Clinicopathologic features and prognosis of adenoid cystic carcinoma of external auditory meatus / 中华病理学杂志

Objective@#To investigate clinicopathologic features and prognosis of adenoid cystic carcinoma (ACC) involving external auditory meatus.@*Methods@#The clinical presentation and follow-up data of 63 patients with ACC of external auditory canal were collected from January 2006 to February 2017 at PLA General Hospital and Hainan Branch of PLA General Hospital. The clinicopathologic features and prognostic factors of external auditory canal ACC were analyzed.@*Results@#(1) There were 28 males and 35 females and the average age of the first diagnosis was 48.9 years (22-81 years). The tumors showed cribriform pattern in 35 cases (15 cases of late stage), tubular pattern in 14 cases (8 cases of late stage), and solid pattern in 14 cases (9 cases of late stage). Cases with solid pattern was relatively more frequent than that of cribriform pattern and tubular pattern, but the difference was not statistically significant (P>0.05). (2) The average follow-up time was 62.4 months (2-228 months) in the 57 available cases. Among the 33 cases with recurrence, 18 cases had local recurrence and 15 cases had distant metastasis. The mean recurrence time was 40.6 months (2-204 months). Nine patients died of ACC: 2 cases in early stage (died at 48 and 102 months after the first treatment), 7 cases in late stage and 57 with (died at 9, 30, 32, 60, 72, 94 and 228 months). (3) Among the 37 patients with perineural invasion, there were 21 cases of cribriform pattern, 4 cases of tubular pattern and 12 cases of solid pattern; the number of cases in early stage and late stage were 15 and 22, respectively; and the differences were statistically significant (P<0.05). In addition, 31 cases had otalgia among the 37 patients with perineural invasion, where differences were not significant (P>0.05). (4) Thirty of 45 cases with tumor resection or partial resection of temporal bone had recurrence, whereas 3 of 12 cases of tumor combined with superficial lobectomy of parotid gland had recurrence. The difference was statistically significant (P<0.05). Postoperative adjuvant radiotherapy was given in 19 cases, including 7 cases of early stage (2 cases of recurrence), and 12 cases of late stage (8 cases of recurrence), among which there was no significant difference (P>0.05).@*Conclusions@#ACC occurring in external auditory canal frequently recurs. Superficial parotid lobectomy at the first operation is necessary to prevent tumor recurrence. Postoperative adjuvant radiotherapy has certain curative effect on patients with early stage tumor, but it does not affect the recurrence rate. Patients at late stage are more prone to perineural invasion than those in early stage. In addition, cribriform and solid patterns are more common that tubular pattern, and there is no significant correlation between perineural invasion and otalgia.

Characteristics of ERG, Fli-1, CD34, CD31 and FⅧRAg expression in hepatic malignant vascular tumors / 中华病理学杂志

Objective@#To investigate the expression of ERG, Fli-1, CD34, CD31 and factor Ⅷ-related antigen(FⅧRAg) in hepatic malignant vascular tumors.@*Methods@#A retrospective analysis was conducted on 63 cases of primary hepatic malignant vascular tumors and 31 cases of hepatic other malignant spindle cell tumors collected during January 1986 to January 2014. EnVision method was used to detect the expression of ERG, Fli-1, CD34, CD31, FⅧRAg.@*Results@#Sixty-three cases of malignant vascular tumors, including 24 cases of angiosarcoma, 38 cases of epithelioid hemangioendothelioma and 1 case of hepatic Kaposi′s sarcoma. All of the cases were positive for ERG(100.0%, 63/63). Positive rate of Fli-1, CD34, CD31, FⅧRAg was 96.8% (61/63), 87.3% (55/63), 81.0% (51/63) and 41.3% (26/63), respectively. In other hepatic malignant spindle cell tumors, the positive rate of ERG, Fli-1, CD34, CD31 and FⅧRAg was 3.2% (1/31), 19.4% (6/31), 19.4% (6/31), 9.7%(3/31) and 3.2%(1/31), respectively.The sensitivity of ERG, Fli-1, CD34, CD31, FⅧRAg was 100.0%, 96.8%, 87.3%, 81.0% and 41.3%, respectively.The specificity was 96.8%, 80.6%, 80.6%, 90.3% and 96.8%, respectively.@*Conclusion@#ERG is a more sensitive and specific diagnostic marker for hepatic malignant vascular tumors in comparison to Fli-1, CD34, CD31 and FⅧRAg.

