Axillary lymph‐node metastases as the primary presentation of high‐grade serous ovarian carcinoma: A case report

We reported a female presented with an initial diagnosis of metastatic axillary lymph‐node carcinoma that comprehensive assessments revealed a definitive diagnosis of high‐grade serous ovarian carcinoma as the primary tumor.     

Plantar fasciitis and impaired vision: A case report

We report a case of acute bilateral central serous chorioretinopathy in a patient who received a local injection of triamcinolone for the treatment of plantar fasciitis. Central serous chorioretinopathy is a serious, though rare, ocular complication of steroid treatment and it may occur even when the steroid is administered at a site as remote from the eye as the foot. This case report highlights the need for greater awareness of this complication amongst all medical personnel who prescribe steroids. It is advisable that patients, undergoing steroid treatment for any cause, be alerted to the risk of sudden visual impairment.     

Differentiating reactive mesothelial cells from metastatic adenocarcinoma in serous effusions: The utility of immunocytochemical panel in the differential diagnosis

Differentiating reactive mesothelial cells (RMs) from metastatic adenocarcinoma cells (MAC) in serous fluids based on cytomorphologic features alone can be very challenging. Various immunocytochemical (ICC) markers have been used to maximize the diagnostic accuracy, however, cytopathologists still encounter difficulties in effusion cytologic diagnosis. The aim of this study was to evaluate previous and recent ICC stains to identify the most sensitive and specific markers and the best panel for differentiating RM from MAC. Cell block sections from 41 MAC and 43 RM effusions cases were subjected to ICC staining for MOC‐31, BerEp4, carcinoembryonic antigen (CEA), calretinin, HBME‐1, CK5/6, and D2‐40. For the MAC cases, the sensitivity of BerEp4, MOC‐31, and CEA was 82.9, 92.6, and 17%, respectively, and the specificity was 95.3, 93, and 100%, respectively. For the RM cases, the sensitivity of calretinin, CK5/6, D2‐40, and HBME‐1 was 95.3, 27.9, 58.1, and 93%, respectively, and the specificity was 70.7, 73.1, 75.6, and 82.9%, respectively. The results show that BerEp4 and MOC‐31 are highly sensitive and specific for detecting MAC, whereas calretinin and HBME1 are highly sensitive but only modestly specific for detecting RM cases (P < 0.05). Forced entry logistic regression revealed that using MOC‐31, BerEp4, HBME‐1, and calretinin, is an excellent panel for making correct diagnosis with 97.6% sensitivity in detecting MAC and 90.7% specificity in detecting RM. We conclude that adding a panel of MOC‐31, BerEp4, calretinin, and HBME‐1 immunostains to routine cytomorphologic features can greatly enhance the diagnostic accuracy of serous effusions. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

MMP-2和CD_(44)V_6基因蛋白在卵巢浆液性肿瘤中的表达及临床意义

目的探讨MMP-2和CD_(44)V_6的表达与卵巢浆液性肿瘤侵袭和转移的关系。方法应用流式细胞免疫法定量检测MMP-2和CD_(44)V_6在45例卵巢浆液性肿瘤中的表达。结果MMP-2在卵巢浆液性癌中的表达明显高于卵巢浆液性瘤(P<0.05),且与卵巢浆液性癌组织分级和临床分期密切相关(P<0.05)。CD_(44)V_6在卵巢浆液性癌中的表达明显高于卵巢浆液性瘤(P<0.05),且与卵巢浆液性癌组织分级和临床分期密切相关(P<0.05)。MMP-2和CD_(44)V_6在卵巢浆液性癌中的表达密切相关(P<0.05)。结论卵巢浆液性癌中MMP-2和CD_(44)V_6的高表达促进了癌的侵袭和转移,MMP-2和CD_(44)V_6在卵巢浆液性癌中的表达有相关性。提示MMP-2和CD_(44)V_6的共同检测可作为诊断和判断预后的参考指标。     

