ABSTRACT
Objective:To discuss the clinic features and diagnosis of one case of hepatic angiomyolipoma (HAML) , and to analyze and summarize its diagnosis and treatment methods.Methods:The clinical materials of one case of HAML patient who was misdiagnosised as hepatocellcular carcinoma were analyzed retrospectively, and the related literatures were reviewed.Results:A middle-aged female patient visited our outpatient service because of low back discomfort.The upper abdominal CT and MRI suggested that a space occupying lesion located at the left lobe of liver inner lower segment, considering a high possibility of hepatocellular carcinoma.The patient underwent the left lobe of inner lower segmentectomy.The postoperative histopathological examination and immunohistochemical staining showed the tumour was HAML, After operation, the patient recovered well and the follow-up examination after hepatectomy found no tumor recurrence.Conclusion:HAML has no specific clinical characteristics or imaging features.The diagnosis of HAML mostly depend on the histopathological examination and hepatectomy is the effective treatment.
ABSTRACT
Objective: To discuss the clinic features and diagnosis of one case of hepatic angiomyolipoma (HAML), and to analyze and summarize its diagnosis and treatment methods. Methods: The clinical materials of one case of HAML patient who was misdiagnosised as hepatocellular carcinoma were analyzed retrospectively, and the related literatures were reviewed. Results: A middle-aged female patient visited our outpatient service because of low back discomfort. The upper abdominal CT and MRI suggested that a space occupying lesion located at the left lobe of liver inner lower segment, considering a high possibility of hepatocellular carcinoma. The patient underwent the left lobe of inner lower segmentectomy. The postoperative histopathological examination and immunohistochemical staining showed the tumour was HAML, After operation, the patient recovered well and the follow-up examination after hepatectomy found no tumor recurrence. Conclusion: HAML has no specific clinical characteristics or imaging features. The diagnosis of HAML mostly depend on the histopathological examination and hepatectomy is the effective treatment.
ABSTRACT
Objective To explore the risk of tuberculosis infection in patients with malignant tumors.Methods The sputum samples and blood samples from 396 patients with malignant tumor and 80 healthy subjects were detected by modified Roche cul-ture,real-time fluorescence quantitative PCR,colloidal gold,T cell spots(TSPOT.TB)and single immunodiffusion(SRID).Results The positive rate of the experimental group of 396 cases of malignant tumor patients with five kinds of methods for detection of Mycobacterium tuberculosis were improved Lowenstein Jensen 12.1%(48/396),real-time PCR(169/396)42.7%,colloidal gold 38.9%(154/396),TSPOT.TB 44.9%(178/396),SRID 10.4%(41/396).In the control group,the positive result was detected only by real-time fluorescent PCR 8.7%(7/80),colloidal gold 6.3%(5/80),and TSPOT.TB 27.5%(22/80).The differences of the results of the same detection method were statistically significant(P<0.01).The experimental group was grouped according to the location of the lesion,and there was no statistical difference between the indexes of each group(P>0.05).In comparison with other types of tumor,there were no statistical differences in every index of every group(P>0.05).But the positive rates of liver cancer patients were lower than those of other types of tumor,and all the positive rates of lung cancer patients were higher than those of other types of tumor.Conclusion Patients with malignant tumor is a high-risk group of TB infection.It is suggested that early screening and regular monitoring of TB infection should be done for patients with malignant tumor,so as to achieve early de-tection and early treatment.
ABSTRACT
Objective To investigate the clinical features of uterine empyema complicated with perforation of the uterus,the causes of misdiagnosis and measures of reducing misdiagnosis.Methods Twenty clinical cases from 2008 to 2013 in the First People's Hospiptal of Shangqiu were treated postmenopausal,uterine empyema and uterine perforation,and 16 cases of whose first diagnosed leak or misdiagnosed patients were retrospectively analyzed.Summarize the clinical characteristics,misdiagnosis and experiences in order to reduce the misdiagnosis of the disease.Results Among 20 cases of uterine perforation and Uterine empyema,16 cases first diagnosed misdiagnosed,and the incidence was 80％ (16/20).One case was diagnosed tumor torsion,1 case of diagnosis of pelvic abscess,14 cases first diagnosed of surgery (8 cases of acute peritonitis,gastrointestinal perforation in 4 cases and 2 cases of perforated appendicitis).It all occurred in postmenopausal women,and the main clinical features were that:high fever,lower abdominal pain,feel bloated in the rectal,mass pelvic cavity,weakened movement of intestine and cervical disturbance pain.results of emoyemic bacteria culture were mainly colon bacillus (E.coli).The main causes of misdiagnosis were atypical clinical manifestations,clinicians lack of comprehensive analysis and dynamic observation of the disease,over-reliance on laboratory examinations;their performance was often the first diagnosis of acute abdomen surgery,the surgeon only undergraduate examination,as well as undergraduate diagnosis of inertia thinking,neglect gynecological examination.All patients had a one-time cure after surgery.Conclusion Uterine empyema complicated with uterine perforation occurs mainly in postmenopausal women,which had a higher rate of misdiagnosis.Correctly diagnosis and timely treatments make benefits to the prognosis.