A study on clinical target volume of pancreatic cancer under the scope of ct scanning and pathology / 中华放射肿瘤学杂志

Objective To compare the tumor sizes of primary lesions in pancreatic cancer based on CT scan and postoperative pathological analysis and measure the extent of filtration under a microscope,and to determine the CTV in radiotherapy target delineation.Methods A total of 19 patients with pancreatic cancer who were admitted to PLA General Hospital and Air Force General Hospital,PLA from 2013 to 2014 were analyzed.In 15 patients,the maximum diameters of tumor cross-section were measured based on the images of preoperative multi-slice spiral CT and postoperative gross samples,respectively.In 19 patients,the extent of tumor infiltration was measured on pathological sections under a microscope and the actual extent of infiltration was calculated.The paired t-test was applied to analyze the differences in the results of different measurement methods.Results In the 15 patients,the maximum tumor diameters measured with gross samples and CT scan were 33.6 mm and 30.1 mm,respectively (P=0.000),and the median and mean of the differences were 3.1 mm (1.2-8.0 mm) and 3.6±2.0 mm,respectively (95％ CI 1.2-6.0).In the 19 patients,the maximum actual infiltration distance and the maximum distance measured were 3.50 mm and 3.19 mm,respectively (P=0.000),and the median and mean of the differences were 0.31 mm (0.15-0.50 mm) and 0.30±0.09 mm,respectively.The maximum distance between the margin of primary lesions and the infiltrating lesions was 5.21 mm,with a median of 3.34 mm (2.19-5.21 mm) and a mean of 3.50± 0.88 mm (95％ CI 2.19-5.06).Conclusions Contrast-enhanced CT scan underestimates the actual size of primary lesions in pancreatic cancer,and an extension of 5 mm outside gross tumor volume (GTV) as CTV may not be sufficient.It is recommended to extend another 1-3 mm outside GTV as CTV.

Association between obesity-related plasma hemodilution and the concentration of prostate specific antigen / 南方医科大学学报

<p><b>OBJECTIVE</b>To determine the effect of obesity on prostate specific antigen (PSA) in men with benign prostatic hyperplasia (BPH) and develop a PSA-related parameter that can eliminate the effect of obesity.</p><p><b>METHODS</b>We reviewed the clinical data of 706 patients with BPH. Two PSA-related parameters, namely PSA mass (total circulating PSA protein) and PSA mass ratio (total circulation PSA protein per prostate volume), were calculated for all the patients and the association of BMI with PSA, PSA mass, and PSA mass ratio was assessed.</p><p><b>RESULTS</b>A higher BMI was significantly associated with a greater plasma volume and prostate volume (P<0.05). Linear regression analysis revealed a greater adjusted R2 of BMI versus plasma volume than of BMI PSA (0.569 vs 0.027). PSA was positively associated with the prostate volume and negatively with BMI and plasma volume (P<0.05). PSA mass was positively associated with prostate volume (P<0.05) but was not associated with BMI or plasma volume (P>0.05). PSA mass ratio was not associated with prostate volume (P>0.05) but negatively associated with BMI and plasma volume. Plasma volume and prostate volume, PSA, and PSA mass ratio (P<0.05), but not PSA mass (P>0.05), differed significantly among normal-weight, overweight, and obese patients.</p><p><b>CONCLUSION</b>A higher BMI is associated with a greater plasma volume in BPH patients. In obese patients with BPH, a lower PSA concentration may result from hemodilution caused by a greater plasma volume, and PSA mass can eliminate the effect of obesity on PSA.</p>

