Recurrence and progression factors of papillary urothelial neoplasm of low malignant potential / 中华泌尿外科杂志

Objective@#To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.@*Methods@#We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019. Among the 150 patients, 118 patients were males and 32 patients were females. The average age was 57 years, ranging 20-93 years. There were 112 cases of single tumor and 38 cases of multiple tumor. All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy, including 61 patients for pirarubicin, 58 patients for gemcitabine, 11 patients for epirubicin, and 11 patients for mitomycin. 14 patients did not receive bladder infusion chemotherapy. In this study, univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.@*Results@#The average follow-up time was 25.6 months, ranging 5.5-122.7 months. Among the patients, 21 patients occurred recurrence. The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months). 12 patients had pathological progression, including 9 patients for low-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade invasive urothelial carcinoma, 1 patient for squamous cell carcinoma. The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months). Among the 150 patients, 18 patients with inverted growth pattern did not recur. There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups, same as the progression and non-progression groups. The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR=7.884, 95%CI 2.815-22.082, P<0.05)and progression(OR=6.107, 95%CI 1.659-22.473, P=0.006) in patients of bladder PUNLMP. Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression.@*Conclusions@#About 14% (21/150) patients of bladder PUNLMP reoccurred after TURBT. About half of them had pathological progression, and most of them progressed to low-grade non-invasive papillary urothelial carcinoma. Multiple tumors was an independent risk factor for postoperative recurrence and progression. Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP.

Recurrence and progression factors of papillary urothelial neoplasm of low malignant potential / 中华泌尿外科杂志

Objective To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.Methods We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019.Among the 150 patients,118 patients were males and 32 patients were females.The average age was 57 years,ranging 20-93 years.There were 112 cases of single tumor and 38 cases of multiple tumor.All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy,including 61 patients for pirarubicin,58 patients for gemcitabine,11 patients for epirubicin,and 11 patients for mitomycin.14 patients did not receive bladder infusion chemotherapy.In this study,univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.Results The average follow-up time was 25.6 months,ranging 5.5-122.7 months.Among the patients,21 patients occurred recurrence.The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months).12 patients had pathological progression,including 9 patients for low-grade non-invasive papillary urothelial carcinoma,1 patient for high-grade noninvasive papillary urothelial carcinoma,1 patient for high-grade invasive urothelial carcinoma,1 patient for squamous cell carcinoma.The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months).Among the 150 patients,18 patients with inverted growth pattern did not recur.There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups,same as the progression and non-progression groups.The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR =7.884,95％ CI 2.815-22.082,P ＜ 0.05) and progression (OR =6.107,95％ CI 1.659-22.473,P =0.006) in patients of bladder PUNLMP.Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression.Conclusions About 14％ (21/150) patients of bladder PUNLMP reoccurred after TURBT.About half of them had pathological progression,and most of them progressed to low-grade noninvasive papillary urothelial carcinoma.Multiple tumors was an independent risk factor for postoperative recurrence and progression.Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP.

A rare case of multilocular cystic renal neoplasm of low malignant potential diagnosed on intra-operative fine needle aspiration cytology

Multi-locular Cystic Renal Cell Carcinoma (MCRCC) is now considered as Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) in World health organisation classification (WHO) 2016. It is usually seen in elderly people where it can mimic most of the time as benign cystic lesion. Authors are reporting a case of MCRNLMP in a 70 year male diagnosed intraoperative with the help of Fine Needle Aspiration Cytology (FNAC). Radiological and other clinical findings are in favour of cystic renal lesion. And it is very important to differentiate it from conventional renal cell carcinoma which requires radical nephrectomy. So, radiological finding and FNAC is instrumental in diagnosing this rare case which require different mode of surgical management.

Features of CT imaging and clinicopathological characteristics in multilocular cystic re-nal neoplasm of low malignant potential and cystic nephroma / 中国肿瘤临床

Objective: To explore the clinicopathological features and the diagnostic value of the CT scan in multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) and cystic nephroma (CN). Methods: The clinical data of 12 patients with CN and 20 patients with MCRNLMP, confirmed by pathology at the Renmin Hospital of Wuhan University and Jingzhou Central Hospital from Janu-ary 2000 to March 2019, were retrospectively analyzed. The receiver operating characteristic (ROC) curves were used to analyze the feature of contrast-enhanced CT images of the tumors, and the immunophenotypes of the tumors were observed by immunohisto-chemistry. Results: There were statistically significant differences between MCRNLMP and CN in terms of thickness of the cyst wall and partition, number of soft-tissue enhancing masses, peak intensity of enhancement, and the Bosniak classification (P<0.05). Based on ROC curve analyses, when the thickness of the capsule wall and partition was greater than 2.25mm, the number of enhanced high-density lesions was greater than 1, and the peaking intensity of fortification was above the moderate level in the diagnosis of CRNLMP. The areas under the curve of the three indexes were 0.879, 0.800 and 0.838, which can be used as the best diagnostic criterion for MCRNLMP. Immunophenotyping revealed that MCRNLMP characteristically expressed the renal cell carcinoma (RCC) marker, and CN characteristically expressed the estrogen receptor(ER) and progesterone receptor(PR). Conclusions: The cyst wall and septal thickness, number of soft-tissue enhancing masses, and peak intensity of enhancement show a higher diagnostic value in differentiating MCRN-LMP and CN. The precise diagnosis relies on the pathological and immunohistochemical examination.

