A Case of Senile Langerhans Cell Histiocytosis with Soft Tissue Mass as the Main Manifestation / 罕见病研究

Langerhans cell histiocytosis (LCH) is a rare disease characterized by the proliferation of Langerhans cells and the destruction of local tissue. LCH large occurs in children, whilst incidence of the elderly population is extremely low, and there are few related studies. LCH lesions can involve multiple organs and systems, including bone tissue, lymph nodes, skin, liver, and spleen. However, it is rare that multiple soft tissues are implicated for eldly patients with LCH and present with soft tissue mass as the main manifestation. Here is a report on the clinical features, treatment and prognosis of an elderly LCH with multiple soft tissue masses as the main manifestation, in order to provide clinical reference.

Establishment of a vx2 bone tumor model in rabbit tibia / 中国组织工程研究

BACKGROUND: Many methods have been developed to establish a rabbit VX2 tumor model, but the reliability of each method has not been explored. In order to develop a reliable method, we made some improvements based on the existing methods. OBJECTIVE: To investigate the reliability of rabbit VX2 tumor tissue block implantation and cell suspension via modified and traditional implantation to make the rabbit tibia VX2 tumor model. METHODS: Forty healthy adult New Zealand white rabbits were randomly divided into two groups. Group A was treated with tissue block implantation for tibia VX2 tumor modeling, and group B was treated with cell suspension for tibia VX2 tumor modeling. Modified and traditional implantation was performed on the left and right tibia of the experimental animals, respectively. One hour after successful modeling, ultrasound examination of the puncture site was performed to determine whether there is hematoma. All experimental animals were sacrificed at 3 weeks. X-ray examination of the bilateral tibia was performed to confirm the tumor growth range. Tumor tissue and soft tissue around the puncture site were taken for general and pathological observation to compare the size of the tumor and identify whether there is tumor cell metastasis. RESULTS AND CONCLUSION: One rabbit died in the tissue block group, and all the experimental animals in the cell suspension group survived. X-ray examination indicated the tumors in the tissue block group invaded the cortex, but the tumors in the cell suspension group did not invade the cortex. Gross observation revealed that the tumor volume of the tissue block group was greater than that of the cell suspension group. In the tissue block group, there were one and seven cases of hematoma around the puncture site at 1 hour after modified and traditional implantation, respectively. In the cell suspension group, there were two and nine cases of hematoma around the puncture site at 1 hour after modified and traditional implantation, respectively. Pathological examination showed that local tumor invasion was found in 1 and 8 cases in the tissue block group as well as in 2 and 11 cases in the cell suspension group at 3 months after modified and traditional implantation, respectively. Our findings indicate that the tissue block implantation method is easier and more convenient than the cell suspension method for making rabbit VX2 bone tumors, and the tumor invasion rate of the tissue block implantation method is lower than that of the cell suspension method. Improved tissue block implantation can effectively reduce the tumor invasion rate during modeling.

Analysis of electrocautery generated smoke by chromatographic-mass spectrometry / Análise, mediante cromatografia/espectrometria de massas, da fumaça gerada por eletrocautério

ABSTRACT Objective: to analyze the chemical components of the smoke from electrocautery from coagulating muscle and liver tissues of pigs. Methods: we collected smoke produced by electrocautery applied to porcine tissue in previously evacuated bottles, with qualitative and quantitative analysis of the compounds present through the hyphenated technique gas chromatography / mass spectrometry. Results: there was a majority of decanal aldehyde in the fumes from the subcutaneous, muscle and liver tissues. Fumes of subcutaneous and muscular tissues also showed the presence of hexanal and phenol. In the fumes of subcutaneous and liver tissues we also found toluene and limonene and, finally, nonanal smoke was present in the muscle and liver tissues. Conclusion: there is increasing evidence showing that smoke from electrocautery used in subcutaneous, muscle and liver tissue is harmful to human health. Thus, there is need to reduce exposure to it or wear masks with filters capable of retaining these particles.

