Objective:To analyze the clinicopathological characteristics, diagnosis, and differential diagnosis of hepatic perivascu-lar epithelioid cell neoplasm (PEComa). Methods:The clinicopathological features of seven hepatic PEComa patients treated in Shanxi Cancer Hospital from March 2008 to March 2015 were studied with light microscopy and immunohistochemistry combined with litera-ture review. Results:The age range of the seven patients was 41-56 years old (median:51.5 years old). Two were males and five were females. Their histopathological subtypes were classic type (2/7), smooth muscle type (3/7), and fat type (2/7), respectively. Immunohis-tochemical study showed that HMB45 was positive in 7 cases, SMA and VIM were expressed in 6 cases, Melan A was positive in 5 cas-es, and Desmin was expressed in 2 cases. In addition, the mean proliferative index was 1.3%(range:0%-5%), and TFE3 was negative in all cases. Conclusion:Hepatic PEComa is a rare primary liver tumor. The diagnosis and treatment of this disease should be intensi-fied, and long-term close follow-up is necessary. Positive result for HMB45, Melan A, and SMA are the key features of PEComa.

Objective To analyze the ultrasound features of ultrasonograpy-false-positive benign thyroid nodules in 37 cases. Methods With pathology results as the golden standard, thirty-seven patients with forty-six nodules were misdiagnosed as thyroid cancer by ultrasonography. The pre-operative diagnosis of ultrasonography were retrospectively reviewed and analyzed. Results Among forty-six thyroid nodules, twenty-one nodules had a diameter of 10.0 mm or smaller, while the other twenty-five nodules had a diameter of larger than 10.0 mm. In all forty-six thyroid nodules, the pre-operative ultrasonography found the majority of nodules with 3 or more than 3 malignant signs. The forty-six thyroid nodules showed solid (89.1%, 41/46), cystic-solid (10.9%, 5/46), marked hypoechogencity (87.0%, 40/46), ill-defined margin (56.5%, 26/46), calcification (76.1%, 35/46),microcalcification and macrocalcification), and taller-than-wide shape (30.4%, 14/46). The thyroid imaging reporting and data system (TI-RADS) lexicon was introduced to describe the lesions:forty-one nodules were categorized as TI-RADS 4c and 5 nodules were categorized as TI-RADS 5. On histology, these misdiagnosed thyroid nodules revealed severe fibrosis, hyalinization and calcification. The ultrasonic images were complicated and difficult to be differentiated from thyroid cancer. Conclusion Benign thyroid nodules with fibrosis, hyalinization, hemorrhage and calcification will lead tothe significant change on lesions' morphology, echo intensity and internal structure. When the benign and malignant signs ultrasound co-existed in a single thyroid nodule, benign thyroid nodules might be easily misdiagnosed as thyroid cancer.

Objective To study the expressions of metadherin (MTDH) and cyclinD1 in esophageal squamous cell carcinoma (ESCC) and their clinical significances. Methods The protein expressions of MTDH and cyclinD1 were detected by immunohistochemistry in 78 cases of ESCC. Results The positive expression rate of MTDH in ESCC was 71.79%(56/78) and the positive expression rate of cyclinD1 in ESCC was 74.36%(58/78). The expressions of MTDH and cyclinD1 were significantly correlated with the degree of differentiation and lymph node metastasis (both P< 0.05), but not with the age, gender of patients and depth of tumor invasion (all P> 0.05). Conclusion The over expressions of MTDH and cyclinD1 protein may involve in the occurrence and development of esophageal carcinoma, which play important roles in the invasion and metastasis of esophageal cancer.

Carcinoma, Medullary ; pathology ; Duodenal Neoplasms ; pathology ; Humans

Objective:To analyze the pathogenesis, clinicopathological characteristics, diagnosis, and treatment of the malakoplakia for the purpose of avoiding misdiagnosis and missed diagnosis. Methods:Clinicopathological features of four malakoplakia patients admit-ted to the Shanxi Cancer Hospital from March 2007 to March 2017 were studied by light microscopy, immunohistochemistry, and spe-cific stain technology, combining with a review of literature. Results:The onset age of the 4 patients (two males and two females) ranged 56-76 years (median:63 years). Two patients had malakoplakia in bladder;one patient had malakoplakia in bilateral ureters;and one case had malakoplakia in right pelvic. One patient has a history of systematic lupus erythematosis and diabetes. Malakoplakia is characterized by the accumulation of foam cells and concentrically-layered basophilic inclusions called Michaelis-Gutmann (M-G) bodies. The foam cells were positive for CD68 and PGM-1 by immunohistochemistry, indicating its derivation from the histocyte. M-G bodies were positive for periodic acid-Schiff reaction, iron, and calcium by specific staining technology. Conclusion:Malakoplakia is a rare inflammatory condition and a common urinary tract disease, but it may involve any organ with non-specific symptoms and can form tumor-like nodules that clinically simulate malignancy in various organs. Clinicopathological features can be used as diagnostic markers in malakoplakia diagnosis through specific stain technology.

