Fluorescence in-situ hybridization as a diagnostic tool for cutaneous melanoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the utility of fluorescence in situ hybridization as a diagnostic tool for cutaneous melanoma.</p><p><b>METHODS</b>Twenty cutaneous melanomas and 20 cutaneous nevi from pathology files were selected and analyzed by Vysis melanoma FISH probe kit targeting 3 loci on chromosome 6 (MYB, CEP6 and RREB1) and 1 locus on 11q (CCND1) and data were interpreted based on the Abbott criteria provided by the kit.</p><p><b>RESULTS</b>Informative FISH results were obtained in 16 melanomas and 18 nevi. Chromosomal aberrations were detected in 12 of the 16 melanomas and only 1 of 18 nevi.</p><p><b>CONCLUSION</b>FISH is a useful diagnostic tool and able to distinguish cutaneous nevus from melanoma with good sensitivity and specificity.</p>

Tumors with poroid features: a clinicopathologic analysis of 45 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features and the differential diagnosis of poroma and porocarcinoma.</p><p><b>METHODS</b>Histopathological characteristics and clinical data of 35 cases of poroma and 10 cases of porocarcinoma were analyzed retrospectively.</p><p><b>RESULTS</b>The average age of 35 patients of poroma was 48 years. The average age of 10 patients of porocarcinoma was 65 years. Both poroma and porocarcinoma occured most frequently on the scalp and face,as well as the extremities. Histologically, cases of poroma were divided into three subtypes, including classic poroma (23 cases), hidroacanthoma simplex (3 cases) and dermal duct tumor (9 cases). Residual foci of benign poroma were found in all cases of porocarcinoma, most of which were classic poroma. The malignant components showed severe dysplasia and/or stromal infiltration.</p><p><b>CONCLUSION</b>The diagnosis of poroma and porocarcinoma is mainly based on the microscopic characteristics. An invasive architectural pattern and/or significant cytologic pleomorphism are the most important clues for the diagnosis of porocarcinoma. Neither focal mitotic activity nor the presence of necrosis was the diagnostic feature of porocarcinoma. Malignant transformation can occur in some cases of long existing poroma with recent, rapid tumor enlargement.</p>

Clinicopathologic analysis of spiradenoma: 25 case reports / 中华皮肤科杂志

Objective To analyze clinicopathologic features and malignant transformation of spiradenoma (SA).Methods Clinicopathologic data on 25 cases of SA were retrospectively analyzed.An immunohistochemical study was conducted on 5 of the 25 patients.Clinicopathologic features of SA were summarized based on clinicopathologic data,immunohistochemical results and relevant literature.Results The average age of these patients was 40 years.Lesions were acquired and solitary in 24 cases (96％,24/25),and occurred most frequently in the extremities.The diameter of tumors was less than 2 cm in 20 cases (87％,20/23).Twenty-three cases were benign SA with various histological manifestations,including 15 cases (65％,15/23) of typical SA,8 cases (35％,8/23) of cylindroma.VarTing numbers of mitotic figures were observed in different cases.The immunohistochemical study showed epithelial and myoepithelial differentiation.Two cases of SA experienced malignant transformation into poorlydifferentiated basal cell adenocarcinoma and well-differentiated adenocarcinoma respectively.Lymphocytes decreased significantly in number or disappeared in the malignant area,and both the malignant tumors exceeded 2 cm in diameter.Conclusions SA is a kind of neoplasm with distinct histological characteristics and nonspecific clinical manifestations.Most SA cases have a benign clinical course,but malignant transformation should be considered in some cases with longterm clinical course and large size.

Fibromucinous Primary Cutaneous T -Cell Lymphoma Rich in Blood Vessels: A Case Report / 中华皮肤科杂志

Objective To study a new clinicopathological subtype of primary cutaneous T-cell lym phoma (PCTCL). Methods A case of T-cell lymphoma was systematically evaluated clinically and by using H-E staining, special staining,immunohistochemical staining,gene rearrangement and PCR.Results The skin lesion presented as tender nodules with mucocele. Skin biopsies showed that in the dermis and subcutaneous tissue,most of the angiotropic tumor cells were small T cells; no obvious epidermotropic phenomenon was detected.A few vessels were observed with obvious fibromucinous matrix formation. Immunohislochemical studies showed the following:CD3(+),CD43(+),CD45RO(+),CD56(a few),CD68(-), CD79?(-),CD20 (-), CD30(-), CD117(-), ALK(-), S-100(-),CD45R(-),EMA(-),SMA(-).The mucoid matrix was positive for Alcian blue staining.The rearrangement of T-cell ? receptor gene was detected.EBV was not detected with PCR.Conclusion Fibromucinous T-cell lymphoma rich in blood vessels is a new and distinct variant of PCTCL; it is not a subtype of mycosis fungoides.

