Immunochemistry

免疫化学
  • 文章类型: Case Reports
    细胞性血管纤维瘤是一种罕见的良性间质瘤,通常发生在中年妇女的外阴区域。本报告强调了组织学分析在诊断这种罕见疾病中的重要性,并强调了其良性性质和直接管理。我们介绍了一个58岁的北非妇女的案例,在左阴唇的轮廓分明的肿块,已经进化了两年多。MRI通过描绘肿瘤的边界证实了肿瘤的可切除性。肿瘤,尽管增长缓慢导致诊断延迟,通过广泛的手术切除有效治疗。通过组织学和免疫组织化学评估证实了诊断,显示梭形细胞增殖与厚壁血管。细胞性血管纤维瘤,尽管最初由于其规模而令人担忧,通常通过手术成功治疗,预后良好,复发风险低。
    Cellular angiofibroma is a rare benign mesenchymal tumor, typically occurring in the vulvar region of middle-aged women. This report highlights the importance of histological analysis in diagnosing this uncommon condition and emphasizes its benign nature and straightforward management. We present a case of a 58-year-old North African woman who had a large, well-defined mass in the left labia majora, which had been evolving over 2 years. MRI confirmed the resectability of the tumor by delineating its boundaries. The tumor, despite its slow growth leading to delayed diagnosis, was effectively treated with wide surgical excision. Diagnosis was confirmed through histological and immunohistochemical evaluations, revealing spindle cell proliferation with thick-walled vessels. Cellular angiofibroma, although initially alarming due to its size, is generally managed successfully with surgery and prognosis is favorable with a low risk of recurrence.
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  • 文章类型: Case Reports
    不像肝和肺,胃很少是癌症的转移部位。我们报告了一例62岁的男性,已知他患有肺腺癌低分化,并在诊断后1个月出现黑便。上镜检查显示幽门前窦有一个溃疡肿瘤。通过甲状腺转录因子-1和细胞角蛋白CK7/CK20-模式的免疫组织化学染色证实了肺癌胃转移的诊断。总之,原发性肺癌的胃转移是每个临床医生都必须牢记的罕见现象。
    一名62岁男性,已知肺腺癌低分化,诊断后1个月出现黑便。上镜检查显示幽门前窦有一个溃疡肿瘤。组织学证实肺癌胃转移的诊断。
    Unlike liver and lung, the stomach is rarely a metastatic location for cancers. We report a case of a 62-year-old man known to have lung adenocarcinoma poorly differentiated presented with melena 1 month after diagnosis. Upper endoscopy revealed an ulcerated tumor in the prepyloric antrum. The diagnosis of gastric metastasis from pulmonary cancer was confirmed by the immunohistochemical staining for the thyroid transcriptional factor-1 and the pattern cytokeratine CK7+/CK20-. In conclusion, gastric metastasis from primary lung cancer is a rare phenomenon that every clinician must keep in mind.
    A 62-year-old man known to have lung adenocarcinoma poorly differentiated presented with melena 1 month after diagnosis. Upper endoscopy revealed an ulcerated tumor in the prepyloric antrum. The diagnosis of gastric metastasis from pulmonary cancer was confirmed by histology.
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  • 文章类型: Case Reports
    描述阑尾杯状细胞类癌是一种罕见的肿瘤,具有神经内分泌和腺癌的组织学特征。它的攻击性行为的结合,很少发生,和不同的临床表现完善了该肿瘤的管理。我们报告了一名75岁女性出现急性阑尾炎的病例。进行了腹腔镜阑尾切除术。病理报告显示阑尾底部有杯状细胞类癌,近端手术边缘受累。在她术后就诊时,患者的病理报告和治疗方案进行了审查,患者同意在阑尾切除术后8-10周进行右半结肠切除术。
    Description Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient\'s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks after her appendectomy.
