目的 探讨膜联蛋白A1(ANXA1)和S100A16蛋白在脑胶质瘤组织中的表达水平及其意义.方法 收集广东祈福医院和南部战区总医院在2015年1月-2020年12月确诊的160例胶质瘤病例以及20例胚胎发育不良性神经上皮肿瘤(DNT)病例,用免疫组化(IHC)方法检测ANXA1和S100A16蛋白的表达水平.结果 ANXA1在胶质瘤组阳性率为80.6％(129/160),高于正常脑组织阳性率(7.5％,12/160).S100A16在胶质瘤组阳性率为86.3％(138/160),高于正常脑组织组阳性率(10.0％,19/160).ANXA1和S100A16在WHO分级Ⅰ～Ⅳ级胶质瘤中的阳性率差异无统计学意义.ANXA1在不包含WHO Ⅰ级的星形细胞来源肿瘤中的阳性率最高,达到95.0％(76/80),远比少突胶质细胞瘤中阳性率(42.9％,15/35)高.S100A16在不包含WHO Ⅰ级的星形细胞来源肿瘤中的阳性率(83.8％,67/80)与在少突胶质细胞瘤中阳性率(88.6％,31/35)比较差异无统计学意义.ANXA1在DNT组阳性率(100.0％,20/20)高于低级别胶质瘤组(78.8％,63/80)且差异有统计学意义.结论 ANXA1可用于胶质瘤的辅助诊断标记,也可用于复杂型DNT与少突胶质细胞瘤的鉴别诊断,有一定的临床辅助诊断价值.S100A16的表达在胶质瘤中与正常脑组织之间差异有统计学意义,但不能作为辅助标记物用于DNT与低级别胶质瘤的鉴别诊断.

目的 探讨硫酸软骨素蛋白聚糖4(CSPG4)和水通道蛋白1(AQP1)在脑胶质瘤中的表达及其对低级别脑胶质瘤和胚胎发育不良性神经上皮肿瘤(DNT)的鉴别诊断价值.方法 选取于广东祈福医院和南部战区总医院确诊的160例脑胶质瘤初诊患者和20例DNT患者的病理标本.采用免疫组化(IHC)法检测患者肿瘤组织和正常脑组织中的CSPG4和AQP1表达水平.结果 CSPG4和AQP1在脑胶质瘤组织中的阳性率均高于正常脑组织(P<0.05).CSPG4和AQP1在不同WHO分级脑胶质瘤组织中的阳性率比较,差异具有统计学意义(P<0.05),且随着脑胶质瘤WHO分级的提高两者的阳性率逐渐升高.CSPG4和AQP1在低级别脑胶质瘤和DNT组织中的阳性率比较,差异均无统计学意义(P>0.05).CSPG4和AQP1在脑胶质瘤组织中的表达无相关性.结论 CSPG4和AQP1可用于脑胶质瘤的辅助诊断,且表达水平随着脑胶质瘤WHO分级的提高而升高.但CSPG4和AQP1不能用于低级别脑胶质瘤与DNT的鉴别诊断.

目的 探讨膜联蛋白A1在高级别与低级别胶质瘤患者中的表达情况.方法 选取2017年1月至2020年6月我院收治的100例胶质瘤患者作为研究对象,比较膜联蛋白A1在不同性别、年龄、级别胶质瘤患者中的含量及膜联蛋白A1在不同组织及不同级别胶质瘤的阳性率.结果 100例患者中,胶质瘤组织阳性率明显高于瘤周组织(P<0.05);高级别胶质瘤患者血清膜联蛋白A1含量高于低级别胶质瘤患者(P<0.05).结论 膜联蛋白A1与胶质瘤患者病情发展之间存在一定的联系,可作为评估胶质瘤恶性程度的指标,为临床治疗胶质瘤提供有效指导.

目的 分析结直肠癌患者临床特征和病理类型.方法 选取2015年3月—2018年5月我院行手术及病理诊断为结直肠癌患者100例临床资料行回顾性分析,分析结直肠癌患者临床特征及病理类型特征.结果 患者首发症状以腹部不适或腹痛、排便习惯改变及便血为主,分别占 27. 00%、16. 00%、44. 00%.结肠癌41 例(41. 00%),直肠癌59例(59. 00%).肿瘤以溃疡型为主,占76. 00%.结直肠癌患者以腺癌为主,占69. 00%,其次为黏液腺癌,占19. 00%,其余腺鳞癌、印戒细胞癌、神经内分泌癌、鳞状细胞癌较为少见.结直肠癌患者分化程度均较低,中低分化患者占96. 00%.结直肠患者TNM分期以Ⅱ、Ⅲ期为主,分别为34. 00%、40. 00%.结论 结直肠癌患者发病早期可有腹部不适或疼痛、大便习惯改变及便血,肿瘤病理以腺癌为主,且分化程度较低,分期较高.

