骨旁脂肪瘤临床影像学表现与病理分析(文献综述附14例报告)

[目的]结合文献探讨骨旁脂肪瘤的命名、病因、临床病理表现和影像学特点。[方法]将国内文献的20例一起列入临床资料分析,包括作者14例共34例术前均行X线摄片,18例行CT检查,4例行MRI检查。[结果]本病发生于任何年龄,成人多见,以四肢长管状骨为好发,其次发生于扁平骨(骨盆、肩岬骨、髌骨、肋骨)、不规则骨(胸椎、腰椎、骶尾椎)、短管状骨和跗骨;本病临床误诊率为41.17%,X线误诊率26.47%,CT及MRI诊断率100%;34例均手术切除,病理报告为脂肪瘤,3例低度恶变;随访2~10年,仅1例复发并恶变。[结论]骨旁脂肪瘤是最佳的命名,病因未明,但与遗传和先天因素及创伤和炎症因素有关;病理表现为带骨蒂的脂肪瘤,细胞学形态为脂肪组织;影像学具有特征性表现。     

抑癌基因PTEN在胃癌中的表达及临床意义

目的探讨胃癌组织中PTEN基因表达与胃癌临床病理的关系及其对预后的判断价值。方法应用免疫组化SP技术和图像分析技术,研究PTEN在胃癌和正常胃黏膜组织中的表达情况及阳性表达面积、强阳性表达面积,分析与病理参数的关系,并采用Kaplan-Meier生存曲线分析不同表达水平对术后生存率的影响。结果发现胃癌组织PTEN表达阳性率、阳性面积、强阳性面积均明显低于正常胃黏膜组织（P〈0.01）。胃癌组织PTEN表达与胃癌组织分化程度、浸润深度、淋巴转移、肿瘤分期明显相关,术后3、5 a生存率低表达者明显低于高表达者（P均〈0.05）。结论PTEN基因表达低下或丢失与胃癌发生、浸润、转移有关,可作为预测术后生存率的指标。     

病理技术质量控制的探讨

病理技术是病理学诊断不可分割的一部分,正确的染色结果是病理诊断的重要依据之一.病理技术的规范与否,制片质量的好坏很大程度上影响病理医生作出正确的病理诊断.     

Clinical parameters that predict histology of postchemotherapy retroperitoneal lymph node mass in testicular cancer

BACKGROUND: Since the advent of cisplatin-based chemotherapy, the majority of metastatic testicular cancers can be cured by chemotherapy followed by retroperitoneal lymph node dissection (RPLND). However, postchemotherapy RPLND confers no therapeutic benefit if the residual mass contains no viable cells. Therefore, to determine which parameters predict a patient's likelihood of having only necrosis in the residual mass, we retrospectively analyzed clinical parameters of patients who underwent postchemotherapy RPLND. METHODS: Data from 27 patients with metastatic testicular cancer were analyzed. The histology of the primary tumor was seminoma in 11 cases and non-seminoma in 16 cases. All of the patients with non-seminoma showed a normalization of tumor markers after chemotherapy. Analysis of clinical parameters included data for the initial histology, pretreatment tumor marker levels, postchemotherapy retroperitoneal mass size, and the histology of the dissected RPLNs. RESULTS: Histological examination of dissected RPLNs showed residual tumor in 27% of seminoma patients and 38% of non-seminoma patients. In seminoma patients, no viable cells were found in all six patients with pretreatment lactate dehydrogenase (LDH) levels below 7.5 times the upper limit of normal, or in all five of the patients with postchemotherapy RPLNs less than 2.5 cm. In non-seminoma patients, no viable cells were found in nine of 10 patients with pretreatment alpha-fetoprotein (AFP) levels less than 2700 ng/mL, or in eight of nine patients with residual mass less than 2.5 cm. CONCLUSIONS: Both postchemotherapy RPLN mass size and pretreatment tumor marker levels are possible predictors for necrosis of the residual mass in testicular cancer patients.     

Chronic GVHD in minor salivary glands and oral mucosa: histopathological and immunohistochemical evaluation of 25 patients

BACKGROUND: Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells. METHODS: Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining. RESULTS: The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands. CONCLUSIONS: Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.     

Extragastrointestinal stromal tumor possibly originating from the prostate

We report a case of extragastrointestinal stromal tumor possibly originating from the prostate. The patient underwent radical prostatectomy because of no metastatic evidence. No recurrence and metastasis have been found during 14 months of follow up. To our knowledge, this may be the third such case published in a report in terms of pathological type.     

What factors influence survival in patients with unresected synchronous liver metastases after resection of colorectal cancer?

OBJECTIVE: The aim of this study was to determine whether the survival of patients with untreated synchronous liver metastases after resection of a colorectal cancer was associated with any features of the primary tumour. METHODS: Information for 398 consecutive patients with unresected liver metastases in the period 1971-2001 was examined by multivariate survival analysis. RESULTS: Of 19 clinical and pathological variables considered, survival was independently associated only with residual tumour in a line of resection (hazard ratio (HR) 1.95), venous invasion (HR 1.87), right colonic tumour (HR 1.68), lymph node metastasis (HR 1.54), and extra-hepatic metastasis (HR 1.16); 8.3% of patients had none of these adverse features. Their 2-year overall survival rate was 39.2%, compared with only 16.5% (P < 0.001) in those with one or more adverse features. CONCLUSIONS: These findings may assist in selecting patients most likely to benefit from treatment of hepatic metastases and in counselling patients and their relatives.     

实验性尘细胞灶与胸片细网状阴影形成的关系

本文从21只实验性矽肺家兔中筛选出5只胸片有细网状阴影者,用病理与 X 线对照观察的方法,探讨了实验性矽肺尘细胞灶与死后胸片细网状阴影形成的关系。证明,分布在肺细叶内直径约1mm 的尘细胞灶,其分布密度为113个/cm~2以上时,可构成胸片细网状阴影。实验排除了弥漫性肺间质纤维化的结论。并对胸片细网状阴影的形成从肺细叶解剖与 X 线投影进行了讨论。     

可见光对培养的人RPE细胞生长的影响以及SOD和CAT的防护作用

目的：观察外源性超氧化物歧化酶(superoxide dismutase,SOD)和过氧化氢酶(caralase，CAT)对培养的人视网膜色素上皮(retinal pigment epithelium,RPE)细胞光化学损伤的保护作用． 方法:将铺满期原代培养的人RPE细胞分为三组．A组直接作光照处理，B组在培养液中加入SOD(90U/mL)和CAT(900U/ml)后30分钟进行光照，c组为对照组．光照强度2 400 Lx，时间6小时．处理结束后将三组细胞以2.4X10⁵/ml的密度分别接种于24孔板，每孔0.4m1l．于接种后1、3、5和7天观察细胞形志，井进行细胞计数． 结果：光照后3天时，A、B组细胞生长缓慢，C组细胞生长活跃，3天后B组细胞生长接近C组，比A组明显活跃(P＜0.05)相似文献   

Neuroleptic malignant syndrome in the intensive therapy unit

A case of the neuroleptic malignant syndrome occurred in a 40-year-old male after administration of chlorpromazine while on an Intensive Therapy Unit. Treatment with dantrolene sodium was successful, and a muscle biopsy was examined in the recovery phase of the illness. The importance of this condition and the difficulties in establishing a diagnosis at an early stage in patients on an Intensive Therapy Unit are discussed, along with implications for treatment.