Endoscopic surgery first started as snare polypectomy and then progressed to endoscopic mucosal resection (EMR). In order to resect a lesion that is more than 2 cm, endoscopic submucosal dissection (ESD) was develope... Endoscopic surgery first started as snare polypectomy and then progressed to endoscopic mucosal resection (EMR). In order to resect a lesion that is more than 2 cm, endoscopic submucosal dissection (ESD) was developed. ESD therapy has now been established and is being used for early stage neoplastic lesions in the stomach, colon, esophagus, larynx and pharynx. In ESD specimens, we deal with relatively small lesions; therefore, more meticulous and precise pathological diagnosis is required compared to that in surgically resected specimens. In addition, we should be expert in the eligibility criteria of the different organs for ESD therapy. Here, we explain the biopsy diagnosis, including the Japanese group classification as well as the Vienna classification, handling the specimen, including fixation, photography, cutting and paraffin embedding, histological type, depth, vascular invasion and evaluation of the surgical margins, based on the latest Japanese guidelines. Japanese histopathology diagnostic criteria for the stomach, colon and esophagus are also described. We also demonstrate some examples of those mentioned above.展开更多
文摘 Endoscopic surgery first started as snare polypectomy and then progressed to endoscopic mucosal resection (EMR). In order to resect a lesion that is more than 2 cm, endoscopic submucosal dissection (ESD) was developed. ESD therapy has now been established and is being used for early stage neoplastic lesions in the stomach, colon, esophagus, larynx and pharynx. In ESD specimens, we deal with relatively small lesions; therefore, more meticulous and precise pathological diagnosis is required compared to that in surgically resected specimens. In addition, we should be expert in the eligibility criteria of the different organs for ESD therapy. Here, we explain the biopsy diagnosis, including the Japanese group classification as well as the Vienna classification, handling the specimen, including fixation, photography, cutting and paraffin embedding, histological type, depth, vascular invasion and evaluation of the surgical margins, based on the latest Japanese guidelines. Japanese histopathology diagnostic criteria for the stomach, colon and esophagus are also described. We also demonstrate some examples of those mentioned above.
文摘目的探讨小儿梅克尔憩室(MD)的CT表现,以提高对该病的诊断水平。方法回顾性分析11例(12人次)MD(8例经手术病理证实、3例未经手术病理证实但临床资料及CT表现典型)的临床资料及CT表现,与病理结果进行对照。所有患者客观数据采用SPSS 13.0软件进行统计学分析,计量资料采用平均数±标准差(x珋±s)表示,两两间比较采用t检验;计数资料间比较采用χ^2检验,P<0.05为差异有统计学意义。结果CT检查阳性11例,阳性率91.6%,术前CT诊断与手术结果相符6例,诊断符合率75%。病变位于右下腹9例,呈类肠管结构7例,与回肠相通9例,肠壁厚度大于3 mm 10例,肠壁明显强化7例,发现来自肠系膜动脉异常供血血管10例,MD肠管断面直径大于相邻回肠,但无统计学差异(P=0.126)。其管壁厚度及强化程度均高于相邻回肠,统计学分析具有显著性差异(P<0.05)。本组患者同时行超声检查,CT所发现征象和诊断符合率均高于超声,具有统计学差异(P<0.05)。结论小儿MD CT特征表现为病变段肠管管壁增厚,强化明显,肠管直接由增粗的肠系膜上动脉终末支供血,大部分可见与回肠相通。因此CT检查对该病术前诊断及鉴别诊断具有重要价值。
