ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

For differentiation of melanoma in situ (MIS) from melanocytic hyperplasia (MH) in sun-damaged skin, several criteria have been proposed. To assess sensitivity and specificity of those criteria, we examined the epidermis adjacent to 50 consecutive basal cell carcinomas and 50 MISs in skin with significant solar elastosis. The most valuable criteria for the diagnosis of MIS, as opposed to MH, were presence of nests of melanocytes, irregular distribution of melanocytes, descent of melanocytes far down adnexal epithelial structures, irregular distribution of pigment, presence of melanocytes above the junction, a high number of melanocytes, pleomorphism of melanocytes, and atypical nuclei of melanocytes. Other criteria, e.g., collapse of cytoplasm around nuclei of melanocytes; flattening of rete ridges; differences in the area, shape, and contour of nuclei of melanocytes as assessed by nuclear morphometry; and presence of melanocytes stained by HMB-45 and Ki-67/MIB-1 monoclonal antibodies, were found to be of low or no value for differential diagnosis.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The so-called maturation parameter (MP) (that is, the ratio of the mean nuclear areas in the deep portion and in the superficial portion of a tumor) was measured and calculated using a computer-assisted interactive image analysis system in 29 compound Spitz nevi (SNs) and 37 primary invasive cutaneous malignant melanomas (MMs), of which 16 and 14 lesions, respectively, measured up to 1 mm in Breslow thickness (that is, thin). The MPs of the SNs and MMs were found to be 0.37-0.89 (mean ± SD, 0.64 ± 0.1) and 0.81-1.16 (mean ± SD, 0.96 ± 0.1), respectively (p < 0.001). The MPs of the subgroups of thin SNs and MMs were 0.56-0.87 (mean ± SD, 0.67 ± 0.1) and 0.86-1.10 (mean ± SD, 0.98 ± 0.1), respectively (p < 0.001). Most of the SNs and MMs had MP values of <0.81 and >0.89, respectively. This pattern of distribution prevailed in the subgroup of thin lesions. Thus, the previously shown difference in MPs between SN and MM for thicker lesions (≥1.0 mm) was demonstrated in this study in thin lesions (≤1.0 mm) as well. Although a relatively small area of overlap in MP values exists between compound SNs and MMs, including the thin ones, below this area the lower the MP value the more likely the diagnosis is SN, and vice versa.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The reliability of various in vitro techniques to identifyBorrelia burgdorferiinfection is still unsatisfactory. Using a high-power resolution videomicroscope and staining with the borrelia genus-specific monoclonal flagellar antibody H9724, we identified borrelial structures in skin biopsies of erythema chronicum migrans (from which borrelia later was cultured), of acrodermatitis chronica atrophicans, and of morphea. In addition to typical borreliae, we noted stained structures of varying shapes identical to borreliae found in a “borrelia-injected skin” model; identical to agar-embedded borreliae; and identical to cultured borreliae following exposure to hyperimmune sera and/or antibiotics. We conclude that the H9724-reactive structures represent various forms ofB. burgdorferirather than staining artifacts. These “atypical” forms ofB. burgdorferimay represent in vivo morphologic variants of this bacterium.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We investigated correlations between cell proliferation, p53 overexpression, and degree of malignancy in cutaneous epithelial neoplasms. One hundred and fourteen cases of epithelial neoplasms, including seborrheic keratosis (SEB), basal cell carcinomas (BCCs), solar keratosis (SK), Bowen's disease (BD), and squamous cell carcinomas (SCCs) were examined using argyrophilic necleolar organizer region (AgNOR) staining. In addition, immunohistochemical analysis using the Ki-67 (MIB-1) and anti-p53 (DO-7) monoclonal antibodies was performed. The ratio of tumorous to normal cells according to AgNOR staining was defined as the AgNOR rate, and the ratio of tumorous to normal cells according to Ki-67 recognition was defined as the Ki-67 rate. SCC lesions showed the highest AgNOR rate among the investigated epithelial neoplasms, followed in order by BD, BCC, SK, and SEB lesions. The Ki-67 rate was highest in BD lesions, followed in order by SK, SCC, BCC, and SEB lesions. Expression of p53 protein was highest in SK lesions. SCC is generally considered to be the most malignant neoplasm, followed in order by BCC, BD, and SK. Thus, our results suggest that the Ki-67 rate and overexpression of p53 protein do not always reflect the degree of malignancy in neoplasms.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Examination of 388 follicles in 24 large resections of skin for the presence of histologic folliculitis and Demodex mites uncovered a nonrandom association between these two phenomena. Demodex mites were found in 42% of follicles with inflammation, but in just 10% of follicles without inflammation. Eighty-three percent of follicles with Demodex showed inflammation. The probability that this result could occur by random chance alone was <0.001, thus suggesting that Demodex is associated with histologic folliculitis, even minor folliculitis. The results do not, however, decide whether Demodex is causative, whether it preferentially selects follicles with histologic inflammation, or whether some of both processes operate.