卵巢颗粒细胞瘤预后影响因素的分析

目的 探讨卵巢颗粒细胞瘤临床、病理因素对预后的影响。方法 回顾性分析我院１９５８年至１９９５年收治的１００例卵巢颗粒细胞瘤患者的年龄、临床分期、核分裂相及早期患者的治疗方法选择等因素与预后的,并对复发与未复发患者,近期复发（〈１０年）与远期复发（≥１０年）患者进行比较。结果 全组总的５年和１０年生存率分别为８０％和７２％。不同年龄患者（≥４０岁,〈４０岁）的５年和１０年生存率,分别比较,差异无显著性（Ｐ〉０．０５）。临床分期为Ⅰ期者５年和１０年生存率分别为９８％和９６％,Ⅱ期分别为７０％和６０％,Ⅲ～Ⅳ期均为０％;外院治疗后复发或未控者５年和１０年生存率分别为５８％和４０％,分别比较,差异均有显著性（Ｐ均〈０．０５）。４７例有核分裂相计数的患者中,核分裂相〈５／１０高倍视野（ＨＰＦ）的５年和１０年生存率均为９６     

Histogenesis of granular cell tumour--an immunohistochemical and ultrastructural study

Fifteen cases of granular cell tumour of superficial soft tissues or tongue were immunohistochemically evaluated for different types of intermediate filament proteins and for laminin, a glycoprotein of basal laminae. Four of the tumours were studied ultrastructurally. The tumour cells appeared to contain only vimentin-type of intermediate filament protein. The lobules of tumour cells were surrounded by laminin-positive material, but in contrast to schwannomas and neurofibromas, the individual tumour cells were not covered by laminin. In line with the immunohistochemical observations, by electron microscopy basal lamina-like material could not be demonstrated between individual cells, but only surrounding groups of cells. Lysozyme, a histiocytic marker, was absent in the tumour cells. Our results do not confirm any particular cell type for the histogenetic origin of granular cell tumour, but suggest that it may rather be derived from uncommitted possibly nerve-related mesenchymal cells.     

Ultrastructural changes of the lateral vestibular nucleus in acute experimental thiamine deficiency

Summary This report deals with an ultrastructural study of the lateral vestibular nucleus of 12 rats with acute thiamine deficiency (Group A), 6 rats made deficient but subsequently given a thiamine-supplemented diet and sacrificed when asymptomatic (Group B), and 6 normal controls (Group C). In Group A the most striking changes were observed in the presynaptic boutons and consisted of proliferation of granular-surfaced juxtaposed cisterns, proliferation of smooth-surfaced tubulovesicular cisterns resembling SER, and hypertrophy of the boutons. Other alterations were increased density of the axoplasm, an increased number of mitochondria, a decreased number of synaptic vesicles and necrosis of the matrix. The axons displayed similar assemblies of granular as well as smooth-surfaced cisterns. Moreover, they exhibited fusiform swellings with an increased number of mitochondria, densification of the axoplasm and loss of neurofilaments and microtubules. Although Groups B and C occasionally revealed similar changes in the terminal boutons, these were much less frequent. It is believed that the alterations occurring in acute thiamine deficiency primarily affect the presynaptic boutons and axons, and are for the most part, reversible under the proper treatment.Supported in part by Public Health Service Grant FR 5360-08.     

Oncocytic ependymoma: A new morphological variant of high-grade ependymal neoplasm composed of mitochondrion-rich epithelioid cells

