Indium111 antimyosin for the detection of leiomyosarcoma and rhabdomyosarcoma

¹¹¹In-antimyosin monoclonal antibody complex passes through damaged myocardial cell membranes and binds to the intracellular myosin. Normal myocardial and other muscle cells show no uptake.Rhabdomyosarcoma and Leiomyosarcoma cells also contain intracellular myosin.and the cell membrane permeability is greater than normal. Significant uptake of ¹¹¹In-antimyosin was observed in patient with Leiomyosarcoma and Rhabdomyosarcoma suggesting that the reagent has a potential for the in vivo detection of these tumour types. Tumour to background ratios of 10:1 were measured in one case and in view of the fact that the site of accumulation is intracellular, antimyosin may have a potential as a carrier for therapeutic agents.     

软组织复发及多发性平滑肌肉瘤的临床病理、免疫组织化学及电镜研究

本组报告软组织复发及多发性平滑肌肉瘤22例(多发性2例),进行了组织学、免疫组织化学及电镜观察。本组20例复发性平滑肌肉瘤复发次数为1～5次,间隔时间为2月～12年,病理可分为高分化型、低分化型、中度分化型及临界型平滑肌肉瘤。临界型易被忽略,应进行随访。     

True smooth muscle neoplasms of the gastrointestinal tract: morphological spectrum and classification in a series of 85 cases from a single institute

BACKGROUND AND AIM: True smooth-muscle neoplasms of the GI tract have been only rarely studied in the KIT era. Their incidence among other GI mesenchymal tumours and their clinicopathological spectrum have not been sufficiently analysed. MATERIALS AND METHODS: We reviewed all GI mesenchymal lesions at the Pathology Institute of the Nuremberg Clinic Centre from 1994 through 2005. RESULTS: Among 262 lesions, there were 142 GISTs (54%) and 85 true smooth muscle neoplasms (32%). Smooth muscle neoplasms comprised 72 polypoid leiomyomas (78%, 5 oesophageal and 67 colorectal), 10 intramural leiomyomas (11%, 5 oesophageal, 4 gastric and one ileal), two intramural leiomyosarcomas in the sigmoid colon and ileum (2%) and one polypoid leiomyosarcoma involving the stomach, descending colon and the retroperitoneum concurrently. None of the leiomyomas with available follow-up have recurred or metastasised. CONCLUSION: Smooth muscle neoplasms are the second most common mesenchymal neoplasms in the GI tract after GISTs. They may arise either from the muscularis mucosae or proper muscle layer forming polypoid and intramural lesions, respectively. Polypoid leiomyomas are more common in the rectosigmoid, while intramural ones mainly arise in the vicinity of the oesophagogastric junction. Polypoid leiomyomas are sufficiently treated by endoscopic resection, and local surgical excision is the treatment of choice for intramural leiomyomas. Intramural leiomyosarcomas are rare high-grade sarcomas that commonly have infiltrated into the surrounding tissue or metastasised by the time of diagnosis.     

软组织平滑肌肉瘤中p16基因的甲基化检测

目的 探讨软组织平滑肌肉瘤（ＬＭＳ）中p16基因ＩＮＫ４Ａ的甲基化状态及其与p16表达的关系。方法 应用ＭＳＰ法检测３８例软组织平滑肌肉瘤,１０例平滑肌瘤及５例正常平滑肌组织中p16基因ＩＮＫ４Ａ的甲基化状态,用免疫组织化学ＳＰ方法检测p16蛋白表达情况。结果 ３８例ＬＭＳ中９例发生异常甲基化,异常甲基化率为２３.7%（９／３８）。其中,７例p16蛋白表达阴性,２例p16蛋白弱阳性,在p16蛋白表达阴性的ＬＭＳ中,异常甲基化率为５０％（７／１４）。结论 p16基因第一外显子启动子区５‘CpG岛的异常甲基化是导致p16基因失活、蛋白缺如的重要基因外机制,并可能参与肿瘤的发生。     

A rare case of a laryngeal leiomyosarcoma with a lymph node metastasis

IntroductionLeiomyosarcoma is a rare mesenchymal tumor that originates from smooth muscle cells. Head and neck LMSs represent only 3% of all leiomyosarcomas with less than 50 cases of laryngeal LMS reported in the literature till now.Case presentationWe report a case of 50-year-old male presented at our ENT department for a chronic hoarseness. Clinical examination investigations found small submucosal lesion in the right vocal cord. Treatment consisted of CO2 Laser excision of the lesion. The evolution was marked by the appearance of a tumefaction in the left submandibular region and a severe dyspnea requiring an emergency tracheotomy. Paraclinical examination investigations found a supraglottis–glottis-subglottis tumor. A total laryngectomy with bilateral functional neck dissection was performed and the histopathological examination found a laryngeal leiomyosarcoma.ConclusionLMS of the larynx a very rare malignancy. The accurate diagnosis is histological. Surgery is the mainstay of treatment. Its prognosis is correlated to local recurrence and distant metastases.     

