BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip...BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.展开更多
In this editorial we comment on the manuscript describing a case of adenocarcinoma mixed with a neuroendocrine carcinoma of the gastroesophageal junction.Mixed neuroendocrine and non-neuroendocrine neoplasms of the ga...In this editorial we comment on the manuscript describing a case of adenocarcinoma mixed with a neuroendocrine carcinoma of the gastroesophageal junction.Mixed neuroendocrine and non-neuroendocrine neoplasms of the gastrointestinal system are rare heterogeneous group of tumors characterized by a high malignant potential,rapid growth,and poor prognosis.Due to the rarity of these cancers,the standard therapy is poorly defined.The diagnosis of these tumors is based on combination of morphological features,immunohistochemical and neuroendocrine and epithelial cell markers.Both endocrine and epithelial cell components can act independently of each other and thus,careful grading of each component separately is required.These cancers are aggressive in nature and the potential of each component has paramount importance in the choice of treatment and response.Regardless of the organ of origin,these tumors portend poor prognosis with increased proportion of neuroendocrine component.Multidisciplinary services and strategies are required for the management of these mixed malignancies to provide the best oncological outcomes.The etiopathogenesis of these mixed tumors remains obscure but poses interesting question.We briefly discuss a few salient points in this editorial.展开更多
BACKGROUND Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported).They occur almost exclusively in postmenopausal women,with only seven cases reported in men.As t...BACKGROUND Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported).They occur almost exclusively in postmenopausal women,with only seven cases reported in men.As this entity is very rare,little is known on its imaging features,especially magnetic resonance imaging (MRI) findings.In women,at MRI,the cystic component shows T1 hypointensity and T2 hyperintensity,while the solid component shows T1 hyperintensity and T2 hypointensity.CASE SUMMARY We report the computed tomography (CT) and MRI findings of MESTK in a 19- year-old male adolescent.To our knowledge,this case report is the first report of MRI findings of MESTK in male adolescents.The patient was admitted to Subei People's Hospital (Jiangsu Province,China) in July 2017 after a renal mass on the left side was detected by ultrasound during a clinical examination.Blood tests were all normal.Non-enhanced CT showed a round,well-circumscribed complex mass,approximately 45 mm × 40 mm in size.MRI revealed a clear wellcircumscribed mass with a mixed arrangement of solid and cystic components.On T2 weighted images,some hypointensities were found in the solid areas.After contrast enhancement,moderate or mild enhancement was found in the solid component,which increased with time.A radical left nephrectomy was performed.The pathology analysis revealed a mixed epithelial and stromal tumor.The patient had no imaging findings of recurrence or metastasis at 12 months following surgery.CONCLUSION The possibility of MESTK should be considered in male adolescents.MRI can provide useful information for the preoperative diagnosis.展开更多
Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpresse...Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpressed fibroblast growth factor 23 (FGF23) is responsible for the hypophosphatemia and osteomalacia. The tumors associated with TIO are usually phosphaturic mesenchymal tumor mixed connective tissue variants (PMTMCT). Surgical removal of the responsible tumors is clinically essential for the treatment of TIO. However, identifying the responsible tumors is often difficult. Here, we report a case of a TIO patient with elevated serum FGF23 levels suffering from bone pain and hypophosphatemia for more than three years. A tumor was finally located in first metacarpal bone by octreotide scintigraphy and she was cured by surgery. After complete excision of the tumor, serum FGF23 levels rapidly decreased, dropping to 54.7% of the preoperative level one hour after surgery and eventually to a little below normal. The patient's serum phosphate level rapidly improved and returned to normal level in four days. Accordingly, her clinical symptoms were greatly improved within one month after surgery. There was no sign of tumor recurrence during an 18-month period of follow-up. According to pathology, the tumor was originally diagnosed as "glomangioma" based upon a biopsy sample, "proliferative giant cell tumor of tendon sheath" based upon sections of tumor, and finally diagnosed as PMTMCT by consultation one year after surgery. In conclusion, although an extremely rare disease, clinicians and pathologists should be aware of the existence of TIO and PMTMCT, respectively.展开更多
AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV)...AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls. RESULTS: Cryoglobulinemic patients showed signifi cantly higher mean NTproBNP and TNF-α levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as thepatients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.展开更多
Meningioma-glioma mixed tumor is rare central nervous system tumor. It is necessary to study its clinical and pathological characteristics as well as its possible genesis. This case was a 54-year-old man who was readm...Meningioma-glioma mixed tumor is rare central nervous system tumor. It is necessary to study its clinical and pathological characteristics as well as its possible genesis. This case was a 54-year-old man who was readmitted for recurrent glioma. Magnetic resonance imaging showed a big mass in right temporal lobe which was confirmed as meningioma-glioma by immunohistochemical analysis. Specific immunohistochemical staining is significant in tumor differential diagnosis, and helps to confirm tumor histic origin. By pathological studies, we found that glioma could stimulate adjacent normal meninges into neoplastic proliferation.展开更多
Mixed epithelial and stromal tumor of the kidney (MESTK) is a recently described rare neoplasm. Malignant transformation, recurrence and metastasis are rare, therefore histopathological distinction from other renal ne...Mixed epithelial and stromal tumor of the kidney (MESTK) is a recently described rare neoplasm. Malignant transformation, recurrence and metastasis are rare, therefore histopathological distinction from other renal neoplasms, especially from renal cell carcinoma is important. Histologically the tumor is composed of biphasic components including cysts and tubules embedded in the spindle cell stroma. We report a case of a MESTK in 60-year-old postmenopousal woman who presented with an incidental solid renal mass but no urinary complaint.展开更多
Malignant tumors of the appendix are rare. They are present in 0.1% to 0.5% of appendectomy specimens: confirmed upon histological analysis. Mixed tumors in the appendix are exceptional. We report a mixed mucinous cys...Malignant tumors of the appendix are rare. They are present in 0.1% to 0.5% of appendectomy specimens: confirmed upon histological analysis. Mixed tumors in the appendix are exceptional. We report a mixed mucinous cystadenoma with a moderately differentiated adenocarcinoma of the appendix in a 64-year-old patient presented to the emergency room with bowel obstruction syndrome.展开更多
Mixed adenoneuroendocrine carcinoma(MANEC)is a malignant tumor with adenocarcinoma and neuroendocrine components,with≥30%of each component required.MANEC of the ampulla is rare.To the best of our knowledge,only 15 ca...Mixed adenoneuroendocrine carcinoma(MANEC)is a malignant tumor with adenocarcinoma and neuroendocrine components,with≥30%of each component required.MANEC of the ampulla is rare.To the best of our knowledge,only 15 cases of MANEC of the ampulla have been reported in the English-language literature.Here,we report two cases of MANEC of the ampulla in two womenaged 43 and 60 years,which was confirmed by histology after pancreaticoduodenectomy.These tumors contained neuroendocrine and adenocarcinoma components.The neuroendocrine components were positive for chromogranin A(Cg A),synaptophysin(Syn)and CD56 by immunostaining.The adenocarcinoma components were negative for Cg A,Syn and CD56.Both cases were T3N0M0(StageⅢA).They survived for 15 and 20 mo after surgery,respectively.A brief discussion about the histopathological features,clinical behavior and treatment of MANEC of ampulla,and review of the relevant literature are presented.展开更多
BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal trac...BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally.Though they have been a well-documented entity in the pancreas,where the exocrine-endocrine mixed tumors have been known for a while,recognition and accurate diagnosis of these tumors in the colon and rectum,to date,remains a challenge.This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification.Therefore,dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers.Though,most of these tumors are high grade and of advanced stage,intermediate and low grade lesions of these mixed tumors are also increasingly been reported.There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions.AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape,clinicoradiological features,pathology,treatment,prognosis,the current status of the management of the primary lesions,their recurrences and metastases.METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed,MEDLINE and GOOGLE scholar.The following search terms[“mixed tumors colon”OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors]were used.Eligibility criteria were defined and all potential relevant items,including full articles and/or abstracts were independently reviewed,assessed and agreed upon items were selected for in-depth analysis.RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review.This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives,nomenclature,clinicoradiological features,pathology,treatment,prognosis and the current status of the management of both the primary lesions,their recurrences and metastases.Gaps in knowledge have also been identified and discussed.An important outcome of this manuscript is the justified proposal for a new,simple,clinically relevant,non-ambiguous terminology for these lesions to be referred to as mixed epithelial endocrine neoplasms(MEENs).CONCLUSION MEEN of the colon and rectum are poorly understood rare entities that encompass an extensive range of heterogeneous tumors with a wide variety of combinations leading to tumors of high,intermediate or low grade malignant potential.This proposed new revised terminology of MEEN will solve the biggest hurdle of confusion and misclassification that plagues these rare unique colorectal neoplasms thus facilitating the future design of multi institutional prospective randomized controlled clinical trials to develop and evaluate newer therapeutic strategies that are recommended for continued improved understanding and personal optimization of clinical management of these unique colorectal neoplasms.展开更多
Background:Renal cysts are common in clinical practice,but some may harbor rare pathological entities such as mixed epithelial and stromal tumors(MEST).Imaging studies are crucial for accurate diagnosis.While laparosc...Background:Renal cysts are common in clinical practice,but some may harbor rare pathological entities such as mixed epithelial and stromal tumors(MEST).Imaging studies are crucial for accurate diagnosis.While laparoscopic deroofing is an established approach for symptomatic renal cysts,encountering MEST within a cyst is uncommon.Case Presentation:We present the case of a 37-year-old female who presented with persistent left flank pain.Imaging revealed a large renal cyst in the lower pole of the left kidney,classified as Bosniak 2.Despite analgesia,the patient's symptoms persisted,leading to a laparoscopic deroofing procedure.Histopathological examination postprocedure revealed a MEST.The patient reported complete resolution of symptoms at the 3-month follow-up.Conclusion:This unique case presents the successful identification and surgical management of a MEST masquerading as a lower pole renal cyst through laparoscopic deroofing.It also contributes to the existing literature by highlighting the importance of considering rare pathological entities in the evaluation of renal cysts and the value of laparoscopic techniques in their management.展开更多
BACKGROUND Pancreatic mixed serous-neuroendocrine neoplasms(MSNNs)are mixed tumors containing two components with different pathologies,namely,pancreatic serous cystic neoplasm(PSCN)and pancreatic neuroendocrine tumor...BACKGROUND Pancreatic mixed serous-neuroendocrine neoplasms(MSNNs)are mixed tumors containing two components with different pathologies,namely,pancreatic serous cystic neoplasm(PSCN)and pancreatic neuroendocrine tumor(PanNET).For MSNNs,diffuse PSCN involving the whole pancreas is extremely rare,with only eight previous case reports.CASE SUMMARY A 45-year-old Chinese woman,with a free previous medical history and no obvious symptoms,was found to have a pancreatic neoplasm and admitted to our hospital for further diagnosis in March 2018.Abdominal palpation revealed a painless,mobile mass in the epigastrium,and no