ABSTRACT
The most common tumor of the western world is comprised of forms of non-melanoma skin cancers, previously known as keratinocyte carcinomas (KCs) The purpose of this study was to determine de incidence of non-melanoma skin tumors and the relationship between histopathological risk factors in patients with skin cancers. The study was composed from 332 cases of skin malignancies for which clinical and histopathological aggressivity factors were statistically analyzed through comparison tests and also stored digitally. For basal cell carcinoma (BCC) statistical analysis indicated significant relationships between pT category and gender, tumor size, ulceration, depth of invasion and positive resection limits. For squamous cell carcinoma (SCC) statistical analysis indicated significant relationships between pT category and tumor size, depth of invasion and positive resection limits. Clinical and histological analysis of certain characteristics of the above-mentioned skin cancers is an essential step in documenting and improving both prognosis and therapy standards.
ABSTRACT
Uveal malignant melanoma is a rare malignant tumor comprising less than 5% of melanoma cases. It is nevertheless the intraocular tumor with the highest incidence in adults, that arises from the melanocytes in the uveal tract. The authors present the case of a patient with locally advanced choroidal melanoma: from presentation to diagnosis, treatment, and prognosis. A 63-year-old female patient presented in the Ambulatory of the Emergency County Hospital, Craiova, Romania, on the February 1, 2021, accusing visual acuity drop and photophobia in her left eye for about three weeks. Pathology examination in Hematoxylin-Eosin (HE) staining reveals a dense cell proliferation, with small and medium spindle cells and pigment production. The following immunohistochemical markers were used in our study: human melanoma black 45 (HMB45), Ki67, cyclin D1, B-cell lymphoma 2 (Bcl2), S100, Wilms' tumor 1 (WT1), p16, and p53. Uveal melanoma is a malignant tumor that can arise in all the uveal components: iris, ciliary body, and choroid. Out of the three components, iris melanomas have the best prognosis, while ciliary body melanomas have the worst prognosis. It is mandatory for the patient to respect the follow-up schedule, as follow-ups can provide early diagnosis of eventual metastasis.
Subject(s)
Choroid Neoplasms , Melanoma , Uveal Neoplasms , Humans , Adult , Female , Middle Aged , Uveal Neoplasms/chemistry , Uveal Neoplasms/diagnosis , Uveal Neoplasms/pathology , Choroid Neoplasms/pathology , Melanoma/pathology , Eye/pathologyABSTRACT
Necrobiotic xanthogranuloma is a rare type of non-Langerhans histiocytosis, whose main clinical features are the development of red-brown, purplish or yellowish skin papules and nodules, which evolve by forming infiltrated plaques. The periorbital region is the most commonly affected site. Some cases have lesions on the torso or extremities, with no facial involvement. Extracutaneous involvement of the ocular, respiratory, and cardiac tissues have also been described. Most patients have an associated monoclonal gammopathy (IgG k and λ). The treatment is difficult, with progression and recurrence. We present the clinical case of a 65-year-old woman, who was hospitalized for multiple erythematous plaques and placards, with fine squames and telangiectasis on the surface, disseminated within the scalp, ears, trunk, lower limbs; some plaques have a circinate border with reddish-purple, slightly protruding edges and a whitish and erosive atrophic center. The lesions within the scalp are alopecic. The disease began 15 years ago, the patient being diagnosed with Psoriasis vulgaris and treated with dermatocorticoids and Cignolin, with no remarkable results. Paraclinical investigations did not reveal any associated pathologies. Histopathological and immunohistochemical examination confirmed the diagnosis of necrobiotic Xanthogranuloma. The patient was treated with antihistamines, Neuromultivit, Vit E 100mg/day, Oximed spray, Atoderm emollient cream, Neopreol ointment, with slow favorable evolution. The physical examination and laboratory investigations for the diagnosis and surveillance of malignant diseases should be performed on a regular basis in patients with NXG. Our patient had lesions with a course of 15 years, with no development of multiple myeloma or other systemic involvement.
