Fibrocartilaginous mesenchymoma: a clinicopathological analysis of four cases / 中华病理学杂志

Objective: To investigate the clinical, radiological, histological and molecular features and the differential diagnosis of fibrocartilaginous mesenchymoma (FM). Methods: Four cases of FM diagnosed in the Department of Pathology, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from 2020 to 2022 were analyzed. Related literature was also reviewed. Results: Case 1 was a 10-year-old girl with bone destruction in the sacrum and L5 articular processes revealed by CT scan. Case 2 was a 7-year-old girl with an aggressive lesion in her right distal ulna. Case 3 was an 11-year-old boy with a lesion in the metaphysis of his left proximal tibia. Case 4 was an 11-year-old boy with bone destruction in the distal portion of a radius. Microscopically, the four tumors all consisted of numerous spindle cells, hyaline cartilage nodules, and bone trabeculae. The hypocellular to moderately cellular spindle cell component contained elongated cells with slightly hyperchromatic, mildly atypical nuclei arranged in bundles or intersecting fascicles. Benign-appearing cartilaginous nodules of various sizes and shapes were scattered throughout the tumors. There were areas mimicking epiphyseal growth-plate characterized by chondrocytes arranged in parallel columns and areas of enchondral ossification. The stroma was rich in mucus in case 1. Mutation of GNAS and IDH1/IDH2 and amplification of MDM2 gene were not found in any of the three tested cases. Conclusions: FM is very rare and tends to affect young patients. It most frequently occurs in the metaphysis of long tubular bones, followed by the iliac-pubic bones and vertebrae. FM is characterized by a mixed population of spindle cells, hyaline cartilage nodules and trabeculae of bone, without specific immunophenotypes and molecular alternations. As a borderline, locally aggressive neoplasm, surgical removal with a wide margin is generally the treatment of choice for FM.

Effects of electroacupuncture of different frequencies on electromyography, NOS and ICC of colon in rats with slow transit constipation / 针灸推拿医学（英文版）

Objective: To observe the effects of electroacupuncture (EA) of different frequencies on transmission function, electromyography, nitric oxide synthase (NOS) content and interstitial cells of Cajal (ICC) expression of colon in rat models with slow transit constipation (STC). Methods: Of the 50 healthy male Wistar rats, 10 were randomly selected as a normal group and fed with ordinary diet, and the remaining 40 rats were fed with the diet added with the compound diphenoxylate at a dose of 8 mg/(kg·bw) each day for continuous 120 d. The 40 successfully established STC rat models were randomly divided into a model group, a low-frequency EA group (2 Hz), a high-frequency EA group (100 Hz), and a variable-frequency EA group (2 Hz/100 Hz), with 10 rats in each group. Rats in the normal and the model groups were not given any treatment; the low-frequency EA and the high-frequency EA groups were given EA at Tianshu (ST 25), Zusanli (ST 36) and Zhigou (TE 6) with continuous wave at the designated frequency, and the variable-frequency EA group received sparse-dense wave (2 Hz/100 Hz) EA at the same acupoints, once a day for a total of 15 d. After treatment, the colonic transmission function, electromyography, NOS content and ICC expression (calculated by the difference in the area of the C-kit positive cells) of the rats in each group were measured. Results: For the colonic transmission function, compared with the normal group, the first black stool excretion durations of rats in the other groups were significantly prolonged (all P<0.05); compared with the model group, the first black stool excretion durations of rats in the three EA groups were significantly shortened (all P<0.05), which was significantly shorter in the variable-frequency EA group than in the low-frequency EA and high-frequency EA groups (both P<0.05). For the colonic electromyography, compared with the normal group, the amplitude was significantly increased and the frequency was accelerated in rats of the other groups (all P<0.05); compared with the model group, the amplitude was significantly reduced and the frequency was slowed down in the three EA groups (both P<0.05); compared with the low-frequency EA and the high-frequency EA groups, the amplitude was reduced and the frequency was significantly reduced in rats of the variable-frequency EA group (both P<0.05). Compared with the normal group, the colonic NOS contents were significantly increased in the other groups (all P<0.05); compared with the model group, the NOS contents were significantly reduced in the three EA groups (all P<0.05); compared with the low-frequency EA and the high-frequency EA groups, the content was significantly reduced in the variable-frequency EA group (all P<0.05). For the area of rat colonic C-kit-positive cells, compared with the normal group, the areas were significantly reduced in rats of other groups (all P<0.05); compared with the model group, the areas were increased significantly in the three EA groups (all P<0.05); compared with the low-frequency EA group, the area was increased significantly in the variable-frequency EA group (P<0.05). Conclusion: EA, especially EA at the 2 Hz/100 Hz variable-frequency, has a positive treatment effect on the STC model rats. It may improve rats' colonic function by regulating the electromyography, NOS content and ICC expression of colon.

