軟骨魚類と円口類における腎傍糸球体細胞の欠如

AGGRESSIVE GRANULAR CELL AMELOBLASTOMA

To study the clinicopathologic features, immunophenotype and histogenesis of dysembryoplastic neuroepithelial tumor (DNT). Fourteen cases of DNT were retrieved from the archival files of the Department. The histopathologic features and immunohistochemical findings were retrospectively studied. The long-term follow-up data were analyzed. Eleven of the 14 cases studied were located in the temporal lobe. Histologically, the tumor consisted of a heterogeneous admixture of neuronal and glial cells (including 1 simple form case, 8 complex form cases and 5 non-specific form cases). The specific glioneuronal element was seen in 9 cases. Variable degrees of cortical dysplasia (CD) were found in 10 out of the 11 cases which had sufficient tissue samples for thorough histologic examination. The morphologic appearance of CD included the presence of heterotopic neurons in molecular layer and/or white matter (7 cases), persistent subpial granular cell layer (4 cases), dyslamination (10 cases) and cellular abnormalities. Immunohistochemically, the oligodendroglial-like cells expressed Olig2. Some of which were positive for nestin, MAP-2, neurofilament and glial fibrillary acidic protein, but negative for NeuN. Long-term follow up revealed that 12 patients had class I postoperative seizure and 2 patients had class II seizure. No tumor recurrence was detected. DNT is frequently associated with CD. The morphologic diagnosis can be confirmed by immunohistochemical study using a panel of antibodies.

The ovaries and uterus were collected after ovariohysterectomy from a 16-month-old Labrador bitch in diestrus that never mated. Discrete swellings were found in the uterine horns, with the macroscopic appearance of normal early pregnancy. At histologic examination, the endometrium, devoid of any conceptus and chorion, showed a marked proliferation, on the basis of which a diagnosis of deciduoma was made. A remarkable population of stromal eosinophilic granular lymphocytes was present, especially in the axis of the endometrial folds. Periodic acid-Schiff and Dolichos biflorus-lectin histochemical reaction and a panel of 10 immunohistochemical markers were used to characterize eosinophilic granular cells. Our findings allowed us to compare these granular cells with the granulated decidual cells, whose presence was until now described only in primates, rodents, or a few other epitheliochorial species. On the basis of our results, the importance of eosinophilic granular cells in a decidualization process is hypothesized to occur also in the bitch.

Introduction Voice disorders caused by pseudotumors of the vocal folds or paralysis of the vocal folds with incomplete glottis closure frequently require phonomicrosurgery. These interventions were analyzed with regard to quality of voice after surgery and safety of the intervention. Methods Retrospective analysis of 400 consecutive phonomicrosurgery interventions. The following parameters were collected: distribution of pathologies of the vocal folds, rating of the voice quality by both the surgeon (RBH-system) and patient and videolaryngstroboscopy six weeks after the intervention compared to the state prior to surgery, complications and results of histological examination. Results In our collective vocal fold polyps (36 %), cysts (12 %) and paralysis (10 %) dominated. After the intervention the quality of voice improved in 90 % of all cases. In 14 % voice therapy was needed postoperatively because of hyperfunction.After vocal fold augmentation one patient developed an edema of the larynx and another patient a temporary paralysis of the vocal fold of the opposite side. The histological examination showed as incidental findings a malignant osteoclastic giant cell tumor, a granular cell tumor and a carcinoma in situ of the vocal fold requiring further surgery and follow up. Discussion Phonomicrosurgery is a safe and effective therapy. The histological examination is also useful in patients with macroscopically non suspicious lesions to recognize rare or malignant tumor entities. Patient observation with early detection as well as therapy of complications like edema of the larynx or vocal fold paralysis is recommended.

Obstructive congenital epulis

Solitary congenital granular cell lesion of the tongue

An unusual case of juxtaglomerular cell tumor (JCT) is presented. A 29-year-old woman visited our hospital for the management of incidentally detected renal mass due to newly developed hypertension in the 20th week of pregnancy. Laboratory studies showed increased basal plasma renin activity and hypokalemia but serum aldosterone level was normal. Abdominal computed tomography scan showed about 2.4 cm sized multicystic mass in the right kidney. Nephron-sparing surgery was performed with excellent results. On histological examination, the tumor exhibited a structure typical feature of JCT. A few days later the patient's blood pressure had been normalized.

A granular cell tumor of breast is a rare and usually benign tumor originating from Schwann cells. The mammographic and sonographic appearances of a granular cell tumor pose a diagnostic dilemma because of its similarity to breast malignancy. We describe 2 cases of breast granular cell tumors in male patients, which were confirmed after surgical excision and histologic examination.

Tumeur d’Abrikossoff : à propos d’une localisation cutanée du sillon intermammaire et revue de la littérature

A case of granular cell myoblastoma of the buttock is reported. It is an uncommon tumor of undetermined origin. Usually diagnosis is made after histologic examination. Although it is usually a benign growth involving the tongue or subcutaneous tissues, it can be malignant. Complete removal and long-term follow up is the approved method of treatment.

Granular cell tumour of the oesophagus is rare and usually single. It is diagnosed by endoscopic appearance, results of endosonography, and histological examination of biopsy specimens. Although histological examination is required for diagnosis, it is difficult occasionally to obtain tumour samples by forceps because granular cell tumour is usually located in the submucosal layer. We report the case of a Japanese man with two granular cell tumours of the oesophagus. One lesion was diagnosed as a granular cell tumour by histological examination of a biopsy specimen, but the other was not. Endoscopic resection was performed to obtain the diagnosis and treat the lesions since some granular cell tumours are potentially malignant. Both tumours were completely resected endoscopically, and the diagnosis of granular cell tumour could be established by histological examination of resected tissue. Endoscopic resection is thus useful in the diagnosis and treatment of granular cell tumour of the oesophagus.