Rethink and Understanding of the Concept and Diagnostic Criteria of Lymphoma——Presentation of the Concept of "Low-Grade Malignant Potential Lymphoid Neoplasms" / 现代检验医学杂志

Some monoclonal lymphoid tissue lesions showing benign biological behavior have been found recently,they usually were diagnosed with lymphoma,their malignant potential is extremely limited and almost does not develop.However,it presents a challenge to the concept of lymphoma and its diagnostic standard.Based on this,the auther propose the concept of "benign lymphoma" at the theoretical level,and discusses the possibility of its existence from two aspects of clonality and lymphocyte fluidity.At the same time,based on clinical practice and diagnostic strategies,propose the " Low-grade malignant potential lymphoid neoplasms "diagnostic terms for the first time,on the one hand,it show that this type of lesion is different from lymphoma and avoids overt reatment,on the other hand,clinicians and patients were reminded to follow up observation to prevent recurrence of a small number of cases,so as to trigger the discussion on the biological essence of lymphoma.

Clinicopathologic characteristics and molecular genetic analysis of 17 cases with multilocular cystic clear cell neoplasm of low malignant potential / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features, immunophenotype, molecular genetic alteration in multilocular cystic clear cell neoplasm of low malignant potential. Methods 17 cases of multilocular cystic clear cell neoplasm of low malignant potential with complete clinical data, systematic measurement and follow-up were retrospectively studied. Histopathological evaluation and immunophenotyping were examed by HE staining and EnVision two steps methods, chromosome 3p deletion was analyzed by interphase fluorescence in situ hybridization. Results In 17 cases, there were 12 males and 5 females, and the ratio of male and female was 2.4: 1. The prevalence age was at a range of 28-73 years, and the average age is54 years. Mostly of them were found by incidental or physical exmanination. Microscopically, most cysts were lined by a single layer of tumor cells with clear cytoplasm, small nuclear, and no obvious nucleoli. According to WHO/ISUP nuclear grade, they were level I. Clear cell groups similar to cells lined cysts were seen within the fibrous septa. Immunohistochemically, tumor cells were positive for CK(AE1/AE3), CK7, EMA, vimentin, CD10, CAIX, PAX-2, and PAX-8, but negative for CD68. Ki-67 index were less than 10％. The loss of heterozygosity of 3p chromosome was detected in 11 cases and the rate of the loss of heterozygosity was 64.7％. Conclusion Multilocular cystic clear cell neoplasm of low malignant potential is a relatively rare type of renal cell carcinoma with low malignant potential and a good prognosis. It is suggested that tumor cells may be derived from tumor stem cells with pluripotent potential in renal tubules based on the immunophenotypes. Multilocular cystic clear cell renal cell carcinoma and renal clear cell carcinoma is similar in immunophenotype and molecular genetics, which suggesting that it may be a special histologic subtype of renal clear cell carcinoma.

Tumor mucinoso gigante de ovario de bajo grado de malignidad / Giant Mucinous Ovarian Tumor of Low Malignant Potential

Los tumores de ovario de bajo grado de malignidad o "borderline", se originan del epitelio de este órgano y tienen un comportamiento biológico intermedio entre las lesiones malignas y benignas del ovario. El estudio se realizó con el objetivo de profundizar en el diagnóstico y la conducta terapéutica de esta infrecuente afección nosológica. Se presenta un caso clínico atendido en el servicio de Cirugía General del Hospital General Docente "Leopoldito Martínez", en San José de las Lajas, provincia Mayabeque. No se identificaron signos patológicos. Se identificó vulva y vagina sin alteraciones. El diagnóstico se estableció por el examen histopatológico y el tratamiento quirúrgico fue radical...

Ovarian tumors of low malignant potential or "borderline" originate from the epithelium of this body and they have an intermediate biological behavior between malignant and benign ovarian lesions. This study aims to deepen the diagnosis and therapeutic management of this uncommon nosological condition. A clinical case is presented here. This patient was treated at the Department of General Surgery, at Leopoldito Martinez General Teaching Hospital in San José de las Lajas, Mayabeque province. No pathological signs were identified. Vulva and vagina had no alterations. The diagnosis was established by histopathological examination and surgical treatment was radical...

Serous borderline tumor of the fallopian tube

Serous borderline tumors of the ovary are fairly common, making up between 4% and 14% of ovarian epithelial tumors. While to our knowledge serous borderline tumor of the fallopian tube occurs rarely with only ten previously reported cases in literature. We report the case of the serous borderline tumor of the fallopian tumor in a 25-year-old woman and review the literature.