Oncocytomas are defined as tumors containing in excess of 50% large mitochondrion-rich cells, irrespective of histogenesis and dignity. Along the central neuraxis, oncocytomas are distinctly uncommon but relevant to the differential diagnosis of neoplasia marked by prominent cytoplasmic granularity. We describe an anaplastic ependymoma (WHO grade III) with a prevailing oncocytic component that was surgically resected from the right fronto-insular region of a 43-year-old female. Preoperative imaging showed a fairly circumscribed, partly cystic, contrast-enhancing mass of 2 cm × 2 cm × 1.7 cm. Histology revealed a biphasic neoplasm wherein conventional ependymal features coexisted with plump epithelioid cells replete with brightly eosinophilic granules. Whereas both components displayed an overtly ependymal immunophenotype, including positivity for S100 protein and GFAP, as well as “dot-like” staining for EMA, the oncocytic population also tended to intensely react with the antimitochondrial antibody 113-1. Conversely, failure to bind CD68 indicated absence of significant lysosomal storage. Negative reactions for both pan-cytokeratin (MNF 116) and low molecular weight cytokeratin (CAM 5.2), as well as synaptophysin and thyroglobulin, further assisted in ruling out metastatic carcinoma. In addition to confirming the presence of “zipper-like” intercellular junctions and microvillus-bearing cytoplasmic microlumina, electron microscopy allowed for the pervasive accumulation of mitochondria in tumor cells to be directly visualized. A previously not documented variant, oncocytic ependymoma, is felt to add a reasonably relevant novel item to the differential diagnosis of granule-bearing central nervous system neoplasia, in particular oncocytic meningioma, granular cell astrocytoma, as well as metastatic deposits by oncocytic malignancies from extracranial sites.     

Granular Cell Tumor of the Cervical Esophagus: Case Report and Literature Review of an Unusual Cause of Dysphagia

Granular cell tumors (GCT) of the head and neck are not uncommon; however, involvement of the cervical esophagus is rare. Characterized by an infiltrative growth pattern, these benign tumors are historically difficult to surgically excise and are radioresistant. We present here a case of dysphagia caused by a GCT of the cervical esophagus. Work up with ultrasound-guided fine needle aspiration was suggestive of a GCT due to the presence of cohesive cells with granular cytoplasm that were S-100 and CD68 positive with immunostaining, and PAS positive with histochemistry. Resection required removal of a portion of the muscular wall of the esophagus sparing the overlying mucosa. The patient is currently asymptomatic and without recurrence after 10 month follow-up. Review of the literature revealed 19 reports of cervical esophageal GCTs. There is a female preponderance (75 %), with an average age of 41 years. Dysphagia and weight loss are the most common presenting symptoms. The average tumor size on presentation was 2.7 cm, with symptomatic tumors being significantly larger than asymptomatic lesions; the latter was present in 25 % of patients. Concurrent GCTs in the upper aerodigestive tract were identified in 35 % of cases. Approximately 30 % of tumors required segmental cervical esophageal resection. The purpose of this report is to describe the epidemiology and treatment of GCTs of the cervical esophagus. Lesions should be addressed early with complete surgical excision to prevent growth necessitating more morbid surgery. Due to the high rate of concurrent GCTs, upper endoscopy is advised in the workup of these patients.     

Granular cell tumour of the ulnar nerve in a young adult

Granular cell tumours in peripheral nerve trunks are extremely rare. We report a case of a granular cell tumour of the ulnar nerve just distal to the elbow in a 16-year-old man. The appearance of the intraneural tumour could not be differentiated by magnetic resonance imaging (MRI) from more common nerve tumours. At exploration it was impossible to excise the tumour radically. Microscopic examination showed a clearly benign tumour and no malignant transformation has been found at follow-up after three and a half years.     

骨康宁冲剂治疗骨质疏松的药效学研究

目的观察骨康宁冲剂对骨质疏松的防治作用。方法采用维甲酸致大鼠骨质疏松模型、高分子右旋糖酐致大鼠高黏滞血症模型以及小鼠镇痛模型。结果与模型对照组比较,骨康宁明显升高骨质疏松大鼠的骨质量、骨密度、骨强度、TBV、血钙、骨灰质量、骨钙、骨磷,明显降低尿钙;明显降低高黏滞血症大鼠的全血黏度;明显延长小鼠痛阈、减少扭体次数。结论骨康宁冲剂对大鼠骨质疏松具明显的防治作用。     

Granular cell tumour in the third ventricle

Summary A rare granular cell tumour was found in the third ventricle of a 56-year-old woman. Histological and electron-microscopic features obtained from the biopsy material were identical to those of previously recorded cases. Immunohistochemical study demonstrated vimentin but not S-100 protein in the tumour cells. The possibility should be re-considered that granular cell tumours may have more than one cell of origin.