abnormalities were observed in an examination of the nervous system and ocular system.A computed tomography scan showed multiple cystic lesions involving the whole pancreas ranging in diameter from 0.4 to 2 cm and also revealed an enhanced mass,2.2 cm in diameter,in the head of the pancreas.Moreover,multiple cysts were found in the kidneys bilaterally,and the right lobe of the liver contained a small cyst.A Whipple operation with total pancreatectomy and splenectomy was performed.A diagnosis of pancreatic MSNN was established,consisting of diffuse serous microcystic cystadenoma with a concomitant grade 2 PanNET.Of note,the patient had no personal or family history of Von Hippel-Lindau syndrome or other disease.CONCLUSION We report the first case of MSNN with a diffuse PSCN component involving the entire pancreas in a Chinese woman.It is important to be aware of its relationship with VHL syndrome,and close clinical follow-up is recommended.展开更多
Neuroendocrine neoplasms are the most common epithelial tumors among appendix tumors. Appendix tumors that are completely or partially composed of neuroendocrine cells are divided into two categories: Classic carcinoi...Neuroendocrine neoplasms are the most common epithelial tumors among appendix tumors. Appendix tumors that are completely or partially composed of neuroendocrine cells are divided into two categories: Classic carcinoid tumors and goblet cell carcinoid tumors(GCCT). They are known to progress more aggressively than classic(neuro) endocrine tumors. In this study, three cases with acute appendicitis symptoms are presented, including their clinical and histopathological findings. Microscopic examination detected GCCT in two cases and mixed adenoneuroendocrine carcinoma in one case, in addition to acute appendicitis.展开更多
The authors present 83 patients with mixed glioma with experiences in clinical diagnosis and treatment.In all these cases.there were 44 tumors as grade 1 or 2,and 39 as grade 3 or 4.In 39 tumors.two glial components(o...The authors present 83 patients with mixed glioma with experiences in clinical diagnosis and treatment.In all these cases.there were 44 tumors as grade 1 or 2,and 39 as grade 3 or 4.In 39 tumors.two glial components(oligodendrocytes and astrocytes) occurr展开更多
背景:近年来,许多研究证实类装配体可弥补类器官无法完全重现细胞与细胞、细胞与基质间的互作关系的缺点,但处于发展初期的类装配体构建方式种类繁多,更无统一标准。目的:综述目前类装配体的构建方法、应用和优缺点,为促进体外细胞模型...背景:近年来,许多研究证实类装配体可弥补类器官无法完全重现细胞与细胞、细胞与基质间的互作关系的缺点,但处于发展初期的类装配体构建方式种类繁多,更无统一标准。目的:综述目前类装配体的构建方法、应用和优缺点,为促进体外细胞模型的发展和完善提供指导。方法:以“assembloids,organoids,tumor microenvironment,organoids AND assemble,organoids AND microenvironment”为英文检索词,以“类装配体、类器官、类组装体、肿瘤微环境、类器官重组、多细胞模型”为中文检索词,检索PubMed、中国知网及万方数据库,在排除无关文章及去重后筛选出94篇文章进行综述。结果与结论:①根据细胞来源的不同,可将类装配体的构建方法分为自体组装、直接组装及混合组装3种;根据细胞培养方式的差异,又可分为悬浮培养法、“基质”培养法、器官芯片培养法和3D生物打印法。②自体组装过程涵盖细胞和组织的发育等早期过程,因此,在器官发育和发育障碍等领域有广阔的前景,而分化成熟细胞的功能相对较完善,由它们直接组装成的类装配体在功能障碍及细胞损伤性疾病的研究中更具潜力;自体组装或在器官移植方面更胜一筹,直接组装将更适用于组织损伤的修复,混合组装综合了前两者的优势,多用于探索微环境中细胞的生理和病理机制以及药物筛选等领域。③虽然不同的类装配体各具优势,但都面临脉管系统不完善的难题;每种类装配体构建方法也存在各自的局限性,如自体组装形成的类装配体中细胞分化程度与体内的差异,直接组装模型的细胞种类固定、无法完全反映复杂的体内微环境等均是亟待解决的难题。④将来随着类装配体培养技术的不断完善,研究者们可以在体外组装出具有更复杂组织结构的仿生类器官,为研究人类组织和器官生理及病理过程提供无限趋近真实的模型。展开更多
文摘BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.
文摘In this editorial we comment on the manuscript describing a case of adenocarcinoma mixed with a neuroendocrine carcinoma of the gastroesophageal junction.Mixed neuroendocrine and non-neuroendocrine neoplasms of the gastrointestinal system are rare heterogeneous group of tumors characterized by a high malignant potential,rapid growth,and poor prognosis.Due to the rarity of these cancers,the standard therapy is poorly defined.The diagnosis of these tumors is based on combination of morphological features,immunohistochemical and neuroendocrine and epithelial cell markers.Both endocrine and epithelial cell components can act independently of each other and thus,careful grading of each component separately is required.These cancers are aggressive in nature and the potential of each component has paramount importance in the choice of treatment and response.Regardless of the organ of origin,these tumors portend poor prognosis with increased proportion of neuroendocrine component.Multidisciplinary services and strategies are required for the management of these mixed malignancies to provide the best oncological outcomes.The etiopathogenesis of these mixed tumors remains obscure but poses interesting question.We briefly discuss a few salient points in this editorial.
