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关键词： 转化医学   基础医学   临床医学   病理学教学  

摘要： 病理学是基础医学和临床医学的“桥梁”[1],而病理学教学一直是医学教学中的难点与重点。结合病理学实际教学情况,基于转化医学理念探讨病理学教学-实践相结合模式,能提高病理学教学水平,增强学生的学习兴趣,有利于培养适应新时代要求的高素质应用型转化医学人才。

关键词： 病理学   免疫组化   液基细胞学   恶性胸腹水   腺癌  

摘要： 目的分析液基细胞学和免疫组化检查对诊断恶性胸腹水的作用。方法收集2019年4月—2020年4月在罗定市人民医院经液基细胞学检查被确诊为恶性胸腹水50例患者的临床资料。将所有患者的胸腹水沉淀物进行石蜡包埋切片、巴氏染色和免疫组化染色,分析恶性胸腹水的细胞类型分布和组织来源情况;比较不同方法检出恶性胸腹水的特点。结果①50份胸腹水样本中包括胸水样本30份和腹水样本20份。胸水样本包括腺癌23例,淋巴造血系统肿瘤5例,鳞癌和小细胞癌各1例;腹水样本包括腺癌18例,淋巴造血系统肿瘤和鳞癌各1例。②液基细胞学检查可见,腺癌细胞呈团状聚集,核质比显著增大,细胞核亦有显著增大表现,且形态异常,核染色质细,核仁较突出,可观察到巨核和多核瘤巨细胞,在细胞质内能够观察到黏液空泡;慢性粒细胞白血病、淋巴瘤、小细胞癌以及鳞癌样本的细胞黏附性较差,一般呈散在分布。③细胞巴氏染色可见腺癌细胞一般为花环状或成团聚集,还可呈乳头状或腺管状;慢性粒细胞白血病、淋巴瘤、小细胞癌以及鳞癌的瘤细胞通常呈散在或弥漫状分布,在肿瘤细胞四周可见数量不同的纤维蛋白性物质、间皮细胞和炎症细胞。④免疫组化检查结果显示,恶性胸腹水免疫组化标志物的表达特点不同,依据免疫组化标志物的表达情况和临床资料,能够判断肿瘤细胞的类型和组织来源。结论对胸腹水样本开展液基细胞学和免疫组化联合检查能够对恶性胸腹水进行有效诊断,协助临床判断肿瘤细胞的组织来源,从而对制定治疗方案进行指导。

关键词： 嗜酸粒细胞增多性血管淋巴样增生   眶肿瘤   上皮样血管瘤   诊断,鉴别   Kimura病  

摘要： 目的探讨眼部Kimura病和上皮样血管瘤的临床病理学特点及鉴别诊断。方法回顾性系列病例研究。选取2010年1月至2019年12月复旦大学附属眼耳鼻喉科医院收治及会诊并经组织病理学诊断为眼部Kimura病的10例患者和上皮样血管瘤的3例患者的临床及病理学检查资料,对临床表现、实验室检查、病理形态学特点、免疫表型等进行分析。结果10例眼部Kimura病患者中男性9例,女性1例;年龄7~75岁,平均年龄30岁;单眼病变6例,双眼病变4例;病变累及眼眶软组织为主3例,累及泪腺为主5例,累及眼睑为主2例;主要临床表现为眶周或眼睑皮下扪及质韧肿物,可伴眼睑肿胀下垂及眼球突出移位,运动受限;3例曾有全身其他部位淋巴结肿大病史;病程6个月至7年,平均34个月;10例外周血嗜酸性粒细胞绝对值或百分比均升高。3例眼部上皮样血管瘤均为男性,均单眼发病(右眼1例,左眼2例),年龄25~60岁,病变累及眼睑和眼眶1例、眉弓及内眦部皮肤各1例,表现为眼睑肿胀、眼眶肿物或皮下结节,病程5个月至2年。10例(11只眼)眼部Kimura病患者行肿物切除或部分切除活检术,组织病理学检查均显示泪腺区或眼眶纤维肌肉脂肪组织内或眼睑皮下淋巴组织增生,反应性淋巴滤泡形成,内含活跃的生发中心,滤泡间及腺体周围大量嗜酸性粒细胞浸润,伴嗜酸性微脓肿形成,部分增生的血管内皮细胞肿胀。3例(3只眼)眼部上皮样血管瘤均行肿物切除术,组织病理学检查均显示小至中等大小血管增生,血管内衬胞质丰富红染的突入管腔的上皮样内皮细胞,均表达CD31、第八因子相关抗原、E26转录特异性相关基因等血管内皮标志物,血管周围可见中等量的淋巴细胞、浆细胞和嗜酸性粒细胞的浸润,但无嗜酸性微脓肿形成。结论眼部Kimura病和上皮样血管瘤均为男性好发,组织病理学形态均表现为血管增生、内皮肿胀及嗜酸性粒细胞浸润,但Kimura病是一种以大量嗜酸性粒细胞浸润为特征的良性淋巴组织增生,而上皮样血管瘤是一种以血管内皮显著肿胀为特征的良性血管性肿瘤,可以此进行鉴别诊断。(中华眼科杂志,2021,57:689-695)

