YAP在黑素瘤和痣细胞痣中的表达及意义

目的:研究YAP在皮肤黑素瘤及痣细胞痣中的表达变化情况。方法:采用免疫组化方法检测20例正常皮肤组织、28例痣细胞痣和32例黑素瘤皮损中YAP的表达。结果:在正常皮肤组织中,YAP弱表达于表皮基底层,在表皮全层所占阳性率为25.00%。在痣细胞痣中,YAP表达于靠近表皮的部分痣细胞中,阳性率为32.14%。在黑素瘤中,可见YAP高表达于几乎所有的瘤细胞中,阳性率为93.75%。YAP在黑素瘤中的表达显著高于正常皮肤组织和痣细胞痣(P＜0.001)。而在痣细胞痣中的表达与正常皮肤组织无显著差异(P＞0.05)。结论:YAP可能参与黑素瘤和痣细胞痣的发生和发展。     

透明细胞肉瘤的病理诊断与鉴别诊断

目的 掌握透明细胞肉瘤的临床病理特点及组织学不典型性。方法 光镜观察3例透明细胞肉瘤组织形态结合免疫组化染色结果分析。结果 女性2例，男性1例，年龄 27－50岁，病变部位主要位于四肢远端，组织学显示，该肿瘤细胞组织形态不典型，特别需要和滑膜肉瘤，上皮样肉瘤，恶性腱鞘巨细胞瘤鉴别。 所有病例HMB－45和S－100均表达阳性。结论 透明细胞肉瘤常发生于20至40岁的中青年，透明细胞肉瘤的病理学特点及鉴别诊断紧密结合临床表现和免疫组化结果。     

转移肿瘤的病理鉴别诊断

病理医生对转移肿瘤能准确做出诊断并提供原发部位,无疑会使病人及早得到治疗。但在实践工作中常有一定困难,不少隐匿微小的恶性肿瘤由于细胞分化差,转移早,继发肿瘤却先被发现。为此,探讨肿瘤转移的好发部位,转移规律,掌握转移瘤的鉴别诊断方法十分重要。1根据形态学首先摒除该部位的原发瘤,然后根据肿瘤易转移的部位去理顺鉴别,以便缩小考虑范围(表1、2)。     

巨型脑回状痣的7例临床分析

巨型脑回状痣是黑色素痣中的罕见类型,自１９７６年至１９９７年,共收治７例,全部手术治疗,经１～２０年随访,未见复发。现报告如下：一般资料：本组７例病人,其中男性５例,女性２例,年龄４．５岁～３７岁,平均２２岁。病变位于左侧颞面部１例（１４％）,头顶部１例（１４％）,枕部５例（７４％）。表现为褐色或黑色肿物,多层折叠及凹陷。如沟回状,折叠最多达２３层,最少为８层,每层厚度为１ｃｍ～２ｃｍ,平均１．５ｃｍ,最大３０ｃｍ×１７．５ｃｍ,最小１２ｃｍ×１０ｃｍ,平均２１ｃｍ×１７ｃｍ。质韧,活动度小,其…     

淋巴组织反应性增生的病理诊断与鉴别诊断

淋巴组织反应性增生(RH)的临床表现、病理组织学、免疫表型与鉴别诊断.RH的主要特点为:(1)临床表现为急性发热,淋巴结轻度肿大,致病因子消除后可以痊愈;(2)病理组织学分为单纯性与特异性两类,共同改变为淋巴或T区细胞增生而导致正常组织结构紊乱,大细胞及核分裂象增多(称为假恶性组织象);(3)免疫表型呈现以淋巴滤泡为主的B细胞免疫表型和以T细胞为主的免疫表型保持正常.鉴别诊断最主要的是RH特点为组成细胞量的增多产生假恶性组织象,缺乏细胞的异型性与单克隆性,并且会出现正常组织结构的侵蚀破坏.     

