Faculty Bibliography

A 52 year old male presented with changes in bowel movements, and a mass was detected on digital rectal exam. Both CT and MRI revealed a large pelvic and gluteal mass filling the pelvic cavity displacing the adjacent pelvic structures. After surgical removal, pathology revealed solitary fibrous tumor; a rare neoplasm uncommonly discovered in the thorax, and even less commonly in extrapleural locations. We discuss in this article imaging findings and histological features of extrapleural solitary fibrous tumor.

Emergent treatment of source water polluted by representative herbicide molinate and ametryn was researched. The results indicate that activated carbon adsorption and prechlorination could achieve high efficiencies to remove the herbicides. The pseudo second-order adsorption kinetic model and Freundlich adsorption isotherm model can be used to describe the adsorption process and the adsorption equilibrium of molinate and ametryn adsorbed by powdered activated carbon (PAC) in raw water respectively. Either molinate or ametryn of about 200 microg/L in water could be completely removed by 40 mg/L PAC. The best PAC adding point was 20 min before coagulation. The two herbicides were easily removed by granular activated carbon (GAC) column (20 cm high) which can be the available supplement of PAC treatment to strengthen safety. The Cl2 dosage of 2.5 mg/L could oxidize the two herbicides completely, but the chlorination products as well as their toxicity need further study. PAC adsorption combined with 1 mg/L KMnO4 preoxidation didn't improve the removal efficiencies of molinate and ametryn. The effect of PAC adsorption combined with 1.5 mg/L prechlorination depends on their adding sequence. When source water was simultaneously contaminated by the two herbicides both about 200 microg/L, the PAC and Cl2 dosage have to be increased to 50 mg/L and 3 mg/L respectively, then both herbicides can be removed or oxidized fully.

Type 2 3alpha-hydroxysteroid dehydrogenase (3alpha-HSD) is a multi-functional enzyme that possesses 3alpha-, 17beta- and 20alpha-HSD, as well as prostaglandin (PG) F synthase activities and catalyzes androgen, estrogen, progestin and PG metabolism. Type 2 3alpha-HSD was cloned from human prostate, is a member of the aldo-keto reductase (AKR) superfamily and was named AKR1C3. In androgen target tissues such as the prostate, AKR1C3 catalyzes the conversion of Delta(4)-androstene-3,17-dione to testosterone, 5alpha-dihydrotestosterone to 5alpha-androstane-3alpha,17beta-diol (3alpha-diol), and 3alpha-diol to androsterone. Thus AKR1C3 may regulate the balance of androgens and hence trans-activation of the androgen receptor in these tissues. Tissue distribution studies indicate that AKR1C3 transcripts are highly expressed in human prostate. To measure AKR1C3 protein expression and its distribution in the prostate, we raised a monoclonal antibody specifically recognizing AKR1C3. This antibody allowed us to distinguish AKR1C3 from other AKR1C family members in human tissues. Immunoblot analysis showed that this monoclonal antibody binds to one species of protein in primary cultures of prostate epithelial cells and in LNCaP prostate cancer cells. Immunohistochemistry with this antibody on human prostate detected strong nuclear immunoreactivity in normal stromal and smooth muscle cells, perineurial cells, urothelial (transitional) cells, and endothelial cells. Normal prostate epithelial cells were only faintly immunoreactive or negative. Positive immunoreactivity was demonstrated in primary prostatic adenocarcinoma in 9 of 11 cases. Variable increases in immunoreactivity for AKR1C3 was also demonstrated in non-neoplastic changes in the prostate including chronic inflammation, atrophy and urothelial (transitional) cell metaplasia. We conclude that elevated expression of AKR1C3 is highly associated with prostate carcinoma. Although the biological significance of elevated AKR1C3 in prostatic carcinoma is uncertain, AKR1C3 may be responsible for the trophic effects of androgens and/or PGs on prostatic epithelial cells.

Bronchogenic cysts are lesions that are an anomaly of congenital development. Although most are found in the mediastinum, bronchogenic cysts can be found in many different anatomical positions in the body and can have multiple presentations. These lesions can be asymptomatic and found incidentally, or they can present with specific symptoms. Bronchogenic cysts can be diagnosed on multiple radiographic modalities including conventional radiography, computed tomography, and magnetic resonance imaging. Most are treated conservatively but the possibility of infection or malignant transformation has caused some clinicians to recommend invasive treatment for these lesions. This article presents a case report of the diagnosis and management of a paravertebral bronchogenic cyst in a 64-year-old female.

Expression of CD38 or myeloid-associated markers has been reported to be important in predicting prognosis in B-cell chronic lymphocytic leukemia (B-CLL) in separate studies but the impact of combining these markers on prognosis has not been examined. The current study aimed to evaluate the relative contribution of expression of CD38 and/or myeloid-associated markers (CD11b, CD13, CD15 and CD33) by flow cytometry (FCM) on the clinical course of 24 B-CLL patients. B-CLL patients with high levels of CD38 expression, defined as greater than or equal to 30% of neoplastic lymphocytes expressing CD38, had a significantly poorer OS than those with low levels of CD38 expression (54% cumulative survival: 51 months vs. 103 months, Kaplan-Meier survival analysis, p < 0.005, Logrank test). High levels of expression of myeloid-associated markers showed no statistically significant impact on OS in these patients. Ten of 11 patients (91%) with high levels of CD38 expression required chemotherapy. In contrast, only 5 of 13 patients (38%) with low levels of CD38 expression required chemotherapy (p < 0.009, Chi Square). There was no significant difference in the requirement for chemotherapy between patients with high levels of expression of myeloid-associated marker and those without (5/8 or 63% vs. 10/16 or 63%). Thus, our results suggest that CD38 is superior to myeloid-associated markers in predicting the prognosis of patients with B-CLL. Further studies with a larger sample size are indicated to confirm our observation.

Ectopic breast tissue has been described rarely in the vulva and is known to develop a variety of pathologic changes. Our review of the literature found a total of 11 reported cases of primary infiltrating ductal adenocarcinoma arising in ectopic breast tissue of the vulva. We report what we believe is the first case of primary mucinous adenocarcinoma arising in ectopic breast tissue of the vulva diagnosed by characteristic histopathologic features and immunohistochemical stain results. We discuss the criteria used in diagnosis of primary breast carcinoma of the vulva and review previously reported cases.