Clinicopathologic analysis of mixed epithelial and stromal tumor of kidney and adult cystic nephroma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney (MEST) and adult cystic nephroma (CN).</p><p><b>METHODS</b>Five cases of MEST and 4 cases of CN were retrospectively analyzed. Immunohistochemical study was carried out and the literature was reviewed.</p><p><b>RESULTS</b>All of the five patients with MEST were females. Their median age was 45 years. For CN, there were 3 males and 1 female and their median age was 41 years. All patients presented with loin pain and hematuria. On gross examination, MEST was well-circumscribed but non-encapsulated. There was no evidence of haemorrhage or necrosis. Three of the cases were solid in nature. One was composed of a mixture of solid and cystic elements, while the remaining case showed a multicystic cut surface bridged by thick fibrous septa. On the other hand, CN were well-circumscribed and encapsulated. They were multiloculated cystic in nature. The cystic spaces were separated by thin septa and there was no significant solid or necrotic component. Histologically, MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns. Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified. The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium. In contrast, the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen. The spindle cells in MEST expressed vimentin (5/5), smooth muscle actin (3/5), desmin (4/5), CD10 (5/5), estrogen receptor (4/5) and progesterone receptor (4/5). They were negative for HMB45, CD34, CD117 and S-100 protein. On the other hand, the spindle cells in CN were variably positive for vimentin (4/4), smooth muscle actin (4/4), desmin (1/4), estrogen receptor (3/4) and progesterone receptor (1/4). They were negative for CD10, HMB45, CD34, CD117 and S-100 protein.</p><p><b>CONCLUSIONS</b>Both MEST and CN are uncommon renal neoplasm. Most of them run a benign clinical course. The stromal cells in MEST show smooth muscle or myofibroblastic differentiation. Areas demonstrating Müllerian features also existed in some cases. MEST and CN share overlapping histological and immunohistochemical features, and may represent spectrum of the same group of lesions.</p>

Cystadenoma of the seminal vesicle: 1 case report / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical presentation pathologic characteristics, diagnosis and treatment of cystadenoma of the seminal vesicle.</p><p><b>METHODS</b>One case of cystadenoma of the seminal vesicle was analyzed and relevant literature reviewed.</p><p><b>RESULT</b>The patient underwent surgical removal of the right seminal vesicle along with the tumor, which was pathologically confirmed to be cystadenoma of the seminal vesicle. Ultrasonography and CT scanning revealed no recurrence 3 months later.</p><p><b>CONCLUSION</b>Cystadenoma of the seminal vesicle is extremely rare and easily missed in diagnosis. Routine digital rectal examination (DRE) is necessary and ultrasonography and CT scan are helpful to diagnosis. Seminal vesiculectomy with tumor removal is an ideal option with good prognosis.</p>

Perivascular epithelioid cell tumor of uterus: report of 5 cases and literature review / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathologic features, diagnosis, differential diagnosis and biologic behavior of uterine perivascular epithelioid tumor.</p><p><b>METHODS</b>Five cases of uterine perivascular epithelioid cell tumor were studied by light microscopy and immunohistochemistry. Follow-up information was reviewed.</p><p><b>RESULTS</b>All the five tumors were composed by clear or eosinophilic cells arranged in nests and cords, associated with abundant small vessels and hyalinization in the stroma. Immunohistochemically, the tumor cells demonstrated positive staining for melanocytic markers (HMB45 and/or Melan-A), desmin and smooth muscle actin. The staining for cytokeratin and CD10 was negative. All the patients followed for a certain period are still alive, with no evidence of disease recurrence.</p><p><b>CONCLUSIONS</b>Perivascular epithelioid cell tumor is a rare mesenchymal tumor of uterus, with distinctive histologic and immunohistochemical features. It should be distinguished from clear cell carcinoma and epithelioid leiomyoma of uterus. Positivity for melanocytic markers (especially HMB45) plays an important role in the diagnosis of this tumor. In general, the tumor is categorized as benign, with uncertain malignant potential and malignant.</p>

