Discrepancies in pathologic evaluation of dyaplasia/early cancer in 60 gastric endoscopic submucosal dissection specimens / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the reasons for the discrepancies in pathologic diagnosis of gastric dysplasia/early cancer in endoscopic submucosal dissection (ESD) specimens, and how to cope with the discrepancies.</p><p><b>METHODS</b>The pathologic diagnoses in 60 cases of ESD specimens according to the three currently used classification systems (namely Western criteria, Japanese criteria and Vienna classification) were compared. The diagnostic discrepancies were analyzed.</p><p><b>RESULTS</b>Fifteen of the 17 cases diagnosed as low-grade intraepithelial neoplasia according to the Western criteria were revised as adenoma by the Japanese criteria. Amongst the 43 cases of gastric intramucosal adenocarcinoma diagnosed according to the Japanese criteria, 23 cases had concordant diagnosis by the Western criteria. While the diagnosis of low-grade intraepithelial neoplasia/adenoma was basically similar irrespective of classification system used, there were significant differences in the interpretation of gastric early cancer.</p><p><b>CONCLUSIONS</b>The diagnostic discrepancies in the gastric dysplasia/early cancer are mainly related to the morphologic criteria applied in different classifications. In order to facilitate clinical and pathologic communication, a consensus using Vienna/WHO classifications, supplemented with Japanese system, is desirable.</p>

Study on diagnostic standards for fine needle aspiration cytological diagnosis of breast masses: a comparative analysis of cytology and histology of 951 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the basic morphological factors and the reliability and limitations of the diagnostic standards of fine needle aspiration cytology (FNAC) of breast masses which drafted.</p><p><b>METHODS</b>A total of 4 309 fine needle aspiration biopsy cases of breast were performed and 951 cases of which were checked with their histological diagnosis.</p><p><b>RESULTS</b>Of the 413 aspiration smear studies, relatively identical morphological features were found on the smears of lesions of the same nature. The sensitivity of diagnosis of malignant tumor in 732 cases, the specificity of diagnosis of benign lesion in 219 cases and the overall accuracy of diagnosis were 97.3%, 97.7%, and 97.4% respectively. The false negative rate, potential false positive rate and the overall misdiagnosis rate were 2.7%, 2.3% and 2.6% respectively, no false positive diagnosis case was found.</p><p><b>CONCLUSIONS</b>(1) The differentiation and the arrangement pattern of the tubular epithelial cells and the amount of benign naked nuclear cells are the three essential factors in the analysis of morphological changes of FNAC of breast mass. (2) The examination of our diagnostic standards of FNAC of breast masses shows that the standards are very reliable but have certain limitations which need to be resolved by histopathological diagnosis.</p>

Clinicopathological observation of renal adenomas / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the morphologic features and diagnostic criteria of various types pf renal adenomas of the kidney.</p><p><b>METHODS</b>In addition to light microscopy, electron microscopy, histochemical and immunohistochemical assays were applied. All 19 cases of adenomas were followed up.</p><p><b>RESULTS</b>Three (3) cases of papillary adenoma were featured as papillary or tubulopapillary growth in patterns consisting of tumor cells with basophilic or acidophilic cytoplasm and were positive for both epithelial membrane antigen (EMA) and cytokeratin (CK7). Thirteen (13) cases of oncocytoma were characterized by the diversity of the structures including to be nest, tubular and papillary in pattern; a mixture of cell types including the classic oncocytes, oncoblasts and clear cells which were negative for vimentin and CK7 but positive for EMA. Enormous large mitochondria were obtained in 4 cases of oncocytoma by electronic microscopy. Three (3) cases of metanephric adenoma consisted of closely packed, round tubules lined by small bland cells with solid, glomeruloid constructure. Branching, elongated tubules and polypoid fronds were also detected. Tumor cells were negative for EMA, negative or only focally positive for CK7. Eighteen (18) patients were alive except one oncocytoma patient died 5 years after the diagnosis convinced. All the cases reported in this article had been followed up of 3 - 5 years.</p><p><b>CONCLUSIONS</b>There are 3 kinds of renal adenomas, namely, the papillary adenoma, oncocytoma, and metanephric adenoma and each kind has its own clincopathological features. The latter two can be recognized by their distinctive morphology, and the former can only be diagnosed according to the size of the tumor as the reference. Histochemical and immohistochemical assays are helpful in differential diagnosis.</p>

