Simultaneous Pulmonary Leiomyosarcoma and Leiomyoma in Pediatric HIV Infection

The case of a 7-year-old girl with acquired immunodeficiency syndrome treated for 5 years with AZT and intravenous gamma globulin is reported. Shortly before her demise she developed a pulmonary leiomyosarcoma and leiomyoma. Does prolonged survival in pediatric acquired immune deficiency syndrome increase the incidence of secondary malignancies?     

皮肤交界性平滑肌瘤的复发与恶性转化

目的探讨皮肤交界性平滑肌瘤的复发与恶性转化。方法复习2例皮肤交界性平滑肌瘤及其复发恶性转化的临床病理特征、免疫组化表型及相关文献。结果2例病变位于下肢和额部，肉瘤组织平滑肌标记阳性。结论少数病理诊断为皮肤平滑肌瘤的病例，虽然浅表且组织形态良性，但其生物学恶性潜能尚不能确定，部分病例复发后可转变为典型的平滑肌肉瘤。     

Detection of Epstein Barr virus in an hepatic leiomyomatous neoplasm in an adult human immunodeficiency virus 1-infected patient

We report the first case of a human immunodeficiency virus (HIV)-related primary hepatic leiomyoma in an adult patient. The diagnosis was made at autopsy and confirmed by immunohistochemistry. Epstein Barr virus (EBV) was identified in tumour cells by in situ hybridization. Review of the literature revealed 13 cases of visceral myogenic tumours occuring in acquired immunodeficiency syndrome children, and only 2 cases in adults. One was a spinal epidural leiomyoma, the other multiple smooth muscle tumours of the colon and adrenal gland. This is the first report of EBV in smooth muscle neoplastic cells in an HIV-infected adult patient.     

A case of multiple leiomyomatous lesions of the lung: An analysis of flowcytometry and hormone receptors

A 36 year old woman was admitted to our department because of a chest X-ray which showed multiple developing shadows. She underwent bilateral exploratory thoracotomies and a total 5 tumors were resected and pathologically diagnosed as benign metastasizing leiomyoma, the largest of which was positive for the progesterone receptor and negative for the estrogen receptor. A histogram of this tumor using a flow cytometer showed a diploid pattern and 4.6 percent of the S phase which was not more than that of a leiomyoma of the uterus from another patient. Two months later, she underwent a hysterectomy and bilateral salpingo-oophorectomy for treatment of the positive progesterone receptor in the pulmonary lesions. The resected uterine myoma and normal myometrium showed positive estrogen and progesterone receptors. For the subsequent 28 months she has been free of any further symptoms. Benign metastasizing leiomyoma of the uterus is a rare disease and very interesting because of its histological benignity and hormonal dependency. However, according to the literature, it is often confused in entity due to the fact that normal lung tissue also possesses hormone receptors. Considering our data on hormone receptors, it is rational to think that multiple leiomyomatous lesions in the lung should only be diagnosed as benign metastasizing leiomyomas when they possess positive estrogen and progesterone receptors.     

子宫内膜间质肉瘤7例临床病理分析

本文对6例子宫内膜间质肉瘤,1例间质结书观察,平均发病年龄37岁,临床多误诊为平滑肌瘤,肿瘤表现出肿块状、息肉状、浸润状多种病理大体形态,核分裂相多少与病变程度不一致,所以,核分裂相不能作为单一诊断恶性程度指标,免疫组织化学染色7例Vi－mentin阳性结果。4例MSA阳性结果,说明该肿瘤有向平滑肌分化趋势,3例病例肿瘤组织中伴有卵巢性索样结构。     

Congenital leiomyoma of the distal ileum associated with ileal atresia and malrotation

A leiomyoma of the small bowel in a neonate was found causing luminal occlusion and was associated with malrotation. This association and the lack of intestinal mucosa at the level of the tumor suggest that the growth originated at or near the solid core stage of intestinal development.     

