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2.
Medicina (B Aires) ; 82(1): 154-158, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35037876

RESUMO

Diffuse idiopathic hyperplasia of neuroendocrine cells is an extremely rare condition. It is a widespread proliferation of neuroendocrine cells, without primary process justifying it. Usually symptomatic in most cases, asymptomatic forms are also described. We describe three cases, 2 women and 1 man, average age 63 years (range 57-71) who presented with bilateral pulmonary nodules. Average follow-up: one year and three months (range 1 month-3 years). The two women had cough, progressive dyspnea and airflow obstruction in the spirometry, and were treated for asthma and chronic obstructive pulmonary disease, respectively, with little relief of symptoms. The remaining patient consulted for diagnosis of pulmonary nodules of unknown cause and a suspicion of metastatic disease. The biopsies diagnostic were: in the first and third case diffuse idiopathic hyperplasia of euroendocrine cells - tumorlets; and in the second case typical carcinoid tumor and diffuse idiopathic hyperplasia of neuroendocrine cells. The first patient controlled the symptoms with maximum bronchodilator therapy. The second patient presented immediate postoperative severe bronchospasm and respiratory failure which required ventilatory assistance, atrial fibrillation with rapid ventricular response (both signs interpreted as paraneoplastic syndromes) which responded favorably to the empirical octeotride management. The third patient is asymptomatic and in control. The diffuse neuroendocrine cell hyperplasia represents a diagnostic challenge because of the rarity of this condition. Lung biopsy in patients with multiple, bilateral pulmonary nodules and clinical history of cough and progressive dyspnea should be considered to confirm this entity.


La hiperplasia difusa idiopática de células neuroendocrinas es una entidad extremadamente infrecuente caracterizada por una proliferación generalizada de células neuroendocrinas, sin proceso primario que lo justifique, generalmente, aunque también están descriptas formas asintomáticas. Se describen los casos de dos mujeres y un hombre, edad promedio 63 años (rango 57-71) que consultaron por presentar nodulillos pulmonares bilaterales. Promedio de seguimiento: 1 año, 3 meses (rango 1 mes-3 años). Las dos mujeres presentaban tos, disnea progresiva y obstrucción al flujo aéreo en el estudio espirométrico, fueron tratadas por asma y enfermedad pulmonar obstructiva crónica respectivamente con poco alivio de los síntomas. El tercer paciente, varón, consultó por hallazgo incidental en una tomografía de tórax, de nódulos pulmonares, con razonable sospecha de enfermedad metastásica de origen desconocido. En sendas biopsias se diagnosticaron: en el primer y tercer caso hiperplasia neuroendócrina difusa idiopática-tumorlets; y en el segundo caso tumor carcinoide típico e hiperplasia neuroendocrina difusa idiopática. En el primer caso los síntomas se controlaron con tratamiento broncodilatador máximo. La segunda paciente tuvo en el postoperatorio, insuficiencia respiratoria que requirió asistencia respiratoria mecánica y fibrilación auricular con alta respuesta ventricular, interpretados ambos signos como síndromes paraneoplásicos, que respondieron favorablemente a la administración empírica de octeotride. El tercer paciente se halla asintomático y en control. La hiperplasia difusa de células neuroendócrinas representa un desafío diagnóstico. La biopsia pulmonar en pacientes con nodulillos pulmonares múltiples, bilaterales e historia clínica de tos y disnea progresiva debe ser considerada para confirmar esta entidad.


Assuntos
Tumor Carcinoide , Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Células Neuroendócrinas , Tumores Neuroendócrinos , Idoso , Tumor Carcinoide/patologia , Feminino , Humanos , Hiperplasia/patologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/patologia , Células Neuroendócrinas/patologia , Tumores Neuroendócrinos/patologia
3.
Anticancer Res ; 42(1): 609-617, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34969770