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  • 文章类型: Case Reports
    胃神经鞘瘤(GS)是非常罕见的梭形细胞,由胃壁神经丛的雪旺细胞引起的粘膜下间充质肿瘤。它们通常是良性的,但可以变成恶性并转移到其他器官。手术切除伴活检是GS诊断和治疗的金标准。在这篇文章中,我们介绍了一位68岁的女性患者,她出现了腹痛,恶心,呕吐,打嗝了几个月.经进一步评估,她被发现有一个4.2厘米的胃肿块,通过活检和免疫组织化学检查与胃神经鞘瘤一致。患者接受了肿瘤的完整手术切除,没有任何并发症。在这篇文章中,我们将讨论有关GS的文献,包括其临床表现,诊断,和管理选项。
    Gastric schwannomas (GS) are very rare spindle cell, submucosal mesenchymal tumors that arise from Schwann cells of nerve plexuses in the stomach wall. They are usually benign but can become malignant and metastasize to other organs. Surgical resection with biopsy is the gold standard for diagnosis and management of GS. In this article, we present a 68-year-old female patient who presented with abdominal pain, nausea, vomiting, and belching for a couple of months. Upon further evaluation, she was found to have a 4.2 cm gastric mass, which was consistent with gastric schwannoma through biopsy and immunohistochemistry. The patient underwent complete surgical resection of the tumor without any complications. In this article, we will discuss the literature about GS including its clinical presentation, diagnosis, and management options.
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  • 文章类型: Case Reports
    合并小细胞肺癌(C-SCLC)是具有增加的非小细胞形态的小细胞肺癌(SCLC)。我们报告了一例表皮生长因子受体(EGFR)突变阳性C-SCLC的84岁转移性脑病变患者,对奥希替尼产生内在耐药,酪氨酸激酶抑制剂(TKI)。该患者被诊断为非小细胞肺癌(NSCLC)的小细胞转化,并接受了6个周期的剂量调整的durvalumab与依托泊苷和卡铂。2021年12月,患者在诊断后19个月接受了第17个周期的durvalumab维持治疗,并表现出持续的治疗反应和疾病控制。在一线EGFR-TKIs进展的NSCLC患者中,建议进行综合分子谱分析和重复活检。Durvalumab联合化疗似乎对对TKI耐药的EGFR突变阳性C-SCLC患者有益。
    Combined small-cell lung carcinoma (C-SCLC) is small-cell lung carcinoma (SCLC) with added non-small-cell morphology. We report a case of epidermal growth factor receptor (EGFR) mutation-positive C-SCLC in an 84-year-old patient with metastatic brain lesions who developed intrinsic resistance to osimertinib, a tyrosine kinase inhibitor (TKI). The patient was diagnosed with small-cell transformation of non-small-cell lung carcinoma (NSCLC) and received 6 cycles of dose-adjusted durvalumab with etoposide and carboplatin. In December 2021, the patient received the seventeenth cycle of maintenance durvalumab 19 months after diagnosis and showed continued treatment response and disease control. Comprehensive molecular profiling and repeated biopsies are recommended in NSCLC patients who progress on first-line EGFR-TKIs. Durvalumab in combination with chemotherapy appears to be beneficial for EGFR mutation-positive C-SCLC patients that are resistant to TKIs.
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  • 文章类型: Case Reports
    BACKGROUND: A metastatic lesion located in the ampulla of Vater is considered extremely rare, with only 32 cases reported globally.
    METHODS: A 65-year-old patient was primarily diagnosed with a rectal adenocarcinoma. Twenty-four months later as part of the oncological follow-up, the patient was diagnosed with a single secondary tumor in the ampulla of Vater. After undergoing a pancreaticoduodenectomy (Whipple procedure), the patient experienced an uneventful recovery and received adjuvant chemotherapy. Sixteen months later the patient remained disease-free.
    CONCLUSIONS: To the best of our knowledge, the present case represents the first reported metastatic tumor in the ampulla of Vater, originating from a rectal adenocarcinoma. This case underlines the critical role of immunohistochemistry in arriving at a correct diagnosis in order to guide clinical decision-making.
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  • 文章类型: Comparative Study
    先前的研究支持使用结肠镜检查或粪便免疫化学测试(FIT)预防结直肠癌(CRC)。然而,关于结肠镜检查或FIT降低CRC风险的相对有效性的具体证据很少.在这项研究中,我们使用全国性数据库比较了CRC风险与结肠镜检查和FIT的相关性.
