Retrospective Analysis of Pathological Diagnosis of Central Nervous System Diseases in Tibet / 中国医学科学院学报

Objective To analyze the disease spectrum and clinicopathological characteristics of central nervous system(CNS)diseases diagnosed based on pathological findings in Tibet. Methods We collected the data of all the cases with CNS lesions in Tibet Autonomous Region People's Hospital from January 2013 to December 2020.The clinicopathological features were analyzed via light microscopy,immunohistochemical staining,and special staining. Results A total of 383 CNS cases confirmed by pathological diagnosis were enrolled in this study,with a male-to-female ratio of 188∶195 and an average age of(40.03±17.39)years(0-74 years).Among them,127(33.2%)cases had non-neoplastic diseases,with a male-to-female ratio of 82∶45 and an average age of(31.99±19.29)years;256(66.8%)cases had neoplastic diseases,with a male-to-female ratio of 106∶150 and an average age of(44.01±14.87)years.The main non-neoplastic diseases were nervous system infectious diseases,cerebral vascular diseases,meningocele,cerebral cyst,and brain trauma.Among the infectious diseases,brain abscess,granulomatous inflammation,cysticercosis,and hydatidosis were common.The main neoplastic diseases included meningioma,pituitary adenoma,neuroepithelial tumor,schwannoma,metastatic tumor,and hemangioblastoma.The meningioma cases consisted of 95.4%(103/108)cases of grade Ⅰ,3.7%(4/108)cases of grade Ⅱ,and only 1(1/108,0.9%)case of grade Ⅲ.Among the neuroepithelial tumor cases,the top three were glioblastoma,grade Ⅲ diffuse glioma,and ependymoma. Conclusions There are diverse CNS diseases confirmed by pathological diagnosis in Tibet,among which non-neoplastic diseases account for 1/3 of all the cases.Infectious and vascular diseases are the most common non-neoplastic diseases in Tibet,and tuberculosis and parasitic infections are relatively common.The types and proportion of brain tumors in Tibet are different from those in other regions of China,and meningioma is the most common in Tibet,with higher proportion than neuroepithelial tumor.

Ultrasound image and pathological features analysis of invasive fibromatosis / 肿瘤研究与临床

Objective:To investigate the ultrasound image and pathological features of invasive fibromatosis, and to provide a basis for the diagnosis of invasive fibromatosis.Methods:The clinicopathological data of 22 patients pathologically diagnosed with invasive fibromatosis from January 2016 to March 2019 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. The clinical, ultrasound and pathological data were also summarized.Results:Ultrasound images of invasive fibromatosis showed irregular morphology, unclear boundaries, uneven echo, spot-like or strip-shaped blood flow signals. The coincidence rate of ultrasound diagnosis was 59.1% (13/22), 3 cases were misdiagnosed as fibrous, fat and other sarcomas, 4 cases were misdiagnosed as nerve-derived tumors, 1 case was misdiagnosed as nodular fasciitis, and 1 case was misdiagnosed as gastrointestinal stromal tumor. The pathological characteristics of invasive fibromatosis were more typical, and the positive expression rate of vimentin and β-catenin in immunohistochemistry was 100.0% (22/22); the coincidence rate of preoperative pathological diagnosis of puncture was 78.6% (11/14), 1 case was misdiagnosed as nerve fiber tumor, 1 case was misdiagnosed as low-grade fibromyxoid sarcoma, and 1 case was misdiagnosed as nodular fasciitis.Conclusion:Invasive fibromatosis has a certain specificity in ultrasound and pathological diagnosis, which can be diagnosed and differentially diagnosed according to the ultrasound image and pathological characteristics.

Diagnóstico Patológico en Mora de Castilla Rubus glaucus Bentham (Rosales:Rosaceae) / A pathological diagnosis of Rubus glaucus Bentham Andean blackberry (Rosales:Rosaceae) / Diagnóstico patológico em amora preta de Castilla Rubus glaucus Bentham (Rosales:Rosaceae)

Resumen Se realizó un diagnóstico patológico de un cultivo de Mora de Castilla en la vereda Pascote, municipio de Gutiérrez Cundinamarca, Colombia. Las muestras vegetales se tomaron de las hojas, tallo, flor, fruto y raíz; las cuales, se procesaron en identificaron en el laboratorio de fitopatología de la Universidad de los Llanos. En el campo se evaluó incidencia de cada síntoma. Se encontraron cuatro patógenos fungosos Colletrotrichum . gloesporoides (Penz.) Penz. con 40.00% de incidencia, Peronospora sparsa Berk con una incidencia del 20.00 %, Oidium sp, con 12.50% de incidencia y Botrytis cinérea Perms., con una incidencia del 7.50 %.

