热带海洋珍珠贝类立克次体病研究 Ⅳ.组织细胞病理学研究

类立克次体（RLO）对大珠母贝和合浦珠母贝具有强烈的致病性，引起基本一致的病理变化．在急性坏死破坏期内，RLO导致外套膜、鳃、消化管、肝胰腺、生殖腺腺管及全身血管内皮系统等多器官组织的变性坏死，使器官组织结构的完整性遭到破坏，破坏程度与RLO包涵体的数目密切相关，而细胞的破坏与细胞内RLO的生长发育及繁殖到大量数目密切相关．鉴于此，将RLO引起的珍珠贝病称为类立克次体病（RLO病）．RLO病呈急性变质性炎症和慢性增生性炎症病理，在前者细胞呈现崩解性坏死、溶解性坏死和退变性坏死；在后者存在实质细胞增生和纤维母细胞增生为纤维细胞并形成纤维化．根据炎症病理的发展过程，RLO病可分为急性坏死破坏期和慢性增生修复期．

组织细胞坏死性淋巴结炎40例临床病理特征及治疗分析

目的:探讨组织细胞坏死性淋巴结炎(Histocyticnecrotizinglym phadenitis,HNL)临床病理特征及治疗方法。方法:分析40例HNL临床资料及病理特征;免疫组化检测细胞表型。结果:(1)HNL多见于年轻女性,淋巴结肿大伴高热、外周血白细胞降低。(2)淋巴结常破碎状,淋巴结内片状凝固性坏死及大量组织细胞增生不伴有中性粒细胞浸润。(3)激素治疗HNL有效。结论:(1)淋巴结内片状凝固性坏死及大量组织细胞增生不伴有中性粒细胞浸润为HNL的临床病理特征;(2)激素治疗HNL有效。

皮肤原发性组织细胞肉瘤临床病理观察

患者女性,56岁,2014年11月8日发现四肢及颈背部多发皮下结节,未予重视。后结节逐渐增多、增大,于2015年1月3日就诊于本院肿瘤外科门诊,初步考虑淋巴瘤或多发转移癌,行右上腹部皮下小结节活检术并送病理检查。后患者行全身PETCT检查,可见多发皮下肿物,

p53蛋白和Ki-67在恶性纤维组织细胞瘤组织中的表达及意义

目的:研究p53蛋白和Ki-67在恶性纤维组织细胞瘤(malignant fibrous histi-ocytoma,MFH)组织中的表达及其临床意义。方法:应用免疫组化SP法检测50例MFH中p53和Ki-67的表达。结果:p53蛋白和Ki-67在MFH中表达阳性率分别为32·0%(16/50)和56·0%(28/50);在有复发转移的患者中,p53蛋白和Ki-67的阳性率分别为48%(12/25)和68%(17/25);在无复发转移的患者中,p53蛋白和Ki-67的阳性率分别为16·0%(4/25)和40·0%(10/25);生存期<5年的患者中,p53蛋白和Ki-67的阳性率分别为48·1%(13/27)和70·4%(19/27),生存期>5年的患者中p53蛋白和Ki-67的阳性率分别为17·4%(4/23)和39·1%(9/23)。p53蛋白和Ki-67与患者的复发转移及生存期显著相关,P<0·05。p53蛋白与Ki-67的表达关系密切,P<0·05。结论:p53蛋白和Ki-67的高表达与MFH的复发转移及患者生存期相关,两者的表达关系密切,并可作为MFH患者预后判断的两个指标。肿瘤防治杂志,2005,12(19)

骨原发性恶性纤维组织细胞瘤(附8例报告)

报告8例骨的恶性纤维组织细胞瘤。肉眼观大小形态很不一致。镜下观主要为纤维母细胞样细胞,呈车辐状排列,以及异形的单核双核和多核组织细胞。背景中常见有炎细胞及泡沫细胞,伴有出血坏死。以上特点少呈典型集中,故需多取材切片,以免误诊。并对起源、发病率、鉴别诊断等进行了讨论。

