Purpose To investigate the clinicopathologic features and prognostic factors of apocrine carcinoma ( AC) of breast. Meth-od Clinical data of 70 ACs and 283 invasive carcinomas, not otherwise specified were collected. Differences between the prognostic outcomes of the two groups were compared, and the relationship between clinicopathological characteristics and prognosis was also ana-lyzed. Results The mean age of the patients with AC (56. 17 ± 12. 41 years) was older than those with invasive carcinoma not other-wise specified (52. 77 ± 11. 07 years) (P=0. 039). The patients with AC had a lower frequency of axillary nodal metastasis, a lower frequency of ER and PR positivity comparing to invasive carcinoma not otherwise specified ( P<0. 05 ) . No significant differences in the overall survival (P=0. 221) and disease-free survival (P=0. 378) periods of the two groups were observed. Kaplan-Meier surviv-al analysis showed tumor size, lymph node metastasis, pathological stage, lymph node tissue infiltration were related with prognosis of patients with AC ( P<0. 05 ) . In multivariate analysis, lymph node metastasis was associated with a worse prognosis ( P<0. 05 ) . Conclusions Although AC and invasive carcinoma not otherwise specified have different clinicopathologic characteristics, the prog-noses of patients with these diseases are similar. Lymph node metastasis could be used as an independent factor for predicting the prog-nosis of patients with AC, early diagnosis and early treatment is the key to improve its prognosis.

Objective To investigate prenatal ultrasound diagnosis of clubfoot and its clinical value.Methods Three thousands pregants ranging gestational age from 12 through 40 weeks were checked using Ascuson Sequoia 512 equipment.The diagnosis of clubfoot was made prospectively at the time of the scan by the following criteria: the ball of foot had to be visible in the same plane as the longitudinal section of bones of the lower leg,unchanging with fetal activity and reproducible for several images.All prenatal ultrasonographic dignoses of clubfoot were proved by autopsy or newborn physical examination.Results A total of 17 cases clubfoot fetuses were prenatal diagnosed by ultrasonography.Fourteen of 17 clubfoot fetuses had associated with complex abnormalities,three of them were isolated clubfoot.Fourteen of 17 cases with clubfoot prenatal diagnosed by ultrasound were proved by autopsy.Another three cases with clubfoot were proved by newborn physical examination,two of them were false positive diagnosis.Conclusions Prenatal diagnosis of clubfoot is reliable by ultrasound.It is helpful in diagnosis with other structural abnormalities associated with clubfoot.It can also provide direction for clinical obstetrical management.

Objective To investigate prenatal ultrasound diagnosis of radial ray abnormalities and its clinical value. Methods All the fetus that entered usual prenatal ultrasound diagnosis were scanned each limb using a systematic continuous sequence approach (SCSA) with Acuson Sequoia 512 and GE Logiq 400 equipments. All the artificial aborted fetal radius malformation also had ultrasound examination in a simulating intrauterine estate and /or X-ray examination. Results Correctly diagnosis was made in 13 cases fetal radial ray abnormalities by prenatal ultrasonography following SCSA through the scaning course. All the fetal radial ray abnormalities had radius absence(only one skeleton in the forearm) or radius dysplasia and characteristic radial club hand. Ray abnormalities can be classifyied into three types on ultrasonography: type Ⅰ, radius absence; type Ⅱ,radius part absence; type Ⅲ,radius dysplasia.Conclusions Mastering characteristic radial club hand and SCSA are the keys to diagnose fetal radial ray abnormalities by prenatal ultrasonography.