RESUMO Objetivo: analisar quimicamente os componentes da fumaça do eletrocautério, provenientes da coagulação de tecidos, muscular e hepático de suino. Métodos: coleta de fumaça produzida por eletrocauterização de tecido porcino em frascos previamente evacuados com análise qualitativa e quantitativa dos compostos presentes, através de técnica hifenada, cromatografia a gás/espectrometria de massas. Resultados: houve presença majoritária do aldeído decanal nas fumaças provenientes dos tecidos subcutâneo, muscular e hepático. Fumaças dos tecidos subcutâneo e muscular mostraram também a presença de hexanal e fenol. Nas fumaças dos tecidos subcutâneo e hepático foram encontrados ainda tolueno e limoneno e, por fim, nonanal estava presente nas fumaças dos tecidos muscular e hepático. Conclusão: há número crescente de evidências mostrando que fumaça proveniente de eletrocauterização de tecidos subcutâneo, muscular e hepático é nociva à saúde de seres humanos. Portanto, há necessidade de reduzir a exposição a ela ou usar máscara com filtro capaz de reter essas partículas.

Rare case of intramuscular hemangioma of infraspinatous muscle.

Intramuscular hemangiomas are rare benign neoplasms accounting for <1% of all hemangiomas. Intramuscular hemangiomas are relatively uncommon and frequently misdiagnosed, due to their vague presentations. In any patient with soft-tissue mass suspected of a hemangioma, MR imaging may provide very specific information regarding the characteristics, the origin, and the extent of the lesion than other imaging modalities. The definitive diagnosis is made by histopathological study of the surgical specimen. Here, we present a case report of intramuscular hemangioma occurring in the left infraspinatous muscle in an 18-year-old boy. Due to rare nature of such lesions, the patient's diagnosis was delayed and patient was treated for chronic pain in left shoulder joint. Magnetic resonance imaging finally clinched the diagnosis and patient was successfully operated upon and subsequently cured.

Factors Influencing the Finding of Strain Ultrasound Elastography in Benign Subcutaneous Tumors

PURPOSE: The purpose of this study is to investigate factors influencing strain sonoelastography findings in evaluation of subcutaneous tumors. MATERIALS AND METHODS: Retrospective analysis of sonoelastography findings performed by two radiologists in 38 consecutive patients with 38 pathologically confirmed benign subcutaneous tumors was performed. Elastographic finding of the lesions was graded from 1 (softer) to 3 (harder) according to stiffness. Analysis of correlations between elastographic findings and height, width and depth of the lesion, and the distance from bone was performed using the Kruskal-Wallis test. RESULTS: By reviewer 1, 11 lesions were grade 1 on sonoelastography, eight were grade 2, and 19 were grade 3, respectively. By reviewer 2, 11 lesions were grade 1 on sonoelastography, nine were grade 2, and 18 were grade 3, respectively. The distance from bone differed significantly among the three grades groups for both reviewers; grade 1, 2, and 3, 0.78 +/- 0.75 cm, 1.56 +/- 0.68 cm, and 1.77 +/- 0.63 cm, for reviewer 1 (P = .006) and 0.86 +/- 0.79 cm, 1.55 +/- 0.72 cm, and 1.74 +/- 0.65 cm for reviewer 2 (P = .016). No significant difference in height, width, and depth of the lesion was observed among the three groups. CONCLUSION: Distance from bone showed a significant association with strain sonoelastographic findings of benign subcutaneous tumors.

Periprosthetic Mass after Total Hip Replacement / 대한고관절학회지

PURPOSE: To analyze the characteristics and causes of periprosthetic huge mass which occur after treatment by total hip arthroplasty. MATERIALS AND METHODS: Of the patients who had undergone total hip arthroplasty from January 2000 to October 2007, we retrospectively evaluated the 10 patients who suffered huge soft tissue mass. Five of these patients had received metal-on-metal bearing (group 1) prostheses, and the other 5 had received metal-on-polyethylene bearings (group 2). We evaluated the size and location of the mass, the extent of osteolysis, and the hematologic and pathologic examination results. RESULTS: Roentgenographically, the location of the masses varied from the acetabular area to the distal femoral stem. The mean mass diameter of all 10 patients was 14.6 cm(7-21 cm)x6.2 cm(3-9 cm)x7.2 cm(4-12 cm). Osteolytic lesions were found in 3 group 1 patients and 3 patients in group 2. High counts of lymphocytes and eosinophils were present in group 1. High counts of macrophages were present in group 2. CONCLUSION: The occurrence of osteolysis and huge soft mass after total hip arthroplasty is thought to be related to foreign body reaction by polyethylene wear particles and metal hypersensitivity. Outside-in patterned cortical thinning was considered to be indicative of a long standing periprosthetic soft tissue mass effect.

