对造血系统肿瘤及淋巴组织肿瘤2001年WHO分类的再认识

世界卫生组织（World Health Organization，WH0）2001年以全书的形式公布了造血系统肿瘤和淋巴组织肿瘤分类，被成为WHO造血系统肿瘤和淋巴组织肿瘤新分类。该书的全名为《world Health Organization classification of tumor．Pathology ＆ Genetics．Tumors of hematopoietic and lymphoid tissues》，即《肿瘤的世界卫生组织分类：造血系统肿瘤和淋巴组织肿瘤病理学与遗传学》。据了解，WHO造血系统肿瘤和淋巴组织肿瘤新分类自公布至今已4年过去了，但国内血液病临床及病理界对这一分类的应用与认知程度值得担忧与关注，     

WHO胸部肿瘤分类（第5版）中肺肿瘤部分解读

国际癌症研究机构（International Agency for Research on Cancer，IARC）于2021年5月出版了《WHO胸部肿瘤分类（第5版）》。与2015年出版的《WHO胸部肿瘤分类（第4版）》相比，《WHO胸部肿瘤分类（第5版）》变更了主要章节的框架，新增和调整了部分疾病的命名和分类，并充实了流行病学、病因学、组织病理学和分子遗传学等相关内容。现就《WHO胸部肿瘤分类（第5版）》中肺肿瘤分类变化较大的内容予以简要介绍。     

原发性中枢神经系统淋巴瘤的诊断研究进展

 原发性中枢神经系统淋巴瘤（PCNSL）是一种临床上较为罕见的结外淋巴瘤,病理学分类多为弥漫性大B细胞淋巴瘤。WHO（2008）造血与淋巴组织肿瘤分类将"PCNSL"作为独立疾病实体列出。文章就近年PCNSL的临床诊断研究进展作一介绍。     

WHO胸部肿瘤分类（第5版）中胸膜、心包及胸腺肿瘤部分解读

国际癌症研究机构（International Agency for Research on Cancer,IARC）于2021年5月出版了《WHO胸部肿瘤分类（第5版）》。与2015年出版的《WHO胸部肿瘤分类（第4版）》相比,《WHO胸部肿瘤分类（第5版）》变更了主要章节的框架,新增和调整部分疾病的命名和分类,并充实了流行病学、病因学、组织病理学和分子遗传学等相关内容。现就《WHO胸部肿瘤分类（第5版）》中胸膜、心包及胸腺肿瘤分类变化较大的内容予以简要介绍。     

纵隔灰区淋巴瘤的研究进展

 纵隔灰区淋巴瘤（mediastinal gray zone lymphoma）作为一个疾病实体,常不能依据现有的诊断标准进行分类。这类淋巴瘤同时具有纵隔弥漫大B细胞淋巴瘤（PMBL）和经典霍奇金淋巴瘤（cHL）的特征。在2008年WHO造血与淋巴组织肿瘤分类中将其命名为“B细胞淋巴瘤,不能分类,具有介于弥漫大B细胞淋巴瘤和经典霍奇金淋巴瘤之间的特征（BCLu）”。BCLu具有独特的临床特点、免疫表型和分子遗传学特征,临床过程更具侵袭性,预后较差。目前尚无达成共识的治疗方案,可参照侵袭性B细胞淋巴瘤的方案化疗。     

自然杀伤细胞肿瘤的研究进展与探索

正自然杀伤(natural killer,NK)细胞肿瘤是一组少见的异质性疾病。基于对正常NK细胞和相关肿瘤认识的进展,WHO造血及淋巴组织肿瘤分类(2008年版)已纳入慢性NK细胞增殖性疾病和NK细胞淋巴母细胞白血病/淋巴瘤,作为新的暂定疾病实体。值得注意的是母细胞NK细胞淋巴瘤(WHO分类2001)现在认为是来源于前体浆细胞样树突细胞的肿瘤,并更名为母细胞浆细胞样树突细胞肿瘤。     