RESUMO

BACKGROUND/AIM: We generated a novel disease mouse model in which a fructose-containing western diet (FD) induces development of non-alcoholic steatohepatitis (NASH). MATERIALS AND METHODS: C57BL/6J mice were fed FD for 60 weeks and body weight and blood pressure were monitored. Plasma cholesterol level was measured at the end of the experiments. Histopathology of NASH was examined by hematoxylin and eosin staining, Masson-Trichrome staining, periodic acid-Schiff staining, and immunohistochemistry against a proliferation marker. Circadian gene expression levels were compared by sampling the livers in 4-h intervals, followed by quantitative RT-PCR analysis. RESULTS: FD-fed mice developed obesity, transient hypertension, hypercholesterolemia, and liver adiposity. The mice spontaneously developed hepatic nodules, which were diagnosed as non-neoplastic nodular regenerative hyperplasia. FD-fed mice had increased expression of growth factor genes and cirrhosis markers compared to control mice. Circadian expression of lipid metabolism genes was deregulated by FD intake. CONCLUSION: C57BL/6J mice fed FD developed non-alcoholic steatohepatitis and nodular regenerative hyperplasia over time.


Assuntos
Hiperplasia/genética , Metabolismo dos Lipídeos/genética , Hepatopatia Gordurosa não Alcoólica/genética , Obesidade/genética , Animais , Colesterol/sangue , Dieta Ocidental/efeitos adversos , Modelos Animais de Doenças , Frutose/efeitos adversos , Frutose/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Hiperplasia/etiologia , Hiperplasia/metabolismo , Hiperplasia/patologia , Fígado/metabolismo , Fígado/patologia , Camundongos , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/patologia , Obesidade/etiologia , Obesidade/metabolismo , Obesidade/patologia
5.
Croat Med J ; 62(5): 523-527, 2021 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-34730894

RESUMO

We report on a 34-year-old woman diagnosed with tuberous sclerosis complex. The patient was admitted for respiratory manifestations, while multi-organ involvement made the diagnostic process challenging. Genetic testing revealed a novel mutation TSC1 c.2094_2110del (p.His699Ter), which expands the disease-causing variant spectrum. Our results may facilitate the disease diagnostics and help to devise genetic counseling and targeted gene therapy.


Assuntos
Células Epiteliais Alveolares , Esclerose Tuberosa , Adulto , Células Epiteliais Alveolares/patologia , Feminino , Humanos , Hiperplasia/genética , Hiperplasia/patologia , Mutação , Esclerose Tuberosa/diagnóstico , Esclerose Tuberosa/genética
6.
Pathologica ; 113(5): 354-359, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34837093

RESUMO

Atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) and flat epithelial atypia (FEA) are common lesions mainly detected during mammographic screening. They are considered lesions at risk for the development of breast cancer, and they have been documented as non-obligate precursors of low grade in situ carcinomas. In a monumental work in 1991 Rosai gathered them as "borderline epithelial lesions", and he described and demonstrated the subjectivity in their microscopic interpretation. Such subjectivity persists nowadays and limits considerably the diagnostic consistency. With his incredible ability to see, analyze and rationalize, Rosai introduced the concept of "mammary intraepithelial neoplasia (MIN) of either ductal or lobular type, followed by a grading system" which would have better represented the biological continuum between these lesions and benign and malignant lesions.


Assuntos
Neoplasias da Mama , Carcinoma in Situ , Carcinoma Intraductal não Infiltrante , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma in Situ/diagnóstico por imagem , Carcinoma in Situ/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Hiperplasia/patologia
7.
Medicine (Baltimore) ; 100(42): e27574, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34678900

