Objective To explore the clinicopathological features of adult pulmonary sequestration and summarize the misdiagnosis experiences.Methods Data of 16 cases of adult pulmonary sequestration ( 18 years),who were confirmed by surgery and biopsy in our hospital were collected and reviewed.Results The median age of all the patients was 38.5 years.The female seemed to be more likely to suffer from adult pulmonary sequestration ( n =12) with cough to be the most frequent symptom ( n =9 ).CT scans revealed most of the lesions were located in the left lower lobes of the lungs ( n =9 ).Half of the lesions were characterized by pulmonary cyst-like changes and/or multiple cystic bronchiectasis ( n =8 ),followed by soft tissue mass in or out of the lung fields ( n =7).Enhanced CT scans showed abnormal arteries from the systemic circulation.Only two cases were diagnosed as pulmonary sequestration correctly in the primary diagnosis.The remaining were mostly misdiagnosed as pulmonary cyst-like changes with bronchiectasis ( n =6) or tumors (n =6).According to the findings during surgery,13 cases were intralobar pulmonary sequestrations; 3 cases were extralobars,whose tissues were all detected dysplasia and chronic inflammatory by histopathological examinations.Conclusions The misdiagnosis rate of pulmonary sequestration is high because of its non-specific clinical symptoms.Since it is characterized by abnormal arteries and pulmonary dysplasia,enhanced CT scans should be used as a preferred screening method for suspected cases,especially for those middleaged patients with cystic or mass-like lesions in the left lower lobes of the lungs.

Purpose To explore the clinicopathological features, differential diagnosis of solitary bronchial papilloma, and its relation with and human papilloma virus infection.Methods Four cases of SBP were studied by routine histologic,immunohistochemical staining and in situ hybridization, together with review of the literature.Results One of four lesions was squamous cell papilloma, with focal malignant change of squamous cell carcinoma with microinvasion. The case was an old woman and the cancer located in central bronchus. Others were mixed squamous cell and glandular papilloma, and two cases with features of moderate cytologic atypia. The age ranged from 25 to 73 years (average 54), and tumors were located in the bronchi and segmental bronchi. Papillary arborizing connective tissue stalks were lined by both squamous and glandular epithelium. Four papillomas were exophytic, with one case inverted partly. Four cases were examined for HPV DNA and all were negative.Conclusions SBP in adults is a rare lung neoplasm. Based on uncommon cases association with malignant change, all endobronchial papillomas should be completely excised.

BACKGROUND AND OBJECTIVEPleuropulmonary blastoma (PPB) is a rare malignant tumor with unique clinicopathological features. The aim of this study is to investigate the clinicopathological features, the diagnosis and differential diagnosis of pleuropulmonary blastoma.

METHODSFive cases of PPB were analyzed by light microscopy, immunohistochemistry and their clinical data, and the relative literatures were reviewed.

RESULTSFive cases of patients suffered from PPB were aged from 21 to 47 months (mean 32.8 months). Most of the masses were located in the thoracic cavities and 4 cases accompanied with pleural effusions. Histologically, these tumors included 1 case of type I PPB which showed pure cystic architecture; 2 cases were type II PPB which showed cystic and solid masses accompanied with rhabdomyoblastic differentiation and nodules of cartilage; the other 2 cases were type III PPB and characterized by absolute solid masses with anaplastic undifferentiated sarcomatous components. Immunohistochemical studies showed that tumor cells were positive for Vimentin and some for Desmin and Myogenin, the nodules of cartilage were positive for S-100. The tumor cells were negative for PCK, EMA and CD99.

CONCLUSIONPleuropulmonary blastoma is a rare and highly aggressive malignancy arising in the lung and pleural of infancy and early childhood. The type I, II and III PPB have unique clinicopathological features respectively. This kind of tumor should be distinguished from some benign and malignant diseases such as congenital cystic adenomatoid malformation (CCAM) and embryonal rhabdomyosarcoma.

Adult ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Middle Aged ; Pleural Neoplasms ; mortality ; pathology ; surgery ; Pulmonary Blastoma ; mortality ; pathology ; surgery

BACKGROUNDIt has been proven that ezrin protein may interact with E-cadherin protein and take part in metastasis of tumors. The aim of this study is to detect the expression of ezrin and E-cadherin and their significance in non-small cell lung cancer (NSCLC) with tissue microarray technique.

METHODSEzrin and E-cadherin proteins were detected in 25 cases of benign pulmonary tissues, 287 cases of NSCLC tissues and 120 cases of metastatic lymph nodes by LSAB method of immunohistochemical staining. All patients were followed up.

RESULTSThe overexpression rate of ezrin in primary NSCLC tissues and metastatic lymph nodes was 57.8% and 83.3% respectively (P=0.000). The abnormal expression rate of E-cadherin in primary NSCLC tissues and metastatic lymph nodes was 82.6% and 98.3% respectively (P=0.000). The overexpression rate of ezrin was significantly related to grading (P=0.005) and metastasis (P=0.032). The abnormal expression rate of E-cadherin was closely related to grading (P=0.024), metastasis (P=0.015) and TNM stages (P=0.037). There was a negative correlation between expression of ezrin and E-cadherin (P=0.029). Grading, metastasis of NSCLC, TNM stages, overexpression of ezrin and abnormal expression of E-cadherin were independent prognostic factors of NSCLC (P < 0.05).