目的:探讨脾炎性肌纤维母细胞瘤（SIMT）的临床病理特征、诊断与治疗。方法:收集广州军区广州总医院收治的4例与文献报道68例SIMT患者的临床资料,分析和总结患者主要临床表现、影像学特征、病理学诊断依据、治疗方法及疗效。结果:患者多为成年男性,大部分以左上腹痛为首发主要症状,常伴有发热、乏力、消瘦、贫血等全身症状,影像学检查示绝大部分为单发、边界多清楚的局限性包块。B超检查为脾内不均匀回声包块,彩色多普勒血流显像示肿块乏血供或少血供;CT检查示脾内均匀或不均匀低密度肿块,部分增强各期强化不明显,大部分动脉期轻度强化,静脉与延迟期持续进一步强化,稍低于或等于脾密度,以周边较明显;MRI检查示T1WI、T2WI序列多为低信号,大部分增强扫描各期未见强化,部分动脉期轻微强化,静脉及延迟期进一步明显强化。镜下可见增生的梭形细胞及浸润的慢性炎细胞及胶原纤维形成;免疫组化vimentin、SMA、Desmin、CD68等表达阳性。72例均行脾切除,随访4个月至14年,1例术后2年复发,1例术后4年发生肝转移。结论:SIMT是较罕见的交界性间叶性肿瘤,临床无特征性,易误诊为恶性肿瘤,影像学检查有一定的诊断意义,确诊需病理学检查和免疫组化,脾切除是有效的治疗方法,预后良好,但需长期随访。

Objective To study the clinicopathologic features of primary lymphoepithelial-like carcinoma(LELC) of the lung.Methods Clinical data of 18 patients with lung primary LELC who were hospitalized between January 2006 and May 2016 and confirmed as LELC by surgical resection and pathological diagnosis were collected.Examination of nasopharynx was routinely performed in all patients,and no primary nasopharyngeal neoplasm was found.The clinical characteristics,pathomorphological features,the results of relevant immunohistochemical detection and in situ hybridization (ISH) detection of Epstein-Barr virus encoded-small RNA (EBER) were studied.Review of relevant literature was carried out.Results There were 5 males and 13 females aged 39 to 69 years (median age:54 years).Naked eye view showed that neoplasm nodules mostly were solitary,quasi-circular,solid and medium texture;boundary was not clear;cut surface presented hoartaupe.Microscopic observation showed that the tumor cell was very similar to that of nasopharyngeal vesicular nuclei cell carcinoma;the tumor cell presented size-unequal blocky or nest like arrangement;cancer cell was large;cytoplasm had moderate quantity,pale or weakly eosinophilic in color;cell nucleus appeared bulliform;nucleolus was clear;mitotic figure of nucleus was visible;there were no features of squamous cells or glandular differentiation;the infiltrations of a large number of mature lymphocytes and plasma cells in fibrous stroma were found.The positive rates of pan-cytokeratin (panCK) and CK5/6 were all 100％ (18/18).The positive rate of p63 was 94.4％ (17/18).The positive rate of ISH of EBER was 100％ (18/18).Conclusions Lung primary LELC is a rare variant type tumor in lung large cell carcinoma.Clinical manifestations of LELC were no specific.LELC was closely related to EB virus infection.The diagnosis of LELC mainly depends on the testing results of pathological tissue morphology,immunohistochemistry and ISH.Positive ISH of EBER can be used as an effective diagnostic basis.