Replantation methods of mini tissue mass of amputated finger / 中华显微外科杂志

Objective To investigate the replantation methods and outcomes of mini tissue mass of amputated finger. Methods Twenty-six fingers of 20 patients were replanted with multiple vessel anastomosis methods to restore blood supply.The methods include vascular anastomosis,vascular bridge,arteriovenolization,veno-arteriolization,et al. Results Twenty-five replanted tissues were survived completely.Partly necrosis occur in 1 case,and rehabilitation by change dressings.The patients were follow up from 6 to 12 months.The contour and function of the replantation fingers recovered satisfactory. Conclusion By using the rational anastomosis according to the traumatic condition,it could be obtain good outcome of mini tissue mass replantation

Superficial Soft Tissue Masses: Sonographic and Pathologic Findings

Superficial soft tissue masses are frequently encountered in clinical practice. Sonographic imaging is a first-choice screening modality to confirm or exclude the presence of a soft tissue mass at a site of clinical concern. In this pictorial review, we demonstrate the sonographic and pathologic findings of superficial soft tissue masses including benign and malignant lesions, which can occur in the skin and subcutaneous layer.

Calcific Myonecrosis of the Antetibial Area

Calcific myonecrosis is a rare late post-traumatic condition, in which a single muscle is replaced by a fusiform mass with central liquefaction and peripheral calcification. Compartment syndrome is suggested to be the underlying cause. The resulting mass may expand with time due to recurrent intralesional hemorrhage into the chronic calcified mass. A diagnosis may be difficult due to the long time between the original trauma and the symptoms of calcific myonecrosis. We encountered a 53-year-old male patient diagnosed with calcific myonecrosis in the lower leg. We report the case with a review of the relevant literature.

Anaplastic Large Cell Lymphoma Presenting as a Soft

Anaplastic large cell lymphoma (ALCL) is a rare tumour, accounting for approximately 3% of adult non-Hodgkin lymphomas.1 Primary systemic ALCL frequently involves both lymph nodes and extranodal sites. A 44-year-old woman presented with a firm, mobile mass in the left iliac fossa region. Ultrasound findings showed a well defined inhomogenous soft tissue mass, measuring 4x4x2.6cm in the deep subcutaneous region. Histopathological examination revealed that the mass was infiltrated by large lymphoid cells with marked nuclear atypia including kidney-shaped nuclei. These neoplastic cells expressed anaplastic lymphoma kinase (ALK) (both nuclear & cytoplasmic staining), CD30 and EMA but not for T-cell (CD45RO and CD3), and B-cell (CD20 & CD79α) markers. Fluorescence in situ hybridization (FISH) analysis showed a t(2;5)(p23;q35) chromosomal translocation. Subsequently the patient developed shortness of the breath and a thoracic computed tomography (CT) scan showed a mass encasing the right upper lobe bronchus. She also had bilateral axillary lymph nodes, measuring 1 cm in diameter (biopsy was not done). The mediastinum and endobronchial region did not show any abnormalities. She received 6 cycles of CHOP chemotherapy and remained disease free 2 years after diagnosis. ALCL, rarely present as a soft tissue tumour and this disease should be included as a differential diagnosis of any soft tissue mass.