Muscle tissue lymphoma presenting only with fever of unknown origin: a case report and literature review / 南方医科大学学报

Extra-nodal malignant lymphoma is often characterized by a lack of typical symptoms and positive results of auxiliary examinations, which make diagnosis difficult. In some cases, fever can be the only clinical manifestation. For the lymphoma patients presenting with persistent fever with a duration over 3 weeks, characteristics of fever including time of fever attack, fever type and effects of drugs may have significant value in the diagnosis, especially in the early stage of the disease or in rare cases.

Diagnosis and clinical characteristics of patients with non-allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore a step-by-step exclusive diagnosis and analyze the clinical characters of non-allergic rhinitis (NAR).</p><p><b>METHODS</b>Patients with symptoms (nasal itching, sneezing, rhinorrhea, nasal congestion) were selected to take four-step exclusive diagnosis for NAR and we tried to eliminate the false NAR and retain the true NAR. First step was to exclude the patients who were not suitable for skin prick test (SPT, such as during pregnancy, breastfeeding, asthma, oral antihistamine medication in 7 day, severe skin diseases). The second step was to exclude the patients with positive SPT and the third step was to exclude the patients with 1 level or above of specific sero-immunoglobulin E (sIgE). The fourth step was to exclude the patients with infection rhinitis, clear abnormal nasal structure, drug-induced rhinitis, nasal neoplasm. The remained patients were finally diagnosed as NAR and who were further differential diagnosed as vasomotor rhinitis (VMR) or non-allergic rhinitis with eosinophilia syndrome (NARES) according to the eosinophilia counts in nasal secretion and venous blood. The common characters of patients with NAR were analyzed and their symptoms and quality of life were evaluated by visual analogue scale (VAS) and rhino-conjunctivitis quality of life questionnaire (RQLQ) separately.</p><p><b>RESULTS</b>One thousand four hundred and thirty-seven patients were included after first step exclusion and 735 cases with negative SPT were remained after second step exclusion. Of 735 patients, 302 were tested in vitro for sIgE and 93 cases with 0 level of sIgE and total IgE were remained after third step exclusion. Sixty-two patients were finally diagnosed as NAR after fourth step exclusion. The NAR diagnosis rate was 51.15% (735/1 437) with negative SPT alone and the NAR diagnosis rate was 29.06% (93/302) with combination of negative SPT and sIgE. Of 62 patients with NAR, 47 patients (75.81%) were diagnosed as VMR and 15 cases (24.19%) as NARES. There were 23 males and 39 females in the 62 patients aged 11 - 77 years. The history was 11-47 months. The biggest numbers of patients with VMR or NARES were among 41-50 years. Their onset ages were among 21-30 years in both two groups. VAS scores of nasal congestion in VMR patients were the highest with significant difference among nasal symptoms (F = 3.958 0, P = 0.009 1). VAS scores of sneezing in NARES patients were the highest but without significant difference among nasal symptoms. There were no difference in seven domain scores of RQLQ and the total mean scores between VMR group and NARES group but the nasal symptoms got the highest scores with significant difference among the seven domains in each group (VMR group, F = 9.771 2, P = 0.000 0;NRAES group, F = 3.226 9, P = 0.006 2).</p><p><b>CONCLUSIONS</b>SPT combined with sIgE may exclude much more patients with AR. Females with NAR are much more than males. Patients with NAR aged 21-30 years. The characters of NAR are helpful to improve our knowledge about NAR. VAS and RQLQ may be a suitable tool in assessment of NAR.</p>

