摘要:目的:研究胸腺瘤与前纵隔(血管前间隙)淋巴瘤的MSCT表现,提高对二者的诊断与鉴别诊断能力。方法:回顾性分析经手术病理证实的30例胸腺瘤与18例血管前间隙淋巴瘤MSCT表现,着重观察肿瘤的密度、形态及其与周围结构的关系。结果:30例胸腺瘤中,24例良性胸腺瘤与邻近大血管分界清晰,肿块表现 “D”字或反“D”字状,平扫CT值16~59 Hu,增强CT值20~110 Hu;6例侵袭性胸腺瘤边界不清,呈分叶状、不规则形,密度不均,平扫CT值23~42 Hu,增强CT值23~60 Hu。18例淋巴瘤中,单发于前上纵隔者6例,其余12例呈多结节、肿块状,侵入血管间隙生长,致大血管受压,增强扫描呈轻度强化,常伴有其它部位淋巴结增大。结论:MSCT能清晰显示胸腺瘤与前纵隔淋巴瘤的影像学表现特征,并能有效提高对二者的鉴别诊断。Abstract: Objective: To diagnosis and differentiate thymoma and malignant lymphoma in the anterior mediastinum on the basis of multislice CT (MSCT) imaging features. Methods:We retrospectively reviewed 30 cases with thymoma and 18 cases with malignant lymphoma proven by surgery and pathology.More attention was put on the density, morphology and relation with the surrounding structures of the tumors. Results: The CT manifestations of 30 cases of thymoma were shown as: For 24 cases of benign thymoma, the boundaries were clear, the shapes were “D” signs or contra“D” signs, CT attenuation value were 1659Hu and 20110Hu on unenhanced and contrastenhanced scanning. For 6 cases of malignant thymoma, the boundaries were unclear, the shapes were lobulated or irregular, the density was heterogeneous, CT attenuation value were 2342Hu and 2360Hu on unenhanced and contrastenhanced scanning. For 18 cases of malignant lymphoma, 6 cases were located at anterior mediastinum, 12 cases were nodes or multiple mass, enveloped the neighboring vessel structures, mildly enhanced on contrastenhanced scanning, and associated with enlargement of lymph nodes in other place. Conclusion: MSCT can display the imaging features of thymoma and anterior mediastinal lymphoma, and effectively differentiate thymoma and mediastinal lymphoma.
ObjectiveTo summarize the experience of diagnosis and treatment on primary gastric lymphoma. MethodsThirtyseven patients, proved by pathology, were included in the study. ResultsAmong clinical presentation, the upper abdominal pain, intestinal bleeding, and weight loss were common. Only 4 cases were diagnosed as PGL in 33 cases with the examination of Xray barium meal, 88.5% ( 23 of 26 cases) were missdiagnosed as gastric ulcer under gastroscopy. All cases underwent operation, among them 33 had been performed a radical operation. The survival period was over 5 years in 12 of 25 patients who have been followed up. ConclusionThe multiple biopsy sampling from submucosal layer via gastroscope may improve diagnostic rate on primary gastric lymphoma. Operative removal of the tumor should be the first choice of treatment. Additional chemotherapy after the surgery increases the fiveyear survival rate.
Objective To analyze the potential causal relationship between sunscreen/ultraviolet protection and the risk of non-Hodgkin lymphoma using a two sample Mendelian randomization (MR) study method. Methods The summary data of genome-wide association study was used to select three types of non-Hodgkin lymphoma, namely diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, T/NK cell lymphoma, and sunscreen/ultraviolet protection highly correlated genetic loci, namely single nucleotide polymorphism (SNP), as instrumental variables. The reverse variance weighting method was used as the main method for MR analysis, MR Egger and MR-PRESO were used to detect level pleiotropy, and leave-one-out method was used for sensitivity analysis to ensure the robustness of the results. Results A total of 132 SNPs were included in the analysis. The results of the inverse variance weighted analysis showed that sunscreen/ultraviolet protection increased the incidence of DLBCL [odds ratio=2.439, 95% confidence interval (1.109, 5.362), P=0.027]. The heterogeneity test results showed that there was no heterogeneity in the causal relationship between sunscreen/ultraviolet protection and DLBCL (P>0.05). The results of the horizontal pleiotropy test showed that SNP did not exhibit horizontal pleiotropy (P>0.05). The leave-one-out method showed that no SNP with a significant impact on the results was found. There was no causal relationship between sunscreen/ultraviolet protection and follicular lymphoma and T/NK cell lymphoma. Conclusion There is a positive causal relationship between sunscreen/ultraviolet protection and the incidence of DLBCL.
