Construction of pathological sample repository and its application in experimental pathology curriculum for medical undergraduates / 中华医学教育探索杂志

The gross specimens and tissue slices used for traditional experimental pathology curriculum are fragile, and some specimens or slices are difficult to be supplemented. Besides, the classroom and schedule for experimental pathology teaching are inflexible. Therefore, the teaching effects for experimental pathology course are limited. The development of digital technology has promoted the teaching reform of medical experimental curriculum. We have digitalized the gross specimens and tissue slices to preserve and expand the samples, and constructed pathological sample repository containing both physical samples and digital samples. Furthermore, we have established a platform for remote access, and thus improved the flexibility and autonomy of study for experimental pathology curriculum. Additionally, we have integrated clinical information of the teaching samples, and interpreted the specimens with the assistance of two-dimensional code technology and voice broadcast technology, to realize human-computer interactive learning. The questionnaire shows that the application of pathological sample repository in experimental teaching has improved student learning effect and recognition.

Exploration and practice of specimen sampling teaching in standardized residency training of clinical pathology / 中华医学教育探索杂志

Pathological specimen sampling is not only the prerequisite of a good pathological diagnosis, but also the primary clinical skill that must be mastered by the standardized residency training trainees (resident trainees) in clinical pathology department. In view of the problems and difficulties encountered in the teaching of specimen sampling, through five years of exploration and attempt, this paper has gradually established a new model with five basic elements, including theory teaching, practice teaching, promoting teaching effect by examination, learning from senior students, and review teaching. The results of evaluation analysis and questionnaire survey show that the teaching mode can make the trainees master the methods of specimen sampling quickly and efficiently, learn and improve clinical skills in practice, and lay a solid foundation for the subsequent standardized training of histopathological diagnosis.

Clinicopathological features and prognosis of pleomorphic giant cell adenocarcinoma of the prostate / 中华泌尿外科杂志

Objective:To investigate the clinicopathological features and prognosis of pleomorphic giant cell adenocarcinoma (PGCA) of the prostate, and to strengthen the understanding of this rare variant.Methods:From January 2009 to December 2019, 383 pathological samples of prostate adenocarcinoma with Gleason scores of 8-10 were selected from the First Affiliated Hospital, Army Medical University. PGCA was screened by reviewing the histomorphology of hematoxylin and eosin stained sections. Then the expression of prostate specific markers and mismatch repair (MMR) proteins of PGCA were detected by immunohistochemistry (IHC), and microsatellite instability (MSI) status was detected through polymerase chain reaction (PCR)-capillary electrophoresis. Meanwhile, the clinicopathological characteristics, diagnosis, treatment and prognosis of PGCA were summarized and analyzed along with those reported in the literature.Results:Three patients with PGCA of the prostate were 68, 63 and 71 years old respectively, and case 1 had a history of transurethral resection of the prostate and oral bicalutamide 3 months before surgery. All 3 patients underwent radical prostatectomy and received endocrine therapy, radiotherapy and/or chemotherapy, and died at 18, 23, and 10 months after surgery, respectively. Histologically, both the usual prostate adenocarcinoma with Gleason score of 9-10 and the pleomorphic giant cell component with anaplastic characteristics were observed in 3 tumors, and the latter accounted for 90%, 10%, and 20%, respectively. Immunohistochemical staining showed that both components expressed epithelial markers (CK, CK8/18) and prostate-specific markers (NKX3.1, PSA, P504S) to varying degrees, and the expression of MMR proteins (MSH2, MSH6, MLH1 and PMS2) were not defective. MSI was not detected in the usual prostate adenocarcinoma and pleomorphic giant cell components obtained by microdissection in 3 cases. Combined with 10 cases reported in the literature, there were totally 13 cases of PGCA for reviewing. The patients were 45-81 years old, the average age was 66 years old, and the median age was 66 years old. During the follow-up period of 3-36 months, 7 cases relapsed/metastasized, 6 cases died within 23 months after diagnosis, and 4 of which died within 1 year.Conclusions:PGCA is a newly recognized rare variant of prostate adenocarcinoma. At present, all cases are accompanied with high-grade usual prostate adenocarcinoma with Gleason score of 9-10, but it is different from the latter in pathological morphology and clinical manifestations, by presenting high invasiveness and poor prognosis. PGCA is not sensitive to conventional endocrine therapy, radiotherapy or chemotherapy. Accurate diagnosis of PGCA is helpful to judge the prognosis of patients and guide the treatment.

