胃血管球瘤1例及文献复习

目的:探讨胃血管球瘤的病理学特点及临床表现。方法:对1例胃血管球瘤进行组织学表现、免疫组化染色观察及文献复习。结果:组织学特点:肿瘤细胞围绕薄壁血管呈实性排列,大小一致,圆形或多角形,胞质丰富红染或透亮,界限清楚。免疫组化特点:肿瘤细胞表达SMA(++)、Vimentin(+++)。结论:胃血管球瘤是胃一种少见的肿瘤,易误诊为胃肠间质瘤、平滑肌瘤及类癌,可以通过免疫组化染色及形态学观察进行鉴别诊断。     

肝脏假性淋巴瘤的临床病理学研究及分析

目的:探讨肝脏假性淋巴瘤的临床病理特征、免疫表型及鉴别诊断。方法:在光学显微镜下对肝脏假性淋巴瘤进行组织学形态观察,并借助免疫组化进一步对其形态进行分析。由于原发于肝脏的假性淋巴瘤极为罕见,故本文将报道一例发生于肝脏的假性淋巴瘤,结合文献探讨其临床病理特点,以提高诊断及鉴别诊断水平。结果:大体上为切面可见灰白结节,结节切面灰白色,质地中等,与周围分界清,周围肝组织灰红质软。显微镜下组织学表现为肝周边淋巴结淋巴组织增生,细胞大小较一致,核圆形,细胞无异型,未见明显核分裂,其中见嗜酸性白细胞浸润及少数异型细胞。免疫组化显示肿瘤细胞表达CD3、CD20及CD30。结论:肝脏假性淋巴瘤为罕见的、良性淋巴组织增生性病变,形态学特征、免疫组化染色在肝假性淋巴瘤诊断中具有重要价值。在临床病理实践中,必须首先与常见的发生于该部位恶性肿瘤如霍奇金淋巴瘤肿瘤等鉴别。     

甲状腺上皮样血管内皮瘤临床病理及分子生物学特点分析

为探讨甲状腺上皮样血管内皮瘤的病理形态特征、免疫表型和鉴别诊断,对2例甲状腺上皮样血管内皮瘤进行临床资料分析、随访,并观察其病理形态及免疫组织化学染色分析。2例甲状腺上皮样血管内皮瘤均位于甲状腺下极,实性,切面暗红色,镜下由增生的血管内皮细胞构成,具有上皮样细胞形态,胞浆较丰富,嗜酸性,多呈空泡状,细胞间可见血管腔,免疫组化:CD34(+)、Vim(+)、细胞角蛋白(cytokeratin,CK)(-)、甲状腺球蛋白(thyroid globulin,TG)(-)。上皮样血管内皮瘤是一种罕见的甲状腺肿瘤,其生物学行为属于低度恶性。     

乳腺纤维瘤病样化生性癌临床病理分析

目的探讨乳腺纤维瘤病样化生性癌的临床病理学特点及免疫组化特征。方法收集并分析1例纤维瘤病样化生性癌病例的临床特征及病理资料,进行HE染色和免疫组化标记,并复习文献。结果组织学乳腺纤维瘤病样化生性癌大部分区域为温和的梭形细胞,仅于靠近导管区域细胞密集,并伴轻-中度异型,可见假血管瘤样、黏液样间质,并见胶原化,肿瘤周边可见乳腺增生性病变;免疫组化标记,梭形细胞既表达上皮标记CK(AE1/AE3)、CKH(34βE12)和CK7,,也表达肌上皮的相关标记CK5/6、p63、CD10,而ER、PR、HER-2、SMA、desmin、CD34、CD117和S-100均阴性。随访13个月,尚未发现复发或转移。结论乳腺纤维瘤病样化生性癌是乳腺化生性癌的一种亚型,诊断时需结合组织学特点及免疫标记表达情况,注意与乳腺相关的梭形细胞病变相鉴别。     