关键词： outcome   pattern 4   prostate cancer   radical prostatectomy   tumor volume  

摘要： Background Increasing percentages of Gleason pattern 4 (GP4%) in radical prostatectomy (RP) correlate with an increased likelihood of nonorgan-confined disease and earlier biochemical recurrence (BCR). However, there are no detailed RP studies assessing the impact of GP4% and corresponding tumor volume (TV) on extraprostatic extension (EPE), seminal vesicle (SV) invasion (SV+), and positive surgical margin (SM) status (SM+). Methods In 1301 consecutive RPs, we analyzed each tumor nodule (TN) for TV, Grade Group (GG), presence of focal versus nonfocal EPE, SV+ , and SM+. Using GG1 (GP4% = 0) TNs as a reference, we recorded GP4% for all GG2 or GG3 TNs. We performed a multivariable analysis (MVA) using a mixed effects logistic regression that tested significant variables for risk of EPE, SV+, and SM+, as well as a multinomial logistic regression model that tested significant variables for risks of nonorgan-confined disease (pT2+, pT3a, and pT3b) versus organ-confined disease (pT2). Results We identified 3231 discrete TNs ranging from 1 to 7 (median: 2.5) per RP. These included GG1 (n = 2115), GG2 (n = 818), GG3 (n = 274), and GG4 (n = 24) TNs. Increasing GP4% weakly paralleled increasing TV (tau = 0.07, p < .001). In MVA, increasing GP4% and TV predicted a greater likelihood of EPE (odds ratio [OR]: 1.03 and 4.41), SV+ (OR: 1.03 and 3.83), and SM+ (1.01, p = .01 and 2.83), all p < .001. Our multinomial logistic regression model demonstrated an association between GP4% and the risk of EPE (i.e., pT3a and pT3b disease), as well as an association between TV and risk of upstaging (all p < .001). Conclusions Both GP4% and TV are independent predictors of adverse pathological stage and margin status at RP. However, the risks for adverse outcomes associated with GP4% are marginal, while those for TV are strong. The prognostic significance of GP4% on BCR-free survival has not been studied controlling for TV and other adverse RP findings. Whether adverse pathological stage and

关键词： Anti-vascular endothelial growth factors   Bruch membrane   Choroidal neovascularization   Myopic choroidal neovascularization   Pathological myopia  