Inflammatory myofibroblastic tumor of bladder: a clinicopathologic study of five cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, diagnosis and differential diagnosis of inflammatory myofibroblastic tumor of the urinary bladder.</p><p><b>METHODS</b>Excisional specimens from 5 cases of vesical inflammatory myofibroblastic tumor were studied by light microscopy and immunohistochemistry (EnVision). The clinical data were also analyzed.</p><p><b>RESULTS</b>Among the 5 patients studied, 3 were males and 2 were females. The age of the patients ranged from 10 to 53 years (mean age = 35 years). The most common clinical presentation was micturition pain and hematuria. Three cases were located at the dome of the urinary bladder and the remaining 2 cases were found in the left lateral wall. Histologically, the tumor varied from myxoid to highly cellular. The tumor cells were spindle to stellate in shape, widely separated or showed a compact fascicular pattern. There were often associated with mixed inflammatory infiltrates and an irregular meshwork of small dilated vessels. Immunohistochemical study showed that the tumor cells expressed AE1/AE3 (5/5), vimentin (5/5), smooth muscle actin (5/5), calponin (5/5), caldesmon (3/5), desmin (4/5) and anaplastic lymphoma kinase protein (4/5). Follow-up data were available in 4 patients and none had local recurrence or died of this disease.</p><p><b>CONCLUSION</b>Inflammatory myofibroblastic tumour of urinary bladder is a rarely encountered but distinctive neoplasm with intermediate malignant potential.</p>

Clinico-pathological analysis of 6 cases of post-transplant lymphoproliferative disorders / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate clinical and pathological features of post-transplant lymphoproliferative disorders (PTLD) and its significance in diagnosis.</p><p><b>METHODS</b>Six cases of PTLD were studied by light microscope, immunohistochemistry, in-situ hybridization, and gene rearrangement analysis. The clinical and follow-up information were also reviewed.</p><p><b>RESULTS</b>Among the 6 cases, 3 with monomorphic PTLD were renal transplant recipients, and died 4, 2, and 1 months after diagnosis. 2 were liver transplant recipients, 1 of whom with monomorphic PTLD died 5 months after diagnosis, the other one was diagnosed as early lesion of PTLD and the post-bone marrow transplant case was classified as polymorphic PTLD who survived for 12 months after diagnosis of PTLD. EBER 1/2 DNA was demonstrated in 4 cases.</p><p><b>CONCLUSIONS</b>PTLD is a lymphoproliferative disease with distinctive morphologic and clinical characteristics after organ transplantation. The prognosis of PTLD correlates with the pathological subtypes and clinical stage.</p>

Study on the prognostic value of hepatocyte growth factor and c-met for patients with hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the prognostic value of hepatocyte growth factor (HGF) and c-met for patients with hepatocellular carcinoma (HCC) after hepatectomy.</p><p><b>METHODS</b>Twenty-five patients undergoing partial hepatectomy for HCC were studied. Serum HGF level was determined using ELISA kit before and after operation respectively. c-met protein and mRNA expression in cancerous and paracancerous tissues were detected by immunohistochemical and RT-PCR methods respectively. The correlations of clinical-pathologic parameters with the HGF level in serum and c-met expression in cancerous tissue were analyzed respectively.</p><p><b>RESULTS</b>HCC patients had a significantly higher concentration of serum HGF than normal controls and chronic hepatitis B respectively [(1.03 +/- 0.09) ng/ml vs (0.69 +/- 0.02) ng/ml and (0.74 +/- 0.09) ng/ml]. No significant difference in serum HGF was observed between HCC and cirrhosis patients with Child-Pugh score B/C [(1.03 +/- 0.09) ng/ml vs (1.04 +/- 0.11) ng/ml]. Serum HGF concentrations were positively correlated with tumor size (> 5 cm), node cirrhosis, portal vein tumor thrombi (PVTT) and preoperative alpha-fetoprotein (AFP) level (> or = 400 microg/L). After the resection of tumor, serum HGF concentration had a peak on the third postoperative day (POD), and then declined, but did not return to normal level on the tenth POD. From preoperative day to third POD, HGF concentration had a higher elevation in patients with major resection than with local resection. Moderately or strongly positive expression of c-met protein was observed in 21 cancerous regions (21/25), and only in 5 paracancerous regions. The intensive expression of c-met mRNA was 100% (25/25) detectable in the cancerous tissues, but only 24% (6/25) in the paracancerous tissues. The expression extent of c-met protein was correlated with portal vein tumor thrombi (PVTT). In paracancerous tissues, the expression of c-met protein was more intense in patients with cirrhosis than those without cirrhosis. The patients with recurrence or metastases after operation had a higher level of serum HGF and more intensive expression of c-met than other patients. No significant association was observed between HGF in serum and c-met expression in cancerous tissue.</p><p><b>CONCLUSIONS</b>The over-expression of HGF and its receptor c-met indicate an adverse prognosis for HCC patients. The sustained high level of serum HGF after hepatectomy may be a factor related to early tumor recurrence and metastasis.</p>

