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Objective@#To study the clinicopathological features, differential diagnosis and prognosis of primary histiocytic sarcoma of central nervous system(CNS).@*Methods@#Three cases of CNS histiocytic sarcoma were collected at Chinese People′s Liberation Army General Hospital from 2005 to 2018. Their clinicopathological characteristics were analyzed, and the related literature reviewed.@*Results@#The three patients included two females and one male, aged 36, 44, 58 years (median 44 years). MRI showed heterogeneously enhancing lesions which were considered meningioma, high-grade glioma or metastatic carcinoma. Histopathologically there were moderately pleomorphic, mitotically active tumor cells with a loose arrangement, effacing the normal brain tissue. These cells possess abundant eosinophilic cytoplasm, highly atypical nuclei, predominant nucleoli, and hemophagocytosis; multinucleated or spindled forms were also seen, as was background reactive inflammation. The tumor cells were typically positive for CD68, CD163, vimentin and lysozyme, S-100 protein, two of three cases were positive for BRAF V600E,one of three cases was partly positive for CD45, CD45RO, CD4, CD34, and negative for GFAP, Olig-2, CK, EMA, SSTR2, CD99, CD117, MPO, CD1a, Langerin, CD21, CD23, CD35, CD15, CD30, CD38, and CD138. The index of Ki-67 was 30%-75%. Rich reticular fiber network was seen in all cases; BRAF V600E mutation was present in two cases.@*Conclusions@#CNS histiocytic sarcoma is a rare malignant tumor; histopathologic and immunohistochemical examination are necessary for the diagnosis and to exclude other primary CNS and hematolymphopoietic tumors. Primary CNS histiocytic sarcoma is treated by surgery, chemotherapy and radiation therapy, but the prognosis is poor. Complete resection combined with high dose focused radiotherapy can improve the prognosis.
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Objective To analyze the treatment methods of the mesh infection after tension-free repair of inguinal hernia. Methods The clinical data of 6 patients with mesh infection after tension-free repair of inguinal hernia from January 2012 to December 2017 were retrospectively analyzed. The materials of the meshes were standard knitted polypropylene. Transabdominal preperitoneal technique (TAPP) was performed in 1 case, modified Kugel repair was performed in 1 case, and Lichtenstein repair was used in 4 cases. Five patients accepted reoperation, and the infected meshes were removed combined with closed drainage. One patient accepted conservative treatment. Results The patients who received the reoperation all healed and were discharged without perioperative death; the patients were followed up 6 to 40 months (average 19 months), and there were no recurrence patients. The patient with conservative treatment developed incision chronic infectious sinus formation. Conclusions There are many reasons for mesh infection after tension-free repair of inguinal hernia, and the management should be individual. Once the infection occurs, the infected mesh should be removed timely so as to shorten the course of disease, but the key is prevention.
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Objective@#To identify the candidate epigenetic biomarkers of Wnt subtype of medulloblastoma(MB).@*Methods@#MicroRNAs(miRNAs) expression array was used to detect the expression of miRNAs in MB cell lines with or without treatment by demethylation reagent. Nanostring gene expression array was used to detect the expression level of mRNA in 45 samples of primary MB. Molecular subtyping was performed based on the NanoString data. The status of methylation was confirmed by methylation specific PCR. The expression of candidate miRNA was confirmed by real-time PCR.@*Results@#All 45 MBs except one were classified into the four molecular groups: 4 in WNT group, 8 in SHH group, 16 were in Group3 and 16 in Group4. Methylation specific PCR (MSP) assay confirmed miR-449a was silenced due to aberrant DNA methylation in MB cell lines.WNT subtype of MBs showed relatively higher expression of miR-449a comparing with other subgroups.@*Conclusion@#MiR-449a, a candidate tumor suppressor gene regulated by hypermethylation, is a novel potential epigenetic marker for WNT subtype of MBs.