Ultrasonographic Evaluation of Osteosarcomas / 华中科技大学学报（医学）（英德文版）

The ultrasonographic appearances of osteosarcomas and the roles of ultrasonography in the diagnosis and surgical staging of osteosarcomas were investigated. A comparative study was performed on 45 cases of osteosarcomas by ultrasonography and radiography. Bony changes, periosteal reaction and soft tissue mass were evaluated for each lesion. The results showed that ultrasonography revealed a solid mass around bone in 42 patients, bone destruction in 24 patients and periosteal reaction in 16 patients. Plain radiographs showed bony changes in 44 patients and no bony change in remaining one patient, shadowing of soft tissue swelling in 30 patients, and pulmonary metastases in 3patients. Surgical biopsy and pathological examination confirmed osteosarcoma in all 45 patients.Soft tissue mass was confirmed in 42 patients surgically. The diagnostic accuracy of soft tissue masses by ultrasonography and radiography was 100 % (42/42) and 71.4 % (30/42), respectively. The positive rate of ultrasonography and radiography in displaying bony changes was 53.3 % (24/45) and 97.8 % (44/45), respectively. In conclusion, in the detection of soft tissue mass of osteosarcoma, ultrasonography is superior to radiography, and in displaying bony changes of osteosarcomas, radiography is superior to ultrasonography. So it may come to a conclusion that plain radiography combined with ultrasonography can completely display the bony and soft tissue lesion of osteosarcomas.

Replantation of the amputated mass of fingers / 中华显微外科杂志

Objective To explore the replantation methods of the amputated tisue mass of fingers. Methods Fifteen cases were replanted using the physiological blood circulation replantation and the no physi- ological blood circulation replantation.Results All eleven cases survived with the physiological blood circu- lation replantation,one case failure with no physiological blood circulation replantation.Postoperative follow up ranged from six months to two years,with an average of fifteen months,the function and appearance were satis- factory.According to Hand Surgery of Chinese Medical Association' s functional evaluation in digital replanta- tion,eleven cases were excellent and two cases were good,the excellent and good rates were up to 86.7%. Conclusion For the amputated tissue mass of fingers,the physiological blood circulation replantation is the best choose.

The study of amputated finger complex mini tissue mass replantation / 中华显微外科杂志

Objective To investigate the operative methods and treatment outcomes of replantation of amputated complex mini tissue mass of the fingers Methods Seventeen severed complex mini mass in 16 cases were replanted with microsurgery technique using different revascularization procedures Results Fifteen replanted masses were survived completely,proximal partial skin margin necrosis in 1 case,only one case was failure Both function and appearance in surviving replantations were excellent after 6～24 months follow up Conclusions Replantation of amputated complex mini tissue mass of the fingers is rewarding as long as the mass remained intact and the vessels for anastomosis could be found

Effect of physical exercise in daily life on the aging process in healthy women in terms of aerobic capacity, serum lipid concentration, body composition and bone mineral density / 体力科学

