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经典型霍奇金淋巴瘤发病机制的分子病理进展
霍奇金淋巴瘤(Hodgkin lymphoma,HL)是起源于淋巴组织的恶性肿瘤,占全部恶性淋巴瘤的8%.WHO淋巴造血组织分类[1]将HL分为结节性淋巴细胞为主型霍奇金淋巴瘤(NLPHL)和经典型霍奇金淋巴瘤(CHL)两大类,两者的肿瘤细胞分别称之为L&H(lymphocytic and/or histiocytic)细胞和HRS(Hodgkin and Reed-Sternberg)细胞.
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肿瘤增殖标记分子Ki-67和增殖细胞核抗原及其在病理诊断中的应用
活跃的增殖能力是恶性肿瘤的重要标志之一,在日常病理诊断工作中,判断肿瘤的增殖能力是鉴别肿瘤良恶性、提示肿瘤预后的重要指标.在高倍视野下进行核分裂象计数是简单易行的方法,然而由于视野选择和不同阅片者之间判断差异所带来的误差,使这种计数容易带有一定的主观性.
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三维病理大体标本制备及应用
病理学是一门介于基础医学和临床医学之间的桥梁学科,学好病理学对医学生至关重要.实验教学是病理教学的重要内容,通过观察病理大体标本和切片可以加深对疾病发生发展过程及临床症状的理解和认识.
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2010年版消化系统肿瘤WHO分类解读
新版WHO肿瘤分类消化分册[1]经过多次及多个专业的共识会议定稿,终于2010年11月正式出版发行,书名也由<消化系统肿瘤病理学和遗传学>(Pathology and Genetics of Tumours of the Digestive System)(以下简称旧版)[2]更改为<消化系统肿瘤WHO分类>(WHOClassification of Tumours of the Digestive System)(以下简称新版).
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炎性乳腺癌分子病理学研究进展
炎性乳腺癌(inflammatory breast cancer,IBC)~([1])虽为一种较少见的乳腺恶性肿瘤,但由于它的高侵袭性、高转移复发率和低无病生存率而引起肿瘤学家的关注.而以往病理学者多认为IBC是一种以临床表现为特征的乳腺癌,对其缺乏重视.近年来国外学者们对于其概念和意义有了新的认识,在分子病理学方面的研究进展也很快.但国内研究尚少~([2-3]).笔者拟从几方面介绍其新进展,希望能引起同道们的研究兴趣.
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多灶性前列腺癌分子病理及临床应用
前列腺癌在美国占男性恶性肿瘤的第1位.我国随着生活水平的提高和生存寿命的延长,前列腺癌的发病率在逐年增加.但前列腺癌仍然是一个较为复杂的疾病,因为从临床来看,大部分患者临床表现很隐匿,进展缓慢,对患者的长期生存和生活质量无实质影响,而少部分前列腺癌有很高的侵袭性,病情进展很快甚至导致过早死亡.
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对骨肿瘤分类的认识和探讨
随着分子生物学、影像学和病理学技术的飞速发展及人们认识的不断提高,世界卫生组织(WHO)不断更新对骨肿瘤的分类,这其中包括增添新病种,更新概念,更名病种等.WHO邀请多位病理、临床及相关学科的专家参加撰写2002版<骨和软组织肿瘤的病理和遗传学>(Pathology and Genetics of Tumours of Soft Tissue and Bone,以下简称WHO分类),促进病理学家和临床医学专家在骨肿瘤的研究、诊断和治疗方面达成共识.
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数字病理切片系统可视化数据应用简介
数字病理切片(digital slide of pathology)又称虚拟病理切片( virtual slide of pathology),是一种现代数字系统与传统光学放大装置有机结合的技术.它将传统的玻璃病理切片通过全自动显微镜或光学放大系统扫描采集得到高分辨数字图像,再应用计算机对得到的图像自动进行高精度多视野无缝隙拼接和处理,获得优质的可视化数据以应用于病理学的各个领域.
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HER2对病理学产生的影响
本期中华病理学杂志发表了由我国病理和临床医师组成的HER2指南编写组经过多次研讨会形成的2009版"乳腺癌HER2检测指南"和其他多篇相关的文章.
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骨关节病理诊断和研究任重而道远
骨关节病理是外科病理诊断中一大难题,这不仅因为这类疾病相对少见,而且因为其种类繁多,在形态学上相互重叠,有些良性病变可以呈"恶性"表现,而有些恶性肿瘤可呈"良性"表现.此外,大量非肿瘤性瘤样病变、代谢性、创伤性、炎性和发育不良性骨病以及系统性疾病中骨的改变都可与骨关节肿瘤混淆,造成病理鉴别诊断的困难.目前国内尚无骨关节病理专科医师培养制度,很多病理医师,即便长期从事病理诊断的高年资医师,对骨关节疾病的病理诊断常感觉困难.
