Early-stage primary signet ring cell carcinoma of the colon

Primary signet ring cell carcinoma of the colorectum detected at an early stage is very rare; most cases are detected at an advanced stage. Therefore, its progno-sis is poorer than that of ordinary colorectal cancer. A 56-year-old Korean man was seen at this hospital for management of signet ring cell carcinoma of the co-lon. Colonoscopic examination revealed a Ⅱa-like, ill-defined and flatly elevated 9-mm residual tumor in the cecum. Endoscopic mucosal resection was preformed. Pathological examination of the resected specimen re-vealed signet ring cell carcinoma that had invaded the lamina propria without venous or perineural invasion. Abdominal computed tomography (CT) and positron CT showed no evidence of primary lesions or distant me-tastasis. An additional laparoscopic right-hemicolectomy was performed; no residual tumor or lymph node me-tastasis was found. We report a case of primary signet ring cell carcinoma of the colon detected at an early stage and provide a review of the literature.

Synchronous multiple primary gastrointestinal cancers with CDH1 mutations:A case report

BACKGROUND Synchronous multiple primary cancers (SMPC) mean two or more malignant tumors occurring simultaneously and with different origins no matter what types they are or where they are located. The carcinogenesis of SMPC often involves variations of some specific genes. However, the correlation between CDH1 mutations and synchronous multiple primary gastrointestinal cancers is largely unknown. CASE SUMMARY A 62-year-old woman had sustained abdominal pain for one week and visited our hospital. Gastrointestinal endoscopy revealed multiple small polypoid lesions in both the stomach and colorectum. Computed tomography and laboratory results were within normal limits. Pathological evaluation confirmed signet ring cell carcinoma without obvious metastatic evidence. Malignant cells showed negativity for E-cadherin and positivity for β-catenin in the cytoplasm and nucleus. DNA sequencing performed on paraffin-embedded tissue revealed two exactly coincident alterations in CDH1, C.57T>G and C.1418A>T. CONCLUSION This case suggests that the combination of CDH1 mutations and WNT/β-catenin signaling activation contributes to the carcinogenesis of gastrointestinal SMPC.

Primary signet ring cell carcinoma of the appendix: A rare case report

Primary adenocarcinoma of the appendix is a rare malignancythat constitutes < 0.5% of all gastroin-testinalneoplasms. Moreover, primary signet ring cell carcinomaof the appendix is an exceedingly rare entity. In the present report, we describe a rare case of primary signet ring cell carcinoma of the appendix with ovarian metastasesand unresectable peritoneal dissemination occurring in a 45-year-old female patient. She was clinically misdiagnosed as torsion of ovarian cyst. She underwent appendicectomy and unilateral salpingooophorectomy.Histopathology revealed signet ring cell carcinoma and a right hemicolectomy was done. She then received palliative systemic chemotherapy with 12 cycles of oxaliplatin, 5-fluorouracil, and leucovorin(FOLFOX-4). The patient is doing well till today on follow up without progression of disease 10 mo after beginning chemotherapy.

Immunohistochemical analysis of PD-L1 and tumor-infiltrating immune cells expression in the tumor microenvironment of primary signet ring cell carcinoma of the prostate

Primary signet ring cell carcinoma(SRCC)of the prostate is a rare neoplasm.However,its potential tumorigenic mechanism,clinicopathological features,and prognostic outcome have not been systematically described.To determine the pathogenic mechanism,we detected distributions of programmed cell death-ligand 1(PD-L1),programmed death 1(PD-1),and cellular components in the tumor microenvironment,including tumor-infiltrating lymphocytes(CD4 and CD8),tumor-associated macrophages(TAMs;CD163 and CD68),and tumor-associated fibroblasts(vimentin and alpha-smooth muscle actin[α-SMA]),in tumor tissues from four patients with primary prostatic SRCC compared with corresponding adjacent tissues and tumor tissues from 30 patients with prostate adenocarcinoma(PCa)by immunohistochemical staining.We found higher expression of PD-L1,CD163,and CD68 in primary SRCC specimens than that in both corresponding adjacent nontumor specimens and PCa specimens with different Gleason scores,indicating that TAMs may participate in the malignant biological behavior of primary SRCC of the prostate.For further analysis,we searched electronic journal databases and Surveillance,Epidemiology,and End Results(SEER)to identify 200 eligible patients including our four cases.According to Kaplan–Meier survival curve analysis,patients<68 years old,with radical prostatectomy(RP),Gleason score of 7–8,and lower clinical stage had longer overall survival(OS).Moreover,Cox multivariate analysis indicated that race(hazard ratio[HR]=1.422),surgical approach(HR=1.654),and Gleason score(HR=2.162)were independent prognostic factors for OS.Therefore,primary SRCC of the prostate represents a distinct and aggressive subtype of prostate cancer associated with a higher distribution of PD-L1 and TAMs,which warrants further clinical investigation.