Objective To sum up experiences in diagnosis and treatment for thyroid malignancy. Methods Clinical records of 8 patients diagnosed as Hashimoto’s disease associated with thyroid malignancy by histologic examination at our hospital from Jan. 1998 to Dec. 1998 were analyzed. Results There were 1 male and 7 females with average age of 37.6 years. The incidence of Hashimoto’s disease associated with thyroid cancer and malignant lymphoma were 7.7% and 2.6%, respectively. No operative mortality and complication was found. Conclusion Hashimoto’s disease is not uncommon. The combined thyroid cancer is small with papillary carcinoma predominance and the prognosis is good. If it is complicated with malignant lymphoma, the thyroid is rapidly enlarged with pain and dyspnea.
ObjectiveTo summarize the individualized diagnosis and treatment experience in a patient with primary pancreatic diffuse large B-cell lymphoma.MethodsBy muti-disciplinary term (MDT) model, a patient with primary pancreatic diffuse large B-cell lymphoma admitted in the People’s Hospital of Chishui in Dec. 2016 was discussed. The diagnosis, perioperative period management, and operation scheme were carried out by the MDT.ResultsThe patient’s general condition was good. After multidisciplinary discussion in the Department of Radiology, Oncology, Interventional, and Hepatobiliary and Pancreatic Surgery, the patient was considered to have surgical indications. After thorough communication with the patient and family, the patient was selected for surgical resection. The whole operation lasted for 5 hours, and the intraoperative blood loss was about 300 mL. The operation was successfully completed and no complications such as pancreatic fistula occurred after operation. Liquid drainage tube was drawn out at 10 days after opertion, and pancreatic tube stent and T tube were retained. The patient discharged on 13 days after surgery. Subsequently, the patient underwent adjuvant chemotherapy. At present, the patient has been followed up for 1 year, no signs of tumor recurrence and metastasis, and continued follow-up.ConclusionsPrimary pancreatic diffuse large B-cell lymphoma is rare and has a poor prognosis. The main treatment is mutli-mode treatment based on surgical resection combined with chemotherapy.
Objective To investigate the effect s of T lymphoma invasion and metastasis inducing factor 1 ( Tiam 1) antisense oligonucleotides (ASODN) on morphological remodeling of gast ric cancer cells. Methods The high-invasive and metastastic subgroup (MH ) was separated f rom human gast ric cancer cell line MKN245 (M0 ) by laminin adhesion method in vi t ro. And they were divided into four group s according to different further t reatment s : no t ransfection group (cont rol group ) , liposome t ransfection group , sense oligonucleotides2liposome t ransfection group ( SODN t ransfection with liposome group ) and antisense oligonucleotides2liposome t ransfection group (ASODN t ransfection with liposome group) . Then the expressions of Tiam 1 mRNA and protein were detected by RT-PCR and flowcytomet ry , respectively. The morphology changes between Tima 1 ASODN t ransfected MH cells and no t ransfected cells were observed by using HE stain , cytoskeletal protein stain and scanning elect ronic microscope (SEM) . Results Compared with the other group s , the expressions of Tiam 1 mRNA and protein in MH cells were significantly decreased af ter the cells were t ransfected with 0. 43 μmol/ L Tiam 1 ASODN ( P lt; 0. 01) . Additionally , it was observed that the t ransfected MH cells had less membrane surface projections , fewer or shortener pseudopodia , less irregular cytoskeletal network and less spotted-like actin bodys than no t ransfected MH cells did. Conclusion ASODN t ransfection could effectively suppress the expression of Tiam 1 and the remodeling in gast ric cancer cells , which may play an important role in the invasion and metastasis of gast ric cancer cells.
Objective To summarize the clinical and pathological manifestation, therapy, and prognosis of primary thyroid lymphoma(PTL). Methods The clinical and pathological data of 20 patients with PTL treated in our hospital from Jan.2002 to Feb.2014 were retrospectively analyzed. Results Of the 20 patients, 14 patients were female, 6 patients were male. The median age were 63.5 years old (45-77 years old). Seven patients (35.0%) were diffused large B-cell lymphoma (DLBCL), and 12 patients (60.0%) were extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma, 1 patient (5.0%) was follicular lymphoma (FL). Twelve patients complicated with Hashimoto thyroiditis. Six patients(30.0%) accepted surgery only, 13 patients(65.0%) were supplemented with chemotherapy and (or) radiotherapy, 1 patient (5.0%) accepted chemotherapy and radiotherapy only. Two patients lost during follow-up, but 18 patients were followed-up for 6-104 months with the median time of 46.5 months. During the follow-up period, 6 patients died of PTL. The cumulative survival rates of 2-year and 5-year were 74.4% and 66.9%, respectively. Conclusion Most PTL are B-cell original non-Hodgkin lymphoma. In order to get good prognosis, chemotherapy and (or) radiotherapy are mostly needed, while surgery is performed for definitive pathological diagnosis.
