ABSTRACT
Objective: To investigate the clinicopathological features and molecular phenotypes of gastric cancer with enteroblastic dif-ferentiation (GCED). Methods: A retrospective analysis of 337 patients with gastric adenocarcinoma diagnosed by the pathology de-partment of the First Affiliated Hospital of Zhejiang University in March 2013-2017 was conducted. Of them, 8 patients were diag-nosed with gastric carcinoma with intestinal blastocyte differentiation. All the patients were elderly, including 6 men and 2 women. The onset age was 68-83 years (mean 76.6 years). Two cases had serum AFP≥200 μg/L before treatment. According to the histopatho-logical morphology, the immunophenotype was analyzed by immunohistochemistry, the SALL4 gene was detected using reverse tran-scription-polymerase chain reaction (RT-PCR), and the relevant literature was reviewed. Results: Microscopically, all cases had primi-tive enteroid structures, consisting of cubic or columnar cells with clear cytoplasm, and immunohistochemical staining showed positivi-ty for either AFP and GPC3 or SALL4. The expression of SALL4 mRNA was significantly increased by RT-PCR. Follow-up from 1 to 5 years showed that 5 patients had liver and other organ metastases, 2 patients died, and 1 patient survived without a tumor. Conclusions:GCED is a rare invasive gastric adenocarcinoma with a worse prognosis than that of normal intestinal adenocarcinoma. The treatment of general intestinal adenocarcinoma has little effect. There are some characteristic changes in histology. It would be helpful for diag-nosis and differential diagnosis if clinicians are familiar with the tumor spectrum and genetic characteristics. Target therapy for an origi-nal marker, such as SALL4, has a bright future.
ABSTRACT
Objective To evaluate the renal oxygenation in patients with primary nephrotic syndrome (PNS) using BOLD MRI.Methods Twenty patients with untreated first-onset PNS and 18 healthy control subjects underwent BOLD MRI.The R2* of renal cortex and medulla were measured.Blood and urine samples were obtained on the day of MRI,and the patients underwent renal biopsy after MRI.The renal tubulointerstitial damage scores (TIDS) were determined using Katafuchi criteria.All patients received corticosteroids within 7 days after MRI and were followed up for 12 months.The difference of R2* levels between the PNS patients and controls were compared,and the correlations between R2* values and TIDS,laboratory parameters (eGFR,etc.) were tested.Results R2* values of renal medulla in PNS patients significantly decreased compared that of the controls (t =-9.270,P＜0.001).R2* values of renal medulla in PNS patients were negatively correlated with eGFR (r=-0.462,P=0.040) and positively correlated with TIDS (r=0.809,P＜0.001).There was a slight tendency for higher R2* values of renal medulla in individuals with poor prognosis.Conclusion BOLD MRI is a noninvasive method for the detection of renal oxygenation changes,which can evaluate the renal function and tubulointerstitial impairment,as well as prediction of the prognosis for PNS patients.
ABSTRACT
Objective@#To analyze the prognostic significance of TP53, Bcl-2, Bcl-6, Myc proteins expression by immunohistochemical method (IHC) in diffuse large B cell Lymphoma (DLBCL) .@*Methods@#Clinical and pathologic data of 223 patients with DLBCL hospitalized in Zhejiang First Hospital from March 2009 to June 2015 were retrospectively analyzed.@*Results@#The 223 cases, a median age of 56 years old with a male predominance, had shown a 39.0% of TP53 positive expression, 38.6% of Myc, 69.1% of Bcl-2, 56.5% of Bcl-6, and 22.7% of Myc/Bcl-2 double expression. According to Hans’ classification, 27.4% were GCB and 72.6% were non-GCB. With a median follow-up of 38 (2-97) months, the 3 and 5 years survival rates were 70% and 66% , respectively. By multivariate analysis, TP53 over-expression and Myc/Bcl-2 double expression were independently associated with poor outcomes. 3-year and 5-year overall survival were 59% and 57% for patients with TP53 positive, 77% and 71% for patients with TP53 negative expression. Patients with non-GCB subtype receiving chemotherapy combined with rituximab had a higher OS than those without rituximab. But rituximab did not improve the prognosis of patients with TP53 positive.@*Conclusion@#Myc/Bcl-2 double expression and TP53 over-expression are poor prognosis for DLBCL patients. Patients with Myc/Bcl-2 double expression have shorter OS. Patients with non-GCB subtype who received chemotherapy combined with rituximab have a better OS than those without rituximab. But rituximab does not improve the prognosis of patients with TP53 positive.
