Primary pleomorphic malignant fibrous histiocytoma of the heart

Primary pleomorphic malignant fibrous histiocytoma of the heart is rare. The present study was performed to study the clinical and pathological features of the disease. We describe two rare cases of primary cardiac malignant fibrous histiocytoma and review the published individual data of the patients. Both patients complained of dyspnea, and underwent palliative tumor resection. However, they died several months after surgery. A thorough literature review with clinical presentations, diagnostic features, treatment, and outcomes was done. We have for the first time analyzed the factors related to the survival of malignant fibrous histiocytoma. It is usually difficult to make an appropriate preoperative diagnosis. Despite complete surgical resection and aggressive chemotherapy and radiotherapy, the prognosis is still poor.     

Pseudomalignancies of the head and neck

Pseudomalignancies are benign or reactive lesions that mimic malignant neoplasms either clinically or histologically. In the head and neck region there are a number of pseudomalignancies that may present to a histopathologist, including soft tissue lesions, benign odontogenic tumours and salivary gland pathology. In this review we discuss common pseudomalignant lesions that may present in the head and neck, including their clinical presentation, histopathological features and differential diagnosis.     

肺多形性癌23例临床及病理分析

目的：探讨肺多形性癌（pleomorphic carcinoma,PC）的临床表现、手术方式、病理特点及预后。方法回顾性分析我院胸外科2010年1月～2014年3月收治的23例肺多形性癌患者的临床及病理资料。结果23例患者发病年龄为35～75岁,平均年龄（54±11）岁,其中男16例,女7例,男女比为2．3∶1。17例患者有既往大量吸烟史,吸烟指数为400～1200,平均（688±225）。患者常见首发症状为咳嗽、痰中带血或咯血。术前纤维支气管镜检查难以确诊。23例患者中行肺癌根治术22例,行肿块活检术1例。23例患者中含有恶性上皮成分和多形性成分19例,4例仅含多形性成分,多形性成分中可见 CK 阳性表达。23例患者均获得随访,最长生存时间为18个月,仍存活,中位生存期12个月。结论肺多形性癌好发于中老年男性吸烟患者,免疫组织化学检查有助于明确诊断,外科手术为主要治疗方法。肺多形性癌预后差。     

临床路径在腮腺多形性腺瘤手术治疗中的应用研究

目的:探讨临床路径在腮腺多形性腺瘤手术治疗中应用的意义。方法:选择63例腮腺多形性腺瘤接受手术治疗的住院病例。随机抽取34例按临床路径的流程进行治疗和护理(路径组),29例按传统常规程序进行治疗和护理(对照组),在住院天数、住院总费用、患者满意度及临床疗效方面进行分析和比较。结果:进入临床路径组平均住院天数由过去的(13.4±3.6)d下降到(6.2±1.8)d(P<0.05),平均住院费用由6050±451元下降至4100±362元(P<0.05),患者满意度由86.8%上升至95.4%,路径组与对照组比较除涎瘘发生率略高外,余无明显差异。结论:临床路径作为一种科学的医疗护理模式,可使患者获得最佳医疗护理服务,明显降低了住院费用,减少了住院天数,有效提高患者满意度。     

Pleomorphic adenoma of the buccal salivary gland: magnetic resonance imaging findings with differential diagnoses

The majority of minor salivary gland tumors are malignant. Of the benign tumors, pleomorphic adenomas are most common. The cheeks, lips, and gingiva are rarely sites of occurrence. A case of pleomorphic adenoma of the buccal salivary gland is presented here with a discussion of the importance of magnetic resonance imaging in demonstrating the extent of the lesion and establishing a differential diagnoses.     

