Clinicopathological features of dedifferentiated liposarcomas with meningothelial-like whorls: report of six cases / 中华病理学杂志

Objective@#To investigate the histopathologic, immunohistochemical, molecular genetic characteristics of dedifferentiated liposarcomas with meningothelial-like whorls(DDLMW).@*Methods@#Six cases of DDLMW diagnosed at Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University) from March 2012 to August 2018 were enrolled. The cases were analyzed by routine HE staining, immunohistochemistry(MDM2, CDK4 and p16) and fluorescent in-situ hybridization(FISH) on MDM2 gene. Related literatures were also reviewed.@*Results@#Three of the 6 patients were male.The patient ages ranged from 40 to 77 years (mean, 58 years). Four tumors occurred in the retroperitoneum and two in the mediastinum. Histologically, the tumors showed, in addition to foci of well-differentied liposarcoma, characteristic, scattered meningothelial-like concentrical whorls. The whorls were composed of tightly, concentrically arranged, spindle to ovoid cells with mild to mederate cytological atypia. Metaplastic bone was present within or in their immediate vicinity in four case. The tumors cell also showed strong and diffuse immunoreactivity to MDM2, CDK4 and p16, but no immunoreactivity to S-100 protein, SMA, SOX10, EMA, CD21, CD23 or CD35. The Ki-67 labeling indexes were low, while FISH showed high levels of MDM2 amplification in all cases.@*Conclusions@#DDLMW is a rare morphologic variant of dedifferentiated liposarcoma. The whorls in DDLMW do not represent perineurial or follicular dendritic differentiation. Recognition and familiarity with its existence, as well as combined application of immunohistochemical staining and MDM FISH, are important to avoid confusion with other lesions.

Clinicopathological observation of adamantinoma of long bone / 中华病理学杂志

Objective@#To investigate the clinicopathological features and differential diagnosis of adamantinoma of long bone.@*Methods@#Seven cases of adamantinoma on long bone were selected at Jiangsu Province People′s Hospital from June 2012 to May 2018. Clinicopathologic details, immunohistochemical and molecular analysis were performed,and the relevant literature reviewed.@*Results@#There were 6 males and 1 female patients,age ranging from 21 to 60 years (mean 38 years). Six cases were on the right side and one case was on the left; in five cases the tumors arose from tibia, one from patella and one from humerus. Microscopically,tumour cells were mainly composed of spindle cells arranged in bundles or braids,with irregular epithelial island. Immunohistochemically,the epithelial island expressed high molecular weight cytokeratin but not CK8/18. Both epithelial and spindle components expressed vimentin. One case that was microscopically similar to intraosseous synovial sarcoma did not show SYT gene rearrangement. Clinical follow-up was available for five patients: one patient had axillary metastases seven months after operation, one patient had recurrence 34 months after surgery, 3 patients were uneventful with follow up duration from half a month to 32 months.@*Conclusion@#Adamantinoma occurring in long bones is very rare. The correct diagnosis requires adequate sample selection, careful morphologic observation, immunohistochemistry and molecular genetics.

Dedifferentiated liposarcoma with inflammatory myofibroblastic tumor-like features: a clinicopathological analysis of five cases / 中华病理学杂志

