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Objective To evaluate the differences of the malignant rate of thyroid nodules between primary hyperparathyroidism (PHPT) patients and health examination population, and analyze the clinical characteristics of PHPT combined with papillary thyroid carcinoma (PTC). Methods The clinical data of 158 PHPT patients who had underwent parathyroidectomy and 468 thyroid nodule patients who had underwent fine-needle aspiration (FNA) from 2009 to 2014 were retrospectively analyzed, and the detection rate of PTC in patients with thyroid nodule was recorded. Results Of the 158 patients with PHPT, 61 patients had thyroid nodules, the incidence of PHPT with thyroid nodule was 38.6% (61/158), and postoperative pathologically proved PTC was in 12 cases (19.7%). Of the 468 thyroid nodule patients who had underwent FNA, postoperative pathologically proved PTC was in 19 patients (4.1% ). The malignant rate of thyroid nodules in PHPT patients was significantly higher than that in health examination population (P＜0.01). The adjusted serum calcium in patients with PHPT combined with PCT was significantly lower than that in patients with PHPT combined with benign thyroid nodules and patients with PHPT without thyroid nodules: (2.63 ± 0.26) mmol/L vs. (2.92 ± 0.32) and (2.93 ± 0.47) mmol/L, and there was statistical difference (P＜0.05). Conclusions The malignant rate of thyroid nodules in PHPT patients is significantly higher than that in patients from health examination population, which suggests that PHPT might be a risk factor for the malignancy of thyroid nodules. A lower level of serum calcium may predict the existence of PCT in PHPT patients with thyroid nodules.
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Purpose To investigate the clinicopathological features of adolescent mixed epithelial and stromal tumor of the kidney ( MESTK) and improve recognization of this rare disease. Methods Clinicopathological and immunohistochemical characteristics of MESTK occured in 17-year-old girl were studied. Reviewed the related literatures, clinical and pathological characteristics of adoles-cent MESTK were analysed comprehensively. Results Congenital perineal spill was the main clinical manifestations. Microscopically, the tumor showed nodules and was composed of a mixture of epithelial and stromal elements. Glands were lined with columnar or cilia-ted columnar cells. Stromal cells surrounding glands seemed like ovaries and away from glands seemed like the differentiation of smooth muscle. Immunohistochemical staining revealed that the epithelial cells were positive for CK7 and vimentin. Stromal cells expressed desmin, smooth muscle actin ( SMA) , ER and PR. It was noteworthy that stromal cells away from glands expressed desmin. Conclu-sions As a kind of rare benign neoplasm of kidney, MESTK often occurs in perimenopausal women. But MESTK can also occur in ad-olescence, and has nothing to do with the use of hormone. Therefore, the renal tumor occurred in teenagers with biphasic differentiation should be differentiated from MESTK.
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<p><b>OBJECTIVE</b>To investigate clinicopathological characteristics of colorectal sessile serrated adenoma/polyp (SSA/P) and its differential diagnosis from other serrated lesions.</p><p><b>METHODS</b>Clinicopathological features of all cases of colorectal serrated lesions from 5 209 colorectal biopsy samples at Shanghai Tongji Hospital from 2008 to 2013 were reviewed. Three hundred and fifty-three cases of serrated lesions were erolled in the study. Morphological features of SSA/P were investigated with an emphasis on histologic criteria for diagnosis and a literature review was performed.</p><p><b>RESULTS</b>Three hundred and fifty-three cases of serrated lesions were identified, including 25 SSA/P (7.1%), 278 hyperplastic polyp (HP, 78.8%), and 44 traditional serrated adenoma (TSA, 12.5%). Twenty-five patients with SSA/P consisted of 16 males and 9 females with a mean age of 62.2 years (aged 34-84 years) and the lesions involved sigmoid colon (14 cases), ascending colon (9 cases), rectum (1 case) and transverse colon (1 case). Grossly, the majority of SSA/P was sessile with an averaged size of 0.73 cm. Histologically, typical SSA/P had elongated crypts with prominent serration and distorted crypts architecture. The detection rates of crypts dilatation and branching in SSA/P and HP were 100% (25/25) and 24% (12/50, P < 0.01), 72% (18/25) and 4% (2/50, P < 0.01), respectively. Morphological features observed only in SSA/P included L-shaped crypts (48%, 12/25), pseudo infiltration of mucosa muscle (16%, 4/25), atypical nuclei (32%, 8/25), and increased mucus secretion (24%, 6/25).</p><p><b>CONCLUSIONS</b>SSA/P microscopically shows prominent serration and abnormal architectures of crypts. Complete tissue sectioning and correct embedding are helpful for the diagnosis. SSA/P without cytological dysplasia should be distinguished from HP, especially those with only a few distorted crypts.</p>
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Female , Humans , Male , Adenoma , Pathology , China , Colonic Polyps , Pathology , Diagnosis, Differential , Hyperplasia , Intestinal Polyps , Pathology , Polyps , Pathology , Rectal Neoplasms , PathologyABSTRACT
