A case of TFE3 translocation renal cell carcinoma with rare morphological features and literature review

Context: TFE3 translocation renal cell carcinoma (RCC) is a rare tumor that represents approximately 1% of RCC. It was classifed as a member of MiT family translocation RCCs by the World Health Organization in 2016. It is characterized by Xp11 translocation gene fusions involving TFE3. The diagnosis of TFE3 translocation RCC is based on immunohistochemical analysis and TFE3 break apart probes in FISH analysis, rather than histological characteristics and imaging examination. Aims: To determine the clinico-pathological, immuno-phenotypic, and cytogenetic characteristics of TFE3 translocation RCC. Methods and Materials: The clinical data of a 52-year-old-female patient with TFE3 translocation RCC exhibiting rare morphological characteristics was analyzed, and the tumor tissues were probed using histopathological staining, immunohistochemistry, and fluorescence in situ hybridization (FISH). In addition, the relevant literature was reviewed. Results: This case is a TFE3 translocation RCC with rare morphological features. It composed of two types of tumor cells. TFE3 and pax-8 were diffusely and strongly expressed in both tumor cells, and they were partially positive for CAIX, RCC, CK, EMA, CD10, Vim, Melan-A, and p504s. Only 2% of the cells were positive for the proliferation marker Ki-67, and the tumor was negative for CK7, CD117, Inhibin-?, HBM45, and p53. FISH showed a positive signal for TFE3 translocation. Conclusions: This case was a TFE3 translocation RCC with rare morphological features. Through this case report, we emphasize the importance of in situ detection of TFE3 gene translocation and protein in TFE3 translocation RCC.

Blastic plasmacytoid dendritic cell neoplasm: A clinico-pathological retrospective analysis of thirteen cases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinicopathological features of blastic plasmacytoid dendritic cell neoplasm (BPDCN).@*METHODS@#A total of 13 cases of BPDCN diagnosed in Peking University First Hospital from January 2013 to March 2022 were collected. The clinical features, histopathological characteristics, immunophenotypes and prognosis of the patients were analyzed retrospectively, and the related literatures was reviewed as well.@*RESULTS@#Among the 13 patients, 11 were male and 2 were female, with a median age of 62 years (ranging from 5 to 78 years). Among them, single organ involvement occurred in 5 cases, all of which presented with skin lesions. Two or more organs were involved in other 8 cases (single organ with bone marrow involved in 3 cases; skin, bone marrow and lymph node involved simultaneously in 3 cases; skin, bone marrow, lymph node and spleen involved simultaneously in 2 cases). Histopathologically, it was characterized by the proliferation of medium to large atypical blastic cells, which infiltrated the whole thickness of dermis. When involved, the bone marrow lesions mainly appeared in a diffuse pattern, while the lymph node structure was usually destroyed, and the red pulp of the affected spleen was diffusely invaded. Immunohistochemical staining showed that all the 13 cases were positive for CD4, CD56, and CD123 (13/13) in varying degrees. All the 9 cases expressed TCL1 (9/9). Variable expression of CD68 (KP1) (8/13), TdT (7/12), CD117 (2/6), and high Ki-67 proliferation index (40%~80%) were showed. The neoplastic cells lacked expressions of CD20, CD3, MPO, CD34, or CD30; EBER in situ hybridization were negative (0/9). After definite diagnosis, 6 cases received chemotherapy, among which 1 received adjuvant radiotherapy, and 2 received subsequent bone marrow transplantation. Another 2 cases only received maintenance treatment. The median follow-up time was 14 months (ranging from 6 to 36 months), 5 patients died of the disease (6 to 18 months), 3 patients survived (7 to 36 months up to now), and the remaining 5 patients lost follow-up.@*CONCLUSION@#BPDCN is a rare type of malignant lymphohematopoietic tumor with aggressive behavior and poor prognosis. The diagnosis should be made combining clinical features, histopathology, and immunohistochemical phenotype. Attention should be paid to differentiating BPDCN from other neoplasms with blastoid morphology or CD4+CD56+ tumors.

Esophageal Angiolipoma:Report of One Case and Literature Review / 中国医学科学院学报

Esophageal angiolipoma is a rare disease with unspecific clinical manifestations.This paper reported a case of esophageal angiolipoma confirmed by upper gastrointestinal endoscopy and summarized the clinical manifestations,endoscopic and pathological features,treatment and prognosis of the patients by reviewing the relevant literature,aiming to provide references for clinical diagnosis and treatment of this disease in the future.

