2012年 · 第125卷第09期

Regardless of its relatively small size,the prostate is the most common site of pathology in human male,1,2 and the prostate is the site of the two most frequent medical problems affecting elderly men,benign prostatic hyperplasia (BPH) and prostate cancer (PCa).Using the urethra as the key anatomical reference point,the prostate is conventionally divided into three distinct zones:peripheral zone,transition zone,and central zone.2This morphology is of clinical significance in the development of age-associated conditions such as BPH and PCa.3 Each of these zones exhibit a specific susceptibility to pathology,PCa develops mainly in the peripheral zone,whereas BPH occurs almost exclusively in the transition zone,whilst the central zone remains mostly disease-free.2,4,5 The functional basis and molecular mechanisms underlying these differences in disease susceptibility between the zones of the human prostate are unknown.Some of the differences in susceptibility to disease may have an embryological basis。

Abstract：Background Although many midterm oncologic data have been reported for extraperitoneal laparoscopic radical prostatectomy (ELRP) in westem countries,few oncologic data of the extraperitoneal procedure was published in China.The aim of the study was to evaluate the oncologic outcomes of patients treated with ELRP in China.Methods From January 2005 to March 2010,a total of 152 consecutive patients diagnosed with clinically localized prostate cancer were included in this study and treated with ELRP.The patients were staged according to the TNM (tumor,nodes,metastases) system.Median and mean postoperative follow-up were 28.1 months and 27.0 months,respectively.The patients were retrospectively analyzed for progression-free survival.Results One hundred and twelve cases (73.7％) were postoperatively diagnosed as pT2 in,and 40 cases (26.3％) as pT3.Positive lymph nodes were shown in 5 patients (3.3％).Gleason score was ＜7 in 49 men (32.2％),7 in 69 men (45.4％),and ＞7 in 34 men (22.4％).Positive surgical margins (PSM) were observed in 15 patients (9.9％),which included 32.0％ of all pT3a cases and 46.7％ of all pT3b cases,respectively.The overall prostate-specific antigen recurrence-free survival rate was 86％ in all patients.The recurrence-free survival rates were 91.8％ and 62.2％ in pT2N0 patients and pT3N0 patients,respectively.Preoperative prostate-specific antigen,surgical margins,tumor stage,and lymph nodal status were identified as independent predictors of biochemical recurrence-free survival using multivariate Cox proportional hazard model.Conclusions ELRP is a precise,safe and effective procedure at this particular Chinese institution.The prognostic power of prostate-specific antigen relapse after ELRP is not identical to that described previously with transperitoneal or open retropubic approaches。

Abstract：Background Transurethral resection of prostate (TURP) has been widely used as a golden standard therapy of benign prostatic hyperplasia for over 40 years.However,not all patients achieved favorable outcome postoperatively.Since the level of bladder outlet obstruction and the dysfunction of detrusor (overactive and underactive) were both found to affect surgical efficacy,urodynamics was recommended as routine preoperative examination in selecting proper surgical candidates by International Continence Society in spite of its invasiveness and high cost.The aim of this research was to compare the predictive value between ultrasonography and urodynamics for TURP efficacy and determine if preoperative urodynamic test could be replaced by ultrasonography.Methods Two hundred and seventy-one patients took part in the retrospective analysis.All the subjects had preoperative evaluation of symptoms,life quality,and combined examination of ultrasonography and urodynamics.Surgical efficacy was measured according to the recovery of international prostate symptom score,quality of life score,and maximal flow rate 6 months after TURP.Fisher's linear discriminant analysis was applied to establish the predictive models of surgical efficacy by choosing parameters from ultrasonography or urodynamics as independent factors.Receiver's operating characteristic curve was then plotted to compare the values between the models.Results Sensitivity,specificity,positive and negative predictive value of models consisting of parameters from both ultrasonography and urodynamics were favorable.Corresponding models of ultrasonography and urodynamics were found to have non-significant difference in area under curve (P＞0.05).Conclusions Preoperative ultrasonography has as strong v.alue as urodynamics does in predicting surgical outcome of patients undergone TURP and might take the place of urodynamics in selecting surgical candidates.Further prospective analysis with larger popularity and longer period of follow up should be launched to vedfy the result of this research。

