BACKGROUND: Current diagnostic criteria of adrenocortical neoplasms are mostly based on morphology. The utility of immunohistochemistry (IHC) and histochemistry is limited.
METHODS: To evaluate the diagnostic and prognostic utility of clinicopathological features, morphology, ancillary biomarkers, and reticular histochemistry in adrenocortical neoplasms. We examined 28 adrenocortical carcinomas (ACCs) and 50 adrenocortical adenomas (ACAs) obtained from pathology archives. Clinical data were retrieved from medical records. Two pathologists independently assessed hematoxylin and eosin-stained slides, employing modified Weiss criteria for all tumors and Lin-Weiss-Bisceglia criteria for oncocytic variants. Immunohistochemical markers (Calretinin, alpha-inhibin, MelanA, SF-1, Ki-67, PHH3, IGF-2, β-catenin, P53, CYP11B1, CYP11B2, MLH1, MSH2, MSH6, PMS2, EPCAM) and Gomori\'s Silver histochemistry were applied. Statistical analysis utilized SPSS Statistics 26.
RESULTS: ACCs exhibited larger tumor sizes (P<0.001) and symptomatic presentations (P = 0.031) compared to ACAs. Parameters of modified Weiss criteria and angioinvasion demonstrated diagnostic value for ACCs. Six immunohistochemical antibodies((MelanA, Ki-67, IGF-2, β-catenin, P53 and CYP11B1) and reticulin framework alterations showed diagnostic value. Notably, Ki-67 and reticulin staining were most recommended. Evident reticulin staining was frequently present in ACCs (P<0.001). Ki-67 was significantly higher in ACCs (P<0.001). Twenty-one conventional and seven oncocytic entities showed different necrosis frequencies. Symptoms and Ki-67 index ≥ 30% were prognostic for ACCs, correlating with shorter survival.
CONCLUSIONS: This study emphasizes the diagnostic value of reticulin framework alterations and a high Ki-67 index. Markers such as CYP11B1, IGF2, P53, β-catenin and MelanA also contribute to the diagnosis of ACCs. Symptoms and Ki-67 index ≥ 30% predict shorter survival. These findings encourges the use of ancillary markers such as reticulin histochemistry and Ki-67 in the workup of evaluations of adrenocortical neoplasms.

BACKGROUND: To investigate the characteristics of reticular fibre structure (RFS) in parathyroid adenoma (PTA), atypical parathyroid tumour (APT), and parathyroid carcinoma (PTC), and to assess its value as a diagnostic indicator.
METHODS: Clinical data and pathological specimens of patients with PTA, APT or PTC were collected. Reticular fibre staining was performed to observe the characteristics of RFS. This study evaluated the incidence of RFS destruction in parathyroid tumours, compared RFS destruction between primary PTC and recurrent and metastatic PTC, and explored the association between RFS destruction and clinicopathological features of APT and primary PTC.
RESULTS: Reticular fibre staining was performed in 50 patients with PTA, 25 patients with APT, and 36 patients with PTC. In PTA cases, a delicate RFS was observed. In both the APT and PTC groups, incomplete RFS areas were observed. The incidence of RFS destruction was different among the PTA, APT, and PTC groups (P < 0.001, χ2-test), at 0% (0/50), 44% (11/25), and 86% (31/36), respectively. When differentiating PTC from APT, the sensitivity and specificity of RFS destruction were 81% and 56%, respectively. The incidence of RFS destruction was 73% (8/11) in the primary PTC group and 92% (23/25) in the recurrent and metastatic PTC groups. In both the APT group and primary PTC group, no correlation was found between RFS destruction and clinicopathological features.
CONCLUSIONS: RFS destruction may indicate that parathyroid tumours have unfavourable biological behaviours.Reticular fibre staining may be a valuable tool for improving the diagnostic accuracy in parathyroid tumours.

Fibroblastic reticular cells (FRCs), a subpopulation of stromal cells in lymphoid organs and fat-associated lymphoid clusters (FALCs) in adipose tissue, play immune-regulatory roles in the host response to infection and may be useful as a form of cell therapy in sepsis. Here, we found an unexpected major role of TLR9 in controlling peritoneal immune cell recruitment and FALC formation at baseline and after sepsis induced by cecal ligation and puncture (CLP). TLR9 regulated peritoneal immunity via suppression of chemokine production by FRCs. Adoptive transfer of TLR9-deficient FRCs more effectively decreased mortality, bacterial load, and systemic inflammation after CLP than WT FRCs. Importantly, we found that activation of TLR9 signaling suppressed chemokine production by human adipose tissue-derived FRCs. Together, our results indicate that TLR9 plays critical roles in regulating peritoneal immunity via suppression of chemokine production by FRCs. These data form a knowledge basis upon which to design new therapeutic strategies to improve the therapeutic efficacy of FRC-based treatments for sepsis and immune dysregulation diseases.