    这项基于人群的病例对照研究使用了2002年至2013年韩国国民健康保险系统的结肠镜检查和FIT索赔数据。分析了61,221例新诊断的CRC患者(病例组)和306,099例非CRC患者(对照组)的数据。使用多变量逻辑回归模型来评估CRC与结肠镜检查或FIT之间的关联。
    结肠镜检查与后续CRC风险降低相关(校正比值比[OR]0.29)。结肠镜检查和远端CRC之间发现了更强的关联,与近端CRC相比(0.24vs0.47)。在按性别分层的分析中,与男性受试者相比,女性受试者的相关性较弱(0.33vs0.27).任何FIT暴露与CRC风险相关,OR为0.74;远端癌症的这种关联更强。随着累积FIT评估的频率增加(从1增加到≥5),FIT暴露对CRC的OR从0.81逐渐降低至0.45。
    远端CRC的结肠镜检查或FIT与降低CRC风险的相关性强于近端CRC。FIT显示与结肠镜检查相比,CRC风险降低较少。然而,随着累积FIT评估频率的增加,与CRC预防的关联变得更强.
    Use of colonoscopy or the fecal immunochemical test (FIT) for colorectal cancer (CRC) prevention is supported by previous studies. However, there is little specific evidence regarding comparative effectiveness of colonoscopy or FIT for reducing CRC risk. In this study, we compared the association of CRC risk with colonoscopy and FIT using a nationwide database.
    This population-based case-control study used colonoscopy and FIT claims data from the Korean National Health Insurance System from 2002 to 2013. Data were analyzed from 61,221 patients with newly diagnosed CRC (case group) and 306,099 individuals without CRC (control group). Multivariable logistic regression models were used to evaluate the association between CRC and colonoscopy or FIT.
    Colonoscopy was associated with a reduced subsequent CRC risk (adjusted odds ratio [OR] 0.29). Stronger associations were found between colonoscopy and distal CRC, compared with proximal CRC (0.24 vs 0.47). In an analysis stratified by sex, the association was weaker in female subjects compared with male subjects (0.33 vs 0.27). Any FIT exposure was associated with CRC risk with an OR of 0.74; this association was stronger for distal cancer. As the frequency of cumulative FIT assessments increased (from 1 to ≥5), the OR of FIT exposure for CRC gradually decreased from 0.81 to 0.45.
    The association of colonoscopy or FIT with reduced CRC risk was stronger for distal CRC than for proximal CRC. FIT showed less CRC risk reduction than colonoscopy. However, as the frequency of cumulative FIT assessments increased, the association with CRC prevention became stronger.
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  • 文章类型: English Abstract
    The term cutaneous pseudolymphoma (C-PSL) is defined in the literature as a benign, reactive lymphoproliferation that clinically and/or histopathologically imitates cutaneous lymphoma. The exact etiopathogenesis has not been fully elucidated to date. A distinction is made between primary, idiopathic PSL without an identifiable cause and secondary PSL with a known stimulus. We report the occurrence of pseudolymphoma after treatment with medicinal leeches (hirudotherapy). To the best of our knowledge, a total of only nine cases of cutaneous PSL after hirudotherapy have been reported in the literature to date.
    UNASSIGNED: Unter dem Begriff Pseudolymphom (PSL) versteht man eine benigne, reaktive Lymphoproliferation der Haut, die klinisch und/oder histologisch ein malignes Lymphom simulieren kann. Die genaue Ätiopathogenese ist bis heute nicht gänzlich geklärt. Man unterscheidet die primären, idiopathischen PSL ohne erkennbare Ursache von den sekundären PSL mit bekanntem Stimulus. Wir berichten über das Auftreten von Pseudolymphomen nach einer Behandlung mit medizinischen Blutegeln (Hirudotherapie). Bisher wurden nach bestem Wissen und Gewissen insgesamt nur 9 Fälle von kutanen PSL nach Hirudotherapie in der Literatur beschrieben.