Abstract：Background Improving the success rate of ureteroscopic lithotripsy for proximal ureteral stones is the hot issue in this field.Here we reported our experience on the treatment of proximal ureteral stones.Methods From 2005 to 2010,187 consecutive patients with proximal ureteral stones who underwent ureteroscopic lithotripsy were enrolled.The initial 52 patients treated by semi-rigid ureteroscope alone were classified as group 1.The subsequent 135 patients treated by semi-rigid ureteroscope with the aid of stone basket and flexible ureteroscope were classified as group 2.Results In group 1,the overall stone-free rate was 67.3％.By a single procedure of ureteroscopic lithotripsy using a semi-rigid instrument,patients with ureteral stones below the 4th lumbar vertebra level achieved 91.7％ stone-free rate,which was only 50％ in patients with stones above the 4th lumbar vertebra level.Conversion to open surgery occurred in two patients since ureteral perforation was observed.In group 2,the stone-free rate achieved 93.2％ with the aid of an N-Trap basket,which was significantly higher than that of patients without the aid of the basket (51.6％).Flexible ureteroscope was subsequently used in patients with fragment migration,thus making the overall success rate in group 2 increases to 97.0％.Conclusions Ureteroscopic lithotripsy is a safe and efficacious treatment for proximal ureteral stones.A single procedure of ureteroscopic lithotripsy using semi-rigid ureteroscope could achieve a satisfactory stone-free rate in patients with proximal ureteral stones below the 4th lumbar vertebra level.However,patients with urateral stones above the 4th lumbar vertebra level experienced higher stone-migration rate,which would decrease the success rate.Fortunately,the stone-free state could possibly be achieved with the aid of an N-trap basket and flexible ureteroscope。

Abstract：Background Coronary stents are widely used in percutaneous coronary intervention (PCI) procedures.We aimed to explore the incidence,predictors and characteristics of stent thrombosis (ST) after coronary stent implantation in routine clinical practice.Methods From data of 18 063 consecutive patients who underwent successful stent implantation in Shenyang Northern Hospital from 2004 to 2010,we identified patients with definite ST (n=140) and control patients (n=280) matched on age,diagnosis,sex,current antiplatelet medication and stent type.The incidence,predictors and characteristics of ST after coronary stent implantation were investigated.Results The incidence of angiographically confirmed ST was 0.78％ (140/18 063).The time distribution of ST was acute in 43 (30.7％),subacute in 50 (35.7％),and late in 47 (33.6％) patients.Binary Logistic regression analysis identified the angiotensin-converting enzyme inhibitor (ACEI) (odds ratio (OR)=0.472,95％ CI:0.276-0.807,P=0.006)and heparin (OR=0.477,95％ CI:0.278-0.819,P=0.007) were associated with an reduced risk of cumulative ST.Stent length (OR=1.042,95％ CI:1.026-1.058,P ＜0.001),serum creatinine total (OR=1.020,95％ CI:1.004-1.035,P=0.04),cholesterol (OR=1.267,95％ CI:1.021-1.573,P=0.032),glucose (OR=1.086,95％ C/:1.002-1.176,P=0.044),and platelet aggregation (OR=1.113,95％ CI:1.075-1.154,P ＜0.001 ) were associated with an increased risk of cumulative ST.Conclusion ST is associated with longer stent length and higher level of total cholesterol,glucose and platelet aggregation。

Abstract：Background Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly,and SVA with discrete membranous subaortic stenosis is even rarer.The aim of the study was to make sure the incidence of SVA with discrete membraneous subaortic stenosis in SVA and their surgical results.We retrospectively analyzed 234 patients receiving surgical repair of SVA and reported the incidence of ventricular septal defect,aortic regurgitation,and discrete membranous subaortic stenosis.We also reported seven cases of SVA combined with discrete membranous subaortic stenosis and their surgical results.Methods Between January 1999 and December 2009,seven patients of SVA with discrete membranous subaortic stenosis underwent surgical repair of SVA and resection of subaortic discrete membrane.There were six male and one female patients.The mean age was (33.71±13.25) years (range 16-52 years).Associated cardiovascular lesions were aortic regurgitation (n=7),ventricular septal defect (n=5),coarctation of aorta (n=1),bicuspid aortic valve (n=1),patent ductus arteriosus (n=1),and aortic valve stenosis (n=1).The aortic valve was replaced in four patients and valvuloplasty was done in three.The other co-existing anomalies were corrected at the same time.All the seven patients were followed up from 18 to 125 months (mean (63.14±39.54) months).Among 234 SVA patients who underwent surgical repair,the number of cases with coexisting ventricular septal defect,aortic regurgitation,and discrete membranous subaortic stenosis was 129,108,and 7,respectively.Results There was neither early death after operation nor late death during the follow-up period.All the seven patients were in the New York Heart Association (NYHA) functional classes Ⅰ and Ⅱ.There was no recurrence of discrete subaortic membrane during the follow-up period.The incidence of ventricular septal defect,aortic valve incompetence,and discrete membranous subaortic stenosis among 234 SVA patients was 55.13％,46.15％,and 2.99％,respectively.Conclusions Surgical repair of SVAwith discrete membranous subaortic stenosis showed good mid-term results.Resection of discrete subaortic membrane should be done actively while repairing SVAs.Long-term results need to be followed up。

