Clinicopathological Features of Primary Small Cell Neuroendocrine Carcinoma of the Bladder / 中国医学科学院学报

Objective To investigate the clinicopathological features,immunohistochemical features,diagnosis,and relationship with sporadic prostate cancer in primary small cell neuroendocrine carcinoma of the bladder. Methods We retrospectively analyzed the clinical characteristics of 12 patients with primary small cell neuroendocrine carcinoma of the bladder diagnosed at Beijing Chao-Yang Hospital affiliated to Capital Medical University from January 2013 to September 2022.The histological features of primary small cell neuroendocrine carcinoma of the bladder were re-evaluated by two pathologists according to the 2022 revision of the World Health Organization Classification of Tumors of the Urinary System and Male Genital Organs.Electronic medical records were retrieved,and telephone follow-up was conducted from the time of histopathological diagnosis to the death or the end of the last follow-up until January 31,2023. Results The 12 patients include 7 patients in pT3 stage and 1 patient in pT4 stage.Eight patients were complicated with other types of tumors,such as high-grade urothelial carcinoma of the bladder and squamous cell carcinoma.Five patients had sporadic prostate cancer.Immunohistochemical staining showed that 12 (100.0%),10 (83.3%),and 8 (66.7%) patients were tested positive for CD56,Syn,and CgA,respectively.The Ki67 proliferation index ranged from 80% to 90%.Five patients with urothelial carcinoma were tested positive for CK20,GATA3,and CK7.P504S was positive in all the 5 patients with prostate cancer,while P63 and 34βE12 were negative.The follow-up of the 12 patients lasted for 3-60 months.Eight of these patients died during follow-up,with the median survival of 15.5 months.Four patients survived. Conclusions Primary small cell neuroendocrine carcinoma of the bladder is a rare urological tumor with high aggressiveness and poor prognosis.In male patients with bladder prostatectomy,all prostate tissue should be sampled.If prostate cancer is detected,the prostate-specific antigen level should be monitored.

Pulmonary capillary hemangiomatosis: a clinicopathologic analysis of 2 cases with review of literature / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features of pulmonary capillary hemangiomatosis (PCH).</p><p><b>METHODS</b>The clinical and pathologic profiles of 2 PCH cases were evaluated. Immunohistochemical study (EnVision method) was performed on fixed tissues. The biologic behavior was analyzed with follow-up data.</p><p><b>RESULTS</b>The main presenting symptom was dyspnea. Chest radiography of the two cases depicted diffuse, ground-glass nodules, accompanied by enlarged central pulmonary arteries. Microscopically, the most distinctive feature was proliferation of capillary channels within pulmonary interstitium and alveolar walls, accompanied by muscularization of arterioles. Immunohistochemical study showed an abundance of mast cells in the lesion, and staining for platelet-derived growth factor receptor-beta (PDGFR-β) localized to vascular smooth muscles surrounding the proliferating capillaries and the mast cells. The index of Ki-67 was less than 1 percent and the p53 was negative.</p><p><b>CONCLUSIONS</b>PCH is a rare vascular proliferative disease of yang patients. Increased number of mast cell and the up-regulation of PDGFR-β may suggest mechanism for PCH. The clinical and radiologic diagnosis of PCH can be very difficult, and the histological examination is regarded as the most reliable means to establish the diagnosis. Pathologists should improve their knowledge on PCH.</p>

Pathologic diagnosis and clinical analysis of chronic extrinsic allergic alveolitis / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and diagnostic approach of chronic extrinsic allergic alveolitis (EAA).</p><p><b>METHODS</b>Seven cases of chronic EAA diagnosed by open lung biopsy or lung transplant were enrolled into the study. The clinical and pathologic features were analyzed and the literature was reviewed.</p><p><b>RESULTS</b>There were altogether 4 men and 3 women. The age of the patients ranged from 30 to 65 years (mean = 48 years). All cases represented chronic form and five cases diagnosed by open lung biopsy also showed features of recent aggravation, leading to hospitalization. Four cases had known history of exposure to inciting gases, pollens and pets, and only 2 cases were positive for allergens. High-resolution CT scan showed ground-glass attenuation and reticular pattern that often had a patchy distribution and central predominance. Bronchoalveolar lavage analysis showed marked lymphocytosis, with CD4(+)/CD8(+) ratio less than 1. Lung function test demonstrated a restrictive ventilatory defect, with decreased compliance, reduced diffusion capacity and high airway obstruction. Five cases had open lung biopsy performed and two cases had undergone lung transplantation. Pathologic examination showed bronchiolocentric cellular interstitial pneumonia, interstitial fibrosis, non-caseating epithelioid granulomas, epithelioid histiocytic infiltrate in the respiratory bronchioles and intraluminal budding fibrosis. The five cases with open lung biopsy performed also showed neutrophilic infiltrate in the alveoli. The two lung transplant cases were complicated by severe fibrotic changes.</p><p><b>CONCLUSIONS</b>Chronic EAA demonstrates characteristic pathologic features. Definitive diagnosis requires correlation with clinical and radiologic findings due to possible morphologic mimicry of other diffuse parenchymal lung diseases.</p>

