巨大无功能性胰岛细胞瘤一例

患者女,23岁,住院号45776。因左上腹肿块4个月,胀痛1个月就诊。发病以来曾持续性午后低热,抗炎治疗好转。肿块呈进行性增大,腹部呈持续性胀痛。但食欲好,大小便无殊。既往无严重疾病史。查体:一般情况良,全身浅表淋巴结无肿大,腹软,肝助下未及,腹水征(-)。左上腹     

63例宫颈腺癌临床病理分析

原发性宫颈腺癌(以下称宫颈腺癌)相对较少见,约占宫颈癌的3～6％并有增多趋势,甚至高达30％、。宫颈腺癌的预后较鳞癌差。目前认为组织学类型与治疗方式可影响其疗效。本文对我院收治的63例宫颈腺癌组织学类型与治疗     

温度对HID染色结果的影响探讨

八十年代来,许多研究提示分泌硫酸化粘液的胃粘膜大肠化生与肠型胃癌关系密切。高铁二胺一爱先蓝(HID/AB)法能将硫酸化粘液显示成清晰的棕黑色,由于此法的稳定、简便,使之成为胃粘膜常规组化染色。本实验中我们在不同的温度和时间条件下观察HID染色粘液颗粒着     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

十二指肠腺增生性病变18例临床病理分析

目的探讨十二指肠腺增生性病变的临床病理学特点、免疫表型、诊断及鉴别诊断。方法回顾性分析18例十二指肠腺增生性病变的临床资料、病理学特征、免疫表型,并复习相关文献。结果患者发病年龄35～71岁,男、女性各9例。18例患者中十二指肠腺增生、十二指肠腺错构瘤各9例,两者的形态及病变大小无明显差异。十二指肠腺错构瘤的镜下表现比十二指肠腺增生多样,且其腺体可伴上皮内瘤变,免疫组化标记p53、Ki-67及Muc5AC可以辅助诊断。大部分十二指肠腺增生性病变的表面黏膜均有Muc5AC不同程度的表达,提示表面黏膜有不同程度的胃小凹化生,部分表面黏膜还可见糜烂及溃疡形成。结论十二指肠腺增生性病变临床罕见,包括十二指肠腺增生和十二指肠腺错构瘤,两者主要通过镜下形态特点进行鉴别。采用免疫组化检测可鉴别十二指肠腺的上皮内瘤变或原位癌变与硬化性改变;表面黏膜的胃小凹化生、糜烂及溃疡形成提示病变可能的发生、发展机制。     

CD44v6在甲状腺乳头状腺癌中的表达及意义

目的：探讨肿瘤转移相关基因ＣＤ４４ｖ６与甲状腺乳头状腺癌颈淋巴结转移及其生物学行为的关系。方法：采用免疫组化ＬＳＡＢ方法对５０例甲状腺乳头状腺癌存档标本进行ＣＤｖ６表达测定。结果：甲状腺乳头状腺癌颈淋巴结转移组２６例ＣＤ４４ｖ６阳性表达率为７６．９％（２０／２６）,颈淋巴结转移阴性组２４例中阳性率为５０．０％（１２／２４）,二者比较Ｐ〈０．０５;ＣＤ４４ｖ６表达阳性率与病人临床Ｔ分期无明显相关性（     

nm23-H1基因在肺多形性癌组织中的表达及意义

目的　探讨 nm2 3- H1基因表达与肺多形性癌转移及预后的关系。方法　应用免疫组化 S- P法回顾性分析 2 0例肺多形性癌组织中 nm2 3- H1基因表达 ,并结合肺多形性癌的转移、侵袭力、肿块大小及预后进行分析。结果　 nm2 3- H1基因在肺多形性癌中表达阳性率 ,有淋巴结转移组 (2 5 .0 % )低于无淋巴结转移组 (87.5 % ) (P<0 .0 1) ,有侵犯周围组织组 (12 .5 % )低于无侵犯周围组织组 (10 0 % ) (P<0 .0 1) ,肿块直径 >6 cm组 (4 2 .8% )与肿块直径 <6 cm组 (5 0 .0 % ) ,差异无显著性 (P>0 .0 5 )。结论　 nm 2 3- H1基因表达与肺多形性癌有无淋巴结转移、侵袭力强弱关系密切 ,而与肿块大小无关。 nm 2 3- H 1基因高表达预示肺多形性癌转移及侵袭力低 ,预后可能较好     

肉瘤样癌及癌肉瘤的新认识

长期以来，肉瘤样癌与癌肉瘤的组织学起源、病理分型等问题一直存在争议，类似名称众多，从而给病理诊断和临床治疗带来紊乱。从最新的WHO定义及病理学上的研究趋势着手，对此类肿瘤作一分析，还对发生在各部位的肉瘤样癌与癌肉瘤按其临床特点展开讨论。     

原发性乳腺鳞状细胞癌临床病理分析

回顾性分析11例原发性乳腺鳞状细胞癌（primary squamous cell careinoma of the breast,PSCCB）患者的临床病理资料.11例均行手术治疗,术后病理检查4例发生腋窝淋巴结转移,生存超过5年的7例,3例死于肿瘤复发和转移.回顾性研究的结果提示,PSCCB患者的临床表现与普通类型的乳腺癌比较无特异性,确诊需依据病理诊断,由于其发病率低,规范的治疗和预后评价有待进一步研究.     

非小细胞肺癌患者外周血与组织中K-ras基因突变的研究

目的检测非小细胞肺癌患者外周血与肿瘤组织K-ras基因突变率及两者的一致性,探讨外周血K-ras基因突变的临床应用价值。方法应用实时荧光定量PCR方法检测257例非小细胞肺癌组织,318例非小细胞肺癌外周血,其中185例外周血标本和组织标本配对,检测其中K-ras基因突变,比较外周血和组织标本突变一致性,分析K-ras基因突变和患者临床特征相关性。结果外周血标本中检测出37例突变(11.64%),组织标本中29例突变(11.28%),两种标本一致性为76.19%,差异有统计学意义(Kappa=0.671,P=0.000)。结论非小细胞肺癌患者外周血与组织K-ras基因突变一致性较高,在无法获得组织学标本时可以检测外周血K-ras基因状态,为非小细胞肺癌的临床诊疗提供帮助。