ObjectiveTo summarize the clinical manifestations, diagnosis and treatments of chronic eosinophilic pneumonia (CEP).MethodsThe clinical and pathological data of five patients with CEP diagnosed in this hospital between January 2011 and January 2015 were retrospectively analyzed.ResultsThere were five CEP cases including two males and three females, and one case with allergic rhinitis, two cases with bronchial asthma, two cases with allergic history, and one case with allergic skin rash. The main clinical manifestations were fever, cough, expectoration, shortness of breath and chest pain, and often accompanied by fatigue, anorexia and weight loss. The main signs included moist rales, scattered wheeze and crackles. There were significantly increased peripheral blood eosinophils count, the proportion of eosinophils, and the proportion of eosinophils in bronchoalveolar lavage fluid in all five cases. The main imaging features were airway infiltration, real change shadow and ground glass shadow. All of five cases were treated with glucocorticoid, and one of them relapsed during follow-up.ConclusionsThe onset of CEP is insidious. The clinical manifestations of CEP are lack of specificity, and often associate with asthma and allergic dermatitis. Eosinophils significantly increase in peripheral blood and bronchoalveolar lavage fluid in most of CEP patients. The typical image is peripheral and subpleural distribution of lung infiltrates.
Objective To investigate the expression of suppressor gene Runt-related transcription factor 3 (Runx3) in gastric carcinoma and its relationship with clinicopathologic parameters. Methods RT-PCR and Western blot were used to determine the mRNA expression and protein expression of Runx3 gene in primary tumor and corresponding normal tissues respectively in 52 patients with gastric carcinoma. The relationship between Runx3 expression and clinicopathologic parameters was analyzed. Results RT-PCR and Western blot analysis in 52 patients with gastric carcinoma showed down-regulation of Runx3 mRNA and Runx3 protein in 59.6% (31/52) and 48.1% （25/52） of the primary tumors tested, and in none of the normal tissues (P＜0.05) respectively. There was a significant negative correlation between the expression level of Runx3 gene and the clinicopathologic parameters such as tumor size, differentiation, infiltrative depth, lymph node metastasis and TNM stage (P＜0.05， P＜0.01). Runx3 gene transcription was coincident with its protein expression (r=0.840, P＜0.01）. Conclusion The expression of Runx3 gene is down-regulated in gastric carcinoma, which suggests that Runx3 gene plays an important role in carcinogenesis and the progression of gastric carcinoma. It may be a new target of diagnosis and treatment of gastric carcinoma.
Objective To improve our recognition of ground-glass opacity (GGO) through analyzing the imaging and pathological features of patients with focal GGO lung nodule. Methods Thirty patients with focal GGO nodule were assigned into a preinvasive lesion group, a minimally invasive adenocarcinoma (MIA) group, and an invasive adenocarcinoma (IAC) group. The imaging features were retrospectively analyzed and pathological features by histological Masson staining, collagen Ⅳ staining and Vitoria blue staining were also compared among three groups. Furthermore, the relationship between pathology and imaging characteristics was studied too. Results Among 30 patients with focal GGO nodule, preinvasive lesions, MIA and IAC respectively occurred in 13, 3 and 14 cases. Size of nodules and solid portion were highest in the IAC group, middle in the MIA group, and lowest in the preinvasive lesion group. Similarly, signs of lobulation, spiculation and air bronchogram were seen mostly in the IAC group, and least in preinvasive lesion group. The spatial relationship between GGO nodules and supplying blood vessels was analyzed, and Type Ⅲ was more commonly seen in the IAC group with comparison to type Ⅱ more likely seen in the preinvasive lesion group. Moreover, collagen Ⅳ and Vitoria blue staining indicated that reticular fibers and collagenous fibers lessened around tumor tissue in the IAC group, whereas collagenous fibers proliferation and fibrous scar were shown by Masson staining in the IAC group. In CT-pathologic comparison, type Ⅲ supplying blood vessels were mostly seen in the IAC patients with obvious fibrous scar. Conclusions Persistent focal GGO nodules with larger size and higher percent of solid component are signs of malignancy. In tumor progression process, tumor cells break the reticular fibers and collagenous fibers in alveolar wall, then stimulate fibroblast hyperplasia and secrete collagenous fibers, thereby develop the central fibrous scar in tumor tissue, which might be the pathologic foundation of vascular bundle sign.
