RESUMEN
The authors--with expertise in dermatology and pathology--provide pointers that can help you improve your approach to skin biopsy.
Asunto(s)
Biopsia , Errores Diagnósticos/prevención & control , Complicaciones Posoperatorias/prevención & control , Enfermedades de la Piel/patología , Piel/patología , Biopsia/clasificación , Biopsia/métodos , Biopsia/normas , Disección/efectos adversos , Disección/métodos , Disección/normas , Humanos , Enfermedades de la Piel/cirugía , Manejo de Especímenes/métodos , Manejo de Especímenes/normasRESUMEN
Necrobiotic xanthogranuloma (NXG) is an uncommon granulomatous disorder of unknown pathogenesis that often presents with yellowish plaques in a periorbital distribution. While a majority of cases are associated with an underlying paraproteinemia of the IgG kappa type, a much smaller number are found to be associated with an underlying multiple myeloma. We present a case of a 78-year-old male with an isolated lesion of NXG on his right upper extremity. Following his diagnosis of NXG, further investigation for underlying systemic disorders with serum immunofixation revealed a monoclonal IgG kappa immunoglobulin with an M-spike of 1.2 g/dL. A PET-CT demonstrated bone destruction in the left proximal fifth rib, left scapula, the anterior lumbar I (L1) vertebrae, the left lumbar III (L3) vertebrae posterior elements and possibly left sacrum. A bone marrow biopsy revealed 18 % plasma cells. With these findings he was diagnosed with stage I multiple myeloma. Though clinically unimpressive and atypical in location for NXG, early biopsy and diagnosis of this solitary lesion led to the discovery of his hematopoietic disorder.
Asunto(s)
Inmunoglobulina G/inmunología , Mieloma Múltiple/diagnóstico , Xantogranuloma Necrobiótico/etiología , Anciano , Biopsia , Humanos , Cadenas kappa de Inmunoglobulina/inmunología , Masculino , Mieloma Múltiple/complicaciones , Mieloma Múltiple/patología , Xantogranuloma Necrobiótico/diagnóstico , Xantogranuloma Necrobiótico/patología , Estadificación de Neoplasias , Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Extremidad SuperiorRESUMEN
During animal development, adherens junctions (AJs) maintain epithelial cell adhesion and coordinate changes in cell shape by linking the actin cytoskeletons of adjacent cells. Identifying AJ regulators and their mechanisms of action are key to understanding the cellular basis of morphogenesis. Previous studies linked both p120catenin and the small GTPase Rho to AJ regulation and revealed that p120 may negatively regulate Rho. Here we examine the roles of these candidate AJ regulators during Drosophila development. We found that although p120 is not essential for development, it contributes to morphogenesis efficiency, clarifying its role as a redundant AJ regulator. Rho has a dynamic localization pattern throughout ovarian and embryonic development. It preferentially accumulates basally or basolaterally in several tissues, but does not preferentially accumulate in AJs. Further, Rho1 localization is not obviously altered by loss of p120 or by reduction of core AJ proteins. Genetic and cell biological tests suggest that p120 is not a major dose-sensitive regulator of Rho1. However, Rho1 itself appears to be a regulator of AJs. Loss of Rho1 results in ectopic accumulation of cytoplasmic DE-cadherin, but ectopic cadherin does not accumulate with its partner Armadillo. These data suggest Rho1 regulates AJs during morphogenesis, but this regulation is p120 independent.