Primary signet ring cell carcinoma of prostate (report of 2 cases)

Objective To study the clinical features of primary signet ring cell carcinoma of prostate. Methods 2 cases of primary signet ring cell carcinoma of the prostate were studied and reviewed. Results The age of the 2 patients was 64 and 73. The clinical symptoms were dysuria, vesical irritability and perineum discomfort. Histologically, signet ring cell carcinoma was composed of round cells with abundant clear cytoplasm and crescent-shaped nuclei on one side. Mitosis were frequently observed. Immunohistochemical testing showed the cancer cell was positive for prostate specific antigen (PSA.), prostate acid phosphatase ( PAP ), AR, cytokeratin and negative for caicinoernbryonic antigen (CEA), alcian blue/ periodic arid-schiff (AB/PAS). One case (stage D) died 6 months after bilateral orchiectomy and flutamide therapy because of wide-spead metastasis; the other (stage B2) has been surviving 25 months after radical prostatectomy, bilateral orchiectomy, endocrine therapy and local irradiation ministration.

宫颈黏液腺癌的诊治进展

宫颈黏液腺癌是宫颈恶性肿瘤中一种罕见的、特殊的组织学类型,其分类主要有宫颈胃型腺癌、宫颈肠型腺癌和宫颈原发印戒细胞型腺癌等。由于宫颈黏液腺癌的发病机制与人乳头瘤病毒(human papilloma virus,HPV)感染之间的不确定性,因此难以通过常规宫颈癌筛查加以提示。同时,宫颈黏液腺癌的病因及发病机制均不明确,且缺乏典型临床表现及早期诊断方法,临床病理特征及治疗与宫颈普通腺癌有所不同,导致患者易错过最佳治疗时机,因此宫颈黏液腺癌较宫颈普通型腺癌的预后差。近年来,由于对HPV疫苗的普及,宫颈黏液腺癌相对发病率较前略有升高,关于宫颈黏液腺癌的研究越来越受到重视,综述宫颈黏液腺癌的国内外相关研究,探讨宫颈黏液腺癌的相关发病机制、临床特征及治疗,以期为宫颈黏液腺癌的临床诊治提供参考。

原发性肺印戒细胞癌临床回顾研究

目的探讨原发性肺印戒细胞癌(signet ring cell carcinoma,SRCC)的临床和病理特点。方法回顾性分析在解放军总医院住院的12例原发性肺SRCC的临床及病理资料。结果原发性肺SRCC发病年龄较轻,其诊断依靠病理和免疫组织化学检查,该病预后差,治疗除手术外,目前尚无标准化疗方案。结论原发性肺SRCC临床少见,恶性程度高,需提高对该病诊断和治疗的认识。

肺原发性印戒细胞癌临床病理学观察

目的:探讨肺原发性印戒细胞癌的临床病理特点及生物学特征。方法:对8例肺原发性印戒细胞癌患者的肿瘤组织病理学进行分析,并对细胞角蛋白广谱(Ckpan)、细胞角蛋白(CK)7、CK20、血管内皮生长因子(VEGF)、甲状腺转录因子(TTF)-1等指标进行免疫组织化学染色和阿辛蓝(AB)、过碘酸雪夫(PAS)特殊染色。结果:光镜下见肿瘤细胞中等大小、圆形、胞质内含大量黏液,形成圆形黏液滴,推挤细胞核至一侧,呈印戒样外观。特殊染色AB及PAS全部阳性;免疫组化结果Ckpan及癌胚抗原(CEA)8例全部阳性,CK7、TTF-1及VEGF阳性7例,CK20阳性1例。结论:肺原发性印戒细胞癌确诊主要依靠病理及免疫组化检查,其中TTF-1、CK7及CK20有助于鉴别肺原发与转移性印戒细胞癌。