肿瘤的良、恶性判断标准会发生变化吗？

随着诊断技术的发展，对肿瘤性病变本质的认知不断深入，某些类型肿瘤的良、恶性判断标准在经历了长期大量的临床病理学实践之后，依据新的研究结论重新界定。例如，世界卫生组织（WHO）关于淋巴造血组织肿瘤分类标准的研讨从1994年、1997年、2001年到2008年不断推陈出新，新的类型逐一确立，对某些既往难以诊断为恶性淋巴瘤的病变确定了分类和诊断标准。     

套细胞淋巴瘤

<正>套细胞淋巴瘤(mantle cell lymphoma,MCL)是2001年WHO淋巴造血组织肿瘤新分类中的一种独立的B细胞非霍奇金淋巴瘤[1],占非霍奇金淋巴瘤的5%~10%。它来源于初级淋巴滤泡未成熟生发中心前CD5+的B细胞或次级淋巴滤泡套区细胞。好发于中老年人。大多诊断时处于Ⅲ~Ⅳ期,有广     

2012年第4版《WHO乳腺肿瘤组织学分类》介绍

世界卫生组织（World Heahh Organization,WHO）肿瘤组织学和遗传学分类系列——《乳腺肿瘤组织学分类》（第4版）于2012年6月正式出版。相较2003年出版的《乳腺和女性生殖器官肿瘤的病理学和遗传学》（第3版）怛J,新版将乳腺肿瘤单独归为一本,不再与女性生殖道肿瘤合本,内容更为丰富。本文就新版《WHO乳腺肿瘤组织学分类》的主要内容介绍如下。     

套细胞淋巴瘤研究进展

套细胞淋巴瘤是2001年WHO淋巴造血组织肿瘤新分类中的一种独立的B细胞非霍奇金淋巴瘤。该肿瘤有其独特的分子遗传学、病理组织学特点，文章对其分子遗传学、病理特征以及治疗与预后作一综述。     

The 2015 World Health Organization Classification of Tumors of the Thymus: Continuity and Changes

This overview of the 4th edition of the World Health Organization (WHO) Classification of thymic tumors has two aims. First, to comprehensively list the established and new tumor entities and variants that are described in the new WHO Classification of thymic epithelial tumors, germ cell tumors, lymphomas, dendritic cell and myeloid neoplasms, and soft-tissue tumors of the thymus and mediastinum; second, to highlight major differences in the new WHO Classification that result from the progress that has been made since the 3rd edition in 2004 at immunohistochemical, genetic and conceptual levels. Refined diagnostic criteria for type A, AB, B1–B3 thymomas and thymic squamous cell carcinoma are given, and it is hoped that these criteria will improve the reproducibility of the classification and its clinical relevance. The clinical perspective of the classification has been strengthened by involving experts from radiology, thoracic surgery, and oncology; by incorporating state-of-the-art positron emission tomography/computed tomography images; and by depicting prototypic cytological specimens. This makes the thymus section of the new WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart a valuable tool for pathologists, cytologists, and clinicians alike. The impact of the new WHO Classification on therapeutic decisions is exemplified in this overview for thymic epithelial tumors and mediastinal lymphomas, and future perspectives and challenges are discussed.     

Book Reviews

Book reviewed in this article: Radiology in War. By A. Rosenberger and E. Boijsen TNM Classification of Malignant Tumours. Edited by Hermanek P. & Sobin L.H. Physical Principles of Medical Imaging Perry Sprawls, Jr. Functional Studies Using NMR. Edited by V. Ralph McCready Nuclear Medicine —Ionizhg Radiation Exposure of the population of the United States. Ultrasonography of the Neck. Bruneton J-N, et al. Radiologic Management of Musculoskeletal Tumours. By H. Pettersson, D.S. Springfield and W.F. Enneking. Normal Anatomy for Multiplanar Imaging: Head, Neck and Spine —Vol. 1 and Normal Anatomy for Multiplanar Imaging: The trunk and Extremities —Vol. 2 by Bharat Raval; Joel W. Yeakley; and John H. Harris; Jr. Proceedings of the Multinational Postgraduate Course Radiology Today Volume 4. Heuck F. H. W. & Donner M. W. “Lumbar Myelography with Water-Soluble Contrast Media” by Michael Langlotz New Developments in Imaging Sonography —Interventionat Sonography Cine-CT —MRI. Sonography during Neurosurgery. Edited by R.Ch. Otto & C.B. Higgins. Sonography of the Infant Hip: An Atlas“ “Radiology in Emeqency Medicine” By R.C. Levy, H. Hawkins and W.G. Barsan. ‘Living with Lung Cancer’ Barbara G. Cox, David T. Carr and Robert E. Lee.     

