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Erdheim-Chester disease is a rare non-Langerhans histiocytic disease that can involve multiple systems, such as bone and joint, nerve, skin, large blood vessels and endocrine.The most common clinical manifestation is slight bone pain around the lower limb joints. The data reported a patient with multiple serous cavity effusion as the first manifestation and lack of symptoms of bone pain. PET-CT examination showed that the bone and large blood vessels were involved, and finally confirmed as Erdheim-Chester disease by bone biopsy pathology. The patient presented atypical manifestations of rare diseases, and the analysis of clinical data of the case will help improve the recognition of the disease by clinicians.
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@#Objective To analyze the clinical efficacy and safety of endostar or carboplatin combined with endostar intracavitary perfusion in the treatment of malignant serous cavity effusion. Methods We retrospectively reviewed the clinical data of 78 cancer patients with malignant serous cavity effusion who received paracentesis and intracavitary endostar, or carboplatin combined with endostar in Shengjing Hospital of China Medical University between November 2011 and November 2016. There were 42 males and 36 females at a median age of 62 years ranging from 17 to 78 years. According to treatment methods, 78 patients were divided into two groups, in which 33 patients received intracavitary endostar combined with carboplatin (a combination group, 15 males and 18 females at a median age of 56 years ranging from 17 to 66 years), and 45 patients received intracavitary endostar (an endostar group, 27 males and 18 females at a median age of 63 years ranging from 38 to 78 years). The efficacy and safety of two methods were analyzed and compared. Results The response rate in the combination group was 75.8%, which was higher than that in the endostar group (60.0%, P=0.035). In quality of life improvement, there was no statistical difference between the two groups (P=0.113). The incidence of fatigue, myelosuppression and gastrointestinal reactions in the endostar group was significantly lower than that of the combination group (P=0.006, 0.000 and 0.017, respectively). Analysis of long-term efficacy revealed that the median time to progress (TTP) in the combination group and endostar group was 171 days and 143 days, respectively (P=0.030). Conclusion Intracavitary infusion of endostar alone, or carboplatin combined with endostar is effective and tolerable for controlling malignant serous cavity effusion. But for the patients with poor physical state who can not tolerant platinum perfusion, intracavitary infusion of endostar alone can be adopted to control malignant serous cavity effusion.
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Objective To explore the application value of automated cell DNA ploidy analysis system in the diagnosis of benign and malignant serous cavity effusion.Methods 262 cases of serous cavity effusion(169 cases of pleural effusion,78 cases of ascites,15 cases of pericardial effusion)were treated by centrifugation,2 slices of each sample were made.One of them used for dyeing Feulgen,which given automatic cell DNA ploidy analysis,another one for Papanicolaou staining,with a conventional cytology.The positive detection rate of these 2 kinds of different detection methods for malignant serous cavity effusion were compared.Results 119 cases(45.4％)of 262 cases abnormal were detected by conventional cytology of serous cavity effusion.Meanwhile,113 cases (43.1 ％)were detected abnormal by DNA ploidy analysis in the same samples.73 cases of tumor cells and suspicious tumor cells were found by conventional cytology,and different ploidy cells were found in all of these samples In conventional cells,46 cases of nuclear heterogeneous cells were found,while only 34 cases exist different ploidy cells.Conclusion Automated cell DNA ploidy analysis system is helpful to improve the positive diagnosis rate of serous cavity effusion,which can be used as an important auxiliary means of cytology.
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Objective To explore the capacity of the Sweden CellaVision DM96 automatic digital cell morphology analysis sys‐tem (DM96) in nucleated cell classification of serous cavity effusion .Methods 36 specimens of serous cavity effusion were selected from the inpatients of Second Affiliated Hospital of Xi′an Jiaotong University in March 2015 and performed the Wright staining by the two kinds of method ,the Japanese Sysmex SP‐1000Ⅰ automatic smearing machine and manual smearing ,after staining ,the smear was performed the nucleated cells classification by DM96 .The consistency and relevance of the classification results by DM 96 with those by the Sysmex XT‐4000i were calculated .Results The classification results by DM96 had better consistency with the results by XT‐4000i ,moreover the cell images taking by DM96 were clear with high automatic degree .Conclusion The DM96 auto‐mated digital nucleated cell morphology analysis system is reliable and effective ,and has a significance for improving the cellular morphological analysis of serous cavity effusion specimen .
