BACKGROUND Rhabdomyosarcoma(RMS)is a type of malignant tumor originating from rhabdomyocytes or mesenchymal cells differentiating into rhabdomyocytes.Hepatic pleomorphic RMS is a rare malignant liver tumor.Hepatic sar...BACKGROUND Rhabdomyosarcoma(RMS)is a type of malignant tumor originating from rhabdomyocytes or mesenchymal cells differentiating into rhabdomyocytes.Hepatic pleomorphic RMS is a rare malignant liver tumor.Hepatic sarcomatoid carcinoma is also a rare epithelial malignant tumor originating from the liver;it is characterized by the coexistence of both carcinomatous and sarcomatoid spindle cell components.CASE SUMMARY This paper reports a special case of an elderly woman whose initial liver puncture biopsy showed pleomorphic RMS.After chemotherapy with the vincristine+doxorubicin+cyclophosphamide regimen,the alpha-fetoprotein level increased significantly.Therefore,a second liver puncture was performed,the pathological result of which was hepatic sarcomatoid carcinoma.Next-generation sequencing revealed MET gene amplification with an average copy number of 9 in the tumor tissue;however,both fluorescence in situ hybridization and immunohistochemical tests were negative for MET amplification.The treatment regimen was adjusted to chemotherapy combined with immunotherapy;however,the disease progressed rapidly,and the overall survival was only 6 months.CONCLUSION By sharing the diagnosis and treatment process of this patient and reviewing the relevant literature,we aim to help clinicians enhance their understanding of two rare diseases,namely pleomorphic RMS and sarcomatoid carcinoma of the liver.展开更多
Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the c...Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the clinical features of primary lacrimal gland pleomorphic adenoma(LGPA).METHODS:This was a 2-center,retrospective,observational study of primary LGPA patients who underwent tumor resection.Ophthalmic examinations and orbital computed tomography(CT)and/or magnetic resonance imaging(MRI)were performed.RESULTS:Totally 18 patients(10 males and 8 females,mean age 56.3±13.8y)were enrolled.Initial symptoms were unilateral proptosis in 8 patients,diplopia in 3 patients,and pressure sensation and no chief complaint in 2 patients each.The best-corrected visual acuity of the affected eye was 0.26±0.44 logMAR,and the intraocular pressure(IOP)of the affected and healthy eyes was 20.1±9.9 and 15.8±4.3 mm Hg,respectively.The difference in degree of proptosis between the affected and healthy eyes was 4.1±2.2 mm based on the Hertel ocular protrusion meter.One case had a history of breast cancer.Seventeen of 18 patients with an orbital lacrimal gland origin underwent total tumor excision by anterior/lateral orbitotomy.CONCLUSION:Orbital LGPA can complicate IOP elevation,and require total tumor excision by orbitotomy.In rare cases,systemic malignancy may complicate LGPA,and in such cases total removal of the lacrimal gland tumor should be considered at the initial surgery.展开更多
AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA wer...AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.展开更多
Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squa...Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.展开更多
There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epi...There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epitopes of surface proteins, protection against the immune system through tick saliva, the ability to migrate to regions where it is not exposed to the immune system or antibiotics, invagination or invasion within various cells, pleomorphic forms, and the potential to produce biofilms. The window of conventional treatment for Lyme disease is short and has the potential to display different symptoms depending on the strain of Borrelia bugdorferi. These symptoms are dependent on the localization of Borrelia burgdorferi which correlates to the significance of diagnosing Lyme disease early to prevent such a spread throughout the body. Such complications of Borrelia burgdorferi may demand new clinical treatment discoveries for patient fighting the chronic form.展开更多
Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved i...Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved its efficiency by means of high resolution microscopes and in 1934, by controlled clinically tests. However, these results seemed to be unbelievable, since the underlying mechanism was not yet understood. Actually, we are faced with three problems: 1) the functioning of Rife’s supermicroscopes, 2) his observation that bacteria can undergo size reduction, and 3) the decisive resonance phenomenon. We explain the high magnification and resolving power of Rife’s microscopes and show that new discoveries confirm that the postulate of invariable forms of bacteria has to be abandoned. Then we prove that forced oscillations of virus spikes lead to a peculiar resonance, because of nonlinear effects. It causes total destruction of the virus by rupture of its coating. The same theory applies to bacteria and nanobacteria, because of their pili. The worldwide coronavirus pandemic, the constant threat of unpredictable mutations and the now available explanations should make it obvious that biophysical methods cannot be neglected anymore.展开更多
Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant incre...Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant increase in the percentage of 5 and 8 sided cells and a statistically significant decrease in the percentage of six sided cells. Central corneal thickness and the percentage of 4 and 7 and more than 8 sided did not change in a statistically significant way. Comparing the test group and control group, no statistically significant differences were detected in the examined parameters. The present study also shows that the cornea in the eyes with congenital cataract does not show statistically significant changes in the density and the morphology of the corneal endothelial cells and the thickness of the cornea and in terms of corneal thickness in comparison to the corneas of healthy eyes. Although in corneas undergoing cataract occurs statistically significant changes, the influence of the cornea does not affect the improvement in visual acuity which was also demonstrated in this study.展开更多
AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were col...AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.展开更多
Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial ...Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial histogenesis,with some authors favoring an epithelial origin and others favoring a mesenchymal origin.The true origin of these lesions remains unclear at this time.These are also very rare tumors but proper identification and differentiation from more common pancreatic adenocarcinoma is important.The risk factors of these tumors and the prognosis may be different from those associated with standard pancreatic adenocarcinoma.Recognition of these differences can significantly affect patient care.These lesions have a unique appearance when imaged with endoscopic ultrasound(EUS),and these lesions can be diagnosed via EUS guided Fine Needle Aspiration(FNA).This manuscript will review the endoscopic,clinical,and pathologic features of these tumors.展开更多
We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas(ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia(hemoglobin...We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas(ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia(hemoglobin level < 10.0 g/d L) and elevated leucocyte counts(> 12000/mm3), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels.展开更多
BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumo...BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumor and the pleomorphic giant cell carcinoma of the pancreas. Distinctive imaging features of the tumors remain uncharacterized. Surgical removal is the only appropriate treatment for them, but responses to chemotherapy or radiotherapy remain undocumented. METHODS: Clinical, radiological, histopathologic, and immuno- histochemical features of two cases of giant cell tumor of the pancreas are presented along with a brief review of the literature. RESULTS: En-bloc resection was done successfully in both cases. The patient with an osteoclast-like giant cell tumor remained disease-free with no clinical or radiological evidence of recurrence at 6 months after surgery. However, the patient with the pleomorphic type died 4 months later due to diffuse pulmonary metastasis. CONCLUSIONS: En-bloc surgical resection is the only appropriate treatment for giant cell tumors. The overall prognosis of these tumors is poorer than that of pancreatic ductal adenocarcinoma, especially the pleomorphic type. More studies are required to document the management and outcomes of the tumors.展开更多
