简介:摘要目的探讨上皮样血管肉瘤(EAS)患者的临床病理特征、诊断及鉴别诊断方法。方法回顾性分析解放军联勤保障部队第九四〇医院2012年4月至2020年10月诊治的5例EAS患者临床病理资料,并复习相关文献。结果5例患者均为男性,中位年龄38岁(25~74岁)。低倍镜下见肿瘤细胞呈条索状、巢片状、不规则裂隙状浸润生长,并见肿瘤性血管形成,血管腔隙大小不一、互相吻合沟通,内衬异型内皮细胞,腔隙中还可见红细胞。高倍镜下见瘤细胞呈上皮样,具有明显异型性,细胞体积大,胞质丰富,核大,核仁明显,核分裂象易见。5例患者免疫组织化学不同程度表达血管内皮标志物(CD31、CD34、Fli-1、ERG和FⅧ-R-Ag)、上皮性标志物(CKpan、CK8/18)及间叶性标志物(Vimentin),Ki-67阳性指数10%~60%。结论EAS较罕见,极易误诊为低分化癌等恶性肿瘤,确诊需依靠病理活组织检查结果,病理医生需提高对此病的认识。
简介:AbstractImportance:Children with 5-alpha-reductase deficiency (5α-RD) and hypospadias present with micropenis, which makes it difficult to obtain sufficient tissue for urethral reconstruction.Objective:We investigated the therapeutic effects of oral testosterone undecanoate and established a standard androgen treatment protocol for patients with 5α-RD with micropenis.Methods:Patients with 5α-RD were treated with oral testosterone undecanoate for 3 months as a course. All patients were treated with no more than 3 courses. If the penile length (PL) reached 2.5 cm (the minimum criterion for surgery) or greater than or equal to -2.5 standard deviations (SDs) (lower limit of normal), testosterone undecanoate was considered to be effective.Results:The median age of 90 patients with 5α-RD was 1.7 years (0.9, 3.1 years). The baseline PL was 1.9 ± 0.6 cm before treatment. At the end of the first course, the PL of 63 patients (70%) reached 2.5 cm, and 49 patients (54%) reached greater than or equal to -2.5 SDs. After two treatment courses, the PL of 81 patients (90%) reached 2.5 cm, and 90 patients (100%) reached greater than or equal to -2.5 SDs. After three courses, the PL of all patients reached 2.5 cm, and all patients reached a PL greater than or equal to -2.5 SDs. No abnormal increase was observed in height-SD score, weight-SD score, or ratio of bone age to chronological age during the 1-3-year follow-up.Interpretation:After 3-9 months of treatment, PL increased to the target length. No severe adverse reactions were observed during follow-up. Testosterone undecanoate was safe and effective in children with 5α-RD with micropenis.
简介:摘要第5版WHO泌尿及男生殖器官肿瘤分类已于2022年5月出版,与2016年第4版WHO分类相比,睾丸肿瘤虽然在基础研究方面已经取得了不少进展,但第5版分类仍然植根于形态学,保留了第4版的框架结构和主要命名法。本文将就第5版分类中睾丸生殖细胞肿瘤、性索-间质肿瘤以及睾丸附属器官肿瘤相关的主要更新内容进行解读。
简介:摘要第5版WHO泌尿及男生殖器官肿瘤分类已于2022年5月正式出版,内容涵盖多器官、多类型肿瘤的组织病理及分子病理的重要进展,其中肾脏部分不仅更新了对已知肿瘤的认识,也新增了多种独特的肿瘤类型,本文就第5版WHO中肾脏肿瘤分类的主要变化予以解读。