子宫平滑肌肿瘤的病理组织学观察

目的 探讨子宫平滑肌肿瘤的病理诊断标准及其预后。方法 对病例进行病理组织学观察,并用ｄｅｓｍｉｎ,ａｃｔｉｎ免疫组织化学染色。结果 多数子宫平滑肌内瘤核分裂像增多同时伴细胞特异性及凝固性坏死,子宫平滑肌瘤则无以上病理变化。子宫平滑肌肉瘤的ｄｅｓｍｉｎ和ａｃｔｉｎ阳性细胞显著低于子宫平滑肌瘤。结论 尽管核分裂诊断是子宫平滑肌肉瘤的重要指标,但不是唯一指标,应综合细胞异型,边界浸润,凝固性坏死这些改变     

9例结直肠平滑肌肉瘤的诊断及治疗

目的：探讨结直肠平滑肉瘤的临床特点，诊断方法、手术治疗要点以及 局部复发的因素。方法：对我院1976年1月－2002年1月间收治的9例结直肠平滑肌肉瘤患者的临床资料进行回顾性分析。结果：结肠平滑肌肉瘤2例，直肠平滑肌肉瘤7例，根治性切除7例，姑息性切除1例，局部切除1例，再次手术4例，三次手术2例。3年生成率55．6％，5年生存率22．2％，结论：提高疗效的关键取决于首次手术的正确性和彻底性，力争早期诊断较小的复发灶是提高5年生存率的重要因素，局部复发与术式选择密切相关，介入治疗及放疗对控制复发疗效不肯定。     

原发性卵巢平滑肌肉瘤临床分析(附3例报告及国内20例综合分析)

目的 探讨原发性卵巢平滑肌肉瘤的临床特点、诊断、治疗方法，以及可能预后相关因素。方法 对3例原发性卵巢平滑肌肉瘤综合国内近10年报道20例进行分析。结果 原发性卵巢平滑肌肉瘤可发生于任何年龄，主要为绝经后妇女。临床表现不典型，诊断主要依靠病理，同时结合免疫组化Desmin( )，Vimentin( )诊断。结论 原发性卵巢平滑肌肉瘤恶性度高，预后差，并且可能与分化程度及其微血管相关。治疗以手术为主，辅以合适的放疗和化疗综合治疗。     

DIAGNOSTIC IMPLICATIONS OF IMMUNOHISTOCHEMICAL MARKERS IN UTERINE SMOOTH MUSCLE TUMORS

Objective: To evaluate the diagnostic implications of immunohistochemieal markers in uterine smooth muscle tumors. Methods: Formalin-fixed paraffin-embedded tissue blocks were selected from 17 uterine leiomyosarcomas, 40 uterine unusual leiomyomas and 25 uterine usual leiomyomas. Utilizing immunohistochemical techniques with antigen retrieval, serial sections of each tumor for immunoreactivity with myogenic markers, ovarian steroid receptors, CD44v3, proliferating cell nuclear antigen and mast cells were assessed. Results: Although the myogenic markers and CD44v3 showed less frequent positivity in uterine leiomyosarcomas than those in unusual leiomyomas,they were not reliable markers for differentiating leiomyosarcoma from leiomyoma. Uterine leiomyosarcoma tended to have lower ovarian steroid receptors immunoreactivity rates than leiomyoma. Leiomyoma tended to have a higher quantity of intratumoral mast cells than leiomyosarcoma, while the expression of proliferating cell nuclear antigen was lower in them. Conclusion: Because the estimation of mitotic count was subject to significant variation, the immunohistochemical expression of ovarian steroid receptors, mast cells and proliferating cell nuclear antigen seemed to be helpful for the discrimination of unusual leiomyoma from leiomyosarcoma.     

平滑肌肉瘤组织形态与预后的关系(附104例分析)

本文分析了１０４例平滑肌肉瘤（ＬＳ）的随访资料，ＬＳ术后生存率为１年８４．６％，３年５７．７％，５年以上５０％。ＬＳ的预后与肿瘤的核分裂、细胞形态、细胞密度、细胞异形性、患者年龄及发病部位均有密切关系。肿瘤的大小与预后无关。