RESUMO

INTRODUCTION: Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is an uncommon cause of ischemic bowel disease resulting from the proliferation of smooth muscles in the venous intima. Delayed diagnosis could only be made following the surgical resection due to lack of imaging data, which may lead to bowel severe bleeding, perforation, necrosis, infection, or shock. In previous reports, few cases have provided the detailed pre-operative radiological characteristics of IMHMV. Herein, we are the first to provide the complete clinical course and comprehensive pre-operative radiological data of a 21-year-old female diagnosed with IMHMV. PATIENT CONCERNS: A 21-year-old female was admitted to our hospital with bloody diarrhea and abdominal pain. Physical examination revealed tenderness localized to the left lower abdomen. The patient had no prior history of similar symptoms. A computed tomography scan was performed and showed diffuse wall thickening from the rectum to sigmoid colon with poor mural enhancement, multiple ulcers, fat stranding, and free fluid. The arterial phase images demonstrated many tortuous pericolic arteries and submucosal pseudoaneurysm. INTERVENTION: Conservative treatment including empirical antibiotics, Mesalazine, and methylprednisolone sodium succinate were administrated to relief the symptoms. However, the diarrhea and abdominal pain worsened. An emergency surgery was arranged and total proctocolectomy with ileal pouchanal anastomosis with ileostomy was performed. DIAGNOSIS: Macroscopic and histopathological examinations of the excised specimen showed ischemic colitis. Elastica van Gieson staining revealed extensive myointimal hyperplasia and confirmed the diagnosis of IMHMV. OUTCOMES: During the 2-year follow-up period, no additional medical management was needed. The patient was well and surveillance colonoscopy showed normal colon and anastomosis. CONCLUSION: Pre-operative computed tomography with imaging features including pronounced continuous concentric thickening colonic wall with poor enhancement and enlarged tortuous pericolic arteries could specifically facilitate the speedy diagnosis of IMHMV.


Assuntos
Colite Isquêmica/etiologia , Hiperplasia/complicações , Veias Mesentéricas/patologia , Doenças Vasculares/complicações , Colite Isquêmica/patologia , Colite Isquêmica/cirurgia , Feminino , Humanos , Hiperplasia/patologia , Doenças Vasculares/patologia , Adulto Jovem
8.
FASEB J ; 35(11): e21959, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34605572

RESUMO

The proliferation and migration of vascular smooth muscle cells (VSMCs) are essential events in venous neointimal hyperplasia (VNH), a culprit of arteriovenous fistula (AVF) malfunction. Mitotic arrest-deficient protein 2B (MAD2B) is a critical regulator of cell proliferation and differentiation in many scenarios. To address the role of MAD2B in VSMCs proliferation and migration during VNH, AVFs from patients with end-stage renal disease (ESRD) and chronic kidney disease (CKD) mice were used to evaluate MAD2B expression. In cultured VSMCs treated with platelet-derived growth factor-BB (PDGF-BB), the effect of MAD2B on VSMCs proliferation and migration was detected by cell counting kit-8 (CCK8) assay, immunofluorescence, wound-healing scratch and transwell assays. Besides, we exploited different small interfering RNAs (siRNAs) to explore the potential mechanisms in the issue. Furthermore, rapamycin was applied to reveal whether MAD2B-associated pathways were involved in its inhibitory effect on VSMCs proliferation and migration. Accordingly, we found that MAD2B expression was enhanced in AVFs from patients with ESRD, CKD mice and VSMCs stimulated by PDGF-BB. Meanwhile, inhibition of MAD2B alleviated VSMCs proliferation and migration while the number of ski-related novel gene (SnoN)-positive VSMCs was also increased in vivo and in vitro. Moreover, gene deletion of MAD2B decreased the level of SnoN protein in PDGF-BB-stimulated VSMCs. Furthermore, rapamycin suppressed the increased expressions of MAD2B and SnoN induced by PDGF-BB. Thus, our study demonstrates that inhibition of MAD2B suppresses the proliferation and migration of VSMCs during VNH via reducing SnoN expression. Moreover, rapamycin exerts an inhibitory effect on intimal hyperplasia, possibly via the MAD2B-SnoN axis.


Assuntos
Hiperplasia , Falência Renal Crônica/metabolismo , Proteínas Mad2/fisiologia , Neointima , Animais , Movimento Celular , Proliferação de Células , Células Cultivadas , Humanos , Hiperplasia/metabolismo , Hiperplasia/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/patologia , Neointima/metabolismo , Neointima/patologia
9.
Zhonghua Gan Zang Bing Za Zhi ; 29(9): 873-877, 2021 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-34638207