Histologic distribution of borderline ovarian tumors worldwide: a systematic review / 부인종양

OBJECTIVE: The histologic types of borderline ovarian tumors (BOTs) exhibit striking differences in clinical behavior and prognosis. Yet, there is no information available on the histologic distribution of BOTs according to geographic region. The purpose of this study was to systematically review this issue worldwide. METHODS: A comprehensive search of the literature was conducted using electronic databases. Studies were eligible if BOTs were investigated and the histologic distribution of the data was shown. The studies were grouped by geographic region and totaled by country. RESULTS: Of 487 potentially relevant studies, 51 met our inclusion criteria, as follows: 8 studies from North America (2 countries); 26 studies from Europe (14 countries); 7 studies from the Middle East (3 countries); and 10 studies from East Asia (5 countries). The histologic distribution of BOTs was considerably different in different parts of the world, but follows specific patterns. In general, serous-type BOTs were the predominantly identified histology in North America, the Middle East, and Europe, while mucinous-type BOTs predominated in East Asia. CONCLUSION: Significant geographic variation is evident among BOT histology in different parts of the world. More research is needed to understand this phenomenon.

Late presentation of metastatic smooth muscle neoplasm of the uterus with low malignant potential / 부인종양

A 48-year-old woman underwent total abdominal hysterectomy with conservation of the ovaries and tubes. Histology showed a well-circumscribed smooth muscle tumor with foci of degeneration (including infarct-type necrosis) but no coagulative tumor cell necrosis and only mild focal cytological atypia. She presented, 24 years later with shortness of breath and abdominal distension and underwent bilateral salpingo-oophorectomy, appendectomy, omental biopsy and para-aortic lymph node sampling. Histology showed bilateral ovarian smooth muscle tumors with no coagulative tumor cell necrosis or significant cellular atypia. The cells were mitotically active. The tumors in both ovaries were most likely secondary to the previous uterine smooth muscle neoplasm. To our knowledge, this case is the first in the literature to describe a benign cellular leiomyoma that subsequently behaved as a smooth muscle tumor of uncertain malignant potential, which recurred 24 years after the initial diagnosis.

A serous borderline tumor of the fallopian tube detected incidentally / 대한산부인과학회지

Serous borderline tumors (SBTs) of the fallopian tube are very rare and usually diagnosed incidentally. We present a case of SBTs of left fallopian tube incidentally diagnosed during laparoscopic hysterectomy because of increasing symptomatic myoma. Preoperative abdomino-pelvic CT revealed 6 cm sized myoma in uterus but no gross lesion on both adnexa. Preoperative serum CA 125 was 18.9 U/mL. At laparoscopy a 2.0 cm sized polypoid mass protruding from the ampulla portion of the left tube was found. The contralateral fallopian tube, ovaries and uterus were unremarkable except previous known uterine myoma. Exploration of the abdomino-pelvic cavity has shown no abnormal finding. Intraoperative frozen biopsy to tubal mass suggested borderline malignancy but did not completely rule out tubal carcinoma. So, standard laparotomy staging operative procedures such as hysterectomy, bilateral salpingooophorectomy, omentectomy, lymph node dissection, and appendectomy were performed. Serous borderline tumor limited tube was confirmed in permanent pathology. In English literature, only 7 cases have been reported. And the current case is the first report in Korean as far as we know. Treatment for SBTs of fallopian tube is complete excision like borderline ovarian tumor. Recurrence was not reported with up to 6 year follow up in 7 cases.

The pathologic and clinic characteristics of papillary urothelial neoplasm with low malignant potential / 肿瘤

Objective: To discuss the pathologic and clinical characteristics of papillary urothelial neoplasm with low malignant potential (PUNLMP). Methods: We retrospectively analyzed 41 cases of PUNLMP confirmed by pathological examination from 2003 to 2006 and selected 28 cases of urothelial papilloma and 51 cases of low-grade papillary urothelial carcinoma as control. Results: Forty one cases of PUNLMP (male 31; female 10, ranging from 33 to 87 years, average 61.6 years) were recruited in this study. Recurrence occurred in 6 cases (15%) with the mean recurrence period of 24.6 months. No progression was detected by pathological examination. Four patients had multiple tumors, among them 2 (50%) cases recurred. In 28 cases of urothelial papilloma, recurrence was observed in 1 (4%) case with no progression. In 51 cases of low-grade papillary urothelial carcinoma, 18 (35%) cases experienced recurrence and 5 cases (10%) had progressed disease. The difference in recurrence rate among the three groups was significant (P = 0.002). Conclusion: PUNLMP has its own pathologic and clinical characteristics. The term "low maligant potential" is more appropriate than "carcinoma". Long-term follow-up is needed after surgery because of high recurrence rate.