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Objective To investigate the clinical presentation, endoscopy and pathological features of subclinical cellular rejection (SCR) of small bowel allotransplantation. Methods Three times of SCR in a patient after isolated small bowel transplantation were studied by endoscopy and microscopy, and the clinical data and literature were reviewed. Results SCR was an unusual type of acute rejection after small bowel transplantation. SCR showed low-grade morphological changes of acute rejection, and may be relived after low-dose steroid or bolus steroid was given. Conclusion The causes of SCR are not clear now. SCR may be the early stage of clinical acute rejections, and may be correlated with unexpected high grade acute rejection, and chronic loss function of graft. The biopsy through ileoscopy is a "golden standard" of diagnosis of SCR in small bowel transplantation.However, the vessel lesions of graft, ileus, and inflammation should be excluded before diagnosis.
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Plasmablastic lymphoma is a recently described B-cell derived lymphoma. The prognosis of plasmablastic lymphoma patients is usually poor. We performed a systematic review of the literature on the use of highly active anti-retroviral therapy [HAART] and the prognosis of plasmablastic lymphoma. A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Science Citation Index yielded ten randomized controlled trials. Trials were divided into two groups according to therapy. The rates of plasmablastic lymphoma were analyzed using a fixed-effects model. Sensitivity analyses [on publication type, statistical model] were performed to further detect and evaluate clinically significant heterogeneity. Tests of survival for plasmablastic lymphoma were also performed by using Kaplan-Meier method. Meta-analysis result showed that the prognosis of plasmablastic lymphoma patients was statistically different in the patients receiving HAART in addition to chemotherapy and/or radiotherapy than in the patients receiving the chemotherapy and/or radiotherapy alone [pooled relative risk=3.04; P=.03]. Survival analyses also displayed a statistically significant difference [Kappa[2]=6.22, P=.013]. HAART in addition to chemotherapy and/or radiotherapy is effective in improving the prognosis of plasmablastic lymphoma. However, the small sample sizes increase the likelihood of bias in the studies in this meta-analysis, and therefore, the results should be taken cautiously
Subject(s)
Humans , Antiretroviral Therapy, Highly Active , Prognosis , Meta-Analysis as Topic , Treatment Outcome , Randomized Controlled Trials as TopicABSTRACT
Plasmablastic lymphoma is a recently described B-cell derived lymphoma. The prognosis of plasmablastic lymphoma patients is usually poor. We performed a systematic review of the literature on the use of highly active anti-retroviral therapy [HAART] and the prognosis of plasmablastic lymphoma. A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Science Citation Index yielded ten randomized controlled trials. Trials were divided into two groups according to therapy. The rates of plasmablastic lymphoma were analyzed using a fixed-effects model. Sensitivity analyses [on publication type, statistical model] were performed to further detect and evaluate clinically significant heterogeneity. Tests of survival for plasmablastic lymphoma were also performed by using Kaplan-Meier method. Meta-analysis result showed that the prognosis of plasmablastic lymphoma patients was statistically different in the patients receiving HAART in addition to chemotherapy and/or radiotherapy than in the patients receiving the chemotherapy and/or radiotherapy alone [pooled relative risk=3.04; P=.03]. Survival analyses also displayed a statistically significant difference [chi[2]=6.22, P=.013]. HAART in addition to chemotherapy and/or radiotherapy is effective in improving the prognosis of plasmablastic lymphoma. However, the small sample sizes increase the likelihood of bias in the studies in this meta-analysis, and therefore, the results should be taken cautiously
Subject(s)
Humans , Prognosis , Meta-Analysis as Topic , Antiretroviral Therapy, Highly Active , Treatment Outcome , Drug Therapy, CombinationABSTRACT
Objective To explore the morphological, immunohistochemical characters and prognosis in one case of patients with cutaneous anaplastic large cell lymphoma complicated with acute myeloid leukemia (C-ALCL-AML). Methods The histopathology, immunohistochemical markers and follow-up information of one case of ALCL-AML was analyzed and the correlated literature was reviewed. Results The patient, 69 year-old, female, was initially present with shin lesion on one finger and abnormal myelogram. The histopathology of shin lesion showed that tumor cells were composed of large cells with abundant cytoplasm,the nuclei were large and irregular, and were infiltrated by Neutrophil and eosinophil. The CD30,CD3 and CD43 of tumor cells were positive, but ALK negative by immunohistochemical method. The number of WBC in peripheral blood was 15.5×109/L and 51 archaeocytes were in every 100 karyotes. Bone marrow aspiration detection showed that bone marrow was hyperplasia and the ratio of myeloblast was 78 %. This patient was diagnosed as C-ALCL-AML, partly differentiation type(AML-M2a). Conclusion C-ALCL-AML is very rare. Its diagnosis is dependent on clinical data, histopathology and immunohistochemical markers. The first choice of treatment is chemotherapy, but its prognosis is poor.
