Objective　To study the clinico-pathological features of primary adrenal lymphoma (PAL).　Methods　2 cases of PAL were reviewed and studied.　Results　The age of the 2 patients was 45 and 57.The presenting symptoms were nonspecific.Histologically,the neoplasm was composed of numerous medium-sized cells with round nucleus,usually 1-2 in number and with relatively abundant basophilic cytoplasm.The neoplastic cells showed frequent mitosis.Immunohistochemically,the tumor cells were strongly positive for LCA,L26 and CD74 while negative for UCHL-1,S-100 protein and CK. One case was discharged 3 months after operation because of dyscrasia and the other was lost on follow up.Prognosis of PAL was poor.　Conclusions　PAL is extremely rare with a high grade of malignancy.The diagnosis could be made on histopathological studies and immunohistochemical studies.

Tissue microarray is a special biologic microarray, which was invented on the base of cDNA microarray. The principle of the tissue microarray is arraying the tissue on the solid carrier according demand, then hybridizing, marking and dyeing, for researching the special expression of aimed gene or production among the different tissue. The application of tissue microarray is abroad, especially the determinant of tumor predisposing factor, the screening of the special gene and antibody, the earlier diagnosis, the therapy, and the judgment of prognosis. Compared with the traditional pathological investigation, tissue microarray has the behavior of small volume, high throughput (information), and design by different demand. Tissue microarray has important practical significance and broad market prospect in the investigation of the relation between the gene and disease (tumor), the verification of the associated gene of the disease, the development and screening of new drug, the molecular diagnosis of disease, the dynamic observation during therapy, and the judgment of prognosis.

The pathologic grading and clinical staging systems have some restrictions for the evaluation of the prognosis of prostate cancer.Early detection of prostate cancer with clinically sensitive diagnostic methods and / or tumor specific markers is of prime importance.Recently,close attention has been paid to the effects of genes related to apoptosis and tumor suppressor genes on the development,progression and prognostic value of prostate cancer.The importance of enzymes/proteins and hormone receptors have also received more and more emphasis in the studies of prostate cancer.

Ovarian neoplasms,composed predominantly or exclusively of small round cells with scant cytoplasm,is relatively rare.However,there is a wide range of differentiation,and pathologists often struggle to make a correct diagnosis because of its overlapping histological features.Perhaps the best known neoplasm of this kind is ovarian small cell carcinoma of the hypercalcemic type,which may be confused with a wide range of neoplasm from sex cord-stromal tumor to neoplasm in the family of small round blue cell tumor to various undifferentiated malignancies.Small cell carcinoma of the pulmonary type may also arise from the ovary,and this may be a component of a typical ovarian surface epithelial-stromal tumor.Other small cell neoplasm that may arise within the ovary or involve the ovary includes intra-abdominal desmoplastic small round cell tumor,metastatic small cell carcinoma,peripheral primitive neuroectodermal tumor,and endometrial stromal sarcoma.In this review,the morphologic features of some of these neoplasms are described,as well the value of immunohistochemistry and other ancillary techniques in establishing a diagnosis.

Juvenile granulose cell tumor is one of the rare sex cord stromal tumors of the ovary.This review summarizes the new progress in the genetic studies of the disease.

A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimiccarcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet-ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi- or multi-nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nestion, trabeculation, pseudoglandular, pseudopapillary, pseudofollicular, pseudorosetting and angiocentric patterns. Mucoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S-100 protein, NKIC3, HMB45, Melan A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, CD68, CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen.

