Objective To examine the expression of Ki-67,p53,bcl-2 and bax in gastric globoid dysplasia and the relationship between globoid dysplasia and gastric carcinoma.Methods An immunohistochemical staining was used to detect the expression of Ki-67,p53,bcl-2 and bax in 41 cases of gastric globoid dysplasia ,92 gastric carcinoma and 92 normal gastric mucosa.Results 41 cases gastic globoid dyplasia were seen in well differentiated adenocarcinoma,poor differentiated adnocarcinoma,mucinous adenocarcinoma and signet ring cell carcinoma.The histologic transition of globoid dysplasia to carcinoma was in 2 cases signet ring cell carcinoma and 3 poor differentiated tubular adenocarcinoma.Most cells of globoid dysplasia were positive of Ki-67,p53,bcl-2 and bax.The expression of Ki-67 and p53 in globoid dysplasia was higher than that in normal gastric mucosa and approached carcinoma level.The expression of bcl-2 was lower but of bax was higher in globoid dysplasia than that in normal.However,the expression of bcl-2 in higher grade globoid dysplasia was heightened.Conclusions Gastric globoid dysplasia is special active .It is possible that gastric globoid dysplasia is correlated to the occurrence of varied gastric carcinoma.

Carcinoma ; pathology ; Endometrial Neoplasms ; pathology ; Female ; Humans ; Neoplasms, Multiple Primary ; pathology ; Ovarian Neoplasms ; pathology ; Sex Cord-Gonadal Stromal Tumors ; pathology

Objective To investigate the clinical pathological features and imaging findings of primary pulmonary sarcomatoid carcinoma. Methods Fifteen patients with a pathologically verified primary pulmonary sarcomatoid carcinoma were reviewed retrospectively. Fourteen patients had CT examinations and I0 of them had contrast-enhanced CT scan. Nine patients had chest plain films. Results Of 15 patients, 14 were peripheral and 1 was central, diameters ranging from 2.5 cm to 9.5 cm. Five located in the upper, 3 in the middle and 4 in the lower lobe of the right lung. The other 3 located in the upper left lobe. All cases presented with a spheroid solid lung mass on chest plain film and CT examinations. Three had irregular eccentric cavities. Six were well demarcated, 2 were ill defined, 4 were lobulated and 3 were speculated. The central case had obstructive pneumonia and showed ill defined. Ten showed irregular peripheral heterogeneous contrast enhancement. The center part of the tumor showed no enhancement or inhomogeneous enhancement. Seven had thoracic wall or pleural invasion, 4 had hilar or mediastinal lymphopathy and 2 had metastasis. Histopathologically, 8 were pleomorphic carcinoma, 2 were spindle cell carcinoma, 3 were giant cell carcinoma and 3 were pulmonary blastomas. Conclusion The X-ray and CT findings of the primary pulmonary sarcomatoid carcinoma are not specific. The clinicopathologic features were the evidence of diagnosis.

Objective To study the clinical,imaging and pathological characteristics and diagnostic methods of pulmonary mucosa-associated lymphoid tissue-derived lymphoma (MALToma),and differentiate from three kinds of pulmonary lymphatic hyperplasia.Methods Medical history,imaging and pathological examination of three cases of pulmonary MALToma were introduced in detail.And differentiated from lymphocytic pseudolymphoma (nodular lymphoid hyperplasia),follicular bronchiolitis and lymphocytic interstitial pneumonia.Results The clinical manifestations and imaging examination of pulmonary MALToma had no special and were not easy to differentiate from cancer.Histopathologically,widened marginal zones encircled one or more germinal centers.The neoplastic lymphocytes invaded germinal center and bronchiole resulting in follicle colonization and lymphoepithelial lesions.Conclusion Pulmonary MALToma is a rare low grade malignant tumor.Histopathology is the key method to diagnosis,while clinical manifestations and imaging examination have no special symptoms at diagnosis.MALToma is differed from pulmonary lymphatic hyperplasia in widened marginal zone encircled one or more germinal centers,follicular colonization,lymphoepithelial lesions,cell types between follicular.