Objective@#To investigate the clinicopathological features, diagnosis and differential diagnosis of dedifferentiated liposarcoma (DDLPS) with inflammatory myofibroblastic tumor (IMT)-like features.@*Methods@#Five cases of DDLPS with IMT-like features were collected from the First Affiliated Hospital of Nanjing Medical University, the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine and the First People′s Hospital of Qinzhou between 2013 and 2018. EnVision method and fluorescence in situ hybridization (FISH) were used to detect the immunophenotype of the tumor cells and the profile of MDM2 gene amplification respectively.@*Results@#All five cases were male and the median age was 61 (range 53 to 65) years. The clinical symptoms were mainly related to the space-occupying lesions. The tumors were located in duodenal mesentery (two cases), intestinal wall (one case), retroperitoneum (one case), and spermatic cord (one case). Grossly, the tumors were not well encapsulated, ranging from 3 to 13 cm (median 6.7 cm) in diameter, with tan to gray and firm cut surface. Histologically, the dedifferentiated component closely resembled inflammatory myofibroblastic tumor (IMT), with spindle/polygonal/stellate-shaped cells arranged in storiform, sheet-like, or random pattern, with varying degrees of chronic inflammation and fibrosis. All three major patterns seen in IMT (myxoid, cellular and hypocellular fibrous) were observed, the hypocellular fibrous pattern was the most common. Well-differentiated liposarcomatous component was found in the peripheral areas of all the tumors. One case had high grade dedifferentiated component. Four cases were strongly positive for MDM2 and p16. Two cases were positive for SMA, and one case was focally positive for desmin and one for CD34. None of the cases stained for ALK-1. FISH demonstrated MDM2 gene amplification in all five cases. Clinical follow-ups were available in all five cases and the interval ranged from 3 to 66 months (median 23 months). Two patients developed recurrences and one patient had metastasis. The remaining two patients were alive with no evidence of tumor recurrence at 3 and 14 months after surgery respectively.@*Conclusions@#DDLPS with IMT-like features is a more aggressive neoplasm than its histological mimic (IMT), and should not be misdiagnosed as other intermediate or low-grade malignant tumors, such as IMT, sclerosing liposarcoma, inflammatory liposarcoma, aggressive fibromatosis, solitary fibrous tumors, low-grade myofibroblastic sarcoma, and low-grade fibrosarcoma.

Atypical epithelioid hemangioendothelioma: a clinicopathological analysis of eight cases / 中华病理学杂志

Objective@#To study the clinicopathological features, diagnosis, and differential diagnosis of atypical epithelioid hemangioendothelioma (EHE).@*Methods@#Eight cases of atypical EHEs were collected from Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University) between 2010 and 2018. EnVision method and fluorescence in situ hybridization (FISH) were used to detect immunophenotype, WWTR1-CAMTA1 and TFE3 gene rearrangement, respectively.@*Results@#There were 4 males and 4 females, ranging from 42 to 59 years (median 47.5 years). The tumors located in soft tissue (3 cases), lung (3 cases), liver (1 case) and chest wall (1 case). One soft tissue EHE involved also adjacent fibula and pleural involvement was present in all three lung cases at the diagnosis. Regional lymph node metastases were present in two cases (one involving soft tissue tumor and one involving liver). Morphologically, the tumor cells were epithelioid with abundant eosinophilic cytoplasm, moderate to marked nuclear pleomorphism, irregular nuclear membrane, unevenly chromatin, and prominent nucleoli. The cells arranged in cords, small nests or solid pattern. The mitotic rate was 4.3 mitoses/2 mm2 on average (ranging 2 to 9). Tumor necrosis was seen in every case. Among all 8 cases, blister cells were found upon careful observation. Myxohyaline stroma was present in 6 cases. Immunohistochemically, tumor cells expressed CD31 (8/8), CD34 (7/8), ERG (8/8), CKpan (2/7), and CAMTA1 (4/6). None of the tested cases stained for TFE3 (0/6). WWTR1-CAMTA1 fusion gene by FISH was found in all tested 6 cases and TFE3 gene rearrangement was not detected in any. Available clinical follow-up was obtained in 7 cases and the intervals range from 6 to 55 months (average 19.6 months). Six patients had metastasis and 3 patients died of disease. One patient was alive with no evidence of disease.@*Conclusions@#Atypical EHE is a more aggressive tumor than classic EHE, with histological features including high nuclear grade, increased mitotic activity, the presence of solid growth pattern and tumor necrosis. The differential diagnoses include epithelioid angiosarcoma, carcinoma and epithelioid sarcoma.

Pulmonary microcystic fibromyxoma: report of a case with review of literature / 中华病理学杂志

