A case report of prostate cancer with ureteral metastasis / 中华泌尿外科杂志

Prostate cancer is a common malignancy in men, but rarely metastases to the ureter. A 68-year-old patient with ureteral metastases of prostate cancer was admitted to the hospital due to left lumbar and abdominal pain one month. Enhanced CT examination of urinary system after admission: mass in the middle of left ureter; multiple enlarged pelvic, retroperitoneal and left groin lymph nodes. After admission, the patient's PSA was 69.4 ng/ml, a prostate transrectal needle biopsy showed acinar adenocarcinoma. Under ureteroscopy, a smooth hard mass was seen 15 cm from the left ureteral orifice and completely obstructed the left ureter, the biopsy pathology showed infiltration of heteromorphic cell mass, and tumor could not be excluded. Laparoscopic ureteral tumor resection + end to end ureteral anastomosis was planned and intraoperative freezing was performed to determine the nature of the tumor. Due to severe adhesion around the tumor, partial nephrectomy, ureter and cystectomy were performed. The postoperative pathological diagnosis was ureteral metastasis of prostate cancer. The patient was treated postoperatively with abiraterone and goseririn for prostate cancer. CT examination 6 months after surgery showed multiple pelvic and retroperitoneal lymph node enlargement disappeared.

Clinicopathological Analysis of Brain Metastatic Carcinoma in Tibet / 中国医学科学院学报

Objective To investigate the clinicopathological features and immunohistochemical phenotypes of brain metastatic carcinoma in Tibetan patients. Methods The clinical and pathological data of all patients with brain metastases from 2014 to 2020 in Tibet Autonomous Region People's Hospital were retrospectively analyzed,including 13 cases of brain metastatic carcinoma.All cases were diagnosed and classified by immunohistochemical staining. Results 13 cases(9 males and 4 females)of brain metastatic carcinoma,aged 26-62 years old,present with headache,dizziness,nausea and vomiting clinically.Four patients had a medical history of tumor,and among the 9 patients with no history of tumor,7 present space occupying lesions in both the brain and other organs.Imaging data could be found in 10 cases,including 4 cases of single lesion and 6 cases of multiple lesions.Primary tumors were identified in 11 cases(8 located in the lung,including 4 cases of adenocarcinoma,3 cases of small cell carcinoma,and 1 case of squamous cell carcinoma;1 case of urothelial carcinoma of the renal pelvis;1 case of thyroid papillary carcinoma;1 case of uterine choriocarcinoma),whereas the primary tumor was unknown for the other 2 cases(1 case of small cell carcinoma and 1 case of adenocarcinoma). Conclusions Brain metastatic carcinoma are more common among middle-aged and elderly people in Tibet.Most of the cases have no history of tumor,with the initial site at the brain metastatic lesions.The most common primary site is the lung,and the primary site of some cases is unknown.Multiple lesions are common in brain metastatic carcinoma,especially in the cerebral hemisphere.For older patients with multiple brain space occupying lesions,the possibility of brain metastatic carcinoma increases.

Utility of triple tumor markers CA19-9, CA125 and CEA in predicting advanced stage of carcinoma gallbladder: a retrospective study

Background: A combination of serum tumor markers are used in the evaluation and prognosis of carcinoma gallbladder (GBC). Aim of the study was to find the significance of combined use of CA19-9, CA125 and CEA in advanced stage of GBC and to find the cut-off value of each of these tumor markers in metastatic GBC.   Methods: This was a retrospective observational cohort study over 1 year, which was carried out in 42 cases of advanced GBC. The patients were grouped in to locally advanced and metastatic stage on the basis of CECT scan findings. CA19-9, CA125 and CEA were assayed in all patients. These tumor markers were analysed with these two groups of GBCs. Statistical analysis was performed using R statistical software v3.6.2.Results: Out of 42 cases CA19-9 was elevated in 18 (78%), CA125 in 16 (70%) and CEA in 9 (39%) patients with metastatic disease. The cut-off value of CA19-9, CA125 and CEA was determined by ROC curve were >109 U/ml, 55.4 U/ml and 2.56 μg/l respectively. CA19-9 had the highest sensitivity 78.3% followed by CA125 69.6% and CEA has the highest specificity 68.4% for the diagnosis of metastatic stage of the disease. Specificity of these tumor markers were highest when used in combination.Conclusions: Combined use of triple tumor markers increases its specificity in the diagnosis of advanced stage of GBC but their cut-off level is statistically not significant in predicting metastatic GBC.