Abstract A pathological diagnosis was made of an Andean blackberry crop (Rubus glaucus Bentham) in the rural area of Pascote, in the municipality of Gutiérrez, Cundinamarca, Colombia. Samples were taken from blackberry leaves, stems, flowers, fruit and roots; they were processed and identified in the Universidad de Los Llanos' plant pathology laboratory. Pathogen/disease symptom incidence was evaluated in the field. Four fungal pathogens were found and identified: Colletotrichum gloesporoides (Penz.) Penz (anthracnose), 40% incidence, Peronospora sparsa Berk (downy mildew), 20% incidence, Oidium sp. (powdery mildew), 12.5% incidence, and Botrytis cinerea Perms (gray mold disease), 7.5% incidence.

Resumo Realizou-se um diagnóstico fitopatológico num cultivo de amora preta no Vilarejo de Pascote, município de Gutiérrez, Cundi­namarca, Colômbia. As amostras vegetais foram colhidas das folhas, caule, flor, fruto e raiz; que foram processados e identificados no laboratório de patologia vegetal da Universidad de los Llanos. A incidência de cada sintoma foi avaliada no campo. Foram encontrados quatro patógenos fúngicos: Colletrotrichum. gloesporoides (Penz.) Penz. com uma inci­dência de 40,00%; Peronospora sparsa Berk com uma incidência de 20,00%; Oidium sp, com uma incidência de 12,50%; e Botrytis cinérea Perms., com uma incidência de 7,50%.

Tumor de Células de Sertoli del ovario: Reporte de un caso / Sertoli cell tumor of the ovary. A case report

RESUMEN Introducción: Los tumores de Células de Sertoli son una entidad rara, con una frecuencia de 0,2-0,5 % del cáncer de ovario. El diagnóstico inicial de este tipo de tumores es difícil, debido a las variedades histológicas que presenta y a su diferenciación. Objetivo: Demostrar el valor del completamiento del proceso diagnóstico con técnicas de inmunohistoquímica en tumores ováricos para identificar una variante rara como el tumor de Células de Sertoli. Presentación del caso: Se presenta un caso de un tumor de ovario primitivo de Células de Sertoli en una paciente de 43 años de edad, con antecedentes personales de hipotiroidismo, intervenida quirúrgicamente por un tumor sólido del ovario derecho en el Hospital General Docente "Dr. Agostino Neto". En el intraoperatorio, se encontró un tumor gigante de aspecto maligno. El resultado anatomopatológico informó un tumor carcinoide típico. La paciente fue remitida al Instituto Nacional de Oncología y Radiobiología, donde la inmunohistoquímica de la biopsia informó un tumor de Células de Sertoli. Actualmente la paciente se encuentra asintomática. Conclusiones: El diagnóstico anatomopatológico preciso y la inmunohistoquímica correcta son muy importantes para el manejo y tratamiento de este tipo de tumor.

ABSTRACT Introduction: Sertoli cell tumors are a rare entity with an incidence of ovarian cancer of 0,2-0,5 %. The initial diagnosis of this type of tumors is difficult to make due to the histological varieties and its differentiation. Objective: To demonstrate the value of immunochemical techniques in the completion of the diagnostic process of ovarian tumors aimed at identifying a rare variant such as Sertoli cell tumor. Case presentation: A 43-year old woman with a primitive Sertoli cell tumor of the ovary is presented. The patient had personal history of hypothyroidism. She underwent surgery at "Dr. Agostinho Neto" General Teaching Hospital because she had been diagnosed with a solid tumor of the right ovary. During the intraoperative period, a giant tumor with a malignant appearance was found. The pathological result reported a typical carcinoid tumor. The patient was referred to the National Institute of Oncology and Radiobiology where the immunohistochemistry of the biopsy reported a Sertoli cell tumor. Currently, the patient is asymptomatic. Conclusions: The accurate pathological diagnosis and the correct immunohistochemistry are very important for the management and treatment of this type of tumor.