卵巢囊性颗粒细胞瘤的临床病理学特征、诊断及鉴别诊断

目的:探讨卵巢囊性颗粒细胞瘤的临床病理学特征、诊断和鉴别诊断要点。方法:复习1例卵巢囊性颗粒细胞瘤患者的临床资料、肿物的大体以及镜下病理组织学特征、免疫组化染色特征。结果:患者左侧单房囊性颗粒细胞瘤,大小为14.6 cm×18.9 cm×9.8 cm,囊壁厚薄不均一;镜下可见内壁由颗粒细胞组成,细胞层数不一,可见典型的Call-Exner小体;免疫组化染色可见α-inhibin,Vimentin,CD99均阳性。结论:卵巢囊性颗粒细胞瘤可依据镜下发现不典型增生的颗粒细胞、典型的Call-Exner小体和核沟等特征性的组织形态学作出诊断。     

滤泡树突细胞肉瘤二例报道并文献复习

目的探讨滤泡树突细胞肉瘤（FDCS）的临床表现、病理形态、免疫组化、生物学行为和预后,提高对该病的认识。方法对2例滤泡树突细胞肉瘤进行报道,并结合临床资料、肿瘤大体及镜下特征、免疫组化标记结果及预后和国内外文献进行分析。结果2例FDCS,1例发生于颈部淋巴结,另1例发生于肠系膜,镜检肿瘤由梭形及卵圆形细胞组成,呈束状、漩涡状、编织状排列;免疫组化显示肿瘤细胞CD21、CD23和CD35阳性;患者预后不良。结论滤泡树突细胞肉瘤是一种罕见且容易误诊的低度恶性肿瘤,组织化学和免疫组化染色有助于该肿瘤的诊断及鉴别诊断,减少误诊。     

E-cadherin和CD44V6在食管上皮癌变过程及癌组织中的表达

研究不同类型的食管上皮增生和癌组织的 E- cadherin (E- cad)和 CD44 V6的表达 ,并探讨其与食管癌发生和发展的关系。应用免疫组织化学 SABC法 ,观察 10例正常、 3例消化性溃疡、 2 5例单纯性增生、 15例不典型增生的食管粘膜上皮 ,5例食管原位癌与 5 4例浸润癌组织中的 E- cad和 CD44 V6蛋白的表达情况。结果显示正常食管鳞状上皮和高分化肿瘤细胞膜和细胞浆 E- cad和 CD44 V6染色 ,非典型增生、低分化肿瘤细胞两种蛋白抗体表达减弱或呈阴性。E- cad和 CD44 V6的表达与癌组织的组织学分级、类型和淋巴结转移有关 (P<0 .0 1,P<0 .0 5 ) ,与癌组织的浸润深度无关 (P>0 .0 5 )。提示E- cad和 CD44 V6表达减弱是癌组织低分化和高度恶性的生物学标志 ,但其与淋巴结转移的关系有待进一步研究     

乳腺浸润性微乳头状癌临床病理及免疫组织化学分析

目的探讨乳腺浸润性微乳头状癌的临床病理特征、诊断与鉴别诊断要点。方法对乳腺浸润性微乳头状癌进行临床病理分析、组织形态学及免疫组化染色观察,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果浸润性微乳头状癌光镜下特征性表现为癌巢由呈桑椹状或(和)腺管型的微乳头状癌巢组成,与网状间质间形成明显的空隙(主间质分离)。瘤细胞ER、PR、C-erbB-2、CD44V6阳性;Actin(sm)阴性;EMA在瘤细胞簇外周细胞膜和中间腔缘呈阳性表达。结论乳腺浸润性微乳头状癌可在病理诊断时作为一种单独的类型提出。     

