Giant Myofibroblastoma of the Breast:A Case Report and Clinicopathological Analysis

Myofibroblastoma of the breast(MFB)is a rare benign mesenchymal tumor of the breast.A case of giant breast myofibroblastic tumor,which is rarely reported in literature,was recently diagnosed in our department.We also analyzed the clinicopathological features of MFB to improve the understanding of the tumor and avoid misdiagnosis.

Detection of ALK translocation in non-small cell lung carcinoma(NSCLC) and its clinicopathological significance using the Ventana immunohistochemical staining method: a single-center large-scale investigation of 1,504 Chinese Han patients

Objective： The novel fully automated immunohistochemistry （IHC） assay-Ventana anaplastic lymphoma kinase （ALK）-DSF3 for screening ALK rearrangements has been approved by China＇s Food and Drug Administration in 2013, our previous study disclosed a highly specificity and sensitivity nearly 100%, and its efficacy needs to be evaluated in a large cohort of primary lung adenocarcinoma patients, and to compare clinicopathological features with ALK （＋） and ALK （-） lung adenocarcinoma.Methods： A total of 1,504 consecutive surgical lung adenocareinoma eases of Chinese Han population were collected and re-diagnosed according to the 2011 multidisciplinary classification of lung adenocarcinoma. Fully automated Ventana ALK-D5F3 IHC staining with a binary scoring was adopted to evaluate staining and correlated with dinieopathologieal characters, including age, sex, differentiation degree, histological subtype, lymph node metastasis, and clinical staging. ALK （＋） patients were followed-up, and targeted therapy of ALKinhibitors was adopted and observed in patients with stage IV according to the NCCN guideline.Results： ALK positive adenocarcinomas were identified in 6.6% of the surgically resected 1,504 NSCLCs, and significantly younger than the negative group （P〈0.05）.Mucinous adenocarcinoma （28.2%） was determined to be predominant in ALK （＋） cases, followed by the solid type （11.7%）, specific type （6.8%）, papillary type （5.6%）, acinar type （5.5%）, and lepidic type （3.1%）, and the differences were statistically significant （χ2=42.01 1, P〈0.05）. ALK （＋） adenocarcinoma with lymph node metastasis （10.8%） were significantly higher than that without lymph node metastasis （4.5%） （g2=19.809, P〈0.05）; and ALK （＋） in phase Ⅳ （20%） was significantly higher than phaseⅢ （12.9%）, phase Ⅱ （4.2%）, phase Ⅰ （4.5%）, and phase 0 （0） （g2=36.068, P〈0.05）. Multivariate logistic regression disclosed that patient age, AJCC staging, and histological mucinous subtype were correlated with ALK positive staining （OR=0.959, 1.578, 5.036, respectively）. Sixty eight patients had followed-up results, five patients out of which primarily diagnosed or progressed into Stage IV benefited well from targeted therapy with Crizotinib.Conclusions： The ALK fusion protein was seen in 6.6% Chinese NSCLC patients, and mosdy seen in younger, clinically higher staging, mueinous and solid predominant adenoearcinoma. Clinical trials in patients of Stage Ⅳ eonfirmed that ALK-DSF3 Ventana IHC is serviceable in screening ALK-positive candidates for molecular targeted therapy.

Quantitative analysis of E-cadherin expression and clinicopathologic evaluation in gastric cancer

Objective To evaluate the relationship of E cadherin (E CD) expression to cellular DNA content and biological behavior of gastric cancer. Methods E CD expression and cellular DNA content were quantitatively measured by flow cytometry and immunofluorescence methods in 80 cases of formalinfixed, paraffin embedded gastric cancer. Systematic pathological examinations and follow up were performed for all cases. Results E CD expression was significantly reduced in all cases of gastric cancer. Fluorescence Index (FI) of E CD expression was 0.67±0.11 in gastric cancer, 1.0±0.07 in normal gastric mucosa ( P <0.001). The reduction of E CD expression was also found in 2 cases of early gastric cancer. Tumors with a decrease in E CD expression occurred significantly more frequently in undifferentiated, diffuse growth pattern Borrmann 4 type, positive lymph node (LN) metastasis and infiltrated serosa type gastric cancer, of which survival time was within 5 years ( P <0.001). E CD expression was also reduced in gastric cancer with the number of LN metastasis above 5, metastasis to more than group 2. E CD expression was lower in uneuploid cancer than that in diploid cancer ( P <0.01). The value of DI and PI with negative E CD expression was significantly higher than that of positive E CD expression ( P <0.01). Conclusion Down regulation of E CD expression correlates with bad biological behavior and poor prognosis of gastric cancer. The reduction of E CD expression may take place during early time of gastric cancer. Quantitative analysis of E CD expression may have some value in evaluating the intensity of LN metastasis of gastric cancer.

ENDOLYMPHATIC STROMAL MYOSIS OF THE UTERUS CLINICOPATHOLOGICAL ANALYSIS OF FIVE CASES

Five cases of endolymphatic stromal myosis (ELSM) were studied using histological, histochemical and immuno-histochemical methods. ELSM is a well-differentiated tumor resembling the normal endometrial stoma, with a low mitotic activity. So ELSM is considered as a kind of potentially malignant tumor different from endometrial stomal sarcoma and benign stromal nodules as well, though it can metastasize to the outside of uterus. ELSM may be derived from the stem cells that are normally present in the stroma of uterus, and can manifest multidifferentiation.

SUPERFICIAL CARCINOMAS OF THE ESOPHAGUS AND GASTRIC CARDIA A CLINICOPATHOLOGICAL ANALYSIS OF 141 CASES

From January 1970 to June 1999, 141 patients with superficial esophageal and cardiac carcinomas (SEC and SCC) underwent surgical treatment, Of the 141 patients 128 (90.8%) had slight symptoms related to swallowing, and the remaining 13 (9.2%) were asymptomatic, Balloon cytology and esophagoscopy proved very useful for the diagnosis of SEC and SCC, and Lugol's solution staining technique was an effective auxiliary diagnostic measure, Lymph node metastasis was not found in patients with epithelial (EP) cancer, However, it was present in one (2.9%) of 34 patients with muscularis mucosal (MM) invasion, and in 5 (8.6%) of 58 patients with submucosal (SM) cancer, The 5-year survival rates of the patients with SEC and SCC were 75.5% and 71.4%, respectively (P > 0.05). The different depth of tumor invasion including EP, MM and SM cancers showed significant differences in the 5-year survival rate (P < 0.05), Although the prognosis for the patients with lymph node metastasis is poor, we should advocate extended lymph node dissection in surgical treatment of the patients in whom MM and SM cancers are suspected.