ABSTRACT
Nevus sebaceus (NS)(organoid nevus) is a benign follicular neoplasm that commonly occurs on the scalp, face, or neck. With time, it may give rise to benign or malignant tumors such as trichoblastoma, syringocystadenoma papilliferum, and basal cell carcinoma (BCC). Rarely, other types of neoplasms may develop. We present a 76-year-old woman with several trichoblastomas as well as a primary cutaneous apocrine carcinoma arising within a preexisting NS that was treated with frozen section excision.
Subject(s)
Adenocarcinoma/diagnosis , Head and Neck Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Sebaceous Gland Neoplasms/diagnosis , Sweat Gland Neoplasms/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Diagnosis, Differential , Female , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgery , Scalp , Sebaceous Gland Diseases , Sebaceous Gland Neoplasms/pathology , Sebaceous Gland Neoplasms/surgery , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/surgeryABSTRACT
Early HPV infection in males is difficult to detect clinically and pathologically. This study assessed histopathology in diagnosing male genital HPV. External genital lesions (n = 352) were biopsied, diagnosed by a dermatopathologist, and HPV genotyped. A subset (n = 167) was diagnosed independently by a second dermatopathologist and also re-evaluated in detail, tabulating the presence of a set of histopathologic characteristics related to HPV infection. Cases that received discrepant diagnoses or HPV-related diagnoses were evaluated by a third dermatopathologist (n = 163). Across dermatopathologists, three-way concordance was fair (k = 0.30). Pairwise concordance for condyloma was fair to good (k = 0.30-0.67) and poor to moderate for penile intraepithelial neoplasia (k = -0.05 to 0.42). Diagnoses were 44-47% sensitive and 65-72% specific for HPV 6/11-containing lesions, and 20-37% sensitive and 98-99% specific for HPV 16/18. Presence of HPV 6/11 was 75-79% sensitive and 35% specific for predicting pathologic diagnosis of condyloma. For diagnosis of penile intraepithelial neoplasia, HPV 16/18 was 95-96% specific but only 40-64% sensitive. Rounded papillomatosis, hypergranulosis, and dilated vessels were significantly (P < 0.05) associated with HPV 6/11. Dysplasia was significantly (P = 0.001) associated with HPV 16/18. Dermatopathologists' diagnoses of early male genital HPV-related lesions appear discordant with low sensitivity, while genotyping may overestimate clinically significant HPV-related disease. Rounded papillomatosis, hypergranulosis, and dilated vessels may help establish diagnosis of early condyloma.
Subject(s)
Genital Diseases, Male/diagnosis , Genital Diseases, Male/pathology , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Papillomavirus Infections/pathology , Penile Neoplasms/diagnosis , Penile Neoplasms/virology , Adult , Biopsy , Carcinoma in Situ/diagnosis , Carcinoma in Situ/pathology , Carcinoma in Situ/virology , Condylomata Acuminata/diagnosis , Condylomata Acuminata/pathology , Condylomata Acuminata/virology , Genotype , Human papillomavirus 11/genetics , Human papillomavirus 11/isolation & purification , Human papillomavirus 11/pathogenicity , Human papillomavirus 16/genetics , Human papillomavirus 16/isolation & purification , Human papillomavirus 16/pathogenicity , Humans , Male , Papillomaviridae/genetics , Papillomaviridae/pathogenicity , Papillomavirus Infections/virology , Penis/pathology , Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
The growth and survival of cancer cells are often driven by constitutive activity in the mitogen-activated protein kinase (MAPK) and phospho-inositide 3-kinase (PI3K)/AKT signaling pathways. Activity in these signal transduction cascades is known to contribute to the uncontrolled growth and resistance to apoptosis that characterizes tumor progression. There is now a great deal of interest in therapeutically targeting these pathways in cancer using small molecule inhibitors. In this chapter, we describe methods to measure constitutive MAPK and AKT activity in melanoma cell lines, with a focus upon Western blotting, phospho-flow cytometry, and immunofluorescence staining techniques.
Subject(s)
Enzyme Assays/methods , Mitogen-Activated Protein Kinases/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Cell Line, Tumor , Humans , Signal Transduction/genetics , Signal Transduction/physiologyABSTRACT
Chronic edema of the lips is rare but disabling. We present 3 illustrative cases of chronic edema involving the lips. The causes were (1) idiopathic, (2) lymphedema occurring after radiation therapy, and (3) cheilitis granulomatosa. The edema subsided with compression therapy in the first 2 patients. Surgical decompression was helpful in the second patient, and dapsone therapy was initiated in the third. Chronic edema of the lips can be a clinically significant problem. These 3 cases illustrate the various causes and an approach to the management of chronic edema of the lips.