Purpose To investigate the clinicopathological features, treatment and prognosis of perivascular epithelioid cell tumor ( PEComa) of the head and neck. Methods Two cases of PEComa were analyzed by studying clinical data, histopathologic and immu-nohistochemical ( EnVision) changes and the related literatures were reviewed. Results Case 1 was a 26-year-old woman with a re-current larynx tumor, and case 2 was diagnosed in a 56-year-old man with a left nasal cavity mass. Their tumors were well-demarcated, and ranged from 2. 5 to 3. 5 cm in diameter. Microscopically, the tumors were composed of epithelioid cells arranged in nets, organoid pattern. The tumor cells had abundant pale eosinophilic granular to clear cytoplasm, vesicular nuclei, and mild atypia. The stroma was rich in capillaries, sinusoidal vasculature. There was mitotic activity and focal necrosis. By immunohistochemistry, the tumor cells were diffusely or focally positive for vimentin (2/2), HMB-45(1/2), Melan-A(2/2), SMA(2/2), Calponin(2/2), desmin(1/2), and TFE3(1/2). They were negative for CK, CD10, S-100, CgA, Syn, and MyoD1. Conclusion PEComa of the head and neck is rare. Definite diagnosis depends upon the comprehensive analysis of histopathology and coexpression of melanocytic and myoid mark-ers. The differential diagnosis include paraganglioma, malignant melanoma and metastatic carcinoma. Few PEComas of the head and neck behaved in an aggressive fashion with distant or loco-regional metastases and died of disease-related causes, it should be regarded as tumors with a malignant potential.

AIM: To investigate expression of CD44s in lung cancer and it's clinical significance. METHODS: A total of 117 primary lung cancer from patients were examined for CD44s expression by immunohistochemical staining. RESULTS: CD44s mostly expressed in non-small cell lung cancer (NSCLC) but not in small ecll lung cancer (SCLC), and squamous cell carcinoma(SCC) showed much stronger expression of CD44s than adenocarcinoma(ADC)(P

Purpose To study the clinic-pathologic features, differential diagnosis and prognosis of lymphoepithelioma-like carcinoma of cervix. Methods Eight cases of lymphoepithelioma-like carcinoma of cervix were retrieved from our institution. HE staining, im-munohistochemistry and in situ hybridization were perform on those cases. Results Of the 8 cases of lymphoepithelioma-like carcino-ma,the median age was 44 years old ( ranged from 29-67 years) and all of the clinical stage belonged toⅠB. Grossly, 5 cases presen-ted a cauliflower-like appearance, 1 case grew as a polyp protrusion, and the other 2 cases showed a non-specified thicken change of cervix. Histologically, the tumors were composed of undifferentiated large cells, either loosely or closely-packed, with the nested and trabecular growth pattern. The tumor cells were generally oval or polygonal in shape, while the demarcation between the cells was indis-tinct and form the syncytial appearance. The nuclei were vesicular and had one or more prominent nucleoli. There were abundant infil-trates of lymphocyte and plasma cells among the tumor nests. The tumor cells showed positive expression of CK in 100% of cases, p63 in 37. 5% of cases, p16 in 62. 5% of cases, CK5/6 in 75% of cases, Ki-67 in 10% ~30% of cases. The stromal lymphocytes mainly expressed CD3 and CD8. EBER was negative in the entire tumor cells while was weakly positive in the stromal lymphocytes in one case. The follow-up data, which terminated at June 2013, demonstrate 7 cases were alive and 1 case died of the disease. Conclusions Lymphoepithelioma-like carcinoma occurred of cervix is rare. They have distinctive morphologic features and overall favorable prog-nosis. The accurate diagnosis is dependant on the combination of the histologic and immunohistochemical examination.