Abstract：Background Chronic heart failure (CHF) had been characterized as an activated sympathetic system leading to the alteration of adrenergic receptor (AR) levels in the heart.Thus far,not much research has been done with regard to traditional Chinese medical treatment for CHF.We investigated the effect of Shexiangbaoxin pills (SXBXP) on the function of the heart and the expression of α1-AR and β-AR subtypes in the messenger RNA (mRNA) levels and protein levels of non-infarction left ventricular tissue from rats with CHF induced by myocardial infarction.Methods Models of CHF were established by left anterior descending coronary artery ligature.Fifty-four Wistar rats were randomly divided into five groups:normal control group (group A),sham operation group (group B),CHF model group (group C),positive medicine control group (group D),and small-dose SXBXP group (group E) and large-dose SXBXP group (group F),deployed intragastrically.Cardiac function was examined by echocardiography before and after therapy; mRNA expressed levels were measured by semiquantitative reverse transcription polymerase chain reaction (RT-PCR) for β1-AR,β2-AR,β3-AR,α1A-AR,α1B-AR,and α1D-AR; protein levels were measured by Western blotting analysis for β1-AR,β2-AR,α1A-AR,α1B-AR,and α1D-AR in non-infarction left ventricular tissue.Results There was no significant difference in the left ventricular ejection fraction (LVEF) between groups A and B.Compared to group B,LVEF of groups C,D,E,and F were significantly decreased (P ＜0.01) before therapy.After therapy,compared to group C,LVEF of group F was significantly improved (P ＜0.05).Compared to group B,β1-AR and α1B-AR expressed levels were markedly decreased (P ＜0.05),α1A-AR and β3-AR were significantly increased (P ＜0.01 ) in group C,and in both mRNA and protein expressed levels β2-AR had no significant difference between groups B and C (P ＞0.05).α1D-AR mRNA levels were unchanged in each group (P ＞0.05),but α1D-AR protein level was significantly decreased in group C (P ＜0.05).After treatment,compared to group C,mRNA levels of β1-AR and α1B-AR were significantly increased (P ＜0.05 and P ＜0.01),and α1A-AR was markedly decreased in groups D,E,and F (P ＜0.05).β3-AR level significantly declined in both groups D and F (P ＜0.01),but β2-AR and α1D-AR expressed levels remained unchanged in each group (P ＞0.05).Protein levels,compared to group C,β1-AR was significantly increased (P ＜0.01,P ＜0.05,and P ＜0.01) and α1A-AR was markedly decreased in groups D,E,and F (P ＜0.05,P ＜0.01,and P ＜0.01).β2-AR expressed level was significantly increased in group F (P ＜0.05).α1B-AR expressed level was significantly increased in both groups E and F (P ＜0.05),and α1D-AR was remarkably increased in both groups D and F (P ＜0.05).Conclusions After SXBXP treatment,LVEF was increased and cardiac function was significantly ameliorated in rats with CHF.The therapeutic effect of SXBXP may be related to better blood supply for myocardium and up-regulation of β1-AR and α 1B-AR,and down-regulation of α1A-AR and β3-AR.The results show that SXBXP can be used in treatment of CHF and the therapeutic effect of large-dose SXBXP is superior to small-dose SXBXP。

