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Objective To investigate the clinicopathological and prognostic characteristics of intestinal inflammatory myofibroblastic tumours(IMT)in middle-aged and elderly patients.Methods The clinical,pathologi-cal morphology,immunophenotype and follow-up results of 5 cases of intestinal IMT in middle-aged and elderly patients were retrospectively analyzed.Results 4 cases of IMT occurred in the right half colon and 1 in the ileum.Most patients(3/5)had a history of intestinal injury,starting the digestive tract symptoms and increased leukocytes.The tumor tissue was composed of fusiform myofibroblasts and fibroblasts arranged in storiform pattern,with an infiltrative growth pattern,accompanied by a large number of lymphocytes and plasma cells infiltration,collagen formation and myxedema.One case was atypically large and deformed.Immunophenotype:vimentin(5cases),SMA(5 cases),desmin(3 cases),ALK(3 cases),CK(2 cases)were positive.Caldesmon,CD34,β-catenin,MC,CD117,DOG1,S-100,BCL-2,CD99,CD68 were negative,and Ki-67 proliferation index was 1.28%to 10.01%.All the 5 cases underwent complete tumor resection and were followed up for 48.5 to 133 months.Among them,1 patient aged 83 was considered to have tumor recurrence 27 months after surgery.The other patient survived 122 months without tumor and died of other causes.All the others survived without tumor and were in good condition.Conclusion(1)Intestinal IMT in the middle-aged and elderly people in this group was more common in the right half colon,and most of them had a history of intestinal injury,first gastrointestinal symptoms and elevated white blood cells;(2)Vimentin and SMA were positive at the same time,and ALK was more positive;(3)4/5 patients had good surgical resection,and 1/5 patients could relapse 2～3 years after surgery;old age,ALK-positive,Ki67 up to 10%,atypia may be an important risk factor for intestinal IMT recurrence in the elderly,of which ALK-positive patients may have a recurrence risk of 1/3.
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Objective To evaluate the impact of uterine artery embolization (UAE) tor uterine fibroids on ovarian function in young woman. Methods From 50 young patients with symptomatic leiomyomas managed with UAE, completed follow-up 24-36 months of clinical symptomatic, ovarian function continue and pregnancy outcome. All patients participants ranged in age from 24 to 40 years, divided into lower 35 years group (30 cases)and over 35 years group (20 cases). Results There was no significant difference in serum FSH, LH and E2 levels between two groups before UAE and 3-6, 12, 24-36 months after UAE(P > 0.05).The comparison of serum FSH, LH and E2 levels between two groups at the same time points before and after UAE were no significant difference (P> 0.05). Menstrual blood loss reduced and duration of flow shorted after UAE in two groups, the differences were significant (P < 0.05). Cycle interval in over 35 years group was longer in 3-6 months after UAE than that before UAE, the difference was significant (P <0.05). There were 2 patients occurred transient secondary amenorrhea after UAE in lower 35 years group, 3 patients occurred in over 35 years group. One patient had menopausal syndrome in 37 months after UAE, and serum FSH and LH levels were found to heighten obviously, 47% pregnancies and 30% deliveries in lower 35 years group, 45% pregnancies and 20% deliveries in over 35 years group. Conclusion Transient secondary amenorrhea would have been occurred in young patients with uterine fibroid performed UAE, no prematureo varian failure and premature menopause.