子宫肌瘤与孕激素及细胞凋亡的相关研究

目的　通过检测孕激素受体 (PR)、增殖细胞核抗原 (PCNA)、凋亡抑制基因Bcl- 2蛋白在子宫肌瘤组织中的表达 ,探讨子宫肌瘤的发生与孕激素及细胞凋亡的关系。方法　应用免疫组化SP法检测 30例子宫肌瘤及其邻近肌层组织中PR、PCNA、Bcl - 2的表达。结果　PR、PCNA、Bcl- 2在子宫肌瘤细胞中的表达明显高于其邻近肌层 (P <0 0 5 ,P <0 0 5 ,P <0 0 0 1)。PR的表达与PCNA、Bcl- 2的表达均呈正相关。结论　子宫肌瘤是卵巢性激素依赖性肿瘤。孕激素是促进子宫肌瘤生长的重要因素 ,子宫肌瘤与细胞凋亡有关     

子宫动脉栓塞加中药治疗子宫肌瘤疗效分析

目的 :研究子宫动脉栓塞加中药治疗子宫肌瘤的疗效。方法 :40例子宫肌瘤患者 ,采用Seldinger技术 ,穿刺股动脉成功后 ,行双侧子宫动脉超选择插管 ,分别注入 3 5 5～ 70 0 μmPVA颗粒栓塞子宫动脉 ;术后配合中药治疗。分别于术后 3个月、6个月、1年观察疗效。结果 :治疗成功率为 10 0 % ,临床症状逐渐改善、消失。 3个月复查肌瘤平均缩小 3 8 48% ,6个月平均缩小 5 7 40 % ,1年后复查无再增大者。结论 :子宫动脉栓塞加中药治疗子宫肌瘤有很好的临床应用价值     

钙调蛋白结合蛋白在子宫平滑肌肿瘤诊断中的意义

目的　探讨高度敏感和特异的诊断子宫平滑肌肿瘤的指标。方法　选取子宫内膜间质肉瘤 2 6例 ,子宫普通型和富于细胞性平滑肌瘤各 2 5例 ,子宫平滑肌肉瘤 17例 ,正常子宫肌层和正常子宫内膜各 2 5例 ,采用免疫组化 S-P法检测各种组织中结蛋白、平滑肌肌动蛋白、雌激素受体以及重型钙调蛋白结合蛋白 (h-caldesmon)的表达。结果　正常的子宫肌层、子宫普通型平滑肌瘤、富于细胞性平滑肌瘤和子宫平滑肌肉瘤中重型钙调蛋白结合蛋白的表达分别为 10 0 .0 %、10 0 .0 %、96.0 %和 64.7% ,但正常子宫内膜和子宫内膜间质肉瘤细胞中均未见其表达。重型钙调蛋白结合蛋白诊断富于细胞性平滑肌瘤不仅敏感度高于结蛋白 ,而且特异度达 10 0 .0 %。结论　重型钙调蛋白结合蛋白可辅助正确鉴别子宫富于细胞性平滑肌瘤和子宫内膜间质肉瘤     

DIAGNOSTIC IMPLICATIONS OF IMMUNOHISTOCHEMICAL MARKERS IN UTERINE SMOOTH MUSCLE TUMORS

Objective: To evaluate the diagnostic implications of immunohistochemieal markers in uterine smooth muscle tumors. Methods: Formalin-fixed paraffin-embedded tissue blocks were selected from 17 uterine leiomyosarcomas, 40 uterine unusual leiomyomas and 25 uterine usual leiomyomas. Utilizing immunohistochemical techniques with antigen retrieval, serial sections of each tumor for immunoreactivity with myogenic markers, ovarian steroid receptors, CD44v3, proliferating cell nuclear antigen and mast cells were assessed. Results: Although the myogenic markers and CD44v3 showed less frequent positivity in uterine leiomyosarcomas than those in unusual leiomyomas,they were not reliable markers for differentiating leiomyosarcoma from leiomyoma. Uterine leiomyosarcoma tended to have lower ovarian steroid receptors immunoreactivity rates than leiomyoma. Leiomyoma tended to have a higher quantity of intratumoral mast cells than leiomyosarcoma, while the expression of proliferating cell nuclear antigen was lower in them. Conclusion: Because the estimation of mitotic count was subject to significant variation, the immunohistochemical expression of ovarian steroid receptors, mast cells and proliferating cell nuclear antigen seemed to be helpful for the discrimination of unusual leiomyoma from leiomyosarcoma.