Characterization of inflammatory cells in oral paracoccidioidomycosis

Paracoccidioidomycosis (Pmycosis) is one of the most common deep mycoses in many regions of Latin America, particularly in Brazil. Microscopically, it shows granulomatous inflammatory reaction with giant cells, macrophages, lymphocytes, plasma cells, polymorphonuclear neutrophilic leukocytes, and eosinophils. The purpose of this study was to assess the distribution of inflammatory cells in oral Pmycosis. Fifteen cases of oral Pmycosis were studied by immunohistochemistry for the presence of macrophages, CD4(+) and CD8(+) lymphocytes, CD20(+), CD15(+), and S100(+) cells. Macrophages were the main cells in well-organized granulomas and non-granulomatous areas. The CD4 phenotype was predominant in well-organized granulomas and a balance between CD4(+) and CD8(+) cells was observed in non-granulomatous areas. Dendritic, S100(+) cells were found mainly in the epithelium, in subepithelial connective tissue, and at the periphery of organized granulomas. CD15(+) cells were concentrated mainly in areas of intraepithelial microabscess and ulceration. Macrophages and T cells are the predominant cells in oral Pmycosis. Well-organized granulomas contain fewer yeast particles, indicating a more effective host immune response. Better understanding of the histopathological changes in oral Pmycosis might help determine treatment, severity and systemic involvement of the disease.     

Burkitt淋巴瘤细胞骨髓中形态学特征与组织病理学的比较分析

目的比较骨髓和组织所见的Burk itt淋巴瘤细胞的细胞形态与组织病理形态,尝试找出骨髓中Burk itt淋巴瘤细胞的形态特征,为今后在骨髓诊断Burk itt淋巴瘤作一探索。方法抽取病人骨髓涂片,经瑞氏染色、POX、PA S染色,以油镜观察细胞形态,并比较Burk itt淋巴瘤细胞在骨髓及组织的异同形态表现。结果骨髓中Burk itt淋巴瘤细胞可成堆及散在出现,核染色质细网状偏粗,胞浆深蓝色嗜碱性,可见多个嗜碱性蓝色核仁,背景细胞有巨噬细胞、单核细胞,淋巴细胞混在其中,与病理组织肿瘤细胞中出现反应性组织细胞的“星空”现象类似;病理组织肿瘤细胞中等大小,核圆形,有核仁,胞浆量中等,可见吞噬核碎片和凋亡细胞的反应性组织细胞,出现“星空”现象。结论骨髓中Burk itt淋巴瘤细胞及其背景具有一定的形态学特征,可作前驱性预诊,组织病理及免疫组化当然是确诊Burk itt淋巴瘤的金标准。     

Lgr5蛋白和E-钙黏蛋白在胃癌组织中表达的研究

目的检测胃癌组织中Lgr5及E-钙黏蛋白(E-cad)的蛋白表达情况并分析其与胃癌患者临床病理特征及预后的关系。方法采用免疫组织化学SABC方法检测69例胃癌组织及30例癌旁正常胃黏膜组织中Lgr5及E-cad的蛋白表达情况,同时分析其与胃癌患者临床病理特征和生存的关系。结果Lgr5和E-cad蛋白分别在60例(87.0%)和30例(43.5%)胃癌患者的胃癌组织中呈阳性表达,分别有5例(16.7%)和30例(100%)在癌旁正常胃黏膜组织中呈阳性表达,二者在不同组织中的蛋白表达阳性率比较差异均有统计学意义(Lgr5蛋白:χ^2=45.814,P<0.001;E-cad蛋白:χ^2=11.249,P=0.001)。Lgr5和E-cad蛋白在胃癌组织中的阳性表达均与分化程度和浸润深度有关(P<0.05),Lgr5蛋白在胃癌组织中的阳性表达还与淋巴结转移和幽门螺杆菌(HP)感染有关(P<0.05)而E-cad蛋白阳性表达却与此无关(P>0.05)。Lgr5蛋白表达阳性和阴性患者的5年总生存情况比较差异无统计学意义(χ^2=1.819,P=0.117),而E-cad蛋白表达阳性胃癌患者的5年总生存情况明显优于E-cad蛋白表达阴性胃癌患者(χ^2=5.814,P=0.016)。Lgr5蛋白表达与E-cad蛋白表达呈明显的负相关(rs=-0.355,P=0.003)。结论Lgr5蛋白可能参与了肿瘤组织局部浸润、淋巴结转移过程,与肿瘤恶生程度有关,未发现其阳性表达与预后有关;E-cad的表达可能参与了肿瘤的肿瘤局部侵袭和进展且与患者预后有关。     

