颈部不一致性淋巴瘤一例并文献复习

目的 探讨不一致性淋巴瘤的临床病理学特征.方法 结合临床、影像学、病理形态和免疫组织化学检测,对1例不一致性颈部淋巴结结节硬化型霍奇金淋巴瘤及甲状腺左叶及峡部弥漫大B细胞淋巴瘤进行病理分析,并复习相关文献.结果 患者,女性,46岁,以甲状腺双叶实性肿物及双颈部多发淋巴结肿大为首发症状,手术切除甲状腺双叶及颈部淋巴结,术后病理诊断为不一致性淋巴瘤,右颈及部分左颈部淋巴结为经典型霍奇金淋巴瘤,甲状腺左叶及峡部为弥漫大B细胞淋巴瘤.结论 不一致性淋巴瘤较为罕见,表现形式多样,且发生的解剖部位不同,应引起临床和病理医师的足够重视,其治疗方案及预后判断由恶性程度高的肿瘤类型决定.     

卵巢原发恶性淋巴瘤的诊断与鉴别诊断

目的:研究卵巢原发恶性淋巴瘤的诊断、鉴别诊断及临床特点.方法:用免疫组织化学及组织病理学方法观察39例卵巢恶性肿瘤,包括初次病理诊断的2例恶性淋巴瘤和37例具有小圆形细胞为主要特征的卵巢恶性肿瘤.结果:发现5例组织病理学特点、免疫组织化学标记符合卵巢原发恶性淋巴瘤,所有病例临床均诊断为畸胎瘤或腹部包块,临床特点以腹痛,腹部包块为主或无症状.结论:卵巢原发恶性淋巴瘤罕见、起病隐袭、症状不典型,临床及病理诊断很困难,单凭组织化学方法很难与其它小圆形细胞肿瘤鉴别,免疫组织化学标记有重要价值.     

卵巢原发性恶性淋巴瘤临床病理研究

［目的］探讨卵巢原发性恶性淋巴瘤的诊断及鉴别诊断。［方法］用免疫组织化学及组织病理学方法观察３９例具有小圆形细胞为主要特征的卵巢恶性肿瘤。［结果］发现５例组织病理学特点、免疫组织化学标记符合卵巢原发性恶性淋巴瘤。［结论］卵巢原发性恶性淋巴瘤非常罕见、起病慢、症状不典型,临床及病理诊断较困难,单凭形态学方法很难与其它小圆形细胞肿瘤鉴别,免疫组织化学标记有一定价值。     

102例非霍奇金恶性淋巴瘤临床特征分析

目的　研究非霍奇金恶性淋巴瘤的临床特征以利早期诊断、治疗及改善预后。方法　对 1997年 2月～ 2 0 0 0年 5月我院收治10 2例非霍奇金恶性淋巴瘤进行临床病理分析。结果　 10 2例非霍奇金恶性淋巴瘤均经病理检查证明实。首发部位中 ,浅表淋巴结5 4例 ,深部淋巴结 9例 ,结外器官 39例。确诊时累及部位 :浅表淋巴结 81例 ,深部淋巴结 2 5例 ,结外器官 10 4例。Ⅰ期 15例 ,Ⅱ期17例 ,Ⅲ期 32例 ,Ⅳ期 38例。A组 72例 ,B组 30例。并发第二癌 6例。结论　非霍奇金恶性淋巴瘤除可侵犯淋巴结外 ,还可侵犯全身各部位。确诊主要依据病理组织学检查。     

非霍奇金B细胞淋巴瘤150例临床病理分析

 目的 探讨非霍奇金B细胞淋巴瘤（B-NHL）的病理形态和免疫表型在B-NHL诊断的价值,分析B-NHL的临床意义。方法 应用HE 和免疫组织化学（LSAB法）对150例B-NHL重新诊断分类。结果 150例B-NHL中最常见是弥漫大B细胞淋巴瘤（77例 ,51.3 %）,其次是黏膜相关淋巴组织结外边缘区细胞淋巴瘤（23例 15.3 %）。发生于淋巴结者占40.6 %（61例）,结外为54.9 %（83例）。单纯HE形态诊断对比形态结合免疫表型的诊断结果,符合率达80 %,免疫组织化学可将B-NHL的诊断正确率提高近20 %（P＜0.01）。结论 病理形态是淋巴瘤诊断的基础,免疫表型在诊断和分型中具有重要作用,二者与临床特征结合可使绝大多数淋巴瘤得到明确诊断。     

