摘要:

Balanitis of Zoon is a relatively common diagnosis in elderly men, although its nature is controversial and descriptions of its histopathologic features in current textbooks of dermatopathology vary considerably. We studied 45 cases of balanitis of Zoon clinically and histopathologically. The earliest histopathologic changes in cases diagnosed clinically as balanitis of Zoon were slight thickening of the epidermis, parakeratosis, and a patchy lichenoid infiltrate of lymphocytes and some plasma cells. More advanced cases showed atrophy of the epidermis, superficial erosions, a scattering of neutrophils in the upper reaches of the epidermis, scant spongiosis, extravasation of erythrocytes, and a much denser infiltrate with many plasma cells. Additional findings at even later stages were subepidermal clefts, sometimes with loss of the entire epidermis, marked fibrosis of the superficial dermis, and many siderophages. That sequence of histopathologic changes is compatible with the thesis that balanitis of Zoon results from irritation or mild trauma affecting barely keratinized skin in a moist environment. As a reaction to nonspecific stimuli, balanitis of Zoon may be found superimposed on lesions of other diseases and may modify the histopathologic presentation of those diseases to the extent that they are no longer recognizable. In the current study, several cases diagnosed originally as balanitis of Zoon turned out to be examples of allergic contact dermatitis, psoriasis, lichen planus, and squamous cell carcinoma in situ. It is important, therefore, to recognize balanitis of Zoon as a nonspecific pattern that may occur either as an isolated finding or may complicate other diseases affecting the glans penis or prepuce of uncircumcised men.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Oncocytosis is defined as a metaplastic change characterized by the presence of cells with finely granular eosinophilic cytoplasm caused by the accumulation of mitochondria. Although this histologic feature can be found in normal tissues, it can also be seen pathologically as a degenerative phenomenon, where an accumulation of mitochondria is thought to compensate for an uncoupling of oxidative metabolism secondary to cellular aging. Oncocytic metaplasia can be observed in a variety of cutaneous lesions but, to our knowledge, has not been described in melanocytic nevi. We retrospectively reviewed 87 melanocytic nevi from 83 patients that showed significant oncocytic change. We obtained patient clinical history through surveys completed by the patients' physicians. Ultrastructural studies were performed on 4 representative nevi to confirm the presence of increased mitochondria. We prospectively reviewed 100 randomly selected nevi looking for oncocytic changes. We subsequently did not find any correlation with patient demographics or medical histories. Histologic evaluation showed granular eosinophilic cytoplasm in 75% or greater of lesional cells in two thirds of cases. This phenomenon occurred in all types of melanocytic nevi. Ultrastructural studies revealed melanocytes with numerous mitochondria in close apposition to melanosomes. Focal oncocytic change was identified prospectively in 38 of 100 randomly selected melanocytic nevi. We conclude that oncocytosis in melanocytic nevi is a relatively common and underrecognized phenomenon.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