Study on the morphological features, pathologic diagnosis and differential diagnosis of well-differentiated hepatocellular carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To analyze the clinicopathologic characteristics of well-differentiated hepatocellular carcinoma (WD-HCC), and to find clues for its pathologic diagnosis and differential diagnosis.</p><p><b>METHODS</b>Seventy-three cases of WD-HCC were studied with clinical data analysis, gross and microscopic examination.</p><p><b>RESULTS</b>Among the 73 cases, the prevalence of HBV (+) and/or HCV (+) was 94.5% (69/73), liver cirrhosis was 80.8% (59/73), increased hepatic cell density was 95.9% (70/73), dilated and irregular hepatic sinus was 89.0% (65/73), prominent trabecularism was 89.0% (65/73), increased cytoplasmic eosinophilia or basophilia was 90.4% (66/73), glandular-like structure was 16.4% (12/73, and fatty degeneration was 42.4% (31/73) .</p><p><b>CONCLUSIONS</b>There are important clinicopathologic features associated with WD-HCC. These features are useful in the differential diagnosis of WD-HCC with dysplastic nodule (DN), focal nodular hyperplasia (FNH) and hepatocellular adenoma.</p>

Prognostic value of clinical and pathological characteristics in 48 women with pseudomyxoma peritonei / 中华妇产科杂志

Objective To investigate the clinic-pathological characteristics and prognosis of 48 female cases with peritoneal pseudomyxoma(PMP).Methods The clinicopathologic features and follow-up data of 48 female patients with PMP diagnosed in the General Hospital of People's Liberation Army from Jan.1982 to Dec.2011 were retrospectively reviewed.The relationship between clinic-pathological characteristics and prognosis were analyzed using log-rank test and Cox proportional hazards model.Results (1) Clinicopathologic features:the mean age of the 48 cases was 58.8 years (range from 24 to 79 years).Symptoms:abdominal distention and abdominal discomfort were the main symptoms.Imaging examinations showed nonspecific abdominal and pelvic lesions in most cases.Treatment:all the 48 patients underwentlaparotomy and cytoreductive surgery (CRS),in which 15 (31％) patients with completeness of the cancer resection (CCR)-1,24(50％) cases with CCR-2,and CCR-3 in 9(19％) cases.Six (12％) cases were treated by intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin,20 (42％) patients were treated with different options postoperative adjuvant chemotherapy.Pathological types:the cases were histologically classified into 3 subcategories:disseminated peritoneal adenomucinosis (DPAM),peritoneal mucinous carcinomatosis (PMCA),and PMCA with intermediate or discordant features (PMCA-I/D),which were 22 (46％) cases,9 (19％) cases and 17 (35％) cases,respectively.Appendiceal tumors:44(92％) cases underwent appendectomy,in which 38 cases presented appendiceal tumors (including 20 cases of low-grade appendiceal mucinous adenoma and 18 cases of appendiceal mucinous adenocarcinoma),2 cases were diagnosed as appendicitis,4 cases with unknown pathologic diagnosis.And the other 4(8％) cases,who didn't undergo appendectomy at the first operation,presented peritoneal tumor recurrence and appendiceal mucinous tumors 1,11,32 and 85 months after surgery,respectively.Parenchymal organs involved:ovarian involving was happened in 34 (71％)patients including 15 cases with the right ovary involving,13 cases in both sides,and 6 cases involving the left side.The other parenchymal organs in 10(21％) cases.(2) Prognostic factors:11 patients died,31 survived and 6 cases were lost to follow-up.The mean survival time was 99 months(ranged from 1 to 312 months).The 3-year,5-year and 10-year survival rates were 73.3％,68.0％ and 46.6％,respectively.Univariate statistical analysis showed that age,pathological type and parenchymal involvement were significantly relationship with the survival time (all P ＜ 0.05).But the operation times,appendiceal tumor type,ovarian involvement,CCR,intraperitoneal HIPEC and post-operative adjuvant chemotherapy were not significantly correlate with survival time (all P ＞ 0.05).Multivariate analysis showed that age and pathologic type were independent prognostic factors (P ＜ 0.05).Conclusions No specific clinical features presented in PMP.CRS with HIPEC should the recommended treatment.Both ovaries exploration and appendectomy should be carried out routinely in CRS.The 10-year overall survival of PMP is low.Age,pathological type and parenchymal organs involvement other than ovarian are correlated with the prognosis.And the pathological type and age are independent prognostic factors of PMP.