A unique leukoencephalopathy accompanied by palmoplantar pustulosis with identical pathological feature of helper T cell accumulation

@#Palmoplantar pustulosis is a chronic inflammatory skin disease involving the palms and soles where mild accumulation of helper T cells and neutrophils in the dermis histologically are observed. Leukoencephalopathy is a brain disease affecting white matter but is rarely accompanied by skin lesion. Here we report a unique case of leukoencephalopathy accompanied by palmoplantar pustulosis with identical pathological feature of helper T cell accumulation in both the brain and skin, suggesting a possible link in the pathogenesis.

Pathological features of esophageal submucosal tumors and curative effects of endoscopic resection / 西安交通大学学报(医学版)

Objective: To analyze the clinicopathological and biological characteristics of esophageal submucosal tumors (SMTs) and to investigate the safety and efficacy of endoscopic resection for esophageal SMTs. Methods: We retrospectively analyzed the data of 152 cases of esophageal submucosal tumors resected by endoscopy in Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, from February 2013 to June 2018 as well as the pathological properties, distribution characteristics, origin and location of the esophageal SMTs. We also analyzed complications and efficacy of different methods for endoscopic resection. Results: The average age of onset of esophageal SMTs in this group was 52.74±10.53 years, without gender difference. Pathological features were as follows: leiomyoma was more common (73.68%), followed by stromal tumor (11.18%), hemangioma (3.95%), cyst (3.29%), and lipoma (1.97%). SMTs occurred mostly in the middle and lower segments of the esophagus. They were mainly located in the muscularis mucosa (31.58%) and muscularis propria (57.89%), and partly located in the submucosa (10.53%). Endoscopic resection methods consisted of endoscopic mucosal resection (EMR) performed in 36 cases, endoscopic submucosal dissection (ESD) in 52 cases, submucosal tunneling endoscopic resection (STER) in 63 cases, and full-thickness resection (EFTR) in 1 case. All lesions were completely resected. EMR had small tumor resection and shorter operative time; ESD and STER showed large tumor resection and long operation time (P0.05). Complications were effectively controlled. No local recurrence or residual cases were found in postoperative follow-up. Conclusion: Adult onset of submucosal tumors of the esophagus, without gender difference, can occur in all segments of the esophagus, mostly from the mucosal muscularis and muscularis propria. Leiomyoma is common, followed by stromal tumor, spindle cell tumor, and hemangioma. Endoscopic resection depends on the lesion location, source and size, and endoscopic treatment is safe and effective.

Analysis of X-ray signs and postoperative pathological features of breast cancer / 上海交通大学学报（医学版）

Objective · To investigate the relationship between the mammographic signs and the pathological features in breast cancer. Methods · From August 2015 to August 2018, 300 patients with primary breast cancer confirmed by operation and pathology in Shanghai First Maternity and Infant Hospital, Tongji University were selected. All patients had mammography before operation. The relation between characteristics of molybdenum target imaging and pathological types were retrospectively analyzed. The correlation between specific imaging signs such as lump, calcification, spiculation sign and important pathological features were further analyzed. Results · Among 300 cases of breast cancer, 251 cases (83.7％) had lumps, of which 183 cases had spiculation sign, and 190 cases had calcification. Besides, 235 cases (78.3％) had calcification; 77 cases (25.7％) had structural disorder with diffuse density; 98 cases (32.7％) had positive signs of vascular symptoms. Lump (95.1％), spiculation sign (82.3％) and calcification (83.7％) were mostly observed in invasive ductal carcinoma. Structural disorder (88.2％) was mostly observed in invasive lobular carcinoma. Calcification (96.1％) and lump (60.8％) were mostly observed in intraductal carcinoma. Calcification (100.0％) was mostly observed in lobular carcinoma in situ. Lump was mostly observed in simple carcinoma, medullary carcinoma and mucinous adenocarcinoma. The positive expression rates of estrogen receptor (ER) and progesterone receptor (PR) were higher in patients with tumor lump＞5 cm than those with tumor lump ≤5 cm, but there were no significant differences (P=0.165, P=0.317). The positive rate of ER was 54.5％ and the positive rate of PR was 60.8％ in patients with calcification, which were lower than those without calcification (P=0.027, P=0.006). The positive rate of PR in patients with spiculation sign was 71.6％, which was higher than those without spiculation sign (P=0.018). But there was no significant difference in the expression of ER in patients with or without spiculation sign (P=0.321). Patients with lumps alone had a lower incidence of lymph node metastasis (29.5％ vs 37.9％, P=0.009), and lower histological grade (P=0.043), in comparison with patients with lumps and calcification. But they had higher ER positive rate (70.5％ vs 57.9％, P=0.033) and PR positive rate (73.8％ vs 65.3％, P=0.014).Conclusion · Breast cancer patients with different pathological types show different signs of mammography which may have certain associations with the expression of immunohistochemical indicators such as ER and PR. Simple lump shadows in mammography may be a predictor in the good prognosis of breast cancer.