阑尾杯状细胞类癌临床病理分析(附1例报道)

杯状细胞类癌是1种很少见的肿瘤，最常见的发生部位是阑尾，少数也可发生于直肠、盲肠、卵巢、纵隔、胃等部位。发生于卵巢及纵隔者往往是畸胎瘤的成份之一。这种肿瘤被认为是类癌的1种变型。现报道1例，并结合文献复习，探讨其临床病理特点，诊断及治疗方案。     

11例低度恶性子宫内膜间质肉瘤的病理诊断与鉴别诊断

目的：探讨低度恶性子宫内膜间质肉瘤的临床病理学特点及鉴别诊断。方法：收集１１例低度恶性子宫内膜间质肉瘤,复习病历档案进行随防,同时观察其临床病理特点,并作免疫组化染色分析。结果：所有肿瘤具有低度恶性子宫内膜间质肉瘤的临床及组织学特征,其中３例伴性索样成份,患者年龄为３１～６０岁,平均３９岁。１０例患者随访健在,其中３例带瘤存活。结论：低度恶性子宫内膜间质肉瘤,高发年龄为４０岁左右,它是一种低度恶性     

Merkel细胞癌1例临床病理分析及文献复习

目的 回顾性分析皮肤Merkel细胞癌(MCC)的临床病理形态学特征、诊断和鉴别诊断、治疗和预后.方法 对1例MCC的临床表现、病理形态学特征及免疫组织化学染色情况进行分析,同时复习相关文献.结果 皮肤组织病理:镜下见肿物位于真皮和皮下组织内,肿瘤细胞呈巢片状弥漫分布,细胞质少或无,细胞核小、圆形或卵圆形,染色质细腻、...     

内淋巴囊肿瘤四例临床病理观察及鉴别诊断

目的探讨内淋巴囊肿瘤（endolymphatic sac tumor,ELST）的临床病理学特征、免疫表型、诊断要点及鉴别诊断,提高对该罕见肿瘤的认识。方法回顾性分析2008-07-29-2013-11-07山东大学附属省立医院4例ELST患者临床病理资料,并用EnVision二步法进行免疫组织化学染色。结果 4例患者年龄分别为27、40、58和60岁,中位年龄49岁,男女之比为1∶3。主要临床症状是听力下降,并伴有耳鸣、耳聋及面瘫等。影像学显示,肿瘤位于颞骨岩部或桥小脑角,并周围骨质破坏。组织学改变,肿瘤呈乳头状及腺样结构,乳头具有纤维血管轴心,表面被覆单层立方-柱状上皮,胞质嗜酸或透明。部分区域呈囊性扩张,内含粉染的胶样物质,类似甲状腺滤泡。间质中血管丰富。免疫表型示,CK、CK8/18、EMA和Vimentin阳性,其中1例GFAP阳性,2例CK5/6及CD56阳性,CgA、Syn、TTF-1、TG、S-100和NSE阴性。Ki-67指数约为1%。4例均已行手术完整切除,随访至2014-02-07无复发。结论 ELST是罕见的低度恶性肿瘤,组织形态温和,但常呈侵袭性生长,临床及病理易与其他肿瘤混淆,诊断及鉴别诊断主要依据病理组织形态及免疫组织化学,并结合临床影像学资料。     

甲状腺低分化癌（岛状癌）的病理诊断

甲状腺低分化癌的文献报道比较少,但在实际工作中并不罕见。由于对其认识不是很清楚,所以有很多命名,如甲状腺岛状癌、低分化滤泡癌、滤泡癌实体型、低分化乳头状癌等,繁多的名称给诊断及临床治疗带来困惑,从而表现在预后上也有很大差异。为此,2004年版的WHO肿瘤组织学分类中正式把甲状腺低分化癌作为一个单独类型,但其诊断标准比较模糊,近年来病理学界一直在为统一的诊断标准作努力。全文就甲状腺低分化癌的历史、组织起源、临床及病理特点作一综述。     

巨大子宫肌瘤的MSCT诊断与鉴别诊断

目的 分析巨大子宫肌瘤的MSCT表现,探讨MSCT对巨大子宫肌瘤的诊断及鉴别诊断价值.方法 回顾性分析经手术和病理证实的12例巨大子宫肌瘤的MSCT资料.结果 12例均为单发肿瘤,位于浆膜下8例,肌壁间3例,黏膜下1例.最大径线在12 ～ 20 cm者5例,20 ～ 30 cm者4例,＞30 cm者3例.平扫表现为以低、等密度为主的混杂密度肿块,边界较清,增强呈不均匀轻至中度强化,内部低密度影未见强化.6例显示子宫动脉参与肿瘤供血.病理证实12例肿瘤内均有不同程度变性,12例巨大子宫肌瘤诊断准确率100.0％.结论 MSCT对巨大子宫肌瘤的诊断价值较大,结合后处理图像,对多数巨大子宫肌瘤可作出正确诊断.     