Evaluation of contrast-enhanced transrectal ultrasound in differential diagnosis of prostate cancer and benign prostatic hyperplasia / 中华超声影像学杂志

Objective To evaluate the application of contrast-enhanced transrectal ultrasound ( CETRUS) to identify prostate cancer(PCa) from benign prostatic hyperplasia(BPH). Methods A total of 86 patients with focal prostatic disease detected by trans rectal ultrasound(TRUS) were enrolled in this study.Each patient underwent grey-scale TRUS, CE-TRUS, and targeted-biopsy of prostateunder ultrasound guidance successively on the same day. The criteria of perfusion pattern would be statistically analyzed among groups divided by pathological findings. Every patient's images of CE-TRUS were observed and features of perfusion pattern were recorded by two doctors who were blind to any clinical data of patient.Then these features recorded by two doctors were compared, if the features were coherent, they would be recorded as final results,and otherwise two doctors would consult till the features were coherent. Results Compared with BPH group, the enhancement features of PCa group were rapid enhancement, increased enhancement, heterogeneous enhancement, well-defined boundary of lesion after enhancement, asymmetric appearance of intraprostatic vessels, rapid decrease, perfusion defect areas within lesions and the roughly discontinuous juncture between enhancement and no enhancement area within lesions. Conclusions There was significant difference in enhancement pattern between BPH and PCa groups, observing enhancement pattern could help to identify prostate cancer from benign prostate hyperplasia.

Clinical analysis of 7 patients with Paget's disease of bone / 中华内分泌代谢杂志

Clinical and imageological characteristics of Paget's disease of bone in 7 patients who were treated in our hospital from 1991 to 2007 were analyzed. The data showed (1) 6 patients had the symptoms of bone pain and bone deformity, with more long bones involved; (2) Serum alkaline phosphatase was over normal range; (3) Imageology showed that osteoclasia was usually combined with bone sclerosis; (4) All the patients were treated with bisphosphonates; (5) 2 patients with serious bone deformity were treated with orthomorphia. Paget's disease of bone is a kind of metabolic bone disease with the characteristics of osteoclasia combined with bone sclerosis. The main features are bone pain and bone abnormality. Bisphosphonates are the first choice of drugs. Patients with serious bone deformity should be treated with orthomorphia.

Characteristics of coronary microvascular lesions in autopsied elderly with hypertensive left ventricular hypertrophy / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To observe the characteristics of coronary microvascular lesions (CML) in the autopsied elderly cases with hypertensive left ventricular hypertrophy (LVH) and the difference of CML among the groups of essential hypertension (EHT), coronary heart disease (CHD) and diabetes (NIDDM) also with LVH.</p><p><b>METHODS</b>A retrospective study was performed in 206 cases > or = 60 years old of EHT, CHD and NIDDM with LVH and 30 normal cases as control, out of 3195 consecutive autopsied cases from 1954 to 1996 in our hospital. Arterioles with diameters of 10 - 60 microm and capillaries in the muscular layer were shown by the methods of HE, Elastic fiber + VG staining and immunohistochemistry of CD31. Quantitative measurements on the arteriole density (AD), the ratio of arteriolar wall and cavity (RWC), capillary density (CD) and the area of endothelial cell (AEC) were performed with light microscope observation and image analysis by computer. According to the thickness of the left ventricle free wall, the severity of LVH was divided into four degrees from 0 to III. LVH of degree 0-III was observed in EHT group, while only LVH of degree I was found in CHD, EHT + CHD, and NIDDM groups. SAS system was used for statistical analysis.</p><p><b>RESULTS</b>AD and RWC increased while CD and AEC decreased significantly with the progression of LVH in EHT groups (P < 0.05 - 0.01). There was a similar but more severe change in the (HT + CHD) group (P < 0.01); the AD increased (P < 0.05) while all other measurements did not show obvious changes in the CHD group. The AD increased, CD and AEC decreased (all P < 0.05), but RWC did not change very much in the NIDDM group.</p><p><b>CONCLUSION</b>CML in the EHT group was characterized by an increased AD and RWC, decreased CD and AEC, among which the increased RWC was the typical change in EHT groups compared with the groups of CHD and NIDDM. Damaged CML may be one of the main factors for decreased coronary flow reserve and myocardial ischemia in cases of EHT with LVH.</p>