Objective To review the ultrasonographic evaluation on fetal facial anatomy and malformations in prenatal diagnosis. Methods Continuous 4 200 prenatal ultrasonographic evaluation during gestation age 14 40 weeks from August 2000 through June 2002 entered the present study. Routine coronal, sagittal and transverse planes were applied to scan the fetal facial structures after the fetal position was confirmed and/or adjusted. Results Superficial facial anatomic structures as well as the deep bony structures of the fetal faces were clearly displayed and correctly recognized on the three routine planes in 4 184 cases ( 99.62 %), but not the palate. Seventy eight facial malformations of 29 fetuses were correctly diagnosed. Whereas 9 malformations of 7 fetuses were missed to recognize, and 2 suspected cleft palate were demonstrated normal after delivery. The diagnoses were confirmed after subsequent labor or induced labor. The total detection rate reached 89.66 %. The false negative rate was 10.34 %, and the false positive rate was 0.05 %. The sensitivity, specificity, accuracy, positive and negative predictive values were 85.29 %, 99.95 %, 99.83 %, 93.55 % and 99.88 % respectively. Conclusions The majority of fetal facial superficial and deep structures is clearly demonstrated on prenatal ultrasonic imaging on the 3 routine scanning planes. Prenatal ultrasonographic evaluation of the fetal face is a reliable and accurate diagnostic modality so far as the skills become more sophisticated.

Objective To review the prenatal ultrasound features and clinical value of fetal micrognathia.Methods All 13 500 cases were scanned for fetal faces with routine transverse,coronal and sagittal planes during prenatal ultrasonography.Results Thirteen cases with micrognathia were detected by prenatal ultrasonography.Midsagittal and coronal scans of all fetuses with micrognathia demonstrated small mandible and receding chin and the lower lip reside posterior to the upper lip.All prenatal diagnosed fetuses micrognathia were confirmed by autopsy.Conclusions Prenatal ultrasonic diagnosis of fetal micrognathia relied on subjective evaluation of fetal profile on a midline sagittal and a coronal scan of fetal face.Micrognathia may be a clue or marker of chromosomal anomalies and syndrome.Prenatal detecting of micrognathia has important clinical value.

Objective To investigate the values of CD21 and CD43 proteins in the differential diagnosis of mucosa-associated marginal zone B-cell lymphoma (MALToma) from benign lymphadenosis. Methods The expression of CD21 and CD43 proteins in the tissues of 25 MALToma (case group) and 25 benign lymphadenosis (control group) was detected by immunohistochemistry. Results Abnormal CD21+follicular dendritic cells (FDC) meshes were found in all patients of case group. Most of the FDC meshes were sparse and broken, and a few were enlarged or fused into pieces. Intact CD21+FDC meshes were all found, and abnormal FDC meshes were not found in control group. The positive rate of abnormal FDC meshes in case group was significantly increased compared with that in control group (χ2 = 46.080, P= 0.000). The expression rate of CD43+in CD20+cells was 24 % (6/25) in case group, but it was negative in control group (χ2=4.375, P=0.030). Conclusions Abnormal CD21+FDC meshes and CD43+expression in CD20+cells are useful in the differential diagnosis between MALToma and benign lymphadenosis. The abnormal FDC meshes of MALToma are enlarged or fused in the minority of cases.

Objective To compare the sonographic and pathologic features of calcified and non-calcified ductal carcinoma in situ DCIS Methods A total of 83 lesions in 82 consecutive patients with pathologically confirmed pure DCIS were recruited One patient had bilateral lesions All lesions were divided into calcified DCIS and non-calcified DCIS according to the presence of calcifications on mammography Their sonographic features and pathologic reports for all patients with DCIS were retrospectively reviewed Statistical comparisons were performed using the chi-square test Results 1 Calcified DCIS showed positive ultrasound US findings in 80% 44 55 of cases The most common US finding was nonmass lesions 43 6% 24 55 Nine cases had pure ductal dilatations 16 4% 9 55 Non-calcified DCIS showed positive US findings in 96 4% 27 28 of cases The most common US finding was mass 89 2% 25 28 Two cases had pure ductal dilatations 7 1 % 2 28 No significant difference was found in the shape margin orientation posterior feature of a mass between the calcified and non-calcified groups P >0 05 Significant difference was observed in the size boundary echogenicity on ultrasound of the two groups P <0 05 2 At histopathology the pathological scores high nuclear grade positive ER status positive PR status positive Ki67 status and the presence of Her-2 neu oncogene were more common in the calcified group than in the non-calcified group Conclusions Calcified and non-calcified pure DCIS have different pathologic and sonographic features Calcified DCIS has more aggressive histological features than non-calcified DCIS.