Application of high frequency color Doppler ultrasonography combined with detections of serum FIB and CA199 in preoperative diagnosis of breast cancer / 中国医学装备

Objective: To investigate the application value of high frequency color Doppler flow imaging(CDFI)combined with serum fibrinogen(FIB)and sugar antigen 19-9(CA199)in the preoperative diagnosis of breast cancer.Methods: The clinical data of 226 patients with space occupying lesion of breast were analyzed retrospectively.According to the confirmed situation of postoperative pathological examination,they were divided into breast cancer group(158 cases)and breast disease group(68 cases).All patients received examination of preoperative CDFI and detections of preoperative serum FIB and CA199,and the values of single CDFI examination and it combined with detection of serum FIB and CA199 in preoperative diagnosis of breast cancer were compared.Results: In breast cancer group(158 patients),the ultrasonographic images of 146 patients showed the lumps were hypoechoic or weak echoes,irregular shape and uneven surface,and showed the change of lump appeared cauliflower shape,lobulated or crab foot shape.And the levels of serum FIB and CA199 of breast cancer group were significantly higher than those of breast disease group(t=6.821,t=20.061,P＜0.05),respectively.The sensitivity,negative predictive value and diagnostic coincidence rate of CDFI examination combined with detections of FIB and CA199 for diagnosis of breast cancer were 89.24％,79.76％and 92.04％,respectively.And these were significantly higher than those of single CDFI examination(x2=100.148,x2=37.666,x2=79.636,P＜0.05),respectively.Conclusion: The value of high frequency CDFI examination combined with serum FIB and CA199 in the preoperative diagnosis of breast cancer is significantly higher than that of single examination and single detection,and it has clinical application value.

Clinicopathological features and prognosis of dedifferentiated chondrosarcoma: an analysis of 40 cases / 临床与实验病理学杂志

Purpose To explore the clinical, imaging, pathologic features and diagnosis, treatment and prognosis of dedifferentiated chondrosarcoma (DDCS). Methods Forty cases of DDCS confirmed by pathologists were collected from Shanghai Jiaotong University Affiliated Sixth People's Hospital from January 2005 to August 2017, including clinical, imaging, pathologic and follow-up data. HE, immunohistochemistry and statistical methods were used with review of the related literature. Results There were 21 males and 19 females in 40 cases of DDCS, with an average age of 51 years. The tumors were located in hip, proximal femur, humerus, sternum, tibia, shoulder, finger, and thoracic cavity. The main clinical manifestations were local pain, swelling, limited mobility and so on. Typical radiographic manifestations are "bimorphic features", which showed two manifestations of dot or circular like calcification of chondrosarcoma, and invasive soft tissue masses. Histologically, clearly defined well-differentiated chondrosarcoma components juxtaposed highly malignant dedifferentiation components, which can display as follows: osteosarcoma, fibrosarcoma, malignant fibrous histiocytoma, and spindle cell sarcoma that could not be clearly classified. The dedifferentiated components might also be low-grade tumors such as giant cell tumor of bone or low grade osteosarcoma. The proportions of these two ingredients were uncertain. Preoperative biopsy was performed in 34 cases, of whom only 9 (26.5％) were correctly diagnosed as DDCS. The average survival time of patients with metastasis at first visit was significantly shorter than the patient without metastasis. Conclusion Diagnosis of DDCS should be combined with clinical features, imaging and histological morphology. As their histological morphology complex, and preoperative puncture biopsy limitations, its diagnosis is very difficult. Patients with metastases at the time of initial diagnosis have a worse prognosis.

Expression of Cyclin D2 and its clinicopathological significance in diffuse large B cell lymphoma / 临床与实验病理学杂志

Purpose To investigate the expression of Cyclin D2 in diffuse large B cell lymphoma (DLBCL) and its relationship with clinicopathological classification and prognosis. Methods (1) Immunohistochemistry (IHC) of EnVision twostep staining for CD3, CD20, CD10, BCL-6, MUM1, Ki-67 and Cyclin D2 was carried out in 79 cases of DLBCL specimens using tissue microarray constructed from tumor paraffin block.(2) The relative expression of Cyclin D2 mRNA in 79 cases of DLBCL was observed by realtime quantitative PCR (qRT-PCR) in fresh frozen tissue. The relationship between the expression of Cyclin D2 mRNA and survival rate was analyzed by Kaplan-Meier test. Results 79 patients of DLBCL were classified into26 (32.9％) case of germinal center B-cell-like (GCB) sub-types and 53 (67.1％ ) cases of nongerminal center B-cell-like(non-GCB) subtypes. Cyclin D2 protein was expressed in 2(15.4％) cases of GCB subtypes and 11 (84.6％) cases of non-GCB subtypes, respectively. The difference between the GCB subtypes and the non-GCB subtypes was statistically significant (P＜ 0.05). The expression of Cyclin D2 mRNA in non-GCB subtypes was significantly higher than that in GCB subtypes(P＜ 0.05 ). The high clinical stage and the expression of Cyclin D2 mRNA were associated with lower overall survival rate. Conclusion The detection of Cyclin D2 expression can improve the accuracy of clinicopathological classification of DLBCL. The level of Cyclin D2 mRNA may be an important reference for prognosis of DLBCL.