Abstract：Background There is a significant association between obesity and breast cancer,which is possibly due to the expression of leptin.Therefore,it is important to clarify the role of leptin/ObR (leptin receptor) signaling during the progression of human breast cancer.Methods Nude mice with xenografts of MCF-7 human breast cancer cells were administered recombinant human leptin subcutaneous via injection around the tumor site.Mice in the experimental group were intratumorally injected with ObR-RNAi-lentivirus,while negative control group mice were injected with the same dose of negative-lentivirus.Tumor size was blindly measured every other day,and mRNA and protein expression levels of ObR,estrogen receptor α(ERα),and vascular endothelial growth factor (VEGF) for each group were determined.Results Knockdown of ObR-treated xenografted nude mice with a high leptin microenvironment was successfully established.Local injection of ObR-RNAi-lentivirus significantly suppressed the established tumor growth in nude mice.ObR level was significantly lower in the experimental group than in the negative control group,while the amounts of ERα and VEGF expression were significantly lower in the leptin group than in the control group (P ＜0.01 for all).Conclusions Inhibition of leptin/ObR signaling is essential to breast cancer proliferation and possible crosstalk between ObR and ERα,and VEGF,and may lead to novel therapeutic treatments aiming at targeting ObR in breast cancers。

Abstract：Background Because of the complexity and severity of the surgery and its associated complications,pancreaticoduodenectomy (PD) is associated with significant morbidity and mortality,especially the hemorrhage post-PD.Exploring the factors associated with post-PD hemorrhage is very important for the patients' safety.Methods Clinical data from 303 cases of PD between January 1998 and December 2008 were analyzed retrospectively.Results The overall mortality rate was 4.95％ (15/303).However,post-operative bleeding occurred in 25 patients (8.25％) with nine episodes resulting in death (36.00％).Univariate analysis was performed and identified tumor size,Child's classification,total pancreatic uncinatic process resection,and pancreatic leakage as significant risk factors for post-PD hemorrhage.In the severe hemorrhage group,incomplete resection of uncinate process of pancreas and pancreatic leakage were the main causes.The multivariate Logistic regression analysis revealed that each of these variables is an independent risk factor.Conclusions Primary prevention of bleeding complications depends on total pancreatic uncinatic process resection and meticulous hemostatic techniques during surgery.In addition,several peri-operative factors were found to contribute to post-PD bleeding。

Abstract：Background While the incidence of paroxysmal noctumalhemoglobinuria (PNH) is relatively high in Northern China,the exact mechanism of the disease remains unknown.Immunoregulatory cytokine polymorphisms can directly regulate the expression levels of cytokines,which play a crucial role in many diseases.The purpose of this study was to study cytokine gene single nucleotide polymorphisms (SNPs) and the correlated cytokine expression levels in relationship to the PNH pathogenesis.Methods Peripheral blood samples were collected from 30 PNH patients and 40 healthy donors; all of the samples were collected from the Han people of Northern China.Eight SNP loci in five cytokine genes,including tumor necrosis factor-alpha (TNF-α),interferon-gamma (IFN-γ),transforming growth factor-beta (TGF-β),interleukin-6 (IL-6),and IL-10,and aplastic anemia (AA) were assessed.TNF-α,TGF-β,IFN-γ,IL-6,and IL-10 were analyzed by sequence-specific primer polymerase chain reaction (PCR-SSP).The plasma protein levels of TNF-α,TGF-β,and IFN-γwere assessed by an ELISA.Results The PNH patients had a lower frequency of the TC/GG genotype of the TGF-I gene (P ＜0.01) and a higher frequency of the C allele in the TGF-β gene (+10) compared to the controls (P ＜0.05).The predominant genotype of the +874 locus of the IFN-γ gene was TA in the PNH patients,while that in the predominant genotype was AA in the control group and was statistically significant (P ＜0.001).The frequency of the T allele in the IFN-γ gene was dramatically higher in the PNH patients than in the controls (P ＜0.05).The PNH patients had a reduced frequency of the GC and CC genotypes,as well as the C allele at locus -174 of the IL-6 gene compared to the controls (P ＜0.01).In addition,the plasma concentrations of TNF-α,TGF-β,and IFN-γ were significantly higher in the PNH group compared to the control group (P ＜0.01). Conclusions Expression levels of the TNF-α,TGF-β,and IFN-γ cytokines play an important role in PNH.The GC and CC genotypes,as well as the C allele of the IL-6 gene may protect the Han people of Northern China against PNH.Additionally,the TC/GG genotype of the TGF-β gene may be the protective allele.In contrast,the TA genotype and the T allele for the IFN-γ gene,as well as the C allele of TGF-β may be susceptible to PNH.However,SNPs in the TNF-α and IL-10 genes did not correlate with PNH development.Alternatively,the increased plasma concentrations of TNF-α,TGF-β,and IFN-γin PNH patients may also be related to PNH development。

