Cell Biology ; trends ; China ; Humans ; Pathology ; trends

Objective To study the clinical pathological features of Wegener's granulomatosis (WG) in middle-aged and elderly patients,and enhance understanding of this disease.Methods Totally 21 patients with WG (11 males,10 females,aged 45 to 76 years,mean age 58.1 years) in our hospial from February 1999 to July 2012 were selected.The clinical and pathological data of WG patients were retrospectively analyzed.34 biopsies including 2 autopsies from different organs were paraffin embedded and stained by hematoxylin and eosin and histochemistry.13 renal biopsies were all examined by immunofluorescence and electron microscope.Results The average time from the onset of clinical symptoms to the diagnosis was 5.3 months (from 24 days to 11.0 months).Eyes,nose and salivary glands were the most commonly involved parts at the beginning of Wegener's granulomatosis (52.4％,11 cases).The percentages of the skin,lung and renal involvement were 14.3％ (3 cases),81.0％ (17 cases) and 71.4％ (15 cases),respectively.Among 21 patients,18 patients were examined with anti-neutrophil cytoplasmic antibody (ANCA).c-ANCA was positive in 72.2 ％ patients (13 cases,13/18),p-ANCA was positive in 16.7％ patients (3 cases,3/18),and ANCA was negative in 11.1％ patients (2 cases,2/18).3 major pathological manifestations were observed:7 kinds of vasculitis including capillaritis,acute vasculitis,chronic vasculitis,fibrinoid necrosis in vasculitis,necrotizing granulomatous vasculitis,non-necrotizing granulomatous vasculitis and cicatricial vascular changes; 4 kinds of granulomatous inflammation including scattered giant cells,palisading histiocytes,poorly formed granulomas and microabscess surrounded by granulomatousinflammation;2 kinds of parenchymal necrosis including geographic necrosis and microabscess.13 kinds of histopathologic features in 3 major manifestations were found from 2 autopsies,but various kinds histopathologic features presented in small biopsy samples.Minor manifestations such as diffuse pulmonary hemorrhage were found at the periphery of WG.Conclusions The wide variation and broad spectrum of pathologic features can occur in WG.Vasculitis,granulomatous inflammation and parenchymal necrosis are the most important histopathological features.The correct diagnosis of WG requires careful correlation of pathology with complicated clinical features.

Objective To investigate the pathological features of chronic inflammation in prostatic specimens,and study the correlation of chronic prostatic inflammation with prostate cancer and hyperplasia of prostate in the elderly.Methods The histopathologic features of prostatic specimens which were taken during prostatectomy were retrospectively observed.The inflammatory cells in partial cases were labeled by immunohistochemical markers such as CD3,CD20,CD4,CD8,CD117 and CD138,and by inflammation related factors such as nuclear factor(NF)-κB,(COX-2),tumor necrosis factor-α(TNF-α)and inducible nitric oxide synthase (iNOS).Results The chronic prostatic inflammation of different extent were found in 100 patients with prostate cancer and 76 patients with benign prostatic hyperplasia,among them 71 cases (40.3 ％) had mild chronic prostatic inflammation,80 cases (45.5 ％) had moderate chronic prostatic inflammation,25 cases (14.2 ％) had severe chronic prostatic inflammation.Inflammatory cells mainly were CD3-labeled lymphocytes,accompanied by a small amount of mononuclear cells and mast cells.Chronic prostatic inflammation was not correlated with prostatic carcinoma and its differentiation degree,benign prostatic hyperplasia,focal atrophy and its subtypes,and high grade prostatic intraepithelial neoplasia (all P＞ 0.05).There was correlation between chronic prostatic inflammation and expression of COX-2 (P＜ 0.05).Conclusions The histological chronic inflammation is common in the prostate specimens in elderly men.There are no direct correlations of prostatic inflammation with prostatic carcinomas and benign prostatic hyperplasia.Prostatic inflammation is positively correlated with the expression of COX 2,which may be associated with the activation of COX-2 pathway induced by oxidative stress.