BACKGROUND:A malignant fibrous histiocytoma,recently referred to as an undifferentiated pleomorphic sarcoma (UPS),is very rare in the liver,and only 34 cases of primary hepatic malignant fibrous histiocytoma have been...BACKGROUND:A malignant fibrous histiocytoma,recently referred to as an undifferentiated pleomorphic sarcoma (UPS),is very rare in the liver,and only 34 cases of primary hepatic malignant fibrous histiocytoma have been reported in the English literature. METHODS:We report a rare case of a hepatic UPS presenting as a unilocular cystic lesion with respect to histopathologic features,the newly revised diagnostic criteria,and the differential diagnosis. RESULTS:A 60-year-old man presented for evaluation of epigastric pain of 7 months duration.Abdominal computed tomography revealed a hypodense,unilocular cystic mass in the right lobe of the liver,measuring 14.0×11.1 cm.A right lobectomy was performed.Grossly,the cut surface showed a single,well-circumscribed unilocular cystic tumor mass containing dark red-brown necrotic debris and blood clots, which occupied most of the mass.Microscopically,the tumor consisted of haphazardly arranged mononuclear pleomorphic tumor cells,admixed with abundant osteoclast- like multinucleated giant cells.Immunohistochemically,the tumor cells expressed vimentin only.The histopathologic and immunohistochemical findings were compatible with a UPS.The patient is alive and well 41 months after surgery without recurrence. CONCLUSIONS:Clinically,most of the hepatic UPSs are solid masses.Only two cases have presented as multilocular cystic masses.A primary hepatic UPS presenting as a unilocular cyst has never been reported.A UPS should be included in the differential diagnosis of unilocular cystic lesions in the liver.展开更多
AIM: To investigate the treatment status and prognosis of space-occupying lacrimal gland lesions at one tertiary eye center in China. METHODS: A retrospective clinical study was performed on 95 patients with space-occ...AIM: To investigate the treatment status and prognosis of space-occupying lacrimal gland lesions at one tertiary eye center in China. METHODS: A retrospective clinical study was performed on 95 patients with space-occupying lesions of the lacrimal gland surgically treated at the Eye & ENT Hospital of Fudan University from 2003 to 2007. The reviewed clinical data included age, gender, side of the lesion, duration of signs and symptoms, histopathological diagnosis, treatment modality, recurrence (local, regional, and distant metastasis) and survival. RESULTS: Of the 95 cases (99 eyes), pleomorphic adenomas were the most common lesions (43 cases), followed by lymphoid disorders (14), inflammatory pseudotumors (11), carcinoma ex-pleomorphic adenomas (11), and adenoid cystic carcinomas (ACC, 6). There were 8 patients with relapsed pleomorphic adenomas. Five of these 8 cases had malignant pathological changes. All patients with ACC had metastasis and three of them died during their follow-up. CONCLUSION: Our study indicated that the most common lacrimal gland lesions were pleomorphic adenomas. Multiple recurrence and surgical procedures may increase the risk of tumor progression. ACC had a high incidence of tumor metastasis and a poor prognosis.展开更多
AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma(Ca-ex-PA) and pleomorphic adenoma(PA) in the lacrimal gland in order to find some clues ...AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma(Ca-ex-PA) and pleomorphic adenoma(PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them.METHODS: We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed.RESULTS: Median age of PA was 43.2 y(from 21 to 75). The 35 patients(54.7%) were male and 29 patients(45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%;the average proliferation index of Ki-67 was 3.2%;pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3 y(from 26 to 76). There were 7 male patients(46.7%) and 8 female patients(53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%;the average proliferation index of Ki-67 was 29.2%;pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas.CONCLUSION: PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-exPA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-exPA and PA.展开更多
Mice deficient in the transcription factor pleomorphic adenoma gene 1(PLAG1)exhibit reproductive issues that are characterized,in part,by decreased progressive sperm motility in the male.However,the underlying cause o...Mice deficient in the transcription factor pleomorphic adenoma gene 1(PLAG1)exhibit reproductive issues that are characterized,in part,by decreased progressive sperm motility in the male.However,the underlying cause of this impairment is unknown.As epididymal transit is critical for sperm maturation and motility,the morphology of the epididymis of Plag1-deficient mice was investigated and the spatial expression patterns of PLAG1 protein and mRNA were identified.Using X-gal staining and in situ hybridization,PLAG1 was shown to be widely expressed in both the epithelium and stroma in all regions of