Clinicopathological characterization of ten patients with primary malignant melanoma of the esophagus and literature review.

BACKGROUND: Primary malignant melanoma of the esophagus (PMME) is a rare malignant disease and has not been well characterized in terms of clinicopathology and survival. AIM: To investigate the clinical features and survival factors in Chinese patients with PMME. METHODS: The clinicopathological findings of ten cases with PMME treated at Henan Provincial People's Hospital were summarized. Moreover, the English- and Chinese-language literature that focused on Chinese patients with PMME from 1980 to September 2021 was reviewed and analyzed. Univariate and multivariate analyses were employed to investigate the clinicopathologic factors that might be associated with survival. RESULTS: A total of 290 Chinese patients with PMME, including ten from our hospital and 280 from the literature were enrolled in the present study. Only about half of the patients (55.8%) were accurately diagnosed before surgery. Additionally, 91.1% of the patients received esophagectomy, and 88 patients (36.5%) received adjuvant therapy after surgery. The frequency of lymph node metastasis (LNM) was 51.2% (107/209), and LNM had a positive rate of 45.3% even when the tumor was confined to the submucosal layer. The risk of LNM increased significantly with the pT stage [P < 0.001, odds ratio (OR): 2.47, 95% confidence interval (CI): 1.72-3.56] and larger tumor size (P = 0.006, OR: 1.21, 95%CI: 1.05-1.38). The median overall survival (OS) was 11.0 mo (range: 1-204 mo). The multivariate Cox analysis showed both the pT stage [P = 0.005, hazard ratio (HR): 1.70, 95%CI: 1.17-2.47] and LNM (P = 0.009, HR: 1.78, 95%CI: 1.15-2.74) were independent prognostic factors for OS. The median disease-free survival (DFS) was 5.3 mo (range: 0.8-114.1 mo). The multivariate analysis indicated that only the advanced pT stage (P = 0.02, HR: 1.93, 95%CI: 1.09-3.42) was a significant independent indicator of poor RFS in patients with PMME. CONCLUSION: The correct diagnosis of PMME before surgery is low, and physicians should pay more attention to avoid a misdiagnosis or missed diagnosis. Extended lymph node dissection should be emphasized in surgery for PMME even though the tumor is confined to the submucosal layer. Both the LNM and pT stage are independent prognosis factors for OS, and the pT stage is the prognosis factor for DFS in patients with PMME.

Clinicopathologic and neuroradiologic studies of papillary glioneuronal tumors.

BACKGROUND: Papillary glioneuronal tumor (PGNT) is a rare, recently described distinct low-grade brain neoplasm. This study was performed to characterize the clinicopathologic and neuroradiologic features of PGNTs. METHODS: We reviewed the medical records of 16 patients with PGNT who underwent surgery, including 11 males and five females (median age 27 years). The clinical, neuroradiologic, histopathologic, and immunohistochemical findings were documented. RESULTS: Headache was the principal presentation. Neuroimaging showed contrast-enhancing, cystic-solid or cystic masses with a mural nodule, mostly involved the frontal or parietal lobes. Histologically, the tumors were characterized by glial fibrillary acidic protein (GFAP)-positive small cuboidal cells lining hyalinized vascular pseudopapillae and synaptophysin and/or NeuN-positive interpapillary neuronal elements. Other findings included small angiomatous areas in ten, small islands of neuropil and rosettes in seven, and microvascular proliferation and/or nuclear atypia in six. Mitoses or necrosis were absent. All lacked isocitrate dehydrogenase 1 (IDH1) R132H protein expression. Low expression of p53 was observed in three cases. Ki67 labeling index ranged from less than 1 to 3 %. All but one was totally resected. Median follow-up was 65 months, and one patient had tumor recurrence. CONCLUSIONS: PGNTs display distinct clinicopathologic and imaging characteristics and indicate a favorable prognosis. However, recurrences sometimes occur. Immunohistochemistry facilitates the appropriate diagnosis of these tumors. Complete resection of the tumor is important for a favorable outcome.