Effects of electroacupuncture of different frequencies on free radicals in hippocampus of mice with vascular dementia / 针灸推拿医学（英文版）

Objective:To observe the effects of electroacupuncture (EA) of three different frequencies (2 Hz,80 Hz and 2 Hz/80 Hz) on the free radicals in hippocampus of vascular dementia (VD) model mice.Methods:A total of 100 Kunming mice were randomly divided into a sham operation group,a model group,a 2 Hz EA group,an 80 Hz EA group and a 2 Hz/80 Hz EA group,with 20 mice in each group.The ischemia-reperfusion VD model was established by repeated blockade of bilateral common carotid arteries.Mice in EA groups began EA treatment on the 4th day after the operation.Baihui (GV 20),Dazhui (GV 14),Geshu (BL 17) and Zusanli (ST 36) were punctured and then connected to EA instrument,with different waves of 2 Hz,80 Hz or 2 Hz/80 Hz (10 min/time) applied accordingly,once a day.During the jumping stand experiment,the learning performance,memory performance and hippocampal calcitonin gene-related peptide (CGRP),nitric oxide synthase (NOS),malondialdehyde (MDA),changes in superoxide dismutase (SOD) and true choline esterase (TChE) were observed.In hippocampus,the CGRP level was determined by radioimmunoassay;the MDA level was determined by thiobarbituric acid colorimetric method;the activities of NOS and TChE were determined by spectrophotometry;the activity of SOD was determined by xanthine oxidase method.Results:Compared with the sham operation group,the performances of learning and memory decreased significantly in the model group (P＜0.01);in hippocampus,the CGRP level decreased,the MDA level increased,the activities of NOS and TChE increased,and the activity of SOD decreased in the model group.Compared with the model group,the learning and memory performances of the EA groups were significantly improved (P＜0.05 or P＜0.01);in hippocampus,the CGRP level increased,the MDA level decreased,the NOS and TChE activities decreased,and the SOD activity increased (P＜0.05 or P＜0.01).Among EA groups,the 2 Hz/80 Hz EA group was superior to the 2 Hz EA group and the 80 Hz EA group (P＜0.05 or P＜0.01).Conclusion:EA can improve the cognitive impairment of mice with ischemia-reperfusion VD.The mechanism may be related to the improvement of cerebral blood circulation,regulation of the central neurotransmitters,fighting lipid peroxidation and promoting nerve cell repair.The therapeutic effects of EA with different frequencies were different,and the intervention effect by EA at 2 Hz/80Hz is the most significant.

Effects of electroacupuncture of different frequencies on SP and VIP expression levels in colon of rats with slow transit constipation / 针灸推拿医学（英文版）

Objective:To observe the effects of electroacupuncture (EA) of different frequencies on the expression levels of substance P (SP) and vasoactive intestinal peptide (VIP) in the colon of rats with slow transit constipation (STC).Methods:One hundred healthy male Sprague-Dawley (SD) rats were randomly divided into a normal group,a model group,a low-frequency EA group,a high-frequency EA group and a variable-frequency EA group,with 20 rats in each group.The rats in the normal group were fed with normal diet.The rats in the other groups were fed with phenethylpiperidine in the diet at a dose of 8 mg/(kg·bw) per day,for 120 d,to establish the STC model.Rats in the normal group and the model group did not receive any treatment;rats in the low-frequency EA group were treated with 2 Hz continuous wave EA,rats in the high-frequency EA group were treated with 100 Hz continuous wave EA,and rats in the variable-frequency EA group were treated with 2 Hz/100 Hz sparse-dense EA.The current intensity of the EA was determined by the slight vibration of the rat limbs without painful screaming.The intervention was performed once a day,15 min/time for continuous 15 d.After treatment,the intestinal transit function and the expression levels of SP and VIP in the colon of the rats in each group were determined.Results:After treatment,the defecation duration of the first dark stool in the model group was significantly longer than that in the normal group (P＜0.05);the defecation durations of the first dark stool in the low-frequency EA group,high-frequency EA group and variable-frequency EA group were significantly shorter than the duration in the model group (all P＜0.05);compared with the low-frequency EA group,the first dark stool defecation duration of rats in the variable-frequency EA group was significantly shorter (P＜0.05);compared with the normal group,the SP and VIP expression levels in the colon of the model group were significantly decreased (both P＜0.01);the SP and VIP expression levels in the colon of the low-frequency EA group,the high-frequency EA group and the variable-frequency EA group were significantly higher than those in the model group (all P＜0.05);compared with the high-frequency EA group,the SP expression levels in the colon in the low-frequency EA group and the variable-frequency EA group were significantly increased (both P＜0.05);compared with the low-frequency EA group,the VIP expression levels in the colon in the high-frequency EA group and the variable-frequency EA group were significantly increased (both P＜0.05).Conclusion:EA improves the intestinal function of STC model rats by regulating the expression levels of SP and VIP in rat colon.The EA stimulation with 100 Hz continuous wave,2 Hz/100 Hz sparse-dense wave shows a better improvement in the colonic transit function in STC rats,followed by 2 Hz continuous wave.