目的 应用同位素标记相对和绝对定量蛋白质组学技术(iTRAQ)联合液相串联质谱筛选胚胎发育不良性神经上皮肿瘤与低级别胶质瘤的差异表达蛋白.方法 收集胚胎发育不良性神经上皮肿瘤(编号113)与低级别胶质瘤(编号114)各6例实体组织冻存新鲜标本,各组标本混合,通过蛋白质提取,蛋白质浓度测量(采用Bradford定量),聚丙烯酰胺凝胶电泳,蛋白质酶解,iTRAQ标记,SCX分离,再进行基于QE的液质联用分析,得到信息数据.使用蛋白质鉴定软件Mascot 2.3.02,选择UniProt-Human数据库,然后进行数据库搜索和生物信息学分析.依据蛋白质丰度水平,当差异倍数达到1.3倍以上,且经统计检验其P＜0.05时,视为差异蛋白.结果 鉴定出了中国大陆黄种人DNT相对于低级别胶质瘤的差异蛋白质88个,其中上调蛋白质44个,下调蛋白质44个.这些差异蛋白具有不同生物学活性,并参与多种代谢及信号通路.其中重要的蛋白有水通道膜内在蛋白1、丝氨酸/苏氨酸激酶、细胞内氯离子通道蛋白1、膜联蛋白A1、谷氨酰胺合成酶、硫酸软骨素多糖蛋白4、S100A9、S100A16、S100A13、异柠檬酸脱氢酶等.结论 iTRAQ技术实用可靠,有效筛选出胚胎发育不良性神经上皮肿瘤与低级别胶质瘤的差异表达蛋白.

目的 应用同位素标记相对和绝对定量蛋白质组学技术(iTRAQ)筛选胚胎发育不良性神经上皮肿瘤(DNT)差异表达蛋白.方法 将DNT实体组织标本(2例)与正常脑组织标本(2例),各组标本混合后提取蛋白,进行定量和酶解.iTRAQ标记后进行液相串联质谱分析.通过Mascot软件进行图谱分析.结果 实验匹配到的谱图数量是82 300张,其中特有谱图数量为57 738张,共鉴定到2 663个蛋白,16 341个肽段,其中含14 993个特有肽段.当蛋白丰度差异倍数达到1.3倍以上,且经统计检验其P值小于0.05时,视为差异蛋白,共鉴定差异蛋白225个,其中48个蛋白上调,177个蛋白下调.结论 通过iTRAQ技术分析得到的DNT差异表达蛋白可靠,iTRAQ技术为筛选出有意义的DNT生物标记物提供了一个良好的平台.

目的:检测EML4-ALK融合基因在非小细胞肺癌(NSCLC)人群中的突变率,并分析其与临床病理特征的关系.方法:采用逆转录定量PCR检测66例NSCLC患者组织标本中EML4-ALK融合基因的突变率;采用DNA扩增后直接测序的方法检测EML4-ALK阳性患者的组织标本中EGFR基因(18～21号外显子)及K-Ras基因(2号外显子)的突变情况.结果:66例NSCLC患者的组织标本中,有5例(7.6％)存在EML4-ALK融合基因阳性,这5例组织标本的EGFR(18～21号外显子)及K-Ras(2号外显子)均为野生型.5例阳性患者中,4例年龄小于总体患者的平均年龄(59-±11)岁,占80％ (4/5);女性患者4例,占80％(4/5);不吸烟患者3例,占60％(3/5).EML4-ALK融合基因阳性NSCLC患者均为腺癌,1例NSCLC组织为腺泡样结构,3例组织为印戒细胞样结构,4例伴有胞内或胞外黏液.结论:EML4-ALK融合基因阳性NSCLC多见于年轻女性腺癌患者,多为伴有黏液产生的印戒细胞样结构,不同时合并EGFR和K-Ras突变.

A 29‐year‐old male patient was admitted into hospital with the main complaint of progressive visual disturbance. Both CT SCAN and MRI demonstrated a cystic‐solid contrast‐enhancing sellar‐suprasellar mass with obvious calcification. Histopathological examination of the first resected specimen showed a typical appearance of adamantinomatous craniopharyngioma. The patient received gamma knife therapy after his first operation because of partial tumor removal. He experienced two relapses in the subsequent 2 years, for which only surgical resection was performed. The later histopathology presented malignant appearance with tumor cells moderate to severe pleomorphism, hyperchromasia, increased nuclear cytoplastic ratio, high mitotic activity (30/10 high power fields) and focal coagulative necrosis. The patient died 9 months after identification of histologic malignancy. Clinical and histopathological features, biological behavior of one case of malignant craniopharyngioma were discussed, with a brief review of the relevant literature.

