Clinicopathologic features and differential diagnosis of multilocular cystic renal cell carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and the diagnosis of multilocular cystic renal cell carcinoma (MCRCC).</p><p><b>METHODS</b>The clinicopathological data of 19 MCRCC cases were collected and immunohistochemical staining assays were carried out. Forty-six cases of other cystic kidney lesions within the same period were collected as controls, including extensively cystic clear cell RCC (12 cases), clear cell tubulopapillary renal cell carcinoma (6 cases), tubulocystic carcinoma (2 cases), simple cortical cysts (22 cases), multilocular cystic nephroma (1 cases) and multicystic kidney (3 cases).</p><p><b>RESULTS</b>The patients included 14 males and 5 females. The ages ranged from 31 to 66 years (median age = 50 years). Most of the MCRCC cases were detected incidentally in physical examination, occasionally accompanied with hematuria, back pain or other symptoms. The follow-up period of 17 patients ranged from 6 to 170 months. All patients were alive without evidence of tumor recurrence or metastasis. Pathological findings showed that macroscopically, tumor size ranges from 1.5 to 7.0 cm in the maximum diameter, generally a entirely of various sized. The cysts contain serous, hemorrhagic or turbid fluid. Solid areas or substantially discernible mural nodules were absent; histologicallly, single layer of cuboidal and flattened epithelial tumor cells were lined in the cysts, described as clear cytoplasm, small nuclear, no nucleoli and low Fuhrman nuclear grade (I or II). Multilayer tumor cells could be observed in a few cysts, with granular cytoplasm and small intracystic papillae formed. The clear tumor cell clusters, similar as cystic lined tumor cells, were seen within pathological fibrous in almost all cases, and significant myofibroblastic proliferation was found in 14 cases. Immunohistochemically, the cysts lined epithelial cells and the clear tumor cell clusters were positive for epithelium markers, including CKpan(19/19), EMA(16/19) and CK7 (15/19); higher percentage of CAIX (17/19) and PAX8(15/19) than control groups, but lower percentage of CD10 (7/19), RCC (6/19) and AMACR(2/19); and all were negative for 34βE12, CD117 and CD68.</p><p><b>CONCLUSIONS</b>Multilocular cysts, clear cells clusters of low Fuhrman grade within fibrous septa and capillary vessel proliferation under epithelium are important features of MCRCC. The united using of CAIX, CK7, CD10 and RCC is helpful for differentiating variable cystic renal tumor. MCRCC usually has an excellent prognosis, nephron sparing surgery is first recommended as a therapeutic strategy.</p>

The Effect of Helicobacter Pylori Eradication on Atrophy of Gastric Antrum Mucosa and Intestinal Epithelium Mucosae Metaplasia / 中国慢性病预防与控制

Objective To investigate the pathological changes of gastric antrum mucosa after Helicobacter pylori eradication.Methods Total 180 cases who suffered from epigastralgia and took the endoscopic examination were randomly divided into two groups,one was Hp eradication group which included 98 cases and given anti-Hp medication treatment,and the other was control group which included 82 cases and given an expectant treatment.At the end of the study,they took reexamination by gastroscope and tests on Hp by Giemsa dyeing & rapid urase detection and on gastric antrum pathological changes by HE dyeing.Results In treatment group,atrophic gastritis as well as intestinal metaplasia decreased significantly after Helicobacter pylori eradication,but in control group,no change of atrophic gastritis was found while intestinal metaplasia aggravated.Conclusion The eradication of Helicobacter pylori is able to decrease atrophic gastritis and intestinal metaplasia.