表达CD19~+CD56~-的多发性骨髓瘤浆细胞免疫表型的鉴别

目的:研究多发性骨髓瘤患者浆细胞和对照组正常浆细胞免疫表型,有效地识别表达CD19+CD56-的多发性骨髓瘤恶性浆细胞。方法:采用四色流式细胞仪(BD,FACSCalibur)检测44例MM患者浆细胞以及25例健康骨髓捐献者正常浆细胞膜上的抗原表达。采用CellQuest软件分析结果。细胞膜表面抗原表达率大于20%定义为表达阳性。阳性率为表达阳性的患者及健康对照者所占百分比。结果:44例MM患者浆细胞免疫表型表达频率为:CD138+:97.72%(43/44)、CD38+:100%(44/44)、CD56+:63.64%(28/44)、CD19-:84.09%(37/44)、CD200+:77.27%(34/44)、CD28+:38.64%(17/44);25例对照组正常浆细胞免疫表型表达频率为:CD138+:100%(25/25)、CD38+:100%(25/25)、CD56-:100%(25/25)、CD19+:96%(24/25)、CD200+:0%(0/25)、CD28+:0%(0/25)。在44例MM患者中,9%(4/44)患者表达CD19+CD56-,利用CD200检测4例表达CD19+CD56-的患者,有3例患者伴有CD200阳性表达,可与正常浆细胞鉴别。结论:CD200有利于鉴别表达CD19+CD56-MM恶性浆细胞与正常浆细胞。     

Extramedullary plasmacytoma of the parotid gland. Report of a case with extensive amyloid deposition masking the cytologic and histopathologic picture

BACKGROUND: Extramedullary plasmacytomas are uncommon. Although approximately 90% occur in the head and neck region, parotid gland localization is extremely rare. CASE: This report describes fine needle aspiration and histopathologic findings in an extramedullary plasmacytoma arising in the left parotid gland of a 62-year-old man. Aspiration smears showed multiple amorphous clumps of material admixed with ductal epithelial cells, multinucleated giant cells and inflammatory cells rich in plasma cells, suggestive of pleomorphic adenoma. In surgical material, excessive amyloid deposition was observed. Six months later the tumor recurred, and in the second surgical specimen clusters of atypical plasma cells among amyloid deposits was noted. Clinical and laboratory examination excluded multiple myeloma. After local recurrence, radiotherapy was applied. Ten months later the patient was well and without systemic involvement. CONCLUSION: Two points are important. First, in the salivary gland region, because of the focal metachromasia of amyloid with Giemsa stain, amyloid can be confused with the chondromyxoid matrix of pleomorphic adenoma. Second, although localized forms of amyloid tumor exist, one should keep in mind that amyloid may be so abundant that it may mask an underlying plasma cell neoplasm, as in our case.     

肥大细胞及类胰蛋白酶在人甲状腺肿瘤组织中的表达 及其与微血管密度的关系

目的:探讨肥大细胞(mast cell,MC)及类胰蛋白酶(tryptase)与甲状腺肿瘤微血管密度(microvessel density,MVD)的相关性及其对甲状腺癌发生发展的影响。方法:采用甲苯胺蓝组织化学染色和PV免疫组织化学染色对116例甲状腺癌、56例甲状腺腺瘤和10例正常甲状腺组织中MC和tryptase及其CD31的表达进行了检测;对MC和tryptase与MVD的关系进行了统计学分析。结果:甲状腺肿瘤中MC的数量和tryptase阳性表达高于正常甲状腺,而且与肿瘤的类型有关(P<0.01);Spearman等级相关分析显示各组甲状腺组织MC数量和tryptase表达与MVD呈正相关(r=0.900,r=0.636,P<0.05)。结论:MC及其分泌的tryptase有促进血管新生的作用,因而可促进甲状腺肿瘤的浸润和转移。     

Circulating Serum MicroRNA-130a as a Novel Putative Marker of Extramedullary Myeloma

Poor outcome of extramedullary disease in multiple myeloma patients and lack of outcome predictors prompt continued search for new markers of the disease. In this report, we show circulating microRNA distinguishing multiple myeloma patients with extramedullary disease from myeloma patients without such manifestation and from healthy donors. MicroRNA-130a was identified by TaqMan Low Density Arrays and verified by quantitative PCR on 144 serum samples (59 multiple myeloma, 55 myeloma with extramedullary disease, 30 healthy donors) in test and validation cohorts as being down-regulated in myeloma patients with extramedullary disease. Circulating microRNA-130a distinguished myeloma patients with extramedullary disease from healthy donors with specificity of 90.0% and sensitivity of 77.1%, patients with extramedullary disease from newly diagnosed multiple myeloma patients with specificity of 77.1% and sensitivity of 34.3% in the test cohort and with specificity of 91.7% and sensitivity of 30.0% in the validation cohort of patients. Circulating microRNA-130a in patients with extramedullary myeloma was associated with bone marrow plasma cells infiltration. Further, microRNA-130a was decreased in bone marrow plasma cells obtained from patients with extramedullary myeloma in comparison to bone marrow plasma cells of myeloma patients without such manifestation, but it was increased in tumor site plasma cells of patients with extramedullary disease compared to bone marrow plasma cells of such patients (p<0.0001). Together, our data suggest connection between lower level of microRNA-130a and extramedullary disease and prompt further work to evaluate this miRNA as a marker of extramedullary disease in multiple myeloma.     

