...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Taiwanese journal of obstetrics and gynecology >Disseminated peritoneal tuberculosis simulating advanced ovarian cancer: A?retrospective study of 17 cases
【24h】

Disseminated peritoneal tuberculosis simulating advanced ovarian cancer: A?retrospective study of 17 cases

机译：播散性腹膜结核模拟晚期卵巢癌：17例回顾性研究

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objectives The abdominopelvic cavity is one of the common sites for extrapulmonary tubercular infections. The rate of preoperative misdiagnoses between peritoneal tuberculosis (TB) and ovarian cancer is high because of overlapping nonspecific signs and symptoms. We attempted to analyze the experience within our hospital so as to establish the best means of discriminating between peritoneal TB and advanced ovarian cancer. Methods Seventeen patients diagnosed as having peritoneal TB between July 1986 and December 2008 at the Obstetrics and Gynecology Department of our hospital with the initial presentation simulating advanced ovarian cancer were retrospectively reviewed and evaluated. Results Patients’ ages ranged from 24 years to 87 years (median, 38 years). Ten of 17 patients (60%) were younger than 40 years. All patients except one had elevated serum cancer antigen-125 levels with a mean of 358.8U/mL (range, 12–733U/mL). Computed tomographic (CT) scans showed ascites with mesenteric or omental stranding in all (100%), enlarged retroperitoneal lymph nodes in six (35.3%), and an adnexal mass in three (17.6%). Abdominal paracentesis was performed in seven cases, in which the findings revealed lymphocyte-dominant ascites without malignant cells. Surgical intervention by laparotomy was performed in 13 cases (76%) and by laparoscopy in three cases (18%), and a CT-guided peritoneal biopsy was performed in one case (6%). A frozen section was taken from 16 patients but not the patient who received a CT-guided peritoneal biopsy, and all revealed granulomatous inflammation. A final pathological examination confirmed a diagnosis of peritoneal TB. All?patients responded to anti-TB treatment. Conclusions In view of these data, a clinical diagnosis of peritoneal TB should be considered in a relatively young female with nonspecific symptoms of abdominal distension and wasting, as well as lymphocytic ascites without malignant cells. Laparoscopy or a minilaparotomy to obtain tissue samples for frozen-section analysis may be the most direct and least-invasive approach for a diagnosis, thus avoiding unnecessary extended surgery in these patients.
机译：目的腹腔腔是肺外结核感染的常见部位之一。由于重叠的非特异性体征和症状，腹膜结核（TB）和卵巢癌之间的术前误诊率很高。我们试图分析我们医院的经验，以建立区分腹膜结核与晚期卵巢癌的最佳方法。方法对1986年7月至2008年12月在我院妇产科诊断为腹膜结核的17例初诊为晚期卵巢癌的患者进行回顾性评价。结果患者的年龄为24岁至87岁（中位数为38岁）。 17名患者中有10名（60％）未满40岁。除一名患者外，所有患者的血清癌抗原125水平均升高，平均为358.8U / mL（范围12–733U / mL）。计算机断层扫描（CT）扫描显示，所有腹水均具有肠系膜或网膜绞痛（100％），腹膜后淋巴结肿大的比例为6（35.3％），附件包块的比例为3（17.6％）。腹腔穿刺术在7例中进行，结果发现淋巴细胞优势性腹水而无恶性细胞。 13例（76％）进行了开腹手术干预，三例（18％）进行了腹腔镜手术，其中1例（6％）进行了CT引导的腹膜活检。冷冻切片取自16例患者，但未接受CT引导的腹膜活检的患者，均显示肉芽肿性炎症。最后的病理检查证实了腹膜结核的诊断。所有患者对抗结核药物治疗都有反应。结论鉴于这些数据，应考虑对相对年轻的女性进行腹膜结核的临床诊断，该女性具有腹胀和消瘦的非特异性症状，以及无恶性细胞的淋巴细胞性腹水。腹腔镜或小切口开腹术以获得用于冷冻切片分析的组织样品可能是诊断的最直接，最无创的方法，从而避免了这些患者不必要的延长手术。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号