Corpora amylacea in a leiomyoma of soft tissue

A case of myxoid leiomyoma of deep soft tissue is described. The patient was a 42-year-old woman who presented with menorrhagia, and an ischiorectal mass was identified. A total hysterectomy was performed, and the mass was removed. On gross examination, the mass was 6cm x 5cm x 4cm and had a mucoid cut surface. Histologic examination revealed a myxoid leiomyoma with abundant intracellular corpora amylacea (CA). An infarcted leiomyoma was present in the hysterectomy specimen. The patient remains well, with no evidence of recurrence 3 years after surgery. Leiomyomas of deep soft tissue are rare, and, to our knowledge, none have been described containing CA.     

疤痕子宫孕妇晚期妊娠阴道分娩临床结局分析

目的探讨孕晚期疤痕子宫孕妇经阴道分娩的影响因素并分析其可行性。方法回顾性分析80例孕晚期疤痕子宫孕妇经阴道分娩的临床资料,将其分为疤痕子宫自然临产组（n=38）、疤痕子宫计划分娩组（n=42）,并设定对照组（n=50）。比较3组间的分娩结局如产后出血量、胎盘胎膜滞留率、是否存在子宫破裂、急产率及钳产率等情况。结果自然临产组有9例（23.68%）孕妇以钳产术缩短第二产程终止妊娠,而计划分娩组则有8例（19.05%）,均高于对照组3例（6.00%）,两两比较差异有统计学意义（P〈0.01）。自然临产组孕妇钳产率又稍高于计划分娩组,但两组比较差异无统计学意义（P〉0.05）。自然临产组总产程〈3h者有9人（23.68%）,急产率高于计划分娩组（2.38%）及对照组（10.00%）,差异有统计学意义（P〈0.01）。3组孕妇产后出血量、胎盘胎膜滞留率以及非计生引产胎儿评分比较,差异均无统计学意义（P〉0.05）。3组均无子宫破裂及新生儿重度窒息等不良事件发生。结论疤痕子宫并非阴道试产的绝对禁忌,产前超声检查子宫下段疤痕区域的良好连续性及低位钳产术是其阴道试产的有利因素。     

细胞周期调节蛋白在早期自然流产患者绒毛和蜕膜组织中的表达及其与自然流产发生的相关性研究

目的：探讨细胞周期调节蛋白在早期自然流产患者绒毛和蜕膜组织中的表达情况并研究其与自然流产发生的相关性。方法：选取符合研究要求的人工流产女性与自然流产女性各35例，分为人工流产组与自然流产组。利用Western blotting与免疫组织化学法分别检测两组患者绒毛与蜕膜组织中细胞周期调节蛋白的表达情况。结果：人工流产组绒毛与蜕膜组织的细胞周期调节蛋白的表达量为75%~85%，自然流产组的表达量为45%~55%。人工流产组与自然流产组比较有统计学意义(P<0.05)。结论：早期自然流产可能与细胞周期调节蛋白在绒毛与蜕膜组织中的含量相关。     

In Vitro secretion of tumor necrosis factor-α and interleukin-1 by placental macrophages in various outcomes of pregnancy

Production of tumor necrosis factor-α and interleukin-1β by placental cells obtained after term and premature labors with or without labor activity increases with an increase in the gestational period. The secretory activity of macrophages significantly increases during spontaneous premature labor in the second trimester of pregnancy (abortion) and decreases during normal term labor. The use of phorbol myristate acetate and lipopolysaccharide for stimulating functional activity of macrophages revealed the differences in cell responses in case of the presence or absence of spontaneous labor activity. Translated fromByulleten', Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 7, pp. 97–100, July, 1999     

