Combined hepatocellular-cholangiocarcinoma(CHC) is a rare tumor with poor prognosis,with incidence ranging from 1.0%-4.7% of all primary hepatic tumors.This entity will be soon renamed as hepato-cholangiocarcinoma.The...Combined hepatocellular-cholangiocarcinoma(CHC) is a rare tumor with poor prognosis,with incidence ranging from 1.0%-4.7% of all primary hepatic tumors.This entity will be soon renamed as hepato-cholangiocarcinoma.The known risk factors for hepatocellular carcinoma(HCC) have been implicated for CHC including viral hepatitis and cirrhosis.It is difficult to diagnose this tumor pre-operatively.The predominant histologic component within the tumor largely determines the predominant radiographic features making it a difficult distinction.Heterogeneous and overlapping imaging features of HCC and cholangiocarcinoma should raise the suspicion for CHC and multiple core biopsies(from different areas of tumor) are recommended before administering treatment.Serum tumor markers CA19-9 and alpha-fetoprotein can aid in the diagnosis,but it remains a challenging diagnosis prior to resection.There is sufficient data to support bipotent hepatic progenitor cells as the cell of origin for CHC.The current World Health Organization classification categorizes two main types of CHC based on histo-morphological features:Classical type and CHC with stem cell features.Liver transplant is one of the available treatment modalities with other management options including transarterial chemoembolization,radiofrequency ablation,and percutaneous ethanol injection.We present a review paper on CHC highlighting the risk factors,origin,histological classification and therapeutic modalities.展开更多
Objective： To investigate the histogenesis and differential diagnosis of pulmonary sclerosing hemangioma （PSH）. Methods： Thyroid transcription factor-1 （TTF-1）, surfactant proteins A, B （SP-A, SP-B）, epithelia...Objective： To investigate the histogenesis and differential diagnosis of pulmonary sclerosing hemangioma （PSH）. Methods： Thyroid transcription factor-1 （TTF-1）, surfactant proteins A, B （SP-A, SP-B）, epithelial membrane antigen （EMA）, vimentin, pancytokeratin, cytokeratin7 （CK7）, CK5/6, calretinin, S-100, neurospecific enolase （NSE）, synaptophysin （Syn）, chromogranin A （CgA）, CD34, factor-Ⅷ-related antigen （F-Ⅷ） and smooth muscle actin （SMA）in 55 patients with PSH were examined with immunohistochemistry, while samples from 19 patients were also observed by electron microscope. Follow-up information were reviewed. Results： Pathologically, PSH mainly consisted of both surface lining cuboidal cells and pale polygonal cells. Immunohistochemitry revealed that coexpression of TTF-1, EMA and vimentin in both cuboidal and polygonal cells was 94.5 % （52/55）, 90.5% （50/55） and 58.2% （32/55）, respectively. In cuboidal cells, the expression of SP-A and SP-B was 92.7% （51/55） and 81.8 % （45/55）, respectively. Whereas pancytokeratin and CK7 immunostained the cuboidal cells in all cases. The polygonal cells were difussed immunostained with Syn in 13 PSHs （24%） and NSE in 8 PSHs （15%）, while immunoreactions with S-100 and CgA were separated detected in 7 PSHs （13%）. There was no significant difference of TTF-1 and EMA expression between these two cells （χ^2 value was 1.371 and 3.352, respectively. P 〉 0.05）. In contrast, there was a significant difference of vimentin between them （χ^2 value was 17.720, P 〈 0.001）. Electron microcopy observation showed that ultrastructure may not differ from each other sometime. The follow-up was obtained for 49 cases ranged from 3 months to 14 years. 48 of them had no recurrence or metastasis except one case had recurrence. Conclusion： PSH may origin from the primitive respiratory epithelial. Polygonal and cuboidal cells are all parenchymal neoplasm cells. The concomitant examination of TTF-1, SPA, SP-B, EMA, virnentin and pancytokeratin may favor the diagnosis and differential diagnosis of PSH.展开更多
A granular cell tumor (GCT) is a benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin.GCT is not common and most often affects the tongue,skin and soft tissue,although it may...A granular cell tumor (GCT) is a benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin.GCT is not common and most often affects the tongue,skin and soft tissue,although it may occur anywhere in the body.We experienced a case of GCT that arose in the cecum of a 55-yearold man.The GCT was removed by laparoscopic resection.In addition to the tumor,endoscopic examination revealed the presence of a 5-mm-polyp in the descending colon and multiple tiny polyps in the sigmoid colon and rectum.Histological examination