Calcifying fibrous tumor: a clinicopathological analysis of 32 cases / 中华病理学杂志

Objective@#To investigate the clinicopathological characteristics, histogenesis, immunophenotypes, molecular genetic characteristics, diagnosis and differential diagnosis of calcifying fibrous tumors (CFT).@*Methods@#A total of 32 cases of CFT (22 cases from Henan Provincial People′s Hospital and 10 cases from PLA Army Medical Center) diagnosed between June 2009 and February 2019 were reviewed. The clinical and pathologic data were analyzed.@*Results@#There were 12 male and 20 female patients, aged from 15 to 63 years (mean 40.8 years). Eleven cases occurred in stomach, four cases in retroperitoneum, four cases in ovary, two cases in scrotum, two cases in mediastinum, two cases in head and neck, one case each in thoracic cavity, lung, adrenal gland, kidney, sigmoid colon, epididymis and mesosalpinx. All the tumors were solid masses with clear boundaries. The maximal dimension of the tumors ranged from 0.6 to 10.0 cm. Microscopically, there was hypocellular stromal sclerosis and wavy storiform coarse collagen with superimposed scattered or patchy lymphocytes and plasma cells; calcification or gravel formation were also detected. Immunohistochemistry showed that spindle cells were positive for vimentin and some were positive for CD34; and they were negative for calponin, SMA, desmin, S-100 protein, SOX10, STAT6, β-catenin, ALK, CD117, DOG1, CKpan, and EMA. No ALK rearrangement was detected by FISH in all cases. No C-KIT and PDGFRA mutation was detected in all the tested 11 cases of stomach, four cases of retroperitoneal and one case of sigmoid colon CFT. MDM2 was not amplified by FISH in all four tested cases of retroperitoneal CFT.@*Conclusions@#CFT is a rare benign tumor of fibroblastic cell origin. The diagnosis mainly depends on histomorphologic analysis and immunophenotyping. CFT should be differentiated from other benign and malignant spindle cell mesenchymal tumors.

MRI features to differentiate between peliosis hepatis and hepatic metastases following chemotherapy for gastrointestinal adenocarcinoma / 中华肝胆外科杂志

Objective@#To compare the MRI features of peliosis hepatis and hepatic metastases following chemotherapy for gastrointestinal adenocarcinoma with the aim to improve the differential diagnosis.@*Methods@#The clinical data of 33 patients with gastrointestinal adenocarcinoma treated from June 2014 to December 2017 at Zhongshan Hospital of Fudan University were retrospectively analyzed. Of the 26 males and 7 females aged (56.0±9.8) years, there were 11 patients with peliosis hepatis and 22 patients with hepatic metastases following chemotherapy in these patients. All patients underwent contrast-enhanced abdominal MRI scans. The differences in the MRI features, including morphology, margin, signal intensity on plain scanning and enhancement patterns were compared statistically. The apparent diffusion coefficient (ADC) values of peliosis hepatis, hepatic metastases and adjacent hepatic parenchyma were measured in an ADC map.@*Results@#In 14 lesions of the 11 patients with peliosis hepatis, 10 lesions were ill-defined and 4 lesions were well-defined. In 31 lesions of the 22 patients with hepatic metastases, 5 lesions were ill-defined and 26 lesions were well-defined. Significant differences existed between peliosis hepatis and hepatic metastases in the margin (P<0.05). The ADC value of hepatic metastases was significantly lower than that of peliosis hepatis and the adjacent hepatic parenchyma (P<0.05). In all the 14 lesions of peliosis hepatis, 10 lesions showed gradual filling enhancement, and 4 lesions showed marked and persistent enhancement. In all the 31 lesions of hepatic metastases, 28 lesions showed a ring-shaped enhancement, and 3 lesions showed "quick in and quick out" enhancement.@*Conclusions@#The lesions of peliosis hepatis following chemotherapy for gastrointestinal adenocarcinoma were ill-defined, with no restriction of water diffusion in the diffusion weighted imagings, and with progressive enhancement. The MRI manifestations of peliosis hepatis helped to differentiate peliosis hepatis from hepatic metastases of gastrointestinal adenocarcinoma.

