肝脏血管平滑肌脂肪瘤临床病理分析

目的 探讨肝脏血管平滑肌脂肪瘤(HAML)的临床病理特征.方法 结合文献对1例HAML的临床资料、免疫组化、超微结构和随访结果进行分析.结果 HAML女性好发,成人多见,常无症状,体检发现:影像学因肿瘤成分构成比和分布不同而异;肿瘤由厚壁畸形血管、成熟脂肪和多形肌样细胞构成,并常见有单核、多核和巨核细胞呈散在巢团状集聚和灶性髓外造血灶;上皮样肌样细胞HMB45、CD117阳性及超微结构见不同成熟时期黑色素小体;治疗以手术为主.结论 HAML主要由血管、脂肪、平滑肌3种成分组成,其中变化最大的是肌样细胞,肌样细胞HMB45标记及电镜检查不同发育时期黑色素小体是诊断HAML的关键.HAML多为良性,首选手术,但有恶性HAML的报道.     

Clinicopathologic and mucin histochemical analyses of 90 cases of ovarian mucinous borderline tumors of intestinal and müllerian types

Clinicopathologlc and mucin histochemical characteristics of 90 cases of ovarian mucinous borderline tumors (MBT) of Intestinal (IMET) and müllerian types (MMBT) were studied to determine whether IMBT and MMBT constitute distinct tumor subtypes. The IMBT (77 cases, 78 lesions) contained goblet cells, absorptive cells and endocrine cells, which represented Intestinal differentiation. The average diameter of IMBT was 13.4 cm. Five patients (6.5%) had stage III disease wtth pseudomyxoma perltonel and one of them died from tumor. Approximately 50% of IMBT demonstrated gastrointestinal characteistics on mucin histochemistry. The MMBT (13 cases, 14 lesions) consisted of mumus columnar cells and eosinophilic cells, with no Intestinal differentiation. MMBT accounted for 15.2% of MBT. MMBT averaged 8.4 cm in diameter, and 29% were associated with endometriosls of the ipsilateral ovary. All patients with MMBT had stage I disease, and none suffered from pseudomyxoma peritonel. All patients whose follow-up data were available were alive and well, without evidence of tumor recurrence. The mucin histochemical findings in MMBT resembled those of noml endocervix. Results of the present study suggest that IMBT and MMBT have different characteristics and constitute distinct subtypes of MBT.     

166例涎腺腺样囊性癌的临床病理分析

目的 分析涎腺腺样囊性癌的临床病理特点。方法 对166例涎腺腺样囊性癌行临床资料总结和HE组织学观察。结果 本组腺样囊性癌占涎腺上皮性肿瘤的11．5％，占涎腺癌的27．0％；男性略多于女性；中年以上好发；发生于小涎腺者多于大涎腺，以腭部为最常见；腺样型103例，管状型42例，实性型2l例；Ⅰ级17例，Ⅱ级128例，Ⅲ级2l例。结论 需与基底细胞腺癌、涎腺导管癌、多形性低度恶性腺癌、上皮-肌上皮癌鉴别诊断；浸润性极强是其显著特点，手术治疗以局部大块切除为主要原则。     

Oral manifestation of chronic mucocutaneous candidiasis: seven case reports

BACKGROUND: Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent or recurrent candidal infections of the skin, nails and mucous membranes or by a variable combination of endocrine failure as well as immunodeficiency. Oral clinicopathological features of CMC have seldom been described in detail. METHODS: Seven patients with CMC were reported in the study. The clinical and histological findings, etiological Candida species, immunological evaluation, and therapeutic pattern of oral lesions, were analyzed. RESULTS: Long-standing whitish hyperplastic and nodule-like lesions with exaggerated deep fissure were the typical and characteristic oral manifestations presented by all patients. The tongue was the most common site affected. Histologically, no obvious distinction was found between CMC and other forms of candidal infection. Abnormal proportions of T-lymphocyte subsets and positive titers of autoantibody were observed in three subjects (42.9%) and one patient (14.3%) respectively. Meanwhile, four subjects (57.1%) showed decreased albumin and increased globulin, three cases (42.9%) had high levels of ESR. But no iron deficiency was found. Candida albicans was the microorganism isolated from these patients. CONCLUSIONS: Multiple and widespread candidal infectious lesions can be observed on the oral cavity of CMC patients. Hyperplastic and nodule-like lesion with irremovable whitish patches and deep fissure are the most common oral manifestations of these patients. Dentists, otolaryngologists and pediatricians should be familiar with the clinical appearances of CMC to make an accurate diagnosis. Potential systemic disorders should be concerned to avoid the reoccurrence of oral candidiasis.     