CXCR2在不明原因自然流产患者绒毛和蜕膜组织中的表达

目的研究CXCR2在不明原因自然流产患者绒毛及蜕膜组织中的表达情况。方法应用免疫组织化学染色和图像分析技术,观察CXCR2在不明原因自然流产患者（病例组）和正常人工流产者（对照组）绒毛及蜕膜组织中的表达情况;HE染色后光镜下观察不明原因自然流产患者绒毛与蜕膜组织的形态学变化。结果免疫组化染色结果显示：两组CXCR2蛋白主要表达于绒毛的滋养层、蜕膜组织中的腺体,病例组绒毛滋养层和腺体CXCR2蛋白表达均强于对照组,两组比较,有显著性差异（P〈0.01）。病例组蜕膜细胞CXCR2蛋白呈阳性表达,对照组呈阴性;HE染色可见不明原因自然流产患者绒毛组织的滋养层变薄、滋养层细胞变性甚至坏死、滋养层嗜酸性增强、绒毛中轴纤维化程度增强;蜕膜组织中蜕膜细胞连接松散、蜕膜细胞空泡化、蜕膜组织中有大量炎细胞浸润。结论 CXCR2可能通过与其配体白细胞介素-8结合而参与不明原因自然流产的病理过程。     

The first case of gastric leiomyosarcoma developed through malignant transformation of leiomyoma

Malignant transformation of gastric leiomyoma has not been reported, and therefore it is considered to have virtually no malignant potential. We report a case of gastric leiomyosarcoma arising from leiomyoma. The patient is a 72-year-old man with a submucosal mass measuring 20 mm in diameter, which was incidentally identified by an endoscopic surveillance. A biopsy suggested a diagnosis of leiomyosarcoma, and local excision was performed. Pathological examination revealed that the tumor was composed of two distinct components: typical leiomyoma-like area in the periphery and leiomyosarcoma component exhibiting higher cellularity, prominent nuclear atypia, necrosis, and increased mitosis. Immunohistochemically, in the latter, p53 overexpression, increased Ki-67 labeling index, and attenuated expression of smooth muscle markers were noted. This is the first report to demonstrate the presence of leiomyoma–leiomyosarcoma sequence in the stomach that is well recognized in the uterus. Our observation highlights the potential occurrence of malignant transformation of gastrointestinal leiomyoma.     

反复自然流产患者母胎界面SOCS3蛋白、TNF-α及IL-10的表达

目的:研究反复自然流产患者蜕膜组织中细胞因子信号转导抑制因子SOCS3,细胞因子TNF-α及IL-10的表达,并与正常妊娠作对照。方法:Western blot检测SOCS3的表达,免疫组织化学法检测细胞因子TNF-α及IL-10的表达。结果:反复自然流产组蜕膜组织中SOCS3的表达明显降低(P<0.01),差异有统计学意义,IL-10表达降低(P<0.01),TNF-α表达增高(P<0.05),差异有统计学意义。结论:与正常妊娠相比,反复自然流产组蜕膜组织中SOCS3蛋白及IL-10表达降低,TNF-α表达增高,差异有统计学意义,说明反复自然流产患者母胎界面Th1/Th2失衡,SOCS3蛋白可能通过与细胞因子的相互调控作用影响Th1/Th2平衡导致流产发生。     

Cotyledonoid leiomyoma of the uterus

In the growing knowledge of rare interesting tumors, the cotyledonoid leiomyoma is a tumor with an alarming appearance, of benign nature, but dealt with undue severity. We report a case of cotyledonoid leiomyoma in a 40 yr old female who presented with urinary retention and in whom a clinical diagnosis of uterine fibroid was made. On laparotomy, friable nodules were seen in the lower part of the uterus. Hence the diagnosis of sarcoma was considered and total abdominal hysterectomy with unilateral salpingo-oopherectomy was done. The friable nodules were removed piecemeal. Microscopic examination revealed nodules of bland looking smooth muscle cells arranged in-interlacing fascicles with perinodular hydropic degeneration. Necrosis or nuclear atypia was not seen. Increased awareness of this grossly alarming variant of benign leiomyoma can help avoid over treatment.     

