Analytical and Quantitative Cytopathology and Histopathology最新文献

Background: Histoplasmosis is a fungal infection caused by Histoplasma capsulatum; it mostly occurs in immunocompromised individuals. Disseminated histoplasmosis may affect almost all systems. The lymph node is frequently involved in the reticuloendothelial dissemination. Histoplasmosis of the lymph node can mimic tuberculosis clinically and cytomorphologically. Fine needle aspiration cytology (FNAC) is an effective method for differentiating the two. The histoplasma yeast forms are small and usually intracellular and are likely to be overlooked in Papanicolaou (Pap)-stained smears. Air-dried Giemsa-stained smears can identify them easily and clearly because of their large size and bright purple-to-blue color as compared with fixed Pap-stained smears.

Cases: We report 3 cases of lymph node histoplasmosis diagnosed on cytology seen over a period of 2 years.

Conclusion: Lymph node FNAC is a rapid, cost-effective, reliable diagnostic toolfor histoplasmosis. It can obviate the need of surgical biopsy and hasten the initiation of treatment.

Background: Urinary bladder paraganglioma is a rare neoplasm that originates from embryonic rests of chromaffin cells in the sympathetic plexus of the detrusor muscle, and which occasionally can be observed in transurethral resection specimens. Artifactual changes due to the procedure may frequently simulate an advanced urothelial carcinoma.

Case: A 65-year-old woman presented with episodic macroscopic hematuria. No symptoms of hyperadrenergic stimulation were referred. Cystoscopic examination revealed a protruding mass on the left side of the bladder. Transurethral resection (TUR) was performed, and histological examination revealed a tissue organized in solid nests delineated by delicate fibrovascular septa. There were artifactual changes that consisted of cautery effect and absence of orientation of the fragments. The tumor infiltrated the muscle layer and part of the muscularis mucosae of the bladder. No necrosis or mitoses were observed. On immunohistochemical staining, the tumor cells were negative for epithelial membrane antigen, cytokeratin 7, and carcinoembryonic antigen and positive for chromogranin A, NSE, and PGP9.5. Immunohistochemistry for S-100 highlighted sustentacular cells.

Conclusion: It is essential to consider the diagnosis of urinary bladder paraganglioma on TUR specimens in order to avoid inappropriate treatment.

Objective: To explore the link between cigarette smoking and thromboembolic events and to investigate cigarette smoking as a major risk factor in the etiology of atherosclerosis.

Study design: We determined the effect of nicotine on the expression of adhesion molecules, intercellular adhesion molecule (ICAM-1), and vascular cell adhesion molecule (VCAM-1) in mouse cardiac vascular endothelial cells and the involvement of important known intermediaries, namely p38 mitogen-activated protein kinase (MAPK) signaling pathway.

Results: Our results indicate that nicotine can enhance the expression of ICAM-1 and VCAM-1 on mouse cardiac vascular endothelial cell via p38 MAPK signaling pathway, resulting in increased expression of the cellular adhesion molecules ICAM-1 and VCAM-1.

Conclusion: We demonstrate that 10(-6) M nicotine maximally enhances mouse cardiac vascular endothelial cell expression of ICAM-1 and VCAM-1 at 8 hours. Our results provide a putative mechanism by which nicotine stimulates expression of these adhesion molecules via p38 MAPK signaling pathway.

Objective: To investigate comparisons of the secretory activity between N-glycosylated and nonglycosylated α-amylase, and α-amylase synthetic activity, after β-adrenergic receptor activation in rat parotid acinar cells in vitro.

Study design: Rat parotid acinar cells were incubated in the presence or absence of (-)-isoproterenol. For β-adrenergic blocking experiments, acinar cells were pretreated with (±)-propranolol prior to adding agonist. After the time indicated, the "released amylase" and "total amylase" were obtained. Western blotting was applied to identify and quantify the N-glycosylated and nonglycosylated α-amylase. Amylase activity was also measured.