Clinicopathological features of gastric cancer in 108 young patients / 西安交通大学学报(医学版)

Objective: To evaluate the clinicopathological and prognostic features of young patients with gastric cancer. Methods: We retrospectively analyzed the age trend of all the inpatients gastric with adenocarcinoma pathologically confirmed from 2012 to 2017 in our institution. The cut-off value of 45 years old to distinguish the young and the middle-aged patients with gastric cancer was defined to be the bottom fifth percentile in the age histogram of all gastric cancer patients. Then we analyzed the demographic, clinicaopathological, molecular pathological and prognostic features of the two groups. Results: Based on the age and gender composition of the gastric cancer patients, 45 years was defined as the cut-off age to differentiate the young (n=108) and the middle-aged gastric (n=216) cancer patients. The gender ratio was 1.4:1 and 3.5:1 in the young group and the middle-aged group, respectively (P0.05). Conclusion: The young patients with gastric cancer exhibits different behavior and can be considered as a unique clinical entity. Further studies are required to fully understand the possible carcinogenesis and risk factors among young gastric cancer patients.

Clinicopathological observation of 113 cases of rectal neuroendocrine neoplasms / 上海交通大学学报（医学版）

Objective • To investigate the clinicopathological features, diagnosis and prognosis of rectal neuroendocrine neoplasms (R-NENs). Methods • The clinical data of 113 cases of R-NENs, from January 2008 to June 2017, were collected in Renji Hospital, Shanghai Jiao Tong University School of Medicine, and the clinicopathological features and prognostic factors were retrospectively analyzed. The expression of synapsin (Syn), neural cell adhesion molecule (CD56), and chromogranin A (CgA) were observed by immunohistochemistry in the R-NENs specimens. The specimens were also observed after hematoxylin-eosin staining. Results • In 113 cases of R-NENs, there were 59 males and 54 females, and their ages ranged from 25 to 83 with an average age of (52.3±13.3) years old. All the patients had no obvious clinical manifestations. The main symptoms included changes in bowel habits (21.3%), abdominal pain (8.9%) and anal symptoms (6.2 %), and 63.7% of cases were found in routine medical examinations. The R-NENs were diagnosed as G1 (79.6%), G2 (11.5%), and G3 (8.8%). Immunohistochemistry results demonstrated that 94.7% of tumors were positive for Syn, 80.9% for CD56, and 48.6% for CgA. Till November 2017, the median survival time was 33.10 months (0.40-114.67 months), with 1-year, 3-year, and 5-year survival rates of 93.8%, 90.0%, and 85.9%, respectively. The pathological grade, depth of tumor invasion, lymph node metastasis or distant metastasis, tumor size, and age were all associated with prognosis of patients with R-NENs. Conclusion • Most of R-NENs are low-grade malignant tumors with good overall prognosis and have a lack of specificity in clinical manifestations.

Analysis of X-ray signs and postoperative pathological features of breast cancer / 上海交通大学学报（医学版）