Factors related to biologic behavior in giant cell tumor of bone / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the histogenesis of giant cell tumor (GCT) and factors related to tumor recurrence, invasiveness and malignant transformation.</p><p><b>METHODS</b>The clinical features, radiologic classification, surgical approach, pathologic findings, immunophenotypes and follow-up data of 123 cases of GCT were analyzed.</p><p><b>RESULTS</b>There was a significant correlation between tumor recurrence and radiographic classification (P = 0.032), over-expression of CD147 (P = 0.034) and p53 (P = 0.005), and surgical approach (P = 0.0048) in GCT. The biologic behavior showed no correlation with intramedullary infiltration, cortical bone involvement, parosteal soft tissue extension, tumor thrombi, fusiform changes of mononuclear tumor cells, mitotic count, Ki-67 index, coagulative tumor necrosis, secondary aneurysmal bone cyst formation, and adjoining bony reaction. The positive rate of p63 in stromal cells of GCT (79.7%, 94/118) was significantly higher than that in chondroblastoma (44.7%, 21/47), osteosarcoma (22.2%, 10/45) and other giant cell-rich tumors.</p><p><b>CONCLUSIONS</b>GCT is a bone tumor of low malignant potential. It is sometimes characterized by locally invasive growth, active proliferation, coagulative necrosis, secondary aneurysmal bone cyst and surrounding bony reaction. It is difficult to predict the biologic behavior of GCT. Over-expression of p53 in the tumor cells and CD147 in all components of GCT correlate with tumor invasiveness, recurrence and malignant transformation. Selection of suitable surgical approach with reference to radiologic classification is considered as an important factor in reducing the recurrence rate.</p>

Value of clusterin expression in pathologic diagnosis and histogenesis of giant cell tumor of tendon sheath / 中华病理学杂志

<p><b>OBJECTIVE</b>Analyze the immunophenotype of the different cells in the various subtypes of giant cell tumor of tendon sheath (GCTS) and investigate the value of clusterin in pathological diagnosis and histogenesis of giant cell tumor of tendon sheath.</p><p><b>METHODS</b>A total of 104 cases of GCTS from the surgical pathology files of Shanghai Jiaotong university affiliated the sixth people's hospital were identified. Immunohistochemistry (IHC) for clusterin, desmin, CD163, CD68, p63, p53, Ki-67 and CD35 was performed on all cases, using EnVision technique.</p><p><b>RESULTS</b>All cases of GCTS were researched, including 44 cases of localized type (L-GCTS), 32 cases of diffused type (D-GCTS), 26 cases of pigmented villonodular synovitis (PVNS) and 2 cases of malignant type. There was a slight female predominance in all these subtypes, and the male to female ratio was about 38:66. L-GCTS usually occured within the small joints (90.9%, 40/44), while D-GCTS, PVNS and M-GCTS commonly occured within the large weight-bearing joints [68.8% (22/32), 100% (26/26) and 2/2 respectively]. Of 74 cases with follow-up, the recurrence rates of L-GCTS, D-GCTS, PVNS and M-GCTS respectively were 30.3% (10/33), 30.4% (7/23), 18.8% (3/16) and 2/2. The different subtypes of GCTS had the same cell components, including the large synovial-like mononuclear cells, the small histiocytoid cells, foamy histiocytes cells, inflammatory cells, fibroblasts and the osteoclast-like multinucleated giant cells. There were obvious differences among immunophenotype of the various cell components in GCTS: the large synovial-like mononuclear cells were strong positive for clusterin, partly positive for desmin and Ki-67, and negative for CD163. The small histiocytoid cells were strong positive for CD163 but negative for clusterin and desmin. The osteoclast-like multinucleated giant cells were strong positive for CD68 but negative for clusterin, CD163 and desmin. Normal synoviocytes were strong positive for clusterin, partly positive for desmin. The number of the large synovial-like mononuclear cells that were positive for clusterin in D-GCTS were more than that in L-GCTS (P < 0.01) and PVNS (P < 0.05).</p><p><b>CONCLUSIONS</b>GCTS was synovial tumors, not belonged to the category of fibrohistiocytic lesions. The true tumor cells may be the large synovial-like mononuclear cells, and the number of the cells in the D-GCTS was obviously more than that in L-GCTS and PVNS. This may be the reason that the biological behavior of D-GCTS was more aggressive, destructive and recurrent. Clusterin was an useful marker in pathological differential diagnosis of GCTS.</p>