ABSTRACT
Objective To investigate the CT and MRI features and morphology classification of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B).Methods A total of 18 patients with IPMN-B proved by pathology were retrospectively analyzed.Out of 18 patients,16 patients underwent enhanced and non-enhanced CT,13 underwent contrast enhanced MR,and 11 out of 13 underwent both CT and MRI.IPMN-B was classified into 4 types:typical IPMN-B,cystic-forming IPMN-B,non-tumor IPMN-B and invasive IPMN-B,according to imaging findings and gross pathological findings.Results Typical IPMN-B (9 cases):tumors were distributed along the bile ducts,both upstream and downstream bile ducts were obviously dilated.Cystic-forming IPMN-B (5 cases):single or multiple tumors were found in aneurysmal dilatation of bile ducts.Non-tumor 1PMN-B (2 cases):no mass was found in the widely dilated bile ducts with smooth bile duct wall.Invasive IPMN-B (2 cases):tumors protruded into the dilated bile ducts causing jagged wall of bile duct,with accompanied abnormal density or signal intensity outside the bile ducts.Bile duct dilatations were shown in all 18 cases,and tumors were shown in 16 cases.In 2 cases no mass was displayed in widely dilated bile ducts.CT density of the tumor was lower than that of liver parenchyma,and higher than that of the bile and intraductal mucin.Signal intensity of the tumor was higher than that of stones,and lower than that of bile and intraductal mucin at MR T2WI.All tumors showed high intensity on DWI.Tumors showed mild to moderate enhancement after injection of contrast agent,CT density or signal intensity of the tumors were lower than that of the liver parenchyma during all three phases of contrast-enhanced CT or MRI.Conclusion IPMN-B has some specific CT and MR imaging features,which are helpful for the diagnosis and classification of IPMN-B.
ABSTRACT
The effectiveness of liver autotransplantation for patients with partial hepatic alveolar echinococcosis was analyzed. We retrospectively studied 6 patients with hepatic alveolar echinococcosis who underwent liver autotransplantation in our hospital from 2008 to 2010. We also summarized the surgical indications of liver autotransplantation for hepatic alveolar echinococcosis and our experience in the management of postoperative complications of liver autotransplantation. Of 6 patients, 5 achieved good curative results, and one died of multiple organ failure caused by portal vein thrombosis. Main complications included postoperative bleeding, bile leak and small-for-size liver graft syndrome. Liver autotransplantation offers a new approach to cure hepatic alveolar echinococcosis with non-resectable lesions. It could be the most effective method to cure intractable hepatic alveolar echinococcosis if correct handling in operation and proper prevention of complications are performed. But the long-term outcomes are still needed to be confirmed in longer follow-up.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Echinococcosis, Hepatic , General Surgery , Therapeutics , Hepatectomy , Methods , Liver , General Surgery , Liver Transplantation , Methods , Retrospective Studies , Treatment OutcomeABSTRACT
The effectiveness of liver autotransplantation for patients with partial hepatic alveolar echinococcosis was analyzed. We retrospectively studied 6 patients with hepatic alveolar echinococcosis who underwent liver autotransplantation in our hospital from 2008 to 2010. We also summarized the surgical indications of liver autotransplantation for hepatic alveolar echinococcosis and our experience in the management of postoperative complications of liver autotransplantation. Of 6 patients, 5 achieved good curative results, and one died of multiple organ failure caused by portal vein thrombosis. Main complications included postoperative bleeding, bile leak and small-for-size liver graft syndrome. Liver autotransplantation offers a new approach to cure hepatic alveolar echinococcosis with non-resectable lesions. It could be the most effective method to cure intractable hepatic alveolar echinococcosis if correct handling in operation and proper prevention of complications are performed. But the long-term outcomes are still needed to be confirmed in longer follow-up.