A case report of plasmacytoid urothelial carcinoma of the ureter / 中华泌尿外科杂志

Primary ureteral plasmacytoid carcinomas is a rare tumor with high grade and poor diagnosis.Pathological and immunohistochemical staining play an extremely key role in diagnosis since there is no specific clinical and radiological evidence.The surgical removement is the first line treatment.Herein,we report a case of ureteral plasmacytoid carcinoma that was well controlled with multimodal therapy.

A case report of plasmacytoid urothelial carcinoma of the ureter / 中华泌尿外科杂志

Primary ureteral plasmacytoid carcinomas is a rare tumor with high grade and poor diagnosis. Pathological and immunohistochemical staining play an extremely key role in diagnosis since there is no specific clinical and radiological evidence. The surgical removement is the first line treatment. Herein, we report a case of ureteral plasmacytoid carcinoma that was well controlled with multimodal therapy.

Mucoepidermoid carcinoma arising in Warthin’s tumor of the upper lip: a case report and review / 口腔疾病防治

Objective @#To provide a reference for the diagnosis and treatment of mucoepidermoid carcinoma arising in Warthin’s tumor of the lip by investigating the diagnosis, treatment and prognosis of the disease.@*Methods @# A case of mucoepidermoid carcinoma arising in Warthin’s tumor of lip was reported, including the clinical manifestation, treatment, pathological characteristics and prognosis. The related literature was also reviewed and analyzed.@*Results@# A painless mass on the left lip lasting more than one month was found. Resection of the left lip was performed. Pathological examination showed that the tumor was a hybridoma composed of mucoepidermoid carcinoma and Warthin’s tumor. There was no recurrence or distant metastasis after 34 months. To date, this type of disease has been rarely reported. After thorough resection, the prognosis and survival rate are promising in most cases, with no recurrence or metastasis.@*Conclusion@#Mucoepidermoid carcinoma in Warthin’s tumor of the lip is rare. Clinical manifestations, imaging features and histological examination are useful when diagnosing the disease. Thorough resection will reduce the risk of disease recurrence.

Primary testicular diffuse large B-cell lymphoma: A clinicopathological analysis / 中华男科学杂志

Objective@#To investigate the clinicopathological features, immunophenotype and treatment of primary testicular diffuse large B-cell lymphoma (DLBCL).@*METHODS@#We retrospectively analyzed the pathomorphological characteristics and immunohistochemical markers of 23 cases of primary testicular DLBCL as well as their clinicopathological features with a review of the relevant literature. The patients were aged 48－76 (mean 61.4) years, 82.6% over 50 years, and all clinically presented with painless progressive unilateral testicular swelling, 9 cases in the left and the other 14 in the right testis.@*RESULTS@#Histologically, the lymphomas were composed of large atypical cells with prominent karyokinesis and diffusely infiltrated the testicular parenchyma. The neoplastic cells were positive for B-cell markers. Five of the patients were followed up for 2 to 32 months, of whom 4 survived and 1 died at 9 months.@*CONCLUSIONS@#Primary testicular DLBCL is a rare tumor with an invasive biological behavior, mostly found in elderly males and easily misdiagnosed or missed in diagnosis. Histopathology plays a key role and immunohistochemical markers are of high value in the definite diagnosis and differential diagnosis of the tumor.

Clinical analysis of intravenous leiomyomatosis:report of 9 cases / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the clinical characteristics,diagnosis and treatment of intravenous leiomyomatosis(IVL).METHODS: The clinical data of 9 IVL treated at Women's Hospital,Zhejiang University School of Medicine from January 2013 to December 2017 were analyzed retrospectively. All the cases were followed up.RESULTS: Out of 8702 patients with uterine leiomyoma,9 patients were diagnosed with IVL. Most patients complained of pelvic mass,and 6 patients had enlarged uterus. Preoperative imaging examination demonstrated parametrial mass in 5 cases. All nine cases were confined to the pelvic cavity except for one who had lung metastasis. Two cases had myomectomy,and seven underwent hysterectomy. The lesions were dendritic,dumbbell-shaped,elliptical or elongate in four cases. Nine cases had a mean follow-up of 28.2 months,and recurrence occurred in two cases.CONCLUSION: The obvious enlargement of uterus and parametrial mass are important features of IVL. It is difficult to diagnose preoperatively. Identifying the morphological features of lesions during operation can improve the diagnostic accuracy. Total hysterectomy is the first choice of treatment and long-term follow-up is also needed.