基金Supported by National Natural Science Foundation of China,No.81401384Social Develop Foundation of Yangzhou,No.2017066+1 种基金Yangzhou City Science and Education Strengthening Leading Talents Project,No.LJRC201810Yangzhou City Science and Education Strengthening Key Talents Project,No.ZDRC201873
文摘BACKGROUND Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported).They occur almost exclusively in postmenopausal women,with only seven cases reported in men.As this entity is very rare,little is known on its imaging features,especially magnetic resonance imaging (MRI) findings.In women,at MRI,the cystic component shows T1 hypointensity and T2 hyperintensity,while the solid component shows T1 hyperintensity and T2 hypointensity.CASE SUMMARY We report the computed tomography (CT) and MRI findings of MESTK in a 19- year-old male adolescent.To our knowledge,this case report is the first report of MRI findings of MESTK in male adolescents.The patient was admitted to Subei People's Hospital (Jiangsu Province,China) in July 2017 after a renal mass on the left side was detected by ultrasound during a clinical examination.Blood tests were all normal.Non-enhanced CT showed a round,well-circumscribed complex mass,approximately 45 mm × 40 mm in size.MRI revealed a clear wellcircumscribed mass with a mixed arrangement of solid and cystic components.On T2 weighted images,some hypointensities were found in the solid areas.After contrast enhancement,moderate or mild enhancement was found in the solid component,which increased with time.A radical left nephrectomy was performed.The pathology analysis revealed a mixed epithelial and stromal tumor.The patient had no imaging findings of recurrence or metastasis at 12 months following surgery.CONCLUSION The possibility of MESTK should be considered in male adolescents.MRI can provide useful information for the preoperative diagnosis.
文摘Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpressed fibroblast growth factor 23 (FGF23) is responsible for the hypophosphatemia and osteomalacia. The tumors associated with TIO are usually phosphaturic mesenchymal tumor mixed connective tissue variants (PMTMCT). Surgical removal of the responsible tumors is clinically essential for the treatment of TIO. However, identifying the responsible tumors is often difficult. Here, we report a case of a TIO patient with elevated serum FGF23 levels suffering from bone pain and hypophosphatemia for more than three years. A tumor was finally located in first metacarpal bone by octreotide scintigraphy and she was cured by surgery. After complete excision of the tumor, serum FGF23 levels rapidly decreased, dropping to 54.7% of the preoperative level one hour after surgery and eventually to a little below normal. The patient's serum phosphate level rapidly improved and returned to normal level in four days. Accordingly, her clinical symptoms were greatly improved within one month after surgery. There was no sign of tumor recurrence during an 18-month period of follow-up. According to pathology, the tumor was originally diagnosed as "glomangioma" based upon a biopsy sample, "proliferative giant cell tumor of tendon sheath" based upon sections of tumor, and finally diagnosed as PMTMCT by consultation one year after surgery. In conclusion, although an extremely rare disease, clinicians and pathologists should be aware of the existence of TIO and PMTMCT, respectively.
文摘AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls. RESULTS: Cryoglobulinemic patients showed signifi cantly higher mean NTproBNP and TNF-α levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as thepatients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.
文摘Meningioma-glioma mixed tumor is rare central nervous system tumor. It is necessary to study its clinical and pathological characteristics as well as its possible genesis. This case was a 54-year-old man who was readmitted for recurrent glioma. Magnetic resonance imaging showed a big mass in right temporal lobe which was confirmed as meningioma-glioma by immunohistochemical analysis. Specific immunohistochemical staining is significant in tumor differential diagnosis, and helps to confirm tumor histic origin. By pathological studies, we found that glioma could stimulate adjacent normal meninges into neoplastic proliferation.
文摘Mixed epithelial and stromal tumor of the kidney (MESTK) is a recently described rare neoplasm. Malignant transformation, recurrence and metastasis are rare, therefore histopathological distinction from other renal neoplasms, especially from renal cell carcinoma is important. Histologically the tumor is composed of biphasic components including cysts and tubules embedded in the spindle cell stroma. We report a case of a MESTK in 60-year-old postmenopousal woman who presented with an incidental solid renal mass but no urinary complaint.