Primary Intracranial Atypical Teratoid/Rhabdoid Tumors: A Clinicopathologic and Neuroradiologic Study.

Atypical teratoid/rhabdoid tumors are rare malignant pediatric brain tumors. This study was performed to characterize the clinicopathologic and neuroradiologic characteristics of atypical teratoid/rhabdoid tumors from 8 patients, including 5 male and 3 female infants (median age, 67 months). Neuroimaging revealed bulky masses of heterogeneous intensity with inhomogeneous enhancement. Three cases were infratentorial and 5 were supratentorial. Histopathologically, the tumors were predominantly composed of rhabdoid cells and undifferentiated small cells, mixed with some spindle or epithelial components. The tumors displayed striking polyphenotypic immunoreactivity, including varying degrees of positivity for vimentin, epithelial membrane antigen, smooth-muscle actin, cytokeratin, glial fibrillary acidic protein, neurofilament protein, synaptophysin, and CD99, and immunonegativity for desmin, placental alkaline phosphatase, and INI-1. The median survival duration was 9.5 months (range, 1-15 months) despite aggressive therapy. These results suggest that atypical teratoid/rhabdoid tumors display distinct clinicopathologic characteristics and indicate a poor prognosis. Immunohistochemistry facilitates the appropriate diagnosis of these tumors.

Melanotic neuroectodermal tumor of infancy arising in the temporal bone.

Melanotic neuroectodermal tumor of infancy is a rare melanin-containing neoplasm with locally aggressive and rapid expansile growth, usually involving the maxilla, skull, and mandible of early infancy. Radical surgery is critical for a long-term outcome. We present a case of 14-month-old girl with rapid-growing subcutaneous mass arising in the right temporal bone and extending intracranially on computed tomographic scan. Radical surgery was performed. A brownish-black tumor composed of large pigmented epithelioid cells, positive for cytokeratins and HMB-45, and nests of small neuroblast-like cells positive for neuron-specific enolase and synaptophysin, was diagnosed as melanotic neuroectodermal tumor of infancy. The patient remained well without evidence of recurrence for 1 year after surgery. Clinicopathological features, management alternatives and outcome were discussed.

Dysembryoplastic neuroepithelial tumor: a clinical, neuroradiological, and pathological study of 15 cases.

Dysembryoplastic neuroepithelial tumors are rare, surgically curable, neuronal-glial neoplasms affecting young patients with intractable epilepsy. Its recognition is needed to avoid unnecessary adjuvant therapy. The authors reviewed the records of 15 patients with dysembryoplastic neuroepithelial tumors who underwent epilepsy surgery using intraoperative electrocorticography monitoring, including 8 males and 7 females (mean age, 15.8 years). Neuroimaging showed a predominantly intracortical location, the presence of septations, a triangular pattern of distribution, a lack of contrast enhancement, and an absence of peritumoral edema. Eleven cases were classified as complex type, 3 as simple type, and 1 as "nonspecific" type. Associated cortical dysplasia was found in 5 cases and leptomeningeal involvement in 1 case. Its immunophenotype suggested a pluripotential neuroepithelial origin. The mean follow-up was 37.5 months; 2 patients had tumor recurrence. Although they are generally benign neoplasms, recurrences sometimes occur. Complete resection of the tumor with the epileptogenic zone is important for a favorable outcome.

[Clinicopathologic analysis of dysembryoplastic neuroepithelial tumor].

