Fine needle aspiration cytology in the diagnosis of bone lesions

OBJECTIVE: Fine needle aspiration cytology (FNAC) in combination with radiological examination has recently gained clinical recognition for evaluating skeletal lesions. We evaluated our experience with the use of FNA in diagnosing bone lesions with emphasis on areas of difficulty and limitations. MATERIALS AND METHODS: Over a period of 5 years FNA was performed in 66 cases of bone lesions. Aspirations were done by cytopathologists using 22-gauge needle. Out of 66 cases unsatisfactory aspirate was obtained in 12 cases. Cytohistological correlation was available in 19 cases. RESULTS: Adequate aspirates were categorized into neoplastic (27 cases) and non-neoplastic (27 cases) lesions. Of the 27 neoplastic aspirates, 20 were malignant (12 primary, 8 metastatic deposits) and 7 were benign. In the malignant group osteosarcoma was correctly diagnosed in 3 cases while other 3 were labeled as sarcoma NOS because of lack of osteoid. Metastatic deposits were sub-typed in 6 cases; from renal cell carcinoma (3 cases), proststic adenocarcinoma, follicular carcinoma thyroid, and squamous cell carcinoma. Neoplastic group comprised of 6 cases of cysts and 21 cases of chronic osteomyelitis. Thirteen cases were diagnosed as tuberculous osteomyelitis. CONCLUSIONS: FNA is a frequent indication in metastases in the bone where distinct cytologic features can even identify an unknown primary. However, diagnosis of primary tumours of the bone is limited by precise subtyping of the tumours. FNA has emerged as a cost effective tool for initial diagnosis of both neoplastic and non-neoplastic lesions of the bone.     

Benign mucocele-like lesion of the breast: how to differentiate from mucinous carcinoma before surgery.

The aim of the study was to improve the pre-operative diagnosis of mammary mucinous lesions. All mucinous lesions detected by fine needle aspiration (FNA) and confirmed by histological examination were reviewed by cytological findings, mammographic appearances and sonographic findings. Twenty aspirates had corresponding pathology, including 12 mucinous carcinomas, two mucocele-like lesions (MLL) with atypical ductal hyperplasia, three MLL with ductal hyperplasia and three simple MLL. Simple MLL and mucocele-like with ductal hyperplasia showed scant cellularity, no or rare intact single tumour cells, monolayered arrangement and absence of nuclear atypia. In contrast, most mucinous carcinomas showed higher cellularity, more single tumour cells, three-dimensional clusters, and mild to marked nuclear atypia. However, MLL with atypical ductal hyperplasia showed cytological features overlapping with mucinous carcinoma. MLL had a non-specific mammographic appearance and showed a cystic lesion on sonography. Mucinous carcinoma appeared as a solid mass on sonography and as a distinct nodule on mammography. Based on the combination of FNA cytology and image findings, benign MLL can be correctly distinguished from mucinous carcinoma before surgery.     

黏液性/浆液性胰腺囊性肿瘤囊液蛋白质糖基化差异表达研究

随着影像学技术的进步,胰腺囊性病变(恶性胰腺囊性病变包括黏液性囊腺瘤(mucinous cystic neoplasm,MCN)和导管内乳头状黏液瘤(intraductal papillary mucinous neoplasm,IPMN)以及黏液性囊腺癌(mucinous cystic adenocarcinoma,MCA)的检出率有所提高,但是区分囊性病变的良恶性仍然是一个难题.本研究根据外科手术病理结果及囊液液基细胞结果,从120例经CT或MRI方法诊断为胰腺囊性肿瘤患者中选取35例样本,其中胰腺黏液性囊腺瘤(MCN)组17例与浆液性囊腺瘤(serous cystic neoplasm,SCN)组18例,通过超声内镜下细针穿刺(endoscopic ultrasonography-guided fine needle aspiration,EUS-FNA)方法吸取囊液,采用凝集素芯片分析蛋白质糖链谱差异.经t检验结果表明,MCN组与SCN组相比,6种凝集素,STL、WGA、BPL、DBA、PTL-Ⅰ及MAL-Ⅰ,识别的糖链结构二者之间存在明显差异(P0.05),其中凝集素BPL、DBA、WGA、STL识别的糖链结构在MCN囊液中呈高表达(R2.0),例如DBA特异识别的Tn抗原表达的增多,可能与肿瘤上皮细胞分泌的黏蛋白增多密切相关.而凝集素PTL-Ⅰ、MAL-Ⅰ特异识别Galβ-1、4Glc NAc结构以及Gal NAcα-1、3Gal结构在MCN囊液中表达降低(R0.5).通过凝集素印记法检测了STL和BPL分别于MCN、SCN囊液中蛋白的结合情况,结果表明STL和BPL与囊液中的糖蛋白结合明显强于SCN组.本文通过比较MCN和SCN糖蛋白糖谱表达差异,寻找胰腺囊性肿瘤诊断和肿瘤良恶性评估的新方法,同时为探索胰腺囊性肿瘤发生发展机制和治疗的潜在靶点奠定基础.     