Objective • To investigate the relationship between the mammographic signs and the pathological features in breast cancer. Methods • From August 2015 to August 2018, 300 patients with primary breast cancer confirmed by operation and pathology in Shanghai First Maternity and Infant Hospital, Tongji University were selected. All patients had mammography before operation. The relation between characteristics of molybdenum target imaging and pathological types were retrospectively analyzed. The correlation between specific imaging signs such as lump, calcification, spiculation sign and important pathological features were further analyzed. Results • Among 300 cases of breast cancer, 251 cases (83.7%) had lumps, of which 183 cases had spiculation sign, and 190 cases had calcification. Besides, 235 cases (78.3%) had calcification; 77 cases (25.7%) had structural disorder with diffuse density; 98 cases (32.7%) had positive signs of vascular symptoms. Lump (95.1%), spiculation sign (82.3%) and calcification (83.7%) were mostly observed in invasive ductal carcinoma. Structural disorder (88.2%) was mostly observed in invasive lobular carcinoma. Calcification (96.1%) and lump (60.8%) were mostly observed in intraductal carcinoma. Calcification (100.0%) was mostly observed in lobular carcinoma in situ. Lump was mostly observed in simple carcinoma, medullary carcinoma and mucinous adenocarcinoma. The positive expression rates of estrogen receptor (ER) and progesterone receptor (PR) were higher in patients with tumor lump >5 cm than those with tumor lump ≤ 5 cm, but there were no significant differences (P=0.165, P=0.317). The positive rate of ER was 54.5% and the positive rate of PR was 60.8% in patients with calcification, which were lower than those without calcification (P=0.027, P=0.006). The positive rate of PR in patients with spiculation sign was 71.6%, which was higher than those without spiculation sign (P=0.018). But there was no significant difference in the expression of ER in patients with or without spiculation sign (P=0.321). Patients with lumps alone had a lower incidence of lymph node metastasis (29.5% vs 37.9%, P=0.009), and lower histological grade (P=0.043), in comparison with patients with lumps and calcification. But they had higher ER positive rate (70.5% vs 57.9%, P=0.033) and PR positive rate (73.8% vs 65.3%, P=0.014). Conclusion • Breast cancer patients with different pathological types show different signs of mammography which may have certain associations with the expression of immunohistochemical indicators such as ER and PR. Simple lump shadows in mammography may be a predictor in the good prognosis of breast cancer.

Pathological features and survival of triple positive breast cancer in 271 cases / 中国现代普通外科进展

Objective:To explore pathological features and survival of triple positive breast cancer (TPBC).Methods:The clinical data of 271 cases of triple positive breast cancer from January 2010 to January 2017 in Suqian area were collected,compared with 283 cases of Luminal B I (HER2 negative).The clinical pathological features and survival were analyzed.Results:Among 271 cases of triple positive breast cancer,there were 89 cases (32.84％) of distant recurrence and metastasis in 2 years,and 137 cases (50.55％) of distant recurrence in 5 years.Among 283 cases of Luminal B I,there were 32 cases (11.31 ％) of distant recurrence and metastasis in 2 years.and 52 cases (18.37％) of distant recurrence in 5 years.There were significantly differences(P＜0.05).1 year Disease-free survival (DFS)and Overall survival (OS) of all patients were 100％,Among 271 cases of triple positive breast cancer,2-year DFS and OS were 64.94 ％,85.24％ respectively.3-year DFS and OS were 54.98 ％,69.74％ respectively,5-year DFS and OS were 43.54％,47.23％ respectively.Among 283 cases of Luminal B I,2-year DFS and OS were 86.22 ％,95.76％ respectively.3-year DFS and OS were 81.98 ％,80.92％ respectively,5-year DFS and OS were 76.33％,67.49％ respectively.There were significantly differences(P＜0.05).Conclusion:TPBC has the characteristics of poor biological behavior,large mass,pathological grade of grade Ⅲ,vascular or nerve infiltration,axillary lymph node metastasis,high proliferation index and high tumor load,and early distant recurrence,low DFS and OS.We Should choose individualized,targeted treatment programs,based on patient's hormone receptor and Ki67 expression,so as to benefit patients of TPBC.

Clinicopathological features and prognostic analysis of 136 patients with metastatic triple negative breast cancer / 中国综合临床

