1.Clinicopathologic analysis of 19 cases of urachal adenocarcinoma
Xiang LI ; Ying HUANG ; Weiyu PAN ; Juan YU ; Xinxin GUO ; Xiaolei ZHANG ; Licheng SHEN ; Yingyong HOU ; Jun HOU
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):571-576
Purpose To explore the clinical and pathological features,differential diagnosis,treatment methods and prognosis of urachal adenocarcinoma.Methods Nineteen cases of urachal adenocarcinoma were collected and an-alyzed by combining clinical symptoms,auxiliary examinations,histology,immunohistochemical,and genetic testing and 11 cases of bladder adenocarcinomas.Results Among the 19 patients(15 males,4 females;age range:33-75 years,mean:55 years),tumors were located at the dome or anterior wall of the bladder.Histological subtypes includ-ed mucinous adenocarcinoma(6 cases),adenocarcinoma not otherwise specified(4 cases),enteric-type adenocarci-noma(6 cases),adenocarcinoma with focal mucinous differentiation(1 case),adenocarcinoma with signet-ring cell carcinoma(1 case),and metastatic urachal adenocarcinoma(1 case).Immunophenotypic analysis revealed membra-nous positivity for β-catenin,diffuse positivity for CK34βE 12,MUC-2,and CK20,focal CK7 positivity in some cases,and rare GATA-3 positivity.Mutations in p53 were observed,while KRAS,NRAS,BRAF,and PIK3CA mutations were absent.In colorectal adenocarcinomas,CK34βE12 positivity was 40%,nuclear β-catenin positivity was 48%,and MUC-2 expression was approximately 50%.In bladder adenocarcinomas,GATA-3 and MUC-2 positivity rates were 45%and 63.6%,respectively.Conclusion Distinguishing urachal adenocarcinoma from colorectal and primary bladder adenocarcinomas remains challenging.Urachal adenocarcinoma should be suspected in patients with anterior bladder wall or dome lesions,gross hematuria,or mucinuria.No definitive diagnostic markers currently exist for ura-chal adenocarcinoma.Immunophenotypic features such as membranous β-catenin,MUC-2,and CK7 positivity may fa-vor urachal adenocarcinoma over colorectal adenocarcinoma.Additional markers(e.g.,GATA-3,CK20,CK34βE12)aid in differential diagnosis,though individual markers lack specificity.Comprehensive evaluation integrating clinical presentation,imaging,and clinicopathological features is essential for accurate diagnosis.
2.The molecular subtyping of urothelial carcinoma using GATA-3 and CD44
Xiaodie ZHOU ; Bo YU ; Xuan WANG ; Jianjun WANG ; Qunli SHI ; Qiu RAO ; Wei BAO
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):596-601
Purpose To investigate the correlation between molecular typing of urothelial carcinoma(UC)and its clinicopathologic features and prognosis,in order to explore the prognostic markers and therapeutic targets for UC.Methods 115 patients with UC were retrospectively analyzed.Immunohistochemical markers GATA-3,CK20,CK5/6 and CD44 were used for molecular typing of UC(luminal-like type,basal-like type and null).Correlations between molecular typing and clinicopathological features were analyzed using the Chi-square test and Fisher precise test.Sur-vival analysis was performed using the Kaplan-Meier test and Log-rank test.Results The expression of GATA-3 and CK20 was negatively correlated with the clinical stage of UC,while the expression of CD44 was positively correlated with the clinical stage of UC(both P<0.05).CK20 was a marker of good prognosis(P=0.03).The proportion of clinically advanced UC with basal-like type was significantly higher than that of luminal-like type(78.4%vs 53.4%,P=0.033).Among the histologic variants,UC with neuroendocrine differentiation(100%),sarcomatoid carcinoma(80.0%)and squamous differentiation(77.8%)were basal-like type.All plasmacytoid and lymphoepithelioma-like types,as well as 81.8%of micropapillary UC.Among the null phenotypes,the differential variant predominated(66.7%).Compared with the luminal-like type,although the prognosis of basal-like UC was worse,there was no sta-tistically significant difference(P>0.05).Conclusion Patients with CK20-expressing UC had a significantly better prognosis.The main histologic variants types of basal-like type and coelomofacial type are different.Molecular typing of UC using immunohistochemical markers is suggestive of clinical staging and prognosis of patients.