Diagnosis and differential diagnosis of rhabdoid meningioma: One case report and literature review

Introduction Rhabdoid meningioma （RM） is a special type of meningioma, The pathologic features of RM include sheets of rhabdoid tumor cells with or without the findings typical of conventional meningiomas. Since the disease is rare, and the histologic structure similar to that of other tumors, misdiagnosis and failure to include the entity in the differentiation can occur from time to time. In this article, the pathologic features and immunophenotype of RM are analyzed, in combination with analysis of a case treated at our institution and a review of the literature.     

The Diagnosis and Differential Diagnosis of Umteral Fibroepithelial Polyps

OBJECTIVE To study the clinical pathologic characteristics and differential diagnosis of ureteral fibroepithelial polyps. METHODS One case of ureteral fibroepithelial polyps was studied by clinical data analysis and light microscopy. RESULTS The tumor was located in the lower ureter. Histologically, the polyp was composed of expanded blood vessels and fibrous connective tissue under normal or proliferous transitional epithelium. CONCLUSION Benign ureteral fibroepithelial polyps are extremely rare, recognition of it＇s precise histological features can facilitate its correct diagnosis.     

探讨粒细胞肉瘤的诊断与鉴别诊断

Objective: To discuss the diagnosis and differential diagnosis of granulocytic sarcoma (GS). Methods: Six cases were reported in this paper. They were assessed by pathologists. Immunohistochemistry (IHC) stain and routine hematoxylin and eosin (H&E) stain were applied. Results:All patients involved in different anatomic sites respectively including skin, lymph node, soft tissue, breast, cervix and penis. All cases were previously error diagnoses. Three of them were initially diagnosed as non-Hodgkin lymphoma (NHL). One case of cervical lymph node lesion was first considered as metastasized carcinoma by clinician. One biopsied skin sample was initially reported as Karposi's sarcoma. And one breast case was suspicious of the Iobular carcinoma with the frozen samples without antecedent clinical history information. GS was accompanied with acute myeloid leukemia (AML) in one case and with acute lymphocytic leukemia (ALL) in one case. Histopathologically, blastic, immature and differentiated variants were found in four, one and one, respectively. Immunohistochemistry (IHC) showed that myeloperoxidase (MPO) and lysozyme were both found to be positive in all cases, CD43 was found in 5 of 6 cases. Three of six cases were CD68, CD15 and LCA positive. CD34 and CD117 were positive in 1/5 and 1/6 cases, respectively. However, CD20 and CD3 were negative in all cases. Conclusion: GS was uncommon and it may be misdiagnosed easily in routine practice. Each area had its own character, but they had the common features too. It can be correctly diagnosed by combination of H&E stain, IHC stain, peripheral blood and bone marrow. MPO and Lysozyme were necessary for the nature of granulocytes. In addition, CD43, CD68 and CD15 were very helpful.     

Serum levels of S-100 protein and 5-S-cysteinyldopa as markers of melanoma progression

Serum S-100 protein is widely used as a marker of melanoma and since 5-S-cysteinyldopa (5-S-CD) is a precursor of melanin its serum and urinary levels can reflect melanoma progression. In this study we examined the concentration changes of serum S-100 protein and 5-S-CD in 252 melanoma patients of different clinical stages. Serum samples were taken from 252 melanoma patients at 860 times, from June 1996 to July 1998. The serum S-100 protein was measured by the immunoluminometric assay, levels of 5-S-CD was determined by HPLC. The value of S-100 protein in patients with primary melanoma (0.11m mg/l) and in patients without symptoms (0.15 m mg/l) ranged around the normal level (0.01 0.12 m mg/l). There was a significant difference between the values of patients with or without symptoms. There was a similarly significant difference between the S-100 values of clinical Stage I (0.11 mg/l) and Stage III (2.91 mg/l) as well as between those of clinical Stage II (0.47 mg/l) and Stage III (2.91 mg/l), respectively. Analyzing the values of patients with symptoms we observed significant difference between the S-100 protein values of patients with primary tumor and those with solitary or multiple distant metastases. In case of 5-S-CD significant difference was found between clinical Stage I and III as well as clinical Stage II and III. Furthermore, there was a significant difference between the mean marker values of patients with primary tumor, lymph node, lung metastasis and clinical stage III.     