自然流产模型小鼠蜕膜细胞凋亡及相关基因的表达

目的 通过比较正常妊娠模型小鼠及自然流产模型小鼠蜕膜细胞凋亡及Bcl-2、Bax、Fas、FasL蛋白的表达,从细胞及分子水平探讨自然流产的发病机制.方法建立正常妊娠模型CBAXBALB/c和自然流产模型CBAXDBA/2.用免疫组化SABC法测定两组模型孕13 d蜕膜细胞Bcl-2、Bax、Fas、FasL蛋白的表达,并通过MIAS-2000医用彩色病理图像免疫组化测量系统对其表达进行半定量分析,其结果用平均灰度值表示;同时应用DNA缺口原位末端标记技术(TUNEL)测定两组模型孕13天蜕膜细胞凋亡情况.结果与正常妊娠模型相比,自然流产模型蜕膜细胞Bcl-2蛋白的表达降低(P＜0.01);Bax蛋白的表达明显升高(P＜0.01);FasL的表达明显升高(P＜0.01);Fas的表达两组比较无明显差异(P＞0.05).蜕膜细胞凋亡指数(AI),自然流产模型明显高于正常妊娠模型(P＜0.01).结论 早孕期蜕膜组织细胞凋亡异常是自然流产的机制之一,Bcl-2/Bax,Fas/FasL途径可能是诱导早孕期蜕膜细胞凋亡的重要因素.     

正常妊娠反复自然流产绒毛及蜕膜组织中细胞因子信号转导负调控因子的表达：改变Th1/Th2平衡调节可影响妊娠结局

背景：细胞因子信号转导负调控因子(suppressors of cytokine signaling, SOCS)参与多种细胞因子信号通路的调节,SOCS1-3对妊娠的调节作用较为突出。 目的：通过检测反复自然流产患者和正常妊娠绒毛及蜕膜组织中SOCS3蛋白表达,了解反复自然流产患者SOCS3蛋白的表达。 方法：Westen blotting 方法检测反复自然流产患者和正常妊娠绒毛组织及蜕膜组织SOCS3的表达。 结果与结论：与正常妊娠组相比,反复自然流产组SOCS3在绒毛组织中表达减少(P < 0.05),在蜕膜组织中表达减少(P < 0.01)。推测SOCS3蛋白可能影响妊娠结局,反复自然流产组SOCS3表达降低,可能导致Th2反应降低,从而导致流产发生。      

Caffeine intake and the risk of first-trimester spontaneous abortion

BACKGROUND: Some epidemiologic studies have suggested that the ingestion of caffeine increases the risk of spontaneous abortion, but the results have been inconsistent. METHODS: We performed a population-based, case-control study of early spontaneous abortion in Uppsala County, Sweden. The subjects were 562 women who had spontaneous abortion at 6 to 12 completed weeks of gestation (the case patients) and 953 women who did not have spontaneous abortion and were matched to the case patients according to the week of gestation (controls). Information on the ingestion of caffeine was obtained from in-person interviews. Plasma cotinine was measured as an indicator of cigarette smoking, and fetal karyotypes were determined from tissue samples. Multivariate analysis was used to estimate the relative risks associated with caffeine ingestion after adjustment for smoking and symptoms of pregnancy such as nausea, vomiting, and tiredness. RESULTS: Among nonsmokers, more spontaneous abortions occurred in women who ingested at least 100 mg of caffeine per day than in women who ingested less than 100 mg per day, with the increase in risk related to the amount ingested (100 to 299 mg per day: odds ratio, 1.3; 95 percent confidence interval, 0.9 to 1.8; 300 to 499 mg per day: odds ratio, 1.4; 95 percent confidence interval, 0.9 to 2.0; and 500 mg or more per day: odds ratio, 2.2; 95 percent confidence interval, 1.3 to 3.8). Among smokers, caffeine ingestion was not associated with an excess risk of spontaneous abortion. When the analyses were stratified according to the results of karyotyping, the ingestion of moderate or high levels of caffeine was found to be associated with an excess risk of spontaneous abortion when the fetus had a normal or unknown karyotype but not when the fetal karyotype was abnormal. CONCLUSIONS: The ingestion of caffeine may increase the risk of an early spontaneous abortion among non-smoking women carrying fetuses with normal karyotypes.     

