Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma.

Purpose: To explore the imaging performance for discrimination of combined hepatocellular- cholangiocarcinoma (cHCC-CCA) and hepatocellular carcinoma (HCC). Methods: In total, 35 patients with cHCC-CCA and a matched control group of HCC patients (n = 35) were included retrospectively. We quantitatively evaluated the hypovascular component in tumor and qualitatively assessed LI-RADS features and other aggressive features to develop model for cHCC-CCA diagnose. Subgroup analyses were performed by tumor size and LI-RADS category. Results: cHCC-CCA frequently showed a larger proportion (≥50%) of hypovascular areas followed by HCC (P = 0.000). Among those patients with ≥50% hypovascular areas, 8 patients did not present rim enhancement in atrial phase. The LI-RADS major features were more commonly observed in HCC (82.9-45.7%,), than cHCC-CCA (P = 0.003-0.022). The targetoid appearances and non-smooth margin frequently appeared in cHCC-CCA (34.3-63.9%), compared with HCC (P = 0.000-0.023). We developed a radiologic model based on ≥50% hypovascular component and delayed enhancement, which presented AUC of 0.821, accuracy of 80%. We also obtained good performance by radiologic model in LR-M group and tumor size <50mm group (AUC: 0.841 and 0.866, respectively). Combined group which included CA 19-9 and ≥50% hypovascular component and delayed enhancement did not improve the distinction performance between cHCC-CCA and HCC, which presented good performance of identifying cHCC-CCA in the LR-4/5 subgroup and tumor size ≥50 mm subgroup (AUC: 0.717, 0.730, respectively). cHCC-CCA group presented heterogeneous dominant pathology involving 15 of HCC, 7 of intrahepatic cholangiocarcinoma (iCCA) or cholangiolocellular carcinoma (CLC), 13 of intermediate cells component. Macrotrabecular appearances were higher in cHCC-CCA than that in HCC. The proportion of Hepa-1 was significantly higher in true negative (TN) patients (29 [93.5%]) and false negative (FN) patients (10 [100%]) than in true positive (TP) patients (16 [64%]; P = 0.036). Conclusion: Quantitative assessment of hypovascular component could help the discrimination of cHCC-CCA. Macrotrabecular appearances were more exhibited in cHCC-CCA than that in HCC.

Intrapulmonary solitary fibrous tumor: a clinicopathologic analysis of seven cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic features and differential diagnosis of intrapulmonary solitary fibrous tumor (SFT). Methods Features of pathology and immunohistochemical stains of 7 cases of intrapulmonary SFT were described, with review of the literatures. Results There were 4 females and 3 males in the 7 cases, aged from 24 to 65. The tumors were located in the right lobe of lung. Clinically the patients were characterized by coughing and chest pain. The tumor size ranged from 1.2 to 9.0 cm. Microscopically, it was consistent with SFT in other sites;the lesion displayed a histologic pattern with alternate hypercellular and hypocellular areas;tumor cells were admixed with collagenous stroma and arranged in bundles or swirl or hemangiopericytoma-like pattern. The cells presented short spindle, light to moderate atypia and were characterized by low mitose activity (<4/10 HPF);there was necrosis in 2 cases and epithelioid cells in 1 case;there was slite-like structure lined by benign alveolar epithelium of in all 7 cases.Immunohistochemically, the tumor cells were positive for vimentin, STAT6, CD34, BCL-2 and CD99 in areas and negative for others. Conclusion Intrapulmonary SFT is fairly rare. Its diagnosis relies mainly on imaging and histopathology and immunohistochemistry helps to distinguish it from other tumors such as pulmonary adenofibroma, malignant mesothelioma, synovial sarcoma, sarcomatoid carcinoma, the primary pulmonary meningioma. Patients have good prognosis, and radical surgery is a priority. We should pay more attention to long-term follow-up for the patients.

Prostate-Specific Antigen Density and Gleason Score Predict Adverse Pathologic Features in Patients with Clinically Localized Prostate Cancer.

BACKGROUND: According to recent studies, prostate cancer is the second most common cancer among Iranian men. Radical prostatectomy has been considered the gold standard treatment in patients with clinically localized prostate cancer. Gleason score, PSA density, and PSA velocity are some of the parameters used to predict adverse pathologic features. OBJECTIVES: The aim of this study was to evaluate the prognostic value of PSA density and Gleason score in predicting adverse pathologic features in patients with localized prostate cancer who undergo radical prostatectomy. METHODS: We conducted a cross-sectional study of 105 patients with localized prostate cancer who underwent radical prostatectomy between 2006 and 2013. We recorded Gleason scores and PSA levels, in addition to the results of pathological evaluations after radical prostatectomy, including prostate volume, stage, LNI (lymph node involvement), SVI (seminal vesicle invasion), and extraprostatic extension (EPE). Data were analyzed using SPSS version 21. RESULTS: Mean PSA density was 0.27 (0.17 SD). The frequencies of EPE, SVI, and LNI were 21.9, 16.2, and 2.9, respectively. The Mann-Whitney U-test demonstrated a significant correlation between PSA density and adverse pathologic features (EPE, SVI, and LNI). CONCLUSIONS: PSA, PSA density, and Gleason score should be considered together in order to more accurately predict the adverse pathologic features of prostate cancer.