Imaging resemblance but diagnostic disparity in cervix cancer: a rare case report

F-18 FDG PET-CT is an establish modality for staging of cervical cancer. The high uptake value in PET with no evidence of necrosis in CECT is generally understood malignant pathology in known cancer patients. A 47 year-old-female with cervix carcinoma underwent staging FDG PET-CT. It showed FDG avid primary lesion in cervix with FDG avid pelvic, retroperitoneal, mediastinal and supraclavicular lymph nodes. USG guided FNA from the supraclavicular lymph node revealed tuberculosis. Now patient scheduled for ATT and chemotherapy.

Therapeutic Effect of CT-guided ¹²⁵I Seed Implantation on Advanced Lung Cancer and Pulmonary Metastatic Carcinoma / 中国肺癌杂志

BACKGROUND@#Primary lung cancer and metastatic lung cancer are common malignant tumors of the lung and are the main cause of cancer-related death. Advanced lung cancer and lung metastatic cancer are mainly treated by systemic therapy, and local treatment is also an effective treatment for the refractory or recurrent lesions in the lungs after systemic treatment. ¹²⁵I radioactive particle implantation, as an efficient conformal radiotherapy, has a certain control effect on localized lung cancer. The purpose of this study was to investigate the clinical efficacy and safety of computed tomography (CT) guided percutaneous puncture of lung tissue with ¹²⁵I radioactive particle implantation in the treatment of advanced lung cancer and lung metastatic cancer.@*METHODS@#Continuouslycollectedthe clinical and pathological data of 105 patients with advanced lung cancer and metastatic lung cancer treated by ¹²⁵I radioactive seed implantation in the Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2014 to November 30, 2018. The patients were followed until March, 2019. The clinical efficacy and complications of seedimplantation were analyzed.@*RESULTS@#A total of 105 patients were included in the study, 78 patients with advanced lung cancer and 27 patients with lung metastases. The median survival time after seed therapy was 395 days. The 1-year survival rate was about 78.1%, and the 2-year survival rate was about 56.1%. Seed implantation for advanced lung cancer is equivalent to lung metastasis. Seed combined with radiofrequency ablation, microwave ablation, and chemotherapy did not improve seed treatment. However, particle combined with external radiation therapy has a significant survival disadvantage compared with simple seed therapy.@*CONCLUSIONS@#The CT-guided ¹²⁵I radioactive seed implantation has controllable complications and can be used as a safe and effective treatment for advanced lung cancer and lung metastases.

The long-term clinical efficacy of tumor cytoreduction surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer / 解放军医学杂志