CONCLUSIONSOverexpression of ezrin and abnormal expression of E-cadherin may promote tumor metastasis. Ezrin and E-cadherin may be useful prognostic markers for patients with advanced NSCLC.

BACKGROUNDInflammatory myofibroblastic tumors (IMTs) are rare tumors of soft tissue recognized recently and the lung is one of common organs involved. The aim of this study is to investigate the valuable clinicopathological features for diagnosis of IMTs of the lung.

METHODSThe clinicopathology data of 9 patients with IMTs were collected. The resected lesions of the patients were studied by histological and immunohistochemical methods.

RESULTSThe 9 patients' symptoms mainly included cough, expectoration and dyspnea. Seven patients displayed as benign IMTs and 2 malignant IMTs. The big spindle neoplastic myofibroblastic cells of the benign IMTs had eosinophilic cytoplasm and round or oval nuclei. Mitoses were generally scanty (0-2/50HPF). Compared with the benign IMTs, the malignant IMTs displayed highly atypical polygonal cells with oval vesicular nuclei, prominent nucleoli and variable mitoses ( > 25/50HPF). Ganglion-like myofibroblastic cells with plasma cells, and lymphocytes invasion could be seen in all IMTs. The immunohistochemical results were: in all patients vimentin, muscle-specific actin and α-smooth muscle actin (+), p53 (-), while some patients desmin and anaplastic lymphoma kinase-1 (+).

CONCLUSIONSIMTs patients' symptoms are atypical. IMTs are composed with abundant myofibroblasts accompanied with many inflammatory cells. Surgical resection is the first choice for IMTs, complete resection leads to excellent survival for benign IMTs but not very well for malignancy.

BACKGROUNDTo investigate the relationship between expression of PKC-βI, apoptosis and prognosis of non-small cell lung cancer (NSCLC).

METHODSThe expression of PKC-βI and apoptosis index (AI) were detected in 119 human NSCLC tissues and paracancerous tissues by LSAB and TUNEL, with 32 benign pulmonary disease tissues as control.

RESULTS(1)The expression of PKC-βI (82.27%) in NSCLC tissues was significantly higher than those (62.85% and 50.47%) in paracancerous tissues and benign pulmonary disease tissues (P < 0.05). The AI (5.27%) in NSCLC tissues was significantly lower than that ( 15.84%) in benign pulmonary disease tissues (P < 0.05). (2) No significant relationship was observed between the expression of PKC-βI and clinical physiopathological characteristics of NSCLC (P > 0.05). The AI was closely related to pTNM stage of the cancer, size of primary tumor and lymph node metastasis (P < 0.05), but not to the histological classification, cell differentiation, sex and age of the patients with NSCLC (P > 0.05). (3) A highly significant negative correlation was observed between PKC-βI expression and AI in NSCLC group (P < 0.01). (4) The 5-year survival rate (7.37%) in patients with high PKC-βI expression was much lower than that (37.06%) in patients with low PKC-βI expression (P < 0.01). The 5-year survi-val rate ( 39.24%) in patients with high AI was much higher than that (6.14%) in patients with low AI (P < 0.01).

CONCLUSIONSThe abnormal activation of PKC-βI and suppression of apoptosis may play important roles in the oncogenesis and prognosis of lung cancer. Detection of PKC-βI expression and AI may help to predict the prognosis of patients with NSCLC and guide the postoperative multimodality therapy.

BACKGROUNDTo investigate the contents of trace elements in benign lung tissue, lung cancer tissue and paracancerous tissue of patients with lung cancer and their rule of variation.

METHODSAtomic absorption spectrometry was used to measure the contents of cadmium (Cd), lead (Pb), chromium (Cr), manganese (Mn), nickel (Ni), cuprum (Cu) and zinc (Zn) in lung cancer tissues and paracancerous tissues from 19 lung cancer patients and 9 patients with benign pulmonary diseases. The ratio of a certain element's content in cancer tissues and paracancerous tissues was applied to evaluate the role of the element in tumor generation and development.

RESULTSThe contents of Cu, Pb in cancer tissues were higher than those in paracancerous tissues, and the contents in paracancerous tissues were higher than those in benign tissues; The contents of Cd, Cr, Mn, Ni and Zn were in cancer tissues than those in paracancerous tissues. Pb showed significant accumulation in cancer tissues, while Ni showed significant accumulation in paracancerous tissues.

CONCLUSIONSSignificant differences of the contents of trace elements are found among the different lung tissues, and this result indicates that the change of trace elements' contents is related to the generation and development of lung cancer.

BACKGROUNDTo investigate the expression features of the heterogeneous nuclear ribonucleoprotein A2/B1 (hnRNP A2/B1) in non-small cell lung cancer and its clinical significance.

