【Abstract】Objective To evaluate the pathological diagnosis of liver allograft rejection. Methods Literatures about diagnosis of liver transplantation rejection in recent ten years were reviewed.Results Humoral rejection was rare. The main features were graft blood vessel thrombosis and liver damage and necrosis about some days or one week after transplantation. The humoral rejection of liver graft occurred later than that of kidney and heart transplantation. The diagnosis of acute liver graft rejection was based on Banff Schema. During chronic rejection intrahepatic bile ducts among hepatic lobules in portal area disappeared, and inflammation, fibrosis and stricture of hepatic arteries and veins were found, but the morbidity was less than that of kidney， heart, lung and pancreas grafting. Conclusion Banff standard is the most important base of diagnosing liver graft rejection.
Objective To explore the expression of CD34 and polyclone carcinoembryonic antigen (pCEA) of positive and negative alpha fetoprotein (AFP) detected by puncture biopsy in human hepatocellular carcinoma (HCC) and the significance of pathological diagnosis. Methods Fifty-four HCC tissue specimens from 2013 to 2015 were collected from tumor biopsy samples which confirmed by pathology in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture. The tissue samples were divided into positive AFP group (n=33) and negative AFP group (n=21) according to the detection results of serology and immunohistochemistry analysis of AFP. Expressions of CD34 and pCEA in the fifty-four HCC specimens were detected by immunohistochemistry. Results The positvie expression rate of pCEA in the positive AFP group was 69.7%, which was significantly higher than that in the negative AFP group (38.1%) (P<0. 05). However, the difference in positive expression rate of CD34 between the positive and negative AFP groups (90.91% and 85.71%, respectively) was not significant (P>0.05). Conclusion The associated detection of AFP, pCEA and CD34 in HCC tissues might contribute to the pathological and differential diagnosis of human hepatocellular carcinoma in puncture biopsies.
Objective To investigate inter-observer reproducibility in the pathologic diagnosis of breast intraductal proliferative lesions (BDPL). Methods Forty three BDPL patients were diagnosed by criterion of Page. Every specimen from each case was sorted randomly. All slides were classified as mild usual hyperplasia, moderate-severe usual hyperplasia, mild atypical hyperplasia, moderate-severe atypical hyperplasia, ductal carcinoma in situ, or ductal carcinoma in situ with invasion. Inter-observer agreement of the two groups was statistically analyzed using Kappa test. Then we compared all the diagnoses of individual pathologist with the consensus opinion confirmed by two breast pathologists to analyze the diagnostic accuracy and undue diagnosis. Results Inter-observer reproducibility of the trial group was higher than that of the control group (The total K value of 6, 3, and 2 diagnoses in the two groups were 0.289 3, 0.337 1, 0.492 8, 0.100 3, 0.150 3 and 0.340 3, respectively). When the categories were simplified, inter-observer reproducibility increased. There were still undue diagnoses of different degrees among pathologists of the trial group. Conclusion Using the same criteria is an important method to increase the diagnostic reproducibility and accuracy. More practice is needed to familiarize with these criteria.
Objective To investigate the reasons, status, treatment and precautions of misdiagnosis of pulmonary inflammatory pseudotumor. Methods Between January 2005 and December 2015, one hundred eighteen articles about pulmonary inflammatory pseudotumor published in Wanfang and CNKI databases were retrospectively analyzed, among them forty-four articles referring to misdiagnosis rate. The misdiagnosis rate, distribute of misdiagnosed diseases, reasons and main means of definite diagnosis were analyzed. Results There were 1 286 cases of pulmonary inflammatory pseudotumor in the 44 articles, of them 1 012 cases were misdiagnosed. The misdiagnosis rate was 78.84%. Pulmonary inflammatory pseudotumor was often misdiagnosed as lung cancer (65.81%), tuberculosis (15.42%, which included 72 cases of tuberculoma and accounted for 7.11%) and benign pulmonary neoplasms (9.59%). Most misdiagnosed patients did not suffer from adverse consequences, except a few patients undergo unnecessary extended operations. Lack of specificity in clinical manifestations, lack of awareness about the disease, dependent on auxiliary examination and lack of awareness about the fine feature of the disease were the main reasons of misdiagnosis. The majority of misdiagnosed cases were terminal pathological diagnosed through the operation or after percutaneous biopsy. Conclusions Pulmonary inflammatory pseudotumor is lack of specificity in clinical manifestations and easy to be misdiagnosed. It is very important to analyze and identify the fine feature of imaging changes. To reduce and avoid misdiagnosis, clinicians should improve the awareness of this disease.