Histological analysis of the anterior lobe region in transurethral prostatectomy / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the possibility of injury to the striated urethral sphincter by incision to the anterior lobe region in transurethral prostatectomy.</p><p><b>METHODS</b>We incised the anterior lobe region of 60 patients with benign prostatic hyperplasia (BPH) undergoing transurethral prostatectomy. The patients were divided into four groups according to the incision fields: proximate superficial (group 1), proximate deep (group 2), distal superficial (group 3) and distal deep (group 4). The tissues taken from the anterior lobe region were subjected to HE staining, and the smooth and striated muscles were detected by immunohistochemical identification of smooth muscle actin (SMA) and myoglobin (MYO) in the tissues. The prostate volume, age, and PSA level of the patients were analyzed against their positive or negative results. The relative contents of the striated muscle were compared among groups 2, 3 and 4. The independent-sample between-group t-test was used for statistic analysis.</p><p><b>RESULTS</b>The urethral rhabdosphincter was found in the anterior lobe region, with the smooth muscle intermixed with the striated muscle. The incision injury of the urethral rhabdosphincter was associated with the prostate volume. Increased urethral rhabdosphincter was observed in the anterior lobe region, approaching the apex of the prostate and extending to the urethral lumen.</p><p><b>CONCLUSION</b>The anterior lobe region should not be excessively incised in transurethral prostatectomy so as to avoid direct injury of the striated urethral sphincter, which is especially important for prostates of smaller volume or operation near the apex of the prostate.</p>

Cystic tumour of the atrioventricular node: a case report and review of the literature / 中华医学杂志(英文版)

Cystic tumour of the atrioventricular node is a rare primary cardiac tumour that can cause complete heart block and sudden death. Here, we describe a male case aged 42 years who suddenly died without a medical and family history of cardiac illnesses. After detailed macroscopic and microscopic examinations, a cystic mass was found in the atrioventricular nodal region. The small lesion was less than 1 cm in diameter, and consisted of small and large cystic spaces and tubular structures lined by flat, cuboidal or squamous epithelium. Immunohistochemical staining revealed the tumour epithelium positive for epithelial membrane antigen, carcinoembryonic antigen, antigen epitopes AE1/AE3, cytokeratins CK5/6 and CK7, but negative for calretinin, HBME-1, Wilms' tumor 1, factor VIII, chromogranin, synaptophysin or smooth muscle actin, suggesting an endodermal rather than mesothelial origin.