ABSTRACT
Aims: Our aim was to present a case of pyomyositis and highlight the need to distinguish it from a soft-tissue sarcoma which it can closely mimic. Presentation of Case: We report a 51-year old diabetic patient who presented with a painful swelling in the right upper arm, which was not associated with fever. The mass was well defined, tender and firm but lacked other signs of inflammation such as redness or increased local warmth. Even the magnetic resonance imaging (MRI) findings were more in favor of a soft-tissue sarcoma. A diagnosis of pyomyositis was revealed when the trucut biopsy performed, yielded frank pus discharge. Discussion and Conclusion: This case illustrates a diagnostic quandary of a soft tissue mass. There may be a paucity of inflammatory signs in patients with an underlying immunocompromised state, masking an initial diagnosis of pyomyositis. Although softtissue sarcomas generally present as painless lumps, they can be painful especially with larger tumors that are increasing in size, further adding to a diagnostic dilemma. While MRI is a valuable tool for early diagnosis of pyomyositis, it can still be misleading. Prompt biopsy is recommended to facilitate the correct diagnosis.
ABSTRACT
Objective To investigate the clinical characteristics of pulmonary actinomycosis and to improve the understanding of the clinical misdiagnosis of pulmonary actinomycosis. Method Clinical data of 4 pulmonary actinomycosis patients were analized and related literatures were reviewed. Results All the 4 pulmonary actinomy-eosis cases were misdiaguosed as lung cancer. Pulmonary actinomycosis can be correctly diagnosed through lung bi-opsy by CT-guided percutaneous paracentesis,fiberoptic,bronchoscopy,or pathological examination of the resected pulmonary lobe. Conclusions Pulmonary actinomycosis is a rare lung infection caused by fungus,and is liable to be misdiagnosed as peripheral lung cancer. The capacity of distinguishing pulmonary actinomycosis from peripheral lung cancer needs to be improved.
ABSTRACT
OBJECTIVE To report one case of primary Cryptococcus neoformans pneumonia misdiagnosed to sarcoidosis with its clinical presentations,pathology and imaging manifestation.METHODS Sarcoidosis was obtained by CT and pathologic examination.RESULTS The patient showed fever,headache and abnormal shadows in the lung field after six months.Cerebrospinal fluid examination was defined as C.neoformans.Afer review of his pathology it was diagnosed primary C.neoformans pneumonia.CONCLUSIONS C.neoformans pneumonia always shows no symptoms;only can be showed by CT as multiple nodules or large patches,and always misdiagnosed.
ABSTRACT
@#ObjectiveTo find out the reason of sacro-iliac articulation malposition misdiagnosed as single prolapse of lumbar intervertebral disc, define the essential point of diagnosing sacro-iliac articulation malposition, and choose the best treatment.MethodsChanges such as X-ray photos of lumbosacral portion and pelvis, CT photos, physiological curvature, pyramid space, joint space, pubic symphysis, and wing of ilium showed in MRI photos, and symptoms, signs of 29 patients with sacro-iliac articulation malposition were analyzed and compared with distribution of nerve in the same part.Results29 patients with sacro-iliac articulation malposition all had bulge of lumbar intervertebral disc showed by CT and MRI photos, 26 had retrograde affection of spinal column, 17 had spinal column sequence changes showed by X-ray photos. After 3-10 times treatment on the basis of sacro-iliac articulation malposition, 19 healed, 8 were effective, and 2 had been better.ConclusionCurative method of sacro-iliac articulation malposition is different with prolapse of lumbar intervertebral disc, although there being many same symptoms and signs, only need conservative treatment.
ABSTRACT
Purpose:To explore the clinical feature,and treatment of primary cervical lymphoma. Methods:Clinical data and follow-up survey data of 26 cases were retrospectively analyzed with SSPS software. Results:Primary cervical lymphoma could occur in any age group of women. The misdiagnosis rate was as high as 57.69% (15/26 case).Three of 26 patients died,the five years survival rate was 88.46%.Conclusions:Primary cervical lymphoma is rare,which was very often misdiagnosised. The treatment consisted of an combination of chemotherapy,operation and radiotherapy,which could improve curative results and reduce relapse.