We have identified in malignant melanoma an angiotumoral complex in which tumor cells occupy a pericytic location along the endothelium of microvessels without evidence of intravasation. We have suggested that this pericytic-like angiotropism could be a marker of an extravascular migration of tumor cells along the abluminal surface of vessels. The extravascular migratory metastasis proposed for melanoma has close analogies with glioma migration. To compare our hypothesis of extravascular migration by melanoma with the migration of glioma cells, we have used the B16 murine melanoma cell line and the GL26 murine glioma cell line in an in vivo murine brain tumor model and in vitro using endothelial cells that have formed capillary-like structures and have been cocultivated with tumor cells. In the brain tumors, a clear progression of glioma and melanoma cells was observed along the abluminal surface of vessels, where they occupied a pericytic location along the periendothelial laminin. In vitro, time-lapse videomicroscopy recorded the migration of tumor cells toward endothelial tubules. After 24 hours, both the melanoma cells and the glioma cells were localized along the external surfaces of the vascular tubules, occupying a pericytic-like location. These similarities between glioma and melanoma support the hypothesis of an extravascular migration of melanoma cells, particularly along the abluminal surface of vessels.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Cutaneous ossification is an unusual event that may be primary or secondary to either inflammatory or neoplastic processes. It is classified as primary when it occurs in the absence of a demonstrable preexisting lesion. Secondary lesions have been most commonly reported occurring with pilomatricoma, basal cell carcinoma, acne vulgaris, and melanocytic nevi (nevus of Nanta). Histologically, the osteomas are composed of well-formed bony spicules with prominent cement lines and calcification. They may demonstrate osteoblasts, osteoclasts, and osteocytes and occasionally may even demonstrate bone marrow elements. We searched the files of a reference dermatopathology laboratory to identify cases of either primary or secondary cutaneous ossification. We present a series of 74 cases of primary and secondary cutaneous ossification. Most cases were secondary in nature. Lesions were more common on the head and neck and in whites. Lesions were also more commonly identified in female patients. In addition, included in our series are 19 cases of nevus of Nanta. To our knowledge, this represents the largest series of such cases in the English literature. Cutaneous ossification is seen both in primary and, more commonly, in secondary conditions involving the skin. Benign neoplasms, especially melanocytic nevi, represent the most common cause of secondary osteoma formation. Women are more commonly affected than men, but the reason for this is unclear. The exact reason why osteoma formation occurs is unclear and requires further study.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Syndecan-1 is the prototypic member of a family of heparan sulfate–bearing cell surface proteoglycans that function in adhesion, cell–extracellular matrix interactions, migration, and proliferation. During embryogenesis, syndecan-1 expression in the epithelium is downregulated when the epithelium gives rise to motile mesenchymal cells, whereas mesenchymal syndecan-1 expression is upregulated during organ formation. In aggressive basal cell carcinomas, syndecan-1 expression is evident in the stroma. Some neoplastic cells induce stroma to meet needs for growth, and it may be the mesenchymal cells that produce and shed syndecan-1 into the stroma. The physiologic mechanism by which the hair follicle undergoes its cyclic process of involution and formation of a new active hair follicle is not well understood. Sixty scalp biopsies and a large scalp resection were evaluated for syndecan-1 expression within hair follicles in the growing (anagen), involuting (catagen), and resting (telogen) phases. Strong syndecan-1 immunoreactivity was evident in the outer root sheath (ORS) of the anagen hair follicle, but this expression diminished in intensity with the involution and resting stages in the hair follicle cycle. The diminution of syndecan-1 immunoreactivity in the ORS of involuting and resting hair follicles may be a result of terminal keratinocyte differentiation. Syndecan-1 was also present in the dermal papilla of the anagen hair follicle, where it may promote growth factor–mediated cell signaling that induces and maintains growth of the hair shaft and the inner root sheath.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Mast cells with bilobed or multilobed nuclei have only rarely been observed in the bone marrow of patients with systemic mastocytosis and in a case of subdural mast cell sarcoma. To our knowledge, they have not been reported in cutaneous mast cell disease. We report a rare occurrence of mast cells with bilobed or multilobed nuclei (atypical mast cell type II) in a nodular lesion of a 24-year-old woman with urticaria pigmentosa. The typical and atypical mast cells were confirmed by Giemsa and Leder's naphthol-AS-D-chloroacetate esterase stains and by immunohistochemical staining for tryptase and KIT protein (CD117). Although the nodular lesion with atypical mast cells did not appear to be cytologically malignant, the occurrence of atypical mast cells in a nodular lesion but not in a papular lesion might denote progression of the disease as suggested by the emergence of cells positive for p53.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

We report on a case of a peculiar tumor of the pilosebaceous unit showing a composite histologic appearance. The case presented as a pigmented crusted lesion on the back of the nose of a 62-year-old woman with markedly sun-damaged skin. Histologically, the superficial portion of the neoplasm was composed of buds and nests of basaloid epithelium with varying degrees of pilar and sebaceous differentiation. Adjacent to this component, lobules of squamous cells with cytoplasmic glycogenation suggesting the mature outer root sheath were seen. In the underlying dermis, there was a well-defined nodular proliferation composed of variably pigmented basaloid matrical cells forming clusters of “shadow” or “ghost cells” admixed with numerous melanized dendritic melanocytes; this last component of the neoplasm was identical to a recently described entity, melanocytic matricoma. The small size, circumscription, and absence of necrosis favored benignity, although the cytologic atypia of matrical cells did not exclude malignancy. The case is interesting not only because it is the third reported case of a peculiar neoplasm imitating the epithelial-melanocytic interaction in the embryonal hair follicle or bulb of the anagen follicle but because the part resembling melanocytic matricoma presented as a component of a complex lesion. We believe that sunlight may have played a role in the development of this peculiar neoplasm.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Trichoblastomas (TBs) are benign skin tumors recapitulating the differentiation of hair follicles. Several pathologic variants have been described, including the rare pigmented TB. We report a deeply pigmented nodular tumor excised on the scalp of a 32-year-old African woman, which was clinically suggestive of blue nevus or melanoma. Histologically, the tumor presented features of TB, remarkable by virtue of heavy melanin deposits found within and around tumor nests. By immunohistochemistry, abundant dendritic melanocytes with features of hair follicle melanocytes (expression of S100 protein, tyrosinase, and, most importantly, gp100/HMB-45) were found within the tumor masses. By analogy with melanoacanthoma, a tumor consisting of a combined proliferation of epidermal keratinocytes and melanocytes, we called this tumor “melanotrichoblastoma” and view it as a peculiar variant of (pigmented) TB.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Frederick Parkes Weber described relapsing nonsuppurative panniculitis in 1925. In 1928, Henry Asbury Christian added the word “febrile” (relapsing febrile nodular nonsuppurative panniculitis), whereas Brill first coined the eponym “Weber-Christian disease” in 1936. This article traces the lives of Parkes Weber and Henry Christian and summarizes their original publications. It addresses only briefly the controversy as to whether Weber-Christian disease does or does not exist.

ISSN:0193-1091    

出版商:OVID    

年代:2002

数据来源: OVID