化学疗法所致荷癌大鼠弥漫性血管内凝血的病理学观察

在应用新化学疗法对大鼠皮下移植肿瘤治疗研究中，观察到弥漫性血管内凝血的发病。通过多种病理学染色方法及组织学图像分析方法，对实验组动物各脏器血栓形成与肿瘤坏死面积进行分析。结果发现：新化学疗法组的治疗效果明显，实验组动物肿瘤坏死面积达66％～99％（平均84．6％），单独治疗组平均为26．9％，非治疗组平均为15．5％（P＜0．01）（P＜0．01）；在新化学疗法组，各例均见有血栓形成，以肾、心、肝、肺为著，肿瘤坏死面积较大的大鼠血栓形成较多。证明有效的化学疗法在短期内使肿瘤大块坏死是导致DIC发病的主要原因之一。     

Disseminated Intravascular Coagulation syndrome — ENT surgeon’s perspective

ENT surgeon is seldom confronted with a systemic disease severe enough to progress to Disseminated Intravascular Coagulation syndrome (DIC), where he has to undertake a definitive surgical procedure for malignancy or perform an emergency tracheostomy. This calls for a judicious calculation of the pros and cons with an element of risk that needs to be accepted. We report two such patients who have been treated in such a scenario where the outcome varied depending on the severity and time of onset of the underlying coagulation disorder.     

Advanced Neuroblastoma and Disseminated Intravascular Coagulation: Report of Six Cases

We have experienced 30 patients with neuroblastoma since 1975.Disseminated intravascular coagulation (DIC) developed in sixof these patients. They were all in stage IV, namely disseminatedneuroblastoma. These six cases with DIC proved that some advancedneuroblastomas have the potential to cause coagulopathy in theprocess of the disease. The plasma concentration of heparin was measured in some patientswho were treated with heparin. The data revealed that the conventionallyused intravenous heparin dose is not appropriate in the caseof DIC. Effective treatment requires monitoring of the plasmaconcentration of heparin.     

Very Fast Recovery of Acute Disseminated Intravascular Coagulation with Abiraterone Acetate in a Patient with Bone Metastases from Castrate-Resistant Prostate Cancer

Disseminated intravascular coagulation (DIC) is a rare, potentially life-threatening complication of advanced prostate carcinoma. We report the successful treatment with abiraterone acetate of acute DIC related to a progressive bone metastatic disease in a chemotherapy-naïve patient with castrate-resistant prostate cancer.Key Words: Abiraterone acetate, Bone metastases, Castrate-resistant prostate cancer, Disseminated intravascular coagulation     

Gastric Cancer with Bone Marrow Invasion and Disseminated Intravascular Coagulation: A Case Report

Gastric cancer is the fifth most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide in 2020. Gastric cancer usually undergoes lymph node metastasis and implantation metastasis, but bone metastasis and bone marrow invasion are rare. However, gastric cancer patients with bone marrow invasion usually have cancer emergency, so special attention should be paid in clinical practice. Herein, we analyzed the clinical characteristics of an asian gastric cancer patient with bone marrow invasion and disseminated intravascular coagulation (DIC) in our hospital and summarized the diagnosis and treatment experience to provide a reference for such diseases.     

Neuroendocrine Carcinoma of the Bladder

The case was a 67-year-old male who visited our hospital with a major complaint of macroscopic hematuria. A bladder tumor was found. When a transurethral resection of the bladder tumor was performed, the histopathological diagnosis was neuroendocrine bladder cancer. After chemotherapy with cisplatin and etoposide a partial shrinkage of the tumor was observed; however, the patient expired 7 months after the first visit.Key Words: Neuroendocrine tumor, Bladder tumor, Bladder cancer     

神经内分泌细胞与乳腺癌患者预后因素的关系

目的 探讨乳腺癌中神经内分泌（NE）细胞的存在及其与临床预后有关指标的关系。方法 收集乳腺癌根治术组织标本53例,采用免疫组织化学法标记1组NE分化的指标：NSE、Syn、CgA以检测NE细胞的存在,同时行电镜检查证实。结果 53例乳腺癌中,NSE、Syn、CgA3种标志物均阳性14例,占26．4％,电镜检查找到肿瘤细胞中存在神经内分泌颗粒。NE阳性者淋巴结转移率高于NE阴性者,其pS2蛋白和nm23-HI表达均低于NE阴性者。结论 根据WHO分类的病理类型乳腺癌中,部分可存在神经内分泌细胞,它们属乳腺癌异质性的表现,具有与一般病理类型乳腺癌不完全一致的生物学行为,在乳腺癌术后治疗方案的决策上需引起应有的重视。     