ABSTRACT
Keratoacanthoma (KA) is an epithelial tumor of the skin, classically considered as having a malignant transformation risk of 15%; however, many authors and the new World Health Organization (WHO) Classification of skin tumors consider KA as an incipient variant of the cutaneous squamous cell carcinoma (SCC). The aims of the study were to assess the clinical, histopathological (HP) and immunohistochemical (IHC) aspects of the KA and the role of these factors in malignancy occurrence. The studied group comprises 194 patients diagnosed with KA or malignant KA, hospitalized in the Clinic of Dermatology, Emergency County Hospital, Craiova, Romania, between 2006 and 2019. There were 83 males and 111 females, aged 34 to 90 years, 57.21% of the patients being from the rural environment. The histopathology diagnosed 51 KAs and 143 malignant KAs (SCCs). Clinical diagnosis had a limited value in detecting the absence or presence of malignancy in the KA lesion, due to a low accuracy (36.08% and 29.89%, respectively) and specificity (23.07% and 27.02%, respectively); therefore, the HP exam of the surgical excision specimen has a paramount importance in establishing the diagnosis. IHC analysis revealed that the immunostainings for apoptosis-associated proteins and keratinocyte proliferative activity [p53, B-cell lymphoma-2 (Bcl-2), Ki-67 and proliferating cell nuclear antigen (PCNA)] provide some arguments to differentiate between KA and SCC in the studied cases. The correlation of clinical, HP and IHC data lead to an accurate diagnosis of KA; moreover, the clinical, HP and IHC data sustain the idea that KA is a particular form of well-differentiated SCC, which require an active therapeutic attitude.
Subject(s)
Carcinoma, Squamous Cell , Keratoacanthoma , Skin Neoplasms , Cell Proliferation , Female , Humans , Keratoacanthoma/diagnosis , Male , SkinABSTRACT
INTRODUCTION: Sweet syndrome (SS), also denominated as acute febrile neutrophilic dermatosis, is a rare disease characterized by the sudden onset of painful, erythematous, firm skin lesions (papules, plaques, and nodules) which show, upon histologic examination, the presence of a diffuse infiltrate of mature neutrophils. The cutaneous manifestation typically involves the face, neck, trunk, and upper limbs and is associated with fever, general malaise, arthralgia. CASE REPORT: A female patient, 60 years old, attended the Dermatology Clinic due to the appearance of violaceous erythematous-oedematous infiltrated plaques, located on the face, neck, upper limbs, trunk and knees. The onset of the cutaneous manifestation had occurred 2 months prior, accompanied by pain, chills, flares of fever and arthralgia. The onset coincided with the surgical treatment of an umbilical hernia. From the medical history we note that the patient was diagnosed in 2014 with histiocytoid SS. She followed a treatment with methylprednisolone, with positive response, but had many relapses after the discontinuation of treatment. In 2017, due to a new episode, the histopathological examination was repeated, which revealed classical SS. She received treatment with Disulone and Colchicine. She had not been administered any treatment throughout the previous year. Laboratory tests revealed leukocytosis with neutrophils, increased ESR, elevated C4, hyperglycemia. The current histopathological examination revealed lymphocytic SS. Under treatment with methylprednisolone 32mg/day, the evolution was favorable. DISCUSSIONS: The first case of SS was described by Robert Douglas Sweet in 1964. As known aetiological factors there have been described gastrointestinal and urinary tract infections, pregnancy, inflammatory bowel disease, drugs or malignancies. There have been described cases of SS that appeared after surgical treatment, as in our case, which registered a new outbreak following the umbilical hernia treatment. The histopathological variants of SS described in the literature are: subcutaneous, eosinophilic, histiocytoid, lymphocytic type. The first line-therapy consists in systemic corticosteroids, which induce a fast remission of lesions and general symptoms. Recurrence may occur in approximately 50% of patients and is common in idiopathic or paraneoplastic cases. CONCLUSIONS: In addition to the neutrophilic infiltrate that is typical for Sweet syndrome, different types of histological manifestations have been described in the literature: subcutaneous, eosinophilic, histiocytoid, lymphocytic. In our case, we noted that the histological profile changed over time, from a histiocytoid SS recorded in 2014, to a classical SS in 2017, followed by the appearance of lymphocytic SS in 2019. Due to the fact that SS can be associated with a numerous other disorders, our patient requires regular monitoring with a view to eliminate them, and potentially to make a diagnosis and initiate early specific treatment.