Isolated pulmonary amyloidosis is a very rare disease. We retrospectively reviewed the records of patients with pathologically proven isolated pulmonary amyloidosis treated at our hospital from 1990 to 2011. There were 9 males and 4 females with a mean age of 54.7 years [range, 45-72 years] and the mean course of disease was 46.5 months [range, 5 months-15 years]. The most common symptoms were cough [10/13], expectoration [8/13], hemoptysis [4/13], chest tightness [12/13], dyspnea [10/13], chest pain [3/13], fever [5/13], and body weight loss [2/13]. Radiological findings included tracheal stenosis [2/13], bronchial stenosis with atelectasis [5/13], pulmonary nodules [3/13], lung consolidation [1/13], and lymph node enlargement with pleural effusion [2/13]. Treatments included endotracheal stenting, endoscopic resection of tracheal and bronchial lesions, lung resection, and drug therapy with glucocorticoids, antineoplastic agents, or antibiotics. Four patients died of the disease within 1 year of diagnosis, 2 died of pneumonia at 3-4 years after original treatment, and the remaining patients are alive with follow-up ranging from 3 to 15 years. Isolated pulmonary amyloidosis is a rare disease with a relatively high mortality and its various manifestations make diagnosis challenging. Surgical resection of lesions and chemotherapy tend to be effective treatments
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Objective To analyze the clinical,radiological and pathdogical characteristics of idiopathic lymphoid interstitial pneumonia (idiopathic LIP) and to discuss its diagnosis,treatment and prognosis.Methods Respiratory physicians,pathologists and radiologists together retrospectively analyzed the clinical,chest roentgenogram,computerized tomography,pathologicM,diagnostic and therapeutic data of 3 patients with idiopathic LIP confirmed by lung biopsy.and reviewed the relevant literatures.Results The major symptoms of the 3 cases of idiopathic LIP were prgressive dyspnea and dry cough.Higher levels of γ-globulins in serum were found in all the cases.The characteristic radiographic manifestations were bilateral diffuse nodules and cysts.The pathologic feature was diffuse interstitial inflammation with polyclonal lymphocytes infiltration,especially with plasma lymphocytes.Corticosteroids and cytotoxic agents were used and good response to therapy was observed in the cases.Conclusions Idiopathic LIP has some characteristics on the clinical,radiological and pathological features,but the best diagnostic method depends on a clinical-radiological-pathological approach.The disease usually shows good response to combinative therapy of corticosteroids and cytotoxic agents.
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<p><b>BACKGROUND</b>Pulmonary malignant fibrous histiocytoma (MFH) is very rare and it is worthy to study the clinical characteristics, treatment method and prognosis of primary pulmonary MFH.</p><p><b>METHODS</b>Fifteen patients with primary pulmonary MFH were reviewed retrospectively.</p><p><b>RESULTS</b>There were 10 males and 5 females. Their ages were 56.2 years±14.0 years (20-72 years). MFH mainly manifested as cough, hemoptysis, fever, chest pain and breathlessness. The diameters of tumors were 8.3 cm±8.0 cm, ranged from 0.3 to 35 cm. All the patients received surgical operations, including 5 pneumonect-omy, 8 lobectomy and 2 exploration. The overall 1-, 3-and 5-year survival rate of 15 patients was 56.2%, 24.1% and 16.7% respectively. Incomplete surgical excision of tumor significantly influenced survival.</p><p><b>CONCLUSIONS</b>Pulmonary MFH is a high-grade malignant tumor with poor prognosis, and surgery is the main treatment method.</p>
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Background and purpose:Angiofollicular lymphoid hyperplasia(Castleman's disease,CD) is a rare kind of abnormal disease with lymphoid hyperplasia. We analyzed the clinical data of 21 patients with pathologically-confirmed CD. Methods:Twenty-one cases,including 10 males and 11 females with a mean age of 38.6 years,with CD were collected from January 1971 to December 2007 in this study. The disease was divided into localized type(n=19) and disseminated type(n=2) . The clinical data,CT images and pathological and surgical results were restrospectively analyzed. Results:All cases were categorized as hyaline vascular type. In 19 cases with localized type of CD,the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.2 cm,located at the left and right hilus of the lung(n=3 and 2 respectively) or in the interior lung(n=3) ,in the thoracic wall(n=2) or in the mediastinum(n=9) . Two cases of disseminated type were characterized by many groups of thoracic lymphadenopathy with a mean diameter of 2.3 cm,without other organ involvement. On plain CT scan,the mean CT value was 42 Hu. After contrast administration,obvious homogeneous enhancement was observed in arterial phase with CT value of 112 Hu. The preoperative misdiagnosis by CT was 90.5%. Conclusion:CD have no specifi c CT characteristic,its verifi cation is mainly based on pathologic examination. Surgical resection for localized type of CD is curative,but for disseminated CD,multidisciplinary therapies are recommended.