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Objective To assess the value of spectral CT in differentiating benign and malignant serous cavity effusion in vitro.Methods 41 plastic tubes filled with serous cavity effusion underwent spectral CT imaging.The gemstone spectral imaging(GSI)viewer was used to measure the mean CT values of water -iodine concentration, iodine -water concentration,monochromatic images(40 -140KeV,interval of 5KeV),140KVp QC,and EFF -Z. Slope of spectral curve was measured also.Based on clinical and pathological diagnosis,30 cases of benign and 11 cases of malignant serous cavity effusion were compared.The difference of the spectral characteristic parameters was evaluated statistically by independent -samples t test using SPSS 18.0.Results The EFF -Z,water -iodine concentration,iodine -water concentration,and slope of spectral curve[7.26 ±0.25,(1 021.82 ±6.37)mg/mL, (-3.23 ±1.53)mg/mL,0.26 ±0.12]of benign serous cavity effusion showed no statistically significant differences between the malignant group[7.31 ±0.10,(1 016.17 ±5.32)mg/mL,(-3.06 ±1.18)mg/mL,(0.24 ±0.10), t =0.652,2.016,0.332,0.482,all P >0.05 ].There were statistically significant differences on 55 -140 KeV between the two groups[(4.87 ±7.13)and (10.66 ±6.70),(7.17 ±6.48)and (12.71 ±5.94),(9.58 ±6.11) and (14.96 ±5.65),(11.63 ±5.97)and (16.77 ±5.52),(13.31 ±5.93)and (18.36 ±5.52),(14.66 ± 5.98)and (19.52 ±5.52),(16.06 ±6.06)and (20.90 ±5.63),(17.03 ±6.10)and (21.42 ±5.88), (17.58 ±6.12)and (22.29 ±5.59),(18.05 ±6.14)and (22.74 ±5.49),(18.52 ±6.17)and (23.19 ± 5.51),(18.74 ±6.20)and (23.33 ±5.46),(19.16 ±6.20)and (23.80 ±5.47 ),(19.30 ±6.26 )and (23.87 ±5.45),(19.57 ±6.26)and (24.19 ±5.48),(19.66 ±6.28)and (24.21 ±5.43),(19.92 ±6.31) and (24.46 ±5.44),(20.00 ±6.32)and (24.53 ±5.43),t =2.339,2.474,2.544,2.489,2.456,2.356,2.301, 2.060,2.231,2.223,2.206,2.161,2.188,2.138,2.162,2.122,2.114,2.104,all P 0.05].The difference be-tween benign and malignant effusion was statistically significant on 140KVp QC also [(10.25 ±6.96,16.60 ±6.84) (t =2.601,P =0.013)].Conclusion Some spectral CT characteristic parameters especially 55 -140 KeV mono-chromatic images can differentiate benign and malignant effusion.Spectral CT maybe afford a new method to differenti-ate benign and malignant effusion.
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Objective To investigate the application of hematology analyzer in cell counting of serous cavity effusion .Methods Humoral mode of Sysmex XE-5000 automated hematology analyzer and manual microscopy were employed to perform cell counting in 85 samples of serous cavity effusion .Results Compared with the manual method and instrument method ,differences of mononu-clear cells and multinucleated cells of serous cavity effusion showed no statistical significance (P>0 .05) ,while those of leukocytes , erythrocytes were found statistical significance (P<0 .05) .Conclusion Sysmex XE-5000 automated hematology analyzer has advan-tages of simple ,stability and accuracy ,however ,its application in the effusion cell counting can not completely replace the manual microscopy .