3.Tumor budding and its correlation with clinicopathological features and prognosis in penile squamous cell carcinoma
Wen HAN ; Qian ZHANG ; Xiang YONG ; Yi ZHANG ; Chun WANG ; Haonan LIU ; Xiaotong GUO
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):608-613
Purpose To investigate the correlation between tumor budding in penile squamous cell carcinoma(SCC)and its clinicopathological features.Methods Clinical data and pathological slides from 69 cases of penile SCC were collected.Tumor budding was examined microscopically,and statistical analyses were performed to assess the relationship between tumor budding and various clinicopathological features.Results Among the 69 cases of pe-nile SCC,41 cases exhibited low-grade tumor budding and 28 cases displayed high-grade tumor budding.Tumor bud-ding was significantly correlated with tumor size,urethral invasion,invasion of the urethral corpus spongiosum,inva-sion of the penile corpus cavernosum,tumor necrosis,nerve invasion,vascular tumor thrombus,and pathological T stage(all P<0.05).In contrast,no significant association was found between tumor budding and HPV-related versus non-HPV-related penile SCC(P>0.05).Log-rank survival analysis indicated that patients with high-grade tumor bud-ding had a significantly lower survival rate compared to those with low-grade tumor budding(P<0.05).Conclusion Tumor budding is a distinct pathological feature of penile SCC,and high-grade tumor budding is associated with a more aggressive biological behavior.
4.Osteolipoma of thyroid gland:a clinicopathological study of 7 cases
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):614-617,626
Purpose To investigate the clinicopathologic features and imaging characteristics of osteolipoma in thyroid gland,and to improve the understanding and diagnosis of the disease.Methods The clinical,pathological,and imaging data of 7 cases of osteolipoma in thyroid gland were retrospectively analyzed,and the histological morphol-ogy of thyroid osteolipoma was observed using hematoxylin-eosin(HE)staining,the pathological changes and imaging manifestations of the disease were analyzed,and relevant literature was reviewed.Results The study included 2 male and 5 female patients,with a male-to-female ratio of 1∶2.5.The patients were ranged in age from 30 to 77 years,with a mean age of 54.3 years.The clinical symptoms were mainly anterior cervical tumor.Laboratory examination showed normal thyroid function 5 cases(5/7),slightly decreased thyroid stimulating hormone(TSH)in 1 case(1/7),in-creased free triiodothyronine(FT3)and decreased TSH in 1 case(1/7).Preoperative ultrasound examination(7/7)showed solid nodules in the thyroid gland,with smooth edges,hypoechoic solid components,and coarse calcifications in the nodules;X-ray computed tomography(CT)examination(2/7)showed thyroid mixed density nodules with clear boundaries.Histological morphology showed that the tumor was composed of mature adipose tissue and bone tissue with different proportions,and the cells exhibited no atypia or necrosis,and mitotic figures were rare.Two cases were com-plicated with papillary thyroid carcinoma and 3 cases with nodular goiter.All cases received surgical treatment,and were followed up from 11 to 42 months,without tumor recurrence.Conclusion Osteolipoma of thyroid gland is rare in clinic and has relatively specific pathological characteristics and imaging changes,aiming to improve the understanding of the pathological and imaging manifestations of osteolipoma.
5.Tryptanthrin inhibits the malignant growth of glioma cells by regulating the MAPK/ERK signaling pathway
Jing WEI ; Han ZHOU ; Fangzheng JIAO ; Zihan YUAN ; Yifan QIAO ; Yan FANG
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):618-626
Purpose To explore whether tryptanthrin(TRYP)can inhibit the malignant behavioral ability of glio-ma cells,and to elucidate the specific mechanism of its action.Methods MTT assay was performed to detect the effect of TRYP on the proliferation of glioma cells;Transwell assay was performed to detect the effect of TRYP on the migration and invasion of glioma cells;AnnexinV-FITC/PI apoptosis assay was performed to detect the effect of TRYP on the apoptosis of glioma cells;PI/RNase cell cycle assay was performed to detect the effect of TRYP on the cell cycle distribution of glioma cells;Western blot assay was performed to detect the effect of TRYP on the protein expressions of p-ERK and c-Myc in glioma cells.The effect of TRYP on the proliferation of glioma cells in vivo was verified by con-structing a subcutaneous transplantation tumor model in nude mice,and the effect of TRYP on the apoptotic ability of cells in the transplantation tumor was detected by TUNEL assay.Immunohistochemistry was used to detect the effect of TRYP on the expression of Ki67,BRAF,c-Myc,and p-ERK proteins in transplanted tumor tissues.Results MTT assay showed that TRYP could effectively inhibit the proliferation of glioma cells(P<0.001).Transwell assay showed that TRYP could inhibit the invasion and migration of glioma cells(P<0.001).AnnexinV-FITC/PI cell apoptosis as-say showed that TRYP could promote the apoptosis of glioma cells(P<0.001).The results of PI/RNase cell cycle as-say showed that TRYP was able to promote the G2 phase block of glioma cells(P<0.001).Western blot results showed that the expression levels of c-Myc and p-ERK proteins in the glioma cells were significantly reduced after TR-YP treatment(P<0.001).The results of subcutaneous transplantation tumor model in nude mice showed that TRYP could effectively inhibit the growth rate(P<0.01)and weight(P<0.05)of transplanted tumor.TUNEL assay showed that TRYP could promote the apoptosis of tumor cells in transplanted tumor(P<0.001).Immunohistochemis-try results showed that TRYP could effectively inhibit the protein expression of Ki67(P<0.01),BRAF,c-Myc,and p-ERK(P<0.001).Conclusion TRYP can inhibit the proliferation,invasion,and migration ability of glioma cells,promote apoptosis of glioma cells,and block the cell cycle of glioma cells.TRYP may inhibit the malignant pro-gression of glioma cells by suppressing the protein expression of BRAF,c-Myc and p-ERK1/2 in the MAPK/ERK sig-naling pathway.