Parapharyngeal chordoma: A diagnostic challenge and potential mimic of pleomorphic adenoma on fine‐needle aspiration cytology

Chordomas are rare tumors that are usually located in the sacrococcygeal and sphenooccipital region. Their cytologic diagnosis is rather straightforward when sampled by fine‐needle aspiration (FNA) from these characteristic locations, especially when physalipherous cells are present. However, chordomas may pose difficult diagnostic challenges when encountered in unusual locations, such as the parapharyngeal region. We report the cytologic findings of a recurrent chordoma sampled through transoral FNA from the parapharyngeal space of a 66‐year‐old woman. As the prior history of chordoma was not available during the rapid onsite evaluation, the presence of bland epithelioid nonvacuolated cells and spindle cells intimately admixed with a fibrillary, intensely metachromatic material led to an initial diagnosis of pleomorphic adenoma. Review of the patient's prior pathology specimen and of the Papanicolaou‐stained smears and cellblock sections showing rare multivacuolated (physalipherous) cells led to the correct diagnosis, which was supported by immunoperoxidase stains (cytokeratin AE1/AE3+, S100+, GFAP?). A review of the literature found no previous instances in which chordomas mimicked pleomorphic adenoma on FNA. However, since the two tumors show significant cytomorphologic overlap, including the presence of abundant fibrillary matrix with embedded neoplastic cells and single bland spindle and epithelioid tumor cells with occasional intranuclear pseudoinclusions, we compared their cytologic features. A review of the FNA cytologic features of this case of chordoma and of 17 consecutive cases of pleomorphic adenoma found that the presence of a more abundant, focally vacuolated cytoplasm favors chordoma over pleomorphic adenoma. Diagn. Cytopathol. 2013. © 2011 Wiley Periodicals, Inc.     

A Case of Carcinoma Ex Pleomorphic Adenoma in the Buccal Mucosa: Review of the Literature

We present a case of carcinoma ex pleomorphic adenoma on the right buccal mucosa in a 52-year-old Japanese woman. Based on the histopathology, the excised tumor was the non-invasive type, but the majority of the tumor consisted of poorly-differentiated adenocarcinoma cells. We performed proton radiation after the surgery. The patient was well, without evidence of disease, 48 months after surgery. Carcinoma ex pleomorphic adenoma in the buccal mucosa has been reported in only four cases during the past twenty years. Therefore, our case was comparatively rare.     

基质金属蛋白酶在涎腺良、恶性多形性腺瘤中的表达

目的:检测基质金属蛋白酶2(MMP-2)、膜型基质金属蛋白酶1(MT1-MMP)、基质金属蛋白酶组织抑制剂2(TIMP-2)及细胞外基质金属蛋白酶诱导因子(EMMPRIN),在人正常涎腺组织和涎腺良、恶性多形性腺瘤中的表达,探讨其表达的生物学意义。方法:通过免疫组织化学技术SP法检测人66例正常涎腺组织、45例涎腺多形性腺瘤及42例涎腺恶性多形性腺瘤中,MMP-2、MT1-MMP、TIMP-2及EMMPRIN的表达,采用χ2检验比较3种组织中MMP-2、MT1-MMP、TIMP-2及EMMPRIN表达的差异。结果:MMP-2在人正常涎腺组织,涎腺良、恶性多形性腺瘤中的阳性表达率分别为9.09%、46.67%、85.71%;MT1-MMP在以上3种组织中的阳性表达率分别9.09%、53.33%、78.57%;TIMP-2在以上3种组织中的阳性表达率分别为10.61%、44.44%、59.52%;EMMPRIN在以上3种组织中的阳性表达率分别为13.64%、48.89%、83.33%。MMP-2、MT1-MMP、TIMP-2及EMMPRIN在涎腺多形性腺瘤中的表达显著高于人正常涎腺组织,且MMP-2、MT1-MMP及EMMPRIN在涎腺良、恶性多形性腺瘤中表达的差异有统计学意义。结论:在涎腺多形性腺瘤中,MT1-MMP、TIMP-2及EMMPRIN的表达与MMP-2的活化有关,且MMP-2、MT1-MMP、TIMP-2及EMMPRIN有可能作为判断多形性腺瘤侵袭性的有效指标。