ABSTRACT
Objective:To investigate the pathological changes of JNET classification of colorectal tumors.Methods:Data of patients with colorectal neoplasms who underwent narrow-band imaging combined with magnifying endoscopy, and whose postoperative pathological specimens were obtained at the endoscopy center of the Affiliated Hospital of Guizhou Medical University from January 2015 to June 2018 were analyzed retrospectively. The endoscopic JNET diagnosis and pathological features (surface pit epithelial exfoliation, surface mucosal necrosis structure, surface mucosal ethmoid reticular structure, fibrous tissue reactive hyperplasia, mucosa muscle without residual and carcinomatous interstitial reaction) were analyzed.Results:A total of 81 patients with colorectal neoplasms (diameter >1.5 cm) were enrolled with 74 cases receiving endoscopic treatment and seven cases receiving surgical treatment. The frequency of surface mucosal sieve reticular structure in type 3 of JNET (20.00%) was lower than that in type 2B (42.86%), which was in turn higher than that in type 2A (2.78%), with significant differences ( P<0.05). The frequencies of fibrous tissue reactive proliferation, no residual mucosal muscles, and carcinomatous interstitial reaction in type 2A and 2B were lower than that of type 3, with significant differences (all P<0.05). There were significant differences in the consistency group and inconsistency group of JNET classification and pathological diagnosis in surface pit epithelial exfoliation and surface mucosal necrosis (all P<0.05). Conclusion:Type 2B of JNET classification indicates that the pathological features may be the surface mucosal reticular structure; type 3 indicates reactive hyperplasia of fibrous tissue, no residual mucosal muscles and cancerous interstitial reaction. The exfoliation of the surface pit epithelium and the necrosis of the surface mucosa may be the pathological interference factors affecting the accuracy of JNET classification diagnosis.
ABSTRACT
Objective To analyze of the prevalence of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) by 2017 World Health Organization ( WHO) classification of tumors of endocrine organs in Guiyang. Methods A retrospectively analysis of patients who had a thyroid surgery and confirmed thyroid cancer by pathological diagnosis in the Affiliated Hospital of Guizhou Medical University from 2009 to 2016. PTC and FVPTC by 2014 WHO classification of tumors of endocrine organs , and according to the 2017 WHO classification of tumors of endocrine organs ,the thyroid papillary carcinomas were reviewed and some had been confirmed as EFVPTC and NIFTP, with analysis of the prevalence and prognosis of NIFTP. Results Of the 1207 cases of thyroid carcinoma, 1150 cases were papillary carcinoma, the constituent ratio of thyroid carcinoma was 95.28％, the FVPTC was 72 cases, and the proportion of thyroid carcinoma was 5. 97％; the proportion of FVPTC in thyroid carcinoma decreased from 2009 to 2016 ( P <0.05). After pathological sections being reviewed, 10 cases had been confirmed as non-encapsulated infiltrative FVPTC, the ratio of thyroid cancer to thyroid cancer was 0.83％; EFVPTC was found in 62 cases, accounting for 5.14％ of thyroid carcinoma, these included 2 cases of NIFTP confirmed by the 2017 WHO classification of tumors of endocrine organs and 60 cases encapsulated invasive FVPTC, the percentage of thyroid carcinoma was 0.17％ and 4.97％. 62 cases of EFVPTC with the exception of 11 cases without further visit, while the remaining 51 cases of EFVPTC were followed up. Death, local or distant metastases were defined as adverse events. An adverse event was seen in 11 of 49 of the cases of invasive EFVPTC, including 2 died of disease; The NIFTP were alive with no evidence of disease. Conclusion The diagnosis of NIFTP according to new WHO classification of endocrine organ tumors in 2017 has little expected impact in Guiyang.
ABSTRACT
Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.
ABSTRACT
Objective To report the inflammatory myopathy with abundant macrophages presenting with abundant foam cells in a Chinese patient.Methods A 44 year-old man with rheumatoid arthritis manifested as progressive proximal muscle weakness in the upper limbs for 13 months and in the lower limbs for 11 months.Laboratory tests showed that serum creatine kinase level was increased,whereas neither the myositis antibody nor paraneoplasma antibodies were detectable,including anti-Jo-1 antibody.Electromyogram showed a classic myogenic pattern with irritable sarcomembrane excitement.Muscle biopsies were carried out in the left and right biceps brechii in 2 months and 13 months of the disease course respectively.The muscle sections were processed with standard histological,enzyme histochemistrical and immunohistochemical workup.Results The first muscle biopsy revealed CD8 positive T lymphocytes infiltrating into major histocompatibility complex (MHC)-Ⅰ positive fibers and distributing around endomysium,accompanied with scattered necrosis and regeneration.The second muscle biopsy showed perifascicular atrophy,fragmented perimysial connective tissue,and a large amount of CD68 positive foam cells and Touton cells accumulating within perimysial connective tissues and endomysium.Some CD20 positive B lymphocytes and plasmacytes were found around perivascular space,but CD8 positive T lymphocytes were only accumulated in the endomysium.MHC- Ⅰ was darkly expressed in the sarcolemma.Conclusions Inflammatory myopathy with abundant macrophages can present with foam cells infiltrating in perimysial and endomysium.The disease can be associated with rheumatoid arthritis and refractory to corticosteroid therapy.