6.Research progress on the role and mechanism of ferroptosis in renal cell carcinoma
Jixin YUAN ; Zhiming WANG ; Zhifei CAO ; Yongsheng ZHANG
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):639-643
Renal cell carcinoma(RCC)is the most common type of malignant kidney tumors,originating from re-nal tubular epithelial cells.The primary treatment options for RCC include surgery and targeted therapy.Despite the notable advancements in RCC research,significant challenges persist,including the high risk of metastasis and recur-rence post-surgery,as well as the low sensitivity to radiotherapy and chemotherapy.Ferroptosis,a form of regulated cell death first identified in 2012,has garnered significant attention due to its involvement in several cellular processes,including redox balance,iron metabolism,and various signaling pathways related to cancer progression.Given its po-tential to be modulated,ferroptosis offers significant promise for the treatment of cancers,ischemic organ damage,and other degenerative diseases associated with lipid peroxidation.This review discusses recent developments in ferroptosis research,with a particular focus on its role in RCC,and explores future research directions in this area.
7.Virtual staining techniques:Emerging applications and prospects in histopathology
Hui CHEN ; Wei SHAO ; Cheng LU ; Xiangxue WANG ; Henghui MA ; Xiaojun ZHOU ; Qiu RAO
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):565-570
Histological staining is the basis of pathological analysis,but the traditional staining method relies on chemical reagents,which not only consumes a lot of resources,but also causes harm to the environment and human health.In recent years,with the rapid development of deep learning technology,virtual staining technology,as a new method,is expected to effectively replace and supplement the traditional histological staining methods.It uses neural networks to analyze unstained tissue images,generate digital images that are highly similar to chemical staining effects,and even realize the mutual conversion between different staining modes,reducing the laboratory's dependence on chemical reagents and providing sustainable research programs.In this paper,the basic principles of virtual staining and its potential applications in histopathology are introduced in detail,and the current challenges and future research directions are discussed.
8.Clinicopathological analysis of 27 cases of renal adenoma of urinary tract
Wenrong ZENG ; Lijuan BIAN ; Aiwei XU ; Yu YU ; Zhi LI
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):577-583
Purpose To explore the clinicopathologic features and differential diagnosis of nephrogenic adenomas(NAs)in urinary tract.Methods 27 cases of NA were collected.The clinicopathological features and differential di-agnosis were analyzed,and the relevant literatures were reviewed.Results A total of 27 cases of NA in urinary tract were included in this study,including 20 males and 7 females,ranging in age from 24 to 84 years.Among them,clini-cal manifestations included urinary tract irritation in 8 cases,hematuria in 7 cases,and no obvious symptoms or other comorbidities in 12 cases.Comorbidities:17 cases combined with urothelial tumors,4 cases with cystitis,2 cases with tuberculosis,2 cases with urethral diverticulum,and 2 cases with ureteral calculi or stenosis.Gross inspection:19 ca-ses occurred in the bladder,5 in the ureter,and 3 in the urethra.The average size of the lesions was about 4.3 mm.Local edema or protrusion of the mucosa with roughness were found in 18 cases,papillary or polypoid masses in 5 ca-ses,or follicular-like neoplasma in 4 cases.Histologic features:these lesions were mainly composed of papillary,tubu-lar and cystic structure,and eosinophilic colloid secretions were seen in the lumen.The lining epithelium was cuboidal or low columnar,some of which were 'hobnail' or signet ring-like cells,and stroma showed edema and chronic inflam-mation.Immunohistochemistry:epithelial cells expressed PAX8 and CK7,partially expressed P504S and GAT A3,but not p63 and PSA.p53 was wild type,and Ki67 proliferation index was low(1%-8%).Molecular testing:no ab-normalities were found in 14 urine FISH tests before surgery,and no fusion mutation was detected in 2 samples selected for second-generation sequencing.Treatment and follow-up:follow-up data were obtained for all cases,of which 24 un-derwent transurethral resection of bladder lesions,and the rest underwent nephroureterectomy or cystoprostatectomy.The mean follow-up was 26.6(1-59)months,and the lesion recurred in 2 cases.Conclusion NAs are relatively rare,and their final diagnosis depends on pathological examination.When the biopsy sample is small or the histomor-phology is atypical,it's often necessary to differentiate it from urothelial tumor,prostate adenocarcinoma and clear cell adenocarcinoma.Understanding the clinicopathologic and immunohistochemical features of NA is helpful to improve the diagnostic rate and avoid missed-diagnosis or misdiagnosis.
