Objective To investigate the correlation between CT imaging features and histopathology invasive behaviors in isoat-tenuating and rim-enhancing pancreatic cancer.Methods A retrospective analysis was conducted on the CT imaging,clinical,and pathological data from 34 patients with atypical pancreatic cancer imaging appearances.All patients underwent surgical resection for diagnostic confirmation.Based on contrast attenuation,all cases were divided into isoattenuating group(13 cases)and rim-enhancing group(21 cases).The CT imaging and pathological characteristics of the two groups of lesions were analyzed.Results Significant differences were observed between the isoattenuating group and the rim-enhancing group in terms of lesion location,CT size,presence of necrosis or cystic changes,and common bile duct amputation/dilation.Pathological parameters,including pathological size,patho-logical grade,and T stage,also showed significant variation between the two groups(P＜0.05).No significant differences were found between the two groups in terms of gender,age,main pancreatic duct amputation/dilation,pancreatic parenchymal atrophy,vascular invasion,fat infiltration,nerve invasion,N stage,metastasis,and CA199 value(P＞0.05).Conclusion Isoattenuating pancreatic cancer and rim-enhancing pancreatic cancer,which display distinct contrast attenuation patterns,may exhibit different clinical and pathological characteristics,with potential implications for diagnostic and therapeutic strategies.

Objective To investigate the correlation between CT imaging features and histopathology invasive behaviors in isoat-tenuating and rim-enhancing pancreatic cancer.Methods A retrospective analysis was conducted on the CT imaging,clinical,and pathological data from 34 patients with atypical pancreatic cancer imaging appearances.All patients underwent surgical resection for diagnostic confirmation.Based on contrast attenuation,all cases were divided into isoattenuating group(13 cases)and rim-enhancing group(21 cases).The CT imaging and pathological characteristics of the two groups of lesions were analyzed.Results Significant differences were observed between the isoattenuating group and the rim-enhancing group in terms of lesion location,CT size,presence of necrosis or cystic changes,and common bile duct amputation/dilation.Pathological parameters,including pathological size,patho-logical grade,and T stage,also showed significant variation between the two groups(P＜0.05).No significant differences were found between the two groups in terms of gender,age,main pancreatic duct amputation/dilation,pancreatic parenchymal atrophy,vascular invasion,fat infiltration,nerve invasion,N stage,metastasis,and CA199 value(P＞0.05).Conclusion Isoattenuating pancreatic cancer and rim-enhancing pancreatic cancer,which display distinct contrast attenuation patterns,may exhibit different clinical and pathological characteristics,with potential implications for diagnostic and therapeutic strategies.

Objective:To investigate the relationship between epicardial adipose tissue (EAT) thickness and left ventricular geometry in patients with obstructive sleep apnea syndrome (OSAS).Methods:Two hundred and twenty-one OSAS patients were enrolled consecutively from the First Hospital of Shanxi Medical University from January to December 2019. According to left ventricular mass index (LVMI) and relative wall thickness (RWT), OSAS patients were divided into 4 groups based on the left ventricular geometry: 110 with normal geometry (NG group), 56 with concentric remodeling (CR group), 32 with concentric hypertrophy (CH group), and 23 with eccentric hypertrophy (EH group). The patients were examineel by echocardiography, the left ventricular end diastolic diameter, LVMI, interventricular septal thickness, left ventricular posterior wall thickness, left ventricle ejcetion fraction, E/A were collected. Age, systolic blood pressure (SBP), diastolic blood pressure (DBP), apnea hypopnea index (AHI), nocturnal lowest oxygen saturation (Lowest-SaO 2), nocturnal mean oxygen saturation (Mean-SaO 2), the percentage of the time that oxygen desaturation below 90%(T90), oxygen desaturation index(ODI), triglyceride (TG), total cholesterol (TC), EAT thickness and the echocardiography parameters were compared among the four groups. The relationships between EAT thickness and the above-mentioned parameters and left ventricular geometry were analyzed by univariate and multivariate linear regressions. Results:①The higher EAT thickness was found in the CH group [(0.50±0.09)cm] and EH group [(0.46±0.07)cm] compared with the NG group [(0.33±0.11)cm] and CR group [(0.36±0.15)cm] (all P<0.05). In addition, age, SBP, DBP, AHI, ODI, T90, LVMI, RWT and E/A ratio were all significantly different among the groups (all P<0.05). ②Univariate linear regression analysis showed that EAT thickness was positively correlated with age, SBP, DBP, AHI, TG, TC and LVMI, RWT, left ventricular geometry, and negatively correlated with Mean-SaO 2 and Lowest-SaO 2. ③Multivariate linear regression analysis showed that EAT thickness was independently correlated with AHI, TG, TC and left ventricular geometry. Conclusions:EAT is independently related to abnormal left ventricular geometry, suggesting that EAT may be involved in the process of left ventricular remodeling.