RESUMO

Objective: To investigate the MRI features of hepatic nodular regenerative hyperplasia (NRH) induced by chemotherapy. Methods: The clinical data and MRI of 20 cases with hepatic NRH induced by chemotherapy and confirmed by pathology in Zhongshan Hospital Fudan University from August 2014 to May 2019 were retrospectively analyzed. There were 13 males and 7 females, with an average age of 49.8 ± 9.7 years. Contrast-enhanced MR scan with Gd-DTPA was performed eighteen patients, and two patients underwent contrast-enhanced MR scan with hepatobiliary specific contrast (Gd-EOB-DTPA). The image analysis includes the number, location, size, shape, signal intensity in plain scan and enhancement pattern of lesions. The apparent diffusion coefficient (ADC) values of the lesions and adjacent hepatic parenchyma were measured on the ADC map, and the difference was compared with paired sample t test. Results: A total of 36 lesions in 20 patients were rounded or oval, including 23 (63.9%) lesions in the right lobe, 12 (33.3%) in the left lobe and 1 (2.8%) in the caudate lobe. The average diameter of all lesions was 15.4 ± 6.4 (7.0-37.0) mm. The boundary was clear in 9 (25.0%) lesions and blurred in 27 (75%) lesions. In T1WI, 35 (97.2%) lesions showed slightly hypointensity, and in 1 (2.8%) lesion was iosintensity. All 36 lesions showed slightly hyperintensity in T2WI. 33 (91.7%) lesions showed slightly hyperintensity in DWI, and 3 (8.3%) lesions showed iosintensity. 31 lesions with Gd-DTPA enhanced MR scan were significantly enhanced in the arterial phase and showed slightly high signal intensity in early portal vein phase, late portal vein phase and equilibrium phase. 5 lesions with Gd-EOB-DTPA enhanced MR scan were also significantly enhanced in the arterial phase and showed slightly high signal intensity in early portal vein phase, late portal vein phase and equilibrium phase, then all lesions showed circular high signal intensity in hepatobiliary specific phase. The average ADC value of 29 lesions was (1.471 ± 0.253) × 10(-3) mm(2)/s, and that of adjacent liver parenchyma was (1.460 ± 0.235) ×10(-3) mm(2)/s. There was no significant difference between the two groups (P > 0.05). Conclusion: MR findings of NRH induced by chemotherapy have certain characteristics, and the morphological manifestations, diffusion-weighted imaging, enhanced imaging and hepatobiliary specific phase features of the lesions can help to diagnose the disease.


Assuntos
Meios de Contraste , Imageamento por Ressonância Magnética , Adulto , Feminino , Humanos , Hiperplasia/patologia , Fígado/diagnóstico por imagem , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
J Transl Med ; 19(1): 395, 2021 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-34538249

RESUMO

BACKGROUND: Restenosis after angioplasty is a major challenge for the treatment of coronary artery diseases. Facilitation of vascular smooth muscle cell (VSMC) apoptosis may be an attractive approach to decrease the incidence of restenosis. We synthesized a 16-amino acid mitofusin-2 (Mfn-2) gene related peptide (MRSP) based on the sequence of the p21ras signature motif, the smallest functional sequence of the Mfn-2 gene with proapoptotic properties in VSMC. We investigated whether MRSP enhanced apoptotic activities to inhibit VSMC accumulation and neointimal hyperplasia in rats with carotid balloon injury. METHODS: VSMCs were treated with different concentrations of MRSP, the PI3K agonist 740 Y-P and the inhibitor LY294002. Cell apoptosis and related pathway molecules were assessed. MRSP was also given to rats with carotid artery balloon injury. Neointimal hyperplasia and cell apoptotic pathways were detected. RESULTS: In vitro experiments revealed that MRSP treatment significantly increased VSMC apoptosis and induced increases in procaspase-9 cleavage, caspase-3 activation, cytochrome c release from mitochondria to the cytoplasm and the Bax/Bcl-2 ratio but not caspase-8 expression, indicating that the mitochondrial apoptotic cascade was activated by MRSP, which might be attributed to suppression of the PI3K/Akt signaling pathway. We further found that the PI3K agonist 740 Y-P prevented and that the inhibitor LY294002 strengthened the proapoptotic effects of MRSP. MRSP strongly inhibited neointimal hyperplasia and VSMC accumulation, but increased VSMC apoptosis in the vascular wall after balloon injury. Moreover, MRSP substantially enhanced Bax and cleaved caspase-3 expression and decreased Bcl-2 levels in intima, accompanied by decreased levels of phosphorylated Akt and PI3K in vivo. CONCLUSIONS: Taken together, the present study showed that MRSP treatment results in a strong proapoptotic effect by activating the mitochondrial apoptotic cascade through suppression of the PI3K/Akt pathway.