组织细胞坏死性淋巴结炎53例临床病理特征分析

目的:探讨组织细胞坏死性淋巴结炎(HNL)的临床、病理特点。方法:回顾分析53例HNL的临床资料、病理特征。结果:临床以首发症状为颈部淋巴结肿大占86.79%、发热占13.21%。HNL病理组织学表现为多种形态的组织细胞、免疫母细胞及浆细胞样单核细胞增生,伴有程度不同的核碎片。病变区淋巴细胞以CD45RO阳性、组织细胞CD68阳性细胞为主。结论:HNL的临床病理特征复杂,病理组织学及免疫组化检查是确诊的依据,此病预后良好,但易误诊为恶性淋巴瘤、其他淋巴结非肿瘤性疾病,应引起注意。

Littoral-cell angioma of the spleen:a case report

Littoral-cell angioma(LCA), a primary angioma which clinically belongs to splenic hemangioma, can be mostly found in normal spleen red sinus shore cells of reticuloendothelial cell system. The cells of LCA strongly express endothelial and tissue cell associated antigens that indicate a dual differentiation characteristic; whereas only endothelial cell markers are positive in normal spleen red sinus shore cells. Diagnosis of LCA relies on histopathology. Regular follow-up is needed to monitor recurrence and metastasis.

Changes of CD8+CD28-T regulatory cells in rat model of colitis induced by 2,4-dinitrofluorobenzene

AIM:To determine the changes of CD8+ T subsets especially CD8+CD28-T regulatory cells in rat model of experimental colitis induced by 2,4-dinitrofluorobenzene (DNFB). METHODS:The rat model of experimental colitis was induced by enema with DNFB.Ten days later,colonic intraepithelial and splenic lymphooltes were isolated from colitis animals (n=16) and controls (n=8).The proportion of CD8+ T cells,CD8+CD28+ T cells and CD8+CD28-T regulatory cells were determined by flow cytometry. RESULTS:The model of experimental colitis was successfully established by DNFB that was demonstrated by bloody diarrhea,weight loss and colonic histopathology.The proportion of CD8+ T cells in either splenic or colonic intraepithelial lymphocytes was not significantly different between colitis animals and controls (spleen:34.6±7.24 % vs 33.5±9.41%, colon:14.0±8.93 % vs 18.0±4.06 %,P>0.05).But CD8+CD28- T regulatory cells from colitis animals were significantly more than those from controls (spleen:11.3±2.26 % vs 5.64±1.01%, colon:6.50±5.37 % vs 1.07±0.65 %,P<0.05).In contrast, CD8+CD28+ T cells from colitis animals were less than those from controls (spleen:23.3±6.14 % vs 27.8±9.70 %,P=0.06; colon:7.52±4.18 % vs 16.9±4.07 %,P<0.05).The proportion of CD8+CD28-T regulatory cells in splenic and colon intraepithelial CD8+ T cells from colitis animals was higher than that from controls (spleen:33.3±5.49 % vs 18.4±7.26 %, colon:46.0±14.3 % vs6.10±3.72 %,P<0.005). CONCLUSION:Experimental colitis of rats can be induced by DNFB with simplicity and good reproducibility.The proportion of CD8+CD28-T regulatory cells in rats with experimental colitis is increased,which may be associated with the pathogenesis of colitis.

Tumor budding as a potential histopathological biomarker in colorectal cancer:Hype or hope?

Colorectal cancer （CRC）, the third most commonly di- agnosed type of cancer in men and women worldwide is recognized as a complex multi-pathway disease, an observation sustained by the fact that histologically identical tumors may have different outcome, including various response to therapy. Therefore, particularly in early and intermediate stage （stages Ⅱ and Ⅲ, respec- tively） CRC, there is a compelling need for biomarkers helpful of selecting patients with aggressive disease that might benefit from adjuvant and targeted therapy. Histopathological examination shows that likely other solid tumors the development and progression of hu- man CRC is not only determined by genetically abnor- mal cells, but also by intricate interactions between malignant cells and the surrounding microenvironment. This has led to reconsider the features of tumor mi- croenvironment as potential predictive and prognostic biomarkers. Among the histopathological biomarkers, tumor budding （i.e., the presence of individual cells and small clusters of tumor cells at the tumor invasive front）has received much recent attention, particularly in the setting of CRC. Although its acceptance as a reportable factor has been held back by a lack of uniformity with respect to qualitative and quantitative aspects, tumor budding is now considered as an independent adverse prognostic factor in CRC that may allow for stratifica- tion of patients into risk categories more meaningful than those defined by tumor-node-metastasis staging alone, and also potentially guide treatment decisions, especially in T2-T3 NO （stage Ⅱ） CRCs.