早期胚胎各器官CXCR4和CD44表达的观察

目的通过观察早期胚胎中CXCR4和CD44在全身各脏器的表达,了解不同器官干细胞的表面标志物特性。方法免疫组化SP法检测输卵管妊娠5例完整早期胚胎组织中CXCR4和CD44的表达情况。结果CXCR4大部分器官都见有表达,尤其在骨细胞和神经细胞中为强阳性表达。CD44主要表达于间叶组织中,如舌肌和胃肠的深肌层,以及各器官的纤维组织中,但不表达于骨、神经组织和髓外造血组织。另外,在少数上皮组织中也见有表达,如胸腺上皮细胞强表达和肺粘膜弱表达。在部分组织中CD44和CXCR4的表达模式相反。结论通过免疫组化法观察的CXCR4和CD44早期胚胎发育中特殊的表达为研究干细胞特性提供了良好直观的依据和线索。     

Expression of the selected adhesive molecules (cadherin E, CD44, LGAL3 and CA50) in papillary thyroid carcinoma

INTRODUCTION: The aim of the study was to determine the expression of selected adhesive molecules in papillary thyroid carcinoma. MATERIAL AND METHODS: 47 papillary thyroid carcinoma cases and 11 nonmalignant goiter cases were analyzed by immunohistochemistry. RESULTS: Galectin-3 (LGAL3) was a sensitive and specific marker, present in 91% of analyzed tumors and only in 5% of tumor margin. The presence of CA50 was 86% and 3% respectively with only 3% positive non-malignant cases. Cadherin E expression was noted in 91% of primary tumors, in 84% of the surrounding tissue and in 63% of non-malignant goiter. CD44 (DF1485) was observed in 89% of primary tumors and 48% of surrounding tissue; the reaction with BBA10 was more characteristic for metastases. CONCLUSIONS: Our study confirms the high diagnostic value of galectin-3 in papillary thyroid carcinoma and reveals the similar efficiency of CA50. CD44 (DF1485) expression in primary tumor is more intensive than in surrounding tissue, but the diagnostical inportance is not high because it is often observed in benign lesions. Using of BBA10 is more sensitive, but less specific. High expression of cadherin E in benign lesions impairs its diagnostical application in papillary thyroid cancer.     

喉癌组织中血管内皮生长因子、CD1a阳性树突状细胞表达及相关性的研究

目的:观察喉癌病人癌组织内CDla~ 树突状细胞(dendritic cells,DC)的分布、形态学特征以及血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达情况,同时探讨喉癌组织CDla~ DC分布与VEGF表达的关系。方法:采用抗VEGF、抗CDla抗体进行免疫组化染色和透射电镜等方法研究了42例喉癌组织。结果:喉癌组织CDla~ 树突状细胞树突状细胞形态不规则,表面有许多不规则树状突起。大部分散在分布于癌巢内,与肿瘤细胞有密切接触,少量分布于癌巢之间的间质和癌周组织。喉癌组织内CDla~ DC密度与喉癌临床期次呈明显的负相关,而VEGF的表达与喉癌临床期次呈明显的正相关。喉癌组织中VEGF表达明显升高的病例,其CDla~ DC密度显著降低。结论:癌巢内树突状细胞为不成熟状态的DC,与肿瘤细胞密切接触而捕获肿瘤抗原。喉癌组织中VEGF表达与DC含量呈负相关。     