Objective: To study the long-term efficacy of cytoreduction surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis from colorectal cancer. Methods: The clinical data were collected of 103 patients with peritoneal carcinomatosis (PC) from colorectal cancer undergoing CRS with HIPEC in the Department of General Surgery of the First Medical Center of Chinese PLA General Hospital from January 1, 2012 to May 31, 2013, and divided into colonic group (n=60) and rectal group (n=43) according to the origin position of peritoneal cancer. The surgical status of patients (whether combined with other organ resection, number of stoma, peritoneal carcinomatosis index (PCI), completeness of cytoreduction (CC) score, transfusion, etc.) and the short-term complications and long-term survival after operation in the both groups were compared. Kaplan-meier method was used to draw the survival curve of patients, and log-rank method was employed to compare the survival differences between the two groups. Results: There was no significant difference in the surgical data between the two groups (PCI, CC score, hepatectomy, number of anastomosed stoma, transfusion, etc., P>0.05). The follow-up time of the 103 patients was (28.43±15.65) months, median survival time (OS) was 26.3 months, median disease free survival time (DFS) was 17.7 months, median recurrence to time of death (TTD) was 18.3 months. The 3-year and 5-year survival rate were 35.9% and 8.7%, respectively. The patients' survival was better in colonic group than in rectal group (OS: 28.5 months vs. 19.7 months; DFS: 21.1 months vs. 13.6 months; TTD: 22.3 months vs. 12.1months; 3-year survival rate: 48.3% vs. 18.6%; 5-year survival rate: 15.0% vs. 0, P<0.05). Conclusion: When CRS with HIPEC is implemented, the incidence of short-term complications in patients with PC originated from colon may match to those with PC originated from rectum, while the long-term efficacy is better in the former than in the latter.

Case report of splenic and bone marrow metastasis from breast cancer and literature review / 国际外科学杂志

Objective@#To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer.@*Methods@#Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23, 2019 were analyzed and literatures were reviewed.@*Results@#Patient admitted to hospital with pain in the left upper abdomen, accompanied with anemia and thrombocytopenia. CT suggested spleen occupying lesions. ECT implied bone metastasis. Bone marrow biopsy indicated breast cancer metastasis. Breast biopsy showed breast cancer. After using letrozole, the lesion of left breast and thevolume of spleen was reduced. The range of the spleen was lower than before. This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation.@*Conclusions@#Splenic and bone marrow metastasis from breast cancer are rare. Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases. Detailed case data, targeted examinations, and comprehensive analysis are important for reducing misdiagnosis.

Case report of splenic and bone marrow metastasis from breast cancer and literature review / 国际外科学杂志

Objective To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer.Methods Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23,2019 were analyzed and literatures were reviewed.Results Patient admitted to hospital with pain in the left upper abdomen,accompanied with anemia and thrombocytopenia.CT suggested spleen occupying lesions.ECT implied bone metastasis.Bone marrow biopsy indicated breast cancer metastasis.Breast biopsy showed breast cancer.After using letrozole,the lesion of left breast and thevolume of spleen was reduced.The range of the spleen was lower than before.This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation.Conclusions Splenic and bone marrow metastasis from breast cancer are rare.Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases.Detailed case data,targeted examinations,and comprehensive analysis are important for reducing misdiagnosis.

Fine Needle Aspiration Cytology (FNAC) Lymph Node - A Diagnostic Tool for Histopathological Diagnosis in a Tertiary Care Teaching Hospital

Background: Fine Needle Aspiration Cytology (FNAC) is used to evaluate the nature of the lesion. Lymphadenopathy in head and neck region have wide spectrum etiology vary from benign reactive hyperplasia to tubercular granulomatous lesion to malignancy. The present study was undertaken to evaluate the sensitivity, specificity and predictive value in tuberculosis and metastatic carcinoma. Methods: A total of 70 patients out of 180 patients at Geetanjali Medical College & Hospital, Udaipur, Rajasthan, who underwent FNAC were evaluated by histopathological examination for correlation. Aspiration smears and histopathological slides were evaluated and results were calculated for sensitivity, Specificity and predictive value. Results: Reactive lymphadenitis was seen in 37 patients followed by tubercular granulomatous lymphadenitis in 17 patients and malignant lesions in 16 patients. Histology revealed 16 patients of tubercular lymphadenitis, 41 of reactive changes, 11 of metastasis in lymph nodes and 5 of lymphomas. Correlating the findings, we could achieve 100% sensitivity and 96.7% specificity for tubercular lymphadenopathy and for metastatic it was 98.5% and 100% respectively. Conclusions: We have discovered FNAC an agreeable instrument in the conclusion of tubercular and harmful lymphadenopathy. FNAC utilized as a part of conjunction with clinical discoveries, radiological and research center examinations can be a financially savvy strategy for the determination of lymphadenopathy