Objective To investigate the changes of autophagy after spinal cord injury (SCI) in rats and its relationship with multisite phosphorylation of B-cell lymphoma-2 (Bcl-2) protein. Methods Forty male Sprague-Dawley rats aged 8 weeks were used to prepare SCI models by modified Allen method, and the SCI model were prepared successfully in 36 rats. The 36 SCI models were randomly divided into SCI group, autophagy inhibitor group, and autophagy promoter group, with 12 rats in each group. Another 12 rats were selected as sham operation group with only laminectomy and no spinal cord injury. At the end of modeling, the autophagy inhibitor group and the autophagy promoter group were intrathecally injected with 20 μL of 600 nmol/L 3-methyladenine and 25 nmol/L rapamycin, respectively, once a day for 4 weeks. The sham operation group and the SCI group were injected with only 20 μL of normal saline at the same time point. The motor function of rat in each group was evaluated by the Basso-Beattie-Bresnahan (BBB) score at 1 day and 1, 2, 4 weeks after modeling. The rats in each group were sacrificed at 24 hours after the last injection and the spinal cord tissues were taken. ELISA assay was used to detect the levels of inflammatory factors in spinal cord tissues, including myeloperoxidase (MPO), tumor necrosis factor α (TNF-α), and interleukin 1β (IL-1β); the morphological changes of spinal cord were observed by HE staining; the autophagy of mitochondria in spinal cord tissues was observed by transmission electron microscopy; the expressions of Beclin1 and microtubule-associated protein light chain 3 (LC3) were detected by immunofluorescence staining; neuronal apoptosis in spinal cord tissues were observed by TUNEL staining; LC3/TUNEL positive cells were calculated by immunofluorescence double staining; the expressions of Bcl-2 associated X protein (Bax), Bcl-2, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) were detected by Western blot. Results Compared with sham operation group, BBB score of SCI group decreased at each time point, while the levels of MPO, TNF-α, and IL-1β increased; peripheral space of nerve cells enlarged, cells swelled, vacuoles appeared, and autophagic bodies appeared in mitochondria; the positive rates of Beclin1 and LC3 proteins, and apoptotic rate of neurons significantly increased; the LC3/TUNEL positive cells significantly increased; the expressions of Bax, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) proteins increased, while the expression of Bcl-2 protein decreased; all showing significant differences (P<0.05). Compared with SCI group, BBB score in autophagy inhibitor group decreased at each time point, while the levels of MPO, TNF-α, and IL-1β increased; a few autophagic vesicles appeared in mitochondria; the positive rates of Beclin1 and LC3 proteins decreased and the apoptotic rate of neurons increased significantly; the LC3 positive cells decreased and the TUNEL positive cells increased; the expressions of Bax, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) proteins increased, while the expression of Bcl-2 protein decreased. The results of autophagy promoter group were opposite to those of autophagy inhibitor group; all showing significant differences between groups (P<0.05). Conclusion Induction of autophagy after SCI in rats can reduce neuronal apoptosis and protect spinal cord function, which may be related to the inhibition of Bcl-2 protein multisite phosphorylation.
Waldenström’s macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is a rare mature B-cell neoplasm. WM is characterized by the presence of a lymphoplasmacytic infiltrate in the bone marrow and high serum levels of monoclonal immunoglobulin M protein. With a deeper understanding of molecular mechanisms of the disease, the update of diagnostic approaches and the introduction of novel therapies, the management of WM/LPL has rapidly evolved over the past few years. On March 7th, 2018, National Comprehensive Cancer Network (NCCN) updated the guideline for WM/LPL. This study mainly interpreted the corresponding diagnosis and treatment of WM/LPL in NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Waldenström’s Macroglobulinemia/Lymphoplasmacytic Lymphoma (Version 1.2018).
ObjectiveTo investigate the proliferation and apoptosis effects of adenovirus-mediated interleukin-24 (Ad-IL-24) gene on Karpas299 cells in vitro. MethodsThe Karpas299 cells were divided into blank control group, Ad-IL-24 group, and the adenovirus which carrying green fluorescent protein gene group (Ad-GFP group). Karpas299 cells of Ad-IL-24 group were infected by adding 200.0 μL Ad-IL-24, Karpas299 cells of Ad-GFP group were infected by adding 200.0 μL Ad-GFP, but Karpas299 cells of blank control group were treated by adding 200.0 μL PBS. Cells' proliferation inhibition rates of 3 groups were detected by cell counting kit (CCK-8) method at 12, 24, and 48 hours after treatment, respectively, and the cells' apoptosis rates of 3 groups were detected by flow cytometry at 48 hours after treatment. ResultsAd-IL-24 can suppress the growth of Karpas299 cells, and the inhibition rate increased over time. Compared with Ad-GFP group at the same time, the cell' proliferation inhibition rate of Ad-IL-24 group was higher at 12, 24, and 48 hours after treatment (P<0.05). In addition, the cells' apoptosis rate of Ad-IL-24 group was higher than those of Ad-GFP group and blank control group at 48 hours after treatment (P<0.05). ConclusionAd-IL-24 can suppress the growth of Karpas299 cells and induce the apoptosis of it.