香港头颈外科的发展现状

头颈外科包括了头颈部肿瘤及相关疾病的诊断和治疗。香港头颈外科的起源可以追述到本世纪60年代中期。当时的香港大学玛丽医院外科学系主任王源美教授是开创这一领域的先驱。香港最初只有普外科医生涉及到这一区域肿瘤的治疗，经过多年来其它专科的发展，目前香港头颈部的疾病已经可以由三个外科次级专科处理，即耳鼻喉科、整形重建科和普外科。20年来，在外科、放射科及化疗科的共同努力下，头颈部肿瘤在诊断及治疗方面获得的迅速的发展，这就使病人的预后得到了很大程度的改善。     

The 2021 WHO Classification of Lung Tumors: Impact of Advances Since 2015

The 2021 WHO Classification of Thoracic Tumours was published earlier this year, with classification of lung tumors being one of the chapters. The principles remain those of using morphology first, supported by immunohistochemistry, and then molecular techniques. In 2015, there was particular emphasis on using immunohistochemistry to make classification more accurate. In 2021, there is greater emphasis throughout the book on advances in molecular pathology across all tumor types. Major features within this edition are (1) broader emphasis on genetic testing than in the 2015 WHO Classification; (2) a section entirely dedicated to the classification of small diagnostic samples; (3) continued recommendation to document percentages of histologic patterns in invasive nonmucinous adenocarcinomas, with utilization of these features to apply a formal grading system, and using only invasive size for T-factor size determination in part lepidic nonmucinous lung adenocarcinomas as recommended by the eighth edition TNM classification; (4) recognition of spread through airspaces as a histologic feature with prognostic significance; (5) moving lymphoepithelial carcinoma to squamous cell carcinomas; (6) update on evolving concepts in lung neuroendocrine neoplasm classification; (7) recognition of bronchiolar adenoma/ciliated muconodular papillary tumor as a new entity within the adenoma subgroup; (8) recognition of thoracic SMARCA4-deficient undifferentiated tumor; and (9) inclusion of essential and desirable diagnostic criteria for each tumor.     

Concordance of histological classification of lung cancer with special reference to adenocarcinoma in Osaka, Japan, and the North-West Region of England

In routinely collected data adenocarcinoma of the lung appeared to be 3 times more frequent in Osaka, Japan, than in the North-Western (NW) Region of England (Manchester). Before embarking on comparative epidemiological studies, it was decided to investigate the comparability of histological diagnosis. Specimens from 60 NW Region lung cancer patients and 52 Osaka patients were exchanged and reviewed. The entire material was then independently assessed by the WHO Collaborating Centre for Histological Classification of Tumours. The interpretation of the WHO Classification (WHO, 1981) by the NW Region and by Osaka was upheld by the WHO Collaborating Centre in 89% and 93% of all cases and in 97% and 100% of adenocarcinoma cases respectively. Agreement between the 2 centres was 88% for the main cell types. Differences in the frequency of adenocarcinoma of lung between the NW Region and Osaka are thus not due to diagnostic artefact and require further exploration. The aetiological implications of the finding that many Chinese and Japanese women with lung adenocarcinoma do not smoke (77% in Osaka) are discussed.     

