IgG4 immunohistochemistry in Riedle thyroiditis / 中华病理学杂志

Objective@#To observe the histopathological changes and immunohistochemical expression of IgG4 in Riedle thyroiditis (RT) and to study the relationship between RT and IgG4-related diseases (IgG4-RD).@*Methods@#A total of 5 RT patients were collected from the Department of Pathology, Peking Union Medical College Hospital during April 2012 to August 2014. The clinical and immunohistochemical features were analyzed in the 5 patients. Histopathologic analysis was performed on hematoxylin and eosin-stained sections.@*Results@#There were one male and four female patients, aged 52 to 78 years (median 59 years). Five cases were characterized by multiple nodules of thyroid, which increased year by year. All patients were found to have surrounding tissue compression symptoms and signs. Two female patients were found to have hypothyroidism. The serum concentration of IgG was elevated in 2 cases, and the serum concentration of IgG was not tested before operation in the remaining patients. By ultrasound, all presented as low echo or medium low echo. Strong echo occasionally appeared in hypoechoic nodules. Microscopically, fibrous tissue hyperplasia was infiltrated with varying numbers of lymphocytes and plasma cells. The occlusion of phlebitis was found in 4 cases and eosinophils were found in 3 cases. IgG4 counts and IgG4/IgG ratios in 5 cases were 20/HPF, 16%; 60/HPF, 82%; 22/HPF, 28%; 400/HPF, 266% and 33/HPF, 71%, respectively.@*Conclusions@#With the similar pathological manifestations between RT and IgG4-RD, immunohistochemical staining shows that the number of IgG4 positive plasma cells and IgG4/IgG ratio of RT are increased in varying degrees. Some cases meet the diagnostic criteria of IgG4-RD, and speculate that some cases of RT belong to IgG4-RD.

Diagnostic value of MYB protein expression in adenoid cystic carcinoma and status of MYB gene copy number / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the diagnostic value of MYB protein expression for adenoid cystic carcinoma and its differential diagnosis from other salivary gland tumors, and to further investigate the status of MYB gene copy number.</p><p><b>METHODS</b>MYB expression was studied by immunohistochemistry in 34 adenoid cystic carcinomas, 55 non-adenoid cystic carcinomas (other salivary gland tumors) including 10 pleomorphic adenomas, 10 basal cell adenomas, 10 epithelial-myoepithelial carcinomas, 9 basal cell adenocarcinomas, 8 mucoepidermoid carcinomas, 4 carcinoma in pleomorphic adenomas, and 4 polymorphous low-grade adenocarcinoma. MYB gene copy number status was detected by FISH in MYB protein-positive cases.</p><p><b>RESULTS</b>82.4% (28/34) of adenoid cystic carcinomas were MYB protein-positive, compared with 9.1% (5/55) of non-adenoid cystic carcinomas, and the difference between the two groups was statistically significant (P < 0.01). 2/18 of adenoid cystic carcinomas had duplication of MYB gene by FISH, and all non-adenoid cystic carcinomas were negative although the difference was not statistically significant (P = 0.435).</p><p><b>CONCLUSIONS</b>MYB protein expression is a useful diagnostic marker for adenoid cystic carcinomas in its separation from other salivary gland tumors. In addition, duplication of MYB gene is no a major mechanism for the MYB protein overexpression.</p>

Gliosarcoma of cerebral hemispheres: a clinicopathologic study of 10 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinical and pathologic features of gliosarcoma of cerebral hemispheres.</p><p><b>METHODS</b>The clinicopathologic features of 10 cases of gliosarcoma involving cerebral hemispheres were reviewed. Immunohistochemical study was carried out using EnVision method.</p><p><b>RESULTS</b>The mean age of the patients was 54 years and the male-to-female ratio was 6 to 4. Clinical symptoms included headache (6/10), nausea/vomiting (5/10), and sensory or motor impairment (4/10). Nine of the cases were primary gliosarcoma, with maximum diameter ranging from 2.4 to 5.5 cm (mean = 4.2 cm). The remaining case represented secondary gliosarcoma involving skull base and extracranial tissues. Histologic examination showed a biphasic pattern in all cases. Regarding the glial component, there were 9 cases of pleomorphic glioblastoma and 1 case of giant cell glioblastoma. Reticulin stain was positive in all cases. Immunohistochemical study showed that the tumor cells variably expressed GFAP (10/10), p16 (4/10), EGFR (1/10), CD68 (1/10) and p53 (6/10). The Ki-67 index ranged from 15% to 70% (mean = 34%). Six patients had follow-up data available. One patient was disease-free for 45 months and 5 patients died of the disease at 3 to 17 months after the operation (mean duration of survival = 9 months).</p><p><b>CONCLUSIONS</b>Gliosarcoma is a highly aggressive tumor, often locates in the deeper part cerebral hemispheres and has a relatively short duration of symptoms. It carries a poor prognosis. GFAP immunostain and reticulin stain are helpful in confirming the diagnosis. p53 and p16 are also expressed in some cases.</p>

The relative study on snoring and hypertension in the elderly / 中国医师进修杂志

Objective To explore the relationship between snoring and hypertension in the elderly.Methods A total of 375 subjects who were ≥40 years without stroke and myocardial infarction accepted questionnaire survey on snoring.Non conditional Logistic regression analysis was used to analyze the factors of hypertension.Results In 375 subjects,non-snore was in 169 subjects,occasionally snore was in 86 subjects and regular snore was in 120 subjects,the prevalence of hypertension in them were 33.7％(57/169),39.5％(34/86) and 49.2％ (59/120),respectively,there was significant difference among them.Non conditional Logistic regression analysis showed:after correcting other factors,regular snore was still risk factor of hypertension,the OR value was 2.124 (95％ CI 1.189-3.796).According to gender stratification,regular snore was still risk factor of hypertension in female,the OR value was 3.993 (95％ CI 1.259-12.663),rather than risk factor in male.Condusion Regular snore is relevant to the increased prevalence of hypertension,and it is a risk factor of hypertension.