Mucinous tubular and spindle cell carcinoma of kidney: Clinicopathology and prognosis / 北京大学学报(医学版)

OBJECTIVE@#To investigate and summarize the clinicopathological features, immunophenotype, differential diagnosis and prognosis analysis of mucinous tubular and spindle cell carcinoma (MTSCC).@*METHODS@#The data of thirteen cases of MTSCC were retrospectively analyzed, the clinical and pathological characteristics and immunohistochemical expression were summarized, and fluorescence in situ hybridization was detected.@*RESULTS@#Among the thirteen patients, four were males and nine females, with a male-to-female ratio of 1 ∶2.25. The average age was 57.1 years, ranging from 39 to 78 years. The maximum diameter of the tumor was 2-12 cm. All cases had no symptoms, and were accidentally discovered, 3 cases underwent partial renal resection, 10 cases underwent radical renal resection, 9 cases were located in the left kidney, and 4 cases were located in the right kidney. Most of the cases showed the classical morphological changes, with 11 cases of nuclear grading [World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grading system] being G2 and 2 cases being G3. There were 6 cases of stage PT1a, 3 cases of PT1b, 2 cases of PT2a, and 1 case of PT2b and 1 case of PT3a. The positive rates of immunohistochemical staining were: vimentin, AE1/AE3, α-methylacyl-CoA racemase (αMACR) and cytokeratin (CK) 8/18, 100% (13/13); CK7, 92.3% (12/13); epithelial membrane antigen (EMA), 92.3% (12/13); CK20, 46.2% (6/13); CD10, 30.8% (4/13); synaptophysin (Syn), 7.7% (1/13); chromogranin A (CgA), CD57, WT1 and Ki-67, 0 (0/13), and fluorescence in situ hybridization showed that no trisomy of chromosomes 7 and 17 were observed in any of the cases. The follow-up period was 6 months to 7 years and 6 months, 2 cases died after lung metastasis (one with ISUP/WHO grade G3, one with necrosis), and the remaining 11 cases had no recurrence and metastasis.@*CONCLUSION@#MTSCC is a unique type of low-grade malignancy kidney tumor, occurs predominantly in females, widely distributed in age, the current treatment method is surgical resection, and cases with necrosis and high-grade morphology are prone to recurrence and metastasis, although most cases have a good prognosis, but they still need close follow-up after surgery.

Expression of Epstein-Barr Virus DNA in Peripheral Blood Lymphocytes and Plasma in Patients with EBV-Associated Diseases / 现代检验医学杂志

Objective To explore the expression of Epstein-Barr virus DNA(EBV DNA)in the peripheral blood lymphocytes and plasma of patients with EBV-associated diseases.Methods The whole blood samples were collected from 112 patients with suspected EB virus infection diseases,including 14 cases of nasopharyngeal carcinoma(NPC),16 cases of infectious mononucleosis(IM),22 cases of lymphoma,23 cases of autoimmune disease,26 cases of upper respiratory tract infection, and 11 cases of abnormal liver function.The levels of EBV DNA in lymphocytes and plasma of the same sample were detec-ted by fluorescence quantitative PCR(FQ-PCR).Results The EBV DNA positive rates in lymphocytes and plasma of all 112 patients were 83.0%(93/112)and 27.7%(31/112)respectively,with statistically significant difference(χ2=60.02,P<0.01).The positive rate and the load of EB virus DNA in lymphocytes and plasma of 14 patients with nasopharyngeal car-cinoma(NPC)had no statistical difference(χ2=2.25,t=-1.04,all P>0.05).However,patients with lymphoma,infec-tious mononucleosis,upper respiratory tract infection,autoimmune disease or abnormal liver function,the positive rates and the concentration of EBV DNA in the plasma were dramatically lower than those in the peripheral blood lymphocytes,and the difference was statistically significant(χ2=4.17~15.06,all P<0.05;t=3.94~10.45,all P<0.01).Conclusion The detection of EB DNA in peripheral blood lymphocytes of non NPC patients by FQ-PCR might be better than that in plasma. There was no statistical difference between the detection of EBV DNA in lymphocytes and plasma of patients with nasopha-ryngeal carcinoma.Appropriate specimen type could be selected according to clinical consideration.