the mouse epididymis.Interestingly,the X-gal staining pattern was markedly different in the cauda,where it could be suggestive of PLAG1 secretion into the epididymal lumen.At all ages investigated,the morphology of epididymides from Plag1 knockout(KO)mice was aberrant;the tubule failed to elongate and coil,particularly in the corpus and cauda,and the cauda was malformed,lacking its usual bulbous shape.Moreover,the epididymides from Plag1 KO mice were significantly reduced in size relative to body weight.In 20%of Plag1-deficient mice,the left testicle and epididymis were lacking.The impaired morphogenesis of the epididymal tubule is likely to be a major contributing factor to the fertility problems observed in male Plag1-deficient mice.These results also establish PLAG1 as an important regulator of male reproduction,not only through its involvement in testicular sperm production,but also via its role in the development and function of the epididymis.展开更多
Soft tissue sarcomas are unusual malignancies comprising 1% of cancer diagnoses in the United States. Undifferentiated pleomorphic sarcoma accounts for approximately 5% of sarcomas occurring in adults. The most common...Soft tissue sarcomas are unusual malignancies comprising 1% of cancer diagnoses in the United States. Undifferentiated pleomorphic sarcoma accounts for approximately 5% of sarcomas occurring in adults. The most common site of metastasis is the lung, with other sites being bone, the brain, and the liver. Metastasis to the gastrointestinal tract has rarely been documented. We present an unusual case of high-grade pleomorphic sarcoma with metastasis to the stomach, complicated by upper gastrointestinal bleeding.展开更多
BACKGROUND Pleomorphic adenoma(PA)is the most common benign tumor that occurs in the salivary glands;however,tracheobronchial PA is rarely observed.To the best of our knowledge,fewer than 50 cases have been reported i...BACKGROUND Pleomorphic adenoma(PA)is the most common benign tumor that occurs in the salivary glands;however,tracheobronchial PA is rarely observed.To the best of our knowledge,fewer than 50 cases have been reported in the literature.We report a 49-year-old woman who had been treated for asthma for 2 years before being diagnosed with PA of the trachea.CASE SUMMARY A 49-year-old woman was referred to our hospital due to dyspnea upon exertion and chronic cough with wheezing for 2 years.Laboratory tests showed an elevated white blood cell count,absolute neutrophil count,and percentage of neutrophils.A chest computerized tomography scan showed a well-defined,softtissue density lesion measuring 2.4 cm×2.1 cm in the lower trachea.Flexible bronchoscopy revealed that nearly 90%of the tracheal lumen was obstructed.The histopathological and immunohistochemistry features suggested PA of the trachea.Furthermore,we review the characteristics of 29 patients with tracheobronchial PA over the last 30 years.CONCLUSION Tracheobronchial PA occurs without gender predominance,mostly in the lower or upper trachea,and has a low recurrence rate.The median age at diagnosis is 48 years.The most common symptoms are cough,stridor,dyspnea,and wheezing.展开更多
基金Supported by Shaanxi Provincial Natural Science Basic Research Program,No.2020JQ-951.
文摘BACKGROUND Rhabdomyosarcoma(RMS)is a type of malignant tumor originating from rhabdomyocytes or mesenchymal cells differentiating into rhabdomyocytes.Hepatic pleomorphic RMS is a rare malignant liver tumor.Hepatic sarcomatoid carcinoma is also a rare epithelial malignant tumor originating from the liver;it is characterized by the coexistence of both carcinomatous and sarcomatoid spindle cell components.CASE SUMMARY This paper reports a special case of an elderly woman whose initial liver puncture biopsy showed pleomorphic RMS.After chemotherapy with the vincristine+doxorubicin+cyclophosphamide regimen,the alpha-fetoprotein level increased significantly.Therefore,a second liver puncture was performed,the pathological result of which was hepatic sarcomatoid carcinoma.Next-generation sequencing revealed MET gene amplification with an average copy number of 9 in the tumor tissue;however,both fluorescence in situ hybridization and immunohistochemical tests were negative for MET amplification.The treatment regimen was adjusted to chemotherapy combined with immunotherapy;however,the disease progressed rapidly,and the overall survival was only 6 months.CONCLUSION By sharing the diagnosis and treatment process of this patient and reviewing the relevant literature,we aim to help clinicians enhance their understanding of two rare diseases,namely pleomorphic RMS and sarcomatoid carcinoma of the liver.
