Objective:To improve the understanding of indolent mantle cell lymphoma (MCL).Methods:The data of a patient with indolent leukemic MCL in the Second Affiliated Hospital of Nanjing Medical University in May 2013 were collected. The cell morphology was analyzed by using cell smear, the flow cytometry was used to make immunophenotype analysis, the karyotype analysis was performed by usig cytogenetic technique, and polymerase chain reaction (PCR) was used to make the immunoglobulin gene analysis. At the same time, lymph node pathology and immunohistochemistry were also analyzed. The related articles published were reviewed to sum up the characteristics and the treatment of indolent MCL.Results:The male patient aged 60 years was obviously asymptomatic accompanied with slow disease progression, leukemic manifestation and without lymphadenopathy. He received pathological biopsy because of located lymphadenopathy in 2008. Small cell morphology, Kappa light chain immunophenotype, t(11;14) translocation showed after the cytogenetic examination, clonal immune globulin gene rearrangement and low Ki-67 positive index were identified. In situ MCL was diagnosed by retrospective pathology.Conclusions:Indolent MCL is extremely rare. It is typically asymptomatic with none or minimal nodal involvement, indolent disease course, leukemic phase with mild lymphocytosis, Kappa light chain expression, simple karyotype, classical or small cell morphology of tumor cells and the positive index of Ki-67 <10%. In situ MCL can be seen in pathology examination. IgVH gene mutation positive and SOX11 negative expression are notable in indolent MCL. International prognostic index of MCL is probably not appropriate in the prognostic analysis of leukemic indolent MCL. It is emphasized that initial observation and having therapies only after the disease progression can be suited for indolent MCL.

Objective:To investigate the clinical characteristics and therapeutic effect of adult primary hemophagocytic syndrome (HPS).Methods:The clinical data of a patient with primary HPS in the Third Affiliated Hospital of Southern Medical University in July 2017 were retrospectively analyzed, and the related literature was reviewed.Results:The patient was a 53-year-old female without history of basic disease, presenting as repeated high fever, with mutation of STXBP2 (FHL5), and was diagnosed as HPS according to hemophagocytic lymphohistiocytosis (HLH)-2004 criteria. The patient was treated with HLH-2004 regimen, and the efficacy was good. The patient was followed up until May 2021, and the overall survival time was 45 months.Conclusions:The atypical primary HPS and delayed primary HPS are rare, with mild clinical symptoms and only manifested by repeated high fever. Therefore, the gene mutations associated with HPS should be detected as soon as possible to confirm the diagnosis and to treat the disease early.

恶性间皮瘤(malignent mesothelioma,MM)是一种显示向间皮分化的恶性肿瘤[1],好发于胸膜和腹膜,少数病例可发生于心包膜和睾丸鞘膜等部位.呈弥漫性生长的称为弥漫性恶性间皮瘤(DMM),少数肿瘤(＜1％)可呈局限性结节性生长,称为局限性恶性间皮瘤(LMM).

肝样腺癌是一种发生于肝外的具有肝细胞癌样分化特点的高度侵袭性肿瘤，易转移，预后差。原发于胆管的肝样腺癌罕见，临床诊断中易被忽视。本文报道1例原发于胆总管并伴有肝转移的肝样腺癌，通过对其临床病理学特征及免疫组织化学特点进行分析并复习相关文献，总结其诊断及鉴别诊断要点。.

目的:在媒介融合趋势下探讨医院利用微信公众号宣传健康科普知识,提高医院品牌影响力的手段.方法:围绕微信公众号在医院宣传健康科普现状、优势、体系构建及注意的问题,以苏州市立医院为例进行探讨.结果:医院微信公众号近年来发展迅速,内容更具互动性、形式多样、个性化突出、信息发布实时受限少等优势,但也存在着一定的发展瓶颈和问题.结论:构建微信公众号健康科普宣传体系,注意相关问题,利用好微信公众号进行健康科普宣传,更好地为患者服务,打造医院服务品牌.