Application of CYP11B2 immunohistochemistry in the histopathological diagnosis of primary aldosteronism / 中华内分泌代谢杂志

Objective@#To evaluate the value of CYP11B2 immunohistochemistry in the histopathological diagnosis of primary aldosteronism(PA) among Chinese population.@*Methods@#Ninety-six cases of unilateral PA patients were retrospectively enrolled, and with 15 cases of non-hyperfunctioning adenoma, and 15 cases of cortisol producing adenoma as control. CYP11B2 immunohistochemistry was performed in the tumor sections of these patients and was analysed by semi-quantified method. The positive rate of CYP11B2 in tumor specimen of all cases enrolled was calculated and PA patients were subtypely classified based on their histopathological features and CYP11B2 expressions.@*Results@#The immune-positive rate of CYP11B2 in the PA group was 91.7% (88/96), with the control group being 6.7% (2/30, P<0.001). Subgroup analysis revealed that the immune-positive rate of CYP11B2 in the aldosterone producing adenoma group and unilateral hyperplasia group were 91.8% (78/85) and 90.9% (10/11), respectively. Based upon histopathological feature and CYP11B2 immunohistochemistry, PA patients were further subtypely classified as aldosterone producing adenoma (85/96), unilateral diffuse adrenocortical hyperplasia (7/96), unilateral mono-adrenocortical micronodules (1/96), unilateral multiple adrenocortical micronodules (1/96), and unilateral multiple aldosterone-producing cell clusters (multiple APCCs, 2/96).@*Conclusion@#CYP11B2 immunohistochemistry may serve as an useful tool for the histopathological diagnosis of PA.

Pathological diagnosis of non-Hodgkin lymphoma / 白血病·淋巴瘤

The clinicopathological characteristics and diagnosis of non-Hodgkin lymphoma were analyzed,including (1) clinical manifestations:lymph nodes are enlarged with B symptoms including extension and fever;(2) histopathology:dysplasia and clonal proliferation of tumor cells,invasion and destruction of normal tissue structure are noted;(3) immunophenotype:it shows an immunophenotype consistent with histopathology;(4) molecular pathology:molecular pathological tests are performed when morphological and immunohistochemical findings cannot determine benign or malignant lesions.Ig and T cell receptor polymerase chain reaction gene rearrangements detection is commonly used to determine the clonality.When the results of above four aspects are the same,lymphoma can be diagnosed,and if there is any doubt,the diagnosis of lymphoma cannot be made.

Analysis of the incidence characteristics of pathologically diagnosed ARVC patients with unexplained sudden death in Yunnan / 中华地方病学杂志

Objective To analyze the characteristic of Yunnan unexpected sudden death (YUSD) cases by pathological diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC),in order to offer clue for ARVC etiologic research of YUSD.Methods The pathological diagnosis results of 9 cases of sudden death of ARVC in Yunnan,as well as epidemiological investigation data,were used to comprehensively analyze the pathological features of the pathological diagnosis of ARVC in Yunnan.Results The 9 cases including 8 females and 1 male,aged 16-47 years.The sudden death time was from June to August,mainly distributed in 8 families from the disease seriously ridden 7 villages.Three of them had a genetic history of family YUSD,2 cases had a history of mental stimulation,1 case had eaten Trogia venenata;and acute symptoms and signs were palpitation,chest tightness,shortness of breath,and loss of consciousness.Pathological observations were the typical ARVC change,mainly right ventricular lesions,with different degrees of cardiac enlargement and extensive adipose tissue infiltration in the ventricular wall.Among them,6 cases of fat infiltration almost reached the full thickness of the heart wall.In addition to the pathological changes of ARVC,8 cases were accompanied by one or several pathological changes in myocarditis,cardiac dysplasia,nephropathy,pulmonary edema,pneumonia and pancreatitis.Of the 9 cases,5 cases were diagnosed with ARVC,2 cases with ARVC and pulmonary edema,1 case with ARVC and acute hemorrhagic necrotizing pancreatitis,and 1 case with ARVC and Trogia venenata poisoning.The clinical examination abnormalities of the family members of the cases mainly showed arrhythmogenic electrocardiography changes and abnormal myocardial enzymes.Conclusions The nine cases have showed typical epidemiology characteristics of YUSD,and cardiachistological changes are consistent with the ARVC pathological diagnostic criteria.A part of YUSD cases may be caused by ARVC,and the inference will be proved by cadaveric pathologic examination and related pathogenic gene detection.

