后纵隔

Objective To evaluate the classification and surgical management of "dumbbell tumor" in mediastinum and spinal in children.

目的探讨小儿后纵隔椎管肿瘤的分型和手术方式，以提高对该病的认识及疗效。

Result: Lung door district 10 of lump （account for 66%, 4 of left side among them, 6 of right side）; Put the leaf and carry and break 1 lump, accounting for take 7%; The bronchus is narrow, block 8, accounting for 53%; 5 cases of blocking pneumonia, accounting for 33%; 8 cases of blocking lung etc., accounting for 53%; The tumour infringes 6 mediastinums and pleuras 40%; The lymph gland of lung door and mediastinum shifts 5, accounting for 33%; After Gd-DTPA is strengthened, 10 lumps are strengthened-notably .

结果：肺门区肿块10例（占66%，其中左侧4例，右侧6例）；下叶背段肿块1例，占7%；支气管狭窄、阻塞8例，占53%；阻塞性肺炎5例，占33%；阻塞性肺不张8例，占53%；肿瘤侵犯纵隔及胸膜6例，占40%；肺门及纵隔淋巴结转移5例，占33%；Gd-DTPA增强后，10例肿块均显著强化。

Results Of the 63 patients with advanced neuroblastoma, the male/female ratio was 2.7:1 and the median age at diagnosis was 4 years old. Most of the initial symptoms included pyrexia, abdominal pain, abdominal mass, and leg or articular pain. Primary tumor sites were adrenal (38%), retroperitoneal (35%), mediastinal (17%), pelvic (6%) and cervical (2%). The sites of metastasis at diagnosis included local (41%) and distant (37%) lymph nodes, hone marrow (60%), hone (46%) and liver (16%).

结果 63例患者中，男女比例为2.7：1，中位年龄4岁；常见首发症状为发热、腹痛、腹部肿块、腿痛或关节疼痛；常见原发部位为肾上腺(38%)、腹膜后(35%)、后纵隔(17%)、盆腔(6%)和颈部(2%)；确诊时常见转移部位为局部(41%)和远处(37%)淋巴结、骨髓(60%)、骨(46%)、肝脏(16%)。

Of these, 12 underwent cervical medistinoscopy combined with right scalene lymph node biopsy and 10 with anterior para-mediastinal small incision.

结果纵隔镜检查后发现9例为不可手术患者，其中3例为右斜角肌淋巴结转移（N3），6例为病灶对侧纵隔淋巴结转移（N3）。

Results 6 cases giant substernal goiter were treated by collar-thyroid-incision and partial upper median sternotomy.3 cases with superior vena cava syndrom were treated with tumor resection and artificial vessel replacement or auto pericardium suture.2 cases were second time surgery for entire resection of the...

结果取颈部低位领状切口切除巨大胸骨后甲状腺肿6例；3例合并上腔静脉综合征患者分别行纵隔肿瘤切除、人工血管置换或自体心包修补术；再次手术完整切除纵隔肿瘤2例；手术治疗因肿瘤反复破溃引起纵隔感染、冻结2例。

Methods 32 cases of diffused pigmented villonodular synovitis were treated by arthroscopic total synovectomy, using routine anterior approach, combined with posteromedial, posterolateral and trans-posterior-septal approach.

方法1999年1月～2001年12月，对32例膝关节弥漫性色素沉着绒毛结节性滑膜炎，在常规关节镜入路的基础上，结合膝关节后内侧、后外侧和跨后纵隔入路，进行滑膜全切。

RESULTS: Of the 44 patients, 25 received adjuvant chemotherapy after operation; 1 received operation alone; 18 received induction chemotherapy. Of the 18 patients, 7 received tumor resection after chemotherapy; 2 patients with primary mediastinal chorioepithelioma with multiple metastases received radiotherapy on residual disease after chemotherapy; 1 patient with postoperative abdominal metastasis and 1 with postoperative lung metastasis achieved complete remission after chemotherapy; 1 patient with mediastinal sinus tumor achieved partial remission after chemotherapy; 6 had poor response to chemotherapy and died of disease progression.

