Congenital primary penile teratoma in a child.

Teratomas rarely present as a pediatric congenital primary penile mass. We describe a 14-month-old boy with a blister-like mass on his distal left penis. The subcutaneous mass measured 1.5 cm (length)×1.0 cm (width)×1.2 cm (height) on ultrasonography. There were clear margins between these structures and the lesion. At the age of 5 years, he received an extirpation surgery. Histologic analysis revealed that it was a mature teratoma. In our view, surgical resection should be the treatment of choice for a pediatric penile mass with the alertness of teratomas because of the possibility of malignant alteration and invasion of adjacent structures till unresectable.

Association of variance in anatomical elements of myocardial bridge with coronary atherosclerosis.

OBJECTIVES: The myocardial bridge (MB) is an anatomical structure consisting of myocardium covering a part of the left anterior descending coronary artery (LAD). The extent and spatial distribution of atherosclerosis in the LAD with an MB is influenced by the anatomical properties of the MB. In this study, the relationship between the overall anatomical framework of the MB including the periarterial adipose tissue as well as fibrosis of the MB itself and coronary atherosclerosis was histomorphometrically examined. METHODS: Full-length LADs with an MB from 180 autopsied hearts were cross-sectioned at 5-mm intervals. Together with measurements of MB - length, thickness, and location, proportional decrease of the atherosclerosis ratio of LAD segments beneath MB for that of LAD segments proximal to MB was defined as the atherosclerosis suppression ratio. The area ratio of adipose tissue in the periarterial area beneath MB and area ratio of fibrosis in the MB muscle were also measured. RESULTS: The atherosclerosis suppression ratio was significantly proportional to MB length and thickness. Periarterial adipose tissue beneath MB was detected in all cases (100%), and fibrosis within MB muscle for 136 cases (75.6%). The amount of adipose tissue beneath MB and MB fibrosis did not statistically affect the atherosclerosis suppression ratio. Multivariate analysis revealed MB length and thickness were the independent factors affecting the atherosclerosis suppression ratio. CONCLUSIONS: The anatomical properties of an MB, especially of its length and thickness, play decisive roles as regulators of atherosclerosis in the LAD regardless of the amount of adipose tissue around LAD and MB fibrosis.

Histopathologic profiles of coronary atherosclerosis by myocardial bridge underlying myocardial infarction.

OBJECTIVE: Anatomic properties of myocardial bridge (MB) are sometimes responsible for myocardial infarction (MI) through the changes in the atherosclerosis distribution in the left ascending coronary artery (LAD). The purpose of this study was to investigate histopathologic profiles of atherosclerotic lesions resulting from the MB presence in the LAD in the MI cases. METHODS: In 150 consecutive autopsied MI hearts either with MBs [MI(+)MB(+); n = 67] or without MBs [MI(+)MB(-); n = 83] and 100 normal hearts with MBs [MI(-)MB(+)], LADs were consecutively cross-sectioned at 5-mm intervals. The most advanced intimal lesion and unstable plaque-related lesion characteristics (UPLCs) in each section were histopathologically evaluated in conjunction with the anatomic properties of the MB, such as its thickness, length, location, and MB muscle volume burden (MMV: the total volume of MB thickness multiplied by MB length). RESULTS: The MB showed a significantly greater thickness (P = 0.0090), length (P = 0.0300), and MMV (P = 0.0019) in MI(+)MB(+) than in MI(-)MB(+). Mean age of acute MI cases was significantly younger (P = 0.0227) in MI(+)MB(+) than in MI(+)MB(-). Frequency of plaque fissure/rupture in the proximal LAD was significantly higher in acute MI cases of MI(+)MB(+) than in MI(+)MB(-). UPLCs tended to be located proximally in MI(+)MB(+) and frequent 2.0 cm or more proximal to the MB entrance in MI(+)MB(+). CONCLUSION: In MI(+)MB(+), UPLCs tend to be located more proximally, and a plaque in the LAD proximal to the MB is prone to rupture, resulting in MI at younger age.

Pathogenesis of lupus-like nephritis through autoimmune antibody produced by CD180-negative B lymphocytes in NZBWF1 mouse.

Toll-like receptors appear to play an important role in the pathogenesis of lupus-like nephritis in mice. In human and mouse, CD180 is a homologue of TLR4. In SLE patients, the number of CD180-negative B cells in peripheral blood changes in parallel with disease activity. In the present study using NZBWF1 mice, the population of splenic CD180-negative B cells increased with progression of renal lesions and aging. These cells produced both anti-dsDNA and histone antibodies; the peripheral blood levels of anti-dsDNA antibody increased markedly with aging. B cells infiltrating into renal lesions were CD180-negative and produced anti-dsDNA antibody. Considered together, these findings indicate that CD180-negative B cells contribute significantly to development of SLE-like morbidity in NZBWF1 mice by autoantibody production.