ABSTRACT
INTRODUCTION: Amongst all malignant tumors, cancers of the digestive tract rank first in terms of yearly deaths. Patients above 60 years of age are the most affected, as the diagnosis is frequently made in advanced stages of the disease when therapy is less effective. Our study aimed to evaluate the efficiency of narrow-band imaging (NBI) endoscopy and probe-based confocal laser endomicroscopy (pCLE) in the correct diagnosis of preneoplastic lesions in the upper and lower digestive tract. PATIENTS, MATERIALS AND METHODS: We included 46 patients with digestive preneoplastic lesions, who underwent either upper or lower digestive endoscopy, followed by NBI and pCLE. We recorded 5-10 frames per each lesion, from different angles and distances during white-light endoscopy and selected frames from full recordings of NBI and pCLE. Usual preparation was used for the endoscopic procedures; pCLE required in vivo administration of 10% Sodium Fluorescein as a contrast agent. Pathology was performed in case of solid tumors. Three medical professionals with different levels of training, blinded to the results, interpreted the data. RESULTS: The experienced physician correlated very well the NBI findings with pathology (0.93, p=0.05), while the resident physician and the experienced nurse obtain lower, albeit still statistically significant, values (0.73 and 0.62, respectively). For pCLE, the experienced physician obtained near-perfect correlation with pathology (0.96), followed closely by the resident physician (0.93). The nurse obtained a modest correlation (0.42). All examiners obtained approximately equal performances in discerning between malignant and benign lesions. CONCLUSIONS: Digestive endoscopy in NBI mode proved its effectiveness. Even less experienced endoscopists can achieve good results, while an experienced nurse can positively influence the diagnosis. In the case of pCLE, when available, it can greatly reduce diagnostic times, while requiring higher expertise and specialty training.
Subject(s)
Endoscopy , Narrow Band Imaging , Gastrointestinal Tract , Humans , Lasers , Microscopy, ConfocalABSTRACT
Epithelial-mesenchymal transition (EMT) is an important mechanism in tumor progression. Snail is a transcription factor, expressed in cells which have undergone almost complete EMT and have left the tumor, and Twist is considered important in the process of metastasis, both playing a major role in EMT by indirect inhibition of E-cadherin. The study analyzed the immunoexpression of E-cadherin, Snail and Twist in 46 cases of colonic carcinomas in comparison with some histopathological prognostic factors. The quantification of reactions was done by using a composite score (CS) resulted from multiplying the percentage of marked cells with the intensity of immunostaining. The majority of cases were moderately differentiated tumors, corresponded to stage III, with vascular and perineural invasion. All cases presented positive cytoplasmic and nuclear signals for Snail and Twist. The immunostaining for both markers was intense, with the highest values of CS in G2 and G3 advanced, invasive vascular colonic carcinomas, in comparison with G1, early stage lesions. We found positive significant linear correlation of Snail and Twist expression. The results obtained indicate the implication of Snail and Twist in colonic carcinoma aggressiveness, useful aspect in the oncological evaluation of patients and guided therapy.
Subject(s)
Adenocarcinoma/genetics , Biomarkers, Tumor/metabolism , Cadherins/immunology , Colonic Neoplasms/genetics , Snail Family Transcription Factors/immunology , Twist-Related Protein 1/immunology , Adenocarcinoma/pathology , Colonic Neoplasms/pathology , HumansABSTRACT
Metatypical basal cell carcinoma (MTBCC) is a rare form of tumor, which associates the clinical and histopathological (HP) characteristics of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), with a 5% chance for the development of metastases. The reference diagnosis remains the HP confirmation from the lesional tissue. The current report illustrates the case of a 74-year-old patient, diagnosed with MTBCC consequently to the biopsy from the clinically malignant lesion with HP and immunohistochemical examination, currently in clinical remission following surgical treatment. The musculoskeletal symptoms represent the patient's admission reason to the Clinic of Rheumatology, where he was diagnosed with paraneoplastic type I complex regional pain syndrome (CRPS-I). The onset was six weeks prior with intense pain in the upper limb, burning sensation and nondermatomal distribution, exacerbated by lowering the position of the upper limb. The clinical evaluation revealed vasomotor disorders: color changes on the skin of the upper limb, venous turgescence on the back of the hands, and local increased temperature. Also, there were evident sudomotor modifications with hyperspiration and fluffy edema. The presence of clinical manifestations associated with the HP confirmation of MTBCC and the information provided by the imaging tests regarding the evaluation of tumor extension advocates for the diagnosis of paraneoplastic CRPS, consequently to both the primary tumor and the pulmonary metastasis. Diagnosis of CRPS-I is generally established on the basis of clinical criteria after excluding other conditions that may explain the degree of pain and the existing dysfunction. The therapist should be aware of the clinical manifestation of CRPS, as early recognition and aggressive treatment often leads to the best response.