Purpose To explore the clinicopathologic characteristics, immunophenotype, diagnosis and differential diagnosis, molecu-lar genetic feature, treatments and prognosis of intra-abdominal EIMS. Methods Two cases of intra-abdominal EIMS were studied with clinical manifestations, histology and immunohistochemical staining, and its clinical and pathological findings were further ana-lyzed with review of the literature. Results Case 1 was a 15-year-olds male and case 2 was a 21-year-olds female both of whom pres-ented with abdominal pain. Two patients were treated by surgical excision. Microscopically the tumor consisted of two different histolog-ical types, one of which was of high cell density and the other with low cell density and myxoid stroma. Both of these areas contained inflammatory cells, mainly neutrophils with few lymphocytes and plasmocytes. Tumor cells had an epithelioid phenotype with round nu-clei and small nucleoli, various nuclear atypia and mitotic figures were also found, which consistented with the diagnosis of epithelioid inflammatory myofibroblastic sarcoma. Immunohistochemical analysis revealed that the tumor cells were positive for ALK, vimentin, desmin, and CK(AE1/AE3) (focal), and were negative for Calretinin, CD30, CD31, CD33, SMA, HHF35, Myogenin, S-100, HMB-45, CD20, CD79a, CD3, CD5, CD45 and CD68. ALK rearrangement was identified in both cases by FISH using ALK break-a-part probe. Conclusions As an extremely rare tumor, the distinguishing between epithelioid inflammatory myofibroblastic sarcoma and conventional inflammatory myofibroblastic tumor is important. ALK inhibitors are theoretically useful for treating these tumors.

BACKGROUNDTo study the correlation of cyclin D₁ oncoprotein with a mutated p53 in pulmonary tumors progression.

METHODSThirty-one male A/J strain mice were treated intraperitoneally with a single injection of 20-methylcholanthrene and sacirificed at various ages. A total of 292 lesions in various histological type were obtained. Immunohistochemical methods were employed to detect the expression of cyclin D₁ and p53 in paraffin-embeded tissues.

RESULTSExpression of cyclin D₁ oncoprotein was seen in 6 out of 7 (86%) in hyperplasias, 89 out of 102 (87%) in alveolar adenomas, 41 out of 56 (73%) in papillary adenomas, and 17 of 25 (68%) in papillary carcinomas. Cyclin D₁ expression did not correlate with the progression of the lung neoplasms, and tended to decrease in papillary carcinomas than in papillary adenomas, in alveolar adenomas and hyperplasias (Chi-square=5.531, P=0.033). Expressions of p53 gene were obviously stronger in malignant lesions than in benign lesions (Chi-square=41.77, P=0.000). The p53 showed positive staining in carcinoma and severe atypical cell population. Expression of p53 was seen in 16 out of 40 (40%) in papillary carcinomas, 6 out of 69 (9%) in papillary adenomas, and 4 out of 121 (3%) in alveolar adenoma. No positive p53 stain was observed in hyperplasias. Co-expressive rate of cyclin D₁ and p53 was highest in papillary carcinomas (26%), but did not show in alveolar adenomas and hyperplasias.

CONCLUSIONSCyclin D₁ oncoprotein may play an important role in the oncogenesis of lung neoplasms, especially in the early stage. p53 expression increases significantly as the histological grade advances, and may correlate with the progression of pulmonary tumors and the malignant potential of tumor.

BACKGROUNDTo investigate the relationship between progressive development of mouse pulmonary tumors and expression of cell surface saccharide and to provide a theoretical basis for diagnosis of pulmonary benign and malignant lesions..

METHODSA/J strain mice at 5 weeks of age were treated intraperitoneally with 20-methylcholanthrene, and 292 pulmonary lesions including 237 benign lesions (hyperplasia, alveolar adenoma, and papillary adenoma) and 55 malignant tumors (papillary adenocarcinoma) were obtained. The binding affinities of cells in normal respiratory epithelia and various proliferative lesions to four peroxidase-conjugated lectins, Maclura pomifera agglutinin (MPA), Arachis hypogea agglutinin (PNA), Ricinus communis agglutinin (RCA), and wheat germ agglutinin (WGA) were examined.

RESULTSCells of hyperplasias and alveolar adenomas showed fairly strong affinities to all the lectins. However, most of papillary adenoma cells and papillary adenocarcinoma cells lost their binding affinities to MPA, PNA, and RCA, but not to WGA. Between the benign and malignant lesions, there were significant differences in binding affinities of cells to MPA (Chi-square =46.89,P < 0.01), PNA (Chi-square =36.77,P < 0.01) and RCA (Chi-square=52.87,P < 0.01), but not to WGA (Chi-square=0.09,P > 0.05).

CONCLUSIONSAccording to the different complex glycoconjugates on cell surface of various pulmonary lesions, the binding affinities to MPA, PNA and RCA are quite different between the benign and malignant lesions. The detection of bindings is helpful to the differential diagnosis of the pulmonary benign and malignant lesions.