Ruptured hepatoblastoma with massive internal bleeding in an adult

Hepatoblastoma is the most common primary hepatic tumor of children. However, only a very few cases have been reported in adults. Most studies support treatment with chemotherapy followed by surgical resection. We present the first reported case of adult hepatoblastoma in Taiwan. A 52-year-old female suffered from sudden onset of abdominal pain and general weakness for days.Internal bleeding with hemorrhagic shock was suspected and two massive lesions in both lobes of the liver with hemoperitoneum were noted from imaging studies.Surgical resection of the larger left lobe tumor and radio-frequency ablation of the right smaller one were performed. The histopathology diagnosis was of a hepatoblastoma.

A case of long survival in poorly differentiated small cell carcinoma of the pancreas

Small cell carcinoma (SCC) of the pancreas is rare. It has similar histological features to pulmonary small cell carcinoma and is equally aggressive. Most patients with SCC in the pancreas reported in case studies died within 1 year after diagnosis. We present a case of unusually long-term survival after surgery and combined chemotherapy for SCC of the pancreas. A 62-year-old woman presented with epigastric pain and jaundice. Computed tomography revealed dilated common bile duct caused by external compression of the mass in the pancreatic head. Exploratory laparotomy and pancreaticoduodenectomy (PPPD) was performed with histopathological analysis confirming a primary small cell carcinoma of the pancreas. After an uneventful postoperative recovery, the patient was treated with 6 cycles of combined chemotherapy consisting of cisplantin and ectoposide. During the follow-up, there was no evidence of recurrence and the patient has remained in a good health condition for 36 mo since the diagnosis.

DEC1 nuclear expression:A marker of differentiation grade in hepatocellular carcinoma

AIM: To investigate the expression patterns of human differentiated embryo chondrocyte 1 (DEC1) in hepatocellular carcinoma (HCC) and corresponding adjacent non-tumor and the normal liver tissues, the association between DEC1 expression and histopathological variables and the role of DEC1 in hepatocarcinogenesis. METHODS: The expression of DEC1 was detected immunohistochemically in 176 paraffin-embedded sections from 63 patients with HCC and 50 subjects with normal liver tissues. RESULTS: DEC1 protein was persistently expressed in the cytoplasm of hepatocytes in normal liver and HCC tissues. Compared with adjacent non-tumor liver tissues, HCC tissues showed high nuclear expression of DEC1 protein. However, high DEC1 nuclear expression was more frequently detected in well-differentiated (83.3%) than in moderately (27.3%) and poorly differentiated HCC (16.7%). Low DEC1 expression was associated with poor histological differentiation and malignancy progression. A correlation was found between the nuclear expression of DEC1 protein and histological differentiation (r = 0.376, P = 0.024). CONCLUSION: DEC1 is expressed in the cytoplasm of hepatocytes and because nuclear DEC1 expression is decreased with decreasing differentiation status of HCC, nuclear DEC1 might be a marker of HCC differentiation.

Lymphomatoidgastropathy mimicking extranodal NK/T cell lymphoma,nasal type:A case report

Extranodal natural killer(NK)/T-cell lymphoma,nasal type,exhibits aggressive tumor behavior and carries a poor prognosis.Recently,lymphomatoid gastropathy with NK/T cell infiltration into gastric mucosa has been recognized as a pseudo-malignant disease which regresses without treatment.Because the conventional immunohistochemical criteria of lymphomatoid gastropathy is similar to that of extranodal NK/T-cell lymphoma nasal type,it is difficult to distinguish between the two conditions by histopathological evaluation only.Here,we report a rare case of lymphomatoid gastropathy in a 57-year-old female.Gastroendoscopy on routine check-up revealed elevated reddish lesions < 1 cm in diameter in the gastric fornix and body.Although repeat endoscopies at 1 and 6 mo later revealed no gastric lesions at any locations without any treatments,at 12 mo later gastric lymphomatoid lesions recurred at gastric fornix and body.Histological examination of endoscopic biopsy specimens at 12 mo showed atypical NK cell infiltration with CD3+,CD4-,CD5-,CD7+,CD8-,CD20-,CD30-,CD56+,CD79a-and T-cell-restricted intracellular antigen-1+ into gastric mucosa.After treatment for Helicobacter pylori(H.pylori) eradication,the lesions disappeared in all locations of the gastric fornix and body over the subsequent 12 mo.Here,we report a case of H.pylori-positive lymphomatoid gastropathy with massive NK-cell proliferation,and also review the literature concerning newly identified lymphomatoid gastropathy based on comparison of extra nodal NK/T-cell lymphoma nasal type.In any case,these lesions are evaluated with biopsy specimens,the possibility of this benign entity should be considered,and excessive treatment should be carefully avoided.Close follow-up for this case of lymphomatoid gastropathy is necessary to exclude any underlying malignancy.