[Pathologic features of the epididymis in patients with epididymal obstructive azoospermia: Observation of 11 cases].

OBJECTIVE: To search for potential therapeutic targets for epididymal obstructive azoospermia (EOA) secondary to epididymal infection by observing the pathologic features and analyzing the possible pathophysiologic mechanisms of the disease. METHODS: Eleven 28－53 years old infertile men with the history of epididymal infection were enrolled in this study, all diagnosed with azoospermia by routine semen examination and centrifugation. EOA was confirmed by further examinations of reproductive hormones and seminal plasma biochemical markers and scrotal ultrasonography, followed by surgical exploration and observation of the pathological characteristics of the epididymis. RESULTS: The gross epididymal specimen showed fluid accumulation in the epididymal tube to be the main pathologic feature. Under the microscope, the epididymal duct lumen was structurally intact but distended and with no sperm. Most of the cases revealed no inflammatory cell invasion in the wall of the duct. A small number of the patients with a longer course of disease exhibited cell infiltration in the lumen, hyperblastosis and glassy degeneration of the interstitial fibers, and scattered infiltration of lymphocytes and acidocytes in addition to expansion of the epididymal duct. CONCLUSIONS: EOA secondary to epididymal infection is pathologically characterized mainly by fluid accumulation in the epididymal duct, and its pathogenesis remains to be further studied.

Pathologic features of the epididymis in patients with epididymal obstructive azoospermia: Observation of 11 cases / 中华男科学杂志

<p><b>Objective</b>To search for potential therapeutic targets for epididymal obstructive azoospermia (EOA) secondary to epididymal infection by observing the pathologic features and analyzing the possible pathophysiologic mechanisms of the disease.</p><p><b>METHODS</b>Eleven 28－53 years old infertile men with the history of epididymal infection were enrolled in this study, all diagnosed with azoospermia by routine semen examination and centrifugation. EOA was confirmed by further examinations of reproductive hormones and seminal plasma biochemical markers and scrotal ultrasonography, followed by surgical exploration and observation of the pathological characteristics of the epididymis.</p><p><b>RESULTS</b>The gross epididymal specimen showed fluid accumulation in the epididymal tube to be the main pathologic feature. Under the microscope, the epididymal duct lumen was structurally intact but distended and with no sperm. Most of the cases revealed no inflammatory cell invasion in the wall of the duct. A small number of the patients with a longer course of disease exhibited cell infiltration in the lumen, hyperblastosis and glassy degeneration of the interstitial fibers, and scattered infiltration of lymphocytes and acidocytes in addition to expansion of the epididymal duct.</p><p><b>CONCLUSIONS</b>EOA secondary to epididymal infection is pathologically characterized mainly by fluid accumulation in the epididymal duct, and its pathogenesis remains to be further studied.</p>

The expression of leptin and soluble leptin receptor in breast cancer patients′serum and the clinical significance / 国际检验医学杂志

Objective To explore the levels of leptin(LEP) and soluble leptin receptor (sOB‐R) in breast cancer patients′ser‐um ,and to discuss the relationship between LEP ,sOB‐R ,free leptin index(FLI) and the patients′clinical pathologic features .Meth‐ods 70 serum specimens of breast cancer patients who confirmed by pathological diagnosis were collected before the surgery ,the serum of benign breast disease group(n=50) and normal group(n=50) were also collected as control .The levels of LEP and sOB‐Rinserumweredetected,andtheresultafterbodymassindex(BMI)correctionwereanalyzed.Finally,therelationshipbetweenthe expression of LEP ,sOB‐R and clinical pathologic features were analyzed .Results The serum level of LEP in breast cancer group was highly increased than the other two groups (P0 .05) .The level of LEP in the postmenopausal breast cancer patients were highly increased than menopause patients (P>0 .05) ,and the expression of LEP in cancer group were signifi‐cant higher than two control groups by both postmenopausal and menopause (P>0 .05) .The result suggested the serum level of LEP and FLI are associated with pTNM stages and lymph node metastases (P<0 .05) ,and elevated level of LEP in postmenopausal patients had differences in pTNM stages and lymph node metastases (P< 0 .05) .Conclusion The serum LEP level and the FLI may be potential indicators to evaluate the prognosis of the patient with breast cancer .The serum LEP may promoted the process of the postmenopausal patients of breast cancer .