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Objective@#To investigate the clinicopathological characteristics, histogenesis, immunophenotypes, molecular genetic characteristics, diagnosis and differential diagnosis of calcifying fibrous tumors (CFT).@*Methods@#A total of 32 cases of CFT (22 cases from Henan Provincial People′s Hospital and 10 cases from PLA Army Medical Center) diagnosed between June 2009 and February 2019 were reviewed. The clinical and pathologic data were analyzed.@*Results@#There were 12 male and 20 female patients, aged from 15 to 63 years (mean 40.8 years). Eleven cases occurred in stomach, four cases in retroperitoneum, four cases in ovary, two cases in scrotum, two cases in mediastinum, two cases in head and neck, one case each in thoracic cavity, lung, adrenal gland, kidney, sigmoid colon, epididymis and mesosalpinx. All the tumors were solid masses with clear boundaries. The maximal dimension of the tumors ranged from 0.6 to 10.0 cm. Microscopically, there was hypocellular stromal sclerosis and wavy storiform coarse collagen with superimposed scattered or patchy lymphocytes and plasma cells; calcification or gravel formation were also detected. Immunohistochemistry showed that spindle cells were positive for vimentin and some were positive for CD34; and they were negative for calponin, SMA, desmin, S-100 protein, SOX10, STAT6, β-catenin, ALK, CD117, DOG1, CKpan, and EMA. No ALK rearrangement was detected by FISH in all cases. No C-KIT and PDGFRA mutation was detected in all the tested 11 cases of stomach, four cases of retroperitoneal and one case of sigmoid colon CFT. MDM2 was not amplified by FISH in all four tested cases of retroperitoneal CFT.@*Conclusions@#CFT is a rare benign tumor of fibroblastic cell origin. The diagnosis mainly depends on histomorphologic analysis and immunophenotyping. CFT should be differentiated from other benign and malignant spindle cell mesenchymal tumors.
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Objective@#To investigate the clinical symptoms, imaging features, pathologic manifestations and diagnosis of tracheobronchopathia osteochondroplastica (TO).@*Methods@#The clinical data, imaging and pathologic features and outcome of 18 TO patients diagnosed at the First Affiliated Hospital of Zhengzhou University from August 2011 to August 2018 were collected and analyzed.@*Results@#The 18 TO patients included 10 males and 8 females; patients′ age range was 31 to 64 years (mean 52 years). Six patients (6/18) were smokers. The main presenting clinical symptoms included cough in 15 cases, expectoration in eight cases (8/18), hemoptysis in five cases (5/18), chest tightness in four cases, wheezing in three cases and chest pain in two cases. The time interval between the initial symptoms and diagnosis was 1.5 to 360.0 months, and the average time interval was 45.2 months. Blood calcium and phosphorus were normal in 18 patients (18/18). Chest X-ray showed no direct evidence of TO. Six patients (6/18) showed irregular changes in the trachea or bronchial wall by chest CT scan. Three patients (3/18) had mild ventilatory obstruction. TO was classified as: 10 cases (10/18) were scattered type, seven cases (7/18) were diffuse type and one case (1/18) was confluent type. Epithelial squamous metaplasia, submucosal cartilage, submucosal ossification and hematopoietic bone marrow within the ossified areas were the characteristic histopathologic findings of TO.@*Conclusions@#TO is a rare benign disorder that shows atypical presentation. CT scan is insensitive, the histopathology shows submucosal cartilage or ossification. TO should be diagnosed by comprehensive consideration of clinical symptoms, imaging and pathology.
