摘要:目的：探討皮膚平滑肌肉瘤的臨床病理特點和診斷要點及預后。方法:對2例皮膚平滑肌肉瘤組織病理學、免疫組化觀察,并復習相關文獻。結果: 例1為皮下平滑肌肉瘤,具有結節型的生長形態,瘤細胞豐富,異型性較大,核分裂活躍；例2為真皮平滑肌肉瘤,具有彌漫型的生長形態,瘤細胞較少,分化好,核分裂象不明顯。免疫組化2例均表達SMA、MSA、Vim,1例灶性表達Desmin。2例隨訪迄今均無復發及轉移。結論:皮膚平滑肌肉瘤少見,可分為真皮和皮下兩種類型,兩者具有不同的組織起源和預后特點,我們要注意區分,診斷除核分裂象計數外,尚需進行綜合評估,對某些病例建議采用惡性潛能未定的平滑肌肉瘤的診斷,治療首選外科手術切除。Abstract: Objective: To investigate the clinic pathological features diagnosis main point and prognosis of cutaneous leiomyosarcoma（CLMS）.Methods:Histopathology,immunohistochemical stainings observation were analyzed in two cases of CLMS and the related literatures were reviewed. Results:Case 1 was subcutaneous leiomyosarcoma with tubercular growth pattern,rich tumor cell,big heterogeneous type,active mitotic；Case 2 was dermis leiomyosarcoma with diffuse growth pattern,few tumor cell,well differentiated,no more mitotic. Immunohistochemically,the two cases reacted positively with smooth muscle action、MSA and Vim,Case 1 also expressed desman partially. The two cases were revisited to date,no recurrences and metastases.Conclusion:Cutaneous leiomyosar coma is a rare tumor,subdivided into dermis and subcutaneous forms because of their different tissue origins and prognosis features. We must discriminate between them. Diagnosis need synthetic appraisal besides mitotic counts and “smooth muscle tumor of uncertain malignant potential” should be used for diagnosis of certain cases.Primary treatment for cutaneous leiomyosarcoma is surgical excision.
摘要:目的: 探討重度、極重度COPD急性加重期合并多MODS臨床特征和預后有關的危險因素。 方法 :回顧分析1999～2009年因重度、極重度COPD急性期合并多器官功能障礙而住院的患者臨床資料。 結果 :本研究共納入226例患者,平均年齡為693±52歲。呼吸系統功能障礙發生率最高,有200例。其次是心血管功能障礙和中樞神經功能障礙,各102例。患者的病死率隨著器官功能障礙的數目增加而增加。 結論 :治療重度、極重度COPD急性加重時,在常規治療基礎的同時防治MODS是降低患者病死率的關鍵。Abstract: Objective: To analyze the clinical characters and risk factors that relevant to prognosis of severe or very severe chronic obstructive pulmonary disease(COPD)exacerbation combining with multiple organ dysfunction syndrome(MODS). Methods :The clinical data of patients who was admitted to hospital for exacerbation of severe or very severe COPD combing with MODS ｉｎ 1999 to 2009 were retrospective analyzed. Results : 226 cases were analyzed in this study, the mean age of patients was 693±52 The incidence of respiratory system dysfunction was highest, which was 200 cases, and followed by the incidence of cardiovascular dysfunction and central nervous system dysfunction, which was 102 respectively. The mortality of these patients increased with the increasing number of organ dysfunction. Conclusion : Pｒｅｖｅｎｔ ａｎｄ te at MODS on the basis of conventional treatment of severe or very severe COPD exacerbation is the key factor that could reduce mortality of these patients.