Helicobacter pylori infection and gastropathy:A comparison between Indonesian and Japanese patients

AIM： To compare the effects of He/icobacter py/ori （Hpylon） infection on gastropathy between Indonesian and Japanese patients. METHODS： Biopsy specimens were obtained during upper gastrointestinal endoscopy from 167 subjects （125 Indonesians and 42 Japanese） with uninvestigated symptoms of dyspepsia. The specimens were analyzed for the presence of H pylori using urease analysis, histopathology, and cell culture. The grade and activity of gastritis was assessed using the updated Sydney system. RESULTS： The percentages of Indonesian and Japanese patients who were H py/ori-positive at the antrum or body of the stomach were similar （68% and 59.5%, respectively; P = 0.316）. Of those who were Hpylori-positive, more Japanese patients than Indonesian patients had high levels of polymorphonuclear cells （P = 0.001）, mononuclear cells （P = 0.013）, glandular atrophy （P = 0.000）, and intestinal metaplasia （P = 0.011） in both the antrum and body of the stomach. CONCLUSION： The grade of gastritis and prevalence of mucosal atrophy and intestinal metaplasia were higher in Japanese patients. The difference between Indonesian and Japanese patients was significant.

PROPERTIES OF PROTEOLYTIC TOXIN OF VIBRIO ANGUILLARUM FROM DISEASED FLOUNDER

Extracellular products (ECP) produced by Vibrio anguillarum strain M3 originally isolated from diseased flounder ( Paralichthys olivaceus ) were prepared. ECP of M3 showed gelatinase, casinase, amylase and haemolytic activity on agarose plates. High protease activity against azocasin was detected. Bacterium M3 showed highest growth and protease activity at 25℃. The protease present in ECP showed maximal activity at pH 8 and 55℃; was completely inactivated by application of 80℃ heat for 30 min; was completely inhibited by EDTA and HgCl 2, and was partially inhibited by PMSF, SDS, MnCl 2 and iodoacetic acid; but not inhibited by CaCl 2 and MgCl 2. The ECP was toxic to flounder fish at LD 50 values of 3.1 μg protein /g body weight. The addition of HgCl 2 and application of heat at 50℃ decreased the lethal toxicity of ECP. When heated at 100℃, ECP lethality to flounder was completely inhibited. After intramuscular injection of ECP into flounder, it showed evident histopathological changes including necrosis of muscle, extensive deposition of haemosiderin in the spleen, dilated blood vessels congested with numerous lymphocytes in the liver. These results showed that ECP protease was a lethal factor produced by the bacterium V. anguillarum M3.

Dynamic contrast-enhanced magnetic resonance perfusion weighted imaging in astrocytomas: correlation with histopathology and immunohistochemistry

Objective:To investigate magnetic resonance perfusion weighted imaging and its relationship with the grading and the expression of vascular endothelial growth factor (VEGF) and angiogenesis in astrocytomas. Methods: A collection of 34 patients with astrocytomas proved by surgery and pathology were examined by magnetic resonance imaging(MRI), with 26 cases of gradeⅠ-Ⅱ(low-grade) and 8 cases of grade Ⅲ-Ⅳ(high-grade). MR perfusion images were obtained with spin-echo echo planar imaging (SE-EPI) techniques. Expression of VEGF was examined by immunohistochemical method of streptavidin-biotin-peroxidase(SP). The vascular development was measured by micro-vascular density (MVD) which was immunostained with anti-factor Ⅷ-related antigen monoclonal antibody. Results: Both of the expression of VEGF and the angiogenesis in 34 cases of astrocytomas were significantly correlated to the maximum relative cerebral blood volume (Max rCBV) (r=0.604, P<0.001;r=0.625, P<0.001, respectively). The Max rCBV and the expression of VEGF, MVD in high-grade astrocytomas were significantly higher than that of in low-grade astrocytomas (t= 3.0, P=0.017; t=7.08, P=0.01;t=3.37,P=(0.011,) respectively). Conclusion: MR perfusion weighted imaging might be a valuable method in in vivo study of the angiogenesis of astrocytomas and evaluating their malignant degree and prognosis.

