人胎儿肾上腺组织发生

本文观察１２￣２６周妊娠中期胎儿肾上腺１０例，结果显示，１２￣２６周胎儿肾上腺永久皮质尚未分带；临时皮质或胎儿皮质呈条索状及网状分带。１２周胎儿髓质细胞夹杂于临时皮质细胞之间，１８￣２２周髓质细胞位于肾上腺中轴。     

Immunohistochemical study on histogenesis of congenital epulis and review of the literature

Congenital epulis is a very rare lesion found only in newborn infants. This tumor is multiple in about 10% of reported cases, rarely with the simultaneous involvement of the maxilla and mandibula, as in this article. In the presented case, light microscopy demonstrated large eosinophilic granular cells arranged in solid nests that are separated by thin fibrovascular areas. The tumors In the maxilla and mandibula were investigated with a panel of polyclonal and monoclonal antibodies, and using immunoperoxidase methods on formalin-fixed, paraffin-embedded sections. Immunohistochemical studies revealed strong and diffuse cytoplasmic staining for neuron specific enolase and vimentin. However, all other reactions were negative. These results suggest that the congenital epulis may be derived from uncommitted nerve-related mesenchymal cells.     

脑膜瘤的免疫组化研究

脑膜瘤在光镜上显示明显的异质性,除间叶成分外,还存在上皮成分。脑膜瘤的组织发生学还有争论。为此我们对28例脑膜瘤应用免疫组化技术显示波形蛋白(Vim)、上皮膜抗原(EMA)、低分子角蛋白(10·11)、S-100蛋白(S-100)、角蛋白(KT)和癌胚抗原(CEA)。结果表明脑膜瘤除间叶组织标志 Vim 阳性外,部分还表达上皮组织标志,证实脑膜瘤的二元分化。根据脑膜瘤的光镜形态和免疫组化结果提示脑膜瘤来源于一种区别于纤维母细胞和血管内皮细胞的特殊细胞类型,可称之为脑膜上皮细胞,具有向间叶和上皮的分化潜能。     

Prichard's structures of the fossa ovalis are age-related phenomena composed of nonreplicating endothelial cells: the cardiac equivalent of cutaneous senile angioma

Prichard's structures or minute endocardial deformities with lacunas of capillary size lined by plump endothelial cells located in the fossa ovalis are an age-related alteration of unknown origin. In this report the histogenesis, the proliferative potential and the incidence in the aged of these structures are investigated. We have undertaken a prospective histological study of the fossa ovalis in a series of 111 consecutive hearts of patients aged >/=70 years obtained at autopsy. Included in this study was immunohistochemical staining for vimentin, CD31, CD34, thrombomodulin, c-kit (CD117), Ki67 (MIB1) and vascular endothelial growth factor receptor 2 in six cases showing these structures. Prichard's structures were observed in 50 hearts (45%), and were more frequent in males. We confirmed that these structures are age-related phenomena. Subendothelial structures were more common than intracavitary structures. Most individuals had Prichard's structures located on the right side; however, the structures were more numerous on the left side of the fossa ovalis. The immunohistochemical study revealed that Prichard's structures consisted of adult, fully differentiated, postmitotic-type endothelial cells. We suggest that Prichard's structures are formed by infolding of the endothelial lining of the endocardium of the fossa ovalis as an irritational response to altered blood flow, eddies or turbulence. A parallel can be established between Prichard's structures and senile angiomas as both structures increase with age; they are not genuine neoplasms; and they are overgrowths made up of endothelial cells with terminal differentiation. We propose that Prichard's structures are the cardiac equivalent of cutaneous senile angioma.     

Molecular histogenesis of plasmablastic lymphoma of the oral cavity

Plasmablastic lymphoma (PBL) of the oral cavity is an aggressive B-cell lymphoma associated with human immunodeficiency virus infection. Although the lymphoma phenotype is consistent with late B-cell maturation, the molecular histogenesis of PBL is unknown. We investigated PBL of the oral cavity (n = 12) for mutations of immunoglobulin variable heavy chain (IgVH) and BCL-6 genes, which are acquired by B cells at the time of germinal centre (GC) transit, and for expression of BCL-6, MUM-1 and CD138, which distinguish GC B cells from post-GC B cells. Somatic IgVH hypermutation occurred in 4/10 PBL whereas 6/10 PBL displayed germline IgVH genes. Among PBL carrying hypermutated IgVH genes, the pattern of IgVH mutations was consistent with antigen stimulation in two cases. Mutations of the BCL-6 gene were restricted to 1/12 patients with PBL of the oral cavity. All cases of PBL of the oral cavity displayed the BCL-6-/MUM-1+/CD138+ phenotype that is consistent with late stage of B-cell differentiation. Overall, these data indicate that, despite a common phenotype and an apparently similar degree of differentiation, PBL of the oral cavity are characterized by histogenetic heterogeneity. A subset of PBL of the oral cavity carried the molecular clues of GC transit and conceivably originated from a B-cell subset corresponding to post-GC B cells. Conversely, another fraction of these lymphomas were devoid of somatic IgVH mutations and appeared to originate from naive B cells that have undergone preterminal differentiation independent of GC transit.     

