Humans ; Lymphoma ; Tumor Microenvironment

China ; Female ; Genital Diseases, Female ; pathology ; Humans

Objective To discuss the treatment and prognosis of multifocal osteosarcoma. Methods Between January 1998 and June 2005, nine patients(seven males and two females), six with synchronous multifocal osteosarcoma and three with metachronous multifocal osteosarcoma were treated in our department. The diagnosis of multifocal osteosarcoma was confirmed by clinical presentation, radiology and pathology. Eight of the nine patients received chemotherapy with adriamycin(60 mg/m2), cisplatinum(100 mg/m2), high-dose methotrexate(8-12 g/m2), vincristine(1.4 mg/m2), ifosfamide(12.5 g/m2), and G-CSF. Based on the response to primary chemotherapy, further chemotherapy plans were made, and different operations were done to control local lesions or to relieve symptoms. Arsenous acid, paclitaxel and VP-16 were used in patients who responded poorly to primary chemotherapy. Results One patient who given up remedy was died in systematic fail due to the cancer after 5 month, five patients who were diagnosed synchronous multifocal osteosarcoma died from progressive disease in 3.5 to 17 months (mean time was 9.8 months). Only two of them had a good response to chemotherapy and had finished at least four cycles of chemotherapy,and they had a better survival time of 15 and 17 months respectively. Three patients with metachronous multifocal osteosarcoma had a better prognosis. After a two-year follow-up, two lived with disease and one lived without disease. Conclusion The prognosis of patients with multifocal osteosarcoma is poor, and patients with metachronous multifocal osteosarcoma have a relatively better prognosis. To improve the prognosis of patients with multifocal osteosarcoma, aggressive chemother-apeutics are needed.

[Objective]To evaluate the effectiveness of biopsy of bone lesions.The factors that might effect on the clinical utility were analyzed in order to find out the independent factor for clinical effectiveness.Also we evaluated the effects of these factors on the open biopsy with needle biopsy previously done.[Method]We retrospectively reviewed 206 cases performed at our institute between June 2003 and Oct 2006,including percutaneous core-needle biopsy or open biopsy.The biopsy result was classified as correct,nondiagnostic,or incorrect.The biopsy results were considered clinical useful if they were correct and not useful if they were nondiagnostic or incorrect.We identified the independent risk factor by analyzing whether the characteristics including biopsy methods,lesion position,myxoid,lesion type reduced the effect on the clinical utility and increased the probability of proceeding to subsequent open biopsy.[Result]In 206 patients,one hundred and forty-seven cases(71.4%)underwent core-needle biopsy.Forty-seven cases(22.8%)underwent open biopsy and twelve cases(5.8%)had open biopsy with needle biopsy first.One hundred and seventy-six cases(85.4%)patients had clinical useful results.Eighteen cases(8.7%)were nondiagnostic,and twelve cases(5.8%)were incorrect.Myxoid histology was identified of independent risk factor on the clinical utility by logistic regression(P=0.02).[Conclusion]Most cases of bone lesions can be diagnosed by core-needle biopsy or open biopsy.The myxoid histology is associated with decrease clinical accuracy;No single characteristic cause increase probability of open biopsy.Correct diagnose of bone lesions requires combining biopsy,radiology and clinical data.

Objective To investigate the clinical manifestation and diagnosis of osteitis deformans. Methods Three male patients with characteristic manifestations of osteitis deformans were reviewed in this study. The ages of the patients were 51, 49 and 43 respectively. Two patients with pelvic lesions on X ray films presented symptomatic pain and malaise localized in hip, one complained of tibial bowing deformity. The typical radiographic characteristics were bone enlarged size, increased bone mineral density with uneven distribution; the bone trabeculae were usually coarse and arrayed irregularly like a grid. All patients underwent the diagnostic biopsy. Under microscopic observation, the bone structures were arranged disorderly, the trabeculae were thickened and enriched with osteoclasts and osteoblasts, irregular blue cement line were also seen in thickened trabeculae, the bone marrow were replaced by the fibrovascular connective tissue. All patients were given calcitonin and diphosphonates as medical treament. Results In the follow up period of an average of 16 months(range 3-26 months), one patients had pain relief at lesioned hip but functional limitation remained, the others did not have any sign of malignant progression. The serum alkaline decreased dramatically and the involved bone did not present with deteriorated change. They were working as usual. Conclusion Osteitis deformans is a disorder of bone architecture resulting from disturbance in the rate of bone turnover; typical radiographic and pathologic feature is the important points for definite diagnosis of osteitis deformans.

ObjectiveTo investigate the clinicopathological features of the needle biopsies of prostatic lesions and to evaluate the value of 34?E12 immunostaining for the diagnosis of prostatic carcinoma.MethodsThe clinical data,levels of serum PSA and HE slides of 103 cases of the needle biopsies of prostatic lesions were reviewed.Immunohistochemical stains for 34?E12 were performed.ResultsThe morphological features revealed 36 cases of benign prostatic hyperplasia(BPH),9 cases of low grade prostastic intraepithelial neoplasia (PIN I)and 34 cases of prostatic carcinoma(PC),24 cases of high grade PIN(PINⅡ and Ⅲ) have been suspected of carcinoma.With immunohistochemical stain,all cases of BPH were strongly reactive for 34?E12 while 32 cases of prostatic carcinoma were negative;14 of 24 cases of high grade PIN were negative for 34?E12 and could be diagnosed as PC.The rest 10 of high grade PIN were interruptedly positive in the basal layer for 34?E12.In the 30 cases of prostastic carcinoma,serum PSA levels of 25 cases was over 10 ng/ml and over 50 ng/ml in 15.ConclusionsThe pathologic diagnosis should based on gland architectures and cytologic features.34?E12 negative expression and elevation of serum PSA are also the important criteria for the diagnosis of prostatic carcinoma.

SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.

Objective To discuss the potential relationship between endometrial serous carcinoma (ESC) and tubal epithelial lesions by pathologic examination of fallopian tubes with ESC. Methods A total of 30 cases of typical ESC were reexamined and chosen by the pathologist. In each case, bilateral fallopian tubes were submitted to examination of pathologic morphology and immunostaining for p53, annexin Ⅳ(ANX-Ⅳ), human epidermal growth factor receptor 2(HER2)/neu, and high-mobility group protein A2 (HMGA2). Results Fallopian tubal epithelial lesions were found in 15 cases, including 9 cases tubal serous carcinoma, 2 cases serous tubal intraepithelial carcinoma (STIC) and 2 cases epithelial hyperplasia. Both sides of tubal serous carcinoma and STIC were found in 1 case. The results showed the positive expression for p53 in 26(87%)out of 30 endometrial malignant specimens tissues and 9(30%)tubal tissues samples (P>0.05). Twenty-five(83%)endometrial malignant specimens tissues and 6(20%)tubal tissues samples showed the positive expression of ANX-Ⅳ. Twenty-one(70%)endometrial malignant tissues and 7(23%) tubal tissues showed the positive expression of HER2/neu. Twenty-five(83%) endometrial malignant tissues and 6(20%)tubal tissues showed the positive expression of HMGA2. While, there were significant differences among the expression of three proteins between endometrium and the fallopian tube site (all P<0.05). Conclusions STIC may be associated with the occurrence of ESC. The expression of p53 was positively correlated between the fallopian tube and the endometrium. ANX-Ⅳ,HER2/neu and HMGA2 were extensively expressed in ESC.

Purpose To study the clinicopathologic features, diagnosis and differential diagnosis of extranodal NK/T-cell lymphoma, nasal type ( EN-NK/TCL) . Methods Twenty-eight cases of EN-NK/TCL were analyzed according to WHO classification of tumors of haematopoietic and lymphoid tissues, the cases were studied by microscopy, immunohistochemistry and in situ hybridization. Results In 28 cases, the male to female ratio was 1 ∶ 1. 2. The mean age was 46 years, with the median of 44. 5. Eighteen cases involved nasal cavity, 5 cases of skin, and 1 case of tonsil, upper palate, root of tongue, adrenal glands and gastric, respectively. The main presentation was nasal obstruction in cases with nasal involvement, and the cases with skin involvement present with rash, ulcer, plaque or nodular mass. Patients might be accompanied by B-type symptoms, lymphoadenopathy or with multiple sites involvement. The tumor cells were small, medium, large-sized, or mixed, and angiocentric and angiodestructive growth pattern was frequently pres-ent. Most cases were mixed with inflammatory cells infiltration. The typical immunophenotype was T-cell ( the most sensitive, CD3ε) , CD56 and cytotoxic markers. In situ hybridization for EBER was positive. Ten cases were followed up, and 1 case died. Conclusions The most common site of EN-NK/TCL is nasal cavity, followed by skin. EN-NK/TCL can be definitely diagnosed by integration of pathological morphology, immunophenotype and in situ hybridization of EBER.

Objective To investigate the clinicopathological features of renal cell carcinoma (RCC).Methods From December 1956 to August 2012,the clinicopathological features of RCC were studied in 705 cases and related literatures were reviewed.Results The diameter of RCC ranged from 0.6 to 18.0 cm,which the average size was 4.6 cm.The proportions of the clear cell,papillary,multilocular clear cell,chromophobe and unclassified histologic subtype were 88.9％ (627/705),4.1％ (29/705),3.3％ (23/705),1.3％ (9/705) and 2.4％ (17/705),respectively.According to the Fuhrman grading system,the proportions of grade 1,2,3,4 were 19.0％ (116/612),58.3％ (357/612),18.1％ (111/612)and 4.6％ (28/612),respectively.The rates of invasion into the renal pelvis,perirenal fat and vascular were 10.9％ (66/603),10.6％ (64/603) and 4.8％ (29/603),respectively.Of 705 cases,464 (76.6％)cases were in T1,65 (10.7％) cases in T2,73 (12.0％) cases in T3,and 4 (0.7％) cases in T4.As to the lymph node and distant metastasis,the rate was 2.8％ (17/606) and 3.5％ (21/606).The percentages of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ RCC were 74.3％ (450/606),9.9％ (60/606),11.7％ (71/606) and 4.1％(25/606),respectively.The 3-,5-,10-and 15-year disease-specific survival rate for RCC was 92.8％,86.9％,76.8％ and 55.5％,respectively.To those patients with clear cell RCC,the disease-specific survival at the same time point was 92.8％,88.1％,77.4％ and 55.4％,respectively.Multivariate analysis showed that the stage was the only independent prognostic factor for RCC.Conclusions Tumor stage of RCC is the independent prognostic factor for disease-specific survival.The evaluation of renal sinus invasion and lymph node should be noted in the diagnosis of RCC.