结果：44例患者中，25例行术后辅助化疗；1例单纯手术；18例行诱导化疗，其中7例患者化疗后肿瘤缩小行手术切除，2例原发纵隔绒癌伴多发转移患者化疗后行残留病灶放疗，1例术后腹腔转移和1例术后肺转移患者化疗后获得完全缓解，1例原发纵隔内胚窦瘤化疗后部分缓解，未做进一步治疗，6例患者化疗无效进展死亡。

Materials and Math- ods: CT and MRI findings of 7 cases with ganglioneuroma and 2 case with ganglioneuroblastoma proved by operation and pathology were analysed retrospectively.

目的：分析后纵隔神经节细胞瘤和神经节神经母细胞瘤的CT和MRI表现及其诊断。

Resujts:① The distribution of lesions are mostly symmetrical, extensive, predominant in the middle and lower lung fields, and posterior areas in peripheral;② There are so many HRCT findings of lung, ILD is predominant: intralobular interstitial thickening 46 cases (100%), ground-glass opacity 41 cases (89.13%), peribronchovascular or centrilobular interstitial thickening 40 cases (86.96%), interlobular septal thickening 38 cases (82.61%), irregular linear opacity 37 cases (80.43%), small nodular opacity 34 cases (73.91%), subpleural line 27 cases (58.70%), bmnchiectasis or bronchiolectasis 19 cases (41.30%), patch opacity 18 cases (39.13%), expiratory mosaic sign 15 cases (32.61%), interface sign 14 cases (30.43%), honeycombing 12 cases (26.09%), emphysema or bulla 3 cases, cystic airspace suspected 1 case, and atelectasis suspected 1 case;③ Mediastinum and pleura: multiple small lymphonodi in mediastinum 41 cases (89.13%), pleural thickening or rough 38 cases (82.61%), esophagoectasis 11 cases (23.91%), unilateral little pleural fluid 1 case, and mediastinal emphysema 1 case.

结果：①皮肌炎肺部病变分布呈对称、广泛、偏中下、偏外后的特点；②肺部HRCT表现多样，以肺间质性改变为主：小叶内间质增厚46例(100%)，磨玻璃影41例(89.13%)，支气管血管束增宽或小叶核心增大40例(86.96%)，小叶间隔增厚38例(82.61%)，不规则纤维索条影37例(80.43%)，结节影34例(73.91%)，胸膜下线27例(58.70%)，支气管或细支气管扩张19例(41.30%)，斑片影18例(39.13%)，呼气相马赛克征15例(32.61%)，界面征14例(30.43%)，蜂窝影12例(26.09%)，肺气肿或肺大泡3例，单纯囊状气腔1例，肺不张l例；③纵隔及胸膜：纵隔小淋巴结影41例(89.13%)，胸膜增厚或毛糙38例(82.61%)，食管扩张11例(23.91%)，单侧少量性胸腔积液1例，纵隔气肿1例。

Results Among 94 cases, 79 cases who were preoperatively diagnosed with unknown mediastinal mass or lymphadenopathy by chest Computer tomography did not obtain the pathological cell by bronchoscopy, sputum cytology or percutaneous pneumocentesis biopsy, by SCM, 74 cases obtained the pathological diagnosis, while the other 5 cases did not obtain the pathological diagnosis.

结果 其中79例CT显示不明原因的纵隔肿物或纵隔淋巴结肿大，且纤维支气管镜和痰脱落细胞学或经皮肺穿刺未找到病理细胞，纵隔镜检查后74例获得病理诊断，5例未获病理明确。

Plunder melds and run with this jewel!

掠夺melds和运行与此宝石！

My dream is to be a crazy growing tree and extend at the edge between the city and the forest.

此刻，也许正是在通往天国的路上，我体验着这白色的晕旋。