外语读物2009,05,06

《外语读物2009,05,06》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、,MULTIPLEPRIMARYMALIGNANTTUMORSTheoralmucosaorjawsareofteninvolvedinthoseunusualwidespreadmalignanttumorsthatareofapparentmulticentricoriginratherthanmetastatic.TheoralmucosamaybeinvolvedwithlesiohsofKaposissarcoma.ThejawsmaybeinvolvedwithlesionsofmultiplemyelomaorEwing'ssa

2、rcoma.Kaposi'sSarcomaKaposi'ssarcoma(idiopathicmultiplehemorrhagicsarcoma)isawell-establishedentity,occurringontheskinandoccasionallyontheoralmucosaandothermucosalsites.Itisfoundpredominantlyinmalesandtheonsetisusuallyafterage40.Kaposi'ssarcomaisanunusualmalignanttumorofblo

3、odvesselorigin.Thelesionsarecomposedofnumerousdilated,engorgedbloodvesselsandthemicroscopicappearanceisthatofawell-differentiatedmalignanttumorofendothelialcells.EarlyKaposilesionsmayresemblenonspecific,granulomatous,inflammatorylesionsmicroscopically,butthereisagradualprol

4、iferationofconnectivetissueandanovergrowthofendothelialcellstoformlargenumbersofvascularchannels.Anangiomatousorafibroblasticpatternmaypredominate.Mitoticfiguresareseenaswellasatypicalspindle-shapedcells.BizarrecellformsandbizarremitosesarenotfoundinKaposi'ssarcoma.Prognosi

5、sforpatientswithKaposi'ssarcomaisgenerallygoodandisfarmorefavorablethanthatforothermalignanttumorsofendothelialcells.Prognosisforotherformsofangiosarcomaispoor.Kaposi'ssarcomaistreatedbysurgicalexcision,cryotherapy,orradiationtherapy.Thetumorisradiosensitive,andmostlesionsa

6、retreatedbythismodality.Becausethelesionsarehighlyradiosensitive,lowdosagessuchas200redsindivideddosescanbeeffective.Clinicalmanifestations.ClinicalmanifestationsoforalKaposi'ssarcomamaybered-purplemacularlesionssuchasthoseseenontheskin,witheventualdevelopmentofraised,indur

7、atedlesionswithcentralareasofnecrosisandulceration(Fig..18.16).Coexistentlesionsontheskinmaybefoundonboththeupperandlowerextremitiesaswellasthetrunk.Thegenitaliamaybeinvolved(Fig.18.17),andgastrointestinallesionsarenotuncommon.Skinlesionsusuallybecomeraisedandnodular.Differ

8、entialdiagnosisoforallesionsofKaposi'ssarcomawouldincludeepidermoidcarcinomaandben