METHODShnRNP A2/B1 expression of cancer tissues, paracancerous lung tissues, resected bronchial stump epithelium tissues was detected in 58 non-small cell lung cancer patients and pulmonary tissues in 30 patients with benigh pulmonary lesions as control by immunohistochemistry methods.

RESULTSThe positive expressive rate of hnRNP A2/B1 in lung cancer tissue (63.79%) was significantly higher than those in paracancerous lung tissue (43.10%) and benign pulmonary lesion tissues (20.00%) (P=0.000), and the positive rate in paracancerous lung tissue was also significantly higher than that in benign pulmonary lesion tissues (P < 0.05). The positive rate of hnRNP A2/B1 in the hyperplastic and dysplastic epithelium (40.00%) of resected bronchial stump was remarkably higher than that in normal bronchial epithelium (15.15%) in lung cancer patients (P=0.032). The positive rate of hnRNP A2/B1 in poor differentiated lung cancer (78.13%) was remarkably higher than that in moderate and well differentiated lung cancer (46.15%) (P < 0.05). The positive rate of hnRNP A2/B1 in lung cancer with lymph node metastasis (75.00%) was significantly higher than that without lymph node metastasis (50.00%) (P < 0.05). The positive rate of hnRNP A2/B1 in stage III+IV disease (78.57%) was significantly higher than that in stage I+II disease (50.00%) (P < 0.05). The positive rate of hnRNP A2/B1 in T3+T4 cancer (77.42%) was significantly higher than that in T1+T2 cancer (48.15%) (P < 0.05). The positive rate of hnRNP A2/B1 expression in lung cancer tissues was not related to histological classification of the cancer (P > 0.05).

CONCLUSIONSThe overexpression of hnRNP A2/B1 in cancer tissues may play an important role in the oncogenesis, development and metastasis of lung cancer. Detection of hnRNP A2/B1 expression may be helpful to diagnose lung cancer and to predict prognosis of the patients with lung cancer.

BACKGROUNDTo investigate the role of protein kinase CβII (PKC-βII) expression and apoptosis in the oncogenesis and development of non-small cell lung cancer.

METHODSThe expression of PKC-βII and apoptosis were detected in 119 human non-small cell lung cancer tissues and paracancerous lung tissues by TUNEL and LSAB, and 32 benign pulmonary disease tissues as control.

RESULTSThe expression of PKC-βII (85.39%) in lung cancer tissues was significantly higher than that in paracancerous lung tissues and benign pulmonary disease tissues (65.69% and 53.22%) ( P < 0.05), and the PKC-βII expression in paracancerous samples was also remarkably higher than that in benign pulmonary disease samples ( P < 0.05). The apoptotic index (AI) (5.27%) in lung cancer tissue was significantly lower than that in the benign lung lesion tissue (15.84%) ( P < 0.05). No significant relationship was observed between the expression of PKC-βII in lung cancer tissue and clinical physiopathological characteristics ( P > 0.05). The AI in the lung cancer tissues was closely related to the stages of the cancer, size of primary tumor and lymph node metastasis ( P < 0.05), but not to the histological classification, cell differentiation and location of the tumor, and sex and age of the patient with lung cancer ( P > 0.05). A highly significant negative correlation was observed between PKC-βII expression and AI in the lung cancer group ( P < 0.01).

CONCLUSIONSThe abnormal activation of PKC-βII and the suppression of apoptosis may play important roles in the oncogenesis and development of non-small cell lung cancer. The overproliferation of cells and suppression of apoptosis transducted by PKC-βII may be one of the important mechanisms of the oncogenesis and development of non-small cell lung cancer.

BACKGROUNDTo study the clinicopathologic and immunohistochemical features of primary pulmonary extranodal marginal zone B-cell lymphomas (MALT lymphomas).

METHODSImmunohistochemical staining for LCA, CD20, CD45RO, CD5, cyclinD1, Ki-67, immunoglobine light chain κ and λ, CK and NSE was carried out in 9 patients with primary pulmonary extranodal marginal zone B-cell lymphomas by the S-P methods.

RESULTSAccording to the histological pattern and immunohistochemical features, all patients were diagnosed as primary pulmonary extranodal marginal zone B-cell lymphomas. There were four males and five females with a median age of 51.5 years (range from 37 to 64 years). The tumor cells were positive for LCA and CD20, however, the positive rates of Ki-67 were low. The tumor cells expressed immunoglobine light chain restriction λ in 5 cases , κ in 1 case, both λ and κ in 1 case, and neither of them in 2 cases. The tumor cells were negative for CD45RO, CD5, cyclineD1, CK, NSE in all patients.

CONCLUSIONSPrimary pulmonary extranodal marginal zone B-cell lymphomas are inert lymphomas which are easily misdiagnosed. The evaluation of pathologic features and immunohistochemistry are useful and practical in the diagnosis and differential diagnosis of primary pulmonary extranodal marginal zone B-cell lymphomas.