Oral venous lakes: a clinicopathologic analysis of 20 cases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To improve the recognization and treatment for oral venous lakes (OVL).</p><p><b>METHODS</b>Clinicopathologically analysis of 20 cases of oral venous lakes was performed. All the samples were removed by surgically.</p><p><b>RESULTS</b>All the lesions occurred in senile persons and located under the mucosa. Among the 20 cases, 11 were male patients and 9 were female; 18 of 20 occurred in the lower lip, another two in the upper lip and buccal mucosa. The lesions were 0.3 approximately 1.2 cm in size. Pathologically, the oral venous lake was composed of single or a few large, dilated and irregular veins. Thrombosis and organization were found within the lesions sometimes.</p><p><b>CONCLUSIONS</b>Oral venous lakes are a kind of focal anomalies of venous structure. All the 20 cases (with a follow-up time from 8 months to 4 years) has no recurrence after surgical treatment.</p>

The diagnosis and treatment of retroperitoneal cystic lymphangioma / 中华泌尿外科杂志

Objective To evaluate the diagnosis and treatment of retroperitoneal cystic lymphangioma. Methods A retrospective study of clinical characteristics and imaging findings of pathologically proved cystic lymphangiomas in 7 adults (2 males and 5 females;mean age,51 years) was conducted,and comparisons were made between these findings and operative and pathological results.All the patients presented no special clinical manifestation.Ultrasonography and CT scan showed smoothly margined cystic masses ranging from 6 cm?7 cm to 20 cm?21 cm;some of them had septums, and the walls and septums could be partially enhanced. Preoperative definite diagnosis was made in only 1 case by CT-guided percutaneous catheter drainage of the lymphangioma; while the others were misdiagnosed as abdominal cavity cysts(2 cases)and retroperitoneal space-occupying cystic lesions(4 cases). Results Complete extirpation was performed in 6 cases,and subtotal cystectomy,in 1 case because of the liver and pancreas involvement by the tumor.Postoperatively,all the lesions were pathologically proved to be retroperitoneal cystic lymphangioma.There was no recurrence during the follow-up of 9 months to 10 years,except for 1 case undergoing subtotal cystectomy who had local recurrence 5 months after operation. Conclusions Ultrasonography and CT are the most useful imaging modality for locating the site and determining the nature of lymphangioma . Surgical excision is the first choice for the treatment.

Expression of apoptosis inhibitor gene survivin in bladder carcinoma and its clinical implication / 中华泌尿外科杂志

Objective To study the expression of survivin, an apoptosis inhibitor gene,in bladder carcinoma,and to investigate its clinical and pathological implications. Methods We detected the expression of survivin in 60 cases (48 men and 12 women) of bladder carcinoma and 10 cases of non-tumor bladder tissues (controls) by immunohistochemistry (SP) method.The mean age of the 60 cases at diagnosis was 59 years.The pathological grading showed Grade Ⅰ in 16 cases,Grade Ⅱ in 24 and Grade Ⅲ in 20.The clinical staging showed T 1 in 13 cases,T 2 in 15,T 3 in 21 and T 4 in 11.Of the 60 cases,21 developed relapse. Results The overall positive rate of survivin in 60 cases of bladder carcinoma was 60.0% (n=36).No survivin was found in 10 cases of non-tumor bladder tissues.The positive rate of survivin in Grade Ⅰ cases of bladder carcinoma was 37.5%(6/16),in Grade Ⅱ and Ⅲ cases of bladder carcinoma was 66.7%(16/24) and 70.0%(14/20);the difference of positive rates between Grade Ⅰ and Grade Ⅱ,Grade Ⅲ cases was significant (P0.05).The positive rate of survivin in cases of relapse was 80.9% (17/21). Conclusions Survivin may play an essential role in bladder carcinogenesis and serve as a marker for prognosis of bladder cancer.