文摘Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the clinical features of primary lacrimal gland pleomorphic adenoma(LGPA).METHODS:This was a 2-center,retrospective,observational study of primary LGPA patients who underwent tumor resection.Ophthalmic examinations and orbital computed tomography(CT)and/or magnetic resonance imaging(MRI)were performed.RESULTS:Totally 18 patients(10 males and 8 females,mean age 56.3±13.8y)were enrolled.Initial symptoms were unilateral proptosis in 8 patients,diplopia in 3 patients,and pressure sensation and no chief complaint in 2 patients each.The best-corrected visual acuity of the affected eye was 0.26±0.44 logMAR,and the intraocular pressure(IOP)of the affected and healthy eyes was 20.1±9.9 and 15.8±4.3 mm Hg,respectively.The difference in degree of proptosis between the affected and healthy eyes was 4.1±2.2 mm based on the Hertel ocular protrusion meter.One case had a history of breast cancer.Seventeen of 18 patients with an orbital lacrimal gland origin underwent total tumor excision by anterior/lateral orbitotomy.CONCLUSION:Orbital LGPA can complicate IOP elevation,and require total tumor excision by orbitotomy.In rare cases,systemic malignancy may complicate LGPA,and in such cases total removal of the lacrimal gland tumor should be considered at the initial surgery.
基金Supported by National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority’Ascent Plan(No.DFL20190201)+1 种基金Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503)Natural Science Foundation of Beijing(No.7222025).
文摘AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.
文摘Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.
文摘There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epitopes of surface proteins, protection against the immune system through tick saliva, the ability to migrate to regions where it is not exposed to the immune system or antibiotics, invagination or invasion within various cells, pleomorphic forms, and the potential to produce biofilms. The window of conventional treatment for Lyme disease is short and has the potential to display different symptoms depending on the strain of Borrelia bugdorferi. These symptoms are dependent on the localization of Borrelia burgdorferi which correlates to the significance of diagnosing Lyme disease early to prevent such a spread throughout the body. Such complications of Borrelia burgdorferi may demand new clinical treatment discoveries for patient fighting the chronic form.
文摘Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved its efficiency by means of high resolution microscopes and in 1934, by controlled clinically tests. However, these results seemed to be unbelievable, since the underlying mechanism was not yet understood. Actually, we are faced with three problems: 1) the functioning of Rife’s supermicroscopes, 2) his observation that bacteria can undergo size reduction, and 3) the decisive resonance phenomenon. We explain the high magnification and resolving power of Rife’s microscopes and show that new discoveries confirm that the postulate of invariable forms of bacteria has to be abandoned. Then we prove that forced oscillations of virus spikes lead to a peculiar resonance, because of nonlinear effects. It causes total destruction of the virus by rupture of its coating. The same theory applies to bacteria and nanobacteria, because of their pili. The worldwide coronavirus pandemic, the constant threat of unpredictable mutations and the now available explanations should make it obvious that biophysical methods cannot be neglected anymore.
文摘Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant increase in the percentage of 5 and 8 sided cells and a statistically significant decrease in the percentage of six sided cells. Central corneal thickness and the percentage of 4 and 7 and more than 8 sided did not change in a statistically significant way. Comparing the test group and control group, no statistically significant differences were detected in the examined parameters. The present study also shows that the cornea in the eyes with congenital cataract does not show statistically significant changes in the density and the morphology of the corneal endothelial cells and the thickness of the cornea and in terms of corneal thickness in comparison to the corneas of healthy eyes. Although in corneas undergoing cataract occurs statistically significant changes, the influence of the cornea does not affect the improvement in visual acuity which was also demonstrated in this study.
文摘AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.
文摘Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial histogenesis,with some authors favoring an epithelial origin and others favoring a mesenchymal origin.The true origin of these lesions remains unclear at this time.These are also very rare tumors but proper identification and differentiation from more common pancreatic adenocarcinoma is important.The risk factors of these tumors and the prognosis may be different from those associated with standard pancreatic adenocarcinoma.Recognition of these differences can significantly affect patient care.These lesions have a unique appearance when imaged with endoscopic ultrasound(EUS),and these lesions can be diagnosed via EUS guided Fine Needle Aspiration(FNA).This manuscript will review the endoscopic,clinical,and pathologic features of these tumors.