肝脾及胃肠道原发性恶性淋巴瘤5例报告及分析

报告5例肝、脾及胃肠道原发性恶性淋巴瘤，介绍其组织学特征及临床表现。应用组织形态、免疫组织化学、结合临床特征进行探讨。肝、脾及胃肠道原发性恶性淋巴瘤较为罕见，临床诊断困难，组织形态学和免疫组织化学检查，并结合临床可作出诊断。     

102例非霍奇金恶性淋巴瘤临床特征分析

目的 研究非霍奇金恶性淋巴瘤的临床特征以利早期诊断，治疗及改善预后。方法 对1997年2月-2000年5月我院收治102例非霍奇金恶性淋巴瘤进行临床病理分析。结果 102例非霍奇金恶性淋巴瘤均经病理检查证明实，首发部位中，浅表淋巴结54例，深部淋巴结9例，结外器官39例，确诊时累及部位：浅表淋巴结81例，深部淋巴结25例，结外器官104例，Ⅰ期15期，Ⅱ期17例，Ⅲ期32例，Ⅳ期38例，A组72例，B组30例，并发第二癌6例，结论 非霍奇金恶性淋巴瘤除可侵犯淋巴结外，还可侵犯全身各部位，确诊主要依据病理组织学检查。     

原发性肺结外边缘区B细胞淋巴瘤九例临床病理分析

目的 探讨原发性肺结外边缘区B细胞淋巴瘤(primary pulmonary extranodal marginal zone B-cell lymphoma，即黏膜相关淋巴瘤，mucosa-associated lymphoid tissue lymphoma，MALT淋巴瘤)的临床病理特征和免疫组织化学(immunohistochemistry，IHC)染色，及其诊断和预后。方法 对9例原发性肺结外边缘区B细胞淋巴瘤进行临床病理、免疫组织化学(LCA、CD20、CD45RO、κ、λ、Ki-67、CD5、cyclinDl、CK、NSE)分析。结果 结合免疫组织化学染色及病理组织形态，按淋巴造血组织肿瘤2001年新WHO分类，9例均被确诊为原发性肺结外边缘区B细胞淋巴瘤(MALT淋巴瘤)。本组男4例，女5例，男女之比为1：1．25；中位年龄51．5岁。所有MALT淋巴瘤病例都呈LCA阳性、CD20阳性，Ki-67阳性率低；免疫球蛋白轻链限制性λ或κ阳性表达者分别为5例、1例，κ和λ均阳性表达者1例，2例无轻链限制性表达；CD45RO、CD5、cyclinDl、CK、NSE均阴性。结论 原发性肺结外边缘区B细胞淋巴瘤属惰性淋巴瘤，临床极易误诊，必须结合其病理组织形态和免疫组织化学染色进行诊断和鉴别诊断。     

原发性直肠淋巴瘤诊断与治疗

恶性淋巴瘤包括霍奇金病（HD）和非霍奇金淋巴瘤（NHL）,后者分为淋巴结来源和淋巴结外来源,淋巴结外占25％～50％。胃肠道是淋巴结外恶性淋巴瘤（extranodal malignant lymphoma,ELA）最常累及部位,大约占所有淋巴结外恶性淋巴瘤的40％。胃肠道的原发性非霍奇金淋巴瘤（NHL）。     

淋巴结外间变性大细胞淋巴瘤临床病理诊断要点的初步探讨

目的　探讨淋巴结外Ki 1阳性间变性大细胞淋巴瘤 (Ki 1positiveanaplasticlargecelllymphoma ,Ki 1ALCL)的临床病理诊断要点。方法　应用病理组织学和免疫组织化学等方法对 12例Ki 1ALCL的临床病理学特性进行观察 ,并设置阴性对照组。结果　淋巴结外Ki 1ALCL病理组织学形态特异。免疫组织化学染色显示 ,12例淋巴结外ALCL均为Ki 1阳性 (CD30或BerH2 ) ,其中 5例为白细胞共同抗原单克隆抗体 (LCA)、上皮膜抗原单克隆抗体 (EMA)阳性 ,2例LCA阴性、EMA阳性 ,1例LCA阳性、EMA阴性 ,其余 4例LCA、EMA均为阴性。T、B细胞标记表明 ,7例为B细胞性 ,2例为T细胞性 ,另 3例为非T非B细胞性。结论　淋巴结外Ki 1阳性ALCL在病理组织学和免疫组织化学上有一定特异性 ,与其他肿瘤能够进行鉴别诊断。     