Subject(s)
Carcinoma, Basal Cell/complications , Complex Regional Pain Syndromes/etiology , Aged , Carcinoma, Basal Cell/pathology , Complex Regional Pain Syndromes/pathology , Humans , MaleABSTRACT
Basal cell carcinomas (BCCs) are the most common malignant skin tumors, with variable prognosis and recurrence rates, depending on histopathological subtypes. The study analyzed the immunoexpression of epidermal growth factor receptors (EGFRs) in 53 cases of nodular, adenoid and morpheaform BCCs in relation to clinico-pathological associated parameters. We found significant differences in the expression of EGFR, HER2 and HER3 reported to histological BCC types. The nodular type presented the weakest expression of EGFRs, while the morpheaform type had a high expression of all receptors and the adenoid type an increased expression only in case of EGFR and HER2. This study supports the involvement of EGFR, HER2 and HER3 in BCC aggressiveness of and in tumor differentiating towards different histological subtypes.
Subject(s)
Carcinoma, Basal Cell/enzymology , Receptor, ErbB-2/biosynthesis , Receptor, ErbB-3/biosynthesis , Skin Neoplasms/enzymology , Carcinoma, Basal Cell/genetics , Carcinoma, Basal Cell/pathology , ErbB Receptors/biosynthesis , ErbB Receptors/genetics , Female , Humans , Male , Middle Aged , Receptor, ErbB-2/genetics , Receptor, ErbB-3/genetics , Skin Neoplasms/genetics , Skin Neoplasms/pathologyABSTRACT
This paper presents a very rarely encountered case of a 45-year-old female, admitted in our Surgical Clinic for upper digestive bleeding (repeated hematochezia). The upper endoscopy was negative, but the barium meal discovered an apparently extrinsic duodenal (D3) stenosis; abdominal ultrasound diagnosed a left liver mass suggesting a metastatic tumor. The hematochezia relapse, with hemodynamic instability imposed emergency surgery; on laparotomy, a bleeding tumor located on the duodenopancreatic region was discovered, and a pylorus-preserving pancreaticoduodenectomy (Traverso-Longmire) was performed. The histology and immunohistochemistry established the diagnosis of duodenal stromal tumor, CD34 and CD117 positive, with an estimated progression risk of 34%. The postoperative evolution was favorable, the patient being alive, four years after the surgery.
Subject(s)
Duodenal Neoplasms/complications , Gastrointestinal Stromal Tumors/complications , Pancreaticoduodenectomy/methods , Duodenal Neoplasms/pathology , Female , Gastrointestinal Stromal Tumors/pathology , Humans , Middle Aged , Neoplasm StagingABSTRACT
Enchondroma, the most frequently reported primary tumor in the long bones of the hand, is a common benign cartilaginous tumor, defined more exactly as a benign mature hyaline cartilaginous tumor that is located into the medullar space of the tubular bones. Between 2012 and 2018, we performed an observational study on six patients (two males and four females), aged 16 to 49 years old (mean 29.5 years), who were diagnosed during routine physical examinations with isolated enchondroma in their hand. The tumor was more frequently located in their proximal phalanges (four patients), while two patients had middle phalange tumors. The most common digit involved was the little finger (five patients), followed by the ring finger (one patient). The symptoms, which prompted surgical interventions, were: enlargement without fracture (two patients), pain or limitation of mobility (four patients), pain without pathological fracture (six patients). Studied patients were completely assessed before the treatment program (surgical intervention and rehabilitation program). The measured parameters and scales used were Visual Analogue Scale (VAS), Health Assessment Questionnaire (HAQ) scale for functional status and histological exam. For both VAS and HAQ, we observed a statistically significant difference between the initial and final evaluations, with p=0.03 and p=0.035, respectively. Histological assessment and differential diagnosis are essential for the post-surgical treatment and rehabilitation program.