Analysis of relation between 18F-FDG PET/CT and clinical manifestations for patients with bone metastases from prostate cancer / 医疗卫生装备

Objective To analyze the relationship between 18F-FDG PET/CT manifestations,tumor differentiation and PSA for the patients with bone metastases from prostate cancer.Methods Retrospective analysis was executed on the distribution,number and density of bone metastases tumor and FDG uptake as well as the relationship between serum PSA,FDG uptake of bone metastases focus,type of bone metastases and the involved range.Results Of the 25 cases,there were 8 ones of poorly differentiated carcinoma and 17 ones of moderately differentiated carcinoma.All the patients had serum PSA higher than 10 μg/ml,of whom there were 19 ones had the PSA not lower than 20 μg/ml.Eight patients with bone metastases restrained in the pelvis and lower lumbar vertebra,and the remained 17 ones had multiple or diffuse bone metastases.Fisher's exact test showed that non-osteoblastic metastases were more common in low-and medium-differentiation patients (P=0.022),the typing of bone metastases had no relationship with the enhancement of PSA,and there were no statistical differences between the involved ranges of the patients.Conclusion Bone metastases from prostate cancer often occurs in the patient with obviously enhanced PSA and poorly differentiation.18F-FDG PET/CT behaves well in the early diagnosis of bone metastases from prostate cancer.18F-FDG PET/CT manifestations differ with the differentiation of carcinoma,poorly differentiated carcinoma shows non-osteoblastic metastases and high FDG uptake,and moderately differentiated carcinoma appears as osteoblastic metastases and low FDG uptake.There is no confirmed correlation between PET/CT manifestation and total serum PSA for the patients with bone metastases from prostate cancer.

CT Perfusion Imaging Can Predict Patients' Survival and Early Response to Transarterial Chemo-Lipiodol Infusion for Liver Metastases from Colorectal Cancers

OBJECTIVE: To prospectively evaluate the performance of computed tomography perfusion imaging (CTPI) in predicting the early response to transarterial chemo-lipiodol infusion (TACLI) and survival of patients with colorectal cancer liver metastases (CRLM). MATERIALS AND METHODS: Computed tomography perfusion imaging was performed before and 1 month after TACLI in 61 consecutive patients. Therapeutic response was evaluated on CT scans 1 month and 4 months after TACLI; the patients were classified as responders and non-responders based on 4-month CT scans after TACLI. The percentage change of CTPI parameters of target lesions were compared between responders and non-responders at 1 month after TACLI. The optimal parameter and cutoff value were determined. The patients were divided into 2 subgroups according to the cutoff value. The log-rank test was used to compare the survival rates of the 2 subgroups. RESULTS: Four-month images were obtained from 58 patients, of which 39.7% were responders and 60.3% were non-responders. The percentage change in hepatic arterial perfusion (HAP) 1 month after TACLI was the optimal predicting parameter (p = 0.003). The best cut-off value was -21.5% and patients who exhibited a > or = 21.5% decrease in HAP had a significantly higher overall survival rate than those who exhibited a < 21.5% decrease (p < 0.001). CONCLUSION: Computed tomography perfusion imaging can predict the early response to TACLI and survival of patients with CRLM. The percentage change in HAP after TACLI with a cutoff value of -21.5% is the optimal predictor.

The clinical analysis of adrenal tumor combined with renal carcinoma in 42 patients / 中华内分泌代谢杂志

Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.