Accuracy of References in Indian Journal of Otolaryngology and Head & Neck Surgery

This study was done to observe the accuracy of references in articles published in Indian Journal of Otolaryngology and Head & Neck Surgery. There were 63 references randomly selected from different issues of Indian Journal of Otolaryngology and Head & Neck Surgery (IJOHNS). It includes: Volume 61, Number 4, December 2009 and Volume 62, Number 1, January 2010. References were examined in details by dividing them into six elements and they were compared with the original for accuracy. References not cited from indexed journals were excluded. Statistical analysis was done by using frequency and percentage. Results show that 30.1% references in Indian Journal of Otolaryngology and Head & Neck Surgery were incorrect. Most common errors were author’s name and journal name. Author’s names were found to be incorrect in 11.1% references while journal name were found to be incorrect in 6.3%. Errors in citing the references are also found in the Indian Journal of Otolaryngology and Head & Neck Surgery. The quoted error in this study is comparable to other international literatures. The majority of errors are avoidable. So, the authors, editors and the reviewers have to check for any errors seriously before publication in the journal.     

Pathological aspects of gynecological malignancies--early stage cancers and borderline lesions

Pathology of gynecological malignancies including cancers of the uterus and ovary were described with a particular focus on early stage cancers and borderline lesions. Histological criteria appeared in this paper are mentioned in accordance with The General Rules for Clinical and Pathological Management of Uterine Cervical Cancer and Uterine Body Cancer and WHO Classification of Ovarian Tumours. Carcinogenesis of the uterine and ovarian cancers were also discussed.     

Understanding the Revised Fourth Edition of the World Health Organization Classification of Tumours of the Central Nervous System (2016) for Clinical Decision-making: A Guide for Oncologists Managing Patients with Glioma

The recognition of specific molecular prognostic factors has altered the management of primary brain tumours over the past decade. These factors have allowed stratification of morphologically similar tumours into different prognostic groups and are now also being used to determine clinical trial eligibility. Many of these factors have been included in the revised fourth edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System, released in May 2016. This revised edition places greater emphasis on molecular testing and, for certain tumour types, molecular testing is required for diagnosis. Many pathology departments have also adopted the four-tiered report format suggested in the Haarlem guidelines, and provide a final ‘integrated diagnosis’ incorporating a morphological diagnosis, the WHO grade and molecular findings. Pathologists need to perform and report these molecular tests in a timeframe that is relevant for clinical decision-making. Clinicians need to understand and incorporate these changes into their daily practice, as they have direct effects on both the type and intent of therapeutic interventions.     

经口腔前庭内镜甲状腺癌切除术治疗甲状腺癌的临床疗效

目的探讨经口腔前庭内镜甲状腺癌切除术对甲状腺癌患者的临床疗效。方法将112例甲状腺癌患者按照治疗方法的不同分为对照组(n=56)和观察组(n=56),对照组患者接受常规甲状腺癌切除术,观察组患者接受经口腔前庭内镜甲状腺癌切除术,观察比较两组患者围手术期情况、临床疗效及术后并发症发生情况。结果对照组患者手术时间短于观察组,术中出血量多于观察组,术后24h疼痛评分高于观察组,开始进食时间、颈部活动时间及住院时间均长于观察组,差异均有统计学意义(P﹤0.05)。观察组患者治疗后的临床总有效率为91.07%(51/56),高于对照组的71.43%(40/56),差异有统计学意义(P﹤0.05)。两组患者术后并发症发生情况比较,差异无统计学意义(P﹥0.05)。结论经口腔前庭内镜甲状腺癌切除术较常规甲状腺癌切除术对患者创伤较小,术后恢复较快,临床疗效较好且安全性较高。     

Evaluation of audiovestibular and conventional neuro-radiological tests in diagnosis of the internal auditory meatus and adjoining posterior fossa tumefaction

Indian Journal of Otolaryngology and Head & Neck Surgery - Early recognition of Cerebellopontine angle tumours reduces the morbidity and mortality of these patients. With this view 112 patients...