Abstract：Background The relationship between apoptosis and tumors is a major focus in cancer research.RNA interference (RNAi) technology has emerged as a very potent tool to generate cellular knockdown phenotypes of a desired gene.The aim of this study was to explore the effect of siRNA specific to the protein casein kinase 2a (CK2α) on apoptosis of laryngeal carcinoma cells and to explore possible mechanisms.Methods An siRNA expression plasmid specific to CK2α,psiRNA-hH1neo-CK2a,and a non-specific siRNA expression plasmid,psiRNA-hH1neo-cont,were constructed and transfected into Hep-2 cells by a lipofectamine method.The mRNA and protein levels of CK2a in transfected cells were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analysis.Apoptosis was measured by Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) double-staining methods.The morphological changes to Hep-2 cells were observed under transmission electron microscopy (TEM).The levels of Bcl-2 and Bax proteins were measured by Western blotting analysis.Results Levels of CK2a mRNA and protein were significantly decreased in the psiRNA-hHlneo-CK2α group compared to the other groups (P ＜0.05).The apoptotic rate of the psiRNA-hHlneo-CK2a transfected group was significantly higher compared to that in the untransfected group and the siRNA-hH1neo-cont transfected group (25.66％±0.83％,3.66％±0.43％,and 5.18％±0.22％) (P ＜0.05).Compared with the untransfected group and the siRNA-hH1neo-cont transfected group,the psiRNA-hH1neo-CK2a transfected group presented with classical ultrastructural features of apoptosis,such as karyopyknosis,chromatic agglutination adjacent to the nuclear membrane,and apoptotic bodies.Compared with the other two groups,the level of Bcl-2 protein in the psiRNA-hH1neo-CK2α transfected group was decreased (0.20±0.09 vs.0.72±0.16,0.56±0.11,P ＜0.01),while the Bax protein level was increased (0.81±0.17 vs.0.26±0.12,0.33±0.17,P ＜0.01) and the ratio of Bcl-2 to Bax was decreased (0.25±0.05 vs.2.76±0.21,1.70±0.22,P ＜0.01).Conclusions The siRNA expression plasmid specific to CK2a could suppress CK2α expression and induce the apoptosis of laryngeal carcinoma cells.This is possibly by decreasing the Bcl-2/Bax ratio.CK2α may provide a potential therapeutic target against human laryngeal carcinoma。

Abstract：Objective To review the in vitro development of bone marrow mesenchymal stem cells culture (BM-MSC).Data sources The data cited in this review were mainly obtained from articles listed in Medline and PubMed.The search terms were “bone marrow mesenchymal stem cell" and "cell culture".Study selection Articles regarding the in vitro development of BM-MSCs culture,as well as the challenge of optimizing cell culture environment in two-dimensional (2D) vs.3D.Results Improving the culture conditions increases the proliferation and reduces the differentiation.Optimal values for many culture parameters remain to be identified.Expansion of BM-MSCs under defined conditions remains challenging,including the development of optimal culture conditions for BMSC and large-volume production systems.Conclusions Expansion of BM-MSCs under defined conditions remains challenges,including the development of optimal culture conditions for BMSC and scale-up to large-volume production systems.Optimal values for many culture parameters remain to be identified。

Abstract：Background Alveolar echinococcosis located in the adrenal gland can be considered a rare and aggressive infestation that radiologically and macroscopically mimics a malignant neoplasm.Its pathogenesis is poorly understood.This paper describes its clinical and radiological aspects and discusses its proper management.Methods The records of two patients with adrenal gland alveolar echinococcosis who were diagnosed and treated in our center in 2009 were evaluated.Results Neither patient showed any signs of recurrence following radical surgical treatment and postoperative oral anthelmintic therapy.Conclusion Radical surgery can be a feasible,effective management option that results in a good prospective outcome。