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Purpose To investigate the clinicopathologic features, diagnosis and differential diagnosis of ovarian juvenile granulosa cell tumor (JGCT).Methods The history records, pathologic features and immunophenotype of 8 cases of JGCT were retrospectively evaluated and their prognosis was achieved by follow-up.Results The age of patients ranged from 6～21 years old,with an average age of 15.1 years.The main clinical manifestations included an abdominal mass, ascites and isosexual pseudoprecocity. Cut surface of the tumor was typically solid with cysts formed. The histopathological changes displayed solid nests, diffuse sheet, multiple round or ovoid follicles in variable size.Macrofollicles could be seen in some cases.The follicular pattern consisted of small cystic cavities containing eosinophilic secretions. The tumor cells were round or polygonal, medium in size. The tumor cells had abundant pale or slightly eosinophilic cytoplasm, round nuclei with fine chromatin. Nuclear grooves were inconspicuous.Mitosis figures could be found. Immunohistochemical results showed that the tumor cells expressed inhibin-α,CD99,vimentin; while Melan-A,calretinin and S-100 were positive staining in part of the cases.CKpan,EMA,PLAP,Syn and CgA were negative in all the cases.Conclusions Ovarian juvenile granulosa cell tumor is a rather rare, low malignant tumor with good prognosis. Its diagnosis depends on the histologic and immunohistochemical findings and clinical features. Its differential diagnosis includes adult granulose cell tumor, hypercalcaemic type small cell carcinoma, carcinoid and dysgerminoma.
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Objective: To investigate EphA7 protein expression of gastric carcinoma cells and its clinicopathological parameters.Methods: The expression level of EphA7 protein in gastric carcinoma and normal mucosa was detected using immunohistochemical staining.Results: The overexpression of EphA7 protein in gastric carcinoma was significantly related to age(P=0.016) and stage(P =0.033).Conclusion: EphA7 was differentially expressed in gastric carcinoma cells.
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Objective: To investigate the expression of survivin in nasal-NK/T cell lymphoma,and to analyze the relationship of the expression with caspase-3 and cell proliferation.Methods: We detected the expressions of survivin,caspase-3 and ki-67 by immunohistochemical EnVision System in 50 cases of nasal-NK/T cell lymphoma and 12 normal lymph nodes,and analyzed the correlation of the survivin gene in the tumor tissues with the caspase-3 gene and ki-67 proliferation.Results: The positive expression rate of survivin was 60%(30/50) in the tumor tissues and 16.7%(2/12) in the normal lymph nodes,with significant differences between the 2 groups(P0.05).The ki-67 proliferation index was significantly higher in the survivin-positive lymphomas(38.23?16.54)% than in the survivin-negative ones.The high expression of the survivin gene was closely correlated with the down-regulation of the caspase-3 gene.Conclusion: survivin may prevent cell apoptosis by inhibiting the activity of caspase-3 play an important role in the carcinogenesis of NK/T cell lymphomas by promoting cell proliferating.