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We studied the immunohistochemical phenotype in 13 cases of the nodular hidradenoma (NH), with special emphasis on the expression of different types of keratins (cytokeratins, 7, 10, 6/18, 8/18, and 10/17/18 and their distribution in normal sweat glands. Variable reactions with keratins, α-smooth muscle actin, and epithelial membrane antigen (EMA) were found, as these markers were present in different cellular components of the tumors. The most constant finding was almost complete absence of cytokeratins (all but keratin 10/17/18, which was positive in two of 13 cases) in clear cells, which yet were positive for EMA. The tumors expressed mostly cytokeratin 6/18, 7, 8/18, and 10/17/18, which were found in 11, 13, 11, and 12 cases, respectively. The cellular distribution and quantity of stained cells differed, as keratins 6/18, 8/18, and 7 produced the most abundant staining and were predominantly localized in small squamoid cells and the cells lining the tubular and cystic spaces. Cytokeratin 10/17/18 was expressed in smaller or larger clusters of squamoid cells and rarely in clear cells. Cytokeratins 10, 19, and 20 were found sporadically in single cells or small cellular clusters. α-Smooth muscle actin was expressed in four cases, whereas we did not find reactivity of S-100 protein. Comparing these results with the pattern of keratin distribution and antigenic reactivity in eccrine sweat glands, we conclude that NH presents cellular heterogeneity of its elements and differentiation toward different parts of the sweat gland.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Bacillary angiomatosis (BA) is a pathologic process characterized by prominent vascular proliferation secondary to organisms of the genusRochalimaea. BA has been most commonly associated with HIV-1+ patients, but has also been reported rarely in other immune-suppressed patients and in a small group of patients with no demonstrated immune suppression. Even in immune-suppressed children, BA is extremely rare. We report a 5-year-old girl with no apparent immune suppression and no risk factors for HIV-1+ disease, who presented with a skin lesion that histopathologically was diagnostic of BA.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The differential diagnosis of cutaneous small round cell malignancies is a relatively uncommon but recurrent problem that usually requires adjuvant techniques including special histochemical stains, immunohistochemistry (IHC), electron microscopy (EM), and cytogenetics (CG) to arrive at a definite answer. This report describes a case of a primary cutaneous malignancy that, after workup, fulfilled the criteria of extraskeletal Ewing's family sarcoma, which was corroborated by IHC with an antibody to glycoprotein p30/32mic2that is highly expressed in these neoplasms. The lesion consisted of a large nodular proliferation of poorly differentiated monotonous small round cells confined to the dermis and subcutaneous tissue. The cells had high nuclear to cytoplasmic (N/C) ratios, scattered prominent nucleoli, and indistinct cytoplasm. A periodic acid-Schiff (PAS) stain with and without diastase demonstrated abundant cytoplasmic glycogen. The glycogen was confirmed with EM, which did not show neurosecretory granules, but extensive sectioning of the tissue blocks demonstrated with light microscopy a single focus with pseudorosette formation. IHC was positive for monoclonal antibody (MAb) O13 to glycoprotein p30/32mic2and negative for lymphoid (CD45), neural (S-100, NF, GFAP), neuroendocrine (NSE), and muscle (MSA, desmin) markers. To the best of our knowledge, this is one of few reported cases of primary cutaneous (extraskeletal/extraosseous) Ewing's sarcoma (EEWS) and the first to use IHC with MAb O13, which recognizes the cell surface glycoprotein p30/32mic2. This case further illustrates the continuum between EEWS and primitive peripheral neuroepithelioma and supports the unifying concept that these two entities are merely subtle morphologic variants of the same malignant neoplasm, which is better designated a Ewing's family sarcoma.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We present the case of a 30-year-old woman who over a 10-year period has developed multiple well-differentiated angiosarcomas involving the trunk and extremities. The clinical and histiologic features are characteristic of retiform hemangioendothelioma (RH), a distinctive form of low-grade angiosarcoma. This case is unique in that multiple lesions developed in different anatomic sites. We discuss the clinical and histologic characteristics, diagnosis, and prognosis of RH.

ISSN:0193-1091    

出版商:OVID    

年代:1996

数据来源: OVID