Objective To study the clinical,pathological features and therapeutic method of metastatic triple negative breast cancer (TNBC) and its relationship with disease-free survival.Methods One hundred and thirty-six cases of metastatic TNBC patients who were treated from January 2007 to January 2012 in the Third People''s Hospital of Dalian were selected as research objects.All patients received operation and radiochemotherapy,the clinical,pathological features,therapeutic method,the survival rate within 3,5 years,and the metastasis and survival situation of the patients were analyzed.Results For the patients in clinical stage Ⅲ period,the survival rate within 3,5 years were 45.9%(17/37),37.8%(14/37),respectively,significantly lower than those in stageⅡperiod (89.9%(89/99),73.7%(73/99)),and the differences were statistically significant (χ2=18.459,12.681,P<0.01).The 3-year survival rate of the patients in pathological grade Ⅲ was 64.9%(37/57),5-year survival rate was 43.9%(25/57),significantly lower than those of gradeⅠ(91.7%(22/24),83.3%(20/24)) and grade Ⅱ(85.5%(47/55),76.4%(42/55)),the differences were statistically significant (χ2=14.728,12.450,P<0.05).The 3-year survival rate of radiotherapy group was 81.8%(27/33),significantly higher than that of the non-radiotherapy group (59.1%(13/22)),the difference was statistically significant (χ2=5.468,P<0.05).Lung,liver,brain,bone and supraclavicular lymph nodes were main distant metastasis,the survival time of patients with metastasis was less than 2 years.Conclusion Metastatic TNBC is a special type of breast cancer that is difficult to treat.Breast conserving surgery has certain application value,radiotherapy can only increase the 3 year survival rate.Pathological grade and clinical staging are the main prognostic factors.

Clinical and pathological features of primary IgA nephropathy in patients of different gender / 西安交通大学学报(医学版)

Objective To explore the clinical and pathological features of primary IgA nephrology in patients of different gender.Methods The clinical manifestations,laboratory examination and renal pathology results were compared in 192 IgA nephrology patients.Results Not only the onset age of the male patients was older than that of the female ones (P0.05 ).Patients of different gender significantly differed in the renal-interstitial lesions grading (Z=-3.0432,P<0.05);to be more specific,the scores of glomerulosclerosis and renal tubule interstitia were higher in the male patients (P<0.05).Conclusion Patients of different gender differ in the clinical and pathological features of primary IgA nephrology.And clinical pathology of male patients is worse than that of female ones.

Diagnosis and treatment of an imported case of schistosomiasis haematobi-um / 中国血吸虫病防治杂志

Objective To report the diagnosis and treatment of an imported case of schistosomiasis haematobium,including the pathological features of the disease and therapeutic efficacy of praziquantel. Methods The data of the patient with schistoso?miasis haematobium were collected,and the pathological features of the bladder tissue were observed under a microscope. More?over,the patient was treated with praziquantel,and his urine was collected before and after the treatment. The eggs in the urine were examined by a microscope after sediment and the miracidia were hatched. Results The patient once worked in Angola for three months,and after returning home he had the symptoms of intermittent painless terminal hematuresis. It was ineffective af?ter anti?inflammatory treatment in a number of hospitals. There were no sand spots discovered under the cystoscope. However , the inflammatory reaction to parasite with a lot of eosinophils infiltration in the bladder mucosa was found on the pathological sec?tions under a microscope,and the egg structure was observed with individual characteristics. The eggs were detected in the urine and the miracidia were hatched before the praziquantel treatment. The hematuria symptoms disappeared after the praziquantel treatment. The eggs were still detected in the urine 7 days post?treatment,but the miracidium could not be hatched. One month and 6 months post?treatment,the eggs were not detected in the urine. Conclusions The imported cases of schistosomiasis hae?matobium are often misdiagnosed,and therefore,it is necessary to strength the health education to the workers overseas and also to improve the ability of diagnosis in medical staff. For the case reported in this paper,there are typical structure of Schistosoma haematobium eggs and egg?granulomas on the pathological sections of bladder tissues. Praziquantel has satisfactory treatment re?sults.

Clinical significance of differential Drosha expression between endometrial cancer tissue and other tissues / 天津医药

Objective To detect the different expressions of Drosha between endometrial cancer (EC) tissue and other tissues and to explore correlation between Drosha mRNA transcription level and protein expression level with clinicopatho?logical characteristics of EC. Methods The mRNA transcription and protein expression levels of Drosha were examinaned by q-PCR and Western blot respectively in normal endometrial tissues (25 cases), atypical hyperplasia of endometrial tis?sues (20 cases) and endometrial cancer tissues (40 cases). Correlations between Drosha mRNA transcription and protein ex?pression with clinicopathological characteristics of EC were analyzed. Results The levels of Drosha mRNA and protein lev?els in EC were obviously lower than those in endometrial atypical hyperplasia and normal endometrium (P0.05). The protein expression levels of Drosha were consistent with transcription of mRNA transcription levels. Drosha mRNA expression does not differ significantly with differentiation, histological type, myometrial invasion, lymphatic metasta?sis and FIGO stages of EC (P>0.05). Conclusion The expression levels of Drosha in EC tissues were down-regulated, therefore the reduction of Drosha may contributed to tumorigenesis of EC.