Special histopathological variants and potential diagnostic traps of classical follicular dendritic cell sarcoma / 中华病理学杂志

Objective@#To investigate the clinicopathological features, special morphologic variants and potential diagnostic traps of classical follicular dendritic cell sarcoma (FDCS).@*Methods@#A total of 25 cases of classical FDCS diagnosed in the First Hospital Affiliated to Army Medical University from 2006 to 2018 were examined by hematoxylin-eosin staining, immunohistochemistry and in situ hybridization for Epstein-Barr virus-encoded mRNA (EBER). Meanwhile, the types and characteristics of the special variants of FDCS were summarized along with those reported in the literature.@*Results@#The age of patients ranged from 23 to 77 years (mean 52 years), the male to female ratio was 1.5, and the maximum diameter of tumor was 1.5 to 20 cm (mean 7.4 cm). Twelve cases (48%) were misdiagnosed at the initial evaluation. Follow-up information was available for 17 patients, and the follow-up time was 5 to 96 months. The propotion of patients having recurrence, metastasis and mortality was 3/17, 5/17 and 2/17, respectively. Microscopically, besides the typical morphology, 10 cases of FDCS showed special histomorphologies and/or structures, including those mimicking lymphoepithelioma-like carcinoma, desmoplastic infiltrating carcinoma, classical Hodgkin′s lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and hemangiopericytoma. These morphologic variants were potential diagnostic pitfalls and warranted attention. Immunohistochemistry showed that more than two markers of follicular dendritic cells (such as CD21, CD23, CD35, etc.) were expressed in cases showing typical morphology and the special variants. All 25 cases were all negative for EBER by in situ hybridization.@*Conclusions@#Classical FDCS is rare, besides the typical morphologic features, there are many special variants. In particular, these may be confused with lymphoepithelioma-like carcinoma in the nasopharynx, CHL or ALCL in the mediastinum/lymph node. Awareness of these variants is essential for accurate diagnosis.

Consistency of ALK Ventana-D5F3 immunohistochemistry interpretation in lung adenocarcinoma among Chinese histopathologists / 中华病理学杂志

Objective@#To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy.@*Methods@#This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS.@*Results@#There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109).@*Conclusion@#There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.

Modularized teaching program on the clinical research training for pathological residents / 中华医学教育探索杂志

To meet the requirement of pathological practice and development, we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training. Additionally, we proposed the principle and implementation strategy for clinical scientific research training. According to features of pathological practice, we employed the modularized teaching to divide the training courses into several modules: discussion module for clinical pathology, lecture module for advanced research, and training modules for basic scientific theory, technology and writing skill. With these approaches, the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.

Modularized teaching program on the clinical research training for pathological residents / 中华医学教育探索杂志

To meet the requirement of pathological practice and development,we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training.Additionally,we proposed the principle and implementation strategy for clinical scientific research training.According to features of pathological practice,we employed the modularized teaching to divide the training courses into several modules:discussion module for clinical pathology,lecture module for advanced research,and training modules for basic scientific theory,technology and writing skill.With these approaches,the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.