OBJECTIVE: To investigate the correlation between the bone marrow fibrous proliferation and the prognosis of acute myeloid leukemia(AML).
METHODS: The quantitative method was used to analyze the reticulin fiber density (RFD) of AML patients. the bone marrow sections from 39 primary AML patients and 35 normal controls were collected to compare the RFD between these 2 groups. The prognosis value of RFD for AML were estimated by using appropriate statistical analysis.
RESULTS: RFD in primary AML was significantly higher than that in normal controls(2.41%±0.23% vs 1.14%±0.06%)(P<0.05). Relapse-free survival(RFS) analysis showed that the patients with RFD more than 1.68% indicated poor RFS, and the overall survival(OS) analysis showed that patients with RFD more than 2.66% indicated poor overall survival (P<0.05). Besides, there were no relationship between RFD and the BM blast count (r=0.01) and WBC counts (r=0.04) at diagnosis(P>0.05).
CONCLUSIONS: The RFD in bone marrow is a high risk factor in poor prognosis of AML patients.

This study was purposed to explore the correlation of chromosome karyotype with dyshaematopoiesis and reticulin in myelodysplastic syndrome (MDS). The data of 202 MDS patients diagnosed and treated in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed in term of chromosome karyotype, dyshaematopoiesis and reticulin detection results. The chromosome karyotypes were categorized according to the International Prognostic Scoring System (IPSS). The results showed that there was a positive correlation between chromosome karyotype grading and number of lineages with dyshaematopoiesis (r = 0.443, P < 0.05). The detected rates of multilineage dyshaematopoiesis in patients with good, intermediate and poor chromosome karyotypes were 44.4%, 71.4% and 96.3% respectively. There was a positive correlation between chromosome karyotype grading and reticulin grading (r = 0.451, P < 0.05). The positive rates of reticulin in patients with good grading, intermediate and poor chromosome karyotypes were 36.8%, 64.3% and 92.6% respectively. The detected rate of multilineage dyshaematopoiesis, number of lineages with dyshaematopoiesis, the positive rate of reticulin and reticulin grade in patients with poor karyotypes were higher than those in patients with intermediate or good chromosome karyotypes (separately P < 0.01). The above data in patients with intermediate chromosome karyotypes were higher than those in patients with good chromosome karyotypes (separately P < 0.01). It is concluded that the chromosome karyotype grading positively correlates with the number of lineages with dyshaematopoiesis and reticulin grading. When the chromosome karyotype changed from good to poor, the detected rate of multilineage dyshaematopoiesis, number of lineages with dyshaematopoiesis, positive rate of reticulin and reticulin grading became higher and higher.

The aggregated lymphoid nodules area (ALNA) in abomasum of Bactrian camels is a special immune structure discovered only in Bactrian camels in recent years (2003). The anatomy research found that there was a close relationship between degree of development, anatomical characteristics and age. To further establish the relationship between histological characteristics of this special structure and animal age, 24 Alashan Bactrian camels of the following four age groups were studied: young (1-2 years), pubertal (3-5 years), middle-aged (6-16 years) and old (17-20 years). Mucosal-associated lymphoid tissue (MALT) of ALNA in abomasum was particularly observed and analyzed by histology, histochemistry and statistical methods. The results showed that the average number of lymphoid nodules in reticular mucosal folds region of ALNA in abomasum from young group to old group was in order of 26.8, 32.7, 17.6 and 7.8, and in longitudinal mucosal folds region was 20.1, 26.0, 10.3 and 5.1. The number of lymphoid nodules in the four experimental groups first increased and then decreased with increasing age (P<0.01). In young and pubertal camels lymphoid nodules were distributed evenly on both sides of the axis of mucosal folds and mostly displayed round, oval or wedge shape. The number of lymphoid nodules, follicle-associated epithelium (FAE), reticular fibers and plasmocytes in mucosal folds gradually increased from 1 to 2 years and peaked at puberty. There were up to 37 visible lymphoid nodules in a mucosal fold. However, ALNA of middle-aged and old camels gradually degenerated as aging. Lymphoid nodules were unevenly distributed on both sides of the axis of mucosal folds, which mostly displayed oval or irregular shape. Lymphoid tissue in old camels mostly existed as diffuse form. Although germinal centers of the lymphoid nodules were still obvious, the number of reticular fiber and plasmocyte and lymphoid nodules gradually decreased. The results indicated that in accord with the anatomical results, there was a close relationship between histology characteristics of lymphoid tissue of ALNA in abomasum and animal age. In summary, the lymphoid tissue of ALNA in abomasums gradually increased from young to pubertal groups with increasing age, peaked in 3-5 year-old camels, and subsequently declined with age and when 17-20 years old this immunity structure had severely atrophied.