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Objective:To explore the expression of Ezrin and CD44v6 in gastric carcinoma and their correlations to clinicopathologic features. Methods:The expression of Ezrin and CD44v6 were detected by immunohistochemistry in gastric carcinoma(n=53) and normal gastric mucosa(n=20).Results:①The positive expression rates of Ezrin in gastric carcinoma and normal gastric mucosa were 56.6% and 30.0%.While the positive expression rates of CD44v6 in gastric carcinoma was 58.5% and no expression in normal gastric mucosa.②The expression of Ezrin was correlated to the differentiation(P0.05).③The expression of Ezrin was positively correlated with that of CD44v6 in gastric carcinoma(rs=0.740,P
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Objective: To observe the impact of spontaneously hypertensive diabetes mellitus(SHDM) on myocardial cell structure and cardiac function.Methods: Twenty-four SD rats were equally divided into an SD(control),a DM,an SH and an SHDM group.DM and SHDM were induced in the SD and SH rats by intraperitoneal injection of streptozotocin combined with high fat diet,followed by invasive detection of the cardiac function and pathological examination of the myocardial cell structure 16 weeks later.Results: Disorganized array,decreased interspaces,scattered degenerate necrosis and damaged mitochondria were observed in the cardiac cells of the SHDM group.The left ventricular end-diastolic pressure(LVEDP) was significantly higher in the SH,DM and SHDM groups than in the SD group(P
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Objective:Clusterin is highly expressed in lymphoid and hematopoietoid tissue tumors in literature.This study is to investigate the significance of clusterin in the diagnosis of tumors by detecting its expression in follicular dendritic cell sarcoma/tumor(FDCS/T) and anaplastic large cell lymphoma(ALCL).Methods: The expression of clusterin was detected by immunohistochemical method in ALCL,diffuse large B-cell lymphoma(DLBCL),follicular lymphoma(FL),mantle cell lymphoma(MCL),NK/T-cell lymphoma(NK/T),peripheral T-cell lymphoma(PTL),plasma cell lymphoma(PCL),classical Hodgkin lymphoma(CHL) and FDCS/T.The expressions of CD30 and ALK in ALCL,and of CD21+CD35 in FDCS/T were also detected,and so were those of clusterin and CD21+CD35 in 10 cases of reactive hyperplasia of the lymph node were detected.Results: Clusterin and CD21+CD35 were both expressed in 8 cases of FDCS/T.The positive expression rates of clusterin,CD30 and ALK1 in 20 cases of ALCL were 85.00%(17/20),100%(20/20) and 50.00%(10/20),respectively.Clusterin was expressed in 4.70% of the 85 DLBCL cases(4/85),but not in other lymphoma tissues;clusterin and CD21+CD35 were both expressed in 100% of the 2 FDCS/T cases,and they were also expressed in reactive hyperplasia of lymph nodes as well as in follicular dendritic cells,but not in B-and T-cells.Conclusion: Clusterin might be a new marker for follicular dendritic cells,helpful to the diagnosis and differential diagnosis of ALCL.
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Objective: Signet-ring cell carcinoma is a relatively rare cancer which occurs principally in the stomach,colon-rectum,bladder and breast,but seldom in other parts.This article analyzes the clinical and pathologic features of 3 extremely rare cases of primary signet-ring cell carcinoma in the uterus.Methods: Three cases of primary signet-ring cell carcinoma in the uterus were observed by HE and immunohistochemical staining,their clinical features analyzed and the relevant literature reviewed.Results: Of the 3 cases,2 presented nodose tumors in the cervix while the other in the uterine cavity.Histologically,there was a diffuse infiltration of the tumor cells,with an appearance of signet-ring cells.Periodic acid-Sciff(PAS) staining revealed PAS-positive diastase resistant introcytoplasmic material.Immunohistochemically,the tumor cells were positive for CK and CEA.Conclusion: Primary signet-ring cell carcinoma of the uterus is extremely rare.It is always necessary to rule out a metastatic neoplasm by clinical examination and to differentiate it from other tumors/lesions with signet-ring cell features.