厌色细胞垂体瘤CT、MRI影像与病理对照研究

目的：探讨厌色细胞垂体瘤CT、MRI影像形成的病理基础。方法：分析26例厌色细胞垂体瘤的CT、MRI平扫及增强MRI与术中所见和病理学结果进行比较。对于海绵窦受侵；颅底骨质受侵、突入蝶窦；颈内动脉粘连包裹受侵进行重点分析。结果：术前较明确诊断垂体瘤22例；海绵窦受侵和颈内动脉粘连包裹受侵无一漏诊，假阳性率为27．3％和36．4％。CT、MRI影像能显示出血和坏死、囊变、变性，颅底骨质受侵病灶无一漏诊，但有5．5％假阳性率。术中判断血供丰富3例、血供一般17例，与CT、MRI影像无对应关系。3例垂体瘤病理学表现为瘤细胞有核异型性及核分裂像。结论：CT、MRI影像能较明确地诊断垂体瘤出血和坏死、囊变、变性、颅底骨质受侵病灶。能敏感地显示海绵窦受侵和颈内动脉粘连包裹受侵，但可出现假阳性。对血供的判断不准确，不能提示垂体瘤生物学特性。     

Multiple myeloma masquerading as chromophobe adenoma.

A 62-year-old woman presenting with intracranial lesion eroding the sella with compression of optic chiasma was found to have plasmacytoma of the pituitary area. At the time of initial surgery, the patient had no biochemical, immunologic or marrow findings of multiple myeloma. The intracranial tumor was interpreted initially as chromophobe adenoma on light microscopy, but the diagnosis of plasmacytoma was established by electron microscopic examination of the tumor. The case illustrates the usefulness of electron microscopy as a diagnostic tool.     

Multitechnical pathological diagnosis in chromophobe renal cell carcinoma

Two new cases of chromophobe renal cell carcinoma were diagnosed on the basis of their morphology and their karyotype complemented by flow cytometry. In one of these cases, however, all these investigations were not sufficient and additional histochemistry investigation had to be used to completely rule out other renal tumors such as oncocytoma, the prognosis of which is totally different.     

Coffee intake and the risk of colorectal adenoma: The colorectal adenoma study in Tokyo

Coffee is a commonly consumed beverage which contains several potential anticarcinogenic and chemopreventive compounds, and has been hypothesized to have protective effects in colorectal neoplasia. However, the limited available data on coffee consumption in relation to colorectal adenoma (CRA), a precursor lesion to most colorectal cancers, remain largely inconsistent. In this study, we evaluated the association of coffee intake with the risk of CRA in a middle‐aged Japanese population. Study subjects were selected from examinees who underwent total colonoscopy as part of a cancer screening program and responded to self‐administered dietary and lifestyle questionnaires. A total of 738 patients with adenoma and 697 controls were included in the study. Coffee intake was assessed with a food frequency questionnaire, and divided into quartiles based on the distribution among controls. Unconditional logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI) of CRA, with adjustment for potential confounding factors. High coffee consumption was associated with a reduced risk of CRA, with a multivariate‐adjusted OR for the highest versus lowest quartile of coffee intake of 0.67 (95% CI = 0.48–0.93; p_trend = 0.02). The inverse association of coffee intake was limited to proximal (OR = 0.64; 95%CI = 0.44–0.95; p_trend = 0.04) and distal colon adenoma (OR = 0.62; 95%CI = 0.39–0.99; p_trend = 0.06), and appeared to be more evident with small (OR = 0.68; 95%CI = 0.49–0.96; p_trend = 0.04) and single adenomas (OR = 0.65; 95%CI = 0.44–0.95; p_trend = 0.02). Green tea intake was not found to be associated with CRA risk. This study provides support for the protective effect of coffee drinking on colon adenomas, a precursor of colon cancer.     

胆囊腺瘤和腺癌中Survivin与p53的定位表达及病理诊断意义

目的：观察胆囊腺瘤和胆囊腺癌细胞中Survivin与p53蛋白定位表达和形态特征,研究其在病理诊断及鉴别诊断中的意义。方法：采用免疫组化方法（SP法）检测25例胆囊腺瘤和53例胆囊腺癌细胞中Sur-vivin与p53蛋白的表达。结果：25例胆囊腺瘤,23例Survivin蛋白细胞浆内表达,阳性率92%;其中21例核上表达,包括＂核上核样＂表达17例、＂核上泥沙样＂表达4例;细胞浆弥漫表达2例;p53蛋白在胆囊腺瘤组织中无表达。53例胆囊腺癌,Survivin蛋白细胞浆弥漫表达,阳性率75.47%;p53蛋白细胞核内表达,核内表达率77.36%。Survivin在胆囊腺瘤和胆囊腺癌中的表达阳性率虽无显著性差异,但表达部位和形态特征显著不同。结论：Survivin在胆囊腺瘤中的＂核上核样＂和＂核上泥沙样＂表达,特异性强,有望成为胆囊腺瘤的诊断性抗体;其与p53在胆囊腺癌组织中核阳性表达、胆囊腺瘤组织中无表达这个结果相结合,构成两者在分子形态学表达的差异性,可作为胆囊腺瘤和胆囊腺癌病理鉴别诊断中的一种分子学方法,结合HE切片,基本可解决胆囊腺瘤与胆囊腺癌的病理诊断与鉴别诊断问题。     

胆囊腺瘤和腺癌中Survivin与p53的定位表达及病理诊断意义

目的:观察胆囊腺瘤和胆囊腺癌细胞中Survivin与p53蛋白定位表达和形态特征,研究其在病理诊断及鉴别诊断中的意义。方法:采用免疫组化方法(SP法)检测25例胆囊腺瘤和53例胆囊腺癌细胞中Sur-vivin与p53蛋白的表达。结果:25例胆囊腺瘤,23例Survivin蛋白细胞浆内表达,阳性率92%;其中21例核上表达,包括"核上核样"表达17例、"核上泥沙样"表达4例;细胞浆弥漫表达2例;p53蛋白在胆囊腺瘤组织中无表达。53例胆囊腺癌,Survivin蛋白细胞浆弥漫表达,阳性率75.47%;p53蛋白细胞核内表达,核内表达率77.36%。Survivin在胆囊腺瘤和胆囊腺癌中的表达阳性率虽无显著性差异,但表达部位和形态特征显著不同。结论:Survivin在胆囊腺瘤中的"核上核样"和"核上泥沙样"表达,特异性强,有望成为胆囊腺瘤的诊断性抗体;其与p53在胆囊腺癌组织中核阳性表达、胆囊腺瘤组织中无表达这个结果相结合,构成两者在分子形态学表达的差异性,可作为胆囊腺瘤和胆囊腺癌病理鉴别诊断中的一种分子学方法,结合HE切片,基本可解决胆囊腺瘤与胆囊腺癌的病理诊断与鉴别诊断问题。