Soft tissue recurrence of giant cell tumor of bone: A report of two cases and literature review

We investigated the clinical features of soft-tissue recurrence in giant cell tumor of bone （GCTB）. Among 106 cases with GCTB in our hospital, there were 2 cases occurring soft-tissue recurrence which histories were reported. These two soft-tissue recurrences occurred with the interval of 6.9 years and 2.5 years respectively from pdmary diagnosis. The clinical presentation was nonspecific masses in soft tissue. Radiographic ossification was not found at periphery or within the masses. Through pathological examination peripheral ossification was found in 1 case and malignant transformation occurred in the other case. Through retrieving and reviewing literatures in PubMed, 19 cases of soft-tissue recurrence with detailed materials were collected and analyzed. Soft-tissue recurrence of GCTB is a rare episode which reflects its locally aggressive nature, the reasons of which are tumor cells implantation and tumor residual. Ossification at periphery or in the masses can be considered as a pathognomonic character of this episode in radiographic and pathohistological examination. The prevention lies in determining tumor extension preoperatively, proper non-tumor manipulations, removing the tumor and irrigating operative wound as completely as possible.

Omentum facilitates liver regeneration

AIM:To investigate the mechanism of liver regeneration induced by fusing the omentum to a small traumatic injury created in the liver. We studied three groups of rats. In one group the rats were omentectomized; in another group the omentum was left in situ and was not activated,and in the third group the omentum was activated by polydextran particles. METHODS:We pre-activated the omentum by injecting polydextran particles and then made a small wedge wound in the rat liver to allow the omentum to fuse to the wound. We monitored the regeneration of the liver by determining the ratio of liver weight/body weight,by histological evaluation (including immune staining for cytokeratin-19,an oval cell marker),and by testing for developmental gene activation using reverse transcription polymerase chain reaction (RT-PCR). RESULTS:There was no liver regeneration in the omentectomized rats,nor was there significant regeneration when the omentum was not activated,even though in this instance the omentum had fusedwith the liver. In contrast,the liver in the rats with the activated omentum expanded to a size 50% greater than the original,and there was histologically an interlying tissue between the wounded liver and the activated omentum in which bile ducts,containing cytokeratin-19 positive oval cells,extended from the wound edge. In this interlying tissue,oval cells were abundant and appeared to proliferate to form new liver tissue. In rats pre-treated with drugs that inhibited hepatocyte growth,liver proliferation was ongoing,indicating that regeneration of the liver was the result of oval cell expansion. CONCLUSION:Activated omentum facilitates liver regeneration following injury by a mechanism that depends largely on oval cell proliferation.

Chronic Toxicity of a Novel Recombinant Human Granulocyte Colony-stimulating Factor in Rats

Objective To assess the severity and reversibility of the chronic toxicity of a novel recombinant human granulocyte colony-stimulating factor (rhG-CSFa) in rats and the dose-effect relationship.Methods A total of 100 Sprague-Dawley rats (equal numbers of male and female) were randomly divided into five groups (20 rats in each group):four groups were treated with rhG-CSFa at 500,100,10,1 μg/kg,respectively,and one group was treated with vehicle only to serve as the control.The rats were received subcutaneous injections of rhG-CSFa or vehicle daily for 13 weeks.During the course of the chronic toxicity study,the physical status,body weight,and food consumption were monitored.Half of the rats in each group (n=10) were sacrificed after the last rhG-CSFa administration,and the other half were sacrificed at five weeks after the last rhG-CSFa administration.Urinalyses,blood biochemistry,hematological analysis,histopathological examination,and immunological tests were performed for each of the rats.Results The hematological analyses revealed that the mean white blood cells count,neutrophils count,and neutrophils percentage were increased in male rats at the dose of 10 μg/kg or higher,and these were related with the biological activity of rhG-CSFa.Some small abnormalities were observed in the spleen of a few rats when used highest dose (500 μg/kg,a dosage of 200 folds higher than the normal clinical dosage),but these abnormalities were recovered within 5-week recovery period.No other rhG-CSFa-related abnormalities were observed in this chronic toxicity study.Conclusion No significant toxicity and immunogenicity are observed with rhG-CSFa administration to rats in the chronic toxicity studies.