Recent application and outlooks of fluorescent diagnostic techniques in clinic / 医疗卫生装备

Current problems and demands of intraoperative diagnosis were presented. Basic theories and classification of fluorescent diagnostic techniques were introduced, and the advantages compared with traditional pathology were also analyzed.Current research and application status of fluorescent diagnostic techniques were summarized and analyzed in two aspects:spectroscopy analysis and image analysis,and it was indicated that fluorescent diagnosis was important for research and clinical application.Furthermore,future development directions of fluorescent diagnostic techniques were analyzed,and improving accuracy and combining diagnosis with clinical treatment were growing trends in fluorescent diagnostic techniques.

Analysis of clinicopathologic features in 55 cases of desmoid-type fibromatosis / 临床与实验病理学杂志

Purpose To explore the clinicopathologic fea-tures, diagnosis and differential diagnosis of desmoid-type fibro-matosis (DTF). Methods The clinicopathological data of 55 cases of DTF were retrospectively analyzed and followed up. Re-sults Among 55 cases of DTF, 18 cases were male and 37 cases were female. Median age was 33 years old (range from 6-71). 19 cases were occurred in abdominal wall, 23 cases were extra-abdomen, 13 cases in intra-abdomen and mesentery. DTF was composed of proliferating spindle fibroblasts and a number of collagen fibers. The cell showed no obvious atypia and the mitot-ic figures were rare. Immunohistochemical results showed posi-tive expression of vimentin, partial expression of SMA, desmin. The positive expression of β-catenin was located in nucleus of DTF cells. CD34, CD117, DOG1, S-100 were negatively ex-pressed. Ki-67 proliferation index was low. The effect of surgical resection was good for DTF. After 2-82 months follow-up, 17 ca-ses recurred and the remainders were disease-free survival. Con-clusion DTF is a rare intermediate tumor of soft tissue with no specificity of clinical and imaging features, which should be dif-ferentiated with a variety of benign and malignant diseases. The nuclear expression of β-catenin acts an important role in diagno-sis and differential diagnosis of DTF.

Histopathological diagnosis and follow-up analysis of gastric mucosal biopsy / 临床与实验病理学杂志

Purpose To investigate the histopathological diagnosis and follow-up of gastric mucosal biopsy. Methods A detailed histopathological observation was performed on 5 748 gastroscopic biopsies and 3 288 patients were followed up. Results In 5 748 cases of endoscopy biopsy specimens, acute gastritis was rechecked in 125 cases, of which 112 cases were cured or improved (89.6％ ), 10 cases (8.0％ ) had little change, and 3 cases (2.4％) were aggravated. There were 2430 cases of chronic atrophic gastritis, in which 1521 cases were cured/improvement (62.6％ ), 737 cases (30.3％ ) had little change, and 172 cases (7.1％ ) were aggravated. In the 71 cases of special type of gastritis, 23 cases were cured or improved, accounting for 32.3％.42 cases were not changed much, accounting for 59.2％, and 6 cases were aggravated (8.5％ ). About druginduced gastritis/stomach reexamination in 94 cases, 57 cases were cured/improved, accounting for 60.6％, 34(36.3％ ) cases did not change, and 2 cases were aggravated(3.2％ ).183 cases of gastric polyp were reviewed, 165 cases(90.2％ ) were cured / improved, 13 cases (7.1％ ) were not changed and 5 cases (2.7％ ) were aggravated. No neoplasia/ nondysplasia was found in 205 cases, 196(95.6％ ) cases was cured / improved, no change was seen in 6 cases (2.9％ ) and aggravation was seen in 3 cases(1.5％). Indefinite neoplasia/ dysplasia was reexamined in 24 cases, 2 cases (8.3％) were cured/improved, no change was seen in 13 cases (54.2％ ), and aggravation was seen in 9 cases(37.5％).156 cases of intraepithelial neoplasia were retrospectively reviewed, in which138 (88.5％ ) cases were cured or improved, 4(2.6％ ) cases showed no change, and 13(8.3％) cases were aggravated. Conclusion It is of great significance to improve the early diagnosis rate, reduce missed diagnosis rate and misdiagnosis rate of gastric cancer by establishing 11 pathological changes and accompanying lesions.