Objective: To investigate androgen receptor(AR)expression in invasive breast carcinoma and the correlation with surrogate molecular breast carcinoma subtypes. Methods: Immunohistochemical staining of AR and other biomarkers was performed in a cohort of 870 cases of primary invasive breast carcinomas collected from August to December, 2016. The association of AR expression with different histological and surrogate molecular subtypes was analyzed. Results: The positive expression rate of AR in the immunohistochemistry-based surrogate subtypes was 96.3%(207/215) for Luminal A, 89.8%(378/421) for Luminal B, 82.4%(75/91) for HER2 overexpression and 37.1%(53/143) for triple negative breast carcinoma, with significant differences among the four groups (P<0.01). AR correlated positively with the expression of ER(P<0.01), PR(P<0.01), HER2(P=0.007), GATA3(P<0.01), GCDFP15(P<0.01)and mammaglobin(P<0.01), while negatively with the expression of Ki-67(P<0.01), CK5/6(P<0.01)and CK14(P<0.01). Conclusions AR exhibits a high expression in invasive breast carcinoma, which is mainly correlated with ER-positive breast carcinoma. Regardless of the relatively low expression rate, AR is a potential therapeutic target in triple negative breast carcinoma.

Objective: To evaluate the morphological and immunohistochemical features of infiltrating epitheliosis and its differential diagnosis. Methods: Nine consultation and routine cases of infiltrating epitheliosis diagnosed from January 2015 to December 2016 in Fudan University Shanghai Cancer Center were collected. All tissues were formalin-fixed paraffin-embedded and routinely HE stained. The HE slides were reviewed. Immunohistochemical staining of CKpan, CK7, CK19, CK5/6, CK14, p63, SMMHC, Calponin, ER, PR, HER2, Ki-67 and S-100 protein was performed using Ventana BenchMark automated immunostainer. Results: The morphological features of infiltrating epitheliosis included: (1) Florid proliferation of epithelial cells forming solid nests or papillary, glandular and cord-like pattern. The proliferative cells possessed nuclei of varying size and shape without atypia. (2) The stroma was altered, showing varying degrees of fibrosis or sclerosis. (3) The proliferative epithelial nests might flow into the spaces within small ducts and lobules at the periphery of the lesion, resulting in pseudo-infiltration. Immunohistochemically, infiltrating epitheliosis was non-uniformly positive for ER/PR, and was positive for high molecular weight CK5/6 and CK14. Myoepithelial markers p63, SMMHC and Calponin demonstrated intact, partial or entire loss of myoepithelial cells around the epithelial nests. The loss of myoepithelial markers staining was more frequent at the periphery of the lesion. The most important differential diagnoses included invasive ductal carcinoma, ductal carcinoma in situ (DCIS), and low grade adenosquamous carcinoma, etc. Conclusions Infiltrating epitheliosis is an important pseudo-infiltrating lesion. The lack of atypia, non-uniform ER/PR expression, positivity for high molecular weight cytokeratins, and the intact to partial to entire loss of myoepithelial markers around the proliferating cell nests are the key points to differentiate it from invasive carcinomas and DCIS.

OBJECTIVETo investigate the clinicopathologic characteristics and differential diagnosis of the metastases to the breast from non-mammary malignancies.

METHODSTwenty-eight cases were collected from 2004 to 2012;microscopic pathologic examinations and immunohistochemistry (EnVision method) were performed.