耳鼻喉粘液表皮样癌15例临床病理分析

目的:探讨耳鼻喉粘液表皮样癌的临床病理特征,并探讨其诊断和鉴别诊断。方法:收集15例粘液表皮样癌,观察其临床病理特点并进行免疫组化分析。结果:15例均为男性,平均年龄55岁。其中高分化者14例,低分化者1例。肿瘤细胞CK、CEA、EMA、CK8均呈阳性表达。结论:粘液表皮样癌是一种较少见的耳鼻喉肿瘤,根据其组织学改变和免疫组化染色结果,可与其他肿瘤鉴别,掌握组织学分类有助于临床的正确治疗和预后判断。     

阴茎疣状癌的诊断及治疗

目的：探讨阴茎疣状癌的临床诊断及治疗方法。方法回顾性分析1例阴茎疣状癌的临床诊治过程,并结合相关文献进行复习。结果阴茎疣状癌的临床表现及其诊断治疗方法不同于普通阴茎鳞癌,常被误诊为局部感染病灶或低度鳞状细胞癌,明确诊断主要依据病理检查。结论阴茎疣状癌为临床罕见病例,易误诊,手术治疗是其有效治疗手段。     

The expression of Bcl-2 family proteins and spontaneous apoptosis in laryngeal carcinomas

Bcl-2 family proteins play an important role in the growth and biological behavior of tumors. This study aimed to determine Bcl-2 family proteins in laryngeal carcinoma and to examine their relationship with spontaneous apoptosis. The material studied was from 39 patients with laryngeal carcinoma. It was found that the expression of both Bak and Bax was lower in tumor tissues than in nontumor tissues. However, there was no difference in the expression of Bcl-2 between tumor and nontumor tissues. The frequency of spontaneous apoptosis was lower in tumor tissues than in nontumor tissues but was not significantly related to the expression of Bak, Bax, or Bcl-2. Bak was decreased in moderately differentiated tumors compared to well-differentiated tumors. In contrast to Bak, the expression of Bcl-2 was increased in moderately differentiated tumors compared to well-differentiated tumors. These results indicate that the reduction in Bak may be associated with an increase in tumor grade and dedifferentiation in laryngeal carcinomas. The lack of correlation between apoptosis and the expression of Bcl-2 family proteins suggests that spontaneous apoptosis in laryngeal carcinoma is a complex process and that molecules other than Bak, Bax, and Bcl-2 participate in it.     

60例肾脏血管平滑肌脂肪瘤临床病理分析

目的 探讨肾脏血管平滑肌脂肪瘤(renal angiomyolipoma，RAML)的临床病理特点、诊断、鉴别诊断以及免疫组织化学对RAML的诊断价值。方法 复习60例RAML的临床资料、影像学资料，采用石蜡切片进行脏染色及免疫组织化学染色。结果 60例：RAML中50例女性，10例男性，平均年龄43．8岁。40例有临床症状。6例合并结节性硬化症。大体检查多数肿瘤与周围组织分界清楚。光镜下由厚壁血管、梭形或上皮样平滑肌细胞及脂肪混合而成。免疫组织化学染色瘤细胞A103和HMB45、SMA均有良好表达。随访42例无肿瘤复发。结论 RAML的确诊依赖于临床、影像学资料及病理学三者相结合。A103有助于确诊。CT诊断困难者可行术前穿刺活检或术中冷冻切片检查并辅以免疫组织化学染色以指导医生确定治疗方案。     

Poorly differentiated carcinoma and germ cell tumors.