[Summary] Sixty-one patients suffering from pituitary apoplexy( PA) were mainly diagnosed according to pathologic findings, and were collected from case record, pathology, and MRI databases. They were classified into 4 types according to the clinical condition: the insidious type was characterized with only positive pathological findings;the asymptomatic type had both positive pathologic and MRI findings; the subacute type had PA associated symptoms longer than 2 weeks; and the acute type had PA associated symptoms for 2 weeks or less. The latter 2 types had positive pathological and MRI findings additionally. The basic lesions, acute or chronic symptoms, endocrinopathies and MRI findings were compared among 4 types. Results showed as followed. In all patients, there were headache(60. 7% ), blurred vision(55. 7% ), vomiting(21. 3% ), and dizziness(14. 8% ). Apoplexy associated symptoms comprised severe headache (24. 6% ), rapid vision loss (29. 5% ), and blepharopotosis or diplopia (9. 83% ). Insidious, asymptomatic, subacute, and acute types were composed of 15 (24. 6% ), 9 (14. 8% ), 19 (31. 1% ), and 18 (29. 5% ) cases, respectively. Aging and intracranial space-occupying symptoms as first complaint showed increasing trend from mild to severe types(both P<0. 05), while in chronic course it showed decreasing trend(P<0. 05). Acute massive symptoms(P<0. 01), and non-functional tumor(P<0. 01) in the 2 clinical types were much more frequent than in the two mild types. Half or more pituitary-target glands showed impaired functions in each type, and the impairment showed increasing trend through mild to severe types(P<0. 01). The present study provided a brief typing system in order to expand PA concept to a wider span covering various conditions. Some differences in tumor composition and endocrinopathies existed among the four types.

目的 探讨5例误诊的中枢神经系统肿瘤和非肿瘤性病例的误诊原因及解决方案.方法 复习5例误诊的中枢神经系统肿瘤和非肿瘤性病例,分析各例误诊的关键因素以及相应的鉴别诊断,提出临床病理诊断方法.结果 5例误诊的病例中,肿瘤病例4例、非肿瘤病例1例;良性病变误诊为恶性2例,恶性肿瘤误诊为良性2例,1例非肿瘤性病变误诊为良性肿瘤.其中1例良性误诊为恶性的病例因后续放疗产生了严重后果.误诊的主要原因是不能系统地认识中枢神经系统病变、不熟悉诊断标准和新进展、不注重结合影像等相关检查结果.中枢神经系统病变的病理诊断应该遵循临床、影像、组织形态、免疫表型等综合分析的方法.结论 中枢神经系统病变的病理误诊并不罕见,减少误诊的解决方案是开展神经系统专科病理.

原发性CD30+间变大细胞淋巴瘤（CD30positive anaplastic large cell lymphoma，ALCL）是一种少见的非霍奇金淋巴瘤，主要发生于淋巴结和结外的皮肤及皮下组织。我科收治1例临床罕见的以皮肤结节及溃疡为表现的面部原发性CD30+间变大细胞淋巴瘤，现报告如下。

Objective To investigate the inflammatory myofibroblastic tumor's ( HIMT) clinical pathology , diagnosis and treatment.Methods Collected 949 cases of HIMT (13 cases were diagnosed and treated by authors , 936 cases reported in the literature ) clinical data , analyze and summarize the main clinical manifestations , imaging , pathology , diagnosis and treatment method and effect .Results HIMT usually occurs in adult men , most of the right upper abdominal pain as the first , often accompanied by fever , fatigue, weight loss and other symptoms;laboratory examination can have white blood cells , in-creased AFP expression;hepatitis B antigen was positive in 54 cases.Imaging examination in 617 cases including 547 cases (88.7%) of solitary localized mass; B type ultrasound examination in 409 cases, intrahepatic inhomogeneous echo mass , CDFI showed no evident:within the tumor blood supply , a small part of it in and around the probe and signal of blood flow , blood flow resistance index ( RI) <0.5; CT examination of 485 cases of intrahepatic: homogeneous or inhomogeneous low density mass , the reinforcement is not obvious enhancement , part of the portal venous and delay phase showed a peripheral ring like enhancement , the central core like enhancement , separated like enhancement; MR examination 216 cases: T1W1 series low or slightly low signal , T2W1 sequence images revealed slightly higher signal , dynamic enhanced scan showed simi-lar to CT.Pathological examination: spindle cell microscopically visible hyperplasia and infiltration of chronic inflammatory cells including lymphocytes , plasma cells and collagen fibers formed;immunohistochemistry showed Vimentin , Actin, MSA, SMA, and CD68 expression was positive in 555 patients (83.7%) underwent surgical operation , operation mode local resec-tion, liver resection and half liver resection .132 cases of operation patients were followed up for 3 months to 15 years after op-eration, 1 cases recurred abdominal abdominal hemorrhage were cured , 1 cases died of cirrhosis, liver failure.In 99 cases (14.9%, 99/663) received conservative treatment,follow-up of 3 months to 8 years,some lesions disappeared,narrowed,some with no change.Conclusion HIMT is borderline rare mesenchymal tumor,without clinical features,imaging characteristics,&nbsp;easily misdiagnosed as malignant tumor , needs to be confirmed by liver biopsy , operation pathology and immunohistochemis-try, local resection or conservative treatment is , the prognosis is good , need long-term follow-up.