Objective Gunshot wound spreads to the surrounding tissues and organs, it is difficult to debride and easy to infect. The conventional treatment is thorough, extensive debridement, fully open drainage, which often causes normal tissue damage and compl ications. To evaluate the effectiveness of vacuum seal ing drainage (VSD) treating thepenetrating wound in porcine extremity by MRI and pathological methods so as to provide theoretical basis for future cl inical use. Methods Eight healthy adult pigs, weighing (45 ± 5) kg, were selected. Eight pairs of hind l imb penetrating wounds (16 wounds) were made by using Chinese-made 95-type rifle at 25 meters distance, which were randomly divided into experimental group (left side, n=8) and the control group (right side, n=8). After debriding and disinfecting the penetrating wounds at 6 hours after injury, wounds were treated with VSD in experimental group. The ball istics exports of the wounds were covered with single-layer gauze and imports were directly sutured and covered with sterile gauze in control group. The trajectory and the general condition of the adjacent skin were observed. MRI and histological observation were taken at 5, 24, 48, and 72 hours after injury, bacterial counting analysis was done at 0, 12, 24, 48, and 72 hours after injury. Results The aperture of the trajectory exit and entry were (5.00 ± 2.50) cm and (0.30 ± 0.15) cm immediately after injury. The wound surface was clean, rosy without leakage and swell ing after 72 hours in experimental group; wound and adjacent tissue were swell ing obviously, pus, muscle necrosis and exfol iative tissue was observed, and deep defect cavity at the trajectory exit could be seen in control group. MRI showed that pairs of l inear low signal in T1WI and T2WI was seen in trajector of experimental group at 5 hours after injury, and signal in T1WI gradually increased at disrupted area and tissue deformation area at 24, 48, and 72 hours; in control group, low signal in T1WI was observed at 5 hours after injury, and signal in T2WI gradually increased and a clear boundari between edema and surrounding tissue, and the increase of signal in T1WI was not obvious at 24, 48, and 72 hours. The histological observation showed that wound was dominated by effusion at 5 hours after injury, granulation tissue gradually increased, muscle tissue dissolved and inflammatory cell infiltration was not obvious at 24, 48, and 72 hours in experimental group; in control group, the gradual dissolution of muscle fibers and inflammatory cell infiltration were observed at 5, 24, and 48 hours, muscle tissue became swell ing, dissolving and degeneration and a large number of inflammatory cell infiltration gathered into the bacteria group at 72 hours. There was no significant difference in the number of bacteria per gram of tissue (P gt; 0.05) between experimental group and control group at 0 hour after injury; the numbers of bacteria in control group were significantly higher than those in experimental group at 12, 24, 48, and 72 hours (P lt; 0.05). Conclusion MRI combined with pathology show diagnostic meaning in treatment of gunshot wound with VSD. MRI can accurately reflect the scope of l imb gunshot wound 72 hours after injury. VSD may be an approach to delay infective time, shorten wound heal ing time, and promote the growth of healthy granulation tissue.