Assuntos
Músculo Liso Vascular , Proteínas Proto-Oncogênicas c-akt , Animais , Apoptose , Proliferação de Células , Células Cultivadas , Hiperplasia/metabolismo , Hiperplasia/patologia , Mitocôndrias/metabolismo , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/metabolismo , Peptídeos/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Transdução de Sinais
12.
Zhen Ci Yan Jiu ; 46(7): 555-61, 2021 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-34369674

RESUMO

OBJECTIVE: To observe the histological and ultrastructural changes of the otopoint "Stomach" (MA-IC) area in chronic gastritis rabbits so as to provide a foundation for auricular acupoint diagnosis and treatment. METHODS: A total of 20 New Zealand rabbits (half male and half female) were randomly and equally divided into control and model groups. The chronic gastritis model was established by gavage of 5% sodium salicylate each day for 5 weeks, while the rabbits of the control group received gavage of clear water at the same volume. Morphological changes of the tissues of gastric mucosa, otopoint "Stomach" and auricular control point were observed under light microscope after staining with hematoxylin-eosin (H.E.), and given scores (0-3 points) according to the levels of inflammatory cells. The ultrastructural changes of the otopoint "Stomach" tissue were observed under transmission electronic microscope (TEM). RESULTS: H.E. staining revealed smoothness of the gastric smooth muscle with no or a few of inflammatory cells in the control group, and appearance of gastric mucosal hemorrhage and erosion, slightly disordered epithelial glands and infiltration of a large number of lymphocytes in the mucosal layer with some clustered lymphocyte aggregation foci in the model group. The pathological score of gastric mucous in the model group was significantly higher than that in the control group (P<0.01). Under light microscope, no obvious changes were observed in the skin of the otopoint "Stomach" of the control group and the control point of the model group, whereas hyperplasia and abscission in the epidermic cuticle and spinous layer and basal layer, dermal tissue and inflammatory cell infiltration were observed in the otopoint "Stomach" of the model group. Results of TEM observation showed no significant changes in the ultrastructure of the otopoint "Stomach" in the control group, and swollen and vacuolated epidermal keratinocyte mitochondria, reduced keratin filament aggregation, widened local cell space, unclear desmosome structure, activation of the dermal fibroblasts, and an increase of the myelinated nerve mitochondria in the "Stomach" region in the model group. CONCLUSION: The otopoint "Stomach" tissue has structural damage and hyperplasia in chronic gastritis rabbits, suggesting a special correlation between the otopoint "Stomach" and gastric tissue, hence, providing a morphological basis for otopoint diagnosis and treatment.


Assuntos
Gastrite Atrófica , Pontos de Acupuntura , Animais , Feminino , Mucosa Gástrica , Hiperplasia/patologia , Masculino , Coelhos
13.
Redox Biol ; 46: 102084, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34364219

RESUMO

Diabetes mellitus (DM) promotes neointimal hyperplasia, characterized by dysregulated proliferation and accumulation of vascular smooth muscle cells (VSMCs), leading to occlusive disorders, such as atherosclerosis and stenosis. Poly (ADP-ribose) polymerase 1 (PARP1), reported as a crucial mediator in tumor proliferation and transformation, has a pivotal role in DM. Nonetheless, the function and potential mechanism of PARP1 in diabetic neointimal hyperplasia remain unclear. In this study, we constructed PARP1 conventional knockout (PARP1-/-) mice, and ligation of the left common carotid artery was performed to induce neointimal hyperplasia in Type I diabetes mellitus (T1DM) mouse models. PARP1 expression in the aorta arteries of T1DM mice increased significantly and genetic deletion of PARP1 showed an inhibitory effect on the neointimal hyperplasia. Furthermore, our results revealed that PARP1 enhanced diabetic neointimal hyperplasia via downregulating tissue factor pathway inhibitor (TFPI2), a suppressor of vascular smooth muscle cell proliferation and migration, in which PARP1 acts as a negative transcription factor augmenting TFPI2 promoter DNA methylation. In conclusion, these results suggested that PARP1 accelerates the process of hyperglycemia-induced neointimal hyperplasia via promoting VSMCs proliferation and migration in a TFPI2 dependent manner.