Objective@#To study the clinicopathologic features, diagnosis and differential diagnosis of pulmonary microcystic fibromyxoma.@*Methods@#In March 2014, at the First Affiliated Hospital to Nanjing Medical University a 58-year-old female patient of pulmonary microcystic fibromyxoma was collected. The clinicopathologic, immunohistochemical and genetic profile of a case of pulmonary microcystic fibromyxoma were studied, and the relevant literature reviewed.@*Results@#The patient was a 58-year-old female who presented with cough and sputum for 1 month. CT scan disclosed a 15 mm nodule in her right middle lobe of lung. The patient underwent a wedge resection with negative margin. Grossly, a well-demarcated peripheral lung nodule was detected, measuring 1.5 cm×1.5 cm×1.0 cm, with myxoid tan-white cut surface containing microcysts. Microscopically, the tumor was composed of bland spindled to stellate-shaped cells widely spaced within prominent fibromyxoid stroma with prominent cystic change. No mitosis or necrosis was present. There were inconspicuous slim curvilinear capillaries and occasional collection of stromal lymphocytes and plasma cells. Immunohistochemically, the tumor cells were positive for vimentin, but negative for CD34, SMA, desmin, S-100 protein, ALK, CKpan, EMA, calretinin and TTF1. Fluorescence in situ hybridization did not show chromosomal translocation involving EWSR1, DDIT3 or FUS genes. The patient was recurrence or metastasis free after follow-up for 38 months.@*Conclusion@#Pulmonary microcystic fibromyxoma is a rare benign lesion that should be differentiated from other lung tumors with myxoid characteristics.

Myxoid variant of angiomatoid fibrous histiocytoma: a clinicopathologic analysis of 3 cases / 中华病理学杂志

Objective@#To study clinicopathologic features, diagnosis and differential diagnosis of myxoid variant of angiomatoid fibrous histiocytoma (AFH).@*Methods@#Three cases of myxoid variant of AFHs were collected from First Affiliated Hospital of Nanjing Medical University during 2008 and 2017. EnVision method and fluorescence in situ hybridization(FISH) were used to detect immunophenotype and EWSR1 gene rearrangement, respectively.@*Results@#There were 2 males and l female with age at 13, 31, and 42 years, respectively. The patients presented with a painless mass located superficially (subcutaneous or submucosal) in two cases or deep-seated (retroperitoneum) in one case. Grossly, the diameters of tumors were 1, 7, and 2 cm, respectively. The cut surface was solid and firm, tan to gray in colour. Histologically, the circumscribed tumor had fibrous pseudocapsule and peritumoal lymphoplasmacytic infiltrates. The tumor cells arranged in vaguely nodular growth pattern, with prominent myxoid stroma (present in 60% to 100% of the entire tumor). In hypocellular myxoid areas, the spindle to stellate tumor cells arranged in cords or reticular pattern, or in a haphazard manner. However, histiocytoid cells arranged in fascicular, sheet-like, or whorled growth pattern, as in classical AFH, were also identified in hypercelluar areas. Mild to moderate atypia was observed with low mitotic rate of (0-2)/10 HPF. Tumor necrosis was not seen. One case presented with slit-like hemorrhage and sclerosing collagen intermingled with myxoid matrix was identified in 1 case. Immunohistochemically, all cases were positive for CD68 and CD163. Two of three were positive for desmin, EMA, CD99 and one for Calponin, SMA. All cases were negative for S-100 protein, CD34, CD31, CD35, CD21 and CKpan. FISH detection was positive for EWSRl gene in all cases. Available clinical follow-up was obtained in 2 cases, revealing no evidence of disease in 6 and 89 months, respectively.@*Conclusions@#Myxoid variant of AFH is a histological subtype of AFH, with clinical features, immunophenotypes, genomic profiles and biological behavior similar to typical AFH. Their unusual morphology is easily confused with a variety of other myxoid mesenchymal neoplasms, including myoepithelioma and nerve sheath tumors.

Clinicopathologic study of primary thymic extranodal marginal zone lymphoma of mucosa associated lymphoid tissue and lymphoepithelial sialadenitis-like thymic hyperplasia / 临床与实验病理学杂志

