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Objective:To investigate the magnetic resonance imaging (MRI) features of desmoplastic small round cell tumor (DSRCT) of the abdomen and pelvis.Method:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 8 patients with DSRCT of the abdomen and pelvis, including 3 cases admitted in Yueqing People's Hospital and 5 cases admitted in Wenzhou People's Hospital, from January 2008 to June 2022 were collected. There were 5 males and 3 females, aged (43±5)years. All patients underwent MRI plain and enhanced scanning. Observa-tion indicators: (1) imaging features of DSRCT of the abdomen and pelvis; (2) treatment and pathological examination characteristics of DSRCT of the abdomen and pelvis; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distri-bution were represented as M(range). Count data were described as absolute numbers. Results:(1) Imaging features of DSRCT of the abdomen and pelvis. ① Tumor location. Of the 8 patients, there were 6 cases with tumors located respectively at the lower edge of the liver in the right quarter costal region, the medial side of the ileocecal region in the right iliac region, the medial side of the caecum in the right iliac region, the gastro-pancreatic space in the left quarter costal region, the mesenteric space in the left iliac region and the right side of pelvic bladder, and 2 cases with tumors located at retroperitoneal space of left quarter rib region. ② Tumor size. There were 13 lesions in the 8 patients, and the maximum diameter of tumor was 9.1 (range, 3.5?20.0)cm. Of the 8 patients, there were 5 cases with single tumor and 3 cases with multiple tumors. ③ Tumor shape and boundary. Of the 8 patients, there were 4 cases with tumor in expansive growth and 4 cases with tumor in invasive growth. There were 5 cases with tumor of intratumoral necrosis and cystic degene-ration, 4 cases with tumor of intratumoral hemorrhage, 4 cases with tumor of intratumoral spot calcification, 3 cases with tumor of peritumoral tissue exudation. One patient may combined with multiple imaging manifestations. ④ Imaging characteristics of MRI plain scanning. Of the 8 patients, there were 4 cases with tumor of homogeneous hypointensity signal and 4 cases with tumor of hypointensity mixed with speckled hyperintensity (with hemorrhage) in T1 weighted imaging of MRI plain scanning. There were 3 cases with tumor of homogeneous hyperintensity and 5 cases with tumor of high signal at the edge, patchy and spot-shaped in the center in T2 weighted imaging of MRI plain scanning. There were 5 cases with tumor of high, equal and low confounding signals and 3 cases with tumor of high and low signals in T2 weighted imaging fat suppression sequence of MRI plain scanning. There were 3 cases with tumor of uniform high signals and 5 cases with tumor of high, equal and low mixed signals in diffusion weighted imaging of MRI plain scanning. ⑤ Imaging characteristics of MRI enhanced scanning. All 8 patients had tumor of heterogeneous enhancement in MRI enhanced scanning, including 2 cases with significant enhancement in arterial phase, continuous enhancement in portal phase, slightly reduced enhancement in delayed phase, 4 cases with moderate enhancement in arterial phase, continuous enhancement in portal phase, slowly exited enhancement in delayed phase, 2 cases with mild enhancement in arterial phase, continuous enhancement in portal phase, slowly exited enhancement in delayed phase. Of the 8 patients, there were 3 cases with tumor of annular enhancement with intratumoral strip or grid signals and 3 cases with tumor of peritumoral blood vessels increased and thickened signals. ⑥ Tumor invasion and metastasis. Of the 8 patients, there were 4 cases with tumor invaded bowel, 2 cases with tumor invaded surrounding tissues, 1 case with tumor invaded left kidney, spleen and pancreatic tail, 1 case with tumor invaded distal of left ureter. There were 5 cases with abdominal, retroperitoneal and inguinal lymph nodes enlargement, 4 cases with multiple nodular thickening of peritoneum and ascites, 2 cases with tumor liver and lung metastasis and 1 case with tumor rib, femur and sacrum metastasis. One patient may combined with multiple tumor metastasis. (2) Treatment and patholo-gical examination characteristics of DSRCT of the abdomen and pelvis. Of the 8 patients, 3 patients underwent complete resection as clear tumor boundary, 3 patients underwent tumor partial resection as tight adhesion between tumor and surrounding blood vessels, 2 cases underwent tumor tissue pathological examination as extensive metastasis of peritoneum, omentum, mesentery and surrounding intestine. All 8 patients were diagnosed as DSRCT by microscopic examination, electron microscopic examination, immunohistochemical staining and cytogenetic examination. (3) Follow-up. All 8 patients underwent postoperative follow-up and died during the follow-up.Conclusion:MRI features of abdominal and pelvic DSRCT include single or multiple lobulated masses with unclear boundaries, invading the omentum, mesentery, peritoneum and adjacent tissues in most cases, mixed signals and heterogeneous mild to moderate enhancement in enhanced scanning.