Primary intermediate hemangioendothelioma of bone: a study of 5 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the radiologic and pathologic features of primary intermediate hemangioendothelioma of the bone.</p><p><b>METHODS</b>Five cases of primary intermediate hemangioendothelioma of bone encountered in the past three years were enrolled into the study. The clinical, radiologic, pathologic and immunohistochemical features of the tumors were reviewed.</p><p><b>RESULTS</b>The patients included 3 children with Kaposiform hemangioendothelioma and 2 elderly with retiform hemangioendothelioma. Four of the cases affected long bones and the remaining case affected the clavicle. One case showed multifocal involvement of the humerus. Radiologically, the tumors showed borderline to low-grade bony destruction, with various degrees of cortical defect. Intralesional or perilesional bone formation was demonstrated in 4 cases and radial spicules were seen in 1 case. The histopathologic features of primary intermediate hemangioendothelioma of bone were similar to those of soft tissue, except for the presence of reactive bone formation. Immunohistochemically, the tumor cells were positive for CD31 (5/5), CD34 (5/5), vimentin (5/5) and smooth muscle actin (3/5) but negative for cytokeratin and epithelial membrane antigen.</p><p><b>CONCLUSIONS</b>Primary intermediate hemangioendothelioma of bone is a distinct entity and similar histologic classification applies as in its soft tissue counterparts. Comparison of the biologic behavior requires long-term follow-up studies.</p>

Correlation between typing of peripheral neuroblastic tumors and prognosis: a clinicopathologic study of 135 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics of peripheral neuroblastic tumors and to investigate the prognostic significance of International Neuroblastoma Pathology Classification (INPC).</p><p><b>METHODS</b>One hundred and thirty-five cases of peripheral neuroblastic tumors encountered in Shanghai Children's Medical Center were enrolled into the study. All the cases were classified according to INPC and International Neuroblastoma Staging System (INSS). The follow-up data were analyzed.</p><p><b>RESULTS</b>The consensus diagnoses of the 135 cases were as follows: 80 cases (59.2%) of neuroblastoma, 24 cases (17.8%) of ganglioneuroblastoma, intermixed, 17 cases (12.6%) of ganglioneuroma and 14 cases (10.4%) of ganglioneuroblastoma, nodular. The cases were subdivided into 2 subgroups: favorable histology (number = 90, 66.7%) and unfavorable histology (number = 45, 33.3%). According to INSS, the number of cases in stages I, II, III and IV was 22 (16.3%), 24 (17.8%), 34 (25.2%) and 55 (40.7%), respectively. The survival of peripheral neuroblastic tumors correlated with histologic diagnosis, INPC and INSS (P < 0.05).</p><p><b>CONCLUSION</b>Diagnostic categorization of peripheral neuroblastic tumors according to INPC is of prognostic value.</p>

Correlation of 53BP1 gene mutation with prostatic adenocarcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the incidence of 53BP1 gene mutations in prostatic adenocarcinoma and benign prostatic hypertrophy, and to analyze the relationship between 53BP1 mutations and prostatic adenocarcinoma.</p><p><b>METHODS</b>Genomic DNA extraction, PCR amplification and gene sequencing were used to detect the occurrence of 53BP1 gene mutations in 50 cases of prostatic adenocarcinoma. Ten cases of benign prostatic hypertrophy were included as controls.</p><p><b>RESULTS</b>Amongst the 50 cases of prostatic adenocarcinoma studied, 15 showed genetic alterations of 53BP1, including 4 cases with single nucleotide polymorphism. The mutation rate was 24.0% (12/50). Seven of the 53BP1 mutations detected represented missense mutations and none of them were situated in functionally important domains. The other 4 were synonymous mutations, in which c. 4760G > T was situated in Tudor domain. There was no obvious correlation between 53BP1 gene mutations and the various clinicopathologic parameters of prostate adenocarcinoma (P>0.05).</p><p><b>CONCLUSION</b>Certain percentage of prostatic adenocarcinoma harbors 53BP1 mutations which may be involved in the carcinogenesis.</p>

