Clinicopathological observation of adamantinoma of long bone / 中华病理学杂志

Objective@#To investigate the clinicopathological features and differential diagnosis of adamantinoma of long bone.@*Methods@#Seven cases of adamantinoma on long bone were selected at Jiangsu Province People′s Hospital from June 2012 to May 2018. Clinicopathologic details, immunohistochemical and molecular analysis were performed,and the relevant literature reviewed.@*Results@#There were 6 males and 1 female patients,age ranging from 21 to 60 years (mean 38 years). Six cases were on the right side and one case was on the left; in five cases the tumors arose from tibia, one from patella and one from humerus. Microscopically,tumour cells were mainly composed of spindle cells arranged in bundles or braids,with irregular epithelial island. Immunohistochemically,the epithelial island expressed high molecular weight cytokeratin but not CK8/18. Both epithelial and spindle components expressed vimentin. One case that was microscopically similar to intraosseous synovial sarcoma did not show SYT gene rearrangement. Clinical follow-up was available for five patients: one patient had axillary metastases seven months after operation, one patient had recurrence 34 months after surgery, 3 patients were uneventful with follow up duration from half a month to 32 months.@*Conclusion@#Adamantinoma occurring in long bones is very rare. The correct diagnosis requires adequate sample selection, careful morphologic observation, immunohistochemistry and molecular genetics.

Recurrent swelling of lower limbs (lymphedema) as manifestations of idiopathic hypereosinophilic syndrome: a case report / 中华皮肤科杂志

A 21-year-old male was hospitalized for recurrent swelling of lower limbs (lymphedema) for 1 year and worsening of it for 1 week.Physical examination revealed several smooth,firm enlarged lymph nodes of the neck,groin without apparent tenderness measuring about 1 cm in diameter.Cardiac and pulmonary auscultation showed no obvious abnormality.The abdomen was soft on palpation without tenderness or rebound tenderness.Skin examination revealed swelling of both lower limbs,especially the left lower limb,as well as scattered irregularly sized,dark erythematous patches with a wood-like consistency on the swollen lower limbs,with high temperature but no tenderness.Elevated peripheral eosinophil count was observed before and after admission,with the eosinophil percentage higher than 70％.Vascular ultrasonography showed thrombosis in the right anterior tibial artery,left dorsal artery of foot and lower portion of the left great saphenous vein.Multiple enlarged lymph nodes were found by computed tomography in the mediastinal,bilateral axillary,retroperitoneal regions and around the abdominal aorta.Lymph node and bone marrow biopsies showed eosinophilia.Histopathology of lesions on the extensor aspect of the left medial thigh and left lateral malleolus showed massive eosinophilic infiltration and lymphatic dilation in the dermis,as well as eosinophil emboli in some lumens.The FIP1L1-PDGFRA fusion gene was undetected.A diagnosis of idiopathic hypereosinophilic syndrome was finally made.The symptoms rapidly regressed after glucocorticoid treatment.