demonstrated a cecal tumor 1.5 cm × 1.0 cm × 0.7 cm with a hard consistency;in cut sections,mixed cells with yellowish and whitish portions were seen.The tumor was located between the mucosa and subserosa,and was composed of plump histiocyte-like tumor cells with abundant granular eosinophilic cytoplasm,which were immunoreactive for S-100 protein,vimentin,neuron-specific enolase,inhibin-α and calretinin.The tumor showed extensive hyalinization and focal dystrophic calcification.Immunohistochemical profiles did not confirm any particular cell type for the histogenetic origin of the GCT,including a nerve sheath origin.Extensive hyalinization and calcifi cation showing involution of tumor cells suggest benign clinical behavior of GCT.展开更多
To investigate the effects of Ligustrazine on histogenesis of bone marrow in the early phase of hematopoietic reconstruction in bone marrow transplantation (BMT ) mice. The syngeneic BMT mice model was established. T...To investigate the effects of Ligustrazine on histogenesis of bone marrow in the early phase of hematopoietic reconstruction in bone marrow transplantation (BMT ) mice. The syngeneic BMT mice model was established. The syngeneic BMT mice were orally given 2 mg Ligustrazine twice a day. 1, 3, 5, 7, 10, 15 and 21 day(s) after BMT, peripheral blood granulocytes and bone marrow nucleated cells (BMNC) were counted and the diameter of central vein and the area of micro vessel in femur were measured. The effect of Ligustrazine on hematopoietic stem cells was observed by colony forming unit of spleen (CFU S). The effect of Ligustrazine on hemopoietic progenitors was studied by observing the number of progenitors of Granulocytes/Macrophage on day 10 and day 20 after BMT. In Ligustrazine treated group, the diameter of center veins and the area of micro vessel of femur were all significantly less than the control group 7, 10, 15, 21 days after BMT ( P <0.01). In addition, Ligustrazine significantly increased the number of CFU S on day 10 and the number of CFU GM on day 10, 20 after BMT. These results indicate that Ligustrazine can accelerate the histogenesis of hemopoietic bone marrow, which may be one mechanism by which Ligustrazine promotes hematopoietic reconstitution after BMT.展开更多
AIM： To investigate the histopathological and geneticdifferences between polypoid growth （PG） and nonpolypoid growth （NPG） submucosal invasive colorectal carcinoma （CRC）.METHODS： A total of 96 cases of submuco...AIM： To investigate the histopathological and geneticdifferences between polypoid growth （PG） and nonpolypoid growth （NPG） submucosal invasive colorectal carcinoma （CRC）.METHODS： A total of 96 cases of submucosal CRC were divided into two groups according to their growth type;60 cases of PG and 36 cases of NPG. The size, histological degree of dysplasia, depth of submucosal invasion and lymph node metastasis were compared between the two groups. Furthermore, expression of p53 was detected by immunohistochemical staining, and K-ras gene mutation was examined by polymerase chain reaction based single-strand conformation polymorphism （SSCP）.RESULTS： The average size of the lesions in the NPG group was significantly smaller than those in the PG group （7.5 mm vs 13.8 mm, P 〈 0.001）. The histological degree of dysplasia tended to be more severe in NPG group, while the incidence of submucosal massive invasion and the lymph node metastasis were both significantly higher in the NPG type than in the PG group （64.3% vs 43.3%, P = 0.004; 43% vs 7%, P =0.008, respectively）. In addition, K-ras gene mutations were detected in 67% of lesions in the PG group, but none in the NPG group, while no difference in p53immunohistochemical expression was found between the two groups.CONCLUSION： Compared with PG submucosal CRC,NPG type demonstrates more frequent submucosal massive invasion, more lymph node metastasis and a higher degree dysplasia. Genetically, NPG type shows much less frequent K-ras mutation.展开更多
Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(201...Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(2017)of odontogenic tumors.We report a case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white female.Immunohistochemical staining showed that granular cells positively expressed CD68 and vimentin,and negatively expressed S-100 protein.Meanwhile,we searched Pub Med,Google Scholar,and Scopus databases to summary the clinico-pathological features of 51 reported cases of CGCOT.The results showed that the granular cells of 28.6%cases were immunopositive for vimentin and CD68,and odontogenic epithelial cells were positive immunoreactivity for cytokeratin.These findings reinforced the mesenchymal origin of granular cells and the odontogenic nature of epithelium islands.展开更多
