[Clinical analysis of 16 cases of pulmonary epithelioid hemangioendothelioma].

Objective: To improve the diagnosis and treatment of pulmonary epithelioid hemangioendothelioma (P-EHE). Methods: Sixteen patients diagnosed with P-EHE in Fuzhou Pulmonary Hospital of Fujian Province from January 2009 to July 2020 were collected. Their gender, age, imaging findings, pathological characteristics, treatment protocols, survival and other clinical data were summarized and analyzed. Results: The ratio of male to female among the 16 patients was 1∶1; and the average age of onset was 47.75 years. Most cases of PEHE (9/16) were found by physical examination, while some cases developed respiratory symptoms such as cough, sputum, shortness of breath, hemoptysis, chest pain, etc. (7/16). In most patients the lesions were localized to the lungs (11/16), while bone metastasis (1/16), lymph node metastasis (1/16), and pleural metastasis (4/16) also occurred. The pathological tissues were obtained mainly through surgical thoracoscopy. Chest CT images showed multiple nodules in both lungs, with most of the nodules less than 2.0 cm in diameter, and calcifications were seen, while solitary nodules and masses were rare, and pleural metastases could be manifested as pleural thickening and pleural effusion. The pathological findings were well-defined eosinophilic nodules with irregularly arranged nest-like structures. Those eosinophilic nodules had few central cells and abundant peripheral cells, which extended into the alveolar cavity like papillae. The tumor cells were epithelioid with small atypia, and vacuoles and red blood cells could be seen in the cytoplasm of individual tumor cells. Immunohistochemically, the tumor cells were positive to CD34, CD31, Factor Ⅷ andvimentin (VIM). Follow-up of 0.5 to 11 years showed that four patients died, two lost to follow-up, and the rest of the patients were in good condition, with a median overall survival (OS) of 4.58 years. Conclusions: PEHE is a rare low-grade lung tumor with no specific clinical manifestations. It can be diagnosed with chest imaging and pathological immunohistochemistry. Moreover, there is currently no standard treatment for PEHE, and most patients have a good prognosis.

[Analysis of 9 cases of nodular type of pulmonary cryptococcosis with coexisting lung cancer confirmed by pathological examinations].

Objective: To describe the characteristics of the nodular type of pulmonary cryptococcosis (PC) with coexisting lung cancer. Methods: A total of 9 cases of PC with coexisting lung cancer, admitted to Fuzhou Pulmonary Hospital of Fujian from 1st January 2009 to 31th December 2016, and confirmed by pathological examinations, were studied and the related literature were reviewed. Results: The patients consisted of 1 male and 8 females, with a mean age of (53±10) years (range, 38 to 68 years). Four patients (44.4%) had underlying diseases, 3 with diabetes mellitus and 1 with gastric cancer surgery. The main clinical manifestations of most cases were cough and phlegm. The lesions of PC on chest CT were mostly solitary or multiple nodules with a diameter < 1 cm, and the lesions of carcinoma were shown as solitary nodules with a variety of signs suggestive of malignancy. All the patients were confirmed to have concomitant PC and lung adenocarcinoma by pathological examinations. Lung cancer stage was early (Tis and Ⅰ-Ⅱ) in 88.9 % (8 cases) of the cases. All the patients received surgery and postoperative medical therapy. The prognosis was relatively good in most of them except 1 case with death due to lung cancer metastasis and 1 case with lung cancer recurrence. Conclusions: Coexistence of PC and lung cancer is rare and the clinical symptoms are not specific. When PC coexists with carcinoma and manifests as pulmonary nodule, it mimics malignant lesions and is extremely easy to be misdiagnosed. Therefore PC must be considered in the differential diagnosis of pulmonary nodules.

[Studies on chemical constituents in the root of Desmos grandifolius (I)].

OBJECTIVE: To investigate new compounds with anti-tumor activities from the root of Desmos grandifolius of Annonaceae. METHOD: The chemical constituents were isolated by silica gel column chromatography, and the structures were elucidated by UV, IR, MS, 1H NMR, 13C NMR, H-H COSY and NOESY analysis. RESULTS: Six compounds have been isolated from the CHCl3 extract of this plant and identified as lawinal(I), isolawinal(II), desmethoxymatteucinol(III), benzoic acid(IV), beta-sitosterol(V) and sitgmasterol (VI). CONCLUSION: All compounds were found from this plant for the first time. Three dihydroflavonoids isolated from this species are characterized by A-ring substitution and no B-ring substitution.

[Characteristics of CDDP-PLA microspheres in vitro and in vivo].

Studies on the drug release in vitro and hepatic arterial chemoembolization in vivo were carried out with the newly developed CDDP-PLA microspheres. The mechanism of the in vitro release was shown to conform to Higuchi equation. After chemoembolization the CDDP-PLA microspheres showed remarkably lower CDDP concentrations in the general circulation and much higher concentrations in the hepatic tissue e. g. up to 21.55 +/- 12.18 micrograms/g at 8 h, which is much higher than that (3.16 +/- 0.09 micrograms/g) of the CDDP in hepatic arterial infusions. Thus, the CDDP-PLA microspheres may improve the curative effects and lower the side effects, especially the kidney toxicity, of the anticancer drug cisplatin.