RESULTS(1) All except one patients were female, ranging from 16 to 77 years old (average 45.8 years). Twenty-six (92.9%) patients initially presented with the primary site lesions; while the other two (7.1%) patients initially presented with breast lesions. The mean interval from primary diagnosis to detection of metastatic breast lesions was 32 months (0-228 months). Fifteen patients (53.6%) had other metastases detected simultaneously or preceded the breast lesions. (2) Macroscopically, all the tumors were relatively circumscribed, with a mean diameter of 4.0 cm (0.6-12.0 cm). The histological types of the corresponding primary tumors were as follows: eight (28.6%) cases from lung adenocarcinoma, five (17.8%) from high-grade ovarian serous carcinoma, three (10.7%) from gastric adenocarcinoma, two (7.1%) from rectal adenocarcinoma, one (3.6%) from pancreatic neuroendocrine carcinoma, one (3.6%) from prostatic carcinoma, four (14.3%) from melanoma, and four (14.3%) from mesenchymal malignant tumors (three rhabdomyosarcomas and one epithelioid malignant peripheral nerve sheath tumor, MPNST). (3) Histologically, the metastatic tumors showed the morphologic characteristics of the primary tumors. Lymph-vascular invasion was observed in 19 cases. Immunohistochemical features of metastatic tumors were consistent with the primary tumors. Molecular markers for breast such as GCDFP15 and mammaglobin were negative. Metastatic tumors from lung adenocarcinoma expressed TTF-1 (8/8). Ovarian serous carcinoma metastases were positive for PAX8 (5/5) and WT1 (4/5). Gastric adenocarcinoma metastases were positive for CDX2 (3/3) and villin (1/3). Rectal adenocarcinoma metastases were positive for CDX2 (2/2). Pancreatic neuroendocrine tumor metastasis was positive for Syn and CgA (both 1/1). Prostate carcinoma metastasis was positive for AR, PSA and P504S (all 1/1). Melanoma metastases were positive for HMB45 (2/3) and S-100 protein (3/3). Rhabdomyosarcoma metastases were positive for vimentin, desmin and myoD1 (all 3/3). MPNST metastasis was positive for S-100 protein (1/1). (4) Follow-up data was available in 17 patients, with median follow-up time 54 months. The median survival from diagnosis to breast metastasis was 24 months.Seven of 17 patients died.

CONCLUSIONSMetastases to the breast from non-mammary malignancies are rare and show pathologic features of primary tumors. It is usually presumed to be a primary breast carcinoma. Histopathologic features and clinical history in conjunction with the immunohistochemical results should be considered in differentiating a secondary mass from a primary breast carcinoma.

Adenocarcinoma ; secondary ; Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; pathology ; secondary ; surgery ; Breast Neoplasms, Male ; pathology ; secondary ; surgery ; Carcinoma, Neuroendocrine ; secondary ; Cystadenocarcinoma, Serous ; secondary ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; pathology ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Mastectomy ; Melanoma ; secondary ; Middle Aged ; Ovarian Neoplasms ; pathology ; Pancreatic Neoplasms ; pathology ; Rectal Neoplasms ; pathology ; Rhabdomyosarcoma ; secondary ; Stomach Neoplasms ; pathology ; Treatment Outcome ; Young Adult

OBJECTIVETo study the clinicopathologic features, immunophenotype and differential diagnosis of cystic hypersecretory lesion (CHL) of the breast.

METHODSClinicopathologic and follow-up data of six cases of breast CHL in 2010-2013 were collected and reviewed.Immunohistochemical and mucinous staining was performed.

RESULTSAll six patients were female, age ranged from 37 to 71 years (average 49.3 years). Three cases were cystic hypersecretory hyperplasia (CHH), the other three cases were cystic hypersecretory carcinoma (CHC). Clinically the lesions presented as either breast mass or mammographic calcification.Grossly, the cystic hypersecretory lesions were poorly circumscribed, with multiple colloid containing cysts on the cut surface. Microscopically, the remarkable feature was numerous enlarged cysts which contained densely eosinophilic homogeneous secretion similar to the colloid seen in thyroid follicles, and calcification was seen in the cyst in one case. The secretion was D-PAS and mucicarmine positive. The lining epithelium of the cysts was uniformly flat, cuboid or columnar, and arranged in a monolayer. The cells may be arranged in turfs, solid or micropapillary patterns in CHH.In cases with dysplasia, the epithelium showed cytological and structural atypia, but the usual morphology of atypical dutal hyperplasia such as arcades, rigid bridges or cribriform pattern was less common. The three CHC included two invasive ductal carcinomas (IDC) and one ductal carcinoma in situ (DCIS).In CHL, there was immunoreactivity to S-100 protein, CK5/6 and CK14.Of the three CHCs, ER and PR were expressed in only one IDC.No HER2 expression was identified in the two invasive CHCs.One patient was lost to follow-up, and the rest were uneventful at 18 months.

CONCLUSIONSCHL of the breast is a rare pathological entity. Multiple colloid-filled cysts is a unique histological feature. The epithelium of CHL may show usual hyperplasia, dysplasia or carcinoma.

Adult ; Aged ; Breast ; pathology ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; surgery ; Epithelium ; pathology ; Female ; Fibrocystic Breast Disease ; metabolism ; pathology ; surgery ; Humans ; Hyperplasia ; Immunohistochemistry ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Lymphatic Metastasis ; Middle Aged ; S100 Proteins ; metabolism