Tuberous sclerosis complex with skin lesions as the initial presentation: A case report and multidisciplinary discussion. / 1例以皮肤损害为首发症状的结节性硬化症并多学科讨论.

We reported a case of tuberous sclerosis complex with facial angiofibroma as the initial presentation and conducted a multidisciplinary discussion. The patient, a young female, was admitted to the Department of Dermatology for cosmetic purpose. After the examination, she was found to have multiple system involvement, including a large renal angiomyolipoma pressing on the liver. She never had any subjective symptom. After consultation by the multidisciplinary team of tuberous sclerosis complex, the patient was treated with everolimus orally and followed up regularly. It is suggested that dermatologists should pay attention to the systemic involvement of patients with tuberous sclerosis complex. Early intervention can prolong the life of patients and improve their life quality. Multidisciplinary collaboration for lifelong disease management is the key to enhance the diagnosis and treatment for tuberous sclerosis complex and enhance the prognosis of patients.

A case of pseudomyogenic hemangioendothelioma misdiagnosed as low-grade malignant fibrous histiocytoma and review of literature. / è¯¯è¯Šä¸ºä½Žåº¦æ¶æ€§çº¤ç»´ç»„ç»‡ç»†èƒžç˜¤çš„å‡è‚Œæºæ€§è¡€ç®¡å† çš®ç˜¤1ä¾‹å¹¶æ–‡çŒ®å¤ä¹ .

Pseudomyogenic hemangioendothelioma (PHE) is a rare angiogenic tumor. Histologically, the morphological characteristics of neoplastic vessels and endothelial differentiation are not obvious, and it is easy to be confused with epithelioid sarcoma, epithelioid hemangioendothelioma and myogenic tumor. PHE usually occurs in arms and legs in young people and has a significant male predominance. The tumor has a predilection for the distal extremities and its typical manifestation is multiple center invasion of a single limb, which can involve all layers of skin and subcutaneous tissues,and is often accompanied by abvious pain. Histologically, PHE is characterized by infiltrative growth of tumor. Most tumor lesions are composed of sheets and loose fascicles of plump spindle or epithelioid cells within a background of variably prominent inflammatory infiltration, which was commonly composed of neutrophils. Some cells may resemble rhabdomyoblasts, and nuclear atypia and mitosis were rare. The tumor cells generally expressed positive cytokeratin (CK), ETS-related gene (ERG), Friend leukemia virus integration 1 (FLI1) and integrase interactor 1(INI1). In some cases, the tumor cells expressed CD31. A case of a young woman was reported in this paper, who presented with a subcutaneous mass with severe pain and was chronologically misdiagnosed with herpes zoster, low-grade malignant fibrous histiocytoma and epithelioid hemangioendothelioma. In this study, the clinical and pathological features, differential diagnosis and the latest progress in therapy of PHE were analyzed based on relevant literature.

The hybridization between Sphagneticola trilobata (L.) Pruski and Sphagneticola calendulacea (L.) Pruski improved the tolerance of hybrid to cadmium stress.

Hybridization is common between invasive and native species and may be accompanied by invasive evolution. The hybrid of Sphagneticola trilobata (alien invasive species) and Sphagneticola calendulacea (indigenous congener) was found in South China. According to previous studies, the hybrid performed weak environmental adaptability in comparison with parents. However, based on the results from this study, the hybridization significantly improved the tolerance of the hybrid to cadmium (Cd) stress (200 µmol L-1). Under Cd stress, the hybrid lines showed lowest level of oxidative damage and the highest level of photosynthetic efficiency. Compared with the parents, the hybrid utilized more active detoxification strategies, such as the cell walls of the leaves and roots adsorbed 88% and 95% Cd, respectively, reducing the amount of Cd entering cells; moreover, most of the Cd that entered cells was transformed into less toxic chemical forms through the reduction of the highly toxic chemical forms; furthermore, it accumulated a large number of phytochelatins to bind Cd2+ and reduced the damage of organelles by Cd2+. The results demonstrate that hybridization between S. trilobata and S. calendulacea improved the adaptability of the new hybrid species to Cd stress and may pose a greater threat to the survival of the native parent species in the presence of serious water and soil pollution.