Spontaneous regression in an ulcerated CK7 positive Merkel cell carcinoma.

Merkel cell carcinoma is an aggressive and frequently lethal tumor of the elderly, associated with sun exposure and immunosuppression which is less common in the dark-skinned. We report the case of a 40-year-old woman who presented with multiple slowly progressive, mildly itchy ulcerated plaques of size ranging from 2 × 3 cm to 5 × 7 cm on the left knee of 1 year duration. Skin biopsy showed diffuse dermal infiltration by small round cells with molding of cells and lymphocyte infiltration. The cells stained positive for cytokeratin (CK) 20, CK7, neuron-specific enolase, and chromogranin. The skin lesions underwent spontaneous regression within 1 month of skin biopsy and have not recurred during the past 2 years. The immune mechanisms triggered by biopsy possibly explain the spontaneous regression.

Clinicopathologic profile of hypopigmented mycosis fungoides in India.

BACKGROUND: Hypopigmented mycosis fungoides (HMF) is an under recognized disease in India, which is often mistaken for Hansen disease or vitiligo, resulting in delayed diagnosis and treatment. AIM: To describe the clinical, histopathologic and immunohistochemical features of HMF in Indian patients. MATERIALS AND METHODS: All cases presenting as hypopigmented lesions that were signed out as MF between 2001 and 2009 (15 cases) were included. Clinical data and histopathology slides were reviewed. Immunostains for CD4, CD8, and CD1a were done, where tissue was available. RESULTS: The age ranged from 14 to 38 years with a male preponderance. The commonest presentation was multiple hypopigmented patches on limbs and trunk with the duration of the lesions varying from 4 months to 14 years. All cases showed a psoriasiform/lichenoid epidermal pattern, disproportionate epidermotropism, basilar tagging of lymphocytes, monomorphous lymphocytes, haloed lymphocytes, and wiry dermal collagen. Other important findings were infiltration of hair follicles, larger epidermal lymphocytes, atypia of dermal lymphocytes, and stuffed dermal papillae. Dermal edema was absent in all cases. Immunohistochemistry done on 10 cases showed a CD8 phenotype in 6 cases and CD4 phenotype in the remaining 4 cases. CONCLUSIONS: Histopathology supplemented by immunohistochemistry is reliable in making a diagnosis of HMF. It is important to be aware of this uncommon, yet significant disease.

[Characterization of phenolic glycolipid-I (PGL-I) like antigen in renal cell carcinoma].

BACKGROUND: We investigated whether phenolic glycolipid-I (PGL-I) produced by Mycobacterium leprae (M. leprae), can be used as a marker of renal tumors. METHODS: Using a preparted anti-PGL-I monoclonal antibody (SF-I), anti-PGL-I group antibodies and PGL-I group antigens were detected and PGL-I immunohistologic staining were performed. RESULTS: The titer of anti-PGL-I antibody in patients with renal cell carcinoma was 0.283 +/- 0.103, showing a trend of rising titer of anti-PGL-I group antibody with higher cytologic atypia. When compared by the extent of tumor infiltration, a high antibody titer was observed in stage 4 infiltration group. Regarding the PGL-I group antigen that was detected using SF-1 in the urine of patients with renal cell carcinoma, no relationships between the positive rte of the antigens with common antigenicity to PGL-I and the grade of carcinoma were observed. However, in terms of the extent of tumor infiltration, a trend that the positive rate for PGL-I group antigen increased with the progression of cancer stage was seen. The Western blot assay of the urine of patients with renal cell carcinoma following electrophoresis revealed a change around 40 KD. The immunohistologic stains with SF-1 disclosed a predominance in the proximal kidney tubule. CONCLUSION: Using PGL-I group antigen and PGL-I group antibody as markers of renal cell carcinoma, a rapid and precise measurement may be provided.