Purpose To discuss the clinicopathological features of primary thymic extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) lymphoma and lymphoepithelial sialadenitis (LESA)-like thymic hyperplasia,their relationship and differential diagnosis.Methods Three cases of thymic MALT lymphoma and one LESA-like thymic hyperplasia were evaluated by HE staining,immunohistochemistry and immunoglobulin (Ig) gene rearrangement technology.Results The symptoms of Sjsgren syndrome were found in the two patients with thymic MALT lymphoma.Microscopically,the normal architecture of thymus was effaced by dense lymphoid infiltration composed predominantly of centrocyte-like and monocytoid B cells with prominent lymphoepithelial lesions.Immunohistochemically,the tumor cells were positive CD20,PAX-5,and BCL-2.The plasma cells showed lambda light chain restriction in one case with prominent plasmacytoid differentiation.In LESA-like thymic hyperplasia,the normal lobular architecture of thymus was generally reserved and abundant lymphoid tissue containing lymphoid follicles was seen with prominent lymphoepithelial lesions in expanding islands of thymic epithelial cells and epithelium lining the cysts,but a monocytoid B-cell population was absent.Immunohistochemically,a mixed B-cell and T-cell population was identified.A monoclonal rearrangement of the Ig gene was detected in all three thymic MALT lymphomas but not in the case of LESA-like hyperplasia.Conclusion Primary thymic MALT lymphoma and LESA-like thymic hyperplasia are both rare lymphoid proliferative lesions and the two lesions have overlapping histological and immunohistochemical features.A combination of genetic rearrangement and analysis of the differential points is helpful to distinguish between them.

Epithelioid hemangioendothelioma: a clinicopathologic analysis of 13 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic characteristics of epithelioid hemangioendothelioma (EHE).</p><p><b>METHODS</b>Thirteen cases of EHE were analyzed by gross examination, light microscopy and immunohistochemical staining.</p><p><b>RESULTS</b>The patients included 6 males and 7 females. The age of patients ranged from 11 to 74 years (mean = 43 years). The tumors were located in soft tissue, liver, lung, mediastinum, sacrum, and pleura. The tumor cells were epithelioid, spindled or polygonal-shaped and exhibited cord-like or small nest growth pattern. Some tumor cells formed cytoplasmic vacuoles, which contained erythrocytes. The tumor cells showed abundant eosinophilic cytoplasm. The stroma varied from highly myxoid to hyaline. In 3 cases, the tumors contained areas with significant atypia, brisk mitotic activity and necrosis. Immunohistochemical study showed that the tumor cells were positive for CD31, ERG, FLI-1, CD34, factor VIII and CKpan to different extents. Follow-up information was available in 10 patients with duration ranging from 8 to 65 months. Seven patients were alive and three died.</p><p><b>CONCLUSIONS</b>EHE is easily a rare maligant vascular tumor,occurs in many organs other than soft tissue.EHE is misdiagnosed as carcinoma for its significant epithelioid morphology. Recognizing its clinicopathologic characteristics and combined application of specific vascular endothelial immunohistochemical markers are important to avoid confusion with other lesions.</p>

Clinicopathologic observation of adenoid cystic carcinoma of esophagus / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of adenoid cystic carcinoma in the esophagus.</p><p><b>METHODS</b>Ten cases of primary adenoid cystic carcinoma of the esophagus were retrieved from the archival file. The clinicopathologic and immunohistochemical features were studied. The differential diagnosis was analyzed.</p><p><b>RESULTS</b>The male-to-female ratio was 9: 1. The age of patients ranged from 59 to 76 years. There were 4 cases with tumor located in mid esophagus, 4 cases with tumor located in mid to lower esophagus and the remaining 2 cases in lower esophagus. Low-power histologic examination showed mainly expansive growth pattern, with cribriform, solid and focal tubular architectures identified. The tumor cells showed nuclear hyperchromasia. Both ductal and myoepithelial differentiation was demonstrated. The stroma showed myxoid degeneration in areas. Comedo-type necrosis was observed in 8 cases and moderate to severe squamous dysplasia was present in one case. Three cases showed focal areas of squamous cell carcinoma. Immunohistochemical study showed that the tumor cells were positive for p63 (10/10), CD117 (10/10) and S-100 protein (9/10). There was focal staining for calponin (2/10) and smooth muscle actin (2/10). The ductal structures expressed CK7 (10/10).</p><p><b>CONCLUSIONS</b>Adenoid cystic carcinoma of the esophagus demonstrates unique morphologic features with expression of S-100 protein and consistent expression of CD117. The above characteristics help to distinguish this entity from basaloid squamous cell carcinoma, mucoepidermoid carcinoma and small cell carcinoma of the esophagus.</p>

Extraskeletal myxoid chondrosarcoma:report of 5 cases and review of literatures / 临床与实验病理学杂志