摘要： Purpose To evaluate the prevalence and visual outcomes of macular Bruch membrane (BM) defects in patients treated with anti-vascular endothelial growth factors (VEGF) for choroidal neovascularization secondary to pathological myopia (mCNV). Methods Single-center retrospective observational case series of 68 eyes from 62 patients with mCNV treated with one anti-VEGF injection followed by a pro re nata (1 + PRN) regimen. A minimum follow-up of 6 months was defined. Chorioretinal atrophy was assessed by fundus examination, fluorescein angiography, and SD-OCT. Results Median follow-up was 28.5 (range 6-89) months with a median number of 5 anti-VEGF injections. At baseline, 27.9% of eyes had macular BM defects increasing to 36.8% during follow-up (p<0.001). Eyes without macular BM defects at the baseline had higher BCVA at the last observation than patients with BM defects (p=0.003). An increase of 5 or more ETDRS letters was more frequent in eyes without BM defects (p=0.001). At the end of follow-up, mCNV-related macular atrophy was present in 44.1%;out of which, 83.3% presented macular BM defects (p<0.001). Eyes with mCNV-related macular atrophy without BM defects had a significant increase of best-corrected visual acuity compared with eyes with mCNV-related macular atrophy and BM defect (p=0.002). Conclusions Macular Bruch membrane defects are often seen in mCNV and have a significant impact in visual acuity and prognosis. Eyes with macular BM defects have a poorer response and worse visual outcomes after anti-VEGF therapy.

关键词： gut   histology   microbiota   oxytetracycline   Pelophylax nigromaculatus   tadpole  

摘要： Antibiotics such as Oxytetracycline (OTC) is widely used around the world and it caused serious environmental issues in China, especially in Yangtze delta area. However, its effects on amphibian gut morphology and intestinal microbiota are still unclear. In this study, tadpoles of Pelophylax nigromaculatus was exposed to 0, 5, 90 and 450 mu g/L OTC of environmentally relevant concentrations from Gosner (Gs) 26 to Gs 38. The results showed that severe histopathological injuries including cytoplasmic damage, cell arrangement disorganisation and structure deformation were observed in the gut of larvae in 90 and 450 mu g/L OTC exposure groups. Moreover, Tunel assay also revealed higher apoptotic ratio in the intestine of tadpoles in 90 and 450 mu g/L OTC treatment groups. Furthermore, the relative abundance of dominant phyla and genera of gut microbial community in OTC exposure groups was significantly different from that of control though the richness and species diversity did not show remarkable changes. We concluded that OTC may pose potential health risks to amphibian larvae through inducing gut histopathological injury and intestinal microbiota dysbiosis.

关键词： blue naevus   dendritic   immunohistochemistry   melanocytic lesions   morphology  

摘要： An accurate diagnosis of melanocytic lesions requires a thorough histopathological evaluation accompanied by appropriate correlation with clinical examination findings. Although most melanocytic lesions can readily be classified as one of the defined diagnostic entities according to well-established diagnostic criteria, a subset of melanocytic lesions, particularly those with blue naevus-like (pigmented dendritic) morphology, have notoriously constituted an enduring challenge for pathologists. These lesions are rare and often show histological ambiguities, with features of both benignity and malignancy, thereby making accurate risk assessment and prediction of their biological behaviours difficult on histological grounds alone. Herein, we outline a practical and systematic approach for the diagnosis of melanocytic lesions with dendritic morphology, with a particular focus on histological and immunophenotypic features that help to distinguish one entity from another. In this review, we provide the most current knowledge on these melanocytic lesions in the literature and our experience with these rare entities, and we discuss the utility of molecular techniques as an ancillary tool, especially in histologically ambiguous and/or borderline lesions.

关键词： Lymphatic malformation   Model mouse   Japanese herbal medicine   Eppikajutsuto  