宫颈神经内分泌癌临床与病理分析

[目的]探讨宫颈神经内分泌癌（NECC）的临床病理特征及治疗方式。[方法]回顾性分析9例宫颈神经内分泌癌患者的临床期别、症状，病理特点（包括肿瘤直径大小、病理类型、间质浸润、脉管转移、淋巴结转移、神经内分泌标记物），以及治疗方式。电话随访预后情况。[结果]9例患者平均年龄38．1岁，Ⅰb期4例，Ⅱa期5例，均无全身内分泌症状。8／9例均至少有2种神经内分泌标记阳性。9例患者中1例失访，余8例患者均接受综合治疗，目前均存活，无复发及远处转移。[结论]神经内分泌标记有助于该病的诊断；综合治疗有利于提高患者的生存率，延长复发时间。     

宫颈神经内分泌癌临床与病理分析

[目的]探讨宫颈神经内分泌癌（NECC）的临床病理特征及治疗方式。[方法]回顾性分析9例宫颈神经内分泌癌患者的临床期别、症状，病理特点（包括肿瘤直径大小、病理类型、间质浸润、脉管转移、淋巴结转移、神经内分泌标记物），以及治疗方式。电话随访预后情况。[结果]9例患者平均年龄38．1岁，Ⅰb期4例，Ⅱa期5例，均无全身内分泌症状。8／9例均至少有2种神经内分泌标记阳性。9例患者中1例失访，余8例患者均接受综合治疗，目前均存活，无复发及远处转移。[结论]神经内分泌标记有助于该病的诊断；综合治疗有利于提高患者的生存率，延长复发时间。     

Primary Small Cell Neuroendocrine Carcinoma of the Endometrium

Background

Small cell neuroendocrine carcinoma is very rarely encountered within the endometrium.

Case Study

A patient underwent a hysterectomy and salpingo-oophorectomy for a suspicious gynecologic condition. Pathology revealed invasive small cell neuroendocrine carcinoma of the endometrium; the neoplasm exhibited positive immunoreactivity for synaptophysin, pancytokeratin and CD56 but was negative for CD3 and CD20. Prior to chemotherapy, a completion lymphadenectomy was indicated to determine the presence of nodal metastases.

Conclusion

The prognosis of small cell neuroendocrine carcinoma of the endometrium is unfavorable but prompt detection with surgery and adjuvant therapy may confer a better clinical outcome.Key Words: Small cell neuroendocrine carcinoma, Endometrium, Gynecologic oncology     

Primary Large Cell Neuroendocrine Carcinoma of the Kidney

We report a case of a 56-year-old male with a primary large cell neuroendocrine renal carcinoma. Grossly, the left kidney was enlarged by a solid tumor that measured 145 × 125 × 100 mm. Histologically, the tumor consisted of large cells with a moderate to abundant amount of eosinophilic cytoplasm. The nuclei were irregular, some of them with finely or coarsely granular chromatin, others with vesicular chromatin and prominent nucleoli. The tumor cells showed multiple mitotic figures (up to 32 mitoses/10 HPF). In some areas, the tumor cells were arranged in solid sheets; however, the predominant pattern was solid-alveolar, trabecular and cribriform. Large areas of tumor necrosis were found. Immunohistochemically, the tumor cells were positive for synaptophysin, CD56 and CD57. Cytokeratin AE1/AE3, vimentin and CD10 were positive only focally. Chromogranin showed weak cytoplasmic positivity in rare tumor cells. Cytokeratin CAM5.2, cytokeratin 34βE12, BerEP 4, EMA, TTF-1, cytokeratin 7, cytokeratin 20, calretinin, serotonin, somatostatin, gastrin, calcitonin, glukagon and insulin were negative. Primary large cell neuroendocrine carcinoma of the kidney is a rare tumor. To the best of our knowledge, only 3 cases of a tumor of this type have been reported to date.     

乳腺神经内分泌癌5例临床病理观察

乳腺神经内分泌癌是乳腺癌的一种少见类型,其在形态和表型上常呈多向性,神经内分泌指标呈阳性表达。全文分析5例乳腺神经内分泌癌的临床表现、组织学特征和免疫表型,总结临床病理特点。     

膀胱神经内分泌癌6例临床与病理学观察

目的:探讨膀胱神经内分泌癌(BNEC)的病理学特征及临床顸后,提高对该病的诊断水平.方法:对6例BNEC患者临床及病理特征进行回顾性分析,探讨肿瘤组织来源、病理及免疫组化特征.并对其进行3个月至9年随访.结果:6例膀胱肿瘤切除标本,病理诊断4例为小细胞神经内分泌癌,2例不典型类癌.免疫组化染色显示肿瘤均表达神经内分泌标记物CD56、Syn和cgA.行膀胱肿物部分切除及术后化疗后,4例术后随访复发.结论:膀胱神经内分泌癌是一类比较少见的高度恶性的肿瘤.有其独特的病理特征,临床以血尿为主要症状,早期即可发生转移,确诊依靠病理诊断及免疫组化,手术切除及联合化疗是较有效的治疗手段.