食管基底细胞样鳞状细胞癌临床病理分析

目的探讨食管基底细胞样鳞癌(BSC)的临床病理特点.方法回顾分析10年间食管癌手术病理档案,对符合基底细胞样鳞癌的病例行免疫组化标记.结果2*!960例食管癌中10例为食管基底细胞样鳞癌,占0.3%.其中8例曾误诊为低分化鳞癌、腺鳞癌、腺样囊性癌和小细胞癌.肿瘤主要由核大浆少的基底细胞样癌组织与多少不等的鳞癌或(和)原位鳞癌构成,两者间无移行.1例部分细胞免疫组化癌胚抗原阳性,2例局部癌组织突出素、嗜铬素阳性,1例灶性角蛋白17、角蛋白8阳性;无一例表达S100和肌动蛋白.结论食管基底细胞样鳞癌主要由基底样细胞组成,并具有鳞癌的变异型,具有高侵袭性又易在病理上误诊,因而需要对其临床和病理特征进行透彻研究和进一步提高认识.     

NK／T细胞淋巴瘤的临床病理、免疫表型及其与EB病毒的相关性

目的 探讨NK／T细胞淋巴瘤的临床病理,免疫表型特点及其与EB病毒的关系。方法 用免疫组织化学染色方法（选用ED3ε、CD56等抗体）确定瘤细胞来源。用原位杂交方法检测EB病毒编码的RNA（EBER1／2）。结果 117例TCL中26例表达NK／T细胞标记（22．2％）,其中鼻部NK／T细胞淋巴瘤15例（57．7％）;肿瘤细胞的多形性（18／26、69．2％）和凝固性坏死（12／26例、46．2％）是主要的病理学特点;EB病毒感染率46．2％（12／26）,其中鼻部感染率73．3％（11／15）,非鼻部为9．1％,两组比较P＜0．005。结论 NK／T细胞淋巴瘤常发生在鼻部,呈侵袭性生长,肿瘤细胞的多形性和坏死是自组织学特点,EBV感染与鼻部NK／T细胞淋巴瘤的发生密切相关。     

甲状腺结节细针穿刺检查的临床病理分析

目的:评价甲状腺结节细针穿刺检查价值,并进行临床病理结果分析,从而为甲状腺结节患者的临床诊断、治疗工作提供参考。方法:选择2018年7月~2019年7月本院收治的200例甲状腺结节患者,予以单纯超声检查的患者作为对照组,超声辅助细针穿刺检查的患者作为观察组。比较不同检查方法下2组检查的准确率、灵敏度、特异性以及病理检查良性、恶性情况,并分析观察组检查患者的风险性情况。结果:此次受试的200例甲状腺结节患者中,观察组检查准确率、灵敏度均明显高于对照组,P<0.05。组间特异性差异无显著性,且观察组患者的安全性较高,P>0.05。结论:甲状腺结节细针穿刺检查灵敏度较高,能够有效区分甲状腺疾病患者的疾病类型以及结节性质等情况,从而为疾病治疗提供参考。     

Generalized multinucleate cell angiohistiocytoma with possible origin from fibroblasts: A clinicopathological study of 15 cases

Multinucleate cell angiohistiocytoma (MCAH) is a vascular and fibrohistiocytic proliferation with unknown pathogenesis. Clinical lesions tend to be localized to an anatomical area. Exceptionally, the generalized variant is rare. This study reports three cases of generalized MCAH, and analyzes the clinicopathological features of 15 cases reviewed in the published work. Compared with the localized variant, generalized MCAH affected both sexes equally, had an earlier age of onset and a predilection for the trunk and extremities. Histopathologically, the most characteristic feature is the giant, bizarre multinucleate cells with angulated cytoplasm. Systemic diseases or abnormal immune conditions were revealed in six patients with generalized MCAH. For the first time, we found that the present cases showed increased elastic fibers in the affected areas, suggesting that the synthetic function of fibroblasts was active. This study suggested that MCAH originates from fibroblasts and is a distinct entity with potential correlation with abnormal immune states.