Objective:To explore the key points of the pathological and differential diagnoses of extra-medullary masses of hematopoietic cell tumors of ambiguous lineage, and to discuss the possible solutions.Methods:Five hematopoietic cell tumors of ambiguous lineage cases were collected, including myeloid sarcoma, mixed phenotype acute leukemia, B/myeloid, T-lymphoblastic lymphoma combined with acute myeloid leukemia, acute undifferentiated leukemia with cutaneous MPDCP and early T-precursor cell acute lymphoblastic leukemia. The data including morphology, immunostaining, and flow cytometry analysis were collected, and we explored the problems and differential diagnosis in the diagnosis of hematopoietic cell tumors of ambiguous lineage.Results:The five cases showed that the accurate pathological diagnosis and classification of hematopoietic cell tumors of ambiguous lineage should be based on lineage-specific antigens. Moreover, tumor cells have the potential of multi-directional differentiation. In different sites or different periods, the differentiation of tumor cells may be different. Biopsy and detection of all related markers should be performed for the initial diagnosis, and the detection should be repeated when the condition of the patient changes. Combined application of multi-techniques, including morphology and flow cytometry analysis, is recommend for the diagnosis of hematopoietic cell tumors of ambiguous lineage, since the conventional morphology and immunophenotyping methods are limited.Conclusion:Hematopoietic cell tumors of ambiguous lineage are derived from hematopoietic stem cells with a potential of multi-differentiation. The differentiation of tumor cells is variable. We need to integrate cell morphology, flow cytometry, pathology, clinical data, and molecular genetics to make a comprehensive diagnosis.

Analyse the differential diagnosis of renal cell carcinoma and benign renal disease.

Aims: The aim of this study was to compare features of colon and rectal cancers such as prognosis, clinicopathological features and tumor markers, namely carcinoembryonic antigen (CEA), matrix metalloproteinase (MMP)-2 and p27kip1. Methods: Two hundred and thirty patients with stage I–III colon or rectal cancer were retrospectively assessed with the endpoint of recurrence or metastasis after curative operation. CEA, MMP-2 and p27kip1 were studied by immunohistochemistry in cancer tissues of all patients. Results: The disease-free 3-year survival rate after operation of the total 230 patients was 63.0%. The prognosis of colon cancer was significantly better than that of rectal cancer (70.6 vs. 57.0%; p = 0.017), especially for stage III (p = 0.0059). Multivariate analysis also demonstrated that tumor location in the colon or rectum, differentiation, venous invasion and the expression of CEA were independent factors for prognosis. The hazard of recurrence and metastasis in rectal cancer was 1.564 times that in colon cancer. In both groups, there were no statistical differences in age, gender, tumor size, tumor gross type, mucin production, tumor differentiation, venous invasion, MMP-2 and p27kip1. Conclusion: We investigated prognosis, clinicopathological factors, oncogenes and tumor suppressor gene production in colon and rectal cancers. The prognosis of colon cancer is better than that of rectal cancer, especially for stage III. This study shows some differences between colon and rectal cancer.