Purpose To evaluate the clinical and pathological features of extramammary Paget’ s disease ( EMPD) and to investigate the related prognostic factors. Methods The clinical and pathological data of 30 patients with EMPD were reviewed retrospectively. The HE slides in the file were rechecked. Immunohistochemical stains were performed on archival paraffin-embedded sections with En-Vision method in 20 cases. Follow-up data were recorded. The relationship between the clinicopathological parameters and prognosis was statistically analyzed. Results Among the 30 patients, there were 26 males and 4 females, aged from 53 to 88 years with median age 70. Macroscopically, typical presentations of EMPD were eczematoid lesions. Microscopically, Paget’s cells were distributed sin-gly or in groups ( as glandular or nests patterns) within the epidermis. Immunohistochemical stains showed that Paget’ s cells were pos-itive for CK7, and negative for CK5/6 and p63. Follow-up data were available in 23 cases, 8 cases recurred resection, among them, 6 patients had positive resected margin and 4 died. The recurrent rate and mortality between the groups of dermal invasion and no der-mal invasion (P<0. 01 and P<0. 05), the groups of lymphatic metastasis and no lymphatic metastasis (P<0. 01), and the groups of positive and negative resected margin (P<0. 01 and P<0. 05) were statistically different. There were no statistically different with age and extent of lesion (P>0. 05). Conclusions CK7 is a sensitive and specific marker of Paget’s cells. Dermal invasion, lymphatic metastasis and positive resected margin are poor prognostic factors in EMPD.

Objective To explore the morphological, immunohistochemical characters and prognosis in one case of patients with cutaneous anaplastic large cell lymphoma complicated with acute myeloid leukemia (C-ALCL-AML). Methods The histopathology, immunohistochemical markers and follow-up information of one case of ALCL-AML was analyzed and the correlated literature was reviewed. Results The patient, 69 year-old, female, was initially present with shin lesion on one finger and abnormal myelogram. The histopathology of shin lesion showed that tumor cells were composed of large cells with abundant cytoplasm,the nuclei were large and irregular, and were infiltrated by Neutrophil and eosinophil. The CD30,CD3 and CD43 of tumor cells were positive, but ALK negative by immunohistochemical method. The number of WBC in peripheral blood was 15.5×109/L and 51 archaeocytes were in every 100 karyotes. Bone marrow aspiration detection showed that bone marrow was hyperplasia and the ratio of myeloblast was 78 %. This patient was diagnosed as C-ALCL-AML, partly differentiation type(AML-M2a). Conclusion C-ALCL-AML is very rare. Its diagnosis is dependent on clinical data, histopathology and immunohistochemical markers. The first choice of treatment is chemotherapy, but its prognosis is poor.

To investigate the clinicpathologic features and the main point of differential diagnosis of T-cell lymphomas in breast. MethodsTwo cases of T-cell lymphomas of the breast were analysed about clinic data, histopathology and imrnunochemistry. ResultsBoth of the patients were women whose age were 37 and 31 years old. Histopathologically, the tumor cells appeared sheet and cord-like arrangements. Some of them distributed around the blood vessel. There was an obvious phenomenon closing blood vessel. Tumor ceils were characterized by less cytoplasm, big and distorted nucleus, thin chromation. Large pieces of necrosis were observed. There were no lympho-epithelial lesions. Immunnohistochemistry showed that CD45, CD45RO, CD3 and CD43 in the tumor cells were all positive, while CD20 and CD74 were negative. Follow-up results showed that one died two and half months after operation and the other died sixteen months after operation. ConclusionsT-cell lymphoma of the hreast is the high malignant tumur which is extremely rare, and its diagnosis mainly depends on the histopathology and the marker of immunohistochemistry.

Objective: Signet-ring cell carcinoma is a relatively rare cancer which occurs principally in the stomach,colon-rectum,bladder and breast,but seldom in other parts.This article analyzes the clinical and pathologic features of 3 extremely rare cases of primary signet-ring cell carcinoma in the uterus.Methods: Three cases of primary signet-ring cell carcinoma in the uterus were observed by HE and immunohistochemical staining,their clinical features analyzed and the relevant literature reviewed.Results: Of the 3 cases,2 presented nodose tumors in the cervix while the other in the uterine cavity.Histologically,there was a diffuse infiltration of the tumor cells,with an appearance of signet-ring cells.Periodic acid-Sciff(PAS) staining revealed PAS-positive diastase resistant introcytoplasmic material.Immunohistochemically,the tumor cells were positive for CK and CEA.Conclusion: Primary signet-ring cell carcinoma of the uterus is extremely rare.It is always necessary to rule out a metastatic neoplasm by clinical examination and to differentiate it from other tumors/lesions with signet-ring cell features.