OBJECTIVE: To improve the knowledge of hepatic epithelioid haemangioendothelioma(EHE).METHODS:To investigated and review the clinicpathologic features of four cases of EHE by light microscopic observation and immunohistochemical method and reviewed the corr elative literatures.RESULTS:The gender of the patients were two females and two males.The age were 55,36 for females and 41 and 44 years old for males respectively.The symptoms were right costal or abdominal pain,windy and one patient with symptoms resemble syndrome.Two cases showed hypohepatia.Imaging studies revealed multiple nodular or diffuse damage and misdiagnosed as cancer or Budd-Chiari syndrome.Three cases were diagnosed by needle biopsy and one case underwent hepatectomy.Histologically,the tumor cells had a epithelioid appearance and were arranged in cords or solid nests,amongst a myxoid or hyaline matrix.The tumor cells had abundance cytoplasm and contained scattered intracytoplasmic vacuoles just like ring cells.The tumor cells of three needle biopsy specimens lacked pleomorphism,mitotic activity whereas the tumor cells of hepatectomy specimens had obvious pleomorphism and mitotic activity 1/10 HPF.Massive necrosis could been seen.They were immunohistochemically positive for CD31,CD34,FⅧ and VEGF.CK staining was positive in some cases,PAS and AB-PAS stain were negative.The follow-up time was 2-22 months.One patient died after operation,2 patient died after leaving hospital,and 1 was lost in follow-up.CONCLUSIONS:Hepatic epithelioid hemangioendothelioma is malignancy and represents a distinct clinical pathological entity.It is rare and often misdiagnosed as other liver tumors.