Objective To investigate the correlation between QRS amplitudes and left ventricular wall thickness in autopsy specimens of elderly men.Methods The data of autopsy cases in our hospital since 1990 were retrospectively analyzed.The cases with QRS duration≥0.12 s and the pacing electrocardiogram were excluded.QRS amplitudes of standard 12-lead electrocardiography in 3 months before death were measured and the correlation between QRS amplitudes and left ventricular wall thickness was analyzed in the elderly men.Results Correlations were found between the amplitudes of the R waves in leads V5 ,V6, Ⅰ ,aVL[(1.1±0.7) mV, (0.95±0.6) mV, (0.44±0.3)mV and(0.35±0.3)mV] and left ventricular wall thickness[(13.6±5.4)mm;r=0.22,0.14,0.22,0.23,all P<0.05], and between the combination of QRS amplitudes SV1 +RV5 or RV6(1.9±1.2) mV] and left ventrieular wall thickness [(13.8± 5.4) mm; r = 0.23, P < 0.05].The correlationbetween the combination of QRS amplitudes (SV1 + RV5 or RV6 ) and left ventricular wall thickness was the strongest in 60-79 years old cases (r=0.48, P<0.01) ,and was decreased in 80-89 years old cases (r= 0.23, P<0.05).There was no correlation between the combination of QRS amplitudes (SV1+RV5or RV6) and left ventricular wall thickness in 90-101 years old cases (r= 0.03, P> 0.05).Conclusions Electrocardiogram is a reliable method for diagnosis of left ventricular hypertrophy in elderly men aged < 90 years.

Objective To study the histopathological features of hepatic portal area in autopsy specimens of elderly men with type 2 diabetes mellitus (T2DM).Methods One hundred and three autopsy cases with T2DM (diabetic group) and contemporary 48 non-diabetic cases matched by gender and age (control group) were selected in the study.The histopathological changes of hepatic portal area were observed by histochemical and immunohistochemical methods.Results (1) In diabetic group, endothelial denudation, eosinophilie deposits, eccentric intimal thickening and luminal stenosis were found in hepatic interlobular artery (arteriole, the lumen diameter < 100 μm).The medial smooth muscle cells proliferated and migrated into intima, and fibroplasia occurred in adventitia.62.1% (64/103) of the patients with T2DM had microangiopathy and there was statistically significant difference between the two groups (χ2= 27.14, P< 0.01 ).(2) Hyaline collagen fiber tissues deposited around interlobular artery, interlobular vein and interlobular bile ducts, resulting in enlargement of the portal area and the secondary atrophy and disappearance of portal triad.65.0% (67/103) of the patients with T2DM had this pathological changes in the portal area and there was statistically significant difference between the two groups(χ2= 23.27,P<0.01).(3) Terminal portal area was notable.Conclusions Mieroangiopathy can be observed in the hepatic portal areas of elderly men with T2DM, which may induce the fibrotic tissue hyperplasia, the atrophy of the portal triad and the sclerosing portal area.

Objective To observe the incidence rate of non-alcoholic fatty liver disease (NAFLD) in elderly male patients with type 2 diabetes mellitus (T2DM) and the features of pathological changes of liver. Methods The 89 cases with T2DM (T2DM group) and contemporary non-diabetic cases (control group, n=48) from 858 autopsy samples matched for gender and age were selected in the study. The histopathological changes of liver were observed by microscopy,histochemistry and immunohistochemistry. Results The incidence rates of NAFLD and nonalcoholic steatohepatitis(NASH) were 49.4% (44/89) and 14.6% (13/89) in T2DM group, 22.9 %(11/48) and 4.2% (2/48) in control group, respectively. The incidence rates of NAFLD and NASH were significantly higher in T2DM group than in control group(P＜0.01, P＜0.05). All of the NASH patients from T2DM group and one patient from control group were complicated with different stages of liver fibrosis. One patient from T2DM group was diagnosed as cirrhosis, no cirrhosis patient was found in control group. Conclusions Compared with control group, the incidence rate of NAFLD is higher and the damage of liver is more severe in T2DM group. The ratio of the progress from NAFLD to liver cirrhosis is low.

Objective: To investigate the prevalence of BRAF V600E mutation in thyroid nodules and to analyze the relationship between BRAF V600E mutation and various clinicopathological features. Methods: BRAF V600E mutant gene test was done in 463 cases of thyroid nodules collected from April 2015 to July 2018 in Beijing Hospital. Pathologic sections of 444 cases of papillary thyroid carcinoma were reviewed and clinical information was collected.Statistical analysis of the relationship between BRAF V600E gene mutation and various clinicopathological features was performed with SPSS 21.0 statistical software. Results: There were 109 males and 354 females in the cohort, with a male to female ratio of 1.0∶3.2. The patient ranged in age from 16 to 82 years, with an average age of 46.1 years. The BRAF V600E mutation rates in papillary thyroid carcinoma, benign thyroid nodules and other thyroid carcinoma were 86.5%(384/444),0/15 and 1/4,respectively.There was significant correlation between BRAF V600E mutation and histological diagnosis of papillary thyroid carcinoma (P<0.05). There was no correlation with age, gender, multifocality, bilaterality, coexisting lymphocytic thyroiditis, nodular goiter, maximum diameter, capsule invasion, extrathyroidal extension and clinical stage (P>0.05). Conclusions BRAF V600E gene mutation is closely related to the occurrence of papillary thyroid carcinoma. BRAF V600E has significant value in the diagnosis of papillary thyroid carcinoma. While BRAF V600E mutation is related to the histological diagnosis, it shows no correlation with other clinicopathologic features. BRAF V600E mutation is not an independent prognostic factor in papillary thyroid carcinoma patients.

