Malignant gastrointestinal stromal tumor in association with Russell body gastritis-A case report.

Russell body gastritis (RBG) is an unusual form of chronic inflammation characterized by accumulation of plasma cells containing Russell bodies (RB) in the gastric mucosa. Although its pathogenesis has not been fully evaluated, there is evidence to support a strong association with Helicobacter pylori infection. Only four cases of RBG in association with malignant epithelial gastric tumors were reported. We report the first case of RBG in peritumoral mucosa of a malignant gastrointestinal stromal tumor in association with coccoid form of Helicobacter pylori and a follow-up.

Eosinophilic metaplasia in transurethral resection of the prostate.

BACKGROUND: To investigate prostatic eosinophilic metaplasia (EM) in a large series of cases and their relationship with the basic prostate pathology in TURP-material: benign prostatic hyperplasia (BPH), National Institutes of Health category IV prostatitis (also called histologic prostatitis or HP), and prostatic adenocarcinoma (PCa). AIM: The relation between EM and basic prostate pathology: BPH, PCa, and HP. MATERIALS AND METHODS: Around 61 consecutive TURP-specimens were reviewed for the presence of EM. The tissue sections were stained routinely with hematoxylin-eosin (HE), hematoxylin-phloxine-saffron (HPS), and periodic acid-Schiff's procedure. Simultaneously BPH, HP, and PCa were evaluated. RESULTS: We found EM in 55.7% of TURP-specimens. EM is located more often in the ductal epithelium (58.8%) and is usually focal (73.5%) and in small groups (88.2%) of secretory luminal cells. They are associated with BPH and with a variable degree of HP in all cases. However, there is no association with PCa. Eosinophilic cytoplasmic granules in EM are better visualized with HPS. Zones induced by tissue electrocoagulation which mimic EM, are seen in the periphery of TURP-fragments. CONCLUSION: EM in prostate is presented by the presence of eosinophilic cytoplasmic granules in benign secretory epithelium. The study presents the first attempt to investigate EM in a large series of patients. Our results enrich the available information about the histoepidemiology of prostatic EM. Moreover, EM is more common in a focal lesion, found in small groups of ductal secretory epithelial cells while EM in TURP-specimens is associated with BPH and HP in all the cases.

Histopathology of nonspecific granulomatous prostatitis with special reference to eosinophilic epithelial metaplasia: Pathophysiologic, diagnostic and differential diagnostic correlations.

BACKGROUND: Recently, we publish two case reports about association of nonspecific granulomatous prostatitis (NSGP) and eosinophilic metaplasia (EM) in benign prostatic epithelium. There is no investigation of large series of this association in medical literature. Aim of the current study is to investigate the frequency of association of NSGP and prostatic EM in a large series of cases and their relationship with the basic prostate pathology: benign prostatic hyperplasia (BPH), National Institutes of Health-category IV prostatitis (so-called histologic prostatitis (HP)), and prostatic adenocarcinoma (PCa). MATERIALS AND METHODS: A retrospective record review for NSGP was performed on a total of 2366 prostatic specimens of all types of material. All cases of NSGP were reviewed for the presence of EM, BPH, and HP. NSGP with EM-cases and control cases with high grade PCa with endocrine differentiation (so-called Paneth cell-like changes) were evaluated immunohistochemically. RESULTS: NSGP was found in nine cases (0.38%). EM was detected in benign perigranulomatous secretory epithelial cells in 100% of cases with NSGP and were closely associated with BPH and HP. Immunohistochemically, in 55.5% of cases with EM, there was weak focal apical false-positive staining for p504s. CONCLUSION: EM is a very common lesion in NSGP and reflects histologically a nonspecific cellular response, connected with repeated inflammation, in close relation with BPH and HP. We speculate that EM might serve as a morphological precursor of the immunologic phase of NSGP. This constant morphological finding could facilitate the histopathological differential diagnosis of NSGP with other types of granulomatous prostatitis and high grade PCa with or without endocrine differentiation.

Nonspecific granulomatous prostatitis in association with eosinophilic epithelial metaplasia and prostatic adenocarcinoma.

We present the first case of nonspecific granulomatous prostatitis (NSGP) associated with both eosinophilic epithelial metaplasia (EM) in benign glands and prostatic adenocarcinoma (PCa). The patient was a 68-year old man with a history of obstructive prostatic syndrome. After a transurethral resection of the prostate, the histologic analysis revealed NSGP and PCa. EM was seen in benign peri-granulomatous secretory epithelial cells as PAS Diastase positive granular eosinophilic transformation of the apical cell cytoplasm. This unusual cell appearance closely simulated the Paneth cell-like changes found in PCa. Negative chromogranin expression and weakly positive P504S immune staining in the foci of EM, surrounded by P63 positive basal cells confirmed the benign EM - phenotype. The combination of NSGP with both EM and PCa has not been reported in medical literature so far. Some observations concerning their differential diagnosis are suggested.

LAMPs and ABH histo-blood group antigens in granulation tissue.

Endothelial cells are major participants in angiogenic processes accompanying wound repair. The functions of ABH histo-blood group antigens (HBGAs) and lysosome-associated membrane proteins LAMP-1 and LAMP-2 in endothelial cells of granulation tissue are currently unkown. Here we hypothesize that HBGAs and LAMPs enrich the phenotypic characteristics of endothelial cells and might be implicated in the plasticity of granulation tissue. Immunohistochemistry revealed permanent expression of HBGAs in the cytoplasm of endothelial cells of all sprouting capillaries regardless of the organ examined. A modulation in both the localization and the intensity of the signal for LAMPs was observed. Interestingly, LAMP-1 showed a more intensive staining compared to LAMP-2. LAMP-1 was found in the cytoplasm, as well as on plasma membranes of endothelial cells. We present the first comparative immunohistochemical study of the expression of HBGA and LAMPs in endothelial cells of granulation tissue. Novel evidence for modulating LAMP reactivity is reported. Our results suggest that both glycoconjugates might contribute to the process of neoangiogenesis and tissue remodeling in wound healing.

Hyaline globules (thanatosomes) in gastrointestinal epithelium: pathophysiologic correlations.

Hyaline globules (HGs; thanatosomes) are well-defined morphologic and functional entities representing a degenerative phenomenon common to all cell types. We present the first quantitative and qualitative study of HGs in normal and pathologic gastrointestinal (GI) epithelium from a series of 2,230 biopsies. HGs were very rarely found in normal epithelium (1.1%), but their number increased significantly in specimens with ischemic injury (47%) and benign regenerative proliferation (70%). Their incidence in adenomatous polyps and adenocarcinomas was about 11% to 27%. Of the HGs, 2.9% contained nuclear fragments. Our results entirely support the unifying morphogenetic concept for HGs. The role of 2 obligatory morphogenetic factors for the generation of thanatosomes (propensity to apoptosis and heterophagy/autophagy) is confirmed. The nature of the third factor, ischemic conditions, is specified. Although a nonspecific microscopic phenomenon, HGs in the GI tract represented a relatively constant and useful histologic marker of enhanced cell turnover and ischemic injury.