Electron microscopic examination on 50 cases of prostatic needle biopsies / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the differences in ultrastructural findings between prostatic carcinoma and benign prostatic hypertrophy, and the various ultrastructural features seen in moderately to poorly differentiated prostatic carcinoma.</p><p><b>METHODS</b>Utrasound-guided needle biopsies were carried out in 50 clinically suspicious cases of prostatic carcinoma. For each case, one additional core was sampled from the most suspicious area, fixed in glutaraldehyde and examined under electron microscopy.</p><p><b>RESULTS</b>In the 50 cases of prostatic needle biopsies studied, there were a total of 42 cases with histologic findings of prostatic carcinoma. Thirty-one cases showed features corresponding to Gleason's score 3 to 5. In contrast to that seen in benign prostatic hypertrophy, the ultrastructural findings of the tumor cells commonly seen in prostatic carcinoma included the centrally located giant nucleoli, a direct contact with stroma, and formation of cytoplasmic microcyst. Occasionaly, there were mitotic figures seen, accompanying with fibromyxoid change of the peritumoural stroma. Amongst the 31 cases of Gleason's score 3 to 5 prostatic carcinoma, 29 cases (93.5%) demonstrated cytoplasmic prostasomes and storage vesicles. Similar to their counterparts in benign prostatic cells, prostasomes and storage vesicles in prostatic carcinoma cells were formed in the Golgi apparatus and released into the lumen by apocrine excretion and exocytosis.</p><p><b>CONCLUSIONS</b>Electron microscopy is helpful in distinguishing between benign and malignant prostatic lesions. Because of the high yield of prostasomes in moderately to poorly differentiated prostatic carcinoma, prostasomes may become a potential target for cancer immunotherapy and one of the useful diagnostic indices for delineating the prostatic origin of metastatic carcinoma.</p>

Clinicopathologic features of osteochondroma with malignant transformation / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic, radiological and immunohistochemical characteristics of osteochondroma with malignant transformation.</p><p><b>METHODS</b>The clinical data, radiological imagings and hematoxylineosin stained histologic sections were reviewed in 463 cases of osteochondroma diagnosed in Shanghai 6th Hospital from 1991 to 2008, including 11 cases with malignant transformation. Immunohistochemical two-step staining was used to detect CK, vimentin, S-100 protein, p53 and c-myc expression in seven cases of osteochondroma with malignant transformation and 10 cases without malignant transformation. The relevant literature was reviewed.</p><p><b>RESULTS</b>Among the 11 cases with malignant transformation, five were single osteochondroma (5/408, 1.2%), and six were multiple osteochondromas (6/55, 10.9%). The male to female ratio was 10:1. These 11 cases were derived from femur (4 cases), tibia (3 cases), ilium (3 cases), shoulder bone (1 case) and pubis (1 case). There was one case that showed malignant transformation in both the femur and ilium. The mean ages for the malignant and non-malignant cases were 39.8 years and 20.4 years respectively. All the malignant cases showed large sized lesions with prominent calcification in the thick cartilage caps. The malignant component was low grade, peripheral chondrosarcoma (grade I-II). In some areas the tumor cells infiltrated the peripheral soft tissue and bone marrow. Of the seven cases with malignant transformation that had immunohistochemical staining, all were positive for vimentin and S-100 protein; p53 protein was positive in 2 of 7 cases.</p><p><b>CONCLUSIONS</b>Malignant transformation of osteochondroma was usually encountered in multiple lesions. Most patients were more than 30 years old with a long clinical history and with a male predominance. These tumors showed thick cartilage caps with prominent calcification. The lobulated nature of the tumors was evident and they infiltrated the surrounding soft tissue. The sarcomatoid component was peripheral type, well differentiated chondrosarcoma. p53 mutation may explain part of the molecular mechanism in the malignant transformation.</p>

Clinicopathologic diagnosis of de-differentiated chondrosarcoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic and radiologic features of dedifferentiated chondrosarcoma, focusing on its diagnosis and differential diagnosis.</p><p><b>METHOD</b>Clinical, radiological and pathologic findings of 14 cases of dedifferentiated chondrosarcoma (including biopsy and surgical specimens) were analyzed by hematoxylin and eosin stained sections and immunohistochemistry.</p><p><b>RESULTS</b>The mean age of patients was 52 years. The male-to-female ratio was 9:5. The most common sites of involvement were pelvis, femur and humerus, similar to the conventional chondrosarcoma. Radiologically, they were malignant tumors with dimorphic pattern. Grossly, central chondrosarcomas were more common than those of the peripheral. An essential histological feature of dedifferentiated chondrosarcoma was an abrupt interface between the low-grade cartilaginous tumor and high-grade anaplastic sarcoma. The most common dedifferentiated components were osteosarcoma, malignant fibrous histocytoma and fibrosarcoma. False negative diagnosis and erroneous diagnosis were frequent when only one-time biopsy was available.</p><p><b>CONCLUSIONS</b>Dedifferentiated chondrosarcoma is a rare subtype of chondrosarcoma with poor prognosis, which has different features of clinical manifestation, imaging features and pathological characteristics, compared to conventional chondrosarcoma and chondroblastic osteosarcoma.</p>