Treatment of infected forearm nonunion and defects represents a difficult task for the operating sur-geons.Conventional methods like composite and vascularized fibular grafts and the induced membranes filled with canc...Treatment of infected forearm nonunion and defects represents a difficult task for the operating sur-geons.Conventional methods like composite and vascularized fibular grafts and the induced membranes filled with cancellous autografts or the Masquelet technique have been reported to be useful and suc-cessful,but sometimes it is difficult to predict the outcome and cannot address simultaneous deformities or the need to apply gradual distraction for reduction of a chronically dislocated radial head.Ilizarov technique has an answer for such conditions.We report a 43 years old man with infected ulnar defect and dislocated radial head as a result of infected Monteggia fracture:the patient was successfully treated by Ilizarov bone transport after failed attempts by bone spacer and fibular graft.展开更多
文摘Combined hepatocellular-cholangiocarcinoma(CHC) is a rare tumor with poor prognosis,with incidence ranging from 1.0%-4.7% of all primary hepatic tumors.This entity will be soon renamed as hepato-cholangiocarcinoma.The known risk factors for hepatocellular carcinoma(HCC) have been implicated for CHC including viral hepatitis and cirrhosis.It is difficult to diagnose this tumor pre-operatively.The predominant histologic component within the tumor largely determines the predominant radiographic features making it a difficult distinction.Heterogeneous and overlapping imaging features of HCC and cholangiocarcinoma should raise the suspicion for CHC and multiple core biopsies(from different areas of tumor) are recommended before administering treatment.Serum tumor markers CA19-9 and alpha-fetoprotein can aid in the diagnosis,but it remains a challenging diagnosis prior to resection.There is sufficient data to support bipotent hepatic progenitor cells as the cell of origin for CHC.The current World Health Organization classification categorizes two main types of CHC based on histo-morphological features:Classical type and CHC with stem cell features.Liver transplant is one of the available treatment modalities with other management options including transarterial chemoembolization,radiofrequency ablation,and percutaneous ethanol injection.We present a review paper on CHC highlighting the risk factors,origin,histological classification and therapeutic modalities.
文摘Objective： To investigate the histogenesis and differential diagnosis of pulmonary sclerosing hemangioma （PSH）. Methods： Thyroid transcription factor-1 （TTF-1）, surfactant proteins A, B （SP-A, SP-B）, epithelial membrane antigen （EMA）, vimentin, pancytokeratin, cytokeratin7 （CK7）, CK5/6, calretinin, S-100, neurospecific enolase （NSE）, synaptophysin （Syn）, chromogranin A （CgA）, CD34, factor-Ⅷ-related antigen （F-Ⅷ） and smooth muscle actin （SMA）in 55 patients with PSH were examined with immunohistochemistry, while samples from 19 patients were also observed by electron microscope. Follow-up information were reviewed. Results： Pathologically, PSH mainly consisted of both surface lining cuboidal cells and pale polygonal cells. Immunohistochemitry revealed that coexpression of TTF-1, EMA and vimentin in both cuboidal and polygonal cells was 94.5 % （52/55）, 90.5% （50/55） and 58.2% （32/55）, respectively. In cuboidal cells, the expression of SP-A and SP-B was 92.7% （51/55） and 81.8 % （45/55）, respectively. Whereas pancytokeratin and CK7 immunostained the cuboidal cells in all cases. The polygonal cells were difussed immunostained with Syn in 13 PSHs （24%） and NSE in 8 PSHs （15%）, while immunoreactions with S-100 and CgA were separated detected in 7 PSHs （13%）. There was no significant difference of TTF-1 and EMA expression between these two cells （χ^2 value was 1.371 and 3.352, respectively. P 〉 0.05）. In contrast, there was a significant difference of vimentin between them （χ^2 value was 17.720, P 〈 0.001）. Electron microcopy observation showed that ultrastructure may not differ from each other sometime. The follow-up was obtained for 49 cases ranged from 3 months to 14 years. 48 of them had no recurrence or metastasis except one case had recurrence. Conclusion： PSH may origin from the primitive respiratory epithelial. Polygonal and cuboidal cells are all parenchymal neoplasm cells. The concomitant examination of TTF-1, SPA, SP-B, EMA, virnentin and pancytokeratin may favor the diagnosis and differential diagnosis of PSH.
