We report on a case of a sarcoma arising in the hyaline- vascular variant of Castleman disease (HVCD) of the skin and subcutis. The patient was a 38- year- old man who clinically presented with a subcutaneous non- fix...We report on a case of a sarcoma arising in the hyaline- vascular variant of Castleman disease (HVCD) of the skin and subcutis. The patient was a 38- year- old man who clinically presented with a subcutaneous non- fixed cyst- like mass on his right shoulder with an unremarkable prior medical history. Histologic sections showed a biphasic tumor with numerous atretic lymphoid follicles located in the deep dermis and subcutis and a spindle- cell neoplasm mainly situated in the deep subcutis and adjacent soft tissue. The atretic lymphoid component fulfilled the criteria for HVCD, whereas the spindle- cell lesion showed all the criteria for sarcoma including nuclear atypia and frequent mitotic figures. The sarcomatous componentwas diffusely positive for fascin, nerve growth factor receptor, and CD34 with focal weak reactivity for CD21 and CNA.42. Stains for CD23, CD31, CD35, CD99, ALK- 1, SMA, ASMA, desmin, factor XIIIa,AE1- AE3, EMA, bcl- 2, S- 100, Melan- A,HMB- 45, Cam 5.2, and factor VIII were negative in the neoplastic spindle cells. No monoclonal population of lymphocyteswas detected andwe could not identify EBV or HHV- 8 virus by PCR. Electron microscopy of the sarcomatous component showed spindle cells with labyrinth- like invaginations of the nucleus and numerous long, slender, interwoven cytoplasmic processes. The sarcomatous component in this case is most consistent with a poorly differentiated follicular dendritic cell sarcoma based upon the morphologic and ultrastructural findings.展开更多
Background: Metalloproteinases (MMPs) are proteins involved in extracellular matrix breakdown and have been implicated in stages of migration and metastasis. MT1-MMP is an MMP anchored to the cell membrane. During mat...Background: Metalloproteinases (MMPs) are proteins involved in extracellular matrix breakdown and have been implicated in stages of migration and metastasis. MT1-MMP is an MMP anchored to the cell membrane. During maturation, melanocytic nevi penetrate the extracellular matrix and express MMPs. Methods: We studied 10 junctional, 10 compound, and 10 intradermal nevi diagnosed by clinical and histological studies and by performing immunohistochemical study to assess MT1-MMP activity. Results: We found evidence of MT1-MMP expression in melanocytic nevus cells, particularly around the entire border of cell nests. Expression was more intense in junctional nevi and gradually decreased with acquisition of intradermal component and became nonexistent in nevi in the deep dermis. Conclusions: MT1-MMP is expressed in the membrane of nevus cells, with expression greater in nest cells in contact with the extracellular matrix. The intensity of expression correlated inversely with the maturation phase of the nevus, being very high in junctional nevi and low in intradermal nevi.展开更多
Background: There are few reports of the histological changes in rosacea,and little attempt has been made to correlate such changes with clinical findings. In the present study,we describe in detail the histopathologi...Background: There are few reports of the histological changes in rosacea,and little attempt has been made to correlate such changes with clinical findings. In the present study,we describe in detail the histopathological features of rosacea in a large number of patients and simultaneously investigate the aetiopathogenesis of the disease based on the comparative assessment of epidemiological,clinical and histological findings. Methods: The study included 73 patients with rosacea. A skin biopsy with a 4-mm punch was performed in each case. All biopsy specimens included subcutaneous tissue. In 10 randomly selected patients,facial biopsy specimens were obtained from both involved and uninvolved (nonlesional) skin. Demodexmite presencewas estimated semi-quantitatively under light microscopy. Patients with self-reported gastro-intestinal symptoms were submitted to upper gastro-intestinal endoscopy,and a rapid urease test was performed. Serological antibodies,IgG and IgA,against Helicobacter pylori were also detected. Results: The patients had a broad clinical spectrum of lesions. No specific histological features associated with either erythematous-telangiectatic or papulopustular clinical forms were noticed. Histological examination showed that there is no histological pattern unique to rosacea. Three different types of granulomaswere observed: small palisaded ones around altered collagen and other granulomas of elastolytic and non-specific epithelioid type,all coexisting in 5 cases. The deep dermis and subcutis were frequently involved. Comparative study in 10 rosacea patients between lesional and nonlesional skin biopsies revealed almost the same histological changes to the latter biopsies,to a lesser degree though. Conclusion: Rosacea seems to be a reaction pattern to which a variety of pathogenetic routes may lead.展开更多