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Objective To study the medical imaging findings and the pathological features of hepatic inflammatory myofibroblastic tumor (HIMT) using CT,MRI and histopathology.Methods The CT and MRI findings of 31 patients with HIMT which were confirmed by histopathology on surgically resected specimen were analyzed retrospectively.The location,size,shape,edge,density or signal,and contrast enhancement of these tumors were analyzed.Results The tumors were located in the right liver in 26 patients,in the left liver in 5 patients,and under the hepatic capsule in 27 patients.The tumors were solitary in 28 patients and multiple in 3 patients.The maximum diameter of the tumor ranged from 2.1 cm to 12.5 cm.The average diameter was (3.6 ± 1.2) cm.The tumors were round or oval in 21 patients and irregular in 10 patients.19 patients underwent CT examination and all tumors showed low density,with a CT value which ranged from 5 to 35HU.The average value was (27.6 ±5.3) HU.The density of tumors was homogeneous in 6 patients and inhomogeneous in 13 patients,and among these 13 patients,3 were alveolate.Twenty-one patients underwent MRI scan and all showed a low signal on T1WI,12 patients showed an equal signal and 9 patients showed a slightly higher signal on T2WI.In 6 patients the signals were homogeneous and in 15 patients they were inhomogeneous.On CT and MRI enhanced scans the whole tumor was enhanced in 12 patients,the edge was enhanced in 9 patients,the septum was enhanced in 8 patients and no enhancement was observed in 2 patients.Pathological examination under microscopy observed the presence of proliferation of spindle cells,chronic inflammatory cells which included the proliferation of lymphocytes,plasma cells and collagen fiber formation.The spindle cells had the characteristics of fibroblasts and myofibroblast cells.Immunohistochemical examination showed the wave type protein (Vimentin) was positive in 23 patients,the smooth muscle actin (SMA) was positive in 18 patients,the muscle actin (MSA) and the specificity of junction protein (Desmin) were positive in 12 patients,CD68 was positive in 4 patients,and the ALK,S-100 protein,CDll7 and CD35 were all negative.Conclusions The radiological features of CT and MRI plain scan varied.The patterns of contrast enhancement included full tumor filling,marginal enhancement,compartment enhancement,and no enhancement.The enhanced features varied from mild to moderate enhancement in the arterial phase,further enhancement in the portal phase and mild enhancement in the delayed phase.
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Objective To study the medical imaging findings and the pathological features of hepatic inflammatory myofibroblastic tumor (HIMT) using CT,MRI and histopathology.Methods The CT and MRI findings of 31 patients with HIMT which were confirmed by histopathology on surgically resected specimen were analyzed retrospectively.The location,size,shape,edge,density or signal,and contrast enhancement of these tumors were analyzed.Results The tumors were located in the right liver in 26 patients,in the left liver in 5 patients,and under the hepatic capsule in 27 patients.The tumors were solitary in 28 patients and multiple in 3 patients.The maximum diameter of the tumor ranged from 2.1 cm to 12.5 cm.The average diameter was (3.6 ± 1.2) cm.The tumors were round or oval in 21 patients and irregular in 10 patients.19 patients underwent CT examination and all tumors showed low density,with a CT value which ranged from 5 to 35HU.The average value was (27.6 ±5.3) HU.The density of tumors was homogeneous in 6 patients and inhomogeneous in 13 patients,and among these 13 patients,3 were alveolate.Twenty-one patients underwent MRI scan and all showed a low signal on T1WI,12 patients showed an equal signal and 9 patients showed a slightly higher signal on T2WI.In 6 patients the signals were homogeneous and in 15 patients they were inhomogeneous.On CT and MRI enhanced scans the whole tumor was enhanced in 12 patients,the edge was enhanced in 9 patients,the septum was enhanced in 8 patients and no enhancement was observed in 2 patients.Pathological examination under microscopy observed the presence of proliferation of spindle cells,chronic inflammatory cells which included the proliferation of lymphocytes,plasma cells and collagen fiber formation.The spindle cells had the characteristics of fibroblasts and myofibroblast cells.Immunohistochemical examination showed the wave type protein (Vimentin) was positive in 23 patients,the smooth muscle actin (SMA) was positive in 18 patients,the muscle actin (MSA) and the specificity of junction protein (Desmin) were positive in 12 patients,CD68 was positive in 4 patients,and the ALK,S-100 protein,CDll7 and CD35 were all negative.Conclusions The radiological features of CT and MRI plain scan varied.The patterns of contrast enhancement included full tumor filling,marginal enhancement,compartment enhancement,and no enhancement.The enhanced features varied from mild to moderate enhancement in the arterial phase,further enhancement in the portal phase and mild enhancement in the delayed phase.