The clinicopathological difference between male and female breast cancer / 中华内分泌外科杂志

Objective To compare the clinical-pathology features between male breast cancer ( MBC) and female breast cancer(FBC)patients.Methods Clinical data of 37 MBC and 300 FBC patients admitted in the First Affiliated Hospital of Zhengzhou University from Jun .2003 to Jun.2013 was retrospectively reviewed . Results The ratio of MBC to FBC was 54:10000.The age of MBC patients ranged from 39 to 80 years with the median age of 62 years old, older than FBC patients(t=3.117, P=0.002).The percentage of invasive ducal carcinoma was much higher in MBC patients than in FBC patients (χ2 =7.535,P=0.023).MBC patients in clinically stage III and IV were more than FBC patients (χ2 =16.471,P=0.000).The positive rate of estrogen receptor(ER)was significantly higher in MBC patients than in FBC patients (χ2 =6.294,P=0.043).The posi-tive rate of human epidermal growth factor receptor-2 ( HER2 ) was lower in MBC patients than in FBC patients (χ2 =11.222,P=0.004).The main surgical method of MBC was modified radical mastectomy , and there was no breast-conserving surgery for MBC, while the surgical method of FBC was various (χ2 =7.720,P=0.021). Conclusion There are significant differences between FBC and MBC patients in clinicopathological features , surgical method and even prognosis , which were important to guide the treatment of MBC and FBC .

Epithelioid hemangioendothelioma in parotid gland misdiagnosed as parotid gland cyst with hemorrhage in 1 case / 实用口腔医学杂志

The report presents a case of epithelioid hemangioendothelioma in parotid gland misdiagnosed as parotid gland cyst with hemor-rhage.Based on the literature review,clinical characteristics,diagnosis and treatment of the disease are discussed.

The Clinico-pathological Features of Suspected Malignant Nodules Associated with Hashimoto's Thyroiditis-Diagnosis / 浙江中医药大学学报

[Objective]To analyze the clinical and biological characteristics of suspected malignant thyroid nodules associated with Hashimoto thyroiditis .To summarize different characteristics of benign and malignant nodules,diagnosis and treatment of suspected malignant nodules associated with Hashimoto's thy-roiditis. [Methods]Surgical y and pathological y confirmed, 58 cases of suspected malignant thyroid nodules associated with Hashimoto's thyroiditis were retro-spectively analyzed with clinical and pathological data. The differences of gender, age, number of nodules, calcification, and thyroid hormone and thyroid an-tibodies levels between malignant and benign nodules were compared from January 2009 to December 2011 .[Results] The average age of malignant thyroid nodules coexisting with HT group was significantly lower than that of benign nodules coexisting with HT group( P<0.05). The proportion of nodular calcifi-cation in malignant thyroid nodules coexisting with HT group was significantly higher than that in benign nodules coexisting with HT group( P<0.05). Pre-operative TSH and anti-TG levels in malignant thyroid nodules coexisting with HT group were significantly higher than that in benign nodules coexisting with HT group. Preoperative FT3, FT4, anti-TPO levels, sex ratio and number of lesions between the two groups were not statistical y significant. [Conclu-sions] The key point of preoperative diagnosis:patients of malignant thyroid nodules coexisting with HT are associated with youth, calcified nodules, elevated serum TSH and anti-TG levels.

Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review

A 10-year-old female patient presented with a rapidly growing nodular mass lesion on her right frontal area. On skull radiography and computed tomography (CT) imaging, this mass had a well-demarcated punch-out lesion with a transdiploic, exophytic soft tissue mass nodule on the frontal scalp. Magnetic resonance (MR) imaging revealed the presence of a 1.5x1.2x1 cm sized calvarial lesion. This lesion was hypointense on T1 and heterogenous hyperintense on T2 weighted MR images, and exhibited heterogeneous enhancement of the soft tissue filling the punch-out lesion after intravenous administration of gadolinium. En block removal of the tumor with resection of the rim of the normal bone was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia (IPEH). After surgery, no recurrence was found for 8 months. IPEH is a rare and benign reactive lesion usually found in thrombosed subcutaneous blood vessels. Involvement of skull bone is rare. In this article, we present a case of IPEH involving the calvarium, in a 10-year-old woman.