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  • 文章类型: Case Reports
    Primary adenoid cystic carcinoma (ACC) of the lung is an unusual thoracic neoplasm with slow growing and low-grade malignancy. Usually, it is diagnosed at a higher clinical stage and is difficult to resect due to its central location. Herein, we report a 56-year-old man with hemoptysis associated with dyspnea and weight loss lasting for one month. Bronchial fibroscopy highlighted a budding nodular tumor in the left main bronchus. The patient underwent a left pneumonectomy with mediastinal lymphadenomectomy. Microscopic examination showed tumor cells infiltrating the bronchial wall and the cartilage and concluded to an ACC of the left bronchus. Ear, nose, and throat examination as well as cervico-facial magnetic resonance imaging were performed to search a primary salivary gland tumor and were returned without abnormalities. The tumor was classified as a primary ACC of the left bronchus without lymph node metastasis. To avoid their misdiagnosis, ACCs of the lung should be well known by the pathologist and surgeons. Their pathological features may be misleading and referring to a benign lesion, however, the presence of cribriform foci and infiltrative pattern are very suggestive. Although, indolent and slow growing tumor, long-term recurrences are quite frequent, especially in case of unclear surgical margin.
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  • 文章类型: Case Reports
    BACKGROUND: The pathogenesis of a ciliated muconodular papillary tumor (CMPT) of the lung is extremely rare which is difficult to distinguish from other lung lesions and it is easy to cause misdiagnosis and missed diagnosis. By collecting CMPT data, its clinical and pathological features can provide medical treatment ideas for the majority of medical workers and reduce medical errors.
    METHODS: The clinical data, pathological features, immunophenotype of a typical CMPT patient and related literature were analyzed.
    RESULTS: The chest computed tomography (CT) showed there was a mixed density nodule in the right lower lung near the pleura with a diameter of about 9 mm. We performed a wedge resection on the patient. The pathological results showed that the nodule was composed of proliferated ciliated cells, mucous cells, and basal-like cells. The ciliated cells were lined on the surface of papillary structures. The basal-like cells were located in the outer layer, while the mucous cells were located between the two. The cell atypia was not obvious. Immunohistochemistry: epithelial cells CEA (+), CK7 (+), CA125 (+), weakly positive for TTF-1, CK20 (-), Ki67 (1%+), CK5/6 (+), and basal cells P63 (+).
    CONCLUSIONS: CMPT is a rare pulmonary neoplasm. There is no definite conclusion about its biologic nature, but most experts prefer a benign to a malignant tumor. CMPT can show many malignant tumor signs on imaging and is often mistaken for lung adenocarcinoma. According to its typical histopathological characteristics and immunohistochemical phenotype, it can be differentiated from other pulmonary diseases. Whether gene mutation is the driving factor is still unknown. Surgical resection for the tumor reveals a good prognosis.
    【中文题目:典型肺纤毛黏液结节性乳头状肿瘤1例 临床病理分析】 【中文摘要:背景与目的 肺纤毛黏液结节性乳头状肿瘤(ciliated muconodular papillary tumor of the lung, CMPT)的发病极其少见,在临床上与其他肺部病变亦难以区别,易造成误诊、漏诊;通过收集CMPT的资料,分析其临床病理特征,可以为广大医务工作者提供诊治思路,减少医疗差错。方法 回顾性分析1例典型的CMPT患者的临床资料、病理特征、免疫表型并结合相关文献进行探讨。结果 患者胸部计算机断层扫描(computed tomography, CT)提示右下肺近胸膜处可见混合密度结节影,直径约9 mm,肿瘤行肺楔形切除术,镜下见结节由增生的纤毛细胞、黏液细胞及基底样细胞混合组成,以乳头状、腺样结构为主,纤毛细胞衬覆于乳头状结构表面,基底样细胞位于外层,黏液细胞则位于两者之间,各种细胞异型不明显。免疫组化:上皮细胞CEA(+)、CK7(+)、CA125(+)、TTF-1(弱+)、CK20(-)、Ki67(1%+)、CK5/6(+);基底细胞P63(+)。结论 CMPT是一种新近发现的罕见的肺部肿瘤,关于其良恶性目前尚无定论,但多数学者倾向于良性,其在影像学上可表现出诸多恶性肿瘤征象而常被误认为是肺腺癌,通过其典型的病理组织学特点及免疫组化表型可与其他肺部疾病进行鉴别,基因突变是否是其驱动因素目前尚不得知,该肿瘤行手术切除预后较好。】 【中文关键词:肺肿瘤;肺纤毛黏液结节性乳头状肿瘤;临床病理学;免疫表型】.
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