目的 探讨非典型官颈腺细胞(AGC)在宫颈细胞学中的应用情况.方法 2012年1月～2019年8月选取南京医科大学第二附属医院病理科经液基薄层细胞检测检查的AGC病例34例,与其组织学结果进行对照并分析.结果 宫颈腺上皮异型增生7例(20.59％),宫颈腺癌2例(5.88％),子宫内膜腺癌4例(11.76％),高度鳞状上皮内病变累及腺体9例(26.47％),低分化鳞状细胞癌2例(5.88％),宫颈管内膜慢性炎7例(20.59％),子宫内膜息肉2例(5.88％),宫颈腺上皮微腺型增生1例(2.94％).根据病变类型,分为腺上皮病变组(13例)和鳞状上皮病变组(11例),两组年龄构成比较,差异有统计学意义(P＜0.05).结论 AGC在官颈组织学对照中,若为良性或者癌前病变,多数为官颈管腺上皮异形增生以及较大比例的需要鉴别的高度鳞状上皮内病变累及腺体;若为恶性,则多数为宫颈腺癌或子宫内膜腺癌及需要鉴别的低分化鳞癌.此外,不同病变类型可能与年龄有关系,40岁以上是腺上皮病变的高发年龄段.

黑素细胞痣(melanocytic nevus)又名色素痣,是皮肤的黑素细胞良性增生性病变,可生长于身体的任何部位,且以颜面部多发[1].因现代人们对外貌的要求并担心其恶变,色素痣手术切除逐年增加,成为病理科较常见的组织标本之一.根据痣细胞巢的生长部位可分为交界痣、复合痣、皮内痣.色素痣组织切片经HE染色后可见形状不一的棕黄色、棕褐色或棕黑色的细小颗粒,我们称之为黑色素.这种黑色素颗粒可掩盖细胞的结构和形态,影响观察,而且其颗粒存积的颜色与进一步免疫组化DAB显色的棕黄色难以区别,对疾病的诊断造成障碍.为去除黑色素颗粒对细胞的影响,提高色素痣标本的制片质量,笔者对传统脱黑色素法进行了探索改良,并对脱色素标本免疫组化的处理方法条件优化,现将实验内容介绍如下.

显微镜下结肠炎( microscopic colitis, MC)是一类慢性水样腹泻,内镜下结肠黏膜正常或轻度异常,病理组织活检呈特异性改变的疾病。近年来该病发病率逐年上升,约占慢性腹泻的13%[1],越来越受到临床医师的关注。 MC肠镜下黏膜并无特殊表现,而其他的相关影像学及一般的实验室检查对该病的诊断并无帮助,因此结肠镜组织活检显得尤为重要[2],而对活检组织进行 Masson特殊染色合并 CD3、CD45免疫组化染色对该病的诊断起到非常关键的作用,现将实验方法介绍如下。

Objective To study the expression of breast cancer susceptbility gene 1(BRCA1) in gastric cancer tissues of patients with advanced gastric cancer and its relationship with the prognosis . Methods The expression of BRCA1 protein in advanced gastric cancer tissues of 637 cases was evaluated by immunohistochemistry .The relationship between BRCA1 expression and prognosis of patients was analyzed .Results The positive expression of BRCA1 protein was found in 219 cases (34.4% ) .The expression of BRCA1 protein was related to the degree of tumor differentiation (P<0 .01) .Univariate analysis showed that survival time of the patients with positive expression of BRCA1 was longer than that of those with negative expression (P<0 .05) .Multivariate analysis showed that tumor size ,infiltration depth ,regional lymph node metastasis ,vascular invasion and presence of chemotherapy were the independent prognostic factors(P<0 .05) .Conclusion Gastric cancer patients with positive expression of BRCA1 have a good prognosis ,while BRCA1 is not an independent prognostic factor of postoperative survival .