The influence of heat-induced epitope retrieval on endogenous avidin-binding activity (EABA) and blocking of EABA in immunohistochemistry / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the influence of heat-induced epitope retrieval (HIER) on endogenous avidin-binding activity (EABA) and to establish an effective way to block EABA in immunohistochemistry.</p><p><b>METHODS</b>Systematically screening EABA in 164 (679 samples) formalin-fixed and paraffin-embedded human tissues including 76 (102 samples) normal tissues and 88 (577 samples) tumor tissues as well as 4 (80 samples) formalin-fixed and paraffin-embedded rat normal tissues using tissue array (tissue chip), HIER, immunohistochemistry and egg white solution blocking. In addition, EABA was also examined in 9 (15 samples) human frozen tissues.</p><p><b>RESULTS</b>(1) EABA was detected in frozen tissues. (2) No staining for EABA was seen in formalin-fixed and paraffin-embedded tissues. (3) EABA was revealed after the tissues treated with microwave HIER. (4) The density of signal for EABA was variable from tissue to tissue and cell to cell. (5) The signals of EABA expressed in scatter or diffuse in tissues and in granular form in cytoplasm. (6) EABA was found in a wide range of epithelial tissues, especially in gland epithelia of normal and tumor tissues. These included kidney, adrenal cortex, liver, C cells of thyroid gland, oxyphil cells of parathyroid, fundal gland of stomach, sebaceous gland of skin, duct of salivary; oncocytoma and papillary adenocarcinoma of kidney and thyroid gland, adenolymphoma of parotid, carcinoma of liver cell, adenocarcinoma of stomach, colon, prostate, gall bladder and endometrium, and so on. (7) EABA was easier revealed by higher pH value buffer (EGTA pH 9.0) than that with lower pH value (EDTA pH 8.0 and citrate pH 6.0). (8) The revealed EABA could be effectively blocked using 20% egg white solution.</p><p><b>CONCLUSIONS</b>HIER could unmask EABA in formalin-fixed and paraffin-embedded tissues. The unmasked EABA present in a wide range of human normal and tumor tissues as well as in rat normal tissues. The EABA could influence routine immunohistochemistry staining when using (strept)avidin-horseradish peroxidase detective system. The egg white solution could effectively block EABA and eliminate the influence of EABA on immunohistochemistry.</p>

Chromophobe cell renal carcinoma: a clinical and pathologic study / 中华泌尿外科杂志

Objective To study the clinical and pathologic features of chromophobe cell renal carcinoma and to improve the diagnosis and treatment of the disease. Methods The clinical and pathologic data of 19 patients (10 men and 9 women;mean age,53 years) with chromophobe cell renal carcinoma (9 on the left and 10 on the right) were analyzed.Of the 19 cases,12 were incidentally diagnosed of renal tumor during physical examination.Gross hematuria,low back pain and discomfort and abdominal mass occurred in 7 cases. Results B-ultrasound was mainly characterized by low echo of mass with intact capsule.CT scan revealed that most of the tumors were homogeneous hypodense solid masses,which were well circumscribed.The tumors averaged 8.2 cm in diameter.By TNM staging,8 cases had T_1N_0M_0 stage tumors and 11 cases had T_2N_0M_0 stage tumors.Radical nephrectomy was performed in 17 cases,and partial nephrectomy,in 2 cases.Follow-up was available for 16 patients (mean,4.8 years;range,3 months to 16 years)who were alive without recurrence and metastasis.Pathological features were as follows.①The cross-sections of the tumors were grossly homogeneous, dark brown and solid. One case had fibrous bands coalescence in the center of the tumor.②Microscopically the tumors were composed of 2 types of cells, typical and eosinophilic types,with very distinct borders.③Immunohistochemical assay was positive for CK8 and negative for Vimentin, and Hale colloidal iron staining was positive for the carcinoma cells.④Electron microscopy showed large numbers of vesicles within the cytoplasm. Conclusions Chromophobe cell renal carcinoma is a morphologically distinctive neoplasm with no specific findings on B-ultrasound and CT examinations.The tumors are larger in most cases but usually at early TNM stages with a favorable prognosis.