中心性浆液性脉络膜视网膜病变患眼的调节功能

目的研究中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)患眼与健眼的调节功能及其影响因素。方法分别对31例原先为正视眼的单眼活动期CSC患眼及健眼进行调节幅度、调节灵活度、调节滞后量的测定。结果在调节幅度的检测中,患眼组的调节幅度值平均为(4.89±1.28)D,健眼组的调节幅度值平均为(6.58±1.53)D,两者相比较差异有显著性(P<0.01);调节灵活度测量结果显示患眼组比健眼组明显要慢,患眼组的调节灵活度为(3.16±2.36)cpm,健眼组的调节灵活度为(5.84±2.41)cpm,两组相比较差异有显著性(P<0.01);在调节滞后的测量中,患眼组大多集中在0.75～1.25D之间,健眼组大多在0.50～0.75D之间,患眼组的调节反应明显滞后于健眼组,两组相比较差异有显著性(P<0.01)。结论CSC患眼的调节功能低于健眼的调节功能。     

视网膜静脉阻塞继发黄斑部浆液性视网膜脱离临床观察

目的观察视网膜静脉阻塞（retinal vein occlusion,RVO）继发黄斑部浆液性视网膜脱离的发病情况和临床特点。方法收集2005年5月至2006年4月在我院就诊的96例（97眼）视网膜中央静脉阻塞和视网膜分支静脉阻塞患者,对其眼底荧光血管造影和光学相干断层扫描检查的结果进行分析。结果97眼中有48眼继发黄斑部浆液性视网膜脱离,黄斑部脱离高度为66～937μm,平均（293.21±56.26）μm,脱离范围大多局限于中心凹。4眼严重者脱离可达近下方血管弓处,脱离边缘可见视网膜下积血。在RVO继发黄斑囊样水肿患者中,同时继发黄斑部浆液性视网膜脱离的占53.03%.结论RVO继发黄斑部浆液性视网膜脱离的发病率远高于以往报道,是引起RVO患者视力下降的主要原因之一,治疗中应给予充分的重视。     

Technical Note: Method for estimating volume of subretinal fluid in cases of localized retinal detachment by OCT ophthalmoscopy

The volume of the subretinal fluid can be used to assess the condition of different types of retinal and macular disorders. The purpose of this report is to introduce a method to measure the volume of the subretinal fluid with the images of the optical coherence tomography (OCT) Ophthalmoscope in three cases of central serous chorioretinopathy and one case of retinal pigment epithelial detachment. We used the topography-mode program of the OCT Ophthalmoscope and measured the average height of the retinal detachment. By multiplying the size of the area of the retinal detachment and the average height of the retinal detachment, the volume of subretinal fluid could be determined. Examples are given to show the results of volume measurement of subretinal fluid in cases of localized retinal detachments.     

中心性浆液性脉络膜视网膜病变的黄斑光敏感度近期观察

目的探讨黄斑光敏感度在中心性浆液性脉络膜视网膜病变病程中的近期变化。方法对正常人20例20眼和中心性浆液性脉络膜视网膜病变患者57例61眼初诊时及治疗后用Humphrey750型自动视野仪行黄斑光阈值测定,结果以dB值表示。根据初诊时及治疗后患者的眼底情况将病例分为轻中重三个层次进行统计学分析：①A组：就诊时黄斑部浆液性渗出范围在0.5～1PD之间,研究结束时渗出完全吸收,计18例20眼;②B组：就诊时黄斑部浆液性渗出范围在1～2PD之间,研究结束时渗出吸收超过50%,计22例24眼;③C组：就诊时黄斑部浆液性渗出范围在1.5～3PD之间,研究结束时渗出吸收低于50%,计17例17眼。结果中心性浆液性脉络膜视网膜病变患者黄斑光敏感度下降,治疗后视力上升,同时黄斑光敏感度均有不同程度的提高。光敏感度变化与视力呈正相关。结论黄斑光敏感度检查可定量地追踪中心性浆液性脉络膜视网膜病变患者的视功能变化,并可作为预后判定的可靠指标。