ABSTRACT
<p><b>OBJECTIVE</b>To study the clinicopathologic features and histogenesis of calcifying fibrous tumor (CFT).</p><p><b>METHODS</b>The clinical manifestations, histopathologic characteristics and immunophenotype were analyzed in 11 cases of CFT.</p><p><b>RESULTS</b>The male-to-female ratio was 5:6, with a mean age of 38 years and age range of 25 to 52 years. The sites of involvement included abdominopelvic cavity (n=6), soft tissue (n=4) and scrotum (n=1). Most patients presented with a gradually enlarging and painless mass. Nearly half of the cases were associated with other diseases or history of inflammation, trauma or surgical intervention. One third of the tumors represented incidental findings and showed no recurrence after resection. Imaging revealed a solitary solid soft tissue mass or multiple nodules with clear borders and associated high-density calcifications. Macroscopically, the tumors were well-circumscribed but non-encapsulated. They ranged from 0.5 to 20.0 cm in diameter and were tan-greyish, round to oval, lobulated or irregular and solid with rubbery consistency. The cut surface was whitish to tan-yellowish, gritty and showed scattered spotty yellowish discoloration corresponding to the foci of dystrophic calcifications. Histologically, CFT was composed of hyalinized fibrous tissue and thickened vessel walls with interspersed bland spindly fibroblastic cells, scattered psammomatous calcifications, dystrophic calcification and lymphoplasmacytic infiltration. In addition, focal cloak-like polymorph infiltration at the tumor periphery and entrapment of adipocytes and nerves were demonstrated in some cases. Foci resembling solitary fibrous tumor, fibromatosis, keloid or inflammatory myofibroblastic tumor were observed. Immunohistochemical study showed that the tumor cells were diffusely positive for vimentin and focally positive for CD34, factor VIII-related antigen and beta-catenin. The admixed plasma cells were notably IgG positive, with more than 50% being IgG4 positive.</p><p><b>CONCLUSIONS</b>CFT has characteristic histopathologic manifestations and shows morphologic and immunohistochemical overlaps with known IgG4-related sclerosing diseases. It is possible that CFT may represent another example of IgG4-related diseases. It often runs a benign clinical course, with rare recurrence after surgical resection. Previous inflammation and trauma may be the precipitating factors of CFT.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Abdominal Neoplasms , Metabolism , Pathology , General Surgery , Antigens, CD34 , Metabolism , Calcinosis , Metabolism , Pathology , General Surgery , Follow-Up Studies , Genital Neoplasms, Male , Metabolism , Pathology , General Surgery , Immunoglobulin G , Metabolism , Incidental Findings , Neoplasms, Fibrous Tissue , Metabolism , Pathology , General Surgery , Pelvic Neoplasms , Metabolism , Pathology , General Surgery , Retrospective Studies , Scrotum , Pathology , Soft Tissue Neoplasms , Metabolism , Pathology , General Surgery , Vimentin , Metabolism , beta Catenin , Metabolism , von Willebrand Factor , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To evaluate the influence of glucose-insulin-potassium treatment (GIK) on the levels of inflammatory cytokines in the scalded rats with MODS.</p><p><b>METHODS</b>One hundred and twenty Sprague Dawley rats were inflicted with 30% TBSA full-thickness scalding, and MODS model was reproduced with intraperitoneal injection of endotoxin following burn injury. Then the rats were randomly divided into GIK, glucose (G) and control (C) groups, with 40 rats in each group. The serum contents of glucose, lactate acid, TNF-alpha, NO and IL-6 of the rats in the three groups were determined during 1 to 7 PSD, and the mortality rate within 7 PSD was observed.</p><p><b>RESULTS</b>The serum contents of glucose, lactate acid, TNF-alpha, NO and IL-6 of the rats in the GIK group were obviously lower than those in the other two groups during 1 to 7 PSD (P < 0.01), and reached the lowest level at 6 to 7 PSD (TNF-alpha: 2.37 +/- 0.54 microg/L; IL-6: 0.28 +/- 0.17 microg/L; NO: 29 +/- 9 micromol/L). The content of glucose and lactate acid in G group were obviously higher than those in control group (P < 0.01), but the contents of TNF-alpha, IL-6 and NO content were similar between these two groups (P > 0.05). The mortality in GIK group within 7 PSD was 20.0%, which was evidently lower than that in G (37.5%) and C (47.5%) groups (P < 0.05), while that between G and C groups was similar (P > 0.05).</p><p><b>CONCLUSION</b>The administration of GIK might ameliorate sepsis by reducing the levels of inflammatory cytokine after burns and endotoxin challenge.</p>