Monoclonal antibodies against human telomerase reverse transcriptase: preparation, characterization, and application / 中华病理学杂志

<p><b>OBJECTIVE</b>To develop monoclonal antibodies against the catalytic subunit of human telomerase hTERT for its expression detection of human tumors.</p><p><b>METHODS</b>A dominant epitope in hTERT (peptide hTERT(9))was automatically synthesized based on Fmoc method, and was used to immunize BALB/c mice. Hybridomas were generated and screened by ELISA for specific monoclonal antibodies, and the characterization of which were performed by Western blotting and immunohistochemical staining.</p><p><b>RESULTS</b>Antigenic peptide hTERT(9) was synthesized and confirmed by MALDI-TOF-MS and HPLC analysis. Three hybridoma cell lines secreting anti-hTERT(9) antibodies designated as H4, G8 and A11 were established after primary screening and consequent three rounds of limited dilution. Both of H4 and G8 were IgM, while A11 was IgG1 in isotyping. The competitive assay showed that the antibodies were hTERT(9) specific, and the affinity of G8 was stronger than that of H4 and A11 assayed by affinity ranking. However, in Western blotting, both of H4 and G8 stained an about 123 000 protein band with HeLa and 293 cell extracts but not with normal 2BS cells. Besides, positive staining presented in the nucleus of HeLa, while 2BS was non-reactive immunohistochemically. The sections from paraffin-embedded blocks of 127 cases of human cancer, 40 of precancerous and 19 of benign tumors were in situ stained by G8 antibody, the results showed that the human cancer tissues were 80.31% (102/127) positive in specific nuclear reaction, on the contrary, only a minority of precancerous lesions present weak positive (17.5%, 7/40), and negative in benign tumors (0/19).</p><p><b>CONCLUSIONS</b>The monoclonal antibodies developed against synthetic peptide were hTERT-specific and could recognize both the native and the denatured form. Thus their use in immunoblotting or immunohistochemistry for detecting the telomerase hTERT expression of cancer cell and tissues was promising.</p>

The clinico-pathological characteristics of nodular goiter with lymphocytes infiltration / 中国普通外科杂志

Objective To investigate the clinico-pathological characteristics of nodular goiter (NG) with lymphocytes infiltration and its relationship with Hashimoto′s disease. Methods Clinical and histologic data were collected and reviewed for 1121 cases of nodular goiter and 55 cases of thyroid adenoma, among which 83 cases had lymphocytes infiltration. These 83 cases of NG with lymphocytes infiltration were observed histologically in detail, followed up and assessed for the correlation of thyroid function to histologic findings. Results The overall incidence of lymphocytic infiltration in non-toxic nodular goiter was 7.4% (83/1121). Most of them were women of middle age. All had lymphocytes infiltration, follicule atrophy and oxiphilic epithelia in the background of nodular goiter. Seventy-six percent underwent cystic degeneration or had fibrous scar. Nineteen percent with lymphocytes infiltration in NG developed post-operative hypothyroidism. Six cases (7%) had high levels of thyroid auto-antibodies. None of the 55 cases of thyroid adenoma had overt lymphocytes infiltration. Conclusion Nodular goiter with lymphocytes infiltration and Hashimoto′s disease shares similar morphology and clinical presentation in some degree. It seems that NG with lymphocytes infiltration is a kind of inflammatory hyperplasia relating to autoimmunity and perhaps the beginning of some cases of Hashimoto′s disease.

A clinicopathologic study on 55 cases of gastrointestinal stromal tumor (GIST) / 中国普通外科杂志

Objective To investigate the clinicopathologic features of GIST. Method Fifty-five GIST cases were collected. Immunohistochemical assays of vimentin, CD117, CD34, S-100, SMA, desmin, NF were used to study the specimen. Results 69% (38/55) of the tumors located in the stomach, 18% (10/55) in the small intestine. Tumors varied greatly in size, ranging from 0.4 to 40 cm (average 6.7 cm). Morphologic criteria of malignancy are tumor size≥5 cm, mitotic rates≥5/50 HPF and ulcer formation and there were significant differences between the benign and the malignant. Immunohistochemical staining results: CD117 positive in 39 cases(71%), CD34 in 45 cases (82%), S-100 in 19 cases (35%), SMA in 12 cases (22%), vimentin in 32 cases (58%), desmin in 6 cases(11%),and NF in 2/4 (50%). All 13 benign cases were alive on the latest follow-up. In 42 cases of malignancy and potential malignancy, 4 developed metastasis, 13 died. Conclusion (1) GIST occur predominantly in middle-aged and older persons.(2) The main criteria of malignancy of GIST are tumor size≥5 cm, mitotic rates≥5/50 HPF and ulcer formation. (3)Whereas it is difficult to identify true leiomyomas/leiomyosarcomars and neuogenic tumors from GIST, immunohistochemical staining is capable of doing this.