Abnormal expression of c-myc, p53, p16 protein and GNAS1 gene mutation in fibrous dysplasia / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the significance of c-myc, p53 and p16 protein expression in fibrous dysplasia, to detect the GNAS1 gene mutation in fibrous dysplasia, and to explore the property of fibrous dysplasia.</p><p><b>METHODS</b>The expression of c-myc, p53 and p16 protein was evaluated by immunohistochemistry SP method in 35 cases of fibrous dysplasia including 1 FD with malignancy, 1 Mazabraud syndrome and 20 control cases (10 cases of bony callus, 10 cases of osteosarcoma). Genomic DNA extraction, PCR amplification and gene sequencing were used to detect GNAS1 gene mutation in 35 cases of fibrous dysplasia.</p><p><b>RESULTS</b>C-myc protein immunoreactivity was detected in 91 percentage of FD (P = 0.001). Compared with the negative control group, the difference was significant. P16 positive was detected in 34 FD cases (P = 0.001). The difference was significant as compared with the positive control group. Positive p53 protein expression was detected in the only 1 case of fibrous dysplasia with malignant transformation. PCR amplification was successful in 12 of 35 FD cases. Two of the 12 FD cases were detected to have GNAS1 gene mutation, in which 1 case was FD of Mazabraud syndrome, 1 case was a monostotic lesion.</p><p><b>CONCLUSIONS</b>C-myc could be another protooncogene in addition to c-fos in the fibrous dysplasia disease. P53 protein overexpression could be useful in the diagnosis of FD malignancy and in the prediction of the prognosis of FD. The abnormal expression of the gene p16 might play an important role in the formation of FD. The GNAS1 mutation exist in FD. All of the results indicate that FD could be a neoplasia disease, caused by multiple factors leading to a dysfunction of bone development.</p>

Clinicopathologic study of Ollier's disease and its chondrosarcomatous transformation / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the clinicopathologic features of Ollier's disease, its chondrosarcomatous transformation and related differential diagnoses.</p><p><b>METHODS</b>A total of 19 cases of Ollier's disease and 8 control cases of pure multiple enchondroma were investigated by imaging studies including X-ray, CT or MRI, and hematoxylin and eosin stain.</p><p><b>RESULTS</b>Among 19 cases of Ollier's disease, 12 were men and 7 were women with a mean age of 20 years (range, 5-66 years). Ollier's disease involving short tubular bones of extremity were lytic defects with bony expansion, thinning or disappearance of the overlying cortex surrounded by periosteal fibrous tissues. When occurring in the long bones, the disease showed radiolucent columns of dysplastic cartilage that extended from the metaphysis to diaphyseal and created bowing deformation and limb asymmetry. Microscopically, the cartilage present in the small bones of the hands and feet tended to be more hypercellular with more abundant enlarged or binucleated nuclei. The lesion in long bones appeared multicentric, surrounding with a thin rim of bone and calcification. Six cases of Ollier's disease had developed secondary low-grade chondrosarcoma.</p><p><b>CONCLUSIONS</b>Low-grade chondrosarcomatous transformation can occur in dysplastic cartilage of Ollier's disease. The diagnosis of such sarcomatous transformation should be determined by invasion, but not atypicality of the cartilagenous cells. There are certain differences between the secondary chondrosarcoma of Ollier's disease and conventional chondrosarcoma on clinical, radiographical and pathological grounds.</p>

Pathologic characteristics of pseudohyperplastic prostatic adenocarcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of 30 cases of pseudohyperplastic prostatic adenocarcinoma (PHPA).</p><p><b>METHODS</b>Eight hundred and sixty cases of ultrasound-guided prostatic needle biopsy and 46 cases of radical prostatectomy specimens collected during the period from January 1, 2005 to December 31, 2006 were retrieved from the archival files. The incidence, morphology, pathologic differential diagnosis, tumor volume, preferred location and Gleason's score were studied. The tissue sections suspicious for PHPA were immunohistochemically stained with high-molecular weight cytokeratin (34betaE12) or CK5/6, p63, AMACR, and cocktail antibody of 34betaE12/p63/AMACR. Cases with PHPA component more than 60% in at least one single slide were selected and pathologically analyzed.</p><p><b>RESULTS</b>PHPA was present in 7% of needle biopsy and 15.2% of prostatectomy specimens. Histologically, 66.7% of PHPA demonstrated direct transition with conventional acinar adenocarcinoma; and 76.7% of cases had coexisting conventional acinar adenocarcinoma in the remaining tissue blocks. The tumor volume accounted for 5% to 100% of total carcinoma among core needle biopsy and 1% to 30% of total carcinoma among radical prostatectomy. PHPA resembled benign prostate glands, in which the hyperplastic malignant acini were predominantly of medium to large size. The neoplastic cells were well-differentiated, with basally located nuclei and luminal corpora amylacea. However, amongst the 20 pathologic indices of prostatic malignancy studied, occurrence of 10 or more indices exceeded 66.7%. Although PHPA looked benign morphologically, 66.7% cases had stromal invasion, 6.7% had perineural invasion and 3.3% had bone metastasis. The tumor was primarily located in the peripheral zone.</p><p><b>CONCLUSIONS</b>PHPA is not a rare phenomenon in prostatic adenocarcinoma. Majority of cases have concurrent conventional acinar adenocarcinoma. It is different from well-differentiated (with Gleason's score 1 or 2) adenocarcinoma with a relatively indolent clinical course. In contrast, PHPA corresponds to moderately differentiated adenocarcinoma with Gleason's score of 3.</p>