文摘Malignant tumors of the appendix are rare. They are present in 0.1% to 0.5% of appendectomy specimens: confirmed upon histological analysis. Mixed tumors in the appendix are exceptional. We report a mixed mucinous cystadenoma with a moderately differentiated adenocarcinoma of the appendix in a 64-year-old patient presented to the emergency room with bowel obstruction syndrome.
文摘Mixed adenoneuroendocrine carcinoma(MANEC)is a malignant tumor with adenocarcinoma and neuroendocrine components,with≥30%of each component required.MANEC of the ampulla is rare.To the best of our knowledge,only 15 cases of MANEC of the ampulla have been reported in the English-language literature.Here,we report two cases of MANEC of the ampulla in two womenaged 43 and 60 years,which was confirmed by histology after pancreaticoduodenectomy.These tumors contained neuroendocrine and adenocarcinoma components.The neuroendocrine components were positive for chromogranin A(Cg A),synaptophysin(Syn)and CD56 by immunostaining.The adenocarcinoma components were negative for Cg A,Syn and CD56.Both cases were T3N0M0(StageⅢA).They survived for 15 and 20 mo after surgery,respectively.A brief discussion about the histopathological features,clinical behavior and treatment of MANEC of ampulla,and review of the relevant literature are presented.
文摘BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally.Though they have been a well-documented entity in the pancreas,where the exocrine-endocrine mixed tumors have been known for a while,recognition and accurate diagnosis of these tumors in the colon and rectum,to date,remains a challenge.This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification.Therefore,dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers.Though,most of these tumors are high grade and of advanced stage,intermediate and low grade lesions of these mixed tumors are also increasingly been reported.There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions.AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape,clinicoradiological features,pathology,treatment,prognosis,the current status of the management of the primary lesions,their recurrences and metastases.METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed,MEDLINE and GOOGLE scholar.The following search terms[“mixed tumors colon”OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors]were used.Eligibility criteria were defined and all potential relevant items,including full articles and/or abstracts were independently reviewed,assessed and agreed upon items were selected for in-depth analysis.RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review.This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives,nomenclature,clinicoradiological features,pathology,treatment,prognosis and the current status of the management of both the primary lesions,their recurrences and metastases.Gaps in knowledge have also been identified and discussed.An important outcome of this manuscript is the justified proposal for a new,simple,clinically relevant,non-ambiguous terminology for these lesions to be referred to as mixed epithelial endocrine neoplasms(MEENs).CONCLUSION MEEN of the colon and rectum are poorly understood rare entities that encompass an extensive range of heterogeneous tumors with a wide variety of combinations leading to tumors of high,intermediate or low grade malignant potential.This proposed new revised terminology of MEEN will solve the biggest hurdle of confusion and misclassification that plagues these rare unique colorectal neoplasms thus facilitating the future design of multi institutional prospective randomized controlled clinical trials to develop and evaluate newer therapeutic strategies that are recommended for continued improved understanding and personal optimization of clinical management of these unique colorectal neoplasms.
文摘Background:Renal cysts are common in clinical practice,but some may harbor rare pathological entities such as mixed epithelial and stromal tumors(MEST).Imaging studies are crucial for accurate diagnosis.While laparoscopic deroofing is an established approach for symptomatic renal cysts,encountering MEST within a cyst is uncommon.Case Presentation:We present the case of a 37-year-old female who presented with persistent left flank pain.Imaging revealed a large renal cyst in the lower pole of the left kidney,classified as Bosniak 2.Despite analgesia,the patient's symptoms persisted,leading to a laparoscopic deroofing procedure.Histopathological examination postprocedure revealed a MEST.The patient reported complete resolution of symptoms at the 3-month follow-up.Conclusion:This unique case presents the successful identification and surgical management of a MEST masquerading as a lower pole renal cyst through laparoscopic deroofing.It also contributes to the existing literature by highlighting the importance of considering rare pathological entities in the evaluation of renal cysts and the value of laparoscopic techniques in their management.