Objective To observe the expression of 7 cytokeratins in skin epithelial tumors and to assess their diagnostic value. Methods The expression of 7 cytokeratins, including cytokeratin 7(K72.2), cytokeratin 8(C-51), cytokeratin 10(DE-K10), cytokeratin 14(LL002), cytokeratin 17(E3), cytokeratin 18(DC10)and cytokeratin 19(KS19.1), was assessed by immunohistochemical staining (S-P method) in 54 cases of different skin epithelial tumors and 20 normal skin specimens. Results Of 54 cases studied, 10 were squmous cell carcinoma (SCC), 10 basal cell carcinoma (BCC), 19 hair follicle tumor, 2 sebaceous carcinoma, and 13 sweat gland tumor. The expression patterns and distribution of the 7 cytokeratins were different in different skin epithelial tumors. Most of the tumor cells stained diffusely for cytokeratins in SCC, BCC and hair follicle tumor; different cytokeratins expressed in different parts of each of the subtypes of sweat gland tumors. Conclusions Analysis of a selected group of cytokeratins may be helpful in the diagnosis and differential diagnosis of SCC, basal cell carcinoma and skin adenexal tumor.

Objective:To observe the clinicopathological features of gastrointestinal stromal tumor (GIST) cases with concurrent carcinoma. Methods:Patient data of 24 GIST cases with concurrent carcinoma were collected from the 157 GIST cases reported be-tween 2002 and 2012. The clinicopathological features of the GIST cases with concomitant carcinoma were studied. The expression of CD117, CD34, and SMA by the tumors was assayed using the immunohistochemical EliVision method. In particular, the expression of the proliferation marker Ki-67 was studied. Results:GIST cases with concurrent carcinoma accounted for 15.3%of the total GIST cas-es studied. The GIST patients with concurrent carcinoma included 14 males and 10 females. The male-female ratio of these patients was 1.4∶1. The age of the patients ranged from 41 years to 66 years, with a median age of 55 years. Lesions at the inferior segment of the esophagus were found in 7 of the 24 selected GIST cases;lesions at the gastric wall and in the intestines were observed in 15 and 2 cas-es, respectively. The diameter of the GIST cases with concurrent carcinoma ranged between 0.6 and 3.8 cm, with an average of 1.50 ± 0.85 cm. Slight dysplasia was observed in 4 of the 24 cases; no heteromorphism was present in the remaining 20 cases. The mitotic counts of GIST cases with concurrent carcinoma ranged from 0/50 HPF to 5/50 HPF, with an average of (0.79±1.83)/50 HPF. The pro-liferative index of Ki-67 in the GIST cases with concurrent carcinoma ranged between 0 and 7.72, with an average of 2.16 ± 3.26. The concurrent carcinoma cases included 5 cases with esophageal carcinoma, 2 with cardiac carcinoma, 15 with gastric cancer, and 2 with intestinal cancer. In contrast to the GIST cases with concurrent carcinoma, the GIST cases without carcinoma complications included 74 males and 59 females. The male-female ratio was 1.25∶1. The age of the patients without concurrent carcinoma ranged from 43 years to 71 years, with a median age of 54 years. Among the 133 GIST cases without cancer complications, gastric, intestinal, and esophageal lesions were found in 114, 13, and 6 cases, respectively. The diameter of GISTs without cancerous complications ranged from 2.4 cm to 15.5 cm, with an average of 6.11 ± 7.09 cm. Different degrees of dysplasia were seen in 82 of the 133 cases. The mitotic counts in the GIST cases without cancer complications ranged from 0/50 HPF to 53/50 HPF, with an average of (3.81±23.67)/50 HPF. The prolifera-tive index of Ki-67 for these cases ranged from 0 to 39.21 and averaged at 6.22 ± 16.96. The male-female ratio of the GIST cases with cancer complications was higher compared with the GIST cases without. The average diameter of GISTs with complications was small-er compared with that of GISTs without complications. The mitotic counts and the proliferative index of Ki-67 were significantly lower in the GIST cases with cancer complications than in those without (t=1.981, P<0.05 vs. t=1.993 5, P<0.05). Conclusion:Concurrent car-cinomas were found in 15.3% of the total GIST cases. No special clinical symptoms were observed in most GIST cases with cancer complications, as revealed when the carcinomas were examined. The proliferative index of Ki-67 in the GIST cases with concurrent car-cinoma is significantly lower compared with that of the GIST cases without complications.