Renal collecting duct carcinoma: report of three cases and literature review / 中华泌尿外科杂志

Objective To investigate the clinicopathological features,diagnosis,differential diagnosis and prognosis of renal collecting duct carcinoma (CDC).Methods The clinical data of 3 patients with renal collecting duct carcinoma,during the period from January 2015 to November 2017,were retrospectively analyzed.3 patients were male with age ranged from 42 to 73 years old,mean of 57.5 years.Two lesions were located in the right kidney and one in the left kidney.Clinical manifestations were hematuria,abdominal mass and waist and abdomen pain.No laboratorial abnormality was found.CT examination showed the tumor diameter ranged from 3.1 to 5.1 cm,mean 3.9 cm.The tumors located in the medullary and renal pelvis with low density or mixed density.Those tumors extended to the peripheral of the kidney,which the boundary was unclear.During enhancement CT,the uneven enhancement effect could be observed.Radical nepheroectomy was performed in all patients.Results Postoperative pathological examination showed surface of incision was gray.The texture of tumor was hard.The invasive growth pattern could be noticed.Under the microscope,the tumors had small ducts and papillary structures of tubules with interstitial fibrosis and some sarcomatous differentiation.Immunohistochemical staining showed strong positive expression of vimentin,CK-L,CKpan and P504S,and positive expression of PAX-2,CK7 and EMA in different degrees.RCC,KSP,CD10,CD117,MOC-31 and TFE3 were all negative.All 3 cases were followed up from 1 to 15 months with an average of 6 months.One case was treated with chemotherapy because of extensive metastases after surgery.Chemotherapy was performed by dissolving 1 500 mg of fluorouracil in 1 000 ml of 5％ normal saline and instillation.It was administered once every 10-12 hours and once a day for 5 days in one cycle.However,the outcome was poor.1 patient died of tumor metastasis and recurrence 7 months after surgery.1 patient had no tumor remaining after surgery.Conclusions CDC is a very rare malignant epithelial neoplasm in kidney.It has obvious clinical symptoms,strong invasive pattern and poor prognosis.Imaging and ultrasonography only play an auxiliary role in diagnosis.CDC's unique histopathology is the main basis of diagnosis and differential diagnosis.

Application of whole mount sections technique in the diagnosis of prostate cancer / 中华泌尿外科杂志