Clinicopathologic features and prognosis of inflammatory pseudotumor-like follicular dendritic cell sarcomas in liver and spleen: an analysis of seven cases / 中华病理学杂志

Objective@#To investigate the clinicopathological features and prognostic parameters of the inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) of liver and spleen.@*Methods@#Ninteen cases of inflammatory pseudotumor (IPT) and 5 cases of IPT-like FDCS of the liver and spleen were collected at the First Affiliated Hospital, Army Medical University from 2006 to 2016. HE sections, immunohistochemical staining, and Epstein-Barr virus encoded nuclear RNA (EBER) in situ hybridization were reviewed along with a summary of the literature.@*Results@#Among the previously diagnosed 19 cases of IPT of the liver and spleen, 2 cases were misdiagnosed (the ratio of 2/19). Among 7 new cases including 3 males and 4 females, 3 cases involved the liver and 4 cases involved the spleen. The age range was 37-64 years (mean 53 years). The maximum tumor diameter ranged from 3.0 to 11.0 cm (mean 6.5 cm). Surgical resections were performed in all patients with follow-up time ranging from 3 to 84 months.All patients were disease-free.7 new cases were all positive for EBER, and showed the expression of at least one of the FDC markers, including CD21, CD23, and CD35. The rest of 17 cases of IPT were all negative for EBER and essentially negative for FDC markers, but were all positive for SMA.@*Conclusions@#IPT-like FDCS of the liver and spleen is a rare low-grade malignant tumor morphologically mimicking inflammatory pseudotumor, and is easy to be misdiagnosis due to under-recognition. EBER in situ hybridization and FDC markers are indispensable for confirming the diagnosis.

Strategies of improving the scientific innovation ability of pathological graduate students based on modularized special training / 中华医学教育探索杂志

Pathology is a subject that studies the etiology,pathogenesis,pathological changes,progression and outcome of diseases.Pathology links the basic research and clinical practice and is an important part of translational medicine.In order to cultivate qualified pathological graduates with solid pathological theories and the abilities of proposing and addressing scientific hypotheses from pathological morphology changes,we employ modularized special training to divide the pathology training courses into morphology learning module,article searching and reading module,project design module,experiment operation module and scientific presentation module.The training contents among these modules are relatively independent but closely connected,and compose a strategy that aims to improve the scientific innovation ability of pathological graduates.

ID3, TCF3 and MYC genes mutation analyses in Chinese Burkitt lymphoma / 临床与实验病理学杂志

Purpose To investigate the mutations of ID3,TCF3 and MYC genes in Chinese Burkitt lymphoma and discuss their significance.Methods Total DNA was extracted from tumor tissues of 32 patients with Burkitt lymphoma,then the DNA was amplified by polymerase chain reaction (PCR),and the products of PCR were sequenced directly with Sanger sequencing methods.Results The mutation rates of ID3 and TCF3 genes were 35.5％ (11/31) and 18.8％ (6/32) respectively.The mutation rate of MYC was 50％.The mutation rates of MYC exon 1,MYC exon 2 and MYC exon 3 were 3.3％ (1/30),50％ (15/30) and 7.7％ (2/26) respectively.Conclusion Recurrent mutations of the ID3,TCF3 and MYC genes in Chinese Burkitt lymphoma were identified by Sanger sequencing.For TCF3 gene,a novel mutation c.2202G ＞ C p.L569V was found in three cases.In two cases,a novel mutation of c.1070A ＞G p.G182D was found in MYC gene.