Assuntos
Lesões das Artérias Carótidas , Diabetes Mellitus Experimental , Hiperglicemia , Animais , Lesões das Artérias Carótidas/patologia , Movimento Celular , Proliferação de Células , Células Cultivadas , Diabetes Mellitus Experimental/genética , Diabetes Mellitus Experimental/patologia , Modelos Animais de Doenças , Hiperglicemia/genética , Hiperglicemia/patologia , Hiperplasia/patologia , Lipoproteínas , Camundongos , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/patologia
14.
Am J Case Rep ; 22: e932450, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34366428

RESUMO

BACKGROUND Pfeiffer syndrome (PS) is a fibroblast growth factor receptor (FGFR)-associated craniosynostosis syndrome, characterized by abnormally broad and medially deviated thumbs and great toes. Tracheal cartilage sleeve (TCS) is associated with several FGFR-associated craniosynostosis syndromes, including PS. TCS is an airway malformation in which the tracheal cartilage rings fuse with each other to form a sleeve of cartilage. CASE REPORT The patient was a 4-year-old girl with PS, TCS, and abnormal hyperplasia of non-fused intrapulmonary cartilages. The patient showed cranial dysplasia on prenatal ultrasonography. At birth, a cloverleaf skull in association with hydrocephalus and digital malformations was apparent. These findings were consistent with PS type 2. The diagnosis of PS type 2 was confirmed from a genetic test detecting a FGFR2 mutation (Y340C). During the clinical course, she underwent several surgeries, including ventriculoperitoneal shunts, sequential cranioplasty surgeries, and tracheotomy due to upper airway abnormalities. At 4 years old, she died of multiple organ failure following aspiration pneumonia. The autopsy revealed that the tracheal cartilages had fused with each other, resulting in a condition called TCS, in which the cartilage rings and tracheal ligaments were absent. The lungs were poorly aerated, and the dilated bronchi had thickened walls surrounded by many cartilage fragments, mainly at the hilum. These cartilages tended to overlap at both ends, did not fuse, and were greatly altered in size and shape. CONCLUSIONS We report the results of autopsy for PS with the first histopathological findings for the lungs and other visceral organs.


Assuntos
Acrocefalossindactilia , Craniossinostoses , Acrocefalossindactilia/patologia , Autopsia , Brônquios , Cartilagem/patologia , Pré-Escolar , Feminino , Humanos , Hiperplasia/patologia , Recém-Nascido , Fenótipo , Gravidez , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/genética , Síndrome
15.
Am J Orthod Dentofacial Orthop ; 160(5): 705-717, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34353687

RESUMO

INTRODUCTION: The objectives of this study were to evaluate postsurgical condylar remodeling using a radiographical interpretation, quantify condylar volumetric asymmetry, and assess soft tissue symmetry after simultaneous unilateral high condylectomy and bimaxillary osteotomies. METHODS: Sixteen patients diagnosed with unilateral condylar hyperplasia underwent unilateral high condylectomy and orthognathic surgery to correct skeletal and facial asymmetries. Cone-beam computed tomography scans were acquired before and 1-year after surgery. A radiographic consensus was evaluated for signs of reparative or degenerative changes. The condyles were mirrored and registered for assessment of volumetric and morphologic asymmetry. Soft tissue symmetry was evaluated by measurement of the distance of soft tissue pogonion from the skeletal midsagittal plane. RESULTS: Patients who undergo unilateral high condylectomy and orthognathic surgery present radiographic signs suggestive of degenerative changes, including sclerosis, osteophytes, flattening, and erosion in both the surgical and nonsurgical condyles (P ≤0.01). There was an average volumetric improvement of 531.9 ± 662.3 mm3 1-year postsurgery (P = 0.006). Soft tissue symmetry improved in all patients, with an average improvement of 65.8% (4.0 mm ± 2.6 mm, P ≤ 0.01). There was no correlation between the change in condylar volumetric asymmetry and the stability of the soft tissue correction. CONCLUSIONS: High condylectomy for the correction of a skeletal asymmetry in patients with condylar hyperplasia successfully reduces the volumetric asymmetry between the condyles. Postsurgical dysmorphic remodeling and degenerative changes were noted in both the surgical and nonsurgical condyles. Despite remarkable changes and remaining joint asymmetry, the soft tissue correction is stable 1-year postsurgery.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/patologia , Assimetria Facial/cirurgia , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Hiperplasia/cirurgia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia
16.
Indian J Pathol Microbiol ; 64(3): 541-544, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34341268