Objective To study the ultrasonographic clues and methods for fetal anomalies of the aorta arch and improve prenatal detection of anomalies of the aorta arch.Methods One thousand four hundred and seventy-two cases fetus who were carried out detailed scan and whose results were confirmed were chose as study objects.Every routine fetal echocardiography included four chamber and left and right outflow tract and three-vessel trachea view(3VT).The more views which included longitudinal and coronary view of the aorta arch and coronary view of the trachea and main bronchus were obtained when the abnormality of aorta arch was suspected.Results One hundred and forty-eight cases with anomalies of aorta arch were diagnosed by ultrasonography.One case was misdiagnosed.Ninety-two fetus with anomalies of aorta arch which included 28 aortic coarctation(CoA) and 10 interrupted aortic arch (IAA) and 52 right-side aortic arch and abnormal aortic branch and 2 double aortic arch were confirmed by postmortem or postnatal echocardiography and surgery.Of the 92 confirmed cases,24 had prenatally diagnosed additional complex intracardiac anomalies.All cases with CoA and IAA presented ventricular and/or great arterial disproportion with smaller left ventricle and aorta diameter on four chamber view and 3VT.Right aortic arch (RAA) and abnormal aortic branch(AAB) displayed aortic arch located on the right side of the trachea and increased distance between the aortic arch and arterial duct and abnormal aortic arch branch-subclavian artery originating from the beginning section of the descend aorta which coursed behind the trachea with U-shaped appearance on the 3VT plane.The display rate of the transverse and longitudinal and coronary view of the aorta arch was 98.4%,90.0%,81.9%,respectively.Conclusions Disproportional ventricular and /or great arterial with smaller left ventricle and aorta diameter are the clues for CoA and IAA.Increased distance between the aortic arch and arterial duct is the clue for RSA.The transverse view of the aortic arch 3VT is the most sensitive for detecting the anomalies of the aortic arch and the most easily be obtained.The longitudinal and coronary view of the aorta arch and coronary view of the trachea and main bronchus are helpful in differentiating the anomalies of the aortic arch.

Objective To investigate ultrasonographic (US) features of mucinous breast carcinoma with pathological correlation and to improve the early diagnosis for the mucinous breast carcinoma.Methods Twenty-two patients with 23 focuses mucinous carcinoma of the breast confirmed by pathology were included in this study,retrospectively evaluate sonographic features according to the American College of Radiology(ACR) Breast Imaging Reporting and Data System(BI-RADS) Lexicon,all cases were classified by BI-RADS before operation.Histological type of mucinous breast carcinoma included mixed and pure two forms,the latter was classified into cellular variants and hypocellular variants.The correlation between the ultrasonographic findings of mucinous carcinoma and histologic features in different types were analysed.Results On US examination,all 22 cases presented as solid mass.In pure form,they showed well-defined margins with no pseudocapsule and isoechogenic or hypoechoic internal echo pattern relative to that of subcutaneous fat in 86.7％ (13/15) focuses which histological type were pure type.93.3％ (14/15) of pure type focuses had posterior enhancement.All pure type focuses demonstrated that the orientation of the mass is parallel to the skin line.75.0％ (6/8) of mixed type focuses and 13.3％ (2/15) of pure type focuses,however,demonstrated ill-defined and or spiculated margins with more hypoechogenic structure (P ＜0.01).Mixed type focuses have more aggressive malignant features.65.2％ (15/23) of cases being classified as BI-RADS 4 or 5 were suspected as malignancy,which included 6 mixed type focuses and 9 pure type respectively accounting for 75.0％ (6/8) and 60.0％ (6/15) of each type focuses.Conclusions Mucinous breast carcinoma especial pure type did not have the typical malignant breast masses sonographic features,which showed some benign masses sonographic features except no pseudocapsule benign feature.Mixed type mucinous carcinomas tumors have more aggressive margin imaging characteristics.It is suggested that mucinous breast carcinoma should be classified category 4 by BI-RADS to avoid diagnosis delay.