A cross-sectional study was carried out to investigate the effect of physical exercise in daily lives of healthy women on the aging process in terms of maximal aerobic capacity (VO<SUB>2</SUB>max), body fat tissue mass (FTM), lean tissue mass (LTM), bone mineral density (BMD), serum triglyceride (TG), total cholesterol (TC), HDL-C and LDL-C concentrations, and systolic (SBP) and diastolic blood pressure (DBP) . These parameters are considered as risk factors of cerebrovascular disease and/or osteoporosis, which are the main causes of becoming bedridden and demented in middle-aged and older women. One hundred sixty-five healthy female volunteers aged 20 to 76 years participated in the study, 82 of whom were postmenopausal with a mean age at menopause of 49.7±3.1 years. Eighty-two of the subjects had been exercising regularly by jogging, swimming, aerobic dancing, or playing tennis more than twice a week for 2 years (Ex group), whereas 83 individuals had not been engaging in regular exercise (Cont group) . Serum lipid concentrations, SBP and DBP measurements at rest and treadmill VO<SUB>2</SUB>max and HRmax measurements were determined in the morning after an overnight fast. Whole-body BMD (TBMD), head, lumbar, arm and leg BMD, FTM and LTM were measured by dual-energy X-ray absorptiometry one to two hours after a light lunch. The mean and SD of each measurement were calculated for five-year age groups between 40 and 60 years and one group each under 40 and over 60 years.<BR>The results were as follows:<BR>1, VO<SUB>2</SUB>max (r=-0.590) and HRmax (r=-0.632) decreased significantly with age. The VO<SUB>2</SUB>max of the Ex group was significantly higher than that of the Cont group in all each age groups. However, no differences in the aging process in terms of HRmax were found between the two groups.<BR>2, Resting SBP (r=-0.391) and DBP (r=0.315) increased significantly with age. However, no hypertensive individuals (160/95 mmHg-) were found among the 165 subjects.<BR>3. Only serum TC (r=0.346) and LDL-C (r=0.339) among the blood constituents measured changed with age. No changes in serum HDL-C were detected with age. Lower TC (189.2±23.3 mg/dl) and higher HDL-C (72.2±10.9 mg/dl) were observed in eleven runners (49.7±7.7 years) among the subjects who participated frequently in official races than in subjects of the same ages in the Cont group. The highest serum HDL-C (75.8±15.8 mg/dl) and HDLC/TC ratios (0.362) were noticed among the subjects (n=26) who both regularly exercised and consumed alcoholic beverages.<BR>4. A tendency for FTM to increase and LTM to decrease with age were observed in both groups, and a lower %FTM (percentage of FTM to body weight) and higher %LTM were evident in the Ex group. Differences in %FTM and %LTM between the Ex and Cont groups at 40-45 years were significant.<BR>5. Partial and whole BMDs decreased significantly with age (TBMD-Age ; r=- 0.527) . Significantly higher leg BMDs in both the 20-39-year and 40-45-year groups, and spine and TBMD in the 20-39 years in the Ex group, who were premenopausal women, were shown. No significant differences in BMDs between the two groups were observed in postmenopausal women, but the Ex group tended to have higher partial and whole BMDs. The postmenopausal official race runners (n=5.52.6-1.5years) also had higher TBMD and leg BMD values than subjects of the same ages in the Cont group.<BR>6. Investigation of correlations between VO<SUB>2</SUB>max, LTM, FTM, BMDs and serum lipid concentrations, yielded a significantly higher correlation (r=0.669) between LTM (kg) and absolute VO<SUB>2</SUB>max (1/mm) . Although VO<SUB>2</SUB>max per LTM (VO<SUB>2</SUB>max/LTM) decreased with age (r=-0.595), VO<SUB>2</SUB>max/LTM in the Ex group was significantly higher than in the Cont group in each age group. The VO<SUB>2</SUB>max per body weight (ml/kg/min) was negatively correlated with %FTM (r=-0.442) and positively correlated with

Malignant Intracranial Osteolytic Meningioma Appearing as an Extracranial Soft Tissue Mass: A Cases Report

Malignant intracranial meningioma is a rare pathologic entity. Although the topic is widely discussed, there is little agreement in the literatures as to the histological and radiological features that warrant the diagnosis of malignant meningioma. An osteolytic lesion of the skull may have been suggested in several cases. But in adults, the most commonly suspected lesion is metastatic lesion;while meningioma is rarely suspected. Meningiomas are occasionally associated even with extracranial masses. However, most of these masses are firm, and are caused by hyperostosis. Extracranial soft-tissue masses rarely arise in meningiomas, thus, the presence of both osteolytic skull lesion and soft-tissue mass is exceedingly rare in meningiomas. The authors report a case of osteolytic malignant meningioma located at the frontal fossa extending to the subgaleal space appearing as an extracranial soft-tissue mass in a 19-year-old female. The clinical, radiological, neurosurgical, and histopathological features of these lesions are discussed together with a review of the literatures.

An Application of the Ultrasonograhy to the Musculoskeletal Masses / 대한정형외과학회잡지

Ultrasonography is suited for screening patients with a mass in the soft tissue because of its safety, low cost, apparent sensitivity and non-invasiveness. But the application in orthopaedic surgery is insufficient. Authors examined 102 patients who had a palpable soft tissue mass of extremities and trunk with ultrasonography. Location, internal echogenicity, margin, and extent of soft tissue involvement, especially neurovascular bundle by tumor were evaluated. The diagnosis of mass was confirmed by histopathology after excision or biopsy of the mass. The ultrasonography correctly identified and differentiated the cystic lesions of 34 cases. The sonograms of all 16 malignant lesions showed ill-defined margin and heterogenous internal echo. The extent of soft tissue involvement, especially neurovascular bundle was confirmed exactly with ultrasonography. Therefore, in malignant tumor, after confirmation of no neurovascular involvemment with ultrasonography, limb-salvage operation could be considered and planned. In one case of abscess, percutaneous biopsy was done under guidance of ultrasonography. Therefore, ultrasonography can be used as a guide for percutaneous biopsy without exposure to radiation.