Clinicopathological characteristics and imaging features of pulmonary adenocarcinoma with micropapillary pattern / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinicopathological characteristics and imaging features of lung adenocarcinoma with a micropapillary pattern (MPP).</p><p><b>METHODS</b>Eighty cases of pulmonary adenocarcinoma with a micropapillary pattern treated in our hospital from July 2011 to December 2012 were selected to retrospectively analyze their clinicopathological characteristics and imaging features.</p><p><b>RESULTS</b>Among the 80 cases of lung adenocarcinoma with MPP, there were 38 cases of stage I (47.5%), 12 cases of stage II (15.0%), 25 cases of stage III (31.3%) and 5 cases of stage IV (6.2%). There were 14 cases of moderately differentiated (17.5%) and moderately/poorly differentiated (82.5%) tumors. Sixty-three cases had pleural involvement, vascular invasion, involving the bronchial wall, invasion of large vessels, nerve invasion, and lymph node metastasis (at least one of them) (78.8%). Immunohistochemical staining revealed that both positive rates of TTF-1 and CK7 were 100%, and that of pulmonary surfactant apolipoprotein-A (SPA) was 84.0%. Imaging examination revealed hilar or mediastinal lymph node enlargement in 15 cases (18.8%). but the pathology confirmed hilar or mediastinal lymph node metastasis in 36 cases (45.0%). Lung CT imaging showed that the majority of the cases were peripheral type, and only a few of central type, and most cases were solid lesions, with lobulation, spiculation, pleural indentation, and vascular convergence sign, while there were few ground-glass opacity sign and vacuole sign.</p><p><b>CONCLUSIONS</b>Lung adenocarcinoma with MPP component often presents with early invasions of pleura, blood vessels, lymphatic vessels, and lymph nodes. Imaging manifestation of this cancer mainly shows as peripheral and solid lesions, often with lobulation, spiculation, pleural indentation, vascular convergence sign, but GGO and vacuole signs are unusual. Overexpression of TTF-1, CK7 and SPA, and elevated CEA level are associated with clinical staging of the disease.</p>

Super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithoto my / 中华泌尿外科杂志

Objective To evaluate the outcome of super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithotomy (PCNL) and its effect on renal function. Methods From May 2008 to Feb 2010,severe bleeding occurred in 7 patients after PCNL in our hospital.(5 males and 2 females,average age of 54.9 years ).All cases were treated with super-selective renal angiography and 6 cases underwent microcoil embolization. Results Renal angiography showed pseudoaneurysm in 5 cases,pseudoaneurysm with arteriovenous fistula in 1 case and no severe bleeding in 1 case.Successful coil embolization was confirmed in 6 cases by angiography,and bleeding stopped within 3 -7 days after embolization.Serum creatinine and blood urea nitrogen were 59 -98 μmol/L(mean,78.3 μmol/L) and 1.86 -6.92 mmol/L( mean,4.8 mmol/L) 2 weeks after embolization,respectively. Conclusions Super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithotomy has the advantages of remarkable hemostatic effects and mild impaired renal function,which is of the first choice.

Application of low-dose in 3D CT pulmonary angiography / 中华放射医学与防护杂志

Objective To explore the feasibility of low-dose multi-slice computed tomography(MSCT) scan on pulmonary artery three-dimensional angiography, and the relationship between pulmonary VR image quality and the SD value of plain scan. Methods Pulmonary artery CT examination was performed in 87 patients. 63 volunteers were administered with low dose as a low-dose group, and the other 24 were scanned with conventional dose as a routine group. Both plain scans were use conventional dose of pulmonary scan with 150 mAs, and the low-dose pulmonary enhanced scans were used with 60 mAs. The images were post-processed with volume rendering(VR) and classified into three grades A, B and C, and VR image quality levels of both groups compared. The receiver operating characteristic curve( ROC) was used to analyze the relationship between VR image quality level and SD value of plain scan image SD value. Results The VR image level of A-class was 100% in the conventional dose group, and 85. 7% was in the low dose group . According to the correlation analysis between the standard deviation(SD) value of plain scan image and pulmonary artery VR image quality, the area under curve in receiver-operated characteristic analysis was 0. 906. Conclusions The low-dose scan of pulmonary artery three-dimensional angiography is feasible. Using 60 mAs low-dose in pulmonary artery enhanced scan could ensure better image quality. With the SD value of the plain scan decreased, the pulmonary artery VR image quality is improved.