Value of three-section contrast-enhanced transrectal ultrasonography in the detection of prostate cancer.

BACKGROUND: To assess the efficacy of three-section contrast-enhanced transrectal ultrasonography (CETRUS) in prostate cancer (PCa) detection. METHODS: A total of 169 consecutive patients with either PSA level ≥ 4 ng/ml or abnormal digital rectal examination findings were prospectively enrolled in this single center study. All patients underwent baseline transrectal ultrasonography (TRUS) and three-section CETRUS by one investigator blinded to any clinical data before TRUS-guided transperineal biopsy. The performances of baseline TRUS, single-section, and three-section CETRUS for PCa detection were compared. RESULTS: On a per-patient basis, the sensitivity, specificity, and overall accuracy for detecting PCa with three-section CETRUS was 92.3%, 69.2%, and 78.1%, respectively. In comparison with conventional (single-section) CETRUS (sensitivity 75.4%, specificity 72.1%, and accuracy 73.4%), three-section CETRUS performed significantly better (p < 0.05, McNemar test). Additionally, the low-grade PCa detection rate for three-section CETRUS was significantly higher than that of conventional CETRUS (26.7% versus 10.2%, p < 0.05). CONCLUSIONS: Our study demonstrated a significant benefit of three-section CETRUS relative to conventional CETRUS, and this technique may find more PCa patients eligible for active surveillance. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:304-309, 2017.

[Solid variant of angiomatoid fibrous histocytoma:report of 3 cases].

OBJECTIVE: To study the clinicopathologic features, immunophenotype, molecular genetics and differential diagnosis of solid variant of angiomatoid fibrous histocytoma. METHODS: The clinicopathologic features of 3 cases of solid variant of angiomatoid fibrous histocytoma were analyzed and the literature was reviewed. RESULTS: There were a total of 2 males and 1 female. The age of patients ranged from 9 to 12 years. The patients presented with a painless mass located in left forearm, left knee or back. The lesions were treated by complete surgical resection. On gross examination, the tumors varied from 1.6 cm to 4.5 cm in greatest dimension. They were well-circumscribed and had pale yellow to grayish-red solid cut surface. Histologically, the tumor was composed of histocytoid cells arranged in sheet-like pattern. A fibrous pseudocapsule surrounded by lymphocytes and plasma cells was identified. Immunohistochemical study showed that the tumor cells in all cases were positive for vimentin and CD68. They were negative for S100 protein, cytokeratin, CD34, CD31, smooth muscle actin, CD35, CD21 and CD30. Two cases also expressed CD99 and one of them was positive for desmin and epithelial membrane antigen. Fluorescence in-situ hybridization was positive for EWSR1 gene. CONCLUSIONS: Solid type represents a variant of angiomatoid fibrous histocytoma and is considered as tumor of borderline malignant potential. Definitive diagnosis requires thorough histologic examination and clinical correlation. Immunohistochemistry and EWSR1 gene study are helpful in further delineation and differential diagnosis. Complete resection or wide local excision with post-operative follow up is the main modality of treatment.