Objective To analyze the association between clinicopathological features and molecular subtypes of breast carcinoma in women aged under 35 years old. Methods The clinicopathological data of 385 women aged under 35 years old who had complete data and were diagnosed as breast cancer from July 2009 to May 2016 were retrospectively analyzed. The relationship between clinicopathological features and molecular subtypes was analyzed by using nonparametric Kruskal-Wallis H test. Results In 415 cases, 385 cases were invasive ductal carcinoma, 22 cases were ductal carcinoma in situ, 4 cases were mucinous adenocarcinoma, 3 cases were invasive lobular carcinoma, 1 case was lobular carcinoma in situ. In invasive ductal carcinoma, luminal B type was the most [218 cases (56.6%)], and 60 cases (15.6%) were triple negative breast cancer (TNBC). There were significant differences in tumor mass, N stage, histological grade and clinical stage between the different molecular subtypes (all P < 0.05). Conclusions Tumor size, histological grade, lymph node staging and clinical stage of young female patients with breast carcinoma are closely associated with different molecular subtypes. The ratio of molecular subtypes with poor prognosis, higher histological grade and later clinical stage is high in all cases, which is related to the poor prognosis of young women breast carcinoma and should be paid more attention to the early diagnosis.

Objective To discuss the BRAF V600E mutation rate in papillary thyroid carcinoma (PTC) and its relationship with the clinicopathological features. Methods Two hundred and sixty-five PTC patients(including 226 cases of classical type,29 cases of follicular type, 3 cases of high cell type, 2 cases of diffuse sclerosis type, 2 cases of eosinophilic type, 3 cases of cystic type) from August 2014 to October in Shanxi Provincial Cancer Hospital, were collected with completely clinical and pathological information. The BRAF V600E mutation was detected by real-time polymerase chain reaction (RT-PCR) method. Pearson χ 2 test and the exact probability method were used to analysis the relationship between gene mutations and clinicopathological data. Results BRAF V600E mutation rate in PTC patients was 73.21 %(194/265). There was no significant difference in the mutation rate of BRAF V600E among patients with different age, gender, tumor location,tumor number and extravaginal invasion(all P>0.05),but the mutation rates of BRAF V600E gene in patients with different tumor size, histopathological subtypes, lymph node metastasis and clinical stage were significantly different(all P<0.05).Conclusion The PTC patients with positive BRAF V600E mutation have poor clinicopathological features,and BRAF V600E mutation may be a predictor of advanced PTC.

Objective:To investigate the correlation between KRAS, NRAS and BRAF V600E gene mutations and the clinicopathological characteristics of patients with colorectal cancer.Methods:Specimens from 217 patients with colorectal cancer who underwent surgical resection and were pathologically confirmed in Shanxi Province Cancer Hospital from January 2020 to December 2021 were selected, and the clinical data of the patients were retrospectively analyzed. The mutation status of KRAS, NRAS and BRAF V600E genes were detected in the paraffin specimens of surgically-resected tissues by direct sequencing. The mutation rates of KRAS, NRAS and BRAF V600E were compared among patients with different clinicopathological characteristics.Results:The mutation rates of KRAS, NRAS and BRAF V600E in 217 patients with colorectal cancer were 48.4% (105/217), 4.1% (9/217) and 3.7% (8/217), of which 1 patient (0.5%) had both KRAS and NRAS mutations. NRAS gene mutation was not correlated with gender, age, tumor size, tumor location, pathological type, degree of differentiation, depth of invasion, lymph node metastasis, distant metastasis, TNM stage, hemangioma thrombus/nerve invasion (all P>0.05); KRAS mutation rate in patients ≥ 60 year old was higher than that in patients < 60 year old [55.3% (63/114) vs. 40.8% (42/103), χ2 = 4.55, P = 0.033),and there was no correlation between KRAS gene mutation and other clinicopathological features (all P > 0.05); the mutation rate of BRAF V600E gene in colorectal cancerpatients with distant metastasis was higher than that in patients without distant metastasis [16.7% (4/24) vs. 2.1% (4/193), P = 0.006], and there was no correlation between BRAF V600E gene mutation and other clinicopathological features (all P > 0.05). Conclusions:Older colorectal cancer patients may be prone to KRAS gene mutation, and the BRAF V600E gene mutation rate is higher in patients with distant metastasis, and there is no correlation between NRAS gene mutation and clinicopathological characteristics.