ObjectiveTo detect 5-FU concentration and investigate the changes of pathology， and Ki-67 protein expression after intraoperative regional chemotherapy (RC) for colon cancer. MethodsAll the patients were randomized into two groups: RC group (n=20), received intraoperational RC with 100 ml physiological saline contained 5-FU (15 mg/kg) and camptothecine (0.06 mg/kg)； control group (n=20), saline alone. The samples from portal vein blood, peripheral blood, peritoneal fluid， and peri-cancerous tissues in RC group were taken to detect the 5-FU concentration by high performance liquid chromatography (HPLC), respectively at 2, 5, 10, 20, 30, and 60 minutes after treatment. The pathological changes were observed and Ki-67 protein expressions were examined by immunohistochemical staining for all the cancer tissues postoperatively in two groups. ResultsPeak concentration of 5-FU appeared at 2 min after treatment, and decreased gradually. 5-FU concentration in peritoneal fluid was the highest, and the lowest in the peripheral blood (Plt;0.01). In RC group， light karyopyknosis, nuclear swelling, and coagulative necrosis of cancer cells, and light intercellular substance hydropsia, inflammatory cells invasion were observed under light microscopic examination; light vasculitis presented also in five cases. Nuclear swelling, heterochromatin agglutination, perinuclear gap expansion, mitochondrial swelling, endoplasmic reticulum expansion, and Golgi complex expansion were observed with transmission electron microscope. Ki-67 protein expression of colon cance tissues in RC group was lower than that in control group （Plt;0.05）. Conclusions Intraoperative RC for colon cancer may sustain a high concentration of chemotherapy drugs in peritoneal fluid and portal vein blood, and alter histopathological morphology of cancer cells, and suppress Ki-67 protein expression. So, intraoperative RC may play an important role in preventing intraoperative spreading and postoperative recurrence of colon cancer.
Objective To analyse the clinico-pathological characteristics of young patients with colorectal cancer. Methods From January 1980 to January 2000, among 1 030 patients with colorectal cancer admitted for surgical treatment, 143 (13.9%) patients were ＜35 years of age. The clinicopathological data of these young patients were reviewed and compared with those of patients in the other age groups. Results In this series of young patients, males were predominat. Most of them were with poorly differentiated (37.8%) and muco-cellular (29.6%) adenocarcinoma. The mast common gross morphology was infiltrating type (56.6%) and colloid carcinoma type (31.5%). The majority of patients (89.5%) were in Dukes stage B and stage C. Conclusion The prognosis of young patients with colorectal cancer surgically treated is worse, due to the fact that most of them are in late stage and their cancers are worse in differentiation. To increase the awareness of cancer in the young is important for early diagnosis and treatment and better prognosis.
ObjectiveTo explore the etiology, clinical manifestation, computed tomography (CT) manifestations, pathological character, diagnosis, differential diagnosis, and treatment of fibrous mediastinitis in China.MethodsThe clinical data of a patient with fibrous mediastinitis admitted to Hospital of Sichuan Provincial Armed Police Force were retrospectively analyzed and the related literature was reviewed. A literature research was performed with " fibrous mediastinitis, mediastinal fibrosis, sclerosing mediastinitis, chronic mediastinitis ”as the Chinese key word in WanFang database and China national knowledge internet, and " fibrous mediastinitis, mediastinal fibrosis, fibrosis of mediastinum, fibrosing mediastinitis, sclerosing mediastinitis, chronic mediastinitis” as English key words in PubMed database. The time interval was from January 1980 to December 2016.ResultsThe patient was a 59 year old male, whose chest CT scan showed soft tissue density in pulmonary hilar and mediastina, with bronchus truncation and obvious stenosis of pulmonary artery in hilar. Literature review found 12 related articles reporting 37 cases of fibrous mediastinitis in China. Fifteen cases were caused by tuberculosis infection presumably, and 9 cases were idiopathic mediastinal fibrosis. The common clinical manifestations were cough, dyspnea, chest tightness and pain, fever, and edema. CT manifested soft tissue density in pulmonary hilar and mediastina, which were diffuse in 32 cases. Trachea and bronchus were involved in 26 cases, while pulmonary artery in 29 cases, pulmonary vein in 13 cases, plural effusion in 16 cases, and vena cava and its branch in 8 cases. Other involved regions were described in 18 cases, including aorta and its branch in 4 cases, esophagus in 1 case, and there were pericardial effusion in 6 cases. Fourteen cases had pathology results.ConclusionsThe most common etiological factor of fibrous mediastinitis in China is tuberculosis infection, secondly idiopathic mediastinal fibrosis. Clinical manifestation is nonspecific. mostly diffuse, surrounding bronchus, esophagus and blood vessels in hilar and mediastina, and sometimes infiltrating into pericardium and pleurae. Its pathological character is proliferation of fibrous tissue, with proliferation of lymphocytes, and without envelope. The diagnosis depends on CT and pathology. Corticosteroid is considered to treat idiopathic mediastinal fibrosis, while surgery and vascular interventional therapy may improve symptoms of vascular compression in mediastina.