Imaging features of solitary extramedullary plasmacytoma of liver / 中华消化外科杂志

Objective To summarize the imaging features of ultrasound, computed tomography (CT) and gadolinium-ethoxybenzyl-diethylenetriamine pentoacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) of solitary extramedullary plasmacytoma (SEP) of liver, and investigate the key points of identification and diagnosis.Methods The clinical data of 1 patient with SEP of the liver who was admitted to the Southwest Hospital of the Third Military Medical University at 7 May, 2015 were retrospectively analyzed.The patient received contrast-enhanced ultrasound (CEUS) , plain and enhanced scan of CT and Gd-EOB-DTPA enhanced MRI.The patient underwent treatment after preoperative examinations.Pathological examination and immunohistochemical staining were done after operation.The patient was followed up by outpatient examination of color Doppler ultrasonography till 12 November, 2015.The location, size, shape, echo, density or signal, enhancement pattern, secondary performance were recorded by imageological examinations.Surgical treatment, results of pathological examination, immunohistochemical staining, postoperative recovery and recurrence of tumor were recorded.Results CEUS examination demonstrated a hypoechoic hepatic lesion at S7 segment of the right liver measuring 24 mm × 19 mm with clear boundary and dotted blood flow signal in the mass.In the arterial phase, the lesion was enhanced rapidly.Abdominal CT scan showed that the mass at the right liver lobe had slightly low density with clear boundary, the CT value of 34-64 HU, and liver capsule having no significant outer convex.On enhanced CT, the lesion presented a homogeneous enhancement and shape of posterior upper tributaries of right hepatic artery in the arterial phase, the lesion presented continuous enhancement which was slightly lower than that of liver parenchyma in the portal venous phase with the CT value of 77-102 HU, the lesion presented decreased enhancement with the CT value of 41-98 HU in the equilibrium phase.The maximum density projected image showed that the shape of an enlarged vascular image was found inside the lesion in the arterial phase and the lesion was adjacent to inferior vena cava and right hepatic vein which was compressed and displaced in the portal venous phase.On Gd-EOB-DTPA enhanced MRI, the right liver lobe showed a homogeneous T1-weighted and T2-weighted signal with clear boundary and without lipid component, hemorrhage or calcification.The lesion presented obvious enhancement in the arterial phase, homogeneous continuous enhancement which was slightly lower than that of liver parenchyma in the portal venous phase, decreased enhancement in the equilibrium phase.The lesion showed mild signal, adjacent to inferior vena cava and right hepatic vein which was compressed and displaced in the hepatobiliary phase.There was no obvious cirrhotic nodule in the liver.The patient received laparoscopic space-occupying lesion resection at the right liver lobe after finishing inspection.The grayish white lesion in hardness was seen, with clear boundary and capsule, adjacent to anterior wall of inferior vena cava and right hepatic vein in the operation.The results of pathological examination showed that the small tumor cells were scattered in bundle, nuclear were round or oval shape and eccentric with mitosis seen.The results of immunohistochemical staining showed that endothelium cell marker CD34, human multiple myeloma gene MUM1, vimentin, plasmacyte markers 38 and 138, expression of λ light chain protein were positive, the positive cell rate of proliferation activity marker Ki-67 was 10％.The results of blood routine test and blood biochemistry showed that the patient had no anemia, hypercalcemia, abnormal renal function or monoclonal immunoglobulin in the serum or urine.The results of postoperative bone marrow aspiration, immunoglobulin determination and whole body bone scan showed normal.Postoperative examinations confirmed the SEP of right liver.The patient recovered well and was discharged at postoperative day 9.Postoperative change at right liver lobe was detected by color Doppler ultrasonography at 1 month after operation.The patient was followed up for 6 months without tumor recurrence.Conclusion SEP of liver mainly locates at the right lobe of liver, and the imaging features include clear boundary, homogeneous echo, density or signal, adjacent capsule showing no significantly outer convex, surrounding vein demonstrating no violation and shifted by compression, enhancement pattern as fast-in and fast-out.

The reform of innovative talents training mode of professional master degree postgraduates in pathology / 中华医学教育探索杂志

The establishment of professional master degree in pathology is a new branch of the professional degree graduate education.It is an important measure to bring the clinical pathology into the teaching system of clinical medicine specialty in China.In response to a wave of education reform in the new century, our department has positively converted the traditional postgraduate training and teaching mode, innovated the teaching idea and content, and continued to improve the teaching method and means.On the basis of fully respecting students' subject consciousness, we have combined traditional and modern teaching means, made full use of modern education information technology, actively built and promoted pathology specialized degree graduate student research, teaching and clinical trinity management: the new training mode.Through the practice of bilingual, network, clinical problems and cases of teaching and combined with the leading edge forum of famous pathologists' research and the professional standardized training of clinical pathology, we have extensively carried out the education training, which is based on the theory, practice, research, and sub specialist guidance.