Objective To investigate the significance of whole mount sections after radical prostatectomy in the diagnosis of prostate cancer.Methods The data of 210 patients with radical prostatectomy in the Department of Urology of Northern Jiangsu People's Hospital from April 2018 to July 2015 were collected,of which 150 cases (control group) were examined with routine tissue section examination and 60 cases (study group) were examined with whole mount sections.The age of the study group and the control group were (69.0 ± 5.0) years and (70.0 ± 7.0) years respectively,and PSA was (18.8 ± 2.5) ng/ml and (19.3 ± 2.1) ng/ml respectively.The BMI of the study group was (23.0 ± 1.2) kg/m2,and the control group was (22.8 ± 0.6) kg/m2.The preoperative Gleason score of the study group and the control group were 7.9 ±0.9 and 7.7 ± 1.6 respectively.There were 137 patients (91.3％) with clinical stage cT1-T2 and 13 patients with cT3(8.7％) in control group.In the study group,there were 51 cases (85.0％) with clinical stage cT1-T2,and 9 cases with cT3 (15.0％).There was no significant difference between the two groups (P ＞ 0.05) in term of the patients' demographics.The postoperative Gleason score,positive surgical margin,seminal vesicle invasion lymph node metastasis and pathological stage were compared between the two groups.Results The median prostate volume of the study group was 45.2 (18.3-121.5) ml,and 47.1 (2 1.3-124.2) ml in the control group.The operation time of the study group was 138.2 (119.5-234.1) mins,and 133.5 (116.8-228.2) mins in the control group.In the control group,there were 8 cases(5.3％) with seminal vesicle invasion,and 8 cases (5.3％) with lymph node metastasis.The pathological stages were pT2-T3 in 145 cases(96.7％),and pT4 in 5 cases (3.3％) in control group.The postoperative Gleason score was 8.0 ± 0.9 in control group.In the study group,17 patients (28.3％) with seminal vesicle invasion were pathologically indicated,and there were 6 patients (10.0％) with lymph node metastasis.The pathological stages were pT2-T3 of 57 cases(95.0％),and pT4 of 3 cases (5.0％),postoperative Gleason score was 7.7 ± 1.0 in study group.There was no statistically significant difference in seminal vesicle invasion,lymph node metastasis,pathological stage and postoperative Gleason score between the two groups (P ＞ 0.05).There were 23 patients (15.3％) with positive margins in the control group,and 28 patients(46.7％) in the study group,which showed significant difference (P ＜0.01).For small lesions,there were 7 cases (4.7％) and 22 cases (36.7％) in the control group and the study group,respectively,which showed significant difference (P ＜ 0.01).There were 17 cases (28.3％) of increased Gleason score in the study group,while 31 cases (20.7％) in the control group,with no statistical difference (P =0.232).Conclusions The whole mount section technique can effectively improve the positive surgical margin and the small lesions detection rate in the pathological evaluation of radical prostatectomy,and provide a precise pathological diagnosis for the postoperative treatment and follow-up of the patients.

Confocal laser endomicroscopy for diagnosing malignant bladder tumour: a pilot study / 中华泌尿外科杂志

Objective To perform an exploratory investigation on confocal laser endomicroscopy (CLE) in the diagnosis of malignant bladder tumour.Methods From June 10 to July 11,2017,6 male bladder cancer patients underwent white light cystoscopy (WLC) + CLE examination,aging 64-86 years (median 72 years).All patients received TURBT on suspected lesions.WLC and CLE imaging results were recorded and validated by pathologic specimens.Results Lesions confirmed by histopathology were 3 low grade non-invasive papillary urothelial carcinomas,1 high grade non-invasive papillary urothelial carcinoma,1 low grade invasive urothelial carcinoma,1 high grade invasive urothelial carcinoma,1 carcinoma in situ (CIS),1 high grade dysplasia,1 cystitis glandularis,1 chronic inflammation,and 1 scar tissue.For CLE images in the normal urothelium,three layers of cells with different presentation were observed,namely,the superficial umbrella cells,the intermediate cells smaller in size and uniformly shaped,and the capillary network in the lamina propria.For non-invasive urothelial carcinoma,tumour cells appeared as papillary lesions growing from fibrovascular cores,with low grade cells appearing monomorphic and more cohesively arranged,and high grade cells relatively pleomorphic,more disorganised and with tortuous blood vessels in the fibrovascular core.For invasive urothelial carcinoma,tumour cells invaded the lamina propria,with uniform appearances,poor cohesion and indistinct cellular borders,and high grade ones were more pleomorphic.CIS and inflammation both appeared as erythematous patch-like flat lesions under WLC and sometimes difficult to differentiate.Under CLE,the former appeared as dysplastic and disorganised cells with indistinct cellular borders,with intact lamina propria,and inflammatory cells were discovered as infiltrative clusters in the lamina propria that were uniformly shaped and loosely connected.Dysplasia appeared somewhat similar compared with CIS under WLC,but with lower cellular irregularity as confirmed with pathology.Cellular appearance and structure in scar tissue was similar to that in the normal urothelium,but superficial umbrella cells were more likely absent,with thinner cell layers,and inflammatory infiltration was sometimes discovered in the lamina propria.Conclusions CLE provides real-time cellular imaging of the urothelium,and shows promising potential for clinical diagnosis,especially in differentiating fiat urothelial lesions.Large prospective studies are required for further validation.