颅咽管瘤的MRI诊断及鉴别诊断颅咽管瘤的MRI诊断及鉴别诊断

目的:研究颅咽管瘤的MRI诊断及鉴别诊断。方法:回顾性分析经病理证实的13例颅咽管瘤的MRI表现。结果:9例呈圆形或类圆形,4例呈不规则形。平扫6例表现为长T1长T2信号,3例表现为等T1长T2信号,2例短T1长T2信号,1例等T1短T2信号,1例混杂T1混杂T2信号。其中囊内见出血1例,分层征象2例,钙化3例,壁结节4例,3例DWI弥散不受限呈低信号。增强后3例实性颅咽管瘤和5例囊实性颅咽管瘤实性部分明显均匀或不均匀强化,5例囊实性和4例囊性颅咽管瘤囊壁呈弧形或环形强化,4例囊性颅咽管瘤壁结节明显强化,1例囊性颅咽管瘤未见明显强化。结论:颅咽管瘤的MRI影像表现具有一定特征,但需注意与垂体腺瘤、Rathke囊肿、生殖细胞瘤等鉴别。     

电镜在小圆细胞未分化恶性肿瘤诊断与鉴别诊断中的应用简

小圆细胞未分化恶性肿瘤在光镜下表现较为相似且瘤细胞缺乏明显的分化方向,形态学上难以鉴别及确定肿瘤的组织来源。电镜作为临床病理诊断一种较为有效的手段,为小圆细胞未分化恶性肿瘤的诊断与鉴别诊断提供一条辅助通路。本文主要介绍电镜在各种小圆细胞未分化恶性肿瘤诊断与鉴别诊断中的应用。     

A pooled analysis of melanocytic nevus phenotype and the risk of cutaneous melanoma at different latitudes

An abnormal nevus phenotype is associated with an increased risk of melanoma. We report a pooled analysis conducted using individual nevus data from 15 case-control studies (5,421 melanoma cases and 6,966 controls). The aims were to quantify the risk better and to determine whether relative risk is varied by latitude. Bayesian unconditional logistic random coefficients models were employed to study the risk associated with nevus characteristics. Participants with whole body nevus counts in the highest of 4 population-based categories had a greatly increased risk of melanoma compared with those in the lowest category (pooled odds ratio (pOR) 6.9 (95% confidence interval (CI): 4.4, 11.2) for those aged<50 years and pOR 5.1 (95% CI: 3.6, 7.5) for those aged>or=50). The pOR for presence compared with absence of any clinically atypical nevi was 4.0 (95% CI: 2.8, 5.8). The pORs for 1-2 and >or=3 large nevi on the body compared with none were 2.9 (95% CI: 1.9, 4.3) and 7.1 (95% CI: 4.7, 11.6), respectively. The relative heterogeneities among studies were small for most measures of nevus phenotype, except for the analysis of nevus counts on the arms, which may have been due to methodological differences among studies. The pooled analysis also suggested that an abnormal nevus phenotype is associated most with melanomas on intermittently sun-exposed sites. The presence of increased numbers of nevi, large nevi and clinically atypical nevi on the body are robust risk factors for melanoma showing little variation in relative risk among studies performed at different latitudes.     

Application of immunocytochemistry and BRAF mutational analysis to direct smears of metastatic melanoma

BACKGROUND:

The cytodiagnosis of melanoma in fine‐needle aspiration (FNA) specimens can be challenging, often requiring the use of immunocytochemistry. As constitutively activating mutations in the BRAF oncogene are present in at least 40% of melanomas, the use of FNA material to interrogate the BRAF mutational status is likely to increase. Because cell blocks, traditionally used for these studies, can occasionally exhibit insufficient tumor cellularity, the authors investigated the utility of direct smears for immunocytochemistry and BRAF mutational analysis.

METHODS:

Immunocytochemistry for S‐100, HMB‐45, and Mart‐1 was prospectively performed on direct smears in 17 FNAs of metastatic melanoma. Next, BRAF sequencing was performed using DNA isolated from archived Diff‐Quik–stained direct smears for 15 cases. In parallel, sequencing was performed using DNA obtained from corresponding cell blocks.

RESULTS:

S‐100 positivity in the tumor cells was observed in all 17 cases. HMB‐45 and Mart‐1 positivity was noted in 81% and 88% of cases, respectively. All 3 markers were positive in 76% of cases. Next, of the 15 archived melanoma FNAs tested, BRAF mutations were observed in 8 (53%); 5 and 3 melanomas harbored the V600E and V600K mutation, respectively. Corresponding cell blocks were also tested for all 15 cases, yielding concordant BRAF results in 14 (93%); 1 cell block yielded a false‐negative result.

CONCLUSIONS:

Cytologic direct smears represent a robust and valuable source of cellular material for immunocytochemistry and molecular studies, especially in instances in which inadequate cell block cellularity is anticipated or encountered. Cancer (Cancer Cytopathol) 2012. © 2011 American Cancer Society.