Lymphoma of nasal cavity and nasopharynx: a report of 319 consultation cases / 临床与实验病理学杂志

Purpose To investigate the clinical features,pathological type and composition of nasal cavity and nasopharyngeal lymphoma.Methods The clinical data,histopathologic features and immunotypes of 319 consulted cases of nasal cavity and nasopharyngeal lymphoma from department of pathology,Beijing Friendship Hospital,Capital Medical University were retrospectively analyzed.According to the new WHO (2008) classification,all data of these cases were reappraised.Results Among these 319 cases,3 cases (0.9％) were diagnosed as classical Hodgkins lymphoma (CHL).Other 316 cases (99.1％) were diagnosed as non-Hodgkins lymphoma (NHL),56.0％ (177 cases) of them were T and NK-cell lymphoma and 44.0％ (139 cases) were B-cell lymphoma.The commonest subtypes were extra-nodal NK/T-cell lymphoma (NK/TCL) in 160 cases (50.6％),diffuse large B-cell lymphoma in 64 cases (DLBCL 20.3％).Among these 319 cases,106 cases (33.2％) over 60 years old were diagnosed as NHL.The most common subtypes were DLBCL in 40 cases (37.7％),NK/TCL in 36 cases (34.0％).There was no statistic difference in the incidence rate between the two types.Other 210 cases of NHL 0.9％ below 60 age including NK/TCL 124 cases (59.0％)and DLBCL 24 cases (11.4％).The diference is statistically significant.Conclusion Among those 319 nasopharyngeal lymphoma cases,3 cases are considered as CHL.NK/TCL is the commonest subtype of other 316 cases.DLBCL and NK/TCL are the most common subtypes in 106 cases over 60 years old.There was no statistic difference in the incidence rate between the two types.

Impact of breast density on computer-aided detection (CAD) of breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the impact of breast density on computer-aided detection (CAD) for breast cancer and the CAD false-positive rate of normal controls.</p><p><b>METHODS</b>Two hundred and seventy-one histologically proven breast malignant lesions (from Feb. 2008 to Dec. 2009) and 238 randomly selected normal cases were classified by mammographic density according to the American College of Radiology breast imaging reporting and data system (BI-RADS). Mammograms of BI-RADS 1 or BI-RADS 2 density were categorized as non-dense breasts, and those of BI-RADS 3 or BI-RADS 4 density were categorized as dense breasts. Full-field digital mammography (GEMS Senographe) were performed in all patients and controls with craniocaudal (CC) and mediolateral oblique (MLO) views. Then the image data were transferred to review workstation (SenoAdvantage), and the lesions were marked by Second Look Digital CAD system (version 7.2, iCAD). The differences of sensitivity and false-positive rate between dense and non-dense breasts were compared.</p><p><b>RESULTS</b>Overall, the sensitivity of CAD in detection of cancers was 84.1% (228/271), there was a statistically significant difference in CAD of cancers in dense versus non-dense breasts (P = 0.015). The sensitivity of CAD in detection of mass cancers was 76.5% (186/243), in detection of calcification cancers was 79.1% (125/158), there was no statistically significant difference in CAD performance for the detection of mass cancers versus calcification cancers (P = 0.547). There was a significant difference in the CAD performance for the detection of mass cancer cases in non-dense versus dense breasts (P = 0.001), but no significant difference in the CAD for the detection of calcification cancers in non-dense versus dense breasts (P = 0.216). In the controls, the distribution of mass false-positive marks did not differ significantly between non-dense and dense breast tissue cases (P = 0.207), but the distribution of calcification false-positive marks differed significantly between non-dense and dense breast tissue cases (P = 0.001). There was a statistically significant difference of false-positive marks in non-dense versus dense breasts (P = 0.043).</p><p><b>CONCLUSIONS</b>The sensitivity of CAD in the detection of breast cancers is impacted by breast density. There is a statistically significant difference in the CAD performance for the detection of cancer cases in non-dense versus dense breasts. The false-positive rate of CAD is lower in dense versus non-dense breasts. It appears difficult for CAD in the early detection of breast cancer in the absence of microcalcifications, particularly in dense breasts.</p>

Acquired somatic mutations in non-coding region of bcl-6 gene in germinal center-type diffuse large B-cell lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the mutation of 5' non-coding region of bcl-6 gene in germinal center B-cell (GCB) subtype of diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>t(14;18) detection and immunohistochemical staining (EnVision method) were performed in 60 cases of DLBCL, which were divided into GCB and non-GCB subtypes. Polymerase chain reaction (PCR), single-strand conformation polymorphism and direct DNA sequencing were used to identify mutations in the 5' non-coding region of the bcl-6 gene.</p><p><b>RESULTS</b>Seven of 60 cases showed t(14;18) translocation in the major breakpoint region. Using minimally acceptable criteria, 18 of 60 cases were probably to be germinal centre derived. Bcl-6 mutations were detected in 12 of 60 cases (20.0%) of DLBCL, with a significantly higher frequency in the GCB subgroups (7/18) than in the non-GCB subgroups (11.9%, 5/42). Bcl-6 mutations occurred most frequently in +363 and +469 sites. An association of bcl-6 mutation and GCB subgroup was obtained.</p><p><b>CONCLUSIONS</b>The 5' regulatory region of the bcl-6 gene underwent less frequent somatic hypermutation during lymphomagenesis than the results of previous reports. Bcl-6 mutation occurred mostly in the GCB subtype and detection of t(14;18) seems helpful in the classification of DLBCL.</p>

Breast intraductal lesion resection under breast fiberoptic ductoscopy / 中南大学学报(医学版)

OBJECTIVE@#To explore the feasibility and to sum up the experience of breast intraductal neoplasm resection under breast fiberoptic ductoscopy (FDS).@*METHODS@#FDS was performed on 548 patients with nipple discharge from Sep.2004 to Nov.2006. The clinical data of breast intraductal neoplasm found by FDS in patients who underwent tumor resection were analyzed, and the breast intraductal neoplasm image characteristics, diagnosis, operative type and postoperative pathological results were analyzed.@*RESULTS@#Of the 548 patients with nipple discharge, intraductal neoplasm was found in 187 cases (34.1%), intraductal papilloma in 159 cases (29.0%), intraductal papillomatosis in 12 cases (2.2%), and breast carcinoma in 16 cases (2.9%). One hundred thirty-five patients were operated on in our hospital, of whom 91 were performed tumor resection or segmentectomy under the localization by FDS, and the other 44 were performed segmentectomy after breast duct infusion of methylene blue. The diagnostic rate under FDS in the FDS group (97.8%) was higher than that in the breast duct infusion methylene group (86.4%) (chi2=6.96, P=0.008).@*CONCLUSION@#FDS is not only an accurate diagnosis for breast intraductal lesion, but also an assistance to localize the breast intraductal neoplasm and to remove them in the operation.