Effective analysis of the posterior vertebral pedicle screw fixation, vertebral body removal, decompression and titanium mesh reconstruction for the treatment of the lower lumbar fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effect of the treatment of the lower lumbar fractures by posterior vertebral pedicle screw fixation, vertebral canal decompression,bone graft and titanium mesh reconstruction.</p><p><b>METHODS</b>From January 2006 to December 2008, 22 patients with lower lumbar fractures were treated by posterior vertebral pedicle screw fixation, vertebral canal decompression, bone graft and titanium mesh reconstruction at same period. There were 18 males and 4 females with an average age of 43.8 years ranging from 22 to 63 years old. The injured vertebrae were L3 in 11 cases, L4, in 8 cases, and L5 in 3 cases. The operative time, blood loss, the preoperative and postoperative vertebral height,sagittal index, and the lumbar lordosis angle were recorded and evaluated.</p><p><b>RESULTS</b>The operative time was 3 to 4.2 hours (means 3.6 h). The blood loss averaged 1300 ml (900 to 1500 ml). The preoperative and postoperative sagittal index were (57.5 +/- 7.6)% and (93.5 +/- 8.1)%, respectively. The preoperative and postoperative lumbar lordosis angle were (34.3 +/- 7.3) degrees and (38.5 +/- 9.8) degrees, respectively. All patients were followed up for 10 months to 3 years (means 2.6 years). No fixation were failed,the segment of titanium mesh reconstruction obtained bone healing, no pseudoarticulation formation. At the last time of followed-up, 15 patients with nerve injuries were evaluated according to Frankel grade, there were 10 cases in grade E, 4 in D, 1 in C. According to the low back outcome scores (LBOS), the results were excellent in 20 cases, good in 1, fair in 1.</p><p><b>CONCLUSION</b>The stability of the lower lumbar spine can be reconstructed by bone graft and titanium mesh combined with transpedicular screw fixation through a posterior approach. The decompression and vertebral body removal can also be performed in this approach. The recovery of the vertebral height and lumbar lordosis can prevent the delayed neurological deficit and traumatic kyphosis.</p>

Fixed-point release with small needle knife for the treatment of upper plexus thoracic outlet syndrome / 中国骨伤

<p><b>OBJECTIVE</b>To study therapeutic effects and mechanisms of fixed-point release with small needle knife for the treatment of upper plexus thoracic outlet syndrome.</p><p><b>METHODS</b>Among 32 patients, 22 patients were female, and 10 patients were male, ranging in age from 25 to 55 years. The disease course ranged from one month to 3 years. All the patients were unilateral thoracic outlet syndrome. The painful trabs at the facet joints of C(5,6) and infraspinatus muscle were fixed-point released one to four times every week.</p><p><b>RESULTS</b>All the patients relieved pain immediately after treatment. Among 26 patients with decreased muscle strength before operation, 20 patients got muscle strength improved after treatment immediately. Among 18 patients with touch and pain sensation compromised, 8 patients got the sensation improved after operation. All the patients were followed up for 1 year. According to Wood evaluation criterion, 19 patients got an excellent result, 7 good, 3 poor, and 3 bad. One patient was transferred to operation. There were no complications.</p><p><b>CONCLUSION</b>Fixed-point release with small needle knife for the treatment of upper plexus thoracic outlet syndrome is safe and curative.</p>

Expression of E-cadherin, beta-catenin, cathepsin D, gelatinases and their inhibitors in invasive ductal breast carcinomas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>E-cadherin, beta-catenin, cathepsin D, matrix metalloproteinase (MMP)-2, MMP-9, tissue inhibitors of metalloproteinase (TIMP)-1 and TIMP-2 are all invasion-related proteins. The expression patterns of these proteins in invasive ductal breast carcinomas, and their associations with known clinicopathological parameters, tumor recurrence and expressions of estrogen receptor (ER), progesterone receptor (PR), PS2 and c-erbB2 were not well studied in Chinese patients.</p><p><b>METHODS</b>In a set of 94 invasive ductal breast carcinomas, protein expressions of these molecular markers were investigated by immunohistochemistry, and their associations with known clinicopathological parameters, tumor recurrence and expressions of ER, PR, PS2 and c-erbB2 were also examined. In addition, the interrelationship between the expressions of these proteins were studied.</p><p><b>RESULTS</b>Preserved membrane E-cadherin expression was associated with late tumor stage and tumor recurrence, whereas the reduced junctional beta-catenin associated with positive lymph node status and c-erbB2 overexpression. Positive staining of cathepsin D in tumor stromal cells displayed a significant association with late tumor stage. High expression of MMP-2 in cancer cells was associated with large tumor size and PR positive expression. TIMP-2 expression was positively associated with tumor recurrence. In addition, inter-relationship between the expressions of these biomarkers was also assessed. Cathepsin D staining in cancer cells was inversely correlated with its staining in stromal cells, and also inversely correlated with MMP-2 staining in tumor stromal cells. MMP-2 expression in stromal cells displayed an inverse correlation with TIMP-2 expression. MMP-9 expression displayed parallel associations with TIMP-1 and TIMP-2 expression.</p><p><b>CONCLUSION</b>Evaluation of E-cadherin, beta-catenin, cathepsin D, MMP-2 and TIMP-2 expression may be of some help in more accurately predicting the prognosis of invasive ductal breast carcinomas.</p>