Purpose To explore the clinicopathologic characteristics, pathologic diagnosis and differential diagnosis of extraskeletal myxiod chondrosarcoma. Methods The clinical and pathological features were studied with HE and immunohistochemical staining in 5 cases of extraskeletal myxoid chondrosarcoma, and the related literatures were also reviewed. Results Extraskeletal myxoid chondro-sarcoma was male predominance (4 males: 1 female), and the age ranged from 32 to 62 years with an average of 52 years. Four tumors occurred in thigh and another in chest. Histologically, the neophlasm were composed of round and oval cells. Immunohisto-chemically, the tumor cells were positive for vimentin in five cases, synaptophysin expressed in one case, S-100 showed focal positivity in two cases, but negative for CK, p63, EMA, CD34, SMA in all cases. Molecular genetics detection shows chromosome exchange be-tween number 9 and 22. Conclusion Extraskeletal myxoid chondrosarcoma is a rare tumor which has no special characteristics in clinical and iconography, and its diagnosis mainly depends on the histopathologic features, immunohistochemistry and molecular genet-ics. Extraskeletal myxoid chondrosarcoma grows slowly, but have a high tendency for local recurrence and metastases.

Expression of TAZ and β-catenin in colorectal carcinoma and their significance / 临床与实验病理学杂志

Purpose To investigate the expression of TAZ and β-catenin in colorectal carcinoma and to analyze their correlation with the clinical pathological features of colorectal carcinoma. Methods The immunohistochemical method was used to detect the expres-sion of TAZ and β-catenin in 168 colorectal carcinoma specimens and 30 normal colorectal mucosal specimens. Results The positive rate of TAZ expression was significantly higher in colorectal carcinoma than that in normal colorectal mucosal (P<0. 01). The ectopic expression ofβ-catenin was significantly higher in colorectal carcinoma than that in normal colorectal mucosa (P<0. 01). The expres-sion of TAZ was correlated with degree of differentiation, lymph node metastasis, invasion depth and TNM stages (P<0. 05), and that of β-catenin was correlated with lymph node metastasis, invasion depth and TNM stages (P<0. 05). The positive expression of TAZ and the ectopic expression of β-catenin were significantly related to the 5-years survival rate ( P<0. 05 ) . The expression of TAZ was significantly positively correlated with the ectopic expression of β-catenin ( P<0. 01 ) . Conclusion Up-regulated expression of TAZ and ectopic expression of β-catenin may be synergistically involved in the occurrence, invasion and metastasis of colorectal carcinoma.

A clinical, imaging, and histological study on metanephric adenoma / 国际外科学杂志

Objective To study the radiological,clinicopathological features and prognosis of metanephric adenoma.Methods Two cases were selected,which underwent partial and radical renal resection.Examined the microscopic,immunohistochemical and radiological features of 2 metanephric adenoma cases.All patients were examined by ultrasound,CT and magnetic resonance imaging.Results They were lack of blood supply in imaging examination.The tumor cells were uniform with few eosinophilic cytoplasm.The chromatin is exquisite and lack pathological mitotic figure.The tumor cells were arranged in small tube or alveolar and locally showed papillary hyperplasia.Sometimes psammoma bodies were shown..Metanephric adenoma showed positive to Vimentin and CK.Conclusions Metanephric adenoma is a rare renal tumor mostly occur in single renal.And its morphological characteristic is diversity,so it's easy being misdiagnosed as malignant tumor.The pathologists should be careful and have the concept of metanephric adenoma when diagnosis.

Metanephric adenoma of kidney: a clinicopathologic study of eight cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinical and histopathologic features of metanephric adenoma (MA).</p><p><b>METHODS</b>Eight cases of recently diagnosed MA were retrieved from archival file. Immunohistochemical study was carried out. The clinical characteristics, pathologic parameters, differential diagnosis, treatment options and prognosis of MA were analyzed, with literature review.</p><p><b>RESULTS</b>The patients included 6 females and 2 males. The age of patients ranged from 12 to 70 years (mean=43.6 years). Eight cases were located in renal cortex and showed well-defined borders. Histologically, the tumor was composed of tubules lined by small basophilic cells and embedded in an edematous stroma. Papillary structures and psammoma bodies were focally seen. Immunohistochemical study showed that the tumor cells were positive for PAX2 and vimentin in all the 8 cases. WT-1 was positive in 2 cases, focal and weak in 5 cases, and negative in 1 case. CK-Pan was positive in 3 cases. CK7 staining was mostly negative, with focal and weak positivity only in 1 case. The proliferative index, as highlighted by Ki-67 staining, was less than 2% in 7 cases and focally around 5% in 1 case. The expressions of CK20, CD10, RCC, epithelial membrane antigen, CD56, synaptophysin and chromogranin A were negative. Follow-up information from 7 to 57 months was available in all patients; and none of them developed local recurrence or distant metastasis.</p><p><b>CONCLUSIONS</b>The diagnosis of MA relies primarily on thorough histologic examination and immunohistochemical study (vimentin and PAX2 positive, WT-1 focally and weakly positive in some cases, and low proliferative index). Correlation with clinical and radiologic findings would also be helpful.</p>

