Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction ...Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction differential malignant tumor specimens withparaffin-embedded were enrolled into our study and made tissue microarray which were dual-stainedwith CD31-PAS and stained with collagen IV. The difference of the areas and distribution withpattern surrounded by between CD31 and PAS positive respectively were identified via grid-counting,as well as the difference of VEGF expression with VE absent and present. Results: The basementmembrane of VM was both PAS and collagen IV positive. VEGF expression in the bi-directiondifferential malignant tumor was higher VM-absent than VM-present and the difference wasstatistically significance in malignant melanoma and alveolar rhabdomyosarcoma (P 【 0.05).Conclusion: PAS positive substance and collagen IV compose the wall of VE and VE could provide theoxygen and nutrition for tumor growth and progression.展开更多
Malignant peripheral nerve sheath tumor(MPNST) is an uncommon sarcoma which arises from pluripotent stem cells of the neural crest and differentiates predominantly towards Schwann cells. Low grade spinal MPNST with sk...Malignant peripheral nerve sheath tumor(MPNST) is an uncommon sarcoma which arises from pluripotent stem cells of the neural crest and differentiates predominantly towards Schwann cells. Low grade spinal MPNST with skeletal muscle differentiation(malignant triton tumor) is vanishingly rare. In this study, we report a case of a 53-year-old female with a homogenously enhancing C2-C4 extradural lesion. The lesion demonstrated a biphasic histologic pattern with a diffusely infiltrating, atypical spindle cell component strongly positive for vimentin and focally positive for S-100. The second component consisted of diffusely scattered clusters of mature skeletal muscle cells which were positive for desmin, fast myosin and muscle specific actin but negative for Myogenin and Myo D-1. The Ki-67 labeling index was low(< 1%) and no necrosis was identified. The present case is remarkable because of its rare location, low grade histology and unusual immunophenotype ofthe skeletal muscle component, which were not previously described.展开更多
BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT o...BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.展开更多
Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in compute...Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in computed tomography. Materials and Methods: 53 cases were included in the study. Primary (n = 42, 31 benign, 11 malignant) or metastatic (n = 11) tumors were detected at various locations in the bone structure of the cervical to coccygeal vertebrae in all cases. 3D CT images taken using the same system and biopsy or post-operative histopathology findings were available for all cases. Thin section images taken retrospectively from the archives were converted to 3D images using the same program and parameters, which were then recorded in the same window settings by two radiologists. Only 3D images were then analyzed to investigate the presence or absence of the dirty interface sign. Results: Dirty interface sign was present in 17 malignant lesions and absent in the remaining 5 lesions. As for benign lesions, the sign was present in only two lesions and the remaining 29 were negative for the sign. There was a high level of consistency between the two radiologists. In conclusion, malignant and benign lesions affecting the bone spinal axis were distinguished based on the presence or absence of the dirty interface sign with 77.3% sensitivity, 93.5% specificity and 86.8% accuracy. Conclusion: When evaluated with standard bone window views, 3D views can be used successfully for the distinction of malignant and benign bone tumors. At least, 3D views generated using low dose regimes in highly developed systems can be used with similar purpose to that of diffusion weighted MRI sequences that give roughly outlined but fast and accurate information about the lesion.展开更多
基金This work was partially supported by a grant from the National Natural Science Foundation of China (No. 30370378)
文摘Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction differential malignant tumor specimens withparaffin-embedded were enrolled into our study and made tissue microarray which were dual-stainedwith CD31-PAS and stained with collagen IV. The difference of the areas and distribution withpattern surrounded by between CD31 and PAS positive respectively were identified via grid-counting,as well as the difference of VEGF expression with VE absent and present. Results: The basementmembrane of VM was both PAS and collagen IV positive. VEGF expression in the bi-directiondifferential malignant tumor was higher VM-absent than VM-present and the difference wasstatistically significance in malignant melanoma and alveolar rhabdomyosarcoma (P 【 0.05).Conclusion: PAS positive substance and collagen IV compose the wall of VE and VE could provide theoxygen and nutrition for tumor growth and progression.
文摘Malignant peripheral nerve sheath tumor(MPNST) is an uncommon sarcoma which arises from pluripotent stem cells of the neural crest and differentiates predominantly towards Schwann cells. Low grade spinal MPNST with skeletal muscle differentiation(malignant triton tumor) is vanishingly rare. In this study, we report a case of a 53-year-old female with a homogenously enhancing C2-C4 extradural lesion. The lesion demonstrated a biphasic histologic pattern with a diffusely infiltrating, atypical spindle cell component strongly positive for vimentin and focally positive for S-100. The second component consisted of diffusely scattered clusters of mature skeletal muscle cells which were positive for desmin, fast myosin and muscle specific actin but negative for Myogenin and Myo D-1. The Ki-67 labeling index was low(< 1%) and no necrosis was identified. The present case is remarkable because of its rare location, low grade histology and unusual immunophenotype ofthe skeletal muscle component, which were not previously described.
文摘BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.
文摘Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in computed tomography. Materials and Methods: 53 cases were included in the study. Primary (n = 42, 31 benign, 11 malignant) or metastatic (n = 11) tumors were detected at various locations in the bone structure of the cervical to coccygeal vertebrae in all cases. 3D CT images taken using the same system and biopsy or post-operative histopathology findings were available for all cases. Thin section images taken retrospectively from the archives were converted to 3D images using the same program and parameters, which were then recorded in the same window settings by two radiologists. Only 3D images were then analyzed to investigate the presence or absence of the dirty interface sign. Results: Dirty interface sign was present in 17 malignant lesions and absent in the remaining 5 lesions. As for benign lesions, the sign was present in only two lesions and the remaining 29 were negative for the sign. There was a high level of consistency between the two radiologists. In conclusion, malignant and benign lesions affecting the bone spinal axis were distinguished based on the presence or absence of the dirty interface sign with 77.3% sensitivity, 93.5% specificity and 86.8% accuracy. Conclusion: When evaluated with standard bone window views, 3D views can be used successfully for the distinction of malignant and benign bone tumors. At least, 3D views generated using low dose regimes in highly developed systems can be used with similar purpose to that of diffusion weighted MRI sequences that give roughly outlined but fast and accurate information about the lesion.