A 30-year-old Chinese male presented with an 8 week history of headaches, visual changes, lightheadedness and balance problems. These symptoms were attributed to increased intracranial pressure secondary to obstructive hydrocephalus. Computed tomography (CT) scans demonstrated an iso-or slightly hyperdense mass within both lateral ventricles. The septum pellucidum was not seen well on imaging studies and the tumor was centered on the midline. Contrast enhancement was mild to moderate. An MRI scan revealed a large midline mass obliterating large portions of the lateral ventricles and giving rise to obstructive hydrocephalus and transependymal edema. The mass was isointense on T1 weighted imaging and contained calcification On T2 weighted images it was relatively isointense with cortex (Fig 1a). There was moderate enhancement after the administration of gadolinium. Postoperative MRI scan showed gross total resection and some blood. After radiotherapy, the nerval symptoms had lapse to. But repeated MRI scans in the following 12 months showed recrudescence in the MRI findings and patient had more nerval symptomatic. Finally, the patient died of hydrocephalus and brain edema 20 months after the surgery. The operative specimen was a broken tissue which had a lobulated, well-circumscribed, gray-colored mass, 5 cm × 4cm × 3 cm, soft in character, attend by intratumoral hemorrhage and putrescence. Microscopic examination showed sheets of monotonously small- to medium-sized neoplastic cells with uniform round-to-oval nuclei and inconspicuous nucleoli. The nuclei were surrounded by perinuclear halos. Cellular borders were indistinct and cells appeared to contain a moderate amount of amphophilic cytoplasm. The tumor cells were dense in some areas and alternate with anuclear, less dense tumor parts. And the anuclear areas had a fine fibrillary matrix. Delicate vasculature formed a branching network in a pattern similar to oligodendroglioma. Focal calcification can be seen. The remarkable characteristic was that there were mitoses, nuclear atypia, necrosis and microvascular proliferation (Fig 1b, 2a,b). Tumor cells had strong cytoplasmic reactivity for NSE (Fig 2c), NeuN (Fig 2d), Synaptophysin, and CD99. A few entrapped astrocytes reacted appropriately with GFAP, but the tumor cells were negative. The MIB-1 (Ki67) labeling index was estimated at 10% in all areas (Fig 2e). What is your diagnosis? Anaplastic central neurocytoma of both lateral ventricles. CN is a well-established pathological entity and is generally regarded as a low-grade well-differentiated neuronal tumor, with limited growth potential. Some doctors theorize CN may derive from bipotential precursor cells of the periventricular germinal matrix, which are capable of both neuronal and glial differentiation, but maintain a low proliferative potential after birth. However, there are multiple reports of local recurrence, abundant mitosis, necrosis, extraventricular extension of tumor, and even craniospinal dissemination. Eng et al 3, was the first to report clinical evidence of CN's aggressive nature; he reported two cases of craniospinal dissemination after craniotomy and subtotal resection of neurocytoma. Yasargil et al 10, reported that two patients had evidence of anaplasia and were treated with radiotherapy after total excision. Those tumors did not relapse at the time of the report after a follow-up of 5–12 months. Three patients in the same study had recurrences 38–92 months after total excision and none had evidence of anaplasia. So, it is not clear if tumors with anaplasia have a higher relapse rate or if they need additional treatment. With GFAP positivity increases and vascular proliferation in CN, might suggest a more malignant course, 2. There have a report, the MIB-1 index tended to be higher in central neurocytoma with mitosis and necrosis, 7. The MIB-1 labeling index showed that a LI of 2% might be critical in determining recurrence. which MIB-1 labeling index cut-off of 2% demonstrated tumor recurrence of 63%, 8. In a larger of 15 central neurocytomas, an elevated MIB- labeling index was felt to be indicative of biological activity comparing histological atypia, proliferation, and clinical outcome, 4. Two other patients who had histological anaplasia and MIB-labeling index <2 did not recur. So, it appears that there is a clinically more aggressive subgroup of central neurocytomas with elevated proliferative potential as determined by labeling index studies. This is testified in another case report of a patient with a recurrent central neurocytoma who had a four-fold increase in MIB labeling index after a 9-year disease free interval, 1. The MIB-1 labeling index at the initial resection was 0.7% compared to 3.9% at the time of relapse. McKenzie showed in a small series of 15 cases of CN that the typical criteria for grading brain tumors such as cellular pleomorphism, necrosis, mitotic activity and endothelial vascular proliferation do not correlate with MIB-1 labeling index. Moreover, he found that the proliferation index was a useful predictor of poor outcome; 4 of 15 patients had tumor recurrence and a MIB-1 labeling index >2%, 4. These results were reiterated in a 129 patient meta analysis which showed 48% recurrence rate for MIB-1 labeling index >3% versus12% for <3%, 5. In 2003, Takao et al reported a patient who had hyperacusis, oscillating vision, and headaches, 9, who was found to have a large left intraventricular mass. She underwent a craniotomy and excisional biopsy of the tumor. Although there was no pleomorphism or mitotic figures, the MIB labeling index was as high as 4.6%. The patient had a recurrence after only 11 months. The most important therapeutic modality is surgery. Tumor total resection and radiotherapy remain the main treatment options for central neurocytomas. The effect of chemotherapy on central neurocytomas has uncertain curative effect. Long-term responses to chemotherapy have not yet been reported. Total resection was suggested to be the best treatment for patients with atypical central neurocytomas, and that postoperative radiotherapy appeared to improve both local control and survival in patients who could not safely undergo total tumor resection 6. The concept that central neurocytomas are benign is not entirely correct and is questioned. Of hundreds of CN reported to date, the incidence of recurrence is low, which makes aggressive forms of this tumor difficult to study. In our case in particular, there was mitoses, nuclear atypia, necrosis and microvascular proliferation appears to be primary, likely correlates with a high MIB-1 labeling index of 10%, display atypical behavior, and finally made the patient die for the tumor recurrence. Our case is an example of a more aggressive CN, we designate anaplastic neurocytoma, WHO grade III is appropriate.