Proximal femoral nail antirotation and bone cement in treatment of metastatic tumors of the peritrochanteric region of femur / 中国医师进修杂志

Objective To investigate the effect of internal fixation with proximal femoral nail antirotation (PFNA) and bone cement on peritrochanteric tumors due to metastatic carcinoma.Methods Clinical data of 19 patients with peritrochanteric tumors due to metastatic carcinoma during June 2007 and July 2013 treated with PFNA and bone cement were retrospectively analyzed.Results Visual analogue scale(VAS) was (8.37 ± 1.12) scores before surgery,and (2.58 ± 1.26) scores after 3 d surgery.There was significant difference (t =22.45,P ＜ 0.05).Conclusion For patients with peritrochanteric tumors due to metastatic carcinoma,internal fixation with PFNA and bone cement is an effective way to relieve pain,restore and improve hmb function and enhance quality of life.

Radioactive 125I seed implantation for the treatment of recurrent cervical lymphatic metastases after radiotherapy：preliminary results in 17 cases / 介入放射学杂志

Objective To investigate the safety and effectiveness of radioactive 125I seed implantation in treating recurrent cervical lymphatic metastases after radiotherapy. Methods During the period from Aug. 2011 to July 2012, 17 patients with recurrent cervical lymphatic metastases who had received radiotherapy before were admitted to authors’ hospital. The clinical data were retrospectively analyzed. A total of 23 metastatic lymph nodes were detected in the 17 patients. Brachytherapy treatment planning system (TPS) was used to formulate the number, activity and distribution of radioactive 125I seeds. The radioactive activity was 0.3 - 0.8 mCi (1.30 × 107- 2.96 × 107 Bq), and the matched peripheral dose (MPD) was 60 - 120 Gy. Guided by ultrasound and CT radioactive 125I seeds were implanted under local anesthesia. CT scanning was performed within 24 hours after the procedure. Postoperative D90 was (81.4 ± 2.1) Gy. CT examination was employed every two months to determine the tumor size and to record the complications. Results All patients were followed up for 6 months. The 6-month local control rate was 65.2%. The control rates (CR+PR) for4 cm (n=13) lymph nodes were 90%and 46%respectively, the difference between the two was statistically significant (P = 0.038). No significant difference existed between the control rate (CR + PR) and the un-control rate (SD + PD) for each lymph node group at cervical Ⅰ, Ⅱ, Ⅲ and Ⅴ grade Ⅱ was seen in 8 cases and grade Ⅰ in 7 cases. No severe complications occurred. Conclusion For the treatment of recurrent cervical lymphatic metastases after radiotherapy, radioactive 125I seed implantation is effective and mini-invasive with fewer complications. This technique is more suitable for < 4 cm solitary metastatic lymph node with clear border.

Metástasis coroideas: clarinada hacia la nada: presentación de casos icónicos / Choroid metastasis: clarion call toward nothing: presentation of two iconic cases

La metástasis intraoculares de tumores sólidos o hematológicos, son un problema clínico para el oftalmólogo práctico y el oncólogo. La localización más frecuente es la coroides, constituyendo el tumor intraocular más frecuente. Suelen diagnósticarsé en pacientes en estadios tumorales muy avanzados, por lo que en el pasado la mayoría de las series publicadas eran descripciones de necropsias. Su diagnóstico generalmente puede hacerse mediante cuidadoso examen. Se estima que la frecuencia general en pacientes que fallecen por cáncer es de aproximadamente 12%, pero puede elevarse en 37% en aquellos con carcinoma mamario, muy superior a la de los tumores primarios, fundamentalmente los melanomas. No obstante, sin compresión ha aumentado en años recientes ofreciendose nuevas formas de tratamiento siendo todavía la radioterapia la que permite a los pacientes mantener una visión.

Intraocular metastases of solid and hematological tumors are clinical problem for the practicing ophthalmologist and oncologist. Its diagnosis can usually be made through careful examination. The most common intraocular tumor. They are often diagnosed in patients in very advanced tumor stages, which is why in the past most of the published series were descriptions of necropsies. The overall frequency of ocular metastases in patients dying of cancer is approximately 12%, but it can be as high as 37% in patients with breast cancer, highly superior to primary tumors, mainly melanomas. Hawever, our understanding of them has increased in recent years, offering new forms of treatment. Radiation therapy is still the cornerstone of treatment, allowing nost patients to maintain usefull vision. Clinical cases with photographic support of an iconic patient are presented to illustrate the problem.