A 77-year-old man presented to the dermatologist's office with a lesion on the skin of his chest. There was no history of any skin malignancies. Clinical examination showed an irregularly contoured and irregularly pigmented dark brown lesion with variable colors of dark brown and black measuring 1.6 cm in its greatest dimension. The lesion was completely excised.The pathology department received this as an elliptic skin excision specimen, 2.1 × 1.0 × 0.6 cm, with a pale tan hair-bearing skin surface. An eccentric dark brown elevated skin lesion 1.6 cm in its greatest dimension with irregular borders and a variegated surface was present. The deep margin consisted of tan-yellow subcutaneous tissue.A histologic examination (Figure 1) showed atypical melanocytes forming confluent nests along the dermal-epidermal junction and infiltrating as groups and single cells through the overlying epidermis to the granular cell layer. These cells also infiltrated the papillary and reticular dermis as nests and sheets showing mitotic activity. The depth of invasion was 0.66 mm. No ulceration, regression, or vascular or neural invasion was identified. A nodule of a tumor 0.15 mm in transverse diameter was present in the deep reticular dermis (Figures 1 [arrow] and 2). This nodule was not contiguous with the bulk of the proliferation and was 0.96 mm from the granular cell layer of the epidermis. The lesion was completely excised.What is your diagnosis?The early vertical growth phase melanoma was first described by Clark et al.1 The early vertical growth phase can be distinguished from the radial growth phase in several ways,2 the most important criterion being the presence of a dominant nest within the papillary dermis that is conspicuously larger than any nest within the epidermis and that forms an expansile nodule. The cells comprising this nodule are cytomorphologically different from those of the intraepidermal component, and they invariably show conspicuous nucleolation, coarse chromatin, and irregularly thickened, notched nuclear chromatinic rims. Several such nodules or their coalescence indicates a progression to the fully evolved vertical growth phase melanoma. It has been shown that the presence of the vertical growth phase incurs a risk for metastasis, in contrast to the radial growth phase–confined lesions, for which surgical excision is almost always curative with the proviso that regression is not identified in the primary tumor.34 A radial growth phase is defined as a neoplastic proliferation of malignant melanocytes that grows either within the epidermis, the papillary dermis, or both in a manner that is oriented parallel to the epidermal surface.2 The presence of a radial growth phase in this tumor, although not illustrated in this study, precluded a diagnosis of nodular melanoma, in which, by definition, a radial growth phase is absent. The survival of patients with invasive melanoma in a vertical and/or radial growth phase can be predicted on the basis of evaluating several light microscopic parameters including measured depth, mitotic count, host response, sex, anatomic site, and presence or absence of regression, angioinvasion, ulceration, or, as in this patient, microscopic satellites.Microscopic satellites are typically characterized by reticular dermal and/or subcuticular nodules of a tumor greater than 0.05 mm in diameter beneath the principal invasive tumor mass but separated from it by normal tissue.2 These satellites may or may not represent intradermal metastases. Melanomas with microsatellites are more likely to have regional lymph node metastases than are lesions of similar thickness without microsatellites.56 In revisions to the American Joint Committee on Cancer staging system for melanoma (2002), satellites were moved from the primary tumor category (ie, T4) to the N category (ie, N3); therefore, the presence of a microscopic satellite constitutes evidence of stage IV disease.2 It is critical to recognize microsatellites, as they are associated with a decreased incidence of disease-free survival as well as overall survival.7–9

A 47-year-old female presented with dysuria and vague discomfort in the suprapubic region that had lasted for the previous 3 months. On evaluation, ultrasonography kidney-ureter-bladder (KUB) and computerized tomographic scan KUB revealed a nodular growth noted in the urinary bladder measuring 2 cm × 2 cm. Urine cytology was negative for malignant cells. Cystoscopy showed a nodular tumor approximately 2 cm × 2 cm in diameter that was located supratrigonal and extended to the posterior wall of the bladder. The patient underwent transurethral resection of the tumor. Histological examination and immunohistochemical staining showed a granular cell tumor (GCT). There were no features suggesting a malignant phenotype. On follow-up, the patient has remained free of bladder recurrence. We herein report this rare case of a GCT of the urinary bladder and review the literature.

Diabetes mellitus is a chronic, lifelong metabolic disorder. Impaired wound healing capabilities in both cutaneous and oral ulceration was denoted among diabetic patients. Topical treatments include natural therapeutic products as oxidized regenerated cellulose/collagen, hyaluronic acid conjugated with glycidyl methacrylate or gelatin dressings and insulin. Different studies have proved the efficacy of topical insulin on skin ulcers. The aim of the present study was to evaluate the effectiveness of topical insulin on oral ulcers in diabetic and non-diabetic rats through histological examinations.Material and methods: 48 male albino rats were used in this study, rat population was divided into diabetic and non-diabetic groups. Each group was subdivided into test subgroup treated by insulin and control subgroup treated by placebo. Histological examination was performed to rats sacrificed after 2, 7 and 14 days.Results: Better healing was observed in nondiabetic groups compared to diabetic groups. Improved healing was noticed in groups treated by insulin manifested by hyperplastic orthokeratinized epithelium with prominent granular cell layer, while ulceration was still denoted in the groups treated by plecebo. Conclusion: From the present study, it was concluded that topical insulin can be considered as a safe and effective treatment modality for oral ulcers.

Secondary Hypertension due to a Renin-secreting Juxtaglomerular Cell Tumor