Subject(s)
Chondroma/rehabilitation , Hand/pathology , Adolescent , Adult , Bone and Bones/diagnostic imaging , Bone and Bones/pathology , Cartilage/diagnostic imaging , Cartilage/pathology , Chondroma/diagnostic imaging , Female , Hand/diagnostic imaging , Humans , Male , Middle Aged , Young AdultABSTRACT
Basal cell carcinoma (BCC) is a variety of cutaneous carcinoma associated with an excellent prognosis because it rarely metastasizes, but it can cause significant local destruction and morbidity if surgical excision is not made. In this study, we examined the immunohistochemical expression of p53 and cyclooxygenase-2 (COX-2) in 51 BCCs, nodular and infiltrative subtypes, with various Clark levels. The immunoexpression of p53 was identified in 74.5% BCC cases and COX-2 reactions in 88.2% of cases. The scores of p53 reactions revealed significant differences depending on Clark level and borderline significance with tumor type, the high positive scores being associated to infiltrative tumors and high Clark level. No differences were revealed between COX-2 scores with both Clark level and tumor type. The analysis of the percentage values of p53 and COX-2 indicated a positive linear correlation. The positivity of p53 and COX-2 in a large proportion of BCCs, regardless of histological type and of depth of invasion, supports the two markers involvement in tumor progression.
Subject(s)
Carcinoma, Basal Cell/metabolism , Carcinoma, Basal Cell/pathology , Cyclooxygenase 2/metabolism , Skin Neoplasms/metabolism , Skin Neoplasms/pathology , Tumor Suppressor Protein p53/metabolism , Humans , Immunohistochemistry , Staining and LabelingABSTRACT
Transcription factors play a central role in the epithelial-mesenchymal transition (EMT), which is one of the biomolecular mechanisms involved in the progression of urothelial carcinomas of the bladder (UCB). In this study, we analyzed the immunoexpression of Twist 1, Snail, Slug and ß-catenin in relation to histopathological prognostic parameters of UCB. The obtained results indicated the association of Snail and ß-catenin expression with low grade and early stage of UCB, as well as the association of Twist 1 and Slug expression with high grade and advanced stage lesions. The specific or sequential action of transcription factors in the bladder tumoral EMT may be useful for identifying the aggressive lesions.
Subject(s)
Transcription Factors/metabolism , Urinary Bladder Neoplasms/immunology , Epithelial-Mesenchymal Transition , Female , Humans , Male , Middle Aged , Prognosis , Urinary Bladder Neoplasms/pathologyABSTRACT
Perinatal autopsy remains the gold-standard procedure used to establish the fetal, neonatal or infant abnormalities. Progressively, perinatal pathology has become a specialized field with important roles of audit for fetal prenatal diagnostic tools, in parents counseling regarding future pregnancies, in scientific research, for epidemiology of congenital abnormalities and teaching. The differences between prenatal ultrasound and autopsy reports represent a strong argument for the autopsy examination following termination of pregnancy. The reasons for such discrepancies are related to the ultrasonographic or pathological examination conditions, the type of the anomalies, the expertise and availability of the operators. Several facts led to an undesirable increase of refusals from parents to consent to a conventional invasive autopsy: the centralization of pathology services, the poor counseling provided by non-experts in fetal medicine and the clinicians' over-appreciation of the importance of the ultrasound diagnostic investigation. Although non-invasive alternatives have been tested with promising results, conventional autopsy remains the gold standard technique for the prenatal diagnosis audit. We report and analyze several cases of prenatally diagnosed malformed fetuses with different particularities that underline the necessity of perinatal autopsy. We discuss the antenatal findings and management and post-mortem autopsies in the respective pregnancies.
Subject(s)
Autopsy/methods , Congenital Abnormalities/diagnostic imaging , Fetus/abnormalities , Ultrasonography, Prenatal/methods , Female , Humans , Pregnancy , Prenatal DiagnosisABSTRACT
Stroke is one of the most important cause of death and disability, especially when considering the increasing life expectancy worldwide, with ischemic stroke being much more common than hemorrhages. In the physiopathological chain of ischemic stroke, brain edema is one first element that if attended to might reduce tissue necrosis, penumbra, and increase functional recovery. Aquaporin 4 (AQP4) has been found to be the most important water channel in the brain, and its inhibition before inducing focal ischemia in an animal model of stroke proved to alleviate the pathology and improve clinical recovery. In this study, we have treated a rat model of ischemic stroke with the AQP4 inhibitor TGN-020 after inducing the lesion, and performed for the first time a direct histopathological evaluation of the brain and infarct's volume. Besides utilizing immunohistochemistry targeting the growth-associated protein-43 (GAP-43) in order to delineate the infarct regions, we have used the Cavalieri's principle of tissue volume measurements starting form seriate sections, and for the first time in neuropathology, we have utilized a high-resolution object scanner to assess global brain volume changes. Our results showed that TGN-020 clearly reduces infarct volume in TGN-020 treated animals compared to untreated animals, as well as the volume of the brain hemispheres. Although reduced, the effect was also present in the contralateral hemisphere. Given these data, a more in-depth characterization of the histopathological and molecular changes induced by AQP-4 are needed for considering it as a bona fide treatment option.