The correlation analysis between helicobacter pylori infection and gastric polypus / 重庆医学

Objective To investigate the correlation between gastric polyps and helicobacter pylori (Hp) infection .Methods 150 patients with gastric polyps(experimental group) and 150 patients with chronic gastritis(control group) from October 2011 to No-vember 2012 in Shapingba people′s hospital of Chongqing were enrolled in this study .The polyps biopsy in patients with gastric polyps and the mucosa in gastric antrum big and small bends ,and the anterior and posterior walls(about 2-5 cm from the pylorus) from both groups were detected for the pathological type ,inflammation degree and stained(modified Giemsa staining) for detection of the existence of Hp .Results In 150 patients with gastric polyps ,58% (87/150) of the cases were infected by Hp mainly in medi-um and low degree ,in which 39 .3% (59/150) of the infection located at polyps and 42% (63/150) of the infection occurred out of polyps .Pathological analysis for this group further demonstrated that the types of hyperplastic polyps ,fundic gland polyps ,inflam-matory polyp and adenomatous polyps accounted for 68 .0% (102 cases) ,20 .7% (31 cases) ,9 .3% (14 cases) and 2 .0% (3 cases) of total 150 gastric polyps cases ,of which 63 .7% (65/102) ,38 .7% (12/31) ,57 .1% (8/14) and 66 .7% (2/3) cases were infected by Hp ,respectively .Pathological analysis also indicated that ,among total 150 gastric polyps cases ,single polyps and multiple polyps types accounted for 62 .0% (93 cases) and 38 .0% (57 cases) .The polyps commonly existed at gastric fundus in which the incidence rate of the hyperplastic polyps type and the fundic gland polyps type were 94 .1% (96/102) and 87 .1% (27/31) ,respectively .The infection rate in hyperplastic polyps was markedly higher than that in fundic gland polyps (P<0 .05) ,and the infection of hyperplas-tic polyps was mainly medium and high degrees .In addition ,the inflammatory response in the hyperplastic polyps was higher ,ac-companied by the intestinal metaplasia and atrophy of gastric mucosa ,as compared with non-hyperplastic polyps .In the total 150 control cases ,52 .0% (78/150) patients were infected by Hp with mainly medium and high degree .Results indicated that there is no relationship between polyps occurring and Hp infection .Conclusion Compared to the chronic gastritis ,there is no positive associa-tion between gastric polyps and Hp infection .There is no remarkable difference for Hp infection rate and degree between the polyps and the non-polyps sites in the stomach .The infection rate and infection degree of hyperplastic polyps is significantly higher than that of fundic polyps .However ,the underlying mechanisms for the development of hyperplastic polyps have to be elucidated in the future .

Significance of histopathologic analysis vs cytomegalovirus (CMV) detection in the diagnosis of CMV-infected hepatitis post liver transplantation / 中华器官移植杂志

Objective To evaluate the sensitivity and specificity of histopathologie analysis vs cytomegalovirus (CMV) detection for the diagnosis of CMV-infected hepatitis post liver transplantation. Methods Twenty-five biopsies with CMV infection and twenty-five without CMV infection were collected. Histopathologic observation, immunohistochemical staining and virus detection were performed on both groups to evaluate the sensitivity and specificity of these examinations for the diagnosis of CMV-infected hepatitis. Results The detection rate of microabscess, aggregation of monocyte and rnacrophage, and cytomegalic change in CMV infection group was higher than that in the group without CMV infection (P<0.05), but there was no significant difference in intranuclear inclusion and eosinophilic body between the two groups (P>0.05). The sensitivity and specificity of IHC and PCR for CMV detection were 20% and 100%, 72% and 84%, respectively. Conclosions CMV detection with PCR combined with histological observation is the most effective diagnostic scheme for CMV disease of liver.