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Objective@#To investigate the clinicopathological features and prognostic indicators of primary pulmonary adenoid cystic carcinoma.@*Methods@#Fifty-nine cases of primary pulmonary adenoid cystic carcinoma were collected from August 2011 to December 2017 at the First Affiliated Hospital of Zhengzhou University. All cases were retrospectively studied by hematoxylin-eosin staining and immunohistochemistry. The clinicopathological features were reviewed and patient survival analysis was performed using Kaplan-Meier method and Cox regression model. Status of epidermal growth factor receptor (EGFR), KRAS, BRAF genes was analyzed in 15 of the 59 study cases.@*Results@#Among 59 cases, there were 25 males and 34 females with male to female ratio of 1.0 to 1.4. The patient age ranged from 29 to 81 years with a mean age of 55 years. The tumor max diameters ranged from 1.0 to 9.6 cm with an average diameter of 2.8 cm. Fifteen (25.4%) patients were smokers while 44 patients (74.6%) were non-smokers. Tumors predominantly occurred in the trachea (28/59,47.5%), the left main bronchus (7/59,11.9%) and the right bronchus (5/59,8.5%). Grossly, the tumors were well circumscribed, greyish-white nodules. Microscopically the tumor cells were small and uniform, and arranged in tubular, cribriform, and solid patterns. Immunohistochemistry showed that the tumor cells were positive for CK7, S-100 protein, Sox-10, CD117 and p63. TTF1 was only positive in 2 cases and Ki-67 index ranged from 3% to 40%. Eighteen cases (30.5%) were gradeⅠ, 26 cases (40.1%) grade Ⅱ, and 15 cases (25.4%) grade Ⅲ. Overall, 39 cases (66.1%), 7 cases (11.9%), 10 cases (16.9%), and 3 cases (5.1%) were at stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. Twenty-three patients (39.0%) received surgical therapy, 3 patients (5.1%) surgery combined with radiotherapy, 9 patients (15.2%) surgery combined with chemotherapy, and 24 cases (40.7%) chemotherapy only. No mutation of EGFR, KRAS and BRAF was detected in all 15 tested cases. The overall survival rate at the first, third and fifth years was 94.9%, 86.4% and 84.7%, respectively. Prognostic analysis showed that patient′s age and tumor size were statistically associated with the survival (P<0.05).@*Conclusions@#Majority of the patients with primary pulmonary adenoid cystic carcinoma are at an early clinical stage with a favorable prognosis. The size of the tumor and the age of the patients are independent prognostic indicators.
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Objective@#To investigate the clinicopathological features, diagnosis and differential diagnosis of pulmonary extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT).@*Methods@#Eleven cases of newly diagnosed (10 puncture biopsies and 1 transbronchial biopsy), previously untreated pulmonary ENKTL-NT were collected at the First Affiliated Hospital of Zhengzhou University, from August 2013 to November 2018. The clinicopathological features including histomorphology, immunohistochemistry and in situ hybridization were collected and analyzed.@*Results@#Among the 11 cases, 8 were males and 3 were females, with a male to female ratio of 8∶3.The age range was from 30 to 74 years, with an average of 48 years and a median of 43 years. Tumors involved bilateral lung lobes in 8 cases, the upper left lobe in 1 case, lower left lobe in 1 case, and upper right lobe in 1 case. Main clinical symptoms included fever, often accompanied by cough, and bloody sputum in most cases. All cases were stage Ⅳ E. Histological features included scattered or focal aggregates of marked pleomorphic tumor lymphocytes, accompanied by necrosis and heavy admixture of inflammatory cells. In a few cases, diffuse neoplastic lymphocytes or vascular central and destructive infiltrations were seen. Tumor cells in most cases expressed CD3ε, CD3, CD43, CD56, TIA-1, granzyme B, but did not express CD20, CD79a, and CD5. Ki-67 index ranged from 40%to 90%.All cases were positive for EBER by in situ hybridization. Four of five patients died during follow-up with a survival period of only 1 week to 13 months.@*Conclusions@#Pulmonary ENKTL-NT is rare, high grade malignancy with a poor prognosis. Misdiagnosis is common due to lesional necrosis and heterogeneous cell components. Immunohistochemistry and EBER in situ hybridization are essential for accurate diagnosis.