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我国医院病理科建设的新纪元
在新中国建立以来的60年中,伴随着各项事业的发展,我国的病理学事业也有了长足的进步.回首诊断病理学的发展轨迹,解放初期仅在少数高等医学院校的病理学教研室和大型医院病理科从事病理学诊断,之后一些大中型医院逐渐组建了病理科,走过了15年的缓慢发展阶段;文化大革命的10年间诊断病理学经历了一段艰辛和曲折的时期;1978年以后的30余年,诊断病理学进入了稳步的发展阶段,包括二级医院在内的许多综合医院和专科医院都先后组建了病理科.
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《Tumors of the mammary gland》评述
由
主编Fattaneh A. Tavassoli教授和分类小组主要成员Vincenzo Eusebi教授共同编写的 ~[1]一书已经面世,此书是AFIP(The Armed Forces Institute of Pathology)出版发行的 第四系列的第十分册. -
AIM To determine whether MAP can be detected in archival paraffin embedded full thickness samples ofintestinal tissue from patients in China with Crohn's disease (CD), ulcerative colitis (UC), and in controlsubjects (NIBD) having surgery for bowel cancer.METHODS Optimized procedures for the removal of paraffin, recovery of tissue and access to MAP DNA,followed by MAP-specific nested IS900 PCR. Confirmation of specific amplification by Southern blotting andDNA sequencing.RESULTS IS900 PCR positive tests identified MAP in 9 (69%) of 13 CD, 1 of 3 UC and 2 (14%) of 14NIBD in the presence of correctly reporting positive and negative sample and reagent control reactions. DNAsequence analysis of the 298bp IS900 PCR amplification product from MAP in 2 Chinese CD patientsdemonstrated 99% homology with the GenBank IS900 sequence accession number X16293.CONCLUSION Although larger numbers of Chinese samples need to be studied, these initial results areconsistent with an exposure of human populations in China to MAP, and an involvement of this pathogen inchronic inflammation of the intestine of the Crohn's disease type. The results are in agreement with similarpositive studies reported from China, from Western Europe and elsewhere.
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优化细针抽吸活检细胞病理学检查
在过去的20年中,随着细针抽吸活检(fine needle aspiration biopsies,FNAB)等微创诊断方法和技术的发展,FNAB在肺部及纵隔淋巴结病变的诊断中的应用越来越普及~([1-5]).肺内肿块及纵隔淋巴结可在支气管内超声(EBUS)、经皮超声或CT引导下经胸壁外或经支气管内行FNAB.尽管FNAB在肺内肿块及纵隔淋巴结病变的鉴别中具有明确作用,但目前其使患者获益的程度仍存在争议,尚有多种方法可优化FNAB的操作.
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对结直肠癌病理的新认识
病理诊断具有确定疾病的性质进而决定治疗方案的关键作用,特别是在肿瘤诊断中,其重要性毋庸置疑.随着病理学的不断发展,人们对肿瘤病理学的认识也在不断深化.现就结直肠癌病理学的新进展、新观点作一概述.
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Previous studies have found that methylmercury can damage hippocampal neurons and accord-ingly cause cognitive dysfunction. However, a non-invasive, safe and accurate detection method for detecting hippocampal injury has yet to be developed. This study aimed to detect methylmer-cury-induced damage on hippocampal tissue using proton magnetic resonance spectroscopy. Rats were given a subcutaneous injection of 4 and 2 mg/kg methylmercury into the neck for 50 consecutive days. Water maze and pathology tests confirmed that cognitive function had been impaired and that the ultrastructure of hippocampal tissue was altered after injection. The results of proton magnetic resonance spectroscopy revealed that the nitrogen-acetyl aspartate/creatine, choline complex/creatine and myoinositol/creatine ratio in rat hippocampal tissue were unchanged. Therefore, proton magnetic resonance spectroscopy can not be used to determine structural damage in the adult rat hippocampus caused by methylmercury chloride.