原发性十二指肠球部印戒细胞癌1例

病例：患者 男，82岁。因“腹痛、腹泻2年，加重3月余”于2012年10月17日拟“腹痛待查”入院。患者2年前无明显诱因下出现上腹部绞痛，伴腹泻，

原发性膀胱印戒细胞癌l例报道

目的探讨原发性膀胱印戒细胞癌(SRCC)的临床特点及诊疗方法。方法回顾分析1例原发性膀胱SRCC患者的临床特征、病理资料及治疗方法等资料,并结合文献进行分析和总结。结果患者术前经活检明确诊断为膀胱印戒细胞癌,在全身麻醉下行"膀胱部分切除术+膀胱脐尿管切除术",术后2 w行双侧髂内动脉灌注介入性化疗,随访1年,患者恢复良好,无复发转移。结论原发性膀胱SRCC非常罕见,进展快、恶性程度高,有早期扩散转移倾向,且临床预后差;临床表现和影像学特点无明显特征,确诊主要依靠病理组织学检查;应早期行根治性膀胱切除术,结合全身化疗等治疗,但膀胱部分切除术、膀胱脐尿管切除术加双侧髂内动脉灌注介入性化疗亦能取得更良好的疗效。

乳腺原发性印戒细胞癌与乳腺黏液腺癌分子指标及预后的比较

目的比较乳腺原发性印戒细胞癌与乳腺黏液腺癌的分子特点及预后。方法对6例乳腺原发性印戒细胞癌患者和25例乳腺黏液腺癌患者的临床病理资料进行回顾性分析,比较其分子分型特点及生存情况。结果乳腺原发性印戒细胞癌与乳腺黏液腺癌患者在发病年龄、肿瘤大小、TNM分期、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)表达及分子分型方面,差异均无统计学意义(P≥0.05);在淋巴结转移、Ki-67表达方面,差异有统计学意义(P﹤0.05)。乳腺原发性印戒细胞癌与乳腺黏液腺癌患者的5年无病生存率分别为66.7%、80.0%。结论乳腺原发性印戒细胞癌比乳腺黏液腺癌更具侵袭性,淋巴结转移率高,Ki-67表达水平高,预后差。

原发性膀胱印戒细胞癌的诊断和治疗:附2例报告

目的提高对原发性膀胱印戒细胞癌的认识和诊治水平。方法回顾分析我院收治的2例原发性膀胱印戒细胞癌,结合文献就其临床表现、诊断及治疗进行讨论。第1例患者,男,57岁,以全程肉眼血尿和继发的贫血就诊,CT检查示膀胱顶部占位性病变,界限清楚,有斑点状钙化。第2例患者,男,66岁,以黏液尿就诊,无其他临床表现,CT示膀胱右侧壁占位性病变。均于术前膀胱镜活检明确诊断。第1例因患者拒绝膀胱全切除术行膀胱部分切除术加脐尿管和相邻腹膜的切除术,第2例因陈旧性心肌梗塞行膀胱部分切除术。结果第1例患者术后血尿消失,贫血纠正。7个月后发现肺部转移,术后8个月死亡。第2例术后黏液尿和膀胱刺激症状消失。随访37个月,患者恢复良好,无复发和转移。结论原发性膀胱印戒细胞癌临床罕见,预后较差,诊断主要依赖病理学检查,全膀胱切除术是其首选治疗方法。

原发性膀胱印戒细胞癌的诊断与治疗(附一例报道)

目的:提高对原发性膀胱印戒细胞癌(PBSRCC)的认知与诊治水平。方法:结合文献回顾性分析1例PBSRCC患者的临床资料,就其发病机制、病理特点、临床表现、诊断、治疗进行讨论。结果:该患者男性,63岁,因间断性肉眼血尿就诊,入院后行手术治疗,术后病理诊断为膀胱印戒细胞癌,转入肿瘤科放化疗治疗,目前正在随访中。结论:PBSRCC是一种罕见的恶性肿瘤,进展快、恶性程度高,预后差。影像学检查及膀胱镜检的综合应用是诊断PBSRCC的主要方法,其确诊主要依靠病理组织学检查。根治性膀胱全切术是目前首选的治疗方法。

胃低分化腺癌合并印戒细胞癌睾丸转移1例报告并文献复习

目的:探讨我院1例罕见胃印戒细胞癌睾丸转移的临床病理特点,免疫组织化学在睾丸转移瘤与原发肿瘤鉴别诊断中的应用。方法:回顾分析了我院收治1例睾丸肿瘤患者,1年前曾行胃贲门癌根治性全胃切除术,术后病理报告提示低分化印戒细胞癌,术后未予以放化疗,此次外院睾丸穿刺活检病理报告为低分化腺癌浸润或转移,考虑患者的病情及预后,行患侧根治性睾丸切除术。结果:术中见睾丸略增大,约4cm×3cm×2cm,质地硬,颜色呈淡红色,附睾大小、质地无异常。术后病理证实胃低分化腺癌合并印戒细胞癌转移。随访半年,临床症状好转。结论:胃印戒细胞癌睾丸转移非常罕见,特定的免疫组织化学指标可以有助于诊断。