High frequency of human papillomavirus 6/11, 16, and 18 infections in precancerous lesions and squamous cell carcinoma of the conjunctiva in subtropical Tanzania.

Dysplastic lesions and epithelial neoplasms of the conjunctiva account for approximately 2% of all malignant tumors in subtropical Tanzania. We examined the pathophysiologic role of human papillomavirus (HPV) in the development of conjunctival carcinoma in subtropical Tanzania, which has a high HPV prevalence. Tissue samples from 14 patients were obtained from the cancer registry archives at the medical center of the university in Dar es Salaam, Tanzania. A highly sensitive nonradioactive in situ hybridization technique (ImmunoMax) was applied to paraffin-embedded tissue samples to identify HPV DNA in conjunctival epithelial dysplasia and epithelial neoplasms. In each case, conventional morphologic evaluation revealed a transitional lesion extending from koilocytic dysplasia to severe dysplasia or invasive squamous cell carcinoma. Highly specific, morphologically easily distinguishable labeling of HPV-6/11, HPV-16, and HPV-18 was found in most cases. Coinfections were observed frequently. The signals showed varying intensities and different patterns of distribution. In general, higher signal intensity was found in dysplasia grades 1 and 2 and in well-differentiated areas of the invasive component of conjunctival carcinoma compared with less differentiated areas. This observation underlines the central role of HPV-16 and HPV-18 in the oncogenesis of conjunctival cancers in subtropical Tanzania.

Immunolocalization of angiopoietin 1 in human peritoneal endometriotic lesions.

OBJECTIVE: To analyze the expression of angiopoietin 1 (ANGPT1) in pigmented and nonpigmented endometriosis implants and specify its role in the interaction of angiogenic factors. DESIGN: Experimental retrospective study. SETTING: University hospital. PATIENT(S): Eighty-two sections from 201 laparoscopic tissue samples of 43 female patients. INTERVENTION(S): Biopsies of peritoneal endometriotic lesions of macroscopically different forms. MAIN OUTCOME MEASURE(S): Angiopoietin 1 expression and location pattern in endothelial cells, periendothelial cells, glandular epithelium, and stromal structures. RESULT(S): Angiopoietin 1 is immunohistochemically detectable in endothelial cells, periendothelial cells, in the glandular epithelium, and in the stroma. Differences in the expression of pigmented and nonpigmented lesions are not statistically significant. CONCLUSION(S): Pigmented and nonpigmented endometriotic lesions differ according to their clinical activity and angiogenic potential. Angiopoietin 1 is an important representative of the angiogenic factors and is involved in the angiogenic processes of these lesions. There were no significant differences in the expression and location within different lesion types for ANGPT1. Thus, it is not a direct activity marker of a lesion.

Carcinoma in situ in a lateral cervical cyst.

BACKGROUND: The development of an invasive squamous cell carcinoma within a lateral cervical cyst as a result of malignant transformation of the epithelium is considered a rare circumstance. The existence of this entity is a source of controversy in light of the differential diagnosis, which includes a cervical metastasis from an unknown primary carcinoma (CUP-syndrome). Apart from site, histologic findings, and follow-up, the principal diagnostic criterion for lateral cervical cyst carcinoma is the histomorphologic demonstration of transition of the benign epithelium into invasive squamous cell carcinoma. Although numerous case reports of this entity exist, carcinoma in situ in a lateral cervical cyst has been reported in only five cases thus far. METHOD: In this context, we present the case of a 44-year-old patient with a 7-month history of cervical swelling. RESULTS: After diagnostic extirpation of the tumor, histologic findings were consistent with a lateral branchial cyst with high-grade dysplasia and carcinoma in situ of the squamous epithelial lining. CONCLUSION: This case of a premalignant lesion within a lateral branchial cyst (ie, carcinoma in situ) supplies the "missing link" and adds credibility to the concept of primary branchiogenic carcinoma.