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Objective: To investigate the clinicopathological features, morphological characteristics, immunophenotypes of littoral cell angioma (LCA) in spleen, and to provide new evidence for making diagnosis and avoiding misdiagnosis.Methods: Clinicopathological data, histological characteristics of 13 cases of LCA were retrospectively studied and immunohistochemical staining was imposed on the paraffi-nembedded specimens, and 5 cases of cavernous hemangioma, 4 cases of normal littoral cells of spleens were used as control groups, simultaneously.Results: All the 13 LCA patients included 7 males and 6 females, aged from 39 to 70 years with an average of 54.2 years and a median age of 55 years.Among these tumor patients, 6 cases were accompanied by malignances, benign tumors or inflammation states at abdominal cavities, and 7 cases were accidentally discovered by physical examinations.Grossly, spleens contained solitary or multiple gray red nodules ,which ranged from 0.5 to 6.2 cm in diameter.Histologically, tumors were composed by anastomosing vascular spaces which were lining by plump, rounded to cuboidal littoral cells that extended into vascular lumens.Usually, papillary frameworks that were covered by these cells were also seen extending into the lumens in some areas.Other types of histiocytoid cells were identified in lumens and the sizes were larger than the littoral cells.Both types of cells absented cytologic atypia.Immunohistochemical study demonstrated that the littoral cells in all cases were positive for vascular endothelial and histiocyte markers, such as CD21, CD31, CD68, polyclone FⅧRAg and ERG, while these cells were negative for CD8, CD34, and WT-1.These findings manifested that immunophenotype of littoral cell in LCA distinctive from that in controls.Conclusion: LCA is a benign lesion, which frequently occurs in the elderly.Its etiology remains confusion, however, immune dysregulation may associate with it because of the concomitance with other tumor or inflammation in some cases.The littoral cells in LCA show a hybrid endothelial-histiocytic phenotype on immunohistochemistry, therefore these cells may have features that intermediate between those of endotheliocytes and histiocytes.Emphasizing the histological findings and immunophenotypes is significant for diagnosis and differential diagnosis.
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<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics, immunophenotypes, pathologic diagnosis and differential diagnosis of gastrointestinal inflammatory fibroid polyp (IFP).</p><p><b>METHODS</b>The clinical data, histologic features and immunohistochemical results of 6 cases of gastrointestinal inflammatory fibroid polyp were analyzed, with review of literature.</p><p><b>RESULTS</b>There were altogether 5 women and a man. The age of patients ranged from 44 to 87 years (median age = 61 years and mean age = 62 years). The sites of involvement included stomach (number = 2), jejunum (number = 2), distal ileum (number = 1) and rectum (number = 1). The patients often presented with abdominal pain or discomfort and tarry stool. All the cases studied showed similar morphology, were submucosa-based and composed of bland spindle cells associated with loose collagenous stroma and perivascular edema. Prominent concentric fibroblastic proliferation ("onion-skin" appearance) and eosinophilic infiltrate were characteristics. Three of the patients underwent surgical resection. The remaining patients had the lesions removed with endoscopy. Follow-up data were available in 5 patients and none of them had disease recurrence or metastasis.</p><p><b>CONCLUSIONS</b>IFP is a rare benign tumor of gastrointestinal tract. Correct diagnosis primarily relies on pathologic examination. It needs to be distinguished from gastrointestinal stromal tumors or inflammatory myofibroblastic tumor.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Diagnosis, Differential , Gastrointestinal Tract , Pathology , Immunohistochemistry , Inflammation , Pathology , Polyps , PathologyABSTRACT
Objective To validate the molluscicidal effect of magnesium borate ore powder (MBOP), and explore the mechanism for providing the scientific basis for the field use. Methods The experiments were performed by the Copper Coin method, Volatilization method and Immersion and Sprinkle methods recommended by WHO. Results The MBOP can't kill the snail by the volatilization. The molluscicidal effect was well by the Immersion and Sprinkle methods. The acted effect was quick by using the Immersion method while the effect was more stable by using the Sprinkle method.LD_(50) of the Sprinkle method (27℃,4 days) was 4.07 g/m2. Conclusion MBOP's molluscicidal effectiveness is well, the action appears gradually and the effect is stable. The possible mechanism of MBOP might act through some dissolved components.