Interdigitating dendritic cell sarcoma/tumor: a clinicopathologic study / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics and diagnostic criteria of interdigitating dendritic cell sarcoma/tumor (IDCS/T).</p><p><b>METHODS</b>The clinical features, histologic findings and results of immunohistochemical study in six cases of IDCS/T were analyzed, with review of literature.</p><p><b>RESULTS</b>The age of patients ranged from 20 to 68 years. The sites of involvement included lymph node, tonsil and soft tissue. Histologically, the tumor cells were arranged in sheets, fascicles or whorls and intimately admixed with abundant lymphocytes and plasma cells. They were oval to spindly in shape and contained pale eosinophilic cytoplasm, oval nuclei and distinct nucleoli.Immunohistochemical study showed that the tumor cells were positive for S-100 protein and CD68.</p><p><b>CONCLUSIONS</b>IDCS/T is a rare malignant tumor with poor prognosis. It carries distinctive histologic pattern and immunophenotype. The entity needs to be distinguished from follicular dendritic cell sarcoma/tumor, anaplastic large cell lymphoma and other spindle cell sarcomas in occurring soft tissue.</p>

Dermatofibrosarcoma: a case report / 中华皮肤科杂志

A 37-year-old female was admitted to the hospital for an itching and painful subcutaneous nodule with ulceration on the extensor aspect of her left forearm for more than 6 months.The pain was severe,continuous and localized.Systemic and local treatment with antibiotics resulted in no obvious improvement.The lesion had gradually increased in size over the past 6 months and the ulcer had enlarged for 1 month.On examination,a hard infiltrative plaque measuring about 5.5 cm × 4.0 cm with a well-defined margin was seen on the extensor aspect of her left forearm,along with ulceration and some dirty discharge on the surface.The diagnosis of fibrosarcoma,grade Ⅱ was eventually made by a biopsy of the lesion,which revealed increased pigmentation in the basal layer,and tumor tissue was tightly adherent to the epidermis.Dermis and subcutaneous fat layer were infiltrated with various sizes of spindle cells with fine collagen fiber bundles between the cells.Obvious atypia and mitotic figures were easily observed in some of the cells.Immunohistochemical analysis showed moderately positive staining for fibronectin,but negative staining for human melanoma black-45 (HMB45),S100,smooth muscle actin (SMA),Melan-a,high molecular weight cytokeratin (HCK),CD34,CD68 or cytokeratin.Some diseases should be differentiated from this case,including dermatofibrosarcoma protuberans,cutaneous spindle cell squamous carcinoma,atypical fibroxanthoma,malignant fibrous histiocytoma,and so on.

Diagnostic values of imprint cytology in sentinel lymph node examination during breast cancinoma operation: an analysis of 169 cases / 临床与实验病理学杂志

Purpose To study the diagnostic value of imprint cytology and to improve the accuracy of the rapid diagnosis of sentinel lymph node (SLN) during the operation of breast cancer.Methods 169 SLNs during 67 operations of breast cancer were detected by both frozen section and imprint cytology, and the results were compared with the histopathological diagnosis of permanent sections.Results Of 169 SLNs, 163 cases were diagnosed correctly with frozen section (163/169, 96.45%); 162 cases were diagnosed correctly with imprint cytology (162/169,95.86%);and 166 cases were diagnosed correctly by combination of imprint cytology and frozen section (166/169,98.22%).Conclusions Combination of imprint cytology and frozen section could increase the accuracy of the rapid diagnosis of SLN in breast cancinoma operation.

