Childhood pleuropulmonary blastoma: a clinicopathologic study of 16 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathological and immunohistochemical features, histogenesis and prognosis of pleuropulmonary blastoma (PPB) in children.</p><p><b>METHODS</b>PPB specimens from 16 pediatric cases with an age ranging from 1 year and 7 months to 5 years and 3 months (mean age of 3 years) were retrieved and analyzed by routine histological, immunohistochemical and electron methods.</p><p><b>RESULTS</b>Among 16 patients, there were 2 type I, 7 type II and 7 type III PPB cases. Type I PPB as multilocular cystic structure, consisted of thin fibrous wall lining the respiratory epithelium, subepithelial primitive blastema or immature mesenchymal cells, with or without rhabdomyoblastic differentiation or cartilage; Type II PPB as cystic-solid tumor, comparing with type I, consisted of intracystic components with appearance of anaplastic tumor cells. Type III PPB consisted of completely solid mass, the same as the solid region of type II, had mixed pattern including blastema, undifferentiated spindle-cell proliferations and sarcomas. In addition, anaplastic tumor cells and intra-and extra- cytoplasmic eosinophilic globules were also commonly present. Epithelial components in PPB were benign. Immunohistochemical study showed primitive mesenchymal differentiation of tumors. All cases were positive for vimentin, desmin, myogenin and SMA in tumors with skeletal muscle differentiation, S-100 was positive in tumors with cartilage differentiation. All tumors were negative for synaptophysin, CD99, and CD117. Benign epithelial components were positive for AE1/AE3 and EMA. In 12 cases, electron microscopy revealed few organelles in the primitive mesenchymal cells and rich heterochromatin in mesenchymal cells, the latter also demonstrating cytoplasmic myofilament dysplasia. Nine cases had clinical follow-up ranging from 5 to 48 months, of which 4 patients died.</p><p><b>CONCLUSIONS</b>PPB is a rare lung neoplasm of children under the age of 6 years, with distinct pathological morphology. PPB may arise from lung or pleura mesenchymal cells and has a poor clinical outcome.</p>

The relationship between chronic stress during pregnancy and N-methyl-D-aspartate (NMDA) induced seizures in rat pups / 临床儿科杂志

Objective To explore the relationship between the stress during pregnancy and the NMDA-induced spasm. MethodsThe pregnant rats were divided into two groups: pregnant control group(PC group)and pregnatal stress group(PS group). The rats in PS group were forced to swim in cold water of 4℃ for five minutes. Pups of the two groups were injected NMDA 7mg/kg intraperitoneally on postnatal day 13 to induced infantile spasm-like attacks. Then the clinical behavior of pups of the two groups were observed and recorded. The ultrastructure of mitochondria was detected with scanning electron and appearance of neurons was observed with HE staining. NMDA receptor and its subuniforms (NR2A, NR2B) in hippocampus, cerebral cortex, hypothalamus and raphe nucleus of brainstem were estimated by immunohistochemistry. Results The average score of pups in PS group is higher than in PC group(7.84 ±1.01 vs 5.90 ± 1.12). There were swelling neurons and no cytonecrosis in hippocampuss of both two groups. The uhrastructure of mitochondria in hippocampuss and raphe nucleus of brainstem showed great changes in pups of PS group as membrane in mitochondria of pups in PS group. NR1, NR2A and NR2B distributed mainly on the membrane and also in cytoplasm and cellular nucleus. The NR1 expressions in hippocampus, cerebral cortex, hypothalamus and raphe nucleus in pups of PS group were elevated than those of PC group and the P value is 0.001, 0.009, 0.015, 0.001 respectively. The NR2B expressions in hippocampus, cerebral cortex hypothalamus and raphe nucleus in pups of PS group were elevated than those of PC group and the P value is 0.004, 0.002, 0.003, 0.002 separately. NR2A expressed more in hippocampus in pups of PS group than that in PC group,but there was no difference in cerebral cortex, hypothalamus and raphe nucleus between two groups and the P value is separately 0.006,0.067, 0.7, 0.5. Conclusions The mitochondria of neurons in rat pup were hurt by maternal severe stress daring pregnancy, which made the energy metabolism of neurons changed. Maternal stress can also elevate the expression of NR1, NR2A and NR2B in cerebral cortex, brainstem and hippocampus and increase the morbidity of infantile spasm-like attacks.