Thymic hormones in cancer diagnostics and treatment

The thymus is an endocrine organ. A unified, physiological concept of humoral regulation of the immune response emerged in the last three decades. The thymus is the primary major site of production of immunocompetent T-lymphocytes from their haematopoietic stem cells. The thymus provides a superior humoral microenvironment for the development of immunocompetent T-lymphocytes. Although yolk sac derived pre-T stem cells enter the thymus using a homing receptor, the immigration process requires also secretion of a peptide, called thymotaxin by the cells of the reticulo-epithelial (RE) network. This complex process requires direct cell to cell, receptor based interactions, as well as in situ paracrine information via the numerous cytokines and thymic hormones produced by the RE cells of thymic microenvironment. Thymic hormones induce in situ T-lymphocyte marker differentiation, expression and functions. These polypeptide hormones have also been shown by means of immunocytochemistry to localise in the RE cells of the thymic cellular microenvironment. Based on the complexity of the intrathymic maturation sequence of T-lymphocytes and the increasing numbers of T-lymphocyte subpopulations that are being identified, it would be surprising if a single thymic humoral factor could control all of the molecular steps and cell populations involved. Rather, it would appear that the control of intrathymic T-lymphocyte maturation and functional maturation involves a complex number of thymic-specific factors and other molecules that rigidly control the intermediary steps in the differentiation process. Thymosin fraction 5 (TF5) and its component polypeptides influence a variety of lymphocyte properties including cyclic nucleotide levels, migration inhibitory factor production, T-dependent antibody production and expression of certain surface maturation/differentiation markers. Recently, thymic hormones, mostly thymosins have been employed not only in neoplasms’ early detection but also in clinical trials to strengthen the effects of immunomodulators in immunodeficiencies, autoimmune diseases and neoplastic malignancies. Combined chemoimmunotherapeutical antineoplastic treatment seems to be useful. Generally, haematopoietic toxicity of every chemotherapeutical clinical trial can be reduced significantly by the immunotherapy, compared to 50% in patients treated with chemotherapy alone.     

卵巢黏液性囊腺瘤合并性索-间质肿瘤的临床病理观察

目的 探讨卵巢黏液性囊腺瘤合并性索-间质肿瘤(MCSC)的临床病理特点、组织起源及其诊断和鉴别诊断.方法 对1例MCSC进行组织形态学、免疫组化观察,并复习相关文献.结果 患者发现盆腔肿物1年,无明显不适及内分泌症状.大体上肿瘤为多房囊性,囊内壁可见散在的实性结节,镜检肿瘤由黏液性囊腺瘤和性索间质肿瘤两种成分组成,前者囊壁衬覆良性肠型黏液柱状上皮,性索间质成分瘤细胞呈小管状、条索状、梁状排列,局部有黄素化,两种成分混合存在,未见移行.免疫组化:性索成分瘤细胞呈Melan A弥漫强阳性;αInhibin和CD56局灶阳性;并见CKpan、vimentin、ER及PR的阳性表达;而EMA、CEA、CD99、S-100、CgA、Syn、nestin及SMA均阴性;Ki-67指数小于5%.结论 MCSC是罕见的卵巢肿瘤,性索间质成分可能是黏液性囊腺瘤囊壁内间质的一种反应性增生.诊断时需与类癌、伴异源成分的支持-间质细胞瘤、畸胎瘤等鉴别.     

Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients

Abstract. Nishimura N, Hachisuga T, Saito T, Kawarabayashi T. Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients.
This study aimed to detail the clinicopathologic features of endometrial carcinomas that developed in Japanese patients receiving adjuvant tamoxifen treatment for breast cancer patients. Ten endometrial carcinomas in tamoxifen-treated breast cancer patients were collected from two medical centers. The endometrial carcinomas included two stage Ia, four stage Ib, two stage Ic and two stage IIIc. Three tumors were Grade 1, six were Grade 2, and one was Grade 3. The tumor was limited to the endometrium in two cases. Myometrial invasion was limited to the inner half of the myometrium in five cases and involved the outer half in three. A mild degree of lymphovascular space invasion was identified in five cases. Deep cervical invasion was recognized in one case. The cell types comprised nine endometrioid adenocarcinomas and one serous carcinoma. Five of eight postmenopausal endometrial carcinomas were associated with polypoid endometrial lesions composed of cystically dilated atrophic and proliferative glands widely separated by fibrotic stroma. Two patients with retroperitoneal lymph node metastases died of endometrial cancer. One patient developed a contralateral breast cancer during tamoxifen treatment. No patient died of breast cancer. We did not demonstrate a higher frequency of either high-grade tumors or unfavorable histologic subtypes in tamoxifen-treated Japanese breast cancer patients.     

并发于肝胆管结石的肝胆管癌的组织发生

通过10例肝胆管结石并发肝胆管癌及75例肝胆管结石病的组织结构及粘液组化观察发现;肝胆管癌的癌组织富于唾液酸粘液,胆石病异型增生的上皮及腺体分别与胆管乳头状腺癌及管状腺癌在形态结构、粘液性质与分布上有相似之处,提示乳头状腺癌及管状腺癌可能分别发源于胆管上皮及腺体,后者为胆石引起的肝胆管癌的主要组织来源。     

Müllerian adenosarcorna of the cervix: Differentr'al diagnosis, histogenesis and review of the literature

A new cam is reported of müllerian adenosarcoma, presenting as a 'benign cervical polyp' protruding through the vulva of a 44 yearold woman admitted with abnormal vaginal bleeding. This report emphasizes the importance of a careful examination of the stroma and special features of the entrapped glands in order to contribute to an earlier and proper diagnosis. The literature is reviewed and the probable histogenesis of this tumor and differential diagnosis with embryonal rhabdomysarcoma (sarcoma botryoides), adenofibroma, malignant mesodermal tumor and carcino-sarcoma is discussed.