9.Clinicopathological and molecular genetic analysis of 10 cases of nephrogenic ade-noma/metaplasia in bladder
Wenwu LUO ; Mei LI ; Kun ZHONG ; Yu YIN
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):584-590
Purpose To investigate the clinicopathological characteristics of nephrogenic adenoma/metaplasia(NA/M)of the bladder and analyze key points for diagnosis and differential diagnosis.Methods A retrospective a-nalysis was conducted on 10 cases of NA/M of the bladder,including clinical data,cystoscopic findings,microscopic morphology,and immunohistochemistry(IHC)results.Subsequently,a whole-exome sequencing(WES)was per-formed and a comprehensive literature review was supplemented.Results The cohort included 6 cases female and 4 cases male,aged 20-72 years(median:46.5 years).Three patients had a history of hydronephrosis(2 cases with nephrolithiasis and hydronephrosis,1 case with acute leukemia and bone marrow transplantation),2 cases had renal tuberculosis,1 case had erectile dysfunction,3 cases had a history of invasive high-grade urothelial carcinoma of the bladder,and 1 case had bladder endometriosis.All patients underwent cystoscopic biopsy,with pathological confirma-tion of NA/M.IHC showed that all 10 cases expressed PAX-8 and CK7 but were negative for GATA-3,p63/CK5/6,and PSA.The Ki67 proliferation index ranged from 1%to 10%.WES analysis of 7 cases revealed somatic single nu-cleotide variants(SNVs)involving multiple genes,with the highest mutation frequencies in FAM186A(86%),GOL-GA6L2(86%),and AQP7(86%).Conclusion NA/M is a benign but recurrent lesion,with rare malignant trans-formation after multiple recurrences.Comprehensive evaluation of histomorphological atypia and IHC results is recom-mended for accurate diagnosis and differential diagnosis to avoid misdiagnosis.Long-term follow-up is advised.WES findings suggest associations between NA/M and mutations in FAM186A,GOLGA6L2,and AQP7,providing potential directions for future research.
10.Clinicopathologic analysis of 17 cases of malacoplakia
Yinhua SHI ; Na WEI ; Jingjie FU ; Mengke QIN ; Jingjing XU
Chinese Journal of Clinical and Experimental Pathology 2025;41(5):591-595
Purpose To explore the clinicopathologic features,pathogenesis and differential diagnosis of Malaco-plakia.Methods The clinical features,imaging manifestations,cytopathologic features,histopathologic features,im-munohistochemistry,special staining and molecular pathological manifestations of 17 patients with Malacoplakia were analysed and the relevant literature was reviewed.Results Seventeen patients with Malacoplakia were mostly female,of which 13 lesions were located in the bladder,1 in the prostate,1 in the colon,1 in the right external auditory canal,and 1 in the retroperitoneum.Cytologic morphology varied depending on the site of the lesion,with phagocytes and MG-like microsomal analogues seen in renal puncture cytology,and small numbers of squamous epithelial cells and uroepi-thelial cells(NHGUC)seen in urinary cytology specimens.Histologic morphology showed a large number of foamy his-tiocytes and small numbers of neutrophils and eosinophils against a background of chronic inflammation dominated by lymphocytes and plasma cells;the cytoplasm of the histiocytes was eosinophilic and granular,with blue calcified vesi-cles scattered throughout,some of which were in the form of target-ring or concentric-circle-like structures,which are known as Michaelis-Gutmann bodies(MG bodies).Special stains showed PAS and iron staining(+);immunohisto-chemistry showed diffuse histiocyte CD68(+),CD163(+),CK(AE1/AE3)(-);molecular pathology showed TB-DNA(-).Conclusion Malacoplakia is a chronic granulomatous disease that can be cured.Imaging often shows occupancy,which is easily misdiagnosed as a tumour clinically,and confirming the diagnosis mainly relies on patholog-ical diagnosis,differential diagnosis includes xanthogranulomatous cystitis,xanthogranulomatous pyelonephritis,colon cancer,granulosa cell tumour and Langerhans histiocytosis.

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