基金National Natural Science Foundation of China,No.81702596
文摘BACKGROUND Pancreatic mixed serous-neuroendocrine neoplasms(MSNNs)are mixed tumors containing two components with different pathologies,namely,pancreatic serous cystic neoplasm(PSCN)and pancreatic neuroendocrine tumor(PanNET).For MSNNs,diffuse PSCN involving the whole pancreas is extremely rare,with only eight previous case reports.CASE SUMMARY A 45-year-old Chinese woman,with a free previous medical history and no obvious symptoms,was found to have a pancreatic neoplasm and admitted to our hospital for further diagnosis in March 2018.Abdominal palpation revealed a painless,mobile mass in the epigastrium,and no abnormalities were observed in an examination of the nervous system and ocular system.A computed tomography scan showed multiple cystic lesions involving the whole pancreas ranging in diameter from 0.4 to 2 cm and also revealed an enhanced mass,2.2 cm in diameter,in the head of the pancreas.Moreover,multiple cysts were found in the kidneys bilaterally,and the right lobe of the liver contained a small cyst.A Whipple operation with total pancreatectomy and splenectomy was performed.A diagnosis of pancreatic MSNN was established,consisting of diffuse serous microcystic cystadenoma with a concomitant grade 2 PanNET.Of note,the patient had no personal or family history of Von Hippel-Lindau syndrome or other disease.CONCLUSION We report the first case of MSNN with a diffuse PSCN component involving the entire pancreas in a Chinese woman.It is important to be aware of its relationship with VHL syndrome,and close clinical follow-up is recommended.
文摘Neuroendocrine neoplasms are the most common epithelial tumors among appendix tumors. Appendix tumors that are completely or partially composed of neuroendocrine cells are divided into two categories: Classic carcinoid tumors and goblet cell carcinoid tumors(GCCT). They are known to progress more aggressively than classic(neuro) endocrine tumors. In this study, three cases with acute appendicitis symptoms are presented, including their clinical and histopathological findings. Microscopic examination detected GCCT in two cases and mixed adenoneuroendocrine carcinoma in one case, in addition to acute appendicitis.
文摘The authors present 83 patients with mixed glioma with experiences in clinical diagnosis and treatment.In all these cases.there were 44 tumors as grade 1 or 2,and 39 as grade 3 or 4.In 39 tumors.two glial components(oligodendrocytes and astrocytes) occurr
文摘背景:近年来,许多研究证实类装配体可弥补类器官无法完全重现细胞与细胞、细胞与基质间的互作关系的缺点,但处于发展初期的类装配体构建方式种类繁多,更无统一标准。目的:综述目前类装配体的构建方法、应用和优缺点,为促进体外细胞模型的发展和完善提供指导。方法:以“assembloids,organoids,tumor microenvironment,organoids AND assemble,organoids AND microenvironment”为英文检索词,以“类装配体、类器官、类组装体、肿瘤微环境、类器官重组、多细胞模型”为中文检索词,检索PubMed、中国知网及万方数据库,在排除无关文章及去重后筛选出94篇文章进行综述。结果与结论:①根据细胞来源的不同,可将类装配体的构建方法分为自体组装、直接组装及混合组装3种;根据细胞培养方式的差异,又可分为悬浮培养法、“基质”培养法、器官芯片培养法和3D生物打印法。②自体组装过程涵盖细胞和组织的发育等早期过程,因此,在器官发育和发育障碍等领域有广阔的前景,而分化成熟细胞的功能相对较完善,由它们直接组装成的类装配体在功能障碍及细胞损伤性疾病的研究中更具潜力;自体组装或在器官移植方面更胜一筹,直接组装将更适用于组织损伤的修复,混合组装综合了前两者的优势,多用于探索微环境中细胞的生理和病理机制以及药物筛选等领域。③虽然不同的类装配体各具优势,但都面临脉管系统不完善的难题;每种类装配体构建方法也存在各自的局限性,如自体组装形成的类装配体中细胞分化程度与体内的差异,直接组装模型的细胞种类固定、无法完全反映复杂的体内微环境等均是亟待解决的难题。④将来随着类装配体培养技术的不断完善,研究者们可以在体外组装出具有更复杂组织结构的仿生类器官,为研究人类组织和器官生理及病理过程提供无限趋近真实的模型。