Imaging diagnosis of abdominal solitary fibrous tumor / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the imaging characteristics of abdominal solitary fibrous tumor (SFT) with its pathological features.</p><p><b>METHODS</b>Six cases of abdominal solitary fibrous tumors were studied using X-ray, CT, MRI examination as well as histopathological and immunohistochemical techniques.</p><p><b>RESULT</b>Contrast enhanced CT showed early intense enhancement as a result of the rich vascularization. On MRI the parenchyma of the tumors showed hypointensity on T1WI, T2WI and some tumors might manifest areas of hyperintensity on T2WI due to myxoid degeneration or hemorrhage. Microscopically, SFT was composed of spindle cells with various patterns and these spindle cells were CD34 positive on immunohistochemistry.</p><p><b>CONCLUSION</b>SFT is a soft tissue tumor originating from mesenchyma. Abdominal SFT shows variable appearance and enhancement pattern on CT and MRI according to tumor cells distribution and myxoid degeneration or hemorrhage within the tumor pathologically.</p>

Correlation between pathology and image characteristics of retroperitoneal liposarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the correlation between the pathological and image features of different subtypes of retroperitoneal liposarcoma.</p><p><b>METHODS</b>Pathological and image characteristics of 21 retroperitoneal liposarcomas were retrospectively analyzed comparing their different histopathological subtypes.</p><p><b>RESULTS</b>This series consisted of 11 well-differentiated, 4 myxoid, 3 round-cell, 2 pleomorphic and 1 dedifferentiated liposarcoma. Well-differentiated liposarcomas were predominantly composed of lipoma-like and sclerosing components. On CT and MRI image, the attenuation and signal intensity of lipoma-like components resembled those of fat, whereas the signal intensity of sclerosing components was similar to those of muscle. Unenhanced CT image of the myxoid subtype showed density resembling that of water. On contrast-enhanced CT image, it showed gradual reticular or sheet-like enhancement. The CT and MRI image appearance of the round cell and pleomorphic subtypes resembled those of nonfatty soft tissue masses with foci of necrosis. The dedifferentiated liposarcoma showed the image feature of a well-differentiated component clearing enhanced soft tissue mass.</p><p><b>CONCLUSION</b>Different subtypes of retroperitoneal liposarcoma show different CT and MRI features relating to their major histologic components. A good understanding of the relation between their radiological and pathological features is helpful to arrive at a correct diagnosis for retroperitoneal liposarcoma.</p>

Carcinoma showing thymus-like differentiation of the thyroid: a study of 2 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To describe the pathologic features and differential diagnosis of carcinoma showing thymus-like differentiation (CASTLE) of thyroid.</p><p><b>METHODS</b>The clinical findings, morphologic features and immunohistochemistry (EnVision) of 2 cases of CASTLE were studied.</p><p><b>RESULTS</b>Macroscopically, the tumor appeared as a hard grayish-white and slightly lobulated mass. Histologic examination revealed well-circumscribed islands of tumor cells associated with desmoplastic stroma. The tumor cells were polygonal to spindle in shape and contained lightly eosinophilic cytoplasm, oval nuclei and small distinct nucleoli. The nuclear atypia was mild to moderate and the mitotic count measured 1 to 2 per 10 high-power fields. Immunohistochemical study showed that the tumor cells expressed CD5 and CD117.</p><p><b>CONCLUSIONS</b>CASTLE is a rare type of thyroid carcinoma with distinctive morphologic findings. It needs to be distinguished from undifferentiated thyroid carcinoma, squamous cell thyroid carcinoma, metastatic lymphoepithelioma-like carcinoma and follicular dendritic cell sarcoma. Immunohistochemical staining for CD5 and CD117 is helpful in confirming the diagnosis.</p>

Analysis of loss of heterozygosity on chromosome 10 in human prostate carcinoma and high grade prostatic intraepithelial neoplasia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect the status of loss of heterozygosity (LOH) on chromosome 10 in prostate carcinoma and high grade prostatic intraepithelial neoplasia (PIN).</p><p><b>METHODS</b>Pure DNA was obtained from prostate neoplasms and normal tissues by tissue microdissection. LOH of chromosome 10 was detected by PCR based microsatellite polymorphism analysis technique using 20 pairs of microsatellite primers in 16 samples of prostate carcinoma and 14 samples of high grade PIN.</p><p><b>RESULTS</b>There were different frequencies of LOH in different loci on chromosome 10, varying from 0 to 46.2%, mainly located at 10q23 and 10q24-q25 regions. Seven samples of high grade PIN had LOH detected on chromosome 10.</p><p><b>CONCLUSION</b>There were high frequency of LOH regions on chromosome 10 of prostate carcinoma. The rate of LOH in high grade PIN was much lower than that in prostate carcinoma. PTEN and MXI1 were two candidate tumor suppressor genes on 10q23 and 10q24-q25. They may be potentially involved in the initiation and progression of prostate carcinoma.</p>