基金Supported by Research funds from Chosun University,2009
文摘A granular cell tumor (GCT) is a benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin.GCT is not common and most often affects the tongue,skin and soft tissue,although it may occur anywhere in the body.We experienced a case of GCT that arose in the cecum of a 55-yearold man.The GCT was removed by laparoscopic resection.In addition to the tumor,endoscopic examination revealed the presence of a 5-mm-polyp in the descending colon and multiple tiny polyps in the sigmoid colon and rectum.Histological examination demonstrated a cecal tumor 1.5 cm × 1.0 cm × 0.7 cm with a hard consistency;in cut sections,mixed cells with yellowish and whitish portions were seen.The tumor was located between the mucosa and subserosa,and was composed of plump histiocyte-like tumor cells with abundant granular eosinophilic cytoplasm,which were immunoreactive for S-100 protein,vimentin,neuron-specific enolase,inhibin-α and calretinin.The tumor showed extensive hyalinization and focal dystrophic calcification.Immunohistochemical profiles did not confirm any particular cell type for the histogenetic origin of the GCT,including a nerve sheath origin.Extensive hyalinization and calcifi cation showing involution of tumor cells suggest benign clinical behavior of GCT.
文摘To investigate the effects of Ligustrazine on histogenesis of bone marrow in the early phase of hematopoietic reconstruction in bone marrow transplantation (BMT ) mice. The syngeneic BMT mice model was established. The syngeneic BMT mice were orally given 2 mg Ligustrazine twice a day. 1, 3, 5, 7, 10, 15 and 21 day(s) after BMT, peripheral blood granulocytes and bone marrow nucleated cells (BMNC) were counted and the diameter of central vein and the area of micro vessel in femur were measured. The effect of Ligustrazine on hematopoietic stem cells was observed by colony forming unit of spleen (CFU S). The effect of Ligustrazine on hemopoietic progenitors was studied by observing the number of progenitors of Granulocytes/Macrophage on day 10 and day 20 after BMT. In Ligustrazine treated group, the diameter of center veins and the area of micro vessel of femur were all significantly less than the control group 7, 10, 15, 21 days after BMT ( P <0.01). In addition, Ligustrazine significantly increased the number of CFU S on day 10 and the number of CFU GM on day 10, 20 after BMT. These results indicate that Ligustrazine can accelerate the histogenesis of hemopoietic bone marrow, which may be one mechanism by which Ligustrazine promotes hematopoietic reconstitution after BMT.
文摘AIM： To investigate the histopathological and geneticdifferences between polypoid growth （PG） and nonpolypoid growth （NPG） submucosal invasive colorectal carcinoma （CRC）.METHODS： A total of 96 cases of submucosal CRC were divided into two groups according to their growth type;60 cases of PG and 36 cases of NPG. The size, histological degree of dysplasia, depth of submucosal invasion and lymph node metastasis were compared between the two groups. Furthermore, expression of p53 was detected by immunohistochemical staining, and K-ras gene mutation was examined by polymerase chain reaction based single-strand conformation polymorphism （SSCP）.RESULTS： The average size of the lesions in the NPG group was significantly smaller than those in the PG group （7.5 mm vs 13.8 mm, P 〈 0.001）. The histological degree of dysplasia tended to be more severe in NPG group, while the incidence of submucosal massive invasion and the lymph node metastasis were both significantly higher in the NPG type than in the PG group （64.3% vs 43.3%, P = 0.004; 43% vs 7%, P =0.008, respectively）. In addition, K-ras gene mutations were detected in 67% of lesions in the PG group, but none in the NPG group, while no difference in p53immunohistochemical expression was found between the two groups.CONCLUSION： Compared with PG submucosal CRC,NPG type demonstrates more frequent submucosal massive invasion, more lymph node metastasis and a higher degree dysplasia. Genetically, NPG type shows much less frequent K-ras mutation.
文摘Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(2017)of odontogenic tumors.We report a case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white female.Immunohistochemical staining showed that granular cells positively expressed CD68 and vimentin,and negatively expressed S-100 protein.Meanwhile,we searched Pub Med,Google Scholar,and Scopus databases to summary the clinico-pathological features of 51 reported cases of CGCOT.The results showed that the granular cells of 28.6%cases were immunopositive for vimentin and CD68,and odontogenic epithelial cells were positive immunoreactivity for cytokeratin.These findings reinforced the mesenchymal origin of granular cells and the odontogenic nature of epithelium islands.
文摘Treatment of infected forearm nonunion and defects represents a difficult task for the operating sur-geons.Conventional methods like composite and vascularized fibular grafts and the induced membranes filled with cancellous autografts or the Masquelet technique have been reported to be useful and suc-cessful,but sometimes it is difficult to predict the outcome and cannot address simultaneous deformities or the need to apply gradual distraction for reduction of a chronically dislocated radial head.Ilizarov technique has an answer for such conditions.We report a 43 years old man with infected ulnar defect and dislocated radial head as a result of infected Monteggia fracture:the patient was successfully treated by Ilizarov bone transport after failed attempts by bone spacer and fibular graft.