The value of using an AMACR/34betaE12/p63 cocktail double staining for diagnosis of prostate carcinoma and precarcinomatous lesions / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the value of using an AMACR/34betaE12/p63 cocktail and double-staining for the diagnosis of small focal protatic carcinoma and precarcinomatous lesions.</p><p><b>METHODS</b>A total of 130 consecutive cases were examined over a 3-month period, including 105 prostate needle biopsy samples, 6 radical prostatectomy specimens and 19 benign prostatic hyperplasia specimens which were excised transurethra or above pubis. 262 paraffin blocks of all the 1030 ones were stained with hematoxylin and eosin and by immunostains for AMACR, 34betaE12, p63, and an antibody cocktail comprising all the three with double-chromogen reaction. The diagnoses were then made according to the immunostaining, HE staining and clinical information.</p><p><b>RESULTS</b>In the sections stained by the 3-antibody cocktail, blue-black cytoplasmic staining was observed in the epithelial cells of prostatic carcinoma and high-grade prostatic intraepithelial neoplasia (HGPIN) the basal cells of benign glands were stained red. There were no red basal cells around the blue-black glandular epithelium of carcinoma, but discontinuous or consecutive red basal cells were present around the blue-black glandular epithelium of HGPIN. Prostatic carcinoma was found in 214 paraffin blocks (82%), including 31 small focal carcinoma. HGPIN were observed in 64 paraffin blocks (24%), including focal HGPIN and small gland alveolus HGPIN. AAH was found in one block. No benign glands were simultaneously positive for AMACR and negative for basal cell markers.</p><p><b>CONCLUSION</b>Inmmunohistochemistry studies using a 3-antibody cocktail and double staining can improve the detection rate of small focal prostatic carcinoma and HGPIN.</p>

Clinical study and pathological examination on the treatment of deep partial thickness burn wound with negative charge aerosol / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of negative charge aerosol (NCA) on the treatment of burn wound.</p><p><b>METHODS</b>Patients with superficial or deep partial thickness burn only were enrolled in the study, and they were randomly divided into trial group (T, including 180 cases of superficial thickness burn and 100 cases of deep partial thickness burn), control group (C, including 30 cases with superficial thickness burn and 30 with deep partial thickness burn), and self control group (SC, including 10 cases with superficial thickness burn and 10 with deep partial thickness burn). The patients in T and SC groups were treated with NCA for 1.5 hours, 1-2 times a day, from 6 postburn hour (PBH) to 2 postburn day (PBD), while those in C group received conventional treatment. For those in SC group, some of the wounds were covered with sterile schissel, while other wounds without schissel covering. The general changes in the wounds during NCA treatment were observed, and bacterial culture before and after NCA treatment was performed. The healing time was recorded and the blood biochemical parameters were determined. Rat model with deep partial thickness scald was established, and the rats were also divided into T and C groups, and received treatment as in human. Tissue samples were harvested from the wounds of rats in the 2 groups before and 1, 2, 3 weeks after treatment for pathological examination.</p><p><b>RESULTS</b>There was no infection and little exudation in the patients in T group. No bacteria were found in the wound before and after NCA treatment. The healing time of the wounds of patients with superficial and deep partial thickness burn in T group was 6.3 +/- 1.6 d and 15.1 +/- 3.1 d, respectively, which was obviously shorter than those in C group (11.3 +/- 1.4 d and 21.2 +/- 1.4 d, P < 0.01). In SC group, the healing time of those with sterile schissel coverage was also significantly shorter than those without covering (P < 0.01). There was no obvious change in the liver and kidney functions and blood biochemical parameters among the patients. Pathological examination showed that the skin structure was almost recovered in the rats in T group 3 weeks after treatment, while those in C group was not.</p><p><b>CONCLUSION</b>Negative charge aerosol is safe and effective in promoting wound healing of the patients with partial thickness burns.</p>