肺转移性透明细胞肾细胞癌的临床病理学观察

［摘要］　目的　探讨肺转移性透明细胞肾细胞癌临床病理学特点。方法　回顾性分析4例穿刺活检诊断肺转移性透明细胞肾细胞癌的临床病理特征,采用免疫组化染色检测CK、p40、p63、TTF-1、Napsin A、PAX8、CD10,观察其表达情况。结果　4例患者中,男3例,女1例,年龄44～71岁,平均58.75岁;均为双肺多发结节,其中各例最大的结节位于左下肺2例,右下肺2例。4例均表达CK、PAX8、CD10,而TTF-1、Napsin A、p40、p63阴性。结论　具有透明细胞形态特点的肺肿瘤需要考虑肺转移性透明细胞肾细胞癌的可能。     

Primary carcinoid tumor of the gallbladder: resection of a case metastasizing to the liver and analysis of outcomes

Gallbladder carcinoid tumor is a rare and aggressive neoplasm, usually lacking specific symptoms, as they typically are unassociated with the carcinoid syndrome, despite frequent hepatic spread. The patient was an 81-year-old man with right upper quadrant pain who underwent radical surgery for carcinoid tumor of the gallbladder with liver metastasis (preoperative diagnosis, carcinoma). We analyzed the outcome of previously reported cases of gallbladder carcinoid. Increasing tumor size and depth of invasion progressively compromised the 2-year survival. These findings underscore the importance of early detection.     

肾嫌色细胞癌ceRNA调控网络的构建与分析

目的 构建肾嫌色细胞癌(CRCC)的内源竞争性RNA(ceRNA)调控网络,筛选出与CRCC预后相关的信使RNA(mRNA)、长非编码RNA(lncRNA)和微小RNA(miRNA),为CRCC的诊断和预后提供理论依据.方法 提取TCGA数据库中CRCC样本(65例)和正常肾样本(24例)的转录组数据,以错误发现率(F...     

Simultaneous renal cell carcinoma of the kidney and transitional cell carcinoma of the bladder

Herein we report a rare combination of two urological tumors simultaneously: renal cell carcinoma of the kidney and transitional cell carcinoma of the bladder. A 67 year old male presented with hematuria. He was diagnosed with left renal cell carcinoma and transitional cell carcinoma of the bladder. Subsequently this patient underwent left nephrectomy (palliative) to control the pain and transurethral resection of bladder tumor. The clinical picture, radiographic and histological finding are presented, as well as the treatment offered.     

An unusual case of pancreatitis revealing a metachronous renal cell carcinoma metastasis to the gallbladder

Clear-cell renal cell carcinoma (RCC) is a common urological tumor known for its potential to metastasize. Common sites of metastasis include the lungs, lymph nodes, liver and bones but rare sites of metastasis are described. Gallbladder metastasis from RCC is very rare and occurs mostly in men. It is admitted that most cases are asymptomatic. Cholecystectomy has been performed as the treatment for solitary lesion. We describe a case of RCC metastasis diagnosed after lithiasic pancreatitis in a 68-year-old male. To our knowledge, this is the first case of a metachronous RCC metastasis to the gallbladder presenting concurrently with lithiasic pancreatitis.     

Adeno-endocrine cell carcinoma of the gallbladder

We encountered a rare case of adeno‐endocrine cell carcinoma of the gallbladder in an 81‐year‐old woman. Imaging study revealed a common bile duct stone. Endoscopic sphincterotomy was performed, and the stone was extracted successfully. Thereafter, cholecystectomy was performed. A papillary tumor was found in the neck of the gallbladder. Histologically, the tumor consisted of two components, well differentiated adenocarcinoma and endocrine cell carcinoma. However, no clinical signs of tumor hormonal activity were observed. The tumor cells in the area of the endocrine cell carcinoma were small and round. Histochemical studies of these tumor cells were positive for chromogranin A and Grimelius silver impregnation. The tumor cells in the area of the adenocarcinoma were well differentiated adenocarcinoma and included goblet‐type cells with a tubular structure or solid growth pattern. These adenocarcinoma cells stained positively for Alcian blue and periodic acid‐Schiff, and both types of tumor cells stained positively for carbohydrate antigen and carcinoembryonic antigen. It was suggested that the histogenesis of the endocrine cell carcinoma of the gallbladder was closely related to that of the adenocarcinoma.     