Results: The potent β-adrenergic agonist (-)-isoproterenol induced a dramatic increase (2-3-fold) of α-amylase secretion for 30 minutes (p < 0.05 vs. control), while the effect was completely abolished when cells were pretreated with (±)-propranolol for 15 minutes. Moreover, the N-glycosylated level of released and total amylase among groups was measured accordingly. Our data showed the N-glycosylated level ratios (released amylase/total amylase) did not differ among groups, which indicated that the N-glycosylated form of α-amylase was not secreted more easily than the nonglycosylated one after stimulation. Interestingly, the total amylase concentration remained unchanged after stimulation within 30 minutes, which might indicate no α-amylase synthesized within the time indicated.

Conclusion: Our findings suggest a parallel increase in secretory activity between N-glycosylated and nonglycosylated α-amylase after β-adrenergic receptor activation. There seems to be a dissociation of α-amylase synthesis from secretion within 30 minutes.

Objective: To describe the tissue distribution, density, and the morphological characteristics of 4 kinds of endocrine cells in the digestive tract of the Chinese yellow quail (Coturnix japonica).

Study design: The streptavidin-biotin-peroxidase complex immunohistochemical method was used to identify the distribution of somatostatin (SS), serotonin (5-HT), gastrin and neuropeptide Y (NPY) in digestive tracts including proventriculus, duodenum, jejunum, ileum, and rectum. SPSS 19.0 software was used to perform biological statistical analysis.

Results: The results showed that the SS and 5-HT secreting cells were mainly distributed in the proventriculus (19.2 +/- 6.9 and 16.1 +/- 3.4 cfu/mm2) and duodenum (2.9 +/- 2.0 and 1.9 +/- 0.6 cfu/mm2). Gastrin and NPY were not detected in each section of the digestive tract. Moreover, there was no significant difference in the quantitative distribution and morphological characteristics of SS and 5-HT secreting cells in the digestive tract between male and female quails.

Conclusion: The distribution and morphological characteristics of endocrine cells were closely related to the physiological functions of different parts in the digestive tract. The preferential location of endocrine cells provides additional information for future studies on the physiological roles of gastrointestinal peptides in the gastrointestinal tract of the Chinese yellow quail.

Objective: To investigate the audiological and histopathological effects of erythropoietin on acoustic overstimulation in rats.

Study design: Twenty-two male Wistar albino rats were divided into 3 groups: sham group (n = 7), erythropoietin injection group (n = 8), and saline injection group (n = 7). Both erythropoietin and saline injection groups were exposed to white noise (100 decibel [dB] sound pressure level [SPL]) for 3 hours. Auditory brainstem responses were measured before, immediately after, and on the 7th day of noise exposure. All animals were sacrificed on the 7th day and temporal bones were collected. The serial sections of the cochleae were stained by caspase-3 and caspase-9 immunostaining and by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method in order to detect apoptotic cells.

Results: In the saline group statistically significant differences were detected between the baseline and immediate postacoustic overstimulation thresholds of click and 6 kHz stimuli. However, when the baseline and immediate postacoustic overstimulation thresholds of click and 6 kHz stimuli were compared in the erythropoietin injection group, no statistically significant difference was determined. Histopathologic evaluations demonstrated that erythropoietin decreased the amount of apoptotic cells in the cochlea.

Conclusion: Erythropoietin is likely to prevent the acute threshold changes and decrease the amount of apoptosis in cochlea after acoustic overstimulation in rats.

Objective: To report on a series of fine needle aspiration (FNA) biopsies for preoperative diagnosis of complex cystic renal mass.

Study design: From August 2002 to February 2009, 32 patients with a complex cystic renal mass were studied. Tumor size ranged from 1.5-7.7 cm, with a median of 3.0 cm. Bosniak classification was 15 IIF, 12 III, and 5 IV. FNA biopsy was performed under CT guidance to obtain the fluid. Malignant and suspect cytological reports were considered as a positive diagnosis, and absence of epithelial cells as a negative diagnosis.