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<p><b>BACKGROUND</b>To explore the clinicopathological changes of non-small cell lung cancer tissues after neoadjuvant chemotherapy with MVP (MMC+VDS+DDP) regimen and its concordance with clinical evaluation, and to study the clinical value of neoadjuvant chemotherapy.</p><p><b>METHODS</b>A total of 84 patients with NSCLC were randomized into combinated therapy group (42 cases) and surgical group (42 cases). The combinated therapy group were given MVP regimen for 2 cycles before operation and 2-4 cycles after operation, however, the surgical group only received surgical treatment. The efficacy of preoperative chemotherapy were determined by pathologic examination under light microscope and electron microscope and clinical evaluation.</p><p><b>RESULTS</b>Combinated therapy group showed various degrees of degeneration and necrosis of tumor cells, which was not found in surgical group. The overall response rate of neoadjuvant chemotherapy was 59.5% (25/42) by both pathological and clinical evaluation. The coincidence ratio of the two evaluation methods was 71.4% (Kappa value=0.407,P < 0.01). Between the two groups, there was a significant difference in total survival rate (P=0.047). And further analysis showed that survival rate was remarkably different in patients with stage III between the two groups (P=0.037), but not in those with stage I and II (P > 0.05).</p><p><b>CONCLUSIONS</b>Degeneration and necrosis with fibrosis are the main pathological phenotypes of the primary lesion after induction chemotherapy, which can be showed by clinical evaluation to chemotherapy efficacy. The preoperative and postoperative adjuvant chemotherapy may be benefical to patients with stage-III NSCLC.</p>
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<p><b>BACKGROUND</b>To investigate the role of nm23 gene mutation in human non small cell lung cancer (NSCLC).</p><p><b>METHODS</b>The mutation of nm23 gene was detected in 53 primary NSCLC tissues and 5 cases of other pulmonary benign or malignant disease tissues by PCR SSCP.</p><p><b>RESULTS</b>No mutation of nm23 gene was found in all 58 specimens.</p><p><b>CONCLUSIONS</b>The mutation of the nm23 gene may not effectively forebode the aggressiveness and metastatic potential of NSCLC.</p>
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<p><b>BACKGROUND</b>To explore the expression level of E-cadherin gene and its relationship with lymph node metastasis and prognosis in patients with primary non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>The expression of E-cadherin protein was detected in 138 human NSCLC tissues by immunohistochemistry, and 23 normal lung tissues as control.</p><p><b>RESULTS</b>The positive rate of E-cadherin expression (41.48%) in lung cancer tissues was significantly lower than that in normal lung tissues (73.12%) (P < 0.05). E-cadherin expression rate was closely related to lymph node metastasis (P < 0.05) and TNM stages of lung cancer (P < 0.05), but not to the size of the primary tumor (T), differentiation of cancer cell, histological classification and history of smoking (P > 0.05). The 5-year survival rate of the patients with high expression of E-cadherin ( > 40%) was significantly higher than those with low expression (≤40%) (P < 0.05 ).</p><p><b>CONCLUSIONS</b>Detection of E cadherin expression may be helpful to predict the prognosis of patients with non-small cell lung cancer.</p>
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Purpose:To investigate prognostic effects of ex pressions of cyclooxygenase-2(COX-2) and epidermal growth factor receptor(EGFR )in non-small-cell lung cancer(NSCLC).Methods:Expression of COX-2 and EGFR in the resected tumors of 60 patients with NSCLC were detected with the method of immunohistochemistry st aining.We used ?2 test and COX regression analysis to compare difference in e xpressions of COX-2 and EGFR in differentiation grade of squamous and adeno-ca rcinoma cells of the lungs and their relationships with the patients survival in NSCLC.Results:The positive rates for COX-2 were 73% and 33% in adeno carcinoma and squamous carcinoma,respectively.The expression rate was significan tly higher in the adenocarcinoma than in the squamous carcinoma.Expressions of C OX-2 and EGFR in NSCLC were not related to patientsage and sex,differentiation grade of tumor cells,TNM staging,size of promary tumor and lymph nodes metastasi s.Median survival time was 30 months and 16 months in COX-2 expression levels o f “+” and of “++”,34 months and 15 months in EGFR expression levels of “+” and of “++” and was significantly lower than in those without expression of C OX-2 or EGFR(P
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0. 05), and were closely correlated to the clinical stage and the curative effect(P 0. 05). Conclusions: VEGF expression was contributes to the tumor neovascularization and tumor metastasis. Local control rate of VEGF positive tumor patients can be increased but their survival can not be prolonged by mono-chemotherapyonly only.