Metastatic Carcinoma Manifesting as Clubbed Finger in a Patient with Lung Cancer / 대한피부과학회지

Metastatic carcinoma on the hand occurs in 0.1% of all metastasis and the diagnosis is difficult since it frequently mimics other conditions such as infection, osteomyelitis, gout, and pseudoclubbing. A 70-year-old woman with lung carcinoma was consulted for the evaluation of a painful swelling patch on the tip of her right 2nd finger. She was initially treated with antibiotics due to the misdiagnosis of the condition as an infection. Her pain persisted for a month. The skin biopsy revealed a metastatic adenocarcinoma with papillary growth pattern. We report a rare and an interesting metastatic carcinoma manifesting as clubbed finger.

METASTATIC CANCER OF THE MANDIBLE: A CASE REPORT

Research progress in minimally invasive treatment of spinal metastatic carcinoma / 国际生物医学工程杂志

With the development of modem tumor diagnostic techniques and therapies, the survival rate of malignant tumor has been remarkably increased. With the increase in survival rate of cancer-beating patients, the chance of tumor metastasis is elevated. Minimally invasive treatment provides a new strategy to the therapy of spinal metastatic carcinoma. Its benefits include smaller surgical wound,, higher efficacy and fewer complications, and thus have a broad application prospects in the field of spinal metastatic tumors. In this article, a general re-view is given on minimally invasive treatments of spinal metastatic carcinoma, as well as the latest progress in the field. It was proposed that the united application of the treatment might be a promising hot spot of tumor therapy.

The Cytopathology of Body Cavity Fluid / 대한세포병리학회지

Cytologic examination of the body cavity fluid is very important because the specimens represent a significant percentage of nongynecologic samples and this cytologic examination may be the first, best or only chance for making the diagnosis of an underlying malignancy. The purposes of body cavity fluid examination are to correctly identify cancer cells and if possible, to identify the tumor types and primary sites when presented with unknown primary tumor sites. The most important basic differential diagnosis is that of benign and reactive disease vs malignant disease. Reactive mesothelial cells are a consistent population in body cavity fluid, and these are the most versatile cells in the body. Due to the specific environment of the body cavity, the exfoliated reactive mesothelial cells may show significant morphologic overlap with the morphology of cancer cells. With a focus on the differential points between reactive mesothelial cells and metastatic adenocarcinoma cells, the practical diagnostic approaches, the diagnostic clues and the pitfalls to achieve a correct diagnosis are presented in this review.

Effects of Sangu Decoction on OPG-RANKL-RANK pPathway in rat model of metastatic carcinoma / 中华中医药杂志

Objective:To evaluate the anti-metastatic and bone preserving therapeutic effects of herbal medicine extraction on rat model of bone metastatic carcinoma.Methods:A rat model of cancer-induced bone pain using the MRMT-1 cell line injected into the tibia was established to investigate the efficacy of the herbal medicine extraction,on osteoclast activity and bone mineral density.The development of the bone tumor and structural damage to the bone was monitored by radiological analysis.Specimens of the tibial bone were processed for tartrate-resistant acid phosphatase(TRAP)stain to observe the bone pathological changes and count TRAP stained osteoclasts.OPG and RANKL expression was evaluated by immunohistological methord.Results:Histological and radiological examination showed that the herbal medicine extraction significantly inhibited tumor proliferation and preserved the cortical and trabecular bone structure.In addition,a dramatic reduction of tartrate resistant acid phosphatase-positive polykaryocytes(osteoclasts)and increase of OPG expression were observed.Conclusions:The herbal medicine extraction was an anti-metastatic and bone preserving therapeutic effects in a rat model of metastatic cancer pain.