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Objective To explore the relati onship between the reliability of information of genetic diversity and sample si ze in morphologic quantitative characteristics of Oncomelania h upensis. Methods Sixty snails ( smooth shell) from Dali City, Yunnan Province and sixty snails (ribbed shell) f rom Yueyang City, Hunan Province were sampled at random, and the morphologic qua ntitative characteristics of the snails were measured, and then the coefficient of variation, proportion of variation between the two groups and Shannon's infor mation index were computed respectively. Results Among 11 indices of morphologic quantitative characteristics, the coefficient of variation of thickness of labra brim was th e largest, and those of ribbed-shell and smooth-shell population were 20.57% and 14.14% respectively, and the next was length of hypo-body whorl, and those of ri bbed-shell and smooth-shell snails were 12.98% and 11.49% respectively. Amon g 11 morphologic quantitative characteristics indices, there were nearly three out of four indices which the coefficients of variation of ribbed-shell snails were m o re than those of smooth-shell population, and the average coefficient of variat i on of ribbed-shell population was also more than those of smooth-shell populat io n. The average Shannon's information indices of ribbed-shell and smooth-shell po pulation were 1.541 and 1.220 respectively, and the former was the bigger. Whe n the sample size was less than 30, the result of genetic diversity gained from th e study was not very reliable, and with the increase of sample size the reliabil ity of the information of genetic diversity was also augmented. When the sample size was more than 55, the result of genetic diversity was reliable. Conclusion In order to get reliable information of genetic variation in the study of morphologic quantitative charac-teristics of Oncomelania hupensis, at least 55 individual s should be investigated for each population.
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Objective To explore morphologic variations and their spatial correlation among Oncomelania hupensis populations from the mainland of China. Methods Twenty-seven snail populations from ten provinces were collected. The morphologic indices of shells and geographic distances between the snail spots were measured respectively, and the morphologic variations among snail populations and the correlations between morphologic variations and geographical distances were analyzed. Results The median of Euclidean distances was 3.24 (95% CI: 2.88-3.81) among 20 snail populations of O.h.hupensis including a snail population from Guangxi Province, and was 3.15 (95% CI: 2.86-3.76) excluding the Guangxi snail population; the median was 1.69 (95% CI: 1.33-2.27) among 6 populations of O.h.robertsoni. Whether including a snail population from Guangxi Province or not, the median among O.h.robertsoni was less than that among O.h.hupensis (P0.05). The correlation coefficient was 0.2655 for O.h.hupensis including a snail population from Guangxi Province, 0.2567 not including it; and was 0.3121 for ribbed-shell population. Conclusions Morphologic variation among O.h.hupensis is bigger than that among O.h.robertsoni, and morphologic variation among ribbed-shell populations is bigger than that among smooth-shell populations. There is significant spatial structure among ribbed-shell snail populations of Oncomelania hupensis distributed in the mainland of China.
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Objective To explore the geographic pattern of morphologic variation within snail populations across the mainland of China. Methods Twenty-one snail populations from the different regions were collected, and Shannon-Winer index and Euclidean distances within populations were used to analyze the spatial distribution of morphologic variation of Oncomelania hupensis. Results Longitude correlated significantly with Shannon-Winer index and Euclidean distances within populations, and the correlation coefficients were 0.719(P
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Objective To explore the degree of genetic diversity among populations of Oncomelania hupensis. {Methods AFLP method} was used to amplify the genomic DNA of thirteen snail populations from nine provinces (i.e. Yunnan, Sichuan, Guangxi, Fujian, Hunan, Hubei, Jiangxi, Anhui and Jiangsu) and the genetic diversities among snail populations were analyzed. Results The number of AFLP fragments amplified ranged from 403 to 472 for thirteen Oncomelania populations. Among the thirteen snail populations, the genetic diversity within the population from Xingzi County, Jiangxi Province, was most significant, and the percentage of polymorphic loci, Nei’s genetic diversity and Shannon’s information index were 93