文摘We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas(ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia(hemoglobin level < 10.0 g/d L) and elevated leucocyte counts(> 12000/mm3), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels.
文摘BACKGROUND: Giant cell tumors are rare and highly malignant tumors of the pancreas. Based on two distinct cell populations, they have been divided into two subtypes corresponding to the osteoclast-like giant cell tumor and the pleomorphic giant cell carcinoma of the pancreas. Distinctive imaging features of the tumors remain uncharacterized. Surgical removal is the only appropriate treatment for them, but responses to chemotherapy or radiotherapy remain undocumented. METHODS: Clinical, radiological, histopathologic, and immuno- histochemical features of two cases of giant cell tumor of the pancreas are presented along with a brief review of the literature. RESULTS: En-bloc resection was done successfully in both cases. The patient with an osteoclast-like giant cell tumor remained disease-free with no clinical or radiological evidence of recurrence at 6 months after surgery. However, the patient with the pleomorphic type died 4 months later due to diffuse pulmonary metastasis. CONCLUSIONS: En-bloc surgical resection is the only appropriate treatment for giant cell tumors. The overall prognosis of these tumors is poorer than that of pancreatic ductal adenocarcinoma, especially the pleomorphic type. More studies are required to document the management and outcomes of the tumors.
文摘BACKGROUND:A malignant fibrous histiocytoma,recently referred to as an undifferentiated pleomorphic sarcoma (UPS),is very rare in the liver,and only 34 cases of primary hepatic malignant fibrous histiocytoma have been reported in the English literature. METHODS:We report a rare case of a hepatic UPS presenting as a unilocular cystic lesion with respect to histopathologic features,the newly revised diagnostic criteria,and the differential diagnosis. RESULTS:A 60-year-old man presented for evaluation of epigastric pain of 7 months duration.Abdominal computed tomography revealed a hypodense,unilocular cystic mass in the right lobe of the liver,measuring 14.0×11.1 cm.A right lobectomy was performed.Grossly,the cut surface showed a single,well-circumscribed unilocular cystic tumor mass containing dark red-brown necrotic debris and blood clots, which occupied most of the mass.Microscopically,the tumor consisted of haphazardly arranged mononuclear pleomorphic tumor cells,admixed with abundant osteoclast- like multinucleated giant cells.Immunohistochemically,the tumor cells expressed vimentin only.The histopathologic and immunohistochemical findings were compatible with a UPS.The patient is alive and well 41 months after surgery without recurrence. CONCLUSIONS:Clinically,most of the hepatic UPSs are solid masses.Only two cases have presented as multilocular cystic masses.A primary hepatic UPS presenting as a unilocular cyst has never been reported.A UPS should be included in the differential diagnosis of unilocular cystic lesions in the liver.
文摘AIM: To investigate the treatment status and prognosis of space-occupying lacrimal gland lesions at one tertiary eye center in China. METHODS: A retrospective clinical study was performed on 95 patients with space-occupying lesions of the lacrimal gland surgically treated at the Eye & ENT Hospital of Fudan University from 2003 to 2007. The reviewed clinical data included age, gender, side of the lesion, duration of signs and symptoms, histopathological diagnosis, treatment modality, recurrence (local, regional, and distant metastasis) and survival. RESULTS: Of the 95 cases (99 eyes), pleomorphic adenomas were the most common lesions (43 cases), followed by lymphoid disorders (14), inflammatory pseudotumors (11), carcinoma ex-pleomorphic adenomas (11), and adenoid cystic carcinomas (ACC, 6). There were 8 patients with relapsed pleomorphic adenomas. Five of these 8 cases had malignant pathological changes. All patients with ACC had metastasis and three of them died during their follow-up. CONCLUSION: Our study indicated that the most common lacrimal gland lesions were pleomorphic adenomas. Multiple recurrence and surgical procedures may increase the risk of tumor progression. ACC had a high incidence of tumor metastasis and a poor prognosis.