ABSTRACT
In the first case, a 15-year-old girl presented with recurrent multiple erythematous edema,bullae and ulceration on the face and extremities for 3 years, which had developed into plaques and nodules on the face and trunk for 6 months. Histology revealed angiocentric and angiodestructive infiltrates with medium-sized atypical lymphoid cells positive for LCA, CD45RO, CD56 and EBV staining throughout the dermis. The patient was diagnosed with extra NK/T-cell lymphoma, nasal-type. She subsequently had a rapid downhill clinical course with resistance to systemic chemotherapy, and died one month later. In the second case, a 44-year-old male was admitted to the hospital with progressive infiltrated mass on the right waist for 1 year, and a 4-month-history of lymphadenectasis. Histologically, there was a massive and dense infiltrate with middle and large-sized, CD4 and CD56-positive lymphoblastics throughout the dennis and subcutaneous tissue. A diagnosis of blastic NK-cell lymphoma was made. The patient was managed with surgical excision followed by systemic chemotherapy. He had been followed up and free of relapse till the time of this writing.CD56 positive cutaneous lymphoproliferative disorders appear to be highly invasive.
ABSTRACT
<p><b>OBJECTIVE</b>To detect the status of loss of heterozygosity (LOH) on chromosome 8 in prostate carcinoma and high grade prostatic intraepithelial neoplasia (PIN).</p><p><b>METHODS</b>Pure DNA was obtained from prostate neoplasms and normal tissues by tissue microdissection. LOH on chromosome 8 was detected by PCR based microsatellite polymorphism analysis technique using 14 pairs of microsatellite primers in 10 samples of prostate carcinoma and 10 samples of high grade PIN.</p><p><b>RESULTS</b>There were different frequencies of LOH on chromosome 8 in 10 samples of prostate carcinoma. 8p23.1-p23.2 and 8p21-p22 were two high-frequency LOH regions. LOH on chromosome 8 was detected in 3 samples of high grade PIN.</p><p><b>CONCLUSIONS</b>There were high-frequency LOH regions on chromosome 8 of prostate carcinoma, located on 8p23.1-p23.2 and 8p21-p22. High grade PIN and prostate carcinoma share the same allelic loss on 8p. Tumor suppressor genes located at these two regions may be potentially involved in the initiation and progression of prostate carcinoma.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Chromosomes, Human, Pair 8 , Loss of Heterozygosity , Prostatic Intraepithelial Neoplasia , Genetics , Prostatic Neoplasms , GeneticsABSTRACT
Objective To explore the pathological and imaging characteristics of focal nodular hyperplasia(FNH) of liver.Methods 17 cases of FNH proven pathologically underwent triphase spiral CT scan,of them,10 cases underwent fast MR imaging.The pathological andimaging features were comparatively analysed.Results All lesions were a solitary globular or lobulated mass,the majority of cases wasapproximately 2~5 cm in diameter.On plain CT and MRI,FNH was classically seen as a solitary,homogeneous and slightly hypoattenuating or isoattenuating area in comparison with normal liver,slightly hyper-or isointense on T_2WI,intense homogeneous enhancement during the arterial phase of enhanced imaging,and hyperattenuating in 12 cases,hypoattenuating or isoattenuating in 6 cases in comparison with normal liver during venous and delayed phase.The central scar was showed in 11 cases during delayed phase and 8 cases showed delayed enhancement,4 cases had pseudocapsular like enhancement in delayed images.In histology,17 cases of FNH were well limited but nonencapsulated,the hyperplastic parenchyma of the liver was subdivided into small nodules surrounded by the fibrous septa,there was a central scar composedof fibrous connective tissue and malformed vessels of various caliber.Conclusion The typical FNH can be easily diagnosed,while theatypical cases should be differentiated from hepatocelluar adenoma,hepatocellular carcinoma and hemangiomas.