Clinicopathological features of chronic inflammatory mass lesion of the pancreas / 中国普通外科杂志

Objective To study the clinicopathological features of chronic inflammatory mass lesion of the pancreas.Methods The clinical data of 37 patients with focal chronic inflammatory mass lesion of the pancreas were retrospectively studied.Seventeen cases congruent with the standard clinical diagnostic of chronic pancreatitis were separated into group A;and Whipple procedure was carried out in two cases,resection of the body and tail of the pancreas in 2 cases,local resection in one case,and choledochojejunostomy in 12 cases.Those without the stander clnical features of Group A but with the features of pancreatic tumor were separated into Group B;and Whipple procedure was carried out in 4 cases,choledochojejunostomy in 16 cases.Results In group A,except for the local mass lesion,sclerosis of the whole pancreas was found in 88.2% of cases.Pathological examination showed proliferation of fibrous tissue with associated inflammation,as well as acinar atrophy,remnant islet cells,and ductular dilatation and focal calcification.While in Group B,only a local mass lesion of the pancreas was found in 19 cases.The pathological features were characterized histologically by proliferation of fibrous tissue with associated moderate or marked inflammation.No pancreatic carcinoma was found during 1 to 12 years follow-up of 33 cases.Conclusions Chronic inflammatory mass lesion of the pancreas showed the clinicopathological features of pseudotumoral pancreatitis.Internal drainage by choledochojejunostomy is suggested as its effective management.

Study on the relationship between the pathology of thymoma and myasthenia gravis / 临床神经病学杂志

Objective To investigate the relationship between the latest WHO criteria of thymic epithelial tumours(TET) and the incidence of MG,Osserman classfication and postoperative prognosis of myasthenia gravis(MG). Methods To analyse the pathological sections of 105 patients with thymoma from 1974 to 2000 with Levine-Rosai's clinicopathological classification,traditional histological classification and WHO classification respectively,and analyse and compare their relevance with the incidence,Osserman classification and postoperative prognosis of MG.Results (1)The cases with benign tumors of type A and type AB were more than those of type B.(2)Type B3 more likely accompanied MG than type A and type AB (P

Evaluation of risks of skin sparing breast conserving surgery for early stage breast cancer / 解放军医学杂志

Objective To evaluate the oncologic risks of skin sparing breast conserving surgery for carcinoma of breast at early stage.Methods Serial sections of skin overlying the tumor were done for pathological examination in 50 cases of early stage breast cancer after skin sparing breast conserving operation.Results In 50 cases of breast conserving surgery,the extent of skin removal was 0.5-1.0cm in 21 cases,1.0-1.5cm in 25 cases,and 1.5-2.0cm in 4cases.Skin involvement was found in one patient with stage Ⅱ breast cancer,and the rate of skin involvement was 2%.Skin involvement was closely related with the changes in skin overlying the tumor,but not with the tumor size,pathologic types or axillary lymph node metastasis.Conclusion The rate of skin involvement in early stage breast cancer is rare,therefore if there are no abnormal clinical manifestations in the skin,skin sparing breast conserving surgery is safe.