Comparative study of nuclear and cytoplasmic glycogen isolated from mutant HD33 ascites cells

Mutant cells of the HD33 subline of the Ehrlich-Lettré ascites tumor synthesize and store glycogen mainly intranuclearly, when growing in vivo, and exclusively in the cytoplasm, when permanently cultivated as a suspension cell strain. To investigate whether there exist differences between glycogen of nuclear and cytoplasmic origin, the ultrastructure and the biophysical and biochemical properties of glycogen from in vivo and in vitro grown HD33 ascites cells were compared. Pronounced heterogeneity and differences in glycogen particle ultrastructure were evident in situ and after isolation of the native, high-molecular polysaccharide. Nuclear glycogen contains a fraction of heavier molecules (up to 2 X 10(9)) and larger particles (up to 340 nm) which could not be found in the cytoplasmic preparations, which contained only particles smaller than 140 nm. The subparticles of beta-type are similar in both nuclear and cytoplasmic glycogen. The absorption spectra and glucose analysis after degradation with phosphorylase and debranching enzyme indicate that nuclear glycogen has a higher degree of branching, associated with a decrease in the average chain length between the branching points, and shorter external polyglucosidic chains than cytoplasmic glycogen. This is the first report about the analysis and properties of isolated nuclear glycogen.     

PET for diagnosis and therapy of brain tumors

Main contribution of PET in the management of brain tumors is at the therapeutic level. Specific reasons explain this role of molecular imaging in the therapeutic management of brain tumors, especially gliomas. Gliomas are by nature infiltrating neoplasms and the interface between tumor and normal brain tissue may not be accurately defined on CT and MRI. Also, gliomas are often histologically heterogeneous with anaplastic areas evolving within a low-grade tumor, and the contrast-enhancement on CT or MRI does not represent a good marker for anaplastic tissue detection. Finally, assessment of tumor residue, recurrence or progression may be altered by different signals related to inflammation or adjuvant therapies, even on contrast-enhanced CT and MRI. These limitations of the conventional neuroimaging in delineating tumor and detecting anaplastic tissue lead to potential inaccuracy in lesion targeting at different steps of the management (diagnostic, surgical, and post-therapeutic stages). Molecular information provided by PET has proved helpful to supplement morphological imaging data in this context. ¹⁸F-FDG (FDG) and amino-acid tracers such as ¹¹C-methionine (MET), provides complementary metabolic data that are independent from the anatomical MR information. These tracers help in the definition of glioma extension, in the detection of anaplastic areas and in the postoperative follow-up. Additionally, PET data have an independent prognostic value. To take advantage of PET data in glioma treatment, PET might be integrated in the planning of image-guided biopsies, radiosurgery and resection.     

胰腺癌组织中巨噬细胞移动抑制因子的表达及其意义

目的研究巨噬细胞移动抑制因子（MIF）在胰腺癌发生发展中的作用,与肿瘤标志物CEA、CA199的关系。方法应用免疫组化方法检测31例胰腺癌组织、癌旁组织以及14例正常胰腺组织中MIF表达水平,分析MIF表达与各项临床病理特点及血清CEA、CA199水平的关系。结果 MIF在胰腺癌组织中的表达为87.1%,高于癌旁组织的54.8%和正常胰腺组织的7.4%（P〈0.01）;癌旁组织的MIF表达高于正常组织（P〈0.01）。MIF的表达与肿瘤分化程度及远处转移有关（P〈0.05）,MIF表达阳性患者的血清CA199水平高于MIF表达阴性患者,而血清CEA水平两组间无显著统计学意义。结论 MIF对胰腺癌的发生发展起重要作用,可能促进正常腺体组织向胰腺癌发生和发展。MIF可作为胰腺癌的一种血清标志物,联合CA199的检测可更好的发现胰腺癌。     

Spontaneous squamous cell carcinomas in 13 baboons,a first report in a spider monkey,and a review of the non‐human primate literature

Abstract Background Squamous cell carcinoma (SCC) is a neoplastic proliferation of epithelial cells undergoing squamous differentiation and represents a diagnostic challenge in non‐human primates (NHP), especially in baboons with perineal SCC. Methods Fourteen SCC (13 baboons, 1 spider monkey) were identified over a 20‐year period. A literature search identified 86 additional published cases of spontaneous NHP SCC. Results Squamous cell carcinoma was most commonly reported in macaques, baboons, marmosets, and squirrel monkeys. Metastasis occurred in 23%, of NHP. The most frequently reported primary locations were the oral cavity, integument, esophagus, and cervix‐uterus. Perineal SCC occurred mainly in baboons. All reported SCC in marmosets occurred in the head. Nasal cavity SCC was only reported in male marmosets. All reported pulmonary SCC occurred in males, mostly in tree shrews. Conclusions Squamous cell carcinoma is a common neoplasm in NHP and exhibits species differences. NHPs may provide a useful SCC animal model.     

基于多目标评价方法的乳腺癌易感基因排序及其网络表达研究

目的利用已有的研究结果和数据,采用多目标评价方法建立乳腺癌易感基因评价模型,对与已知乳腺癌基因关系密切的其它基因进行分析和排序,并给出结果的网络表达模式。方法通过分析已有的文献,并利用有关的基因数据库和已有文献中的数据,提炼出乳腺癌易感基因的多目标评价体系,构建基于加权和法的乳腺癌易感基因评价模型,并利用Cytoscape软件进行评价结果计算和评价结果的网络模式表达。结果利用多目标模型所得到的评价结果,与已有的研究结果一致。其中,乳腺癌易感基因TopBP1排名第二,已知乳腺癌候选易感基因HMMR排名第六。结论文章提出的多目标评价模型能够准确评价被选基因与乳腺癌易感性之间的关系,所提出的评价方法与相关软件结合使用,将成为癌症易感基因研究方面有效的分析方法和途径。