RESUMO

Intravascular papillary endothelial hyperplasia (IPEH) is a benign, reactive proliferation of endothelial cells within areas of thrombus. It most commonly occurs in the skin and subcutaneous tissue, with less than 40 cases reported in intracranial location. Ours is the first case report from India of IPEH in the cavernous sinus. A 45-year-old male presented with headache and decreased visual acuity. Magnetic resonance imaging (MRI) revealed a well-defined, homogeneously contrast-enhancing mass in the cavernous sinus. Postoperatively, examination of tissue showed organizing thrombus within the vessel wall along with delicate, acellular, pseudopapillary cores. The fibrin-rich connective tissue of these showed blue staining with Masson's trichrome stain. These were lined by a single layer of endothelial cells without evidence of atypia; no nuclear pleomorphism, hyperchromasia, atypical mitosis, or areas of necrosis were seen. Hence, it was diagnosed to be IPEH. Follow-up MRI revealed no residual disease and the patient is disease-free at 8 months. Recognition of this entity by pathologic examination is important to rule out angiosarcoma. Gross total resection is curative. Residual lesions have the potential for recurrence, requiring adjuvant therapy.


Assuntos
Seio Cavernoso/diagnóstico por imagem , Células Endoteliais/patologia , Hiperplasia/patologia , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia , Adulto , Criança , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Adulto Jovem
17.
Am J Clin Pathol ; 156(5): 871-885, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34406351

RESUMO

OBJECTIVES: Follicular hyperplasias (FHs) with light chain-restricted (LCR) plasmacytoid/plasma cells (PCs) within germinal centers (GCs) based on immunohistochemistry (IHC)/in situ hybridization (ISH) can potentially lead to diagnostic error. This study aims to better characterize such cases, including their clinical implications. METHODS: LC expression by IHC/ISH was quantitatively assessed in GCs of 17 FHs with LCRGCs. BCL2, CD10, BCL6, BCL2, immunoglobulin (Ig) heavy chains, IgG4, and Epstein-Barr encoding region stains were performed. In total, 8 cases had polymerase chain reaction (PCR)-based clonality studies. RESULTS: All cases showed FH, including 4 with progressively transformed GCs (PTGCs); 0.8% to 52% (median, 21%) of the GCs were LCR; 13 of 17 had both κ- and λ-LCRGCs, and 4 of 17 had only κ-LCRGCs; 7 of 16 had prominent intrafollicular IgG4-positive cells. One case demonstrated BCL2-positive cells in focal LCRGCs but lacked BCL2 rearrangement. B-cell monoclonality was demonstrated in 3 of 8 cases (only after microdissection). Seven patients had autoimmune disorders, and 1 had had a transplant. Three patients had a history of lymphoma, 1 developed lymphoma, and 1 developed lymphomatoid granulomatosis subsequently. CONCLUSIONS: FHs with LCRGC by IHC/ISH are typically not associated with the development of lymphoma, even though they can express BCL2 and show monoclonality by PCR. They may be associated with increased intrafollicular IgG4-positive cells, PTGC, and autoimmunity.


Assuntos
Centro Germinativo/imunologia , Centro Germinativo/patologia , Cadeias Leves de Imunoglobulina/imunologia , Plasmócitos/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia/imunologia , Hiperplasia/patologia , Linfoma/diagnóstico , Linfoma/imunologia , Linfoma/patologia , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/imunologia , Transtornos Linfoproliferativos/patologia , Masculino , Pessoa de Meia-Idade , Plasmócitos/patologia , Estudos Retrospectivos
18.
Clin Imaging ; 79: 337-340, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34399290

RESUMO

MRI features are presented in a multicenter retrospective series of five patients with a unilateral masslike lesion seen in the genitourinary diaphragm at MRI performed for known or suspected prostate cancer. In all cases, the lesion appeared as an encapsulated 1.3 to 3.0 cm mass of heterogeneous low or intermediate T2 signal intensity in the genitourinary diaphragm, and targeted biopsy demonstrated benign Cowper's gland tissue. This entity is a potential imaging pitfall that could result in a diagnosis of an exophytic nodule of benign prostatic hyperplasia or local spread of prostate cancer. We present these cases to facilitate correct identification of Cowper's gland hyperplasia as an occasional finding at MRI of the prostate.


