Objective To research the appearances of CT and pathology in pulmonary hamartoma so as to improve the CT diagnostic accuracy.Methods The CT and pathological findings of 25 cases of pulmonary hamartoma were analyzed. Dynamic contrast enhancement CT scanning were performed in 17 cases without calcification. All cases were confirmed by surgical operation and pathology.Results All hamartomas had smooth edge on CT. Focal fat without calcification inside were present in 8 of 25 cases, focal fat and calcification inside in 6 of 25 cases (24%), calcification without fat inside in 2 of 25 cases (8%). The CT contrasted value was less than 20 HU in16 of 17 cases (88.24% ). Contrast-enhancing septa were present in 13 of 17 cases(76.47%). The enhancing septa corresponded to loose connective tissue between cartilaginous core. Pathologically, all hamartomas had complete fibrous capsule around them. Cartilage ,broncheal gland, smooth muscle and fibrous connective tissue were found in all cases, and fat and calcification were found in 13 (52%) and 8 (32%) respectively.Conclusion Some specific CT features, including smooth edge, calcification and fat inside, are useful for diagnosis of pulmonary hamartoma. Dynamic contrast enhancement CT scanning is useful for differentiating pulmonary hamartoma with peripheral lung carcinoma.

Objective To investigate the correlation of CT features and pathological characteristics with epidermal growth factor receptor(EGFR)gene mutations in invasive peripheral pulmonary adenocarcinoma.Methods The amplification refractory mutation system was used to determine EGFR mutations in 1 9 3 surgically resected invasive peripheral pulmonary adenocarcinomas.CT features and pathological characteristics were analyzed retrospectively.Results The total EGFR mutation rate was 62.2% (120/193).Among the features on CT,the maximum tumor diameter (Dmax)in axial plane CT images was significantly smaller in patients with EGFR mutations than that with wild-type EGFR patients [(2.52 ± 1.01)cm vs (3.11 ± 1.34)cm,P<0.05].Receiver operating characteristic (ROC)results indicated that Dmax=2.01 cm was the diagnosis threshold in forecasting EGFR gene mutations,with the sensitivity and specificity of 79% and 64%,respectively.The frequency of EGFR mutations was significantly greater in tumors with ground-glass opacity(GGO)than that without GGO (78.0% vs 56.6%,P<0.05),and in tumors without cystic airspaces than that with cystic airspaces (65.5% vs 40.0%,P<0.05).No correlations were observed between EGFR mutations and other CT features,including GGO/tumor ratio(G/T),lobulation,spiculation,pleural retraction,vascular convergence,air bronchograms,and vacuole signs (P>0.05).Among pathological characteristics,compared with other subtypes,EGFR mutations occurred most frequently in lepidic predominant adeno-carcinomas (77.5% vs 58.2% in other subtypes,P<0.05),and the least frequently in solid predominant adenocarcinomas(26.3%vs 66.1% in other subtypes,P<0.05).The EGFR mutation rate was significantly higher in tumors without lymph node metastases than that with lymph node metastases (66.9%vs 50.9%,P<0.05).Conclusion The CT features and pathological characteristics may be useful indicators to predict EGFR mutation status in invasive peripheral pulmonary adenocarcinoma.

Objective To study the MSCT appearances of thymic neuroendocrine tumors (NETs)and its correlation with the WHO histological grade.Methods MSCT features of 16 patients with thymic NETs confirmed by pathology were analyzed retro-spectively.The patients were divided into 2 groups according to tumor's grade,i.e.low and intermediate grade,high grade.Results There were 8 patients in low and intermediate grade,8 in high grade.No difference was found among tumor location,size,tumor morphology,calcification,pericardiac thickening,pericardial effusion,pleural thickening,pleural effusion,disappearance of fat line around tumor and mass-pulmonary interface with irregular shape,but significant difference was detected in lymph node metastasis. On enhanced MSCT scanning,statistical difference was detected in linear enhancement of the blood vessels in the tumors,but no difference was found between necrosis and peripheral vessel invasion.Conclusion MSCT findings of different grades in thymic NETs have some characteristics and can be helpful in the grades of predictability.

Objective To analyze the relationship between CT image characteristics and the pathological subtypes of small lung adenocarcinoma (≤3 cm) with ground-glass opacity(GGO).Methods Two hundred and three cases of small lung adenocarcinoma proved by pathology were collected.Use the 2015 World Health Organization(WHO) classification of lung cancers as pathology standard.The relationship between CT findings and pathologic classification were analyzed statistically.Results There was a positive correlation between CT type and pathological type (rs =0.756).The size of atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS) and minimally invasive adenocarcinoma(MIA) lesions were smaller than invasive adenocarcinoma(IAC).AAH lesions were smaller than MIA(P＜0.008 3).However,there were no significant size differences in AAH and AIS lesions,or in AIS and MIA lesions (P＞0.008 3).The critical point of non-or-little-invasive (AAH,AIS and MIA) and IAC was 15.35 mm (sensitivity 80.8％,specificity 90.4 ％).Differences in lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence among pathological types were statistically significant (P ＜0.05).Differences in shape,speculation and cavity among groups were not significant (P ＞0.05).Conclusion The higher CT type,lower GGO content and bigger lesion size are all associated with increasing tumor degree of malignancy.The size of IAC lesion is usually greater than 15.35 mm.Lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence can help to diagnose IAC.

Objective To explore the MSCT features of airway-invasive pulmonary aspergillosis.Methods MSCT features of 27 cases of airway-invasive pulmonary aspergillosis confirmed by pathology or clinical experience were analyzed retrospectively.Results The lesions in 27 cases were distributed along the blood vessel and bronchus and located mainly in the upper and middle lung field in 19 cases.Multiple centrilobular nodules and tree-in-bud sign were found in 27 cases and bronchial wall thickening and patchy opacities around the bronchi were in 25 cases.Bronchiectasis was seen in 17 cases,and cavity-like change and inter-cavity separation were in 15 cases.In 22 cases of follow-up,the lesion progressed within 1 week after diagnosised and treatmented in 20 cases and recurred in slow recovery stage in 5 cases.Conclusion MSCT findings of airway-invasive pulmonary aspergillosis are various which may rapidly progress within a short time.MSCT palys an important role in the evolution and follow-up of airway-invasive pulmonary aspergillosis.

Humans ; Artificial Intelligence ; Lung Neoplasms/pathology* ; Mediastinum/pathology* ; Lymph Nodes/pathology* ; Neoplasm Staging ; Lymph Node Excision

Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. Although several HCV protease/polymerase inhibitors were recently approved by U.S. FDA, the combination of antivirals targeting multiple processes of HCV lifecycle would optimize anti-HCV therapy and against potential drug-resistance. Viral entry is an essential target step for antiviral development, but FDA-approved HCV entry inhibitor remains exclusive. Here we identify serotonin 2A receptor (5-HTR) is a HCV entry factor amendable to therapeutic intervention by a chemical biology strategy. The silencing of 5-HTR and clinically available 5-HTR antagonist suppress cell culture-derived HCV (HCVcc) in different liver cells and primary human hepatocytes at late endocytosis process. The mechanism is related to regulate the correct plasma membrane localization of claudin 1 (CLDN1). Moreover, phenoxybenzamine (PBZ), an FDA-approved 5-HTR antagonist, inhibits all major HCV genotypes in vitro and displays synergy in combination with clinical used anti-HCV drugs. The impact of PBZ on HCV genotype 2a is documented in immune-competent humanized transgenic mice. Our results not only expand the understanding of HCV entry, but also present a promising target for the invention of HCV entry inhibitor.