Abstract：Very late stent thrombosis (VLST) is increasingly being regarded as a complication of drug-eluting stents (DES),and delayed endothelization,local hypersensitivity reactions,and late stent malapposition due to excessive positive remodeling have been postulated as mechanisms.Considering that stent endothelialization seems to be completed within 4 weeks following bare-metal stent (BMS) placement and that BMS do not possess antiproliferative coating,the mechanism of VLST may differ between patients with DES and those with BMS.We report a case of VLST 9 years after BMS implantation,in which thrombus from the ruptured neointima was confirmed by intravascular ultrasound.This finding suggests that de novo plaque rupture at the neointimal layer within the stent may be one of the explanations for VLST。

Abstract：The solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors,which are commonly found in adolescent women.Radical surgical resection of the primary tumor or metastases is the standard treatment for SPTP and could achieve long-term survival.We reported a case of a 20-year-old female with multiple liver metastases of SPTP,and performed surgical resection for primary tumor 14 cm in diameter and 2 major liver metastases (both 5 cm in diameter),radiofrequency ablation (RFA) for small lesions and one major liver metastase 6 cm in diameter successfully.No evidence of recurrence in situ or in the liver was found by computed tomography (CT) scan 3 months after the operation.RFA is a safe and effective treatment for unresectable multiple liver metastases of SPTP。

Abstract：Antithymocyte globulin (ATG) has long been used for immune-induction and anti-rejection treatments for solid organ transplantations.To date,few cases of ATG-induced acute respiratory distress syndrome (ARDS) have been published.Here,we present a case of ARDS caused by a single low-dose of ATG in a renal transplant recipient and the subsequent treatments administered.Although the patient suffered from ARDS and delayed graft function,he was successfully treated.We emphasize that the presence of such complications should be considered when unexplained respiratory distress occurs.Early use of corticosteroids,adjustment of immunosuppressive regimens,and conservative fluid management,as well as empiric antimicrobial therapies,may be effective strategies for the treatment of ARDS caused by ATG。

Abstract：The significance of metastastic disease in the cervical lymph nodes has long been appreciated.The rich lymphatics of the upper aerodigestive tract explained the high incidence of cervical metastasis,occasional bilaterally spread.Even with appropriate treatment,cervical recurrences do occur.Nonetheless,with the resurgence of tuberculosis,the differential of tuberculous cervical lymphadenitis should be excluded.Appropriate modalities should be employed in making the appropriate diagnosis possible。

Abstract：A female patient diagnosed with acute myelocytic leukemia M5a (AML-M5a) relapsed 986 days after her allogeneic peripheral blood stem cell transplantation (allo-PBSCT) from an unrelated male donor with matched human leukocyte antigen (HLA).Three re-induction chemotherapies were administered,and partial remission was achieved.The patient was given repetitive infusion of cytokine-induced killer (CIK) cells expanded from recipient peripheral mononuclear cells of full donor chimerism due to loss of contact of quondam donor for donor lymphocyte infusion (DLI) and rejection of second transplantation.The patient achieved complete cytogenetical remission.This strategy might overcome the obstacle of donor unavailability and present an appealing new therapeutic alternative to donor-recruited adoptive immunotherapy for relapsed disease at post-transplantation。

Abstract：Myxoid adrenocortical neoplasms are rare.Surgical resection of the mass is the first-line therapy.Here we reported a total of four patients,aged 44-66 years,diagnosed with myxoid adrenocortical tumor.The clinical characteristics and immunohistochemical features of the tumor are discussed in the current literature。

Abstract：Clinical categories of Langerhans cell histiocytosis (LCH) include single and multi-system disease.Pulmonary LCH is rare,which is an unusual interstitial lung disease with the characteristics of monoclonal proliferation and infiltration of Langerhans' cells to organs.We report our experience of a rare LCH case of multiple organs such as pulmonary and liver as the main clinical manifestation.The patient was treated with chemotherapy which included prednisone,vinblastine,methotrexate and 6-mercaptopurine for 52 weeks and follow up all along.The patient has a favorable clinical outcome。

Abstract：Natural killer T-cell lymphoma (NKTL) is a malignant neoplasm which usually involves the nasal cavity or paranasal sinuses,while an orbit origin is extremely rare.Here we report the clinical,radiological and histopathologic features of a patient with NKTL originating from the orbit.We analyzed the clinical and radiologic records in the whole course of the disease.We also reviewed the morphology and immunohistochemistry of the neoplasm biopsy,including the presence of CD56,CD3 and cytotoxic molecules.This case demonstrated that nasal-type NKTL with a poor prognosis can originate from the orbit。