Increased lymphocyte infiltration in patients with head and neck cancer treated with the IRX-2 immunotherapy regimen

Twenty-seven subjects with squamous cell cancer of the head and neck received the neoadjuvant IRX-2 immunotherapy regimen prior to surgery in a Phase 2 trial. Pretreatment tumor biopsies were compared with the primary tumor surgical specimens for lymphocyte infiltration, necrosis and fibrosis, using hematoxylin and eosin stain and immunohistochemistry in 25 subjects. Sections were examined by three pathologists. Relative to pretreatment biopsies, increases in lymphocyte infiltration (LI) were seen using H and E or immunohistochemistry. CD3+ CD4+ T cells and CD20+ B cells were primarily found in the peritumoral stroma and CD3+ CD8+ T cells and CD68+ macrophages were mainly intratumoral. LI in the surgical specimens were associated with reductions in the primary tumor size. Improved survival at 5?years was correlated with high overall LI in the tumor specimens. Neoadjuvant IRX-2 immunotherapy regimen may restore immune responsiveness presumably by mobilizing tumor infiltrating effector lymphocytes and macrophages into the tumor.     

Renal cell carcinoma metastatic to follicular adenoma of the thyroid gland. A case report

BACKGROUND: Renal cell carcinoma is an unpredictable tumor that can recur many years after the original diagnosis and metastasize to uncommon sites, including the thyroid gland. Differential diagnosis from primary thyroid tumor is often difficult both clinically and pathologically. We report a case of metastatic renal cell carcinoma in follicular adenoma of the thyroid gland. CASE: A 48-year-old woman presented with a 3-cm-diameter, palpable mass in the left lobe of the thyroid gland. The patient's history included removal of a left renal mass, which was conventional renal cell carcinoma. Fine needle aspiration cytology smears contained a few small clusters of polygonal cells with abundant, clear cytoplasm and irregular, hyperchromatic nuclei as well as bland-looking thyroid follicle cells and stromal cells. A papillary or follicular growth pattern was not detected. A cell block made from the aspirated sample was composed mainly of clear cells. By immunohistochemical stains, the clear cells were completely negative for TTF-1, thyroglobulin, calcitonin and inhibin while equivocally staining for cytokeratin, CD10 and galectin-3. The histologic diagnosis was renal cell carcinoma metastatic to follicular adenoma of the thyroid gland. CONCLUSION: Renal cell carcinoma metastatic to the thyroid may masquerade as a primary thyroid neoplasm. A history of prior nephrectomy, the presence of unremarkable thyroid follicle cells, the absence of a papillary or follicular growth pattern and immunohistochemical study can help differentiating metastatic renal cell carcinoma from a primary thyroid lesion with clear cell change.     

Cytologic findings of epithelioid angiosarcoma of the thyroid. A case report

BACKGROUND: Angiosarcoma of the thyroid is a rare and aggressive tumor and occurs mainly in patients from central Europe, especially the alpine region. The fine needle aspiration findings of a keratin-positive epithelioid angiosarcoma of the thyroid occurring in a nonmountainous area in South America is described. CASE: A 65-year-old male from S?o Paulo, Brazil, presented with a mass in the anterior part of the neck with progressive enlargement for three months. The cytologic findings on the fine needle aspirate were a cellular smear composed of single cells and small clusters of neoplastic cells, oval and round. Cell borders were indistinct, and the cytoplasm was vacuolated. The nuclei were eccentrically located, with irregular nuclear membranes; single, prominent nucleoli; and a coarse chromatin pattern. Features suggestive of intracytoplasmic lumens were identified. Open surgical biopsy demonstrated a tumor infiltrating the thyroid gland and composed of large, round, atypical epithelioid cells lining vascular spaces. These neoplastic cells were immunoreactive for AE1:AE3, CK7, vimentin, CD31 and factor VIII. CONCLUSION: Epithelioid angiosarcoma should be considered in the differential diagnosis of epithelioid neoplasms of the thyroid. An immunohistochemical panel should include vascular markers even in the presence of immunoreactivity for epithelial markers.