MRI features to differentiate between peliosis hepatis and hepatic metastases following chemotherapy for gastrointestinal adenocarcinoma / 中华肝胆外科杂志

Objective To compare the MR] features of peliosis hepatis and hepatic metastases following chemotherapy for gastrointestinal adenocarcinoma with the aim to improve the differential diagnosis.Methods The clinical data of 33 patients with gastrointestinal adenocarcinoma treated from June 2014 to December 2017 at Zhongshan Hospital of Fudan University were retrospectively analyzed.Of the 26 males and 7 females aged (56.0 ± 9.8) years,there were 11 patients with peliosis hepatis and 22 patients with hepatic metastases following chemotherapy in these patients.All patients underwent contrast-enhanced abdominal MRI scans.The differences in the MRI features,including morphology,margin,signal intensity on plain scanning and enhancement patterns were compared statistically.The apparent diffusion coefficient (ADC) values of peliosis hepatis,hepatic metastases and adjacent hepatic parenchyma were measured in an ADC map.Results In 14 lesions of the 11 patients with peliosis hepatis,10 lesions were ill-defined and 4 lesions were well-defined.In 31 lesions of the 22 patients with hepatic metastases,5 lesions were ill-defined and 26 lesions were well-defined.Significant differences existed between peliosis hepatis and hepatic metastases in the margin (P ＜ 0.05).The ADC value of hepatic metastases was significantly lower than that of peliosis hepatis and the adjacent hepatic parenchyma (P ＜ 0.05).In all the 14 lesions of peliosis hepatis,10 lesions showed gradual filling enhancement,and 4 lesions showed marked and persistent enhancement.In all the 31 lesions of hepatic metastases,28 lesions showed a ring-shaped enhancement,and 3 lesions showed "quick in and quick out" enhancement.Conclusions The lesions of peliosis hepatis following chemotherapy for gastrointestinal adenocarcinoma were ill-defined,with no restriction of water diffusion in the diffusion weighted imagings,and with progressive enhancement.The MRI manifestations of peliosis hepatis helped to differentiate peliosis hepatis from hepatic metastases of gastrointestinal adenocarcinoma.

Hepatic angiomyolipoma: a clinicopathologic features and prognosis analysis of 182 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathological characteristics of hepatic angiomyolipoma (HAML) and to evaluate the correlation between clinicopathological parameters and tumor subtypes.</p><p><b>METHODS</b>Retrospective analysis of clinicopathological features was conducted in 182 cases of HAML.</p><p><b>RESULTS</b>HAML patients were predominantly female (M:F=1:4) and most commonly presented with non-specific symptoms. The median age at diagnosis was 46 years, ranged from 17 to 77 years. Tumor diameter was ranged from 0.3 to 32.0 cm with an average of 5.0 cm. Majority of the tumor was epithelioid type (112/165, 67.9%). Extramedullary hematopoiesis, multinucleated giant cells, intranuclear inclusions, nucleolus, cellular atypia, invasive growth pattern, multiple masses, hyperpigmentation and purpura-like changes mostly occurred in the epithelioid type (P<0.05). Extramedullary hematopoiesis was commonly seen in HAML, the significance of which was still uncertain.</p><p><b>CONCLUSIONS</b>Most of HAML are epithelioid type, characterized by a proliferation of predominantly epithelioid cells, in which extramedullary hematopoiesis is commonly seen. Some morphologic features that may predict malignant such as necrosis, mitotic figures, and tumor emboli are only found in the epithelioid HAML. Mitotic activity, tumor necrosis, tumor thrombus, giant cells, periportal invasion, multiple lesions and tumors size over 10 cm are closely related with tumor recurrence and metastasis.</p>