OBJECTIVE: To investigate the expression of CD4, CD69, CD34, RANTES, IL-5 and IL-8 in nasal polyp tissues, and study their roles in the formation of nasal polyp. METHOD: The expression of CD4, CD69, CD34, RANTES, IL-5 and IL-8 were detected by immunohistochemical method and image analysis in 34 cases of nasal polyps and 30 cases of nasal concha mucosa (LNT). RESULT: The positive rate of glandular organ hyperplasia, formation of beaker cell, fiber hyperplasia, interstitial edema and infiltration of lymphocyte and eosinophilic granulocyte in nasal polyps were significantly higher than those in nasal concha mucosa (P<0.01). The cell density (piece/mm2) of CD4+, CD69+, IL-5, IL-8, RANTES in 34 nasal polyps was significantly higher than those in nasal concha mucosa (P<0.05). Marked positive correlations were found between expression of CD4, CD69 and RANTES, IL-5 and IL-8 (P<0.05, P<0.01 and P<0.05), expression of IL-5 and RANTES and infiltration level of eosinophilic granulocyte (P<0.05 and P<0.01), and expression of IL-8 and vaso formation on nasal polyps tissue (P<0.01). CONCLUSION T lymphocytes and correlated cytokines participate in the immunopathogenesis of nasal polyps; IL-5 and RANTES can prompt the infiltration, the aggregation and the activation of eosinophilic granulocytes; IL-8 can promote the vaso formation in nasal polyps.
Chemokine CCL5 ; metabolism ; Female ; Granulocytes ; immunology ; Humans ; Interleukin-5 ; metabolism ; Interleukin-8 ; metabolism ; Lymphocyte Activation ; Lymphocyte Count ; Male ; Middle Aged ; Nasal Mucosa ; immunology ; metabolism ; Nasal Polyps ; immunology ; metabolism ; T-Lymphocytes ; immunology

OBJECTIVETo assess clinical and pathological features of ovarian transitional cell tumors.

METHODSFourteen cases of ovarian transitional cell carcinoma (TCC) were selected and investigated for their clinical and pathological features. Their immunohistochemical profiles were compared with 12 cases of serous adenocarcinoma (SC) admixed with TCC and 4 cases of EC admixed with TCC 20 cases of pure high-grade serous adenocarcinoma (HG-SC), 15 cases of endometrioid adenocarcinoma (EC), 6 cases of Brenner tumor (BT, 2 cases of malignant BT and 4 cases of benign BT).

RESULTSThe patients' age ranged from 36-63 years (mean, 56 years). All cases underwent surgery and postoperative chemotherapy with TP or CAP program. Clinical follow-up was available in 9 cases, of which 2 patients died. Histologically, all cases showed features of transitional cell carcinoma without BT component. Immunohistochemically, 13 of 14 TCCs were positive for WT-1 and all were positive for CK7, ER, PR and CA125, but negative for Uroplakin III and CK20.Similar immunohistochemical staining patterns were seen in SC admixed with TCC and pure HG-SC. Percentage of the 14 TCC cases were also diffusely positive for BRCA1. All SCs admixed with TCC and pure HG-SCs were diffusely or heterogeneously positive for WT-1, with a sharp contrast and mottled distribution pattern in the heterogeneous cases. All TCCs were diffusely and strongly positive for p53, while 16 of 20 cases of pure HG-SC were positive. The positive ratio of p53 in SCs admixed with TCC cases was 11/12.WT-1 expression in TCCs was significantly higher than BTs, ECs and ECs admixed with TCC (P < 0.01), while no obvious difference was seen when compared with SCs admixed with TCC and pure HG-SCs.SCs admixed with TCC, TCCs and EC were positive for BRCA1 except pure ECs and BTs. The positive rate of Ki-67 of BTs was low, while it was higher in TCCs, SCs admixed with TCC and pure HG-SCs. Only BTs expressed Uroplakin III.

CONCLUSIONSOvarian TCC has characteristic morphological and immunohistochemical features, similar to SC but different from BT. Therefore, TCC should be considered as a morphological variant of HG-SC.

Adult ; Brenner Tumor ; metabolism ; pathology ; CA-125 Antigen ; metabolism ; Carcinoma, Endometrioid ; pathology ; Carcinoma, Transitional Cell ; pathology ; Cystadenocarcinoma, Serous ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasms, Glandular and Epithelial ; pathology ; Ovarian Neoplasms ; metabolism ; pathology ; Uroplakin III ; metabolism

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.