Symptomatic multinodular splenic hamartoma preoperatively suspected as metastatic tumor: a case report.

Splenic hamartoma (SH) is a rare benign tumor usually detected accidentally, which is composed of an aberrant mixture of normal splenic elements. Here, we report a case of 54-year-old man who presented with symptomatic multinodular SH and was admitted initially for thrombocytopenia and anemia. Physical examination revealed that the patients had an anemic appearance and palpable spleen, extending 10 cm below the costal margin. Preoperative ultrasound and computed tomography (CT) indicated splenomegaly with multinodular lesions. On enhanced CT scanning, during the arterial phase, the lesions demonstrated inhomogeneous enhancement, and in the portal phase the lesions were more hyperdense than the splenic parenchyma. The images were highly suggestive of a metastatic tumor. Splenectomy was performed 1 wk later. The tumor was eventually diagnosed as SH according to the morphological features and immunohistochemical detection, by which CD34 was positive in lining cells and some spindle cells, vimentin was positive in the tumor, factor-VIII-related antigen was positive multifocally in lining cells, and smooth muscle actin was positive in some spindle cells. Thrombocytopenia and anemia were cured after splenectomy.

[Clinicopathological analysis and differential diagnosis of primary peritoneal adenocarcinoma].

OBJECTIVE: To investigate the clinicopathological characteristics and differential diagnosis of primary peritoneal adenocarcinoma. METHODS: The clinico-pathological data of 8 patients with primary peritoneal adenocarcinoma, all female, aged 55.7 (45 - 69), were analyzed retrospectively. Immunohistochemistry was used to detect the expression of pan-cytokine, cytokine (CK) 7, CK20, CA125, CEA, epithelial membrane antigen (EMA), vimentin, calretinin, and P63 in the specimens of tumor obtained during tumor reduction surgery. Microscopy was conducted for pathological examination. RESULTS: The common clinical symptoms of these 8 patients included abdominal distention and ascites. Pre-operationally, 6 cases were diagnosed as with ovarian cancer, I case as with malignant mesothelioma, and I as with peritoneal carcinoma. The misdiagnosis rate was 87.5%. Post-operational pathological examination showed 7 cases of serous papillary adenocarcinoma and one case of mucinous adenocarcinoma. Immunohistochemistry showed the positive rates of the different biological markers as follows: pan-CK (8/8), CK7 (8/8), CK20 (1/8), CA125 (7/8), CEA (7/8), EMA (8/8), vimentin (1/8), calretinin (1/8), and P53 (8/8). CONCLUSION: A rare malignant tumor arising from the secondary Müllerian system, primary peritoneal adenocarcinoma shares similar histopathological characters with ovary carcinoma, so is easy to be misdiagnosed. Immunohistochemical staining is helpful to the differential diagnosis.

[Establishment of bone metastasis model of prostate cancer in nude mice by intratibia injection of human prostate cancer cell line Du145].

OBJECTIVE: To establish a bone metastasis model of prostate cancer by intratibia injection of Du145 in nude mice, observe the local growth of tumor in tibia and then assess application value of this model. METHODS: For 9 male nude mice, Du145 (5 x 10(6)) was injected in tibia by a TB syringe with a 29-gauge needle at a dose of 30 microl per mouse. Then the vital signs of the nude mice were observed. When the mice were dying, they were sacrificed, and the tissues of right hindlimbs, lymphatic nodes, lungs and livers were taken out, fixed in 10% formalin, embedded in paraffin, stained by HE and then observed microscopically. RESULTS: Incidence of bone tumor after intratibia injection was 67% (6 out of 9). About 48 days later, there were some small palpable nodes in right hind-limbs of the 6 mice and they couldn't walk normally. About 55 days later, cachexia occurred in them. After dissection, some carrion-like tissue grew from marrow cavity to muscular spatium, which was identified as tumor tissue by HE. The envelop of livers became crampy, and acute hepatitis could be diagnosed through microscopy, which represented a large scale of hepatocytic death, liver sinus dilatation and hyperemia, hepatic lobule infiltrated by lymphocyte, macrophage and inconspicuous hyperplasia. Since hypohepatia occurred too early, we couldn't detected distant metastases. CONCLUSION: The intratibia injection model is an optimal animal model to study metastasis of prostate cancer. It mimics the natural situation of human prostate cancer and will help to understand the mechanisms of androgen-independence and osseous metastasis, and tumor-host determinants of PSA expression.

[Clinical study of 22 cases of primary gastrointestinal lymphoma].

BACKGROUND & OBJECTIVE: Primary gastrointestinal lymphoma (PGIL) is extranodal non-Hodgkin's lymphoma (NHL) that originates from extra-nodal tissue of gastrointestinal (GI) tract and has specific clinical and pathological features. This study was to report the clinical and pathological features as well as the treatment outcome of this disease. METHODS: The clinical data of 22 cases of PGIL admitted and treated from January 1994 to June 2000 in the First Hospital of Xi'an Jiaotong University were analyzed retrospectively. The diagnosis was confirmed histologically. RESULTS: All the patients were followed up for more than 3 years; among them 13 patients were followed up to 5 years. The 3-year and 5-year survival rates were 45.5% (10/22) and 38.5% (5/13), respectively. The survival rates decreased with the progression of the clinical stage. Low-grade marginal zone derived mucosa-associated lymphoid tissue lymphoma (MALT) showed a better prognosis than other pathological types. Of the 16 patients who received treatment attained complete remission (CR), the 3-year and 5-year survival rates were 62.5% (10/16) and 45.5% (5/11), respectively, whereas the 3-year and 5-year survival rates of the 6 non-controlled patients were 0 and 0. Among the twelve cases treated with surgery alone, the 3-year and 5-year survival rates were 33.3% (4/12) and 10% (1/10), respectively. For those receiving surgery combined with chemotherapy and radiotherapy (5 cases received adjuvant chemotherapy after surgery, and 1 patient received abdominal irradiation after the surgery), the 3-year and 5-year survival rates were 83.3% (5/6) and 66.7% (2/3), respectively. CONCLUSION: The prognosis of PGIL is related to control of the primary disease.