Although many questions remain unanswered, recent clinical and pathologic studies have shed considerable light on the subject of carcinoma of unknown primary site. It is now clear that some patients in this group have extragonadal germ cell tumors. This is suggested by the superior treatment results in patients with clinical features of extragonadal germ cell tumor and is confirmed by the finding of the diagnostic chromosome abnormality in tumor cells of some patients. These patients have tumors that are unrecognizable using all available pathologic techniques other than molecular genetic analysis; most patients also do not have elevated serum tumor marker levels. Young men with poorly differentiated carcinoma located predominantly in the mediastinum or retroperitoneum should be strongly suspected of having germ cell tumors; chromosomal analysis should be obtained if possible, and these patients should be treated as for germ cell tumor. It is clear that some responsive patients with poorly differentiated carcinoma do not have extragonadal germ cell tumors. A few patients initially thought to have poorly differentiated carcinoma actually have non-Hodgkin's lymphoma. With the widespread availability of immunoperoxidase staining for LCA, this diagnostic error should be minimized. Other responsive patients have poorly differentiated neuroendocrine tumors. The nature and spectrum of neuroendocrine tumors is still being defined; however, our initial documentation of cisplatin responsiveness has been confirmed, even in poorly differentiated neuroendocrine tumors with a known primary site. It is likely that additional responsive subgroups also exist but have not yet been identified. With the availability of a diagnostic chromosomal marker, the answers to other questions regarding the relationship of poorly differentiated carcinoma and germ cell tumors will soon be forthcoming.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epstein-Barr virus related lymphoepithelioma-like carcinoma of lung

A malignant neoplasm localized to the lung is reported in a rather unusual host: a 40-year-old female, nonsmoker, of South-East Asiatic origin. The histology was of nasopharyngeal-like carcinoma character and ultrastructural examination confirmed a diagnosis of nonkeratinizing, poorly differentiated squamous cell carcinoma. The clinicopathologic findings were more suggestive of a primary pulmonary origin than the manifestation of an occult nasopharyngeal primary. The immunological profile was highly suggestive of an Epstein-Barr virus (EBV) associated epithelial neoplasia. This case might widen the spectrum of EBV-associated neoplasia, by inclusion of lower respiratory tract as a target organ.     

Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high-risk group of papillary and follicular carcinomas

The relationship between histologic type and survival of 258 thyroid malignancies has been analysed. A new clinicopathologic entity, poorly differentiated carcinoma of the thyroid, is proposed. Papillary and follicular carcinomas of the thyroid showed no significant difference in survival rates. Both tumors were histologically separated into well differentiated and poorly differentiated carcinomas, so that thyroid cancer, deriving from follicular cells, was divided into well differentiated, poorly differentiated, and anaplastic carcinomas. The characteristic histology of poorly differentiated carcinoma was the presence of solid, trabecular and/or scirrhous patterns. Poorly differentiated carcinoma was found in 13.6% of all thyroid malignancies, and its prognosis was worse than that of well differentiated carcinoma. The differences of survival rates among well differentiated, poorly differentiated and anaplastic carcinomas were statistically significant. Prognostic data support the suggestion that the clinicopathologic entity of poorly differentiated carcinoma is of value in determining management and survival of thyroid cancer patients.     

胃癌组织FRAT1表达与临床病理因素相关性分析

目的:探讨胃癌组织FRAT1的表达及其与胃癌各临床病理因素的关系。方法:采用免疫组化、RT-PCR及蛋白质印迹法检测112例胃癌组织和20例癌旁胃黏膜组织中FRAT1的表达及其在不同病理级别胃癌组织中的表达差异。结果:FRAT1mRNA和蛋白在胃癌组织中的阳性表达率为68.8%,明显高于癌旁胃黏膜组织的阳性表达率0,两者比较差异有统计学意义,χ2=30.23,P=0.000。FRAT1在高、中、低分化的胃癌组织中阳性表达率分别为51.6%、72.1%和78.9%,χ2=6.300,P=0.043。且FRAT1的阳性表达与临床分期(P=0.013)和淋巴结转移(P=0.032)有关,而与患者的年龄和性别无关(P>0.05)。结论:FRAT1蛋白的表达率与胃癌的分化程度、TNM分期、淋巴结转移有关,且随着胃癌组织分化程度的增高而降低,随着TNM分期增高而增高。     

食管基底细胞样鳞癌

目的 探讨食管基底细胞样鳞癌（ＢＳＣＣ）的临床病理特点及鉴别诊断。方法 回顾分析１８７６例食管鳞癌手术切除病例的临床资料,其中９例诊断为ＢＳＣＣ,对其临床资料及病理特点进行总结、分析。结果 食管ＢＳＣＣ主要发生于５０岁以上男性的中段食管,占食管鳞癌的０．４８％。平均生存１７．６个月,２年生存率２２．２％,与低分化鳞癌（２年生存率２８．３％）接近。形态学与遥样囊性癌（ＡＣＣ）或小细胞未分化癌（ＳＣＣ