Clinicopathological features of ampullary cancer and its diagnosis and treatment / 中华消化外科杂志

Objective To summarize the clinicopathological features of ampullary cancer,and investigate the diagnosis and treatment strategy for ampullary cancer.Methods The clinical data of 187 patients with ampullary cancer who were admitted to the Peking Union Hospital from January 2000 to December 2010 were retrospectively analyzed.According to different surgical procedures applied,patients were divided into pancreaticeduodenectomy (PD) group (162 patients) and local resection group (25 patients).Survival curve was drawn by using Kaplan-Meier method,and the difference in survival rate between the 2 groups was compared by using Log-rank test.All data were analyzed by using t test or chi-square test.Results The positive diagnostic rates of B-ultrasound,computed tomography (CT),magnetic resonance imaging (MRI) and endoscopic retrograde cholangiopancreatography (ERCP) were 9.3％ ( 15/161 ),43.9％ (65/148),21.3％ (19/89) and 83.9％ ( 135/161 ),respectively.There were 87 patients with well differentiated adenocarcinoma,64 with moderate differentiated adenocarcinoma,27 with low differentiated adenocarcinoma and 9 with tubular canceration.There were no significant differences in survival rate between patients with ampullary cancer in T1 or T2 stage who received PD or local resection ( x2 =3.163,P ＞0.05).The prognosis of patients with ampullary cancer in T3 or T4 stage who received PD were superior to those who received local resection ( x2 =6.309,P ＜ 0.05 ).Conclusions Most of the ampullary cancer is well differentiated adenocarcinoma,and ERCP has a higher diagnostic rate than B-ultrasound,CT and MRI.Local resection is an ideal treatment for patients with ampullary cancer in T1 or T2 stage,while for patients with ampullary cancer in T3 or T4 stage,PD is the first choice of treatment.

Intrahepatic biliary papillomatosis:a report of 9 cases / 中华肝胆外科杂志

Objective Intrahepatic biliary papillomatosis(IBP)is a rare disease that is characterized by multiple numerous papillary adenomas in the intrahepatic biliary duct(IBD).The clinical features and outcome,however,are not well known.The clinicopathologic features,treatments and follow-up results were retrospectively analyzed in order to improve the efficiency of diagnosis and treatment for the disease.Methods Between August 2006 and October 2008,9 patients were diagnosed with IBP by histological findings at a tertiary referral center,Ningbo Medical Center(University of Ningbo,College of Medicine,Ningbo,China).The authors retrospectively reviewed the medical records to obtain clinical,radiological and pathologic data.The therapeutic results and follow-up data were also reviewed.Results The ratio of male to female was 2:7 and the middle age was 59 years.Repeated episodes of fever and right upper quadrant abdominal pain with or without jaundice were the common clinical manifestations.There were intrahepatic choledocholithiasis and/or history of previous biliary operation in 8 cases.The level of CA19-9 and CEA were almost normal.Imaging workup demonstrated cyst-like dilatation of intrahepatic biliary tree with or without liver atrophy,which were more obvious in the mucin-hypersecreting IBP.All of the 9 cases underwent curative resection with an adequate resection margin.Macroscopic findings demonstrated that the tumors of 9 cases were all located in the left lobe with mucin-hypersecreting type in 7 cases.The diameter of numerous papillary granular was usually less than 10 mm(from 2 to 5 mm.frequently)and friable,that filled the dilated IHD dispersive.Fine fibrovascular cores lined by dysplastic epithelial cells were frequently found under microscope.Few foci of stromalinvasion were noticed in the two cases with malignant transformation.All of the 9 cases survived and there was no recurrence.Conclusion IBP occurs more often in middle and old women who have history of biliary disease. Repeated episodes of cholangitis are the common clinical manifestations. Extra- and intrahepatic biliary tract dilatation is the common imaging finding.MRCP/ERCP is more valuable than others in diagnosis. Clinical and histological finding shows that IBP is a premalignant disease with high malignant potential. Curative resection should be done as earlyas possible for the long-term survival rate. The use of cholangioscopy in operation and rapid biopsy of resection margin will benefit the curative resection.