OBJECTIVE: To investigate the expression of serum sICAM-1,SAA1 and HSP70 in nasopharyngeal carcinoma patients and study its clinical value in such cases.METHODS: The levels of serum sICAM-1,SAA1 and HSP70 were detected by enzyme-linked immunosorbent assay(ELISA) in 30 NPC patients with lymph node metastasis,27 NPC patients withhout lymph node metastasis and 30 healthy adults.RESULTS: The levels and positive rates of serum sICAM-1,SAA1 and HSP70 of NPC group were significantly higher than those in the normal subjects group,and there was significant difference between the NPC group of lymph node metastasis and the group of no lymph node metastasis(P0.01).The 3 proteins became even higher as the malignancy of NPC progressed,and the 3 proteins had pertinence each other by bivariate analysis(P0.01).CONCLUSION: The validate test of serum of NPC patients identified that sICAM-1,SAA1 and HSP70 are significative in NPC diagnosis.

The objective of this study was to roport two cases of epithelioid haemangioendothelioma of cranial base and nasal cavity and analyze the clinical,radiological and pathological characteristic of this tumor.The clinic pathology feature of two cases of EH of cranial base and nasal cavity was investigated by light microscopic observation and an immunohistochemical study.The etiology of this rare disease remained unknown.Symptoms were scanty and usually mild.The radiograph or computed tomography usually revealed unregulate improprite image,invasive growth and with enrich blood supply.Histologically,crown-like clusters of epithelioid tumor cells or spindle cells were obtained which filled in the alveoli locating at the periphery of the tumor nodules,while the central part of the nodules contained myxoid to hyaline matrix.Tumor cells generally lacked pleomorphism,mitotic activity and necrosis.They were immunohistochemically positive for CD31 and CD34.CK staining was positive in some cases.In conclusion,the epithelioid hemangioendothelioma is designated low grade malignancy and represents a distinct clinical pathological entity.It is rare and often misdiagnosed as other diseases.Histopathological detection is the key for physicians from misdiagnosis.

Objective To explore the clinicopathologic features and diagnosis and differential diagnosis of epithelioid hemangioendothelioma(EHE) of bone.Methods The clinicopathologic features and immunohistochemical phenotype were observed in 4 bony EHE cases and related literature was reviewed.Results Bony EHE predominantly occurred at the age from 20 to 30 years of male.The ratio of male to female was 2∶1.The most common clinical symptom was localized pain.Their clinical courses were discordant and recurrence and metastasis may occur.There were predominantly multicentric and nothing special in clinical and X-Ray.Histopathologically,the distinctive features were that isolated,cords and nests of epithelioid tumor cells disposed in a hyaline or myxoid matrix with formation of blood vessels in various differentiation.Cytoplasmic vacules or vessel channel were observed.The bony trabeculae were usually seen and rimmed by osteoclastic giant cells.It was classified into classic type and malignant one according to cytologic and architecture characteristic in order to differentiate malignant degree.Immunohistochemically,tumor cells positively expressed CD34,CD31,FⅧRAg,vimentin and/or cytokeratin-pan.Conclusion EHE of bone is a rare type of malignant angiomatous tumor with distinct clinicopathologic features and often difficult to make diagnosis in clinical and X-ray.Pathologic examination is the best mean to make diagnosis for it.It should be differentiated from infection,metastatic carcinoma and other benign lesions.

Objective To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of myxopapillary ependymoma.Methods Clinical data of 9 patients with myxopapillary ependymoma were analyzed retrospectively.The tumors were observed by histology and immunohistochemistry.Results The tumors of 9 patients localized in the conus medullaris,cauda equina or filum terminale of the spinal cord.The typical pathological changes were arrangement of cuboidal or spindle-shaped tumor cells around vascularized and myxoid stromal cores in a papillary-radial type.A large quantity of mucus accumulated between tumor cells and vessels or within microcysts,accompanied by vascular thickness and hyalinization.The size and shape of tumors were uniform,and mitotic figures were uncommon or vacant.Immunohistochemistry results showed that tumor cells were positive for glial fibrillary acidic protein(GFAP),vimentin and S-100,and negative for cytokeratin(CK) and epithelial membrance antigen(EMA).Total resection was achieved in 9 patients and adjuvant radiotherapy was performed in 2.Six patients were followed up for 17 months to 5 years and recurrence was detected only in 1 patient by MRI.Conclusions The typical location,morphological features and immunophenotype are the essential points of diagnosis and differential diagnosis of myxopapillary ependymoma.The patients who underwent total removal can obtain a good outcome.