文摘We report on a case of a sarcoma arising in the hyaline- vascular variant of Castleman disease (HVCD) of the skin and subcutis. The patient was a 38- year- old man who clinically presented with a subcutaneous non- fixed cyst- like mass on his right shoulder with an unremarkable prior medical history. Histologic sections showed a biphasic tumor with numerous atretic lymphoid follicles located in the deep dermis and subcutis and a spindle- cell neoplasm mainly situated in the deep subcutis and adjacent soft tissue. The atretic lymphoid component fulfilled the criteria for HVCD, whereas the spindle- cell lesion showed all the criteria for sarcoma including nuclear atypia and frequent mitotic figures. The sarcomatous componentwas diffusely positive for fascin, nerve growth factor receptor, and CD34 with focal weak reactivity for CD21 and CNA.42. Stains for CD23, CD31, CD35, CD99, ALK- 1, SMA, ASMA, desmin, factor XIIIa,AE1- AE3, EMA, bcl- 2, S- 100, Melan- A,HMB- 45, Cam 5.2, and factor VIII were negative in the neoplastic spindle cells. No monoclonal population of lymphocyteswas detected andwe could not identify EBV or HHV- 8 virus by PCR. Electron microscopy of the sarcomatous component showed spindle cells with labyrinth- like invaginations of the nucleus and numerous long, slender, interwoven cytoplasmic processes. The sarcomatous component in this case is most consistent with a poorly differentiated follicular dendritic cell sarcoma based upon the morphologic and ultrastructural findings.
文摘Background: Metalloproteinases (MMPs) are proteins involved in extracellular matrix breakdown and have been implicated in stages of migration and metastasis. MT1-MMP is an MMP anchored to the cell membrane. During maturation, melanocytic nevi penetrate the extracellular matrix and express MMPs. Methods: We studied 10 junctional, 10 compound, and 10 intradermal nevi diagnosed by clinical and histological studies and by performing immunohistochemical study to assess MT1-MMP activity. Results: We found evidence of MT1-MMP expression in melanocytic nevus cells, particularly around the entire border of cell nests. Expression was more intense in junctional nevi and gradually decreased with acquisition of intradermal component and became nonexistent in nevi in the deep dermis. Conclusions: MT1-MMP is expressed in the membrane of nevus cells, with expression greater in nest cells in contact with the extracellular matrix. The intensity of expression correlated inversely with the maturation phase of the nevus, being very high in junctional nevi and low in intradermal nevi.
文摘Background: There are few reports of the histological changes in rosacea,and little attempt has been made to correlate such changes with clinical findings. In the present study,we describe in detail the histopathological features of rosacea in a large number of patients and simultaneously investigate the aetiopathogenesis of the disease based on the comparative assessment of epidemiological,clinical and histological findings. Methods: The study included 73 patients with rosacea. A skin biopsy with a 4-mm punch was performed in each case. All biopsy specimens included subcutaneous tissue. In 10 randomly selected patients,facial biopsy specimens were obtained from both involved and uninvolved (nonlesional) skin. Demodexmite presencewas estimated semi-quantitatively under light microscopy. Patients with self-reported gastro-intestinal symptoms were submitted to upper gastro-intestinal endoscopy,and a rapid urease test was performed. Serological antibodies,IgG and IgA,against Helicobacter pylori were also detected. Results: The patients had a broad clinical spectrum of lesions. No specific histological features associated with either erythematous-telangiectatic or papulopustular clinical forms were noticed. Histological examination showed that there is no histological pattern unique to rosacea. Three different types of granulomaswere observed: small palisaded ones around altered collagen and other granulomas of elastolytic and non-specific epithelioid type,all coexisting in 5 cases. The deep dermis and subcutis were frequently involved. Comparative study in 10 rosacea patients between lesional and nonlesional skin biopsies revealed almost the same histological changes to the latter biopsies,to a lesser degree though. Conclusion: Rosacea seems to be a reaction pattern to which a variety of pathogenetic routes may lead.