摘要： Background: Lymphatic malformation (LM) is a congenital disease caused by lymphatic vessel malformation. Although standard therapies for LMs are sclerotherapy and/or surgical excision, a new therapy using Japanese herbal medicine Eppikajutsuto (TJ-28) has been recently reported as clinically effective. We aimed to experimentally confirm the therapeutic effectiveness of TJ-28 for LMs. Methods: LM lesions were generated in the mesentery and peritoneum of mice by intraperitoneal injection of Freund's incomplete adjuvant. Mice with LMs were treated by gavage or dietary administration of TJ-28 for 2 months. Formalin-fixed paraffin-embedded tissue sections of mesentery and peritoneum tissues were histologically and immunohistochemically examined by focusing on lymph nodes and perinodal lymph vessels. Results: Multiple Freund's incomplete adjuvant-associated foreign-body granulomas were formed in the mesentery and peritoneum, resulting in congestion of lymph fluid and dilatation of lymph vessels. The numbers and sizes of lymph nodes were not significantly different between TJ-28-treated and control groups. However, the luminal areas of lymphatic vessels were reduced significantly in the TJ-28 treatment group by both gavage and dietary administrations. Conclusion: TJ-28 conspicuously reduced congestion of lymph fluid. This is the first histopathological evaluation of LM model mice to study the effectiveness of oral TJ-28 treatment. (c) 2020 Elsevier Inc. All rights reserved.

关键词： African catfish   Cyanodiplostomum   Masenia bangweulensis   Orientocreadium batrachoides   Digenetic trematodes  

摘要： Parasitic infection may cause massive losses in Clarias gariepinus fries and fingerlings. Therefore, this study aimed to characterize the digenetic trematodes species (two adults' flukes and one metacercariae) infecting African catfish Clarias gariepinus, as well as their histopathological impacts on infected fish. The intestinal flukes were identified as Orientocreadium batrachoides and Masenia bangweulensis based on their morphological and molecular characteristics. Sequencing of their 28S (LSU rRNA) and 18S rRNA (SSU rRNA) genes confirmed that these trematodes belong to the families Orientocreadiidae and Cephalogonimidae, respectively. The metacercariae trematode infecting skin and muscles were only morphologically identified as Cyanodiplostomum sp. The gene expression levels of MHC II increased in naturally infected fish either with O. batrachoides or Cyanodiplostomum sp. alone, compared with uninfected catfish. In addition, lysozyme levels in individual fish serum increased in catfish infected either with O. batrachoides or Cyanodiplostomum sp. alone. Histopathological examination of the skin revealed embedded parasitic cysts that displaced tissue in the dermis. Surrounding tissues were infiltrated with melanomacrophages and displayed dermal edema. Histopathological analysis showed O. batrachoides or M. bangweulensis between the gastric folds of the stomach of infected catfish, causing infiltration of mononuclear inflammatory cells in the lamina propria.

关键词： Gingival fibroma   Reactive gingival lesion   Bump on the gum  

摘要： Gingival growths, barring a few are mostly reactive and seldom exhibit significant true neoplastic potential. The common etiology is local irritation from dental plaque/calculus, trauma as well as medication-related overgrowth. Such lesions are easily distinguishable and categorized into diagnoses such as pyogenic granuloma, peripheral ossifying fibroma, etc. We present a previously undescribed, but commonly encountered, reactive gingival growth with unique histologic features and suggest the diagnostic term "gingival fibroma." An IRB approved retrospective review of the University of Florida Oral Pathology Biopsy Service encompassing years 2010-2019, was performed to select cases. Demographics, clinical data, and microscopic diagnoses were recorded and analyzed. Four board-certified oral and maxillofacial pathologists agreed upon and established the diagnostic criteria. These are: a prominent fibromyxoid stroma, variable cellularity, a whorled or storiform pattern of arrangement of the cellular elements, lack of significant inflammation or vascularity, and complete absence of calcification, and/or odontogenic islands. A total of 60 cases met all criteria and were included in the study. Age range in years was 14-87 with the mean at 45.11 years. A striking female predilection (90%) was noted. Approximately 62% of cases were reported on the maxillary gingiva, followed by 38.3% in the mandibular gingiva. Majority, 66.7% were in the anterior incisor region followed by 11.7% in the canine/first premolar areas. All lesions were submitted as excisional biopsy, and 4 cases recurred within 2-3 years of excision. In all cases, lesional tissue appeared to extend to the surgical base of the specimen. We present 60 cases of a histologically unique entity occurring exclusively on the gingiva and introduce the diagnostic term "Gingival Fibroma" for these lesions. Further studies with adequate clinical follow-up may help understand the exact clinical behavior of these lesions.