Sclerosing angiomatoid nodular transformation (SANT) is a rarely encountered benign spleen lesion which has recently been gaining recognition. However,the actual pathogenesis of this disease remains unclear.SANT's remarkably characteristic appearance consists grossly of multiple well-circumscribed vascular/angiomatoid nodules of various sizes in a fibrosclerotic stroma. Immunohistochemical studies display a heterogeneous staining pattern of endothelial phenotypes in the angiomatoid nodules,with some cells resembling splenic sinusoids (CD34 -/CD31 +/CD8 + ),capillaries (CD34 +/CD31 +/CD8 - ) and small veins (CD34 -/CD31+/CD8-).Due to the rarity of this disease,it is often mistaken for splenic hamartoma,inflammatory pseudotumor,littoral cell angima or hemangioendothelioma. So far,SANT exhibits a benign clinical course because splenectomy can be curative.In this review,we outline the clinical and pathologic features of SANT and discuss its probable disease mechanism to provide a holistic overview of the disease at this time.

In recent years, promising results have been achieved in retinal pigment epithelium (RPE) cell transplantation in the treatment of diseases such as age-related macular degeneration.The types of transplanted RPE cells include autologous RPE cells, autologous iris pigment epithelium cells, allogeneic fetal RPE cells, allogeneic adult RPE cells, human embryonic stem sell-derived RPE cells, induced pluripotent stem cell-derived RPE cells.According to the transplantation method, RPE cell transplantation can be divided into RPE cell suspension transplantation and RPE cell sheets transplantation.The research on the autologous RPE cells and iris pigment epithelial cells has been reduced due to their limited materials.Fetal RPE cells, which have low immunogenicity and can produce a large number of donor RPE cells, are ideal sources of transplanted cells.Human embryonic stem cell-derived RPE cells and induced pluripotent stem cell-derived RPE cells have adverse effects, including teratogenicity and genetic instability, so transplanted RPE cells need to be optimized.In this article, the experimental researches related to RPE cell transplantation in recent years, the efficacy of transplantation and the existing problems were reviewed.The future trend of RPE cell transplantation may be to establish a comprehensive evaluation system for transplanted cells to screen out relatively suitable donor cells.

Purpose To study the clinicopathological features and immunohistochemical characteristics of IgG4-related disease. Meth-ods The microscopic characteristics and immunohistochemical staining (EnVision) of IgG, IgG4, CD138 and CD34 have been per-formed on 12 cases of IgG4-related disease. Results IgG4-related disease were characterized by diffuse fibrosis, accompanied with in-filtrating of dense lymphocytes and plasma cells surrounding neurovascular and occlusive phlebitis. Immunohistochemical staining re-sults showed the ratio of IgG4+/IgG+ cells were over 40%. Conclusions IgG4-related disease is absent of characteristic clinical and radiographic features and is easily misdiagnosed as tumor. Preoperative serum IgG4 detection could be used as the prior examina-tion for the suspected cases.

Objective To understand the environmental lead pollution status in Tongzhou and the biological burden of lead in children living in the lead polluted area.Methods The 353 pupils aged 7-14 years were randomly selected in Zhangzhishan town central elementary school that was near to steel wire factories,283 pupils were selected as the control by using the same methods in an elementary school around where there is no any steel wire factory.Every students were investigated by questionnaires,meanwhile their hair were collected to determine lead with ASS method.Results In the polluted area group,hair lead of 77 pupils exceeded the normal level,the median was 4.437 ?g/g,the rate of exceeding the normal level(≤10 ?g/g)was 21.81%,and 65 pupils with lead poisoning related symptoms(18.41%).In the control group,the median was 3.965 ?g/g,the rate of exceeding the normal level was 11.31%,38 pupil with lead poisoning related symptoms(13.43%).After controlled the passive smoking confounder,the difference of hair lead level between these two groups was still significant(P

Objective To analyze endoscopic ultrasonography (EUS) image of esophageal granular cell tumor (GCT) by computer image analysis software,and to explore its diagnostic and differential diagnostic value.Methods Eight esophageal GCT and eight leiomyomas confirmed by pathological and immunohistochemical examination were collected,mean gray value and gray value standard deviation of EUS image of the leisons were analyzed by computer image analysis software.The comparison of two groups was analyzed by t test.Results The endoscopic and ultrasound images of esophageal GCT and leiomyomas were similar.The mean gray value of EUS image of esophageal GCT and esophageal leiomyomas was 67.51 and 51.76,the difference was statistically significant (t=2.225,P=0.043).However,there was no significant difference in the standard deviation of gray value (13.54 vs 13.12,t=0.225,P=0.825).Conclusion The accuracy of GCT diagnosed by EUS could be increased by comparing the gray values of EUS images of esophageal GCT and leiomyomas.