Clinicopathological features analysis of common complications in pediatric liver transplantation / 中华器官移植杂志

Objective The purpose of this study was to explore common complications and their clinicopathological features in pediatric liver transplantation.Methods Clinical and pathological data of 240 liver biopsies from 168 children that conducted liver puncture from January 2015 to May 2018 in Tianjin First Central Hospital was retrospectively analyzed.We comprehensively analyzed incidence rate and pathological features of various complications,and correlations between acute rejection and C4d staining result or Banff score.Results A total of 86.67％ (208/240) liver biopsies could be definitely diagnosed with incidence rate of main complications in descending order as follows:T cell mediated rejection (TCMR) 60.57％ (126/208),drug-induced liver injury (DILI) 17.31％ (36/208),biliary complication 8.17％ (17/208),vascular complication 3.37％ (7/208),ischemia/reperfusion injury (IRI) 2.88％ (6/208),antibody mediated acute rejection (AMR) 1.92％ (4/208),HBV infection 1.92％ (4/208),non-alcoholic fatty liver disease (NAFLD) 1.44％ (3/208),chronic rejection (CR) 0.96 ％ (2/208) and HCV infection 0.48 ％ (1/208).TCMR and AMR in acute rejection (AR) accounted for 96.92％ (126/130) and 3.08％ (4/160),and into(portal-based,PB)type TCMR accounted for 96.03％(121/126) with the detectable rate of BP type subtype TCMR of 26.45％(32/121)within 30 d.There were 65.87％ (83/126)、25.40％ (32/126) 和4.76％ (6/126) of BP TCMR samples with "Banff ACR RAI" score within 3-5,6-7 and 8-9,and RAI score was negatively correlated with postoperative time (r =0.127,P =0.084).The incidence rate of central perivenulitis (CP) and portal eosinophils infiltration (PEI) in BP TCMR was 63.63％ (77/121) 和43.80％ (53/ 121),respectively,additionally,the PEI level was positively correlate with RAI score (P＜0.05).CP TCMR and AMR occurred within 30d-365 d and 8 d-180 d,respectively postoperative,while,the two CR occurred at 1095 d and 1335 d postoperative,and significant correlation was strikingly observed between rejection subtype and postoperative time (Z =9.231,P =0.026).C4d positive rate was 10％ (24/240),which was associated with Banff score and postoperative time,besides,C4d score was also correlated with rejection subtype and RAI score.The occurrence of DILI was mainly at time of ＜90 d or ＞180 d postoperative,and the detectable rate of biliary complication within 180 d postoperative was 82.35％ (14/17),IRI Appear in ＜30d.Hepatic artery complication account for nearly 57.14％ (4/7),occurrence time is ≤90 d.Occurrence of HBV infection,CMV infection and NAFLD were mainly at ＞365 d,＜90 d and ＜365 d,respectively.Conclusion There were lots of differences in clinical and pathological features among multi pediatric liver transplantation complications.Liver puncture plays an important role in rejection subtype classification and grading,as well as in non-rejection complications identification.

Pathological diagnosis and differential diagnosis of reactive hyperplasia in lymphoid tissues / 白血病·淋巴瘤

This paper introduces the clinical features, histopathology, immunophenotype and differential diagnosis of reactive hyperplasia (RH) in lymphoid tissues. The characteristics of RH are as follows: (1) Clinical presentations include acute fever and mild enlargement of lymph nodes. The patients can be cured when the causes of disease disappear; (2) Pathological histology is divided into single type and specific type. The common changes of lymphoid tissues are lymph follicle (LF) or T-zone cell hyperplasia, which leads to the disorder of normal tissues, including the increased number of large cells and mitosis (known as the pseudomalignant histological form); (3) Immunophentype is featured by normal pattern of LF and T-zone cells. The key point of differential diagnosis is the overgrowth of cells producing pseudomalignant histological changes in RH, resulting in the lack of cell atypia and monoclonal, damage and erosion of the normal tissue structures.