An immunohistochemical study of primary and secondary ovarian mucinous adenocarcinoma / 解放军医学杂志

Objective To study the histological and immunohistochemical features of primary and metastatic ovarian mucinous adenocarcinoma. Methods 24 cases of primary ovarian mucinous adenocarcinoma and 16 cases of metastatic mucinous adenocarcinoma (5 gastric, 5 appendix, 6 colorectal) with definite diagnosis were included in this study. All the tissue sections with either HE staining or immunohistochemical staining with CK7 and CK20 monoclonal antibodies were studied. Results All the 24 primary mucinous adenocarcinoma were positive for CK7 and only 3 cases showed focal positive for CK20. Among the 16 secondary mucinous adenocarcinoma, 6 colorectal and 5 appendiceal metastatic adenocarcinoma were positive for CK20 and only one metastasis showed focal positiveness for CK7. The five gastric metastatic mucinous adenocarcinoma showed strong CK7 expression and four of them were CK20 positive. Conclusions The primary and secondary mucinous adenocarcinoma of the ovary had different immunohistochemical features. CK7 and CK20 were valuable markers in the differentiation of these two entities.

Clinicopathological and imaging feature of endolymphatic sac tumor / 解放军医学杂志

Objective To study the clinicopathological and imaging features,key points of diagnosis and prognosis of endolymphatic sac tumor.Methods Seven cases of endolymphatic sac tumor were studied with routine histopathological,immunohisochemical staining and CT,MRI scanning.Patients' prognosis and life quality were aesessed by follow-up.Results The clinical symptoms of patients were progressive sensorineural deafness,tinnitus,vertigo and affection of cranial nerves.CT revealed reticular of moth-eaten bony destruction of the petrosal region,and MRI revealed a region of high-signal intensity void of vascular flowing signals.The histopathologic examination of the tumor presented a papillary-cystic pattern.The tumor cells were round or cubaid in shapen,with nuclei in similar shape and size.There were cyst-like structares filled mith pinkish gelatinous.Tumor cells were roundor cuboid in shape,and some of them contained clear cytofrlasm.There was materials,which were stained strongly with PAS.Hemorrhage,cholesterol crystal and foreign body giant cells were found in the tumor stroma with abundant small blood vessels and extravasation of blood,cells with intracellular hematin,and giant cells collagen.There was also proliferation of fibrous connective tissues.Necrosis and bone destruction were also found in some cases.Immunohistochemical results showed that CK and NSE were positive in all the tumors,and CD56 and S-100 were positive in part of cases,GFAP,EMA,CgA,TG and Syn were negative in all the specimens.One patient had received radiotherapy after partial resection.Relapse occurred only in one patient two years after the first surgery,and no metastasis or relapse occurred in the rest of patients.Conclusions Endolymphatic sac tumor is a rare neoplasm.The diagnosis relies mainly on histopathological and immunohisochemical findings.The patients often have good prognosis.

Multicystic renal cell carcinoma:a clinicopathologic study with comparison of it with renal clear cell carcinoma undergoing cystic change / 解放军医学杂志

Objective Multicystic renal cell carcinoma(MCRCC)appears to be a distinct subtype of renal cell carcinoma with characteristic gross and microscopic features.To explore the clinical and pathological features of MCRCC in order to find out its difference from renal clear cell carcinoma undergoing cystic change(RCCCC),and to propose prognosis criteria for therapeutic modalities.Methods From 1999 to 2003 32 patients were identified to have renal carcinoma,and they received radical or partial nephrectomy in the authors' institution.The pathological diagnosis was either MCRCC(n=21)or renal cell carcinoma associated with features of cystic changes(n=11).All specimens were reviewed histologically by two independent pathologists.The clinicopathologic and follow-up prognosis data on MCRCC and RCCCC were collected for study.Results 21 patients with MCRCC were 17 men and 4 women.The mean age at the time of surgery was 49 years(range 37 to 67 years).15 MCRCC patients with follow-up data were still alive with a mean follow-up time of 61 months(ranged 31 to 73)and no evidence of recurrence and metastasis was discovered.The mean survival time for 7 of the 11 patients with RCC was 32 months(ranged 18 to 63).There was significant difference in survival time between the two groups(P