Biopsy, Needle ; Humans ; Male ; Prostate ; pathology ; surgery ; Prostatic Neoplasms ; pathology ; surgery ; Transurethral Resection of Prostate

Adult ; Carcinoma, Renal Cell ; diagnosis ; Diagnosis, Differential ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; diagnosis

Objective To investigate the diagnostic value of endoscopic ultrasonography (EUS) for duodenal cysts.Methods Clinical manifestations, results of conventional gastroscopy and EUS, as well as follow-up, of patients with duodenal cysts were retrospectively analyzed.Results A total of 105 patients with duodenal cysts presented with no lesion-related symptoms, but displayed characteristic imaging changes under EUS, which could reveal the origin, size and nature of duodenal cysts, and differentiate it from other submucosal lesions.A maximum follow-up of 5 years showed no changes in duodenal cysts.Conclusion Duodenal cyst is a benign disease, and EUS plays a very important role in diagnosis of the disease.

Objective To study the diagnosis and treatment of malignant renal angiomyolipoma with metastases. Methods Three cases of advanced malignant renal angiomyolipoma with metasta-ses were retrospectively reviewed. Case 1 was a 55-year-old woman presenting with recurrent low-grade fever and aching pain in left flank. Ultrasound showed solid mass in the left kidney. Left radical nephrectomy was then performed. The right pulmonary lobectomy of the inferior lobe and wedge ex-section of superior lobe was performed 7 years later because of multiple pulmonary metastases. Case 2 was a 37-year-old woman. Left nephrectomy was performed because Ultrasound and CT showed left kidney solid mass. Six years later, multi-site metastases were found in liver and retroperitoneum and mestastasis tumors were resected. At 10 years after the primary diagnosis, CT showed multi-metasta-ses in liver and retroperitoneum. The retroperitoneal masses were resected and liver lesions were trea-ted by radiofrequency ablation. Case 3 was a 34-year-old man presenting with swelling pain in right flank. CT scan showed a lesion in the right kidney and right radical nephrectomy was performed. Four months after the surgery, MRI revealed multiple liver and retroperitoneal nodules. All the 3 cases had not been diagnosed with tuberous sclerosis and did not accept chemotherapy. Results The cut sur-face of the lesions was red-brown and yellow and the texture was tender. Under microscopic examina-tion, the tumors of case 1 and case 3 were composed of sheets or nests of large polygonal epithelioid cells. It revealed that occasionally clear cytoplasm with abundant eosinophilic, prominent nucleoli, and multinucleated and markedly pleomorphic form. Necrosis was presented as well. Large areas of case 2 tumor were made up of spindle smooth-muscle cells, adipose tissue, thick-wall blood vessels and some areas merged with a proliferation of epithelioid which was consistent with typical angiomyolipoma. Im-munohistochemical study showed that the epithelioid cells and spindle smooth-muscle cells were posi-tive for VM, HMB45, Melan-A and negative for S100, CK. Case 1 and case 3 were diagnosed with malignant epithelioid angiomyolipoma, while case 2 was diagnosed with malignant classic angiomyoli-poma and epithelioid in part of the tumor. Case 1 was well alive. Case 2 was alive with tumor 12 years after the diagnosis. And case 3 was missed in the follow-up 3 months after metastasis resection. Conclusions Malignant renal angiomyolipoma is a rare disease. The diagnosis depends on histopatho-logic, immunohistochemieal study and clinical follow-up. Radical resection of the primary, recurrent and metastatic tumors is the main therapy. It needs more research to clarify if metastasis has any effect on prognosis.

Objective To investigate the CT and MRI features and morphology classification of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B).Methods A total of 18 patients with IPMN-B proved by pathology were retrospectively analyzed.Out of 18 patients,16 patients underwent enhanced and non-enhanced CT,13 underwent contrast enhanced MR,and 11 out of 13 underwent both CT and MRI.IPMN-B was classified into 4 types:typical IPMN-B,cystic-forming IPMN-B,non-tumor IPMN-B and invasive IPMN-B,according to imaging findings and gross pathological findings.Results Typical IPMN-B (9 cases):tumors were distributed along the bile ducts,both upstream and downstream bile ducts were obviously dilated.Cystic-forming IPMN-B (5 cases):single or multiple tumors were found in aneurysmal dilatation of bile ducts.Non-tumor 1PMN-B (2 cases):no mass was found in the widely dilated bile ducts with smooth bile duct wall.Invasive IPMN-B (2 cases):tumors protruded into the dilated bile ducts causing jagged wall of bile duct,with accompanied abnormal density or signal intensity outside the bile ducts.Bile duct dilatations were shown in all 18 cases,and tumors were shown in 16 cases.In 2 cases no mass was displayed in widely dilated bile ducts.CT density of the tumor was lower than that of liver parenchyma,and higher than that of the bile and intraductal mucin.Signal intensity of the tumor was higher than that of stones,and lower than that of bile and intraductal mucin at MR T2WI.All tumors showed high intensity on DWI.Tumors showed mild to moderate enhancement after injection of contrast agent,CT density or signal intensity of the tumors were lower than that of the liver parenchyma during all three phases of contrast-enhanced CT or MRI.Conclusion IPMN-B has some specific CT and MR imaging features,which are helpful for the diagnosis and classification of IPMN-B.