BACKGROUND: Solitary fibrous tumor (SFT) is a rare spindle-cell benign neoplasm and located in orbit. The present research represents case reports of ten patients with orbital SFT.
METHODS: Prognosis was assessed by clinic service and telephone interview. Clinical data were retrieved from the medical records. Immunohistochemistry for CD34, CD99, EMA, HMB-45, Bcl-2, GFAP, S-100, MBP, CK, and MIB-1 was performed. Distributions of time to progression and recurrence between different operative methods were estimated using the Kaplan-Meier method and compared using the log-rank test.
RESULTS: The ten patients included six men and four women (range: 19-75 years). The most common initial symptom was painless proptosis (n = 6). After the ten initial surgeries, with four requiring gross total resection (GRT) and six requiring subtotal resection (STR), an additional nine were required to remove recurrent tumors. Eighteen samples were obtained for pathological examination (the third sample for case 4 was not achieved). Cellular areas with partial hemangiopericytoma pattern were noted in four samples (4/18); scarce mitosis was noted in six samples (6/18). All SFTs (18/18) were positive for CD34, CD99 and vimentin, while all SFTs (18/18) were negative for EMA, CK, MBP, HBM-45 and GFAP. Bcl-2 was positive in 13/18 cases, while S-100 was negative in 14/18 cases. The MIB-1 labeling index varied from 1% to 3%. Follow-up was available for nine patients with a median of 88 months. All four patients who underwent GTR on initial operation did not recur; while the five patients who underwent STR recurred. The log-rank test showed that the incomplete surgical resection was significantly associated with recurrence (p = 0.015).
CONCLUSIONS: Orbital SFT is a rare mesenchymal tumor and painless proptosis is the most common initial symptom. Immunohistochemistry should be used to differentiate SFT from other tumors. Orbital SFT usually has a non-aggressive histological characteristic, and has a good prognosis if GTR is performed. Postoperative regular and long-term follow-up remains mandatory to monitor recurrence.

OBJECTIVE: To investigate whether the effect of N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) on macrophage infiltration was involved in AcSDKP\'s antifibrotic effect on the rats with silicosis.
METHODS: Rats were intratracheally instilled with silica as silicotic models in the experiment. Wistar rats were divided into 6 groups randomly: control 1, control 2, silicotic model 1, silicotic model 2, anti-fibrosis treatment of AcSDKP, Preventing fibrosis treatment of AcSDKP. Lung fibrosis in morphology was observed by H.E staining. Collage content was detected by Hydroxyproline assy. The expressions of MCP-1 and ED-1 in lung were observed by immunohistochemistry.
RESULTS: In anti-fibrosis treatment of AcSDKP group, area of of silicosis nodules decreased to 84.28% and 67.93%, content of hydroxyproline decreased to 70.89% and 58.18%, protein expression of MCP-1 decreased to 82.3% and 84.1%, cell numbers of MCP-1 decreased to 67.4% and 72.5%, protein expression of ED-1 decreased to 78.7% and 79.3%, cell numbers of ED-1 decreased to 54.4% and 66.8%. In Preventing fibrosis treatment of AcSDKP group, area of silicosis nodules decreased to 61.13%, content of hydroxyproline decreased to 60.27%, protein expression and cell numbers of MCP-1 decreased to 85.2% and 86.3%, protein expression and cell numbers of ED-1 decreased to 87.2% and 74.9%.
CONCLUSIONS: AcSDKP can decrease and reverse pulmonary fibrosis in rats with silicosis which may be mediated in part by inhibition of the infiltration and aggregation of macrophage and the severity of silicotic alveolitis.

Epithelioid angioleiomyoma is rare in the skin and subcutis. We report here an unusual case of epithelioid angioleiomyoma with prominent clear-cell change. Smooth-muscle differentiation was confirmed by immunostains. The extensive clear-cell change in epithelial cells and the marked hyalinization and calcification made the histologic differential diagnosis challenging. Epithelioid angioleiomyoma shares some histologic characteristics with glomus tumors and seems to be an intermediate entity between angioleiomyomas and glomus tumors.

OBJECTIVE: To present our experience with liver fine needle aspiration (FNA) diagnosis and the adjunctive use of cell blocks with reticulin stain.
METHODS: The authors reviewed the results of cytopathologic diagnosis obtained by FNA biopsy over a 1-year period, from January 2000 to December 2000, in patients who presented primarily with ultrasonographically suspected liver nodules. FNA smears from 936 patients and cell blocks from 796 patients were reviewed.
RESULTS: Among the 936 aspirates studied, the most common malignancy was hepatocellular carcinoma (HCC), which was diagnosed in 427 cases (45.6%), followed by metastatic adenocarcinoma, with 52 cases (5.6%). The concurrent cell block was available in 796 cases. Among them, 574 (72.1%) contained sufficient tissue for diagnosis. Combining analysis of cytologic and histologic specimens, the sensitivity of ultrasound-guided FNA for diagnosis of liver tumors was 85.1% and the specificity 98.7%. The results were better than isolated cytologic analysis, which gave a sensitivity of 78.4% and specificity of 97.4%. The lower diagnostic accuracy of cytology resulted mainly from its lower ability to distinguish well-differentiated HCC from benign lesions. In the cell block sections with reticulin stain, all HCCs showed a decreased or absent reticulin pattern, whereas all the benign hepatocellular lesions usually had a normal trabecular reticulin framework.
CONCLUSIONS: FNA cytology assisted by cell block examination can be an accurate and minimally invasive method for the definitive pathologic diagnosis of primary benign and malignant liver masses and for confirmation of tumors metastatic to the liver. In addition, reticulin staining should be part of the routine assessment of cell blocks. It enhances diagnostic accuracy, particularly for well-differentiated HCC.