Assuntos
Glândulas Bulbouretrais , Próstata , Glândulas Bulbouretrais/patologia , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Imageamento por Ressonância Magnética , Masculino , Próstata/diagnóstico por imagem , Próstata/patologia , Estudos Retrospectivos
19.
Childs Nerv Syst ; 37(11): 3521-3529, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34410450

RESUMO

BACKGROUND: An important feature of hydrocephalus is the alteration of the cerebral spinal fluid (CSF) homeostasis. New insights in the understanding of production, secretion, and absorption of CSF, along with the discovery of the glymphatic system (GS), can be useful for a better understanding and treatment of hydrocephalus in disorders with CSF overproduction. CASE DESCRIPTION: A 1-year-old patient was diagnosed with communicating hydrocephalus; ventricle peritoneal shunt (VPS) is installed and ascites developed. VPS is exposed, yielding volumes of 1000-1200ml/day CSF per day. MRI is performed showing generalized choroidal plexus hyperplasia. Bilateral endoscopic coagulation of thechoroid plexus was performed in 2 stages (CPC) however the high rate of CSF production persisted, needing a bilateral plexectomy through septostomy, which finally decreased the CSF outflow. DISCUSSION: New knowledge about the CSF physiology will help to propose better treatment depending on the cause of the hydrocephalus. The GS is becoming an additional reason to better study and develop new therapies focused of the modulation of alternative CSF reabsorption. CONCLUSION: Despite the current knowledge about hydrocephalus, we remain without a complete understanding of the pathophysiology of this condition. GS could be more important than conventional concept of reabsorption of CSF in the arachnoid villi, therefore GS could be a new key point, which will guide future investigations.


Assuntos
Sistema Glinfático , Hidrocefalia , Ventrículos Cerebrais , Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/patologia , Plexo Corióideo/cirurgia , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/patologia , Hidrocefalia/cirurgia , Hiperplasia/patologia , Lactente
20.
Kardiologiia ; 61(7): 79-84, 2021 Jul 31.
Artigo em Russo | MEDLINE | ID: mdl-34397345

RESUMO

This review addresses morphological changes in coronary arteries following stenting, which result from damage to the vascular wall. These changes include 1) formation of a thrombus in the site of intimal injury; 2) inflammation; 3) proliferation and migration of smooth muscle cells; 4) formation of extracellular matrix. Each of these pathological processes has specific morpho-biological features. The review shows the role of von Willebrand factor in development of early thrombosis after intimal injury, which provokes activation of the inflammatory response followed by proliferation of smooth muscle cell that synthetize the extracellular matrix. These cellular and intercellular changes are based on overexpression of TGF-ß1 protein, which facilitates modulation of various types of smooth muscle cells, including contractile and secretory ones. Issues of fine regulation of cellular and intercellular interactions by apoptosis, activation of mTOR signaling molecules, and microRNA are still understudied. Dynamic changes in drug-coated stents during development of neoatherosclerosis and late thrombosis remain not elucidated. Current reports show that initial mechanisms triggering pathological regenerative and hyperplastic processes that result in coronary restenosis in the area of implanted stents may form early (first hours or days) after stenting. Most studies were performed on experimental rather than on autopsy material, which does not allow fully unbiased interpretation of obtained data. Studying dynamics of morphological and molecular changes in coronary arteries after stenting, including on autopsy material, will allow one to express an opinion on the risk of postoperative thrombosis and restenosis.


Assuntos
Reestenose Coronária , Stents Farmacológicos , Reestenose Coronária/etiologia , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Humanos , Hiperplasia/patologia , Stents/efeitos adversos
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