Simultaneous occurrence of a hepatocellular carcinoma and a hepatic non-Hodgkin's lymphoma infiltration

To investigate the simultaneous occurrence of hepatocellular carcinoma and non-Hodgkin's lymphoma, we report the case of a 70 year old patient with a primary diagnosis of non-Hodgkin's lymphoma in 2002. In a routine follow up investigation of his chronic lymphocytic leukemia a newly detected mass in the Couinaud's segments 2 and 3 was found. No hepatitis C virus or hepatitis B virus infection or cirrhosis was evident. After laparoscopic segmentectomy the histological examination revealed a hepatocellular carcinoma. While the relation between liver parenchyma damages and hepatocellular carcinoma or non-Hodgkin's lymphoma is well known, only a few publications have focused on the coexistence of hepatocellular carcinoma and non-Hodgkin's lymphoma. With this case we demonstrate the coexistence of these diseases without having a predamaged liver parenchyma.     

Simultaneous occurrence of focal nodular hyperplasia and primary sclerosing cholangitis in a young female

We report the case of a 22-year-old female with primary sclerosing cholangitis who was found, during hepatic imaging, to have a large liver mass. Imaging techniques and histological examination confirmed the mass to be focal nodular hyperplasia. A review of the literature indicates that the simultaneous occurrence of these two hepatic pathologies is unique. The differential diagnosis of hepatic masses in primary sclerosing cholangitis is discussed. Focal nodular hyperplasia needs to be included in the differential diagnosis of hepatic lesions in primary sclerosing cholangitis.     

Cytomegalovirus ileitis associated with goblet cell carcinoid tumour of the appendix

We report a female patient with cytomegalovirus (CMV) terminal ileitis and CMV viraemia, associated with a metastatic goblet cell carcinoid (GCC) tumour of the appendix. She was treated with ileocaecal resection followed by ganciclovir. We highlight the importance of vigilant histopathological assessment and discuss the existing literature on gastrointestinal CMV infection in immunocompetent patients.     

Argyrophil cell hyperplasia and a carcinoid tumour in the stomach of a patient with sporadic Zollinger-Ellison syndrome.

In the rat, hypergastrinaemia induced by drug treatment with omeprazole or potent H2-receptor antagonists leads to the development of gastric enterochromaffin-like cell carcinoids. In man, gastric carcinoids induced by hypergastrinaemia have been described only in patients with chronic atrophic gastritis type A and in patients with the multiple endocrine neoplasia syndrome type 1. This patient with Zollinger-Ellison syndrome without gastric mucosal atrophy and without evidence of the multiple endocrine neoplasia syndrome developed an argyrophil gastric carcinoid tumour. This observation indicates that hypergastrinaemia in the sporadic Zollinger-Ellison-syndrome may induce gastric carcinoids.     

How to proceed in the case of a tumour thrombus in the inferior vena cava with renal cell carcinoma

Renal cell carcinoma accounts for about 3% of all malignant tumours in humans at adult age. The occurrence of a tumour thrombus in the inferior vena cava was recorded in 4% up to 10% of patients. In the period of 2006–2014 in the Department of Surgery of the Teaching Hospital and Faculty of Medicine in Pilsen we operated a total of 12 patients at the age from 44 to 80 for renal cell carcinoma with a tumour thrombus. Our results have proven clearly the benefit of nephrectomy with tumour thrombectomy in patients with renal cell carcinoma growing through the venous system.