Histiocyte-rich rhabdomyoblastic tumor: a clinicopathological and molecular genetic analysis / 中华病理学杂志

Objective: To investigate the clinicopathologic and molecular genetic characteristics, diagnosis, differential diagnosis, treatment and prognosis of histiocyte-rich rhabdomyoblastic tumor (HRRMT). Methods: The clinical data of two cases of HRRMT diagnosed in Fujian Provincial Hospital and Fujian University of Traditional Chinese Medicine Affiliated People's Hospital from 2020 to 2021 were collected. Histopathology and immunohistochemical (IHC) staining were used to assess morphological changes; the genetic changes were analyzed with next-generation sequencing. The relevant literature was reviewed. Results: Both cases showed well-defined solid nodules and soft masses. Microscopically, the tumors had a fibrous pseudocapsule with lymphocytic aggregation, and locally invaded the surrounding skeletal muscle tissue, and the tumor cells were fusiform to epithelioid with an intensive foamy histiocytic infiltrate. No necrosis or mitosis was observed. Immunophenotyping showed the tumor cells were positive for desmin, either one or both skeletal muscle markers (myogenin or MyoD1), and negative for h-caldesmon, ALK and SMA. The Ki-67 index was<5%. Using next-generation sequencing, one case was found to harbour KRAS (G12D) and MSH3 (Q470*) mutations. Conclusions: HRRMT is a newly described skeletal muscle tumor with uncertain malignant potential. Its diagnosis and differential diagnosis depend on morphologic and IHC staining. No specific molecular genetics changes have been identified so far.

Treatment of proximal fracture of humerus by percutaneous antegrade Kirschner pinning / 中国骨伤

<p><b>OBJECTIVE</b>To summarize and analyze the clinical indication, surgical techniques and results of percutaneous antegrade Kirschner pinning in the treatment of proximal fracture of humerus.</p><p><b>METHODS</b>Thirty-two patients with displaced fractures of the proximal humerus were treated with 2 to 3 Kirschner wires by percutaneous antegrade transfixation. Among 32 casas, there were 7 male and 25 female, with a mean age of 49.25 years (range, from 28 to 75 years). According to the Neer fracture classification, there were 20 cases of 2-part, 9 of 3-part, and 3 of 4-part fractures.</p><p><b>RESULTS</b>All patients were followed up for 8 to 34 months with an average of 13.5 months. According to Constant-Murley evaluation, the results were excellent in 21 cases, good in 9, fair in 2.</p><p><b>CONCLUSION</b>Percutaneous antegrade transfixaton is a good technique for the management of displaced 2-part fractures of the proximal humerus and also alternative to 3-part or 4-part fractures.</p>