MMP-9、TIMP-1在曲张大隐静脉中的表达及意义

目的：研究基质金属蛋白酶9（MMP-9）与基质金属蛋白酶组织抑制剂1（TIMP-1）在曲张大隐静脉中的表达及其与发病机制的关系。方法：收集佳木斯大学附属第一医院2012-11～2013-09,血管外科手术治疗的大隐静脉曲张患者31例（40条肢体）,其中男19例,女12例,年龄35～71岁,平均51.25岁。标本均取自大隐静脉主干曲张最显著部位。根据CEAP临床分级法,将40条患肢分为C1～C3组（24条肢体）和C4～C6组（16条肢体）。对照组选择同期佳木斯大学附属第一医院血管外科和骨外科,因外伤或动脉硬化闭塞症（排除下肢静脉曲张和静脉曲张家族史）而截肢的正常大隐静脉10例。其中男7例,女3例,年龄25～67岁,平均48.10岁。实验组与对照组均采用免疫组织化学染色法检测MMP-9、TIMP-1蛋白在大隐静脉中的表达。结果：MMP-9可在正常大隐静脉壁中少量表达,而在曲张大隐静脉壁中表达明显增高（P〈0.05）,C4～C6组和C1～C3组表达率无统计学意义（P〉0.05）。TIMP-1也可在正常大隐静脉壁中表达,而在曲张大隐静脉壁中表达明显增高（P〈0.05）,C4～C6组和C1～C3组表达率无统计学意义（P〉0.05）。结论：MMP-9、TIMP-1的异常表达可能参与了大隐静脉曲张的血管重塑过程。     

激活蛋白-2α在鼻咽癌患者表达的作用及意义

目的：探讨激活蛋白-2α的表达与鼻咽癌预后的关系,为指导个体化治疗提供依据。方法采用免疫组织化学技术检测激活蛋白-2α在鼻咽癌组织切片中的表达情况,并结合鼻咽癌患者的临床病理因素及预后进行分析。结果激活蛋白-2α在129例鼻咽癌组织切片中,阳性表达率为87.6%（113/129）,阴性率、低度表达率、中度表达率、高度表达率分别为12.4%（16/129）,21.7%（28/129）,40.3%（52/129）,25.6%（33/129）。单因素分析显示激活蛋白-2α表达性质与鼻咽癌的总生存时间相关,激活蛋白-2α表达阳性的患者5年生存率高于表达阴性的患者,两组差异有统计学意义（P=0.049）。多因素分析结果显示,临床分期是鼻咽癌的独立预后因素（P=0.012）。结论激活蛋白-2α在鼻咽癌发生、发展中具有重要作用。激活蛋白-2α在分期较高的组织中阳性率更高,同时阳性表达的患者更易发生远处转移。提示激活蛋白-2α可能是鼻咽癌的一个预后分子指标。     

Atypical teratoid/rhabdoid tumor arising in pleomorphic xanthoastrocytoma: A case report

Atypical teratoid/rhabdoid tumor (AT/RT) is a rare, highly malignant, true rhabdoid tumor in the central nervous system predominantly presenting in young children. AT/RT typically shows rhabdoid cells which can also be seen in other tumors, but it is differentiated from other tumors by the specific genetic alteration involving the SMARCB1 gene. Only a few cases of AT/RT arising in low‐grade glioma have been reported. A 13‐year‐old girl presented with headache, dizziness, nausea and vomiting. A 4.7 cm cerebellar mass was found on MRI. The mass was totally removed. Histologically, the tumor revealed two distinct morphologic appearances: central areas of AT/RT containing rhabdoid cells and sarcomatous component in the background of pleomorphic xanthoastrocytoma (PXA). Immunohistochemically, PXA areas retained nuclear expression of INI‐1 and low Ki‐67 proliferation index, whereas AT/RT component showed loss of INI‐1 nuclear expression and markedly elevated Ki‐67 proliferation index. Epithelial membrane antigen (EMA), smooth muscle actin (SMA), and p53 protein were positive only in AT/RT. BRAF V600E mutation was identified in PXA by real‐time polymerase chain reaction. We report a rare case of AT/RT arising in PXA which is supposed to progress by inactivation of INI‐1 in a pre‐existing PXA.