自然流产患者蜕膜组织NK细胞受体表达分析

目的研究自然流产患者子宫蜕膜组织中NK细胞受体的表达格局。方法采用RT-PCR和免疫组织化学法检测了12例早期自然流产及40例同期正常早孕要求行人工流产者蜕膜组织的NK细胞受体表达水平。结果NK细胞受体中阳性最高的是KIR2DL4,流产组和对照组分别为100%和95%,其次是KIR2DL1,分别为83.3%和75%。ILT2和ILT4的阳性率较低,流产组和对照组分别为25%、30%和8.3%、10%。统计结果显示,KIR2DL4、KIR2DL1、ILT2和ILT4mRNA阳性率在早期自然流产病人组和对照组之间均无显著性差异。与对照组相比,早期自然流产病人的蜕膜组织中KIR2DL4分子的表达水平明显降低,具体表现在KIR2DL4的分布密度上。结论早期流产的发生与NK细胞受体的转录水平可能并无直接关联,但KIR2DL4分子的表达水平高低,可能对早期胚胎的生长、发育起关键作用。     

103例夫精宫腔内人工授精妊娠的结局分析

目的分析夫精宫腔内人工授精妊娠结局及子代安全性。方法分析2008年1月-2012年12月行夫精宫腔内人工授精后临床妊娠的的103个周期,随访妊娠结局至产后1年。结果异位妊娠率1．94％,自然流产率16．50％,多胎率2．91％,早产率2．38％,剖宫产率72．62％。自然流产组与正常宫内孕组比较女方年龄、自然流产史有差异（P〈O．05）。新生儿男女性别比为1．56,平均出生体重、身长均在正常范围,无出生缺陷,1岁时仅1例体重偏轻。结论夫精宫腔内人工授精多胎率、剖宫产率高,自然流产与患者年龄、自然流产史有关,出生后子代发育正常,男性明显多于女性。     

Case of the month: March 1999--A 26 year old HIV positive male with dura based masses.

A 26-year-old male with AIDS presented with a chief complaint of headaches and neck pain. An MRI revealed two enhancing extra-axial dura based masses, one in the area of the left sphenoid wing and one at the level of C2-3. In both cases, microscopic sections showed actin positive spindle cell neoplasms with long slender nuclei, consistent with leiomyomas. Both tumors were positive for Epstein Barr virus by in situ hybridization. This case report serves to emphasize the importance of considering soft tissue tumors such as leiomyoma in the differential diagnosis of mass lesions that occur in the central nervous system in AIDS and discusses the role of EBV in tumorigenesis.     

Breast leiomyoma: a case report and review of the literature

Breast leiomyoma is a rare and benign tumor which arises from a smooth muscle in nipple and areola or smooth muscle metaplasia of myoepithelial cells or myofibroblastic cells. Common differential diagnosis of the breast leiomyoma was as follows: fibroadenoma, myoepithelioma, phyllodes tumor, and leiomyosarcoma. We present here a rare case of solitary leiomyoma of the breast. We described a case of breast leiomyoma diagnosed in an otherwise healthy 37-year-old woman at the Rajaee Hospital. The patient presented with a palpable mass in her right breast since 2 years. Physical examination showed a mobile and smooth mass, without any axillary lymphadenopathy. The radiologic examinations revealed a well-circumscribed ovoid mass, 5 cm in diameter. Excisional biopsy disclosed a well-circumscribed cellular tumor by interlacing fascicles of spindle cells with fibrillary and eosinophilic cytoplasm. The tumoral cells were immunoreactive for smooth muscle actin. There were not any evidences of disease recurrence for 20 months of follow up. Histopathological study and immunohistochemical examinations help in the discrimination between leiomyoma and other benign and malignant breast lesions and determination of outcome.     

自然流产妇女血清及子宫内膜丙二醛和超氧化物歧化酶含量变化的研究

目的主要研究自然流产妇女血清及子宫内膜组织中丙二醛(MDA)、超氧化物歧化酶(SOD)的变化.方法随机选择有自然流产史妇女20例(病理组)、正常早孕和非孕妇女各20例(对照组).结果①自然流产组血清中MDA含量与对照组间无明显差异(P＞0.05).子宫内膜组织中MDA含量自然流产组却明显高于对照组(P＜0.01)②血清及子宫内膜组织中,自然流产组SOD含量明显低于对照组(P＜0.01).②血清及子宫内膜组织中,自然流产组SOD含量明显低于对照组(P＜0.01).③子宫内膜组织,SOD含量与自然流产次数呈负相关(r=-0.9110,P＜0.01),而MDA则为正相关(r=0.9206,P＜0.01).且MDA及SOD的变化与再次受孕成功可能有关.结论自然流产的发生与子宫内膜局部氧化、抗氧化平衡失调有密切关系.     