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Zinc supplementation can help maintain learning and memory function in rodents. In this study, we hypothesized that zinc supplementation could antagonize the neurotoxicity induced by aluminum in rats. Animals were fed a diet containing different doses of zinc (50, 100, 200 mg/kg) for 9 weeks, and oral y administered aluminum chloride (300 mg/kg daily) from the third week for 7 consecutive weeks. Open-field behavioral test results showed that the number of rearings in the group given the 100 mg/kg zinc supplement was significantly increased compared with the group given the 50 mg/kg zinc supplement. Malondialdehyde content in the cerebrum was significantly decreased, while dopamine and 5-hydroxytryptamine levels were increased in the groups given the diet plemented with 100 and 200 mg/kg zinc, compared with the group given the diet supplemented with 50 mg/kg zinc. The acetylcholinesterase activity in the cerebrum was significantly decreased in the group given the 100 mg/kg zinc supplement. Hematoxylin-eosin staining revealed evident patho-logical damage in the hippocampus of rats in the group given the diet supplemented with 50 mg/kg zinc, but the damage was attenuated in the groups given the diet supplemented with 100 and 200 mg/kg zinc. Our findings suggest that zinc is a potential neuroprotective agent against alumi-num-induced neurotoxicity in rats, and the optimal dosages are 100 and 200 mg/kg.
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Semaphorin 3A expression is thought to increase following spinal cord injury. The impact of olfactory ensheathing cell transplantation remains unclear. The current study demonstrated that spinal cord hemorrhage, edema, degeneration, necrosis, cyst formation, proliferation of glial cells, regeneration of nerve fibers and various pathological reactions occurred following a simple cross-section of spinal cord injury. Transplantation of olfactory ensheathing cells was found to significantly relieve the pathological reactions in the spinal cord described above, decrease the extent of necrosis in damaged neurons and nerve fibers, and downregulate semaphorin 3A expression in the injured zone. The results confirmed that olfactory ensheathing cell transplantation plays a protective role on the injured spinal cord by reducing the expression of semaphorin 3A.
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Magnetic resonance diffusion tensor imaging has been shown to quantitatively measure the early pathological changes in chronic cervical spondylotic myelopathy. In this study, a novel spongy pol-yurethane material was implanted in the rat C 3-5 epidural space to establish a rat model of chronic cervical spondylotic myelopathy. Diffusion tensor data were used to predict pathological changes. Results revealed that the fractional anisotropy value gradual y decreased at 4, 24, and 72 hours and 1 week after injury in rat spinal cord, showing a time-dependent manner. Average diffusion coeffi-cient increased at 72 hours and 1 week after implantation. Hematoxylin-eosin staining and Luxol-fast-blue staining exhibited that the number of neurons in the anterior horn of the spinal cord gray matter and the nerve fiber density of the white matter gradual y reduced with prolonged com-pression time. Neuronal loss was most significant at 1 week after injury. Results verified that the fractional anisotropy value and average diffusion coefficient reflected the degree of pathological change in the site of compression in rat models at various time points after chronic spinal cord compression injury, which potential y has a reference value in the early diagnosis of chronic cervical spondylotic myelopathy.
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Objectives To reveal etiologies of persistent isolated hematuria (PIH) through ultrastructural pathological examination, to disclose clinicopathological correlation in cases with PIH, and to summarize appropriate management of patients with PIH.
Methods we retrospectively studied 155 PIH patients receiving renal biopsy between January, 2003 and December, 2008 in Peking Union Medical College Hospital. All the clinical data and follow-up result were analyzed.
Results All subjects included 38 children and 117 adults, with mean age of 11.38±3.25 years for children and 35.17±8.44 years for adults. Thin basement membrane nephropathy (TBMN) was the most common pathology (55.3% of children and 49.6% of adults), followed by IgA nephropathy (18.4% of children and 32.5% of adults, mainly grade 2-3) and mesangial proliferative glomerulonephritis (MsPGN) without IgA deposition (13.2%of children and 12.8%of adults). Besides, Alport syndrome (2.6%of children) and membrane nephropathy (2.6%of children and 0.9%of adults) were demonstrated as other causes of PIH. Elevated mean arteral pressure or protein excretion rate, as well as episodic macrohematuria, indicated higher risk for MsPGN rather than TBMN. On the other hand, severity of microhematuria was irrelevant to pathological types of PIH. Totally, 86 patients were followed up and 37 cases therein stayed on track for long term (mean duration 41.11±28.92 months, range 8-113 months). Most cases had benign clinical course except 3 cases with TBMN, 5 cases with IgA nephropathy, 1 case with MsPGN (without IgA deposition), and 1 case with Alport syndrome, who developed hypertension or proteinuria. All of them were administered timely intervention.
Conclusions Close follow-up should be required as the primary management for PIH. Equally important is careful monitoring for early identification of undesirable predictors;while renal biopsy and other timely intervention are warranted if there is hypertension, significant proteinuria or renal impairment.