seventeen patients, who experienced unilateral arthrocele or joint pain in the past two weeks, were enrolled into our study. Dual-energy CT was performed in all patients and ultrasound-guided joint aspiration were performed in some patients. The location, quantity and size of urate crystals were analyzed by dual-energy CT.ResultsThirty-three urate crystals were found in 13 gout patients, and the most common sites of deposition were bilateral inter-phalangeal joints of foot (7/33), proximal inter-phalangeal joints (5/33), tissues around distal interphalangeal joint (4/33), metatarsal joints (4/33) and the lower part of the tibia (3/33). The data indicated that urate crystals were more likely to deposit in the soft tissues around joints such as muscles, ligaments and so on, and the sites of deposition were consistent with the locations of arthralgia. The size of urate crystals could also be measured by dual-energy CT. ConclusionUrate crystals can be displayed by dualenergy CT. In addition, dual-energy CT is a non-invasive measure and it has great value in the differential diagnosis of joint diseases.