肝脏血管周上皮样细胞肿瘤的临床病理分析

目的 探讨肝脏血管周上皮样细胞肿瘤(PEComa)的临床病理学特征、诊断、鉴别诊断及预后.方法 报道2例发生于肝脏的PEComa,对2例少见部位PEComa行HE、免疫组化染色,并进行相关文献复习.结果 2例肝脏PEComa均发生于中年女性,45～53岁,临床均无特异性症状.CT分别显示肝右叶后下段和左顶叶部界限清楚的类圆形肿块,初诊考虑肝恶性肿瘤.镜下肿瘤主要由上皮样细胞和丰富血窦组成,1例无脂肪细胞成分,另1例伴多灶性脂肪细胞分化成分.免疫表型:肿瘤细胞均Melan-A、HMB45、SMA阳性.结论 发生于肝脏的PEComa临床较少见,组织起源仍然不清,临床需与原发性肝癌及转移性恶性黑色素瘤鉴别,大多生物学行为偏良性,诊断恶性需足够的证据支持和长期的随访观察.     

Endoscopic molecular imaging of early gastric cancer using fluorescently labeled human H-ferritin nanoparticle

Optical imaging technologies improve clinical diagnostic accuracy of early gastric cancer (EGC). However, there was a lack of imaging agents exhibiting molecular specificity for EGCs. Here, we employed the dye labeled human heavy-chain ferritin (HFn) as imaging nanoprobe, which recognizes tumor biomarker transferrin receptor 1 (TfR1), to enable specific EGC imaging using confocal laser endomicroscopy (CLE). TfR1 expression was initially examined in vitro in gastric tumor cells and in vivo through whole-body fluorescence and CLE imaging in tumor-bearing mice. Subsequently, dye labeled HFn was topically applied to resected human tissues for EGC detection. CLE analysis of TfR1-targeted fluorescence imaging allowed distinction of neoplastic from non-neoplastic tissues (P?<?0.0001), and TfR1 expression level was found to correlate with EGC differentiation degrees (P?<?0.0001). Notably, the CLE evaluation correlated well with the immunohistochemical findings (κ-coefficient: 0.8023). Our HFn-nanoprobe-based CLE increases the accuracy of EGC detection and enables visualization of tumor margins and endoscopic resection.     

In situ localization of gelatinolytic activity during development and resorption of Meckel's cartilage in mice

Degradation of Meckel's cartilage in the middle portion is accompanied by hypertrophy and death of chondrocytes, calcification of the cartilaginous matrix, and chondroclastic resorption. We hypothesize that the gelatinolytic activity of matrix metalloproteinases (MMPs) largely contributes to the degradation of extracellular matrix (ECM) in the process. The activity in Meckel's cartilage of mouse mandibular arches at embryonic days 14-16 (E14-E16) was examined by a combination of in situ zymography (ISZ), using quenched fluorescent dye-labeled gelatin as a substrate, with CTT (a selective inhibitor of MMP-2 and -9) or with EDTA (a general MMP inhibitor). On E14 and E15, ISZ showed fluorescence in the perichondrium, in the intercellular septa between chondrocytes, and in the nucleus of chondrocytes. CTT attenuated fluorescence, and EDTA eliminated it. On E16, calcified cartilaginous matrix showed intense fluorescence, and dot-like fluorescence was observed in as-yet uncalcified intercellular septa, even after CTT treatment. EDTA inhibited fluorescence, but unexpectedly intense fluorescence was found in the cytoplasm of hypertrophic chondrocytes facing the resorption front. MMP-2, -9, and -13 immunoreactivity was detected in the perichondrium and chondrocytes of Meckel's cartilage. These findings suggest that MMPs and other proteinases capable of degrading gelatin play an integral role in the development, calcification, and resorption of Meckel's cartilage through ECM reconstitution.     

Epithelioid hemangioendothelioma of the oral cavity

OBJECTIVE: To investigate the clinicopathological characteristics and biologic behaviour of epithelioid hemangioendothelioma in the oral cavity. MATERIALS AND METHODS: The clinical features and pathological findings of nine cases with intraoral epithelioid hemangioendothelioma were reviewed, including immunohistochemistry study. RESULTS: This series comprised seven males and two females aged 6-53 years (mean 28 years). The sites of the tumour included the tongue (n = 4), lip (n = 1), the gingiva and alveoli of the maxilla (n = 1), the gingiva and alveoli of the mandible (n = 1), buccal mucosa (n = 1), and the floor of the mouth (n = 1). A painless solitary mass was the most common presentation and was found in eight cases. On pathology, the tumour grew in short strands, cords or nests of polygonal to slightly spindled epithelioid cells in fibro-myxoid stroma, with formation of intracytoplasmic lumina. Tumour cells were immunoreactive to CD34, FVIIIRAg, and vimentin. Focal-positive cytokeration were observed in three cases. Immunoreactivity for S-100 protein, epithelial membrane antigen (EMA) and human herpesvirus (HHV)-8 was negative in all cases. Two cases recurred after surgical excision, but no patient developed local or distant metastasis. CONCLUSIONS: Wide local excision with long-term follow-up seems to be the treatment of choice for intraoral epithelioid hemangioendothelioma because of their unpredictable biological behaviour and recurrence potential.     

Altered E-cadherin/beta-catenin expression in oral squamous carcinoma with and without nodal metastasis

OBJECTIVES: The aim of this study was to investigate the potential use of E-cadherin, a tumour-suppressor gene product involved in establishing cell-cell adhesion and one of its associated proteins, beta-catenin, as markers of nodal metastasis in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Thirty invasive OSCCs in patients with (n = 19) and without (n = 11) nodal metastases, as confirmed on histopathologic examination of the resected regional lymph nodes (n = 30), were examined for E-cadherin and beta-catenin expression by immunohistochemistry. RESULTS: There was a highly significant association (P < 0.0001) between E-cadherin and beta-catenin expression and tumour differentiation by conventional Broders' grading of the whole tumour. Irrespective of the nodal status and invasive tumour front (ITF) grading score, however, loss of expression was recorded at the ITF in 28 (93%) of 30 tumours and 22 (73%) of 30 tumours stained for E-cadherin and beta-catenin respectively. CONCLUSION: The results of this study suggest an association between loss of expression of E-cadherin and beta-catenin and a lower degree of differentiation; however, their use as markers of nodal metastasis in OSCC appears unreliable.     

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。