Solid basal adenoid cystic carcinoma of the breast: A case report and literature review.

RATIONALE: Adenoid cystic carcinoma (AdCC) is a rare malignancy of the breast with a low Ki-67 index and good prognosis. Owing to the rarity of breast AdCC, the misdiagnosis rate is as high as 50%, and there is no consensus or recognized guidelines for the treatment of this disease. Therefore, it is necessary to conduct a detailed clinical and pathological analysis in combination with a literature review to improve our understanding, diagnosis, and treatment of the disease. METHODS: A 68-year-old woman sought medical attention due to a recently increasing mass in the breast. The left breast mass was 1.3 cm × 1 cm in size. We analyzed the morphology, immunohistochemistry, and molecular characteristics of the tumor removed by surgery, and reviewed relevant literature. DIAGNOSES: Solid basal AdCC of the breast. INTERVENTIONS: We performed biopsy, immunohistochemistry and molecular testing on surgical resection specimens. OUTCOMES: Combining morphological and immunohistochemical features, it is consistent with solid basal AdCC of the breast, and Fish detected MYB gene break. LESSONS: Due to the high misdiagnosis rate of AdCC, accurate histopathological diagnosis is particularly important. At present, breast conserving surgery and local tumor resection are mainly used for the treatment of breast AdCC, and postoperative adjuvant radiotherapy is feasible.

[Evaluation of the bleb morphology and the function of post filtration surgery using slit-lamp adapted optical coherence tomography and ultrasound biomicroscopy in glaucoma patients].

OBJECTIVE: To analyze the morphology and the function of subconjunctival filtering bleb in patients with glaucoma by slit-lamp adapted optical coherence tomography (SL-OCT) and ultrasound biomicroscopy (UBM). METHODS: This retrospective study comprised 53 patients with glaucoma filtering surgery from 2002 to 2006. The post-operation blebs in 69 eyes of 53 patients were scanned by a SL-OCT or UBM and categorized by the reference of intrableb morphology. The function of post operation bleb was clarified using Singh's or Yamamoto's criterion. The results of SL-OCT scanning were compared with those of UBM. RESULTS: This is a comparative study. The blebs were classified into four categories according to the images of filtering blebs' by SL-OCT or UBM. SL-OCT had 92.7% (38/41 eyes) sensitivity in predicting a functioning bleb by Singh's standard and 83.3% (20/24 eyes) specificity in predicting a nonfunctioning bleb, whereas, UBM had 66.7% (30/45 eyes) and 75.0% (18/24 eyes) by Yamamoto's criterion, respectively. The sensitivity in predicting a functioning bleb in the SL-OCT group was significantly (P = 0.003, Fisher exact test) different from the UBM group. CONCLUSIONS: Our results suggest that SL-OCT scanning has more sensitivity and specificity than UBM in evaluating the function of filtering bleb. The close relationship between the function and the morphological classification provides an important objective basis in evaluating the outcome of antiglaucomatous surgery.

Evaluating subconjunctival bleb function after trabeculectomy using slit-lamp optical coherence tomography and ultrasound biomicroscopy.

BACKGROUND: The existing classifications for evaluating glaucoma filtering blebs rely mostly on external bleb characteristics and the postoperative control of intraocular pressure (IOP). Internal bleb structures are not carefully observed. This study aimed to analyze and compare glaucoma filtering bleb morphology using slit-lamp-adapted optical coherence tomography (SL-OCT) and ultrasound biomicroscopy (UBM), and to classify blebs according to results and intraocular pressure. METHODS: We followed 29 eyes of 21 male patients and 40 eyes of 32 female patients who underwent glaucoma filtering surgery in Sixth People's Hospital of Shanghai, between 2002 and 2006. The blebs were imaged using SL-OCT and UBM and classified according to the intrableb morphology and control of IOP after surgery. A Fisher's exact test was used to compare the sensitivity for predicting a functioning bleb differed significantly between SL-OCT and UBM. A Fisher's exact test was also used for morphological analysis of the trabeculectomy blebs based on SL-OCT. RESULTS: In the 69 eyes, there were 45 (65.2%) functioning blebs and 24 (34.8%) non-functioning blebs. We classified the blebs into four categories on the basis of SL-OCT images: diffuse, cystic, encapsulated and flat. Diffuse and cystic blebs were typically functional, whereas the other two types were always non-functional. The sensitivity of SL-OCT for predicting a functioning bleb was 92.7% (38/41 eyes) and specificity of predicting a non-functioning bleb was 83.3% (20/24 eyes). By contrast, sensitivity of UBM was 66.7% (30/45 eyes) and specificity was 75.0% (18/24 eyes). The sensitivity for predicting a functioning bleb differed significantly between the two techniques (P = 0.003). CONCLUSIONS: SL-OCT provides high-axial-resolution images of anterior segment structures. The non-contact approach of SL-OCT enables visualization of intrableb structures at any time after surgery. SL-OCT has greater sensitivity and specificity than UBM in evaluating filtering bleb function. The morphological classification supported the assessment of bleb function and could provide objective data for evaluating the outcome of antiglaucoma surgery or the need for a second procedure.

Expression of ciliary neurotrophic factor after induction of ocular hypertension in the retina of rats.

BACKGROUND: Glaucoma is mainly characterized by the loss of retinal ganglion cells. Ciliary neurotrophic factor (CNTF) is believed to stimulate the regeneration of axons of retinal ganglion cells. The objective of our study was to detect the expression of CNTF in the retina of a rat glaucoma model with increased intraocular pressure (IOP). METHODS: The rat glaucoma model was set up by electrocoagulating at least three episcleral and limbal veins. The location and the expression level of CNTF were detected at 1, 3, 7, 14, and 28 days post-surgery by immunohistochemistry, semiquantitative reverse-transcription polymerase chain reaction (RT-PCR), and Western blot analysis. RESULTS: The rat glaucoma model with chronic, moderately elevated IOP was successfully produced. A minimum expression of CNTF was found in the ganglion cell layer of the retinas of the control group, and temporally increased expression and intensity of CNTF were found in the experimental retinas. CONCLUSION: The expression of endogenous CNTF in the rat retina was found altered after the induction of ocular hypertension.