The distribution characteristic of lymph vessel in colorectal carcinoma tissue and its relationship to metastasis and prognosis / 第三军医大学学报

0.05),but the MLD values at the tumor margin were significantly higher than that of normal mucosa(P

Detection of beta-catenin expression in colorectal adenoma and adenocarcinoma by tissue chips and its significance / 第三军医大学学报

Objective To investigate the correlation of ? catenin expression with the carcinogenesis and progression of human colorectal cancer Methods The colorectal adenoma carcinoma tissue chips including 400 cores were constructed and the expression of ? catenin in 220 cases of colorectal adenoma and carcinoma was detected by immunohistochemical staining Results The effective rates of information by tissue chips stained by hematoxylin eosin and immunohistochemistry were 98 8% and 98 0%, respectively The nuclear expression rate of ? catenin was 35 9% in malignant changes in adenoma, which was significantly higher than that in adenoma (16 7%) and carcinoma (19 7%) ( P

Effects of preoperative radiotherapy on the pathological changes of esophageal carcinoma / 第三军医大学学报

Objective To observe the pathological changes of esophageal carcinoma after preoperative radiotherapy. Methods A total of 28 thoracic esophageal carcinoma patients treated with surgery following preoperative radiotherapy of 40 Gy (S+R group), and other 28 patients treated with surgery alone (S group) were studied. The pathological changes of the resected samples of these patients were analyzed and compared. In all of the cases, the tumor regression rate, infiltration depth of tumor cells, involvement rate of blood vessels and lymphatic vessels, and metastasis rate of lymph nodes and residual lesions were studied. Results The tumor regression rate in S+R group was significantly higher than that in S group, but the infiltration depth of tumor cells and involvement rate of blood vessels and lymphatic vessels in S+R group were significantly lower than those in S group. The stromal reaction in S+R group was stronger than that in S group. There was no significant difference in metastasis positive rate of lymph nodes and residual lesions between the two groups. Conclusion Preoperative radiotherapy has obvious effect on the treatment of esophageal carcinoma from the view of pathological changes. However, further studies should be conducted on whether the pathological changes mean the improvement of survival rate or not.

Construction and effect of Neuropilins-2 eukaryotic expression vector for RNA interference / 第三军医大学学报

Objective To construct Neuropilins-2 eukaryotic expression vector for RNA interference.Methods Recombinant targeting on gene NRP2 was designed and established with plasmid pGenSil-1 based on NRP2 cDNA equences of Genomes.Two pairs of oligonucleotides were synthesized according to the Tuschl and inserted into plasmid pGenSil-l to generate siRNA eukaryotic expression vector,DH5? strains were transformed,plasmid were extracted,and recombinant vectors were identified by the restriction map and the sequence analysis.The recombinant plasmid(pGenSil-NRP2) was transfected into the cultured LOVO cells.At 48 h after transfection,the whole cell protein was extracted,and the protein level was detected by Western blotting with mouse-anti-human NRP2 monoclonal antibody.Results Recombinant plasmids were completely coincided with the designs by the restriction map and the sequence analysis.pGenSil-NRP2 expression vector into LOVO cells down-regulated the protein level of NRP2 at 48 h after transfection.The recombinant eukaryotic expression vector were constructed successfully.Conclusion siRNA recombinant can be constructed successfully by RNAi technique for inhibiting NRP2 expression.

Review of Cutaneous Malignant Melanoma from Two General Hospitals in Western China, 1981-2000 / 中华皮肤科杂志

Objective To review the clinical-pathological features, the tendency of incidence over 20 years, the predisposing factors, and the differences between the cases of cutaneous malignant melanoma from two hospitals. Methods A collection of 305 cases diagnosed as cutaneous malignant melanoma, among which 185 cases had complete clinical-pathological data, during 1981-2000 was analyzed. Results Acral malignant melanoma accounted for 63.3%, and the cases associated with congenital small nevi at the primary site accounted for 15.8% of 305 patients. During the period 1981-1990 and 1991-2000, cutaneous malignant melanoma constituted 0.053% and 0.094%, respectively, of all diagnoses with pathological sections, with an growth rate of 3.9% yearly. There was a tendency of the increased lesions located on face and neck, and decreased lesions on acra, over 20 years. Conclusion A rise of diagnosis of cutaneous malignant melanoma has been noticed from two hospitals over 20 years. Acra, especially planta, is the predominant anatomical site of cutaneous malignant melanoma.