自然流产患者血栓前状态的多因子发病趋势分析

目的 通过对自然流产患者血栓前状态的相关血栓标志物进行筛查,评估其发病规律及高危因子,提供有效的预防及治疗方案.方法 将1300例自然流产患者按流产次数分为1次、2次、3次及以上,分别进行血栓标志物的检测,探讨其与流产次数的关系.结果 抗凝血酶Ⅲ、纤溶酶原活性、交联纤维蛋白降解产物、纤维蛋白降解产物、纤溶酶原活化物抑制因子、组织型纤溶酶原激活物等对不良妊娠结局的影响差异具有统计学意义（P＜0.01）,随着流产次数的增加差异具有统计学（P＜0.01）.蛋白C活性、蛋白S活性对不良妊娠结局的影响具有显著统计学差异（P＜0.01）,随着流产次数的增加2次与3次及以上经两两比较不具备统计学差异（P＞0.05）.结论 蛋白C活性、蛋白S活性可能是自然流产血栓前状态诊断与治疗的特征性指标或者无相关性.抗凝血酶Ⅲ、纤溶酶原活性、交联纤维蛋白降解产物、纤维蛋白降解产物、纤溶酶原活化物抑制因子、组织型纤溶酶原激活物是自然流产的影响因素,随着流产次数的增加特征性明显.     

Leiomyoma with atypical cells (atypical leiomyoma) in the larynx

AIMS: To report and confirm the identity of laryngeal leiomyoma with many atypical cells, which has not been described previously. CASE DETAILS: A 53-year-old man was found to have a polypoid tumour in the larynx. The tumour was excised and the patient has shown no evidence of recurrence over a 5-year period. The tumour tissue comprised intersecting fascicles of spindle-shaped tumour cells with blunt-ended nuclei. Many of the tumour cells showed marked atypia. Mitotic activity in the tumour cells was low, and no atypical mitoses were found. Immunohistochemically, the tumour cells were positive for smooth muscle actin and desmin. p53 overexpression was identified in many tumour cells; the p53 labelling index of the tumour cells was 45%. DNA from tumour cells showed loss of heterozygosity on chromosomes 3p, 5q, 8p, 9p, 10q, 17p and 18q. We diagnosed this case as leiomyoma with atypical cells (atypical leiomyoma) based on the clinical course and pathological and genetic findings. CONCLUSION: This is the first report of atypical leiomyoma in the larynx. The clinical course and pathological findings indicate that although laryngeal atypical leiomyoma contains numerous atypical cells, it is a benign neoplasm.     

Recurrent mesectodermal leiomyoma of the ciliary body: a case report

A 19-yr-old woman with a previous history of a mass of the right ciliary body presented with a decreased visual acuity of right eye. Clinicoradiologic examinations suggested a recurrent mass of the ciliary body. Enucleation of the right eye was performed under the impression of malignant tumor. On microscopic examination, the tumor was a mesectodermal leiomyoma of the ciliary body. On immunohistochemistry, the tumor cells were reactive to smooth muscle actin and vimentin, but not reactive to cytokeratin, S-100 protein, neurofilament, desmin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and synaptophysin. Electron microscopy revealed numerous thin longitudinally placed myofilaments and focal densities in the cytoplasms. In the review of the literature, only 27 cases of mesectodermal leiomyoma of the ciliary body were reported, however, there was no report of recurrent cases. Mesectodermal leiomyoma should be differentiated from other orbital spindle-cell tumors such as amelanotic melanomas and glial tumors. Immunohistochemical and electron microscopic studies may be useful for the correct diagnosis by showing smooth muscle differentiation in the tumor cells.     

Mesenteric Castleman's disease

We report here a rare case of mesenteric Castleman's disease presenting as a mesenteric mass. A 13-year-old female child was admitted to our hospital complaining of intermittent vague abdominal pain. She had hypochromic anemia, thrombocytosis and an elevated erythrocyte sedimentation rate (ESR). Ultrasonography and computed tomography indicated an intra- abdominal mass might represent a lymphoma or gastrointestinal stromal tumor or leiomyoma, but the definitive preoperative diagnosis couldn't be confirmed. The surgical resection of the mass revealed the mesenteric hyaline vascular-type Castleman's disease.