Objective To investigate the clinicopathological characteristics and factors influencing the prognosis of rectal carcinoid. Methods Clinical data of 31 cases with rectal careinoid, which identified diagnosis through operation and pathologic examination from January 2003 to March 2010 were retrospectively reviewed. Primary tumors were classified by size （≤1.0 cm， 1.0-2.0 cm， and ＞2.0 cm）and muscularis invasion respectively, compared therapeutic effect of different groups. Results Median age of 31 cases was 49 years (22-83 years). Median follow-up time was 36 months (15-86 months), follow-up rate was 80.6% （25 /31）. During the follow-up period, there were no cases with recurrence among the 15 patients with tumor size≤l.0 cm, 1 case recurred in the 7 patients with turmor size between 1.0 cm to 2.0 cm, and 2 cases died from postoperative liver metastasis among the 3 patients with tumor size＞2.0 cm.There were relations between the tumor size, invasion depth, and metastasis （P＜0.05）. Metastasis and invasion depth of tumor were possibility increment to follow the aggrandizement of the diameter of rectal carcinoid. Conclusion The diameter of rectal carcinoid and muscularis invasion may be important factors affecting survival, which may be an important basis for the choice of operative mode.
ObjectiveTo explore the microscopic character and clinical pathological feature of focal cortical dysplasia (FCD).Methods51 cases were collected from January 2015 to September 2018 in the 988th Hospital of the Joint Logistics Support Force of the People’s Libereation Army. Pathology with FCD of their diseased brain tissue was classified according to the classification standard by the International Anti-Epilepsy Union (ILAE) in 2011. Epileptic seizure characteristics were analysed in different types.ResultsFCD I was 23 cases (45.1%). FCD II was 11 (21.6%). FCD III was 17 (33.3%). Ia was the most common type (23.5%, 12/51). Neurons were arranged into microcolumnar structures in Ia. NF expression in immunohistochemistry was characteristic. It was close to the neuron like line or waterfall. The second type was Ⅲa (15.7%, 8/51). Hippocampal sclerosis was given priority to CA4 area pyramidal cells to reduce or disappear. Three types all happened in bilateral cerebral hemisphere. There was no statistical difference. Temporal lobe was significantly more than frontal lobe. More than 50% of the cases occurredepilepsy before the age of 18. The main manifestation was partial onset seizures and secondary body stiffness clonus. The onset age and history of epilepsy in patients with FCD Ⅲ were earlier than those in the other two types. On image the positive rate of I type was 78.3% and that of Ⅱ and Ⅲ was both 100%.ConclusionFCD is a common pathological feature of epilepsy patients. Carefully pathologic examination is the premise of accurate classification of each subtype. Ⅲ type is different from Ⅰ and Ⅱ type in epileptic seizures.
【Abstract】Objective To investigate the effect of ischemia on the treatment of advanced body and tail carcinoma of pancreas. Methods In operation the proximal spleen artery was ligated, a chemotherapy pump was installed to connect the distal spleenic artery and urea solution (40%) was injected through the device during and after operation. The pathology and pathophysiology change in dogs were observed. Results All the eight dogs studied were alive after operation, no serious complication appeared, pancreatic cells were replaced by fibrosis. Conclusion Infusion of 40% urea solution is a safe and effective ischemic method, it can lead to all sorts of pancreatic cell necrosis and fibrosis. It may be a good madality in the treatment of advanced pancreatic carcinoma.