Subject(s)
Aquaporin 4/antagonists & inhibitors , Brain Edema/etiology , Stroke/complications , Animals , Brain Edema/diagnostic imaging , Brain Edema/pathology , Disease Models, Animal , Immunohistochemistry , Male , Rats , Rats, Sprague-DawleyABSTRACT
Squamous cell carcinoma (SCC) of the lip represents 15-30% of SCC of cephalic extremity, located on the lower lip in about 90% of cases. The present paper aimed to define the profile of SCC of the lip with major risk factors. The study included 20 selected cases diagnosed with lower lip SCC, using a panel of antibodies which addressed cell proliferation (Ki67), perturbation of the cell cycle (p53), angiogenesis (VEGF - vascular endothelial growth factor), factors related to tumor cell interaction with the extracellular matrix (CD44). Ki67 immunoexpression was identified in all the cases. Poorly differentiated (PD) SCC presented a mean value of Ki67 positivity index (PI) significantly higher compared to well-differentiated (WD) and moderately differentiated (MD) SCC. We found significantly higher mean values of Ki67 PI in pT3 lesion, compared with pT2 and pT lesions, and with no statistically significant differences in lip SCC with associated lymph node metastasis (pN1), compared to those with no lymph node metastasis (pN0). PD SCC presented a higher mean value of p53 PI compared to WD and MD SCC, but without significant differences. Analysis indicated significantly higher values in pT3 lesions and in pT2 and pT1 and in pN1 SCC. In WD SCC, CD44 immunoexpression had a higher intensity. For PD and MD SCC the immunolabelings presented low÷moderate heterogeneous intensity. WD lip SCC presented a statistically significant higher mean value for CD44 PI compared to MD and PD SCC, and not statistically significant higher in pT1, pT2 then in pT3 and in pN0 cases then in pN1. WD lip SCC presented statistically significant higher mean value of VEGF PI related to those with MD and PD SCC. VEGF PI values were higher in pT1, pT2 then in pT3 and in the pN0 SCC, but without statistically significant differences. We found a positive linear correlation for Ki67÷p53, although statistically not significant and for CD44÷VEGF statistically significant (p=0.001). Also, the analysis identified negative a linear statistically significant correlation for Ki67÷CD44 and for Ki67÷VEGF statistically significant as well (p=0.001). Immunohistochemical investigations in lip SCC, regarding the expression of p53, Ki67, CD44 and VEGF, revealed results that suggest their ability to assess the prognosis and progression of tumor evolution.
Subject(s)
Carcinoma, Squamous Cell/mortality , Lip Neoplasms/mortality , Carcinoma, Squamous Cell/pathology , Female , Humans , Immunohistochemistry , Lip Neoplasms/pathology , Male , Prognosis , Survival AnalysisABSTRACT
AIM: To study the morphology of the enteric nervous system and the expression of beta-2 adrenergic (B2A) receptors in primary colorectal cancer. METHODS: In this study, we included forty-eight patients with primary colorectal cancer and nine patients for control tissue from the excision of a colonic segment for benign conditions. We determined the clinicopathological features and evaluated the immunohistochemical expression pattern of B2A receptors as well as the morphological changes of the enteric nervous system (ENS). In order to assess statistical differences, we used the student t-test for comparing the means of two groups and one-way analysis of variance with Bonferroni's post hoc analysis for comparing the means of more than two groups. Correlations were assessed using the Pearson's correlation coefficient. RESULTS: B2A receptors were significantly associated with tumor grading, tumor size, tumor invasion, lymph node metastasis (P < 0.05), while there were no statistically significant associations with gender, CRC location and gross appearance (P > 0.05). We observed, on one hand, a decrease of the relative area for both Auerbach and Meissner plexuses with the increase of the tumor grading, and on the other hand, an increase of the relative area of other nervous elements not in the Meissner plexus or in the Auerbach plexus with the tumor grading. For G1 tumors we found that epithelial B2A area showed an inverse correlation with the Auerbach plexus areas [r(14) = -0.531, P < 0.05], while for G2 tumors, epithelial B2A areas showed an indirect variation with both the Auerbach plexus areas [r(14) = -0.453, P < 0.05] and the Meissner areas [r(14) = -0.825, P < 0.01]. For G3 tumors, the inverse dependence increased for both Auerbach [r(14) = -0.587, P < 0.05] and Meissner [r(14) = -0.934, P < 0.05] plexuses. CONCLUSION: B2A receptors play an important role in colorectal carcinogenesis and can be utilized as prognostic factors. Furthermore, study of the ENS in colorectal cancer may lead to targeted molecular therapies.
