Clinicopathological characteristic of ciliated muconodular papillary tumour of the lung

AimsCiliated muconodular papillary tumour (CMPT) is a rare tumour characterised by tripartite cellular components of mucinous cells, ciliated columnar cells and basal cells with a predominantly papillary architecture. Its clinicopathological characteristics and treatment methods have not been fully elucidated.MethodsTwenty-six patients with CMPT diagnosed and treated in our hospital were retrospectively analysed.ResultsThe cohort was composed of 13 males and 13 females, with a mean age of 64.4±5.93 years. The diameter of the primary tumour ranged from 0.3 to 1.4 cm. The lesions appeared as subsolid nodules, ground-glass nodules and cavitary nodules under the CT scan. All the patients underwent surgical treatment and did not receive postoperative adjuvant therapy. All the CMPTs were diagnosed by immunohistochemistry and not by intraoperative frozen sections. Next-generation sequencing detection demonstrated EGFR, KRAS and BRAF mutations and ALK rearrangements in CMPTs. The follow-up duration ranged from 5 to 65 months, and no case of tumour recurrence was observed until the final follow-up.ConclusionsThe incidence of CMPT is low, and the prognosis is good. Immunohistochemistry is helpful for an accurate diagnosis of CMPT, while intraoperative frozen sections cannot fully guide the surgical method. Sublobectomy may be enough without adjuvant treatment. CMPTs exhibited a relatively high rate of driver gene mutations, while the mutation sites were not consistent with those in lung adenocarcinoma.

Misdiagnosed mesonephric adenocarcinoma in the cervix: a case report and review of the literature

Background Mesonephric adenocarcinoma (MNAC) in the female reproductive system is a rare tumour caused by remnants of the mesonephric duct, mainly located in the cervix. Because of the rarity of the disease and few reports to date, no specific clinical features have been identified. Its diagnosis is challenging because MNAC may exhibit multiple morphological patterns, complicating differential diagnosis. Case presentation We report a 57-year-old female with cervical MNAC who was misdiagnosed with squamous cell carcinoma by biopsy. Histological study revealed a solid, glandular and papillary tumour. The pattern of papillary growth exhibited a vascular axis, and the morphology was similar to that of high-grade squamous intraepithelial lesions. Based on immunohistochemistry, the tumour cells were negative for CK5/6, P40 and Vimentin; GATA-binding protein 3 (GATA3), CD10, AE1/AE3, CK7 and P16 were diffusely positive; calretinin was focally positive; and oestrogen receptor (ER), progesterone receptor (PR), thyroid transcription factor-1 (TTF1) and p53 were negative. The patient received neoadjuvant chemotherapy, surgery and adjuvant chemotherapy and had no evidence of disease as of 10 months after the operation. The clinical manifestations, pathological features, treatment and prognosis of MNAC were summarized by reviewing the existing literature. Conclusions When tumours with papillary and squamous epithelial growth patterns are detected by biopsy, it is necessary to apply immunohistochemistry analysis to avoid misdiagnosis.

The clinical analysis of endoscopic pancreaticobiliary separation in the treatment of occult pancreaticobiliary reflux

Objective To investigate the aetiology of occult pancreaticobiliary reflux (OPBR) and the curative effect of EST in patients with cholecystolithiasis. Methods The clinical data of 47 OPBR patients with cholecystolithiasis from October 2013 to October 2016 were analyzed retrospectively.Results The average gallbladder bile amylase (GBA) of 47 patients was 864 ± 575 U/L. Forty patients underwent endoscopic retrograde cholangiopancreatography (ERCP), among which 26 patients were diagnosed with papillitis, 16 patients with peripapillary diverticulum, 14 patients with nipple overlength, five patients with nipple atrophy, three patients with ampullary calculi and two patients with papillary tumour. Thirty-three patients underwent endoscopic sphincterotomy (EST), after the operation, 16 patients reexamined GBA, in which 15 patients had normal GBA, and the difference of GBA was statistically significant (1161 ± 764 U/L vs 47 ± 17 U/L, t=5.641, P<0.05). After following up of 1 to 4 years, 27 patients without cholecystectomy who underwent EST had no recurrence of calculus, and in 9 patients who did not undergo EST, two patients had a recurrence of calculus. There was a significant difference in the recurrence rate of calculus (χ2=21.340, P<0.05). Conclusion Pancreaticobiliary junction disease is an essential cause of OPBR and cholecystolithiasis formation. EST can reduce the retention of pancreatic reflux juice both in gallbladder and bile duct and can reduce the recurrence rate of cholecystolithiasis after choledochoscopic lithotomy.