OBJECTIVE: To study the clinicopathologic features, radiologic findings, treatment options and prognosis of dysembryoplastic neuroepithelial tumor (DNT). METHODS: The clinicopathologic and radiologic features were retrospectively analyzed in 10 cases of DNT. RESULTS: Intractable partial seizure was the main presenting symptom in all patients. The tumor was located in temporal lobe (number = 5), frontal lobe (number = 3) or parietal lobe (number = 2). CT scan displayed a hypodense lesion. MRI scan revealed the tumor was non-enhancing T1WI hypointense and T2WI hyperintense, with internal septation and hyperintense ring around the tumor seen on FLAIR image. There was neither peritumoral edema nor mass effect. Histologically, the tumor showed the presence of glioneuronal element, with oligodendrocyte-like cells, floating neurons, astrocytes and associated microcystic changes. Immunohistochemical study demonstrated positivity for NeuN and synaptophysin in the neurons and some oligodendrocyte-like cells. Olig2 and S-100 protein were also expressed in the oligodendrocyte-like cells. Ki-67 index were lower than 1% in all cases. Nine cases were treated by complete surgical excision and the remaining case was subtotally excised. No post-operative chemotherapy or radiotherapy was given. One of the 10 cases recurred on follow up. CONCLUSIONS: Correct diagnosis of DNT requires correlation with clinicopathologic, radiologic and immunohistochemical findings. Complete resection of the tumor and epileptogenic foci is the mainstay of treatment for DNT, with intraoperative EEG monitoring. Post-operative chemotherapy or radiotherapy is not required.

[Prediction of chlorophyll content of greenhouse tomato using wavelet transform combined with NIR spectra].

In quantitative analysis of spectral data, noises and background interference always degrade the accuracy of spectral feature extraction. The wavelet transform is multi-scale decomposition used to reduce the noise and improve the analysis precision. On the other hand, the wavelet transform denoising is often followed by destroying the efficiency information. The present research introduced two indexes to control the scale of decomposition, the smoothness index (SI) and the time shift index (TSI). When the parameters satisfied TSI < 0.01 and SI > 0.100 4, the noise of spectral characteristic was reduced. In the meanwhile, the reflection peaks of biochemical components were reserved. Through analyzing the correlation between denoised spectrum and chlorophyll content, some spectral characteristics parameters reflecting the changing tendency of chlorophyll content were chosen. Finally, the partial least squares regression (PLSR) was used to develop the prediction model of the chlorophyll content of tomato leaf. The result showed that the predictiong model, which used the values of absorbance at 366, 405, 436, 554, 675 and 693 nm as input variables, had higher predictive ability (calibration coefficient was 0. 892 6, and validation coefficient was 0.829 7) and better potential to diagnose tomato growth in greenhouse.

[The canopy and leaf spectral characteristics and nutrition diagnosis of tomato in greenhouse].

A green house experiment was conducted to research the characteristics of tomato canopy spectral reflectance and leaf spectral reflectance under different nutrition treatments, and the relationships between spectral reflectance and the water content, chlorophyll content, as well as nitrogen content were analyzed. Substrate cultivation method was used to grow the plants. The substrate was made from a mixture of peat and vermiculite. Test area was prepared for four levels of nutrition to form nutritional stress. There were 12 seedlings under each nutritional condition and a total of 48 seedlings were planted for the experiment. The canopy reflectance and leaf reflectance were measured by an ASD handheld spectroradiometer and a FT-NIR spectrometer respectively. It was observed that the trend of tomato canopy reflectance was similar to each others. There was a reflection peak at about 550 nm, and the reflectance in the visible light region was lower than that in near-infrared region. The results of analysis also indicated that under different nutrient conditions, canopy spectral reflectance characteristics of tomato took on disciplinary change. At near-infrared bands, the reflectance gradually increased with adding nutrition, while reduced at visible light bands. The leaf spectral reflectance characteristics at near-infrared bands had the similar change with the canopy reflectance. There were four sensitive wavelengths of water at near-infrared bands: about 980, 1450, 1 930, and 2 210 nm, and the results of single linear regression (SLR) and multi-linear regression (MLR) indicated that the reflectance at these sensitive wavelengths could be used to estimate the water content in tomato leaves. R2 were 0.5903 and 0.7437 respectively. NDCI as one of the most important spectral parameter was calculated by the spectral reflectance of 530 and 760 nm, and the result indicated that there existed a good correlation between NDCI and the nitrogen content, with R2 = 0.7511. Meanwhile, red edge inflection points were analyzed under four nutrition treatments based on the first derivative of canopy spectral reflectance. The analysis results illustrated that red edge inflection position moved to direction of red light (long wavelength) with the nutrition supply.