Results: Sufficient fluid was obtained in all cases. A positive preoperative diagnosis was found in 11 patients, and 21 cysts presented as absence of epithelial cells. Of the 26 patients who underwent surgery, pathology proved that there were 21 malignant and 5 benign cysts. Among the operated patients with a malignant cystic tumor, 11/21 (52.3%) presented a negative preoperative diagnosis. One preoperative positive diagnosis was proved to be a benign cyst. The accuracy of preoperative positive cytology was 10/11 (90.9%).

Conclusion: No difficulty was noticed in obtaining the fluid by FNA of a cystic small renal mass. A false negative diagnosis was due mainly to the absence of malignant cells in the fluid of cysts. Biomarkers in fluid shall be studied to solve the diagnostic problem.

Objective: To investigate whether the size of the lesion correlates with the completeness of excision, and whether human immunodeficiency virus (HIV) infection was a risk factor for incompleteness of excision. We investigated the size of high-grade cervical intraepithelial lesions of loop electrosurgical excision procedure (LEEP) specimens to assess its effect on the status of the excision margins. Because of the possible negative effect of HIV infection on the completeness of excision, we compared HIV-positive with HIV-negative cases.

Study design: Cross-sectional study of 226 consecutive LEEP specimens with cervical intraepithelial neoplasia (CIN). There were 126 CINs > or = 2; 59 (46.8%) were HIV positive. We measured the linear surface, the number of involved crypts, and the number of step sections involved by CIN > or = 2.

Results: The excision margins were involved in 65.1%. The measurable linear extent and the average number of involved crypts and sections were significantly higher with incomplete excision (p < 0.0001, p = 0.001, and p = 0.02, respectively). The endocervical excision margin was involved in 52.4% of incomplete excisions. The excision was incomplete in 43.9% of HIV-infected and 56.1% of HIV-uninfected cases (chi2 = 0.03, p = 0.88).

Conclusion: It appears that instead of the linear surface involvement, it is rather the location in the endocervix and the extension inside the crypts that affects the excision margin status. HIV infection did not affect the completeness of excision.

Objective: To detect mast cell density by toluidine blue and immunohistochemical staining for mast cell tryptase in skin tags as compared to normal skin to determine whether they have a role in skin tag development.

Study design: This study was carried out on 30 patients with skin tags and 10 age- and sex-matched healthy controls without skin tags.

Results: There was a significant difference between skin tag and control groups regarding mast cell density evaluated by toluidine blue staining (p = 0.003) and mast cell tryptase expression (p = 0.001), where the density was higher in skin tags as compared to normal skin. Mast cells were higher in number using toluidine blue staining in lesions arising in sites other than the head and neck (p = 0.028). High expression of mast cell tryptase was significantly associated with marked collagenosis (p = 0.02) and presence of eosinophils (p = 0.04).

Conclusion: The present study demonstrates the possible role of mast cells in promoting fibrosis and facilitating the development of skin tags. Mast cells may attract eosinophils to cooperate in inducing more fibrosis in skin tag development.

Background: Chromophobe renal cell carcinoma (ChRCC) is a morphologically distinct renal cell carcinoma type which may rarely show composite morphology.

Case: A 61-year-old man presented with a composite ChRCC with sarcomatoid transformation containing osteosarcomatous, chondrosarcomatous and squamous metaplastic differentiation and associated with a high-grade collecting duct carcinoma (CDC). The patient presented with a metastatic disease in the regional lymph nodes, comprised only of CDC, and died after 21 months.

Conclusion: Although ChRCC associated with sarcomatoid change has been well documented, the presence of osteosarcoma has been previously reported in only 5 ChRCCs, 2 of which also contained chondrosarcoma. Squamous differentiation has been previously found in only 2 ChRCCs with sarcomatoid change, and ChRCC associated with CDC has been previously reported in only 3 cases, but none with heterologous elements. To our knowledge this represents a previously unreported composite type of RCC, with an aggressive clinical behavior.