Objective:To investigate the features of volume, distribution, grading and staging of prostate cancer(PCa)examined via whole-mount histopathology in transitional PCa.Methods:A total of 129 PCa patients undergone radical prostatectomy(RP)between July 2017 and March 2020 whose whole-mount prostate specimens were prepared after surgery were retrospectively studied.Pathological data on tumor locations, diameters and classification of the International Society of Urologic Pathology(ISUP), radiological data on regions of interest(ROI)and scores of the Prostate Imaging and Reporting Data System(PI-RADS v2)were recorded.The results of pathological whole-mount sections and prostate imaging were compared, and the characteristics and detection rates of lesions in different prostate regions were analyzed.Results:Of all 129 prostate specimens from RP, a total of 213 PCa lesions were detected through whole-mount histopathology.There were 21(9.9%)lesions involving both the peripheral zone(PZ)and the transition zone(TZ), with an average diameter of(2.82±0.71)cm.Of all lesions, 85(39.9%)involved PZ and 107(50.2%)involved TZ, with an average diameter of(1.36±0.81)cm and of(1.60±0.94)cm, respectively.The percentage of lesions involving TZ was higher than that lesions involving PZ, with larger diameters( P<0.05). Of 64 patients with complete MRI data, 105 PCa lesions were detected histopathologically by using whole mount sections, while 75 PCa lesions were detected by MRI, with a statistical difference( P<0.05). For lesions≥1.0 cm or lesions with an ISUP grade group≥2, the detection rate of MRI was lower in TZ lesions( P<0.05). Conclusions:PCa lesions within TZ account for a large proportion and have a relatively large tumor dimeter.PCa lesions within TZ are more likely to be missed in clinical examinations and on MRI, and clinicians should pay close attention during diagnosis and treatment.

Cytology in China developed from nothing and underwent a long journey from gynecologic cytology to that of all organs, laying a solid foundation for new developments in the 21st century. Thyroid fine-needle aspiration (FNA) was primarily developed in an endocrinology department and then in the clinical laboratory department or pathology department in the 1970–80s. Wrights staining is popular in endocrine and clinical laboratory departments, while hematoxylin and eosin staining is common in pathology. Liquid based cytology is not common in thyroid FNA cytology, while BRAF(V600E) mutation analysis has been the most popular molecular test. The history and practice of thyroid FNA practice in China were reviewed based on retrospective study of the practice in Qilu Hospital of Shandong University.
Biopsy, Fine-Needle* ; China* ; Endocrinology ; Eosine Yellowish-(YS) ; Hematoxylin ; Pathology ; Retrospective Studies* ; Thyroid Gland*

OBJECTIVETo study the clinicopathological characteristics diagnosis, differential diagnosis and etiology of demyelination pseudotumors of the brain.

METHODSThe clinical features, CT, MRI scan findings, corticosteroid therapeutic effects and follow-up data of 3 cases of demyelination pseudotumors of the brain were analysed, and pathological changes were observed by histologic (HE, Luxol fast blue and Bodian) and immunohistochemical (S-P method) techniques.

RESULTSThe acute onset of demyelination pseudotumors appeared to be more predominant in our data. Clinical manifestations included headache, vomiting, a depressed conscious level, dysphasia, and paresis. CT, MRI scans showed solitary or multiple lesions in cerebral hemisphere. All the patients presented excellent response to steroid treatment. Follow-up for a period of 6 to 31 months, revealed the absence of progression or recurrence. The pathological changes were mainly located in both cerebral hemispheres, in which there were relative axonal preservation in foci loss of myelin, reactive gliosis, profuse perivascular lymphocytic infiltration and mixtures of foamy macrophages.

CONCLUSIONDemyelination pseudotumor is a distinct clinicopathologic encephalitic entity. The findings of this study suggest that the cause of tumefactive demyelination may be related to an allergic reaction triggered by viral infection.

Adolescent ; Adult ; Demyelinating Diseases ; diagnostic imaging ; metabolism ; pathology ; physiopathology ; Female ; Humans ; Immunohistochemistry ; methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pseudotumor Cerebri ; diagnostic imaging ; metabolism ; pathology ; physiopathology ; Tomography, X-Ray Computed ; methods