Clinical pathology and anatomy features of parapharyngeal region neoplasms: a report of 69 cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the relationship between clinical pathology and anatomy features of primary neoplasms in the parapharyngeal regions.@*METHOD@#A total of 69 cases of primary neoplasms in the parapharyngeal regions were included. Fifty-eight cases were benign, and 11 cases were malignancy.@*RESULT@#Disorders of swallowing, breath or speaking were the common symptoms of neoplasms located in parapharyngeal regions. The majority of neoplasms located in parapharyngeal regions were benign. CT and MRI provides useful information about tumor size, shape and extent. The relationship of the tumor and vessel could be shown with selective angiography.@*CONCLUSION@#Primary parapharyngeal regions neoplasms are rare in head and neck tumors. Surgery is the main treatment for parapharyngeal regions tumors. The operation type was decided by the location and the pathological type of the neoplasm.

Expression of EZH2 mRNA and protein in human prostate carcinoma and its relationship with cell proliferation / 临床与实验病理学杂志

Purpose To investigate the expression of EZH2 mRNA and protein, and its relationship with tumor cell proliferation in human prostate carcinoma (PCa).Methods A tissue microarray was constructed, which contained 68 dots of formalin-fixed,paraffin-embedded tissue samples, including 48 cases of human PCa.Immunohistochemical markers, including EZH2 and Ki-67,were used on the tissue microarray sections by the immunohistochemical staining method.In situ hybridization (ISH) using an EZH2 oligonucleotide probe was also performed on the tissue microarray sections.Additional 15 cases of benign prostate hyperplasia (BPH) and 12 cases of high grade prostate intraepithelial neoplasia (HGPIN) were used as controls.Results The positive rates of EZH2 protein and mRNA expression were 87.50% and 81.25% in the PCa, 16.67% and 16.67% in the HGPIN,13.33% and 6.67% in the BPH,respectively. There were statistical difference between PCa, HGPIN and BPH, respectively (P0.05).The expression of EZH2 protein was related to Gleason score, TNM stage (P0.05). The expression of EZH2 mRNA was related to TNM stage (P0.05).The staining intensity of EZH2 was positively correlated with the Ki-67 indexes (r=0.746,P<0.05).Conclusions Over-expression of EZH2 which is involved in accelerating proliferation may play an important role in the pathogenesis and progression of human prostate carcinoma. As a molecular marker of prostate carcinoma, EZH2 may serve as a new index for estimating the level of malignancy and progression of the prostate cancer.

Clinical analysis on six cases of nonfunctioning parathyroid cysts / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical and pathological characteristics of nonfunctioning parathyroid cysts.@*METHOD@#Six cases of nonfunctioning parathyroid cysts who were hospitalized during 1997-2007 were retrospectively analyzed. The clinical features, serum calcium, B-ultrasonic, CT and nuclide scanning were performed. Postoperative pathologic and immunohistochemistry detection in nonfunctioning parathyroid cysts were made.@*RESULT@#Tumors in the 6 cases were underwent surgical ablation and diagnosis was verified by pathology. CgA (chromogranin A), Syn (synaptophysin), NSE (and neuron specific enolase) expressions were positive. Follow-up six months and five years after operation, there is no recurrence.@*CONCLUSION@#Surgical resection is most effective in treating nonfunctioning parathyroid cysts and diagnosis is made by pathologic examination.

Lymph node marginal zone B-cell lymphoma:A clinicopathological analysis / 临床与实验病理学杂志

Purpose　To study the pathological characteristics, diagnostic criteria and differential diagnoses of the lymph node marginal zone B-cell lymphoma (LMZL), for the clinical treatment and prognosis. Methods　Histopathology and immunohistochemistry(ABC method) were used in ten cases of LMZL. Results　There were six male and four female. Lymphadenopathy was the main symptom in all of the cases, of which none had hepatosplenomegaly and abnormal lymphocytes in the peripheral blood. Two of them were marginal zone type, four nodular type, two diffuse type and two blastic type morphologically. Five of them were central cell like (CCL) type, six monocytic B-cell (MBC), two of them lymphoplasmacytic and two blastic histopathologically. Immunophenotyping was done in ten cases and supported the diagnosis. Conclusions　LMZL and MALT-type lymphoma have similar appearance, immunophenotype and cell origin. Based on the structural features, LMZL is a special entity.