基金Supported by the National Natural Science Foundation of China (No.30371515)
文摘AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma(Ca-ex-PA) and pleomorphic adenoma(PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them.METHODS: We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed.RESULTS: Median age of PA was 43.2 y(from 21 to 75). The 35 patients(54.7%) were male and 29 patients(45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%;the average proliferation index of Ki-67 was 3.2%;pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3 y(from 26 to 76). There were 7 male patients(46.7%) and 8 female patients(53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%;the average proliferation index of Ki-67 was 29.2%;pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas.CONCLUSION: PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-exPA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-exPA and PA.
文摘Mice deficient in the transcription factor pleomorphic adenoma gene 1(PLAG1)exhibit reproductive issues that are characterized,in part,by decreased progressive sperm motility in the male.However,the underlying cause of this impairment is unknown.As epididymal transit is critical for sperm maturation and motility,the morphology of the epididymis of Plag1-deficient mice was investigated and the spatial expression patterns of PLAG1 protein and mRNA were identified.Using X-gal staining and in situ hybridization,PLAG1 was shown to be widely expressed in both the epithelium and stroma in all regions of the mouse epididymis.Interestingly,the X-gal staining pattern was markedly different in the cauda,where it could be suggestive of PLAG1 secretion into the epididymal lumen.At all ages investigated,the morphology of epididymides from Plag1 knockout(KO)mice was aberrant;the tubule failed to elongate and coil,particularly in the corpus and cauda,and the cauda was malformed,lacking its usual bulbous shape.Moreover,the epididymides from Plag1 KO mice were significantly reduced in size relative to body weight.In 20%of Plag1-deficient mice,the left testicle and epididymis were lacking.The impaired morphogenesis of the epididymal tubule is likely to be a major contributing factor to the fertility problems observed in male Plag1-deficient mice.These results also establish PLAG1 as an important regulator of male reproduction,not only through its involvement in testicular sperm production,but also via its role in the development and function of the epididymis.
文摘Soft tissue sarcomas are unusual malignancies comprising 1% of cancer diagnoses in the United States. Undifferentiated pleomorphic sarcoma accounts for approximately 5% of sarcomas occurring in adults. The most common site of metastasis is the lung, with other sites being bone, the brain, and the liver. Metastasis to the gastrointestinal tract has rarely been documented. We present an unusual case of high-grade pleomorphic sarcoma with metastasis to the stomach, complicated by upper gastrointestinal bleeding.
基金Supported by the Natural Science Foundation of Guangdong Province,China,No.2020A1515010119.
文摘BACKGROUND Pleomorphic adenoma(PA)is the most common benign tumor that occurs in the salivary glands;however,tracheobronchial PA is rarely observed.To the best of our knowledge,fewer than 50 cases have been reported in the literature.We report a 49-year-old woman who had been treated for asthma for 2 years before being diagnosed with PA of the trachea.CASE SUMMARY A 49-year-old woman was referred to our hospital due to dyspnea upon exertion and chronic cough with wheezing for 2 years.Laboratory tests showed an elevated white blood cell count,absolute neutrophil count,and percentage of neutrophils.A chest computerized tomography scan showed a well-defined,softtissue density lesion measuring 2.4 cm×2.1 cm in the lower trachea.Flexible bronchoscopy revealed that nearly 90%of the tracheal lumen was obstructed.The histopathological and immunohistochemistry features suggested PA of the trachea.Furthermore,we review the characteristics of 29 patients with tracheobronchial PA over the last 30 years.CONCLUSION Tracheobronchial PA occurs without gender predominance,mostly in the lower or upper trachea,and has a low recurrence rate.The median age at diagnosis is 48 years.The most common symptoms are cough,stridor,dyspnea,and wheezing.