Subject(s)
Adenocarcinoma/metabolism , Colorectal Neoplasms/metabolism , Enteric Nervous System/pathology , Gene Expression Regulation, Neoplastic , Receptors, Adrenergic, beta-2/metabolism , Aged , Case-Control Studies , Female , Gene Expression Profiling , Humans , Lymphatic Metastasis , Male , Middle Aged , Myenteric Plexus/metabolism , Neoplasm Grading , PrognosisABSTRACT
UNLABELLED: G-protein coupled estrogen receptor 1 (GPER), a particular extranuclear estrogen receptor (ER), seems not to be significantly involved in normal female phenotype development but especially associated with severe genital malignancies. This study investigated the GPER expression in different types of normal and abnormal proliferative endometrium, and the correlation with the presence of ERα. GPER was much highly expressed in cytoplasm (than onto cell membrane), contrary to ERα, which was almost exclusively located in the nucleus. Both ERs' densities were higher in columnar epithelial then in stromal cells, according with higher estrogen-sensitivity of epithelial cells. GPER and ERα density decreased as follows: complex endometrial hyperplasia (CEH) > simple endometrial hyperplasia (SHE) > normal proliferative endometrium (NPE) > atypical endometrial hyperplasia (AEH), ERα' density being constantly higher. In endometrial adenocarcinomas, both ERs were significant lower expressed, and widely varied, but GPER÷ERα ratio was significantly increased in high-grade lesions. CONCLUSIONS: The nuclear ERα is responsible for the genomic (the most important) mechanism of action of estrogens, involved in cell growth and multiplication. In normal and benign proliferations, ERα expression is increased as an evidence of its effects on cells with conserved architecture, in atypical and especially in malignant cells ERα's (and GPER's) density being much lower. Cytoplasmic GPER probably interfere with different tyrosine÷protein kinases signaling pathways, also involved in cell growth and proliferation. In benign endometrial lesions, GPER's presence is, at least partially, the result of an inductor effect of ERα on GPER gene transcription. In high-grade lesions, GPER÷ERα ratio was increased, demonstrating that GPER is involved per se in malignant endometrial proliferations.
Subject(s)
Endometrium/metabolism , Endometrium/pathology , Estrogen Receptor alpha/metabolism , Receptors, Estrogen/metabolism , Receptors, G-Protein-Coupled/metabolism , Cell Proliferation , Female , Humans , Immunohistochemistry , Stromal Cells/metabolism , Stromal Cells/pathologyABSTRACT
Hemangiomas are between the most frequent soft tissue masses and despite the vascular origin, they do not generate metastases and do not have malignant evolution. They are frequent in childhood and female sex is more frequently affected. If deeply located, these tumors are difficult to diagnose and thus an imaging method is often needed, but conventional radiology is not sufficient. If superficially located, it frequently involves the skin and subcutaneous tissues, but in the deeper layer, they are often intramuscular. Clinical findings of intramuscular hemangioma include swelling, pain and sometimes loss of muscle function.
Subject(s)
Endothelial Cells/pathology , Hemangioma/diagnostic imaging , Hemangioma/pathology , Muscle Neoplasms/diagnostic imaging , Muscle Neoplasms/pathology , Platelet Endothelial Cell Adhesion Molecule-1/metabolism , Endothelial Cells/metabolism , Female , Hemangioma/metabolism , Humans , UltrasonographyABSTRACT
Hand tendons lesions represent a challenge for an accurate diagnosis, an optimal treatment strategy, the description of the lesion and its location being an important step. The non-invasive ultrasound evaluation was demonstrated to be an important diagnostic method in these types of lesions, especially in those situations where clinical evaluation failed to reveal the pathological changes and therefore has an important role in the adequate management.