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Objective To investigate the relationship between orthostatic hypotension (OH) and antihypertensive therapy in the elderly hypertensive population.Methods A total of 1174 elderly retired people (849 cases with hypertension and 325 cases without hypertension) in Guangzhou Military Region underwent health physical examination.All people were surveyed by questionnaires.The orthostatic blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and then at 0 and 2 minutes after standing.Comparative analysis was made on the prevalence of OH and the relationship between OH and antihypertensive therapy.Results A significant difference in the prevalence of OH was observed between hypertensive patients and nonhypertensive patients [29.4％ (250/849) vs.15.7％ (51/325),x2 =23.32,P＜0.01].There was no significant difference in the prevalence of orthostatic hypotension in patients with versus without antihypertensive therapy [30.5％ (220/721) vs.23.4％ (30/128),x2 =2.62,P＞0.05].Conclusions Orthostatic hypotension is common observed in elderly hypertensive patients.Antihypertensive therapy may not increase the prevalence of OH.
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Objective To elucidate the protein expression and gene expression status and the relationship between epidermal growth factor receptor (EGFR) protein expression and EGFR gene status.Methods Tissue microarray containing 72 cervical squamous cell carcinoma tissues was constructed,and EGFR protein expression and gene status were evaluated by immunohistochemical and fluorescence in situ hybridization (FISH) techniques.Results Protein expression of EGFR:69 of 72 cervical squamous cell carcinomas were observed.The results demonstrated it was significant association with invasion depth,lymphnode metastasis and lymph-vessel invasion (x2 =4.998,P ＜ 0.05 ; x2 =4.299,P ＜ 0.05 ; x2 =4.686,P ＜ 0.05) in cervical squamous cell carcinomas.For FISH assessing EGFR gene,64 of 72 carcinomas were observed; 7 of 64 cases showed EGFR gene amplification,and 25 disomy,23 trisomy and 9 polysomy were detected.There were high levels of protein expression in all the EGFR gene amplification cases,and there were significant association between EGFR protein expression and the gene copy number (x2 =13.564,P ＜ 0.05).Conclusions EGFR may participate in the occurrence,progression and metastasis of cervical squamous cell carcinoma.Overexpression of EGFR protein may result from gene amplification and gene copy number increases,which showed that EGFR gene expression status may be a more effective biological indicator of cervical squamous cell carcinoma targeted therapy.
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OBJECTIVE@#To investigate the expression and clinical pathological significance of PDCD4 in laryngocarcinoma tissue and its potential significance to clinic.@*METHOD@#Western-blotting and immunohistochemistry ana lyse to measure the protein expression of PDCD4 in 54 cases of laryngocarcinoma tissues (studying group) and their paraneoplastic normal tissues (control group). The correlations of PDCD4 with clinical pathological parameters were analyzed.@*RESULT@#PDCD4 protein was positively expressed in paraneoplastic normal tissue while which was lost or decreased in laryngocarcinoma tissue by Western blot and immunohistochemistry. Immunohistochemistry assay showed the location of PDCD4 protein in cells was different between the studying group and the control group. The expression level of PDCD4 was related to the pathological grades of the laryngocarcinoma. It's higher in the well-differentiated tumor group than that in the poorly differentiated ones. But the expressions of PDCD4 were no differences among other clinical parameters including sex, age, clinical classification, clinical stage and the cervical lymphonodus who had been metastases or not.@*CONCLUSION@#PDCD4 gene is anti-oncogene. It may play an important role in the pathogenesis and development of laryngeal carcinoma and it may be a new target of therapy for laryngo carcinoma.