Objective To investigate the pathological features of Epstein-Barr virus (EBV)-associated lymphoepithelioma-like intrahepatic cholangiocarcinoma (EBVaLELICC), and to improve the understanding of this disease in clinical practice. Methods Clinical and pathological data were collected from one patient with EBVaLELICC, and immunohistochemistry, in situ hybridization, and gene rearrangement test were performed for the paraffin-embedded tissue sample of this patient. The pathological features of this disease were analyzed, and a literature review was performed. Results The female patient, aged 56 years, had the tumor located in the left lateral lobe of the liver, with a clear boundary and a size of 1.8 cm×1.5 cm×1.2 cm. The patient underwent laparoscopic left lateral segment liver resection in Department of Hepatobiliary Surgery. Postoperative pathology showed that tumor cells had a glandular tubular structure, and some cells had an irregular, fused or sieve-like shape, with large nuclei, fine chromatin, small nucleoli, and no mitotic figures; proliferation of lymphocytes and plasma cells was observed with the formation of lymphoid follicles in the stroma. Immunohistochemical staining showed that CK7, CK19, and P53 had an expression rate of 10% in tumor cells, with wild type and a Ki-67 proliferation index of 5%; stromal lymphocytes showed the expression of CD3, CD4, CD8, and CD20, lymphoid follicular germinal center cells showed the expression of BCL-6 and CD10 and had no expression of BCL-2, and plasma cells showed the expression of CD38, Kappa, and Lambda; PD-L1 (22C3) was expressed in both tumor cells and interstitial lymphocytes, with a combined positive score of 30. EBER in situ hybridization assay showed diffuse positivity of tumor cells. Polymerase chain reaction detected multiple clones of lymphocyte immunoglobulin and T cell receptor genes. The patient did not receive any treatment before and after surgery and was alive after 8 months of follow-up, without tumor recurrence or metastasis. Conclusion EBVaLELICC is a rare subtype of cholangiocarcinoma with unique pathological features. Patients can benefit from immunotherapy, and EBVaLELICC tends to have a better prognosis than common cholangiocarcinoma.

目的 探讨肠道结节性淋巴组织增生症(nodular lymphoid hyperplasia,NLH)的临床特点、病理特征及鉴别诊断要点.方法 回顾性分析2015年11月—2020年9月青岛大学附属医院确诊为肠道NLH的36例患者的临床资料,并结合文献对其临床病理学特征、免疫表型、分子检测、鉴别诊断及患者预后情况进行总结.结果 36例患者中男30例,女6例;年龄11～66岁(中位年龄30岁).患者大多伴有腹痛、腹泻等肠道症状.36例中5例伴有幽门螺杆菌(HP)感染,2例伴有恶性肿瘤,1例伴有黑斑息肉综合征.1例因恶性肿瘤死亡,其余35例均生存良好.内镜检查可见肠道黏膜表面灰白息肉样隆起,单发或多发.镜下见黏膜层淋巴滤泡结构存在,增生形成大小不一息肉样小结节,增生的淋巴滤泡生发中心扩大,可相互融合,套区境界清楚,淋巴细胞无异型性.免疫组织化学染色示淋巴滤泡CD20强阳性表达,散在T淋巴细胞CD3阳性,生发中心CD10及bcl-6阳性,不表达bcl-2,CD21及CD23染色显示淋巴滤泡内滤泡树突网完整.36例中19例进行了免疫球蛋白基因重排检测,均为阴性.结论 肠道NLH可伴或不伴肠道症状,其诊断及鉴别诊断需要依靠内镜、组织学形态、免疫组织化学检测及基因重排结果,该病或与HP感染、恶性肿瘤发生和转归有关.

目的研究细胞色素P450 4A11（CYP4A11）及Ki-67在肾透明细胞癌中的表达及相关性,并探讨其与患者临床病理特征的关系。方法采用免疫组织化学染色方法检测我院2010—2015年收治的行肾癌切除术并经病理诊断的151例肾透明细胞癌组织中CYP4A11及Ki-67的表达情况,分析CYP4A11及Ki-67的表达与患者临床病理特征的相关性。同时取48例癌旁组织作为对照。结果 CYP4A11在肾透明细胞癌中的表达水平低于癌旁组织（Z=-2.100,P＜0.05）,高级别肾透明细胞癌组织中CYP4A11的高表达率显著高于低级别肾透明细胞癌（χ~2=11.072,P＜0.05）。CYP4A11在肾透明细胞癌中的表达程度与患者性别及肿瘤最大径、WHO/ISUP核分级、临床分期、肉瘤样变、远处转移有关（χ~2=4.438～10.930,P＜0.05）。Ki-67在肾透明细胞癌组织中表达程度与肿瘤最大径、WHO/ISUP核分级、临床分期、肉瘤样变及远处转移有关（χ~2=4.365～10.833,P＜0.05）。Spearman相关性分析显示,肾透明细胞癌组织中CYP4A11与Ki-67表达呈正相关（r s =0.231,P＜0.05）。单因素Cox回归分析显示,性别与肿瘤最大径、WHO/ISUP核分级、临床分期、肉瘤样变、远处转移以及CYP4A11、Ki-67表达水平对患者总生存时间有影响。多因素Cox回归分析显示,临床分期、远处转移为影响肾透明细胞癌患者总生存时间的独立危险因素（P＜0.05）。结论 CYP4A11可能参与肾透明细胞癌的恶性生物学行为过程,并对患者的生存及预后具有提示意义,可作为判断肾透明细胞癌生物学行为及预后的指标。

Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal carcinoma. In July 2019, one case of mucinous tubular and spindle cell carcinoma of the kidney was admitted to our hospital, The laparoscopic partial nephrectomy was performed, and there was no recurrence or metastasis during the follow-up period of 13 months. The disease has no obvious clinical manifestations and its diagnosis depends on pathological and immunohistochemical features. Surgical treatment is the main treatment for this disease, and most patients have a good prognosis.Howerer, the possibility of progression remains in the late stage of the disease.