摘要:

This review will cover acute cutaneous eruptions following marrow ablation in the treatment of various malignant neoplasms. The clinical and histopathological features of 1. the eruption of lymphocyte recovery, 2. acute allogeneic graft‐vs‐host reaction, 3. acute autologous (spontaneous) graft‐vs‐host reaction, 4. eruptions associated with the administration of cyclosporin A, and 5. eruptions associated with the administration of human recombinant cytokines in pharmacologic doses will be considered. The idea is put forth that the second, third, and fourth cutaneous eruptions listed above represent variations on the theme of the eruption of lymphocyte recovery. The final common pathway in the development of all these diffuse erythematous eruptions probably relates to the elaboration of cytokines by infiltrating lymphocytes or to the administration of cytokines in pharmacologi

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00277.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The BCL‐2 gene is the prototype of a newly described family of oncogenes involved in tumorigenesis by blocking apoptosis, or programmed cell death. Overexpression of BCL‐2 protein was originally described in follicular B‐cell lymphomas bearing the 14;18 translocation. BCL‐2 overexpression has also been described in other lymphomas and more rarely in neoplasms outside the lymphoid tissue. The aim of this paper is to determine the immunohistochemical expression of BCL‐2 in intradermal nevi and primary invasive and metastatic melanoma. Formalin‐fixed and paraffin‐embedded tissues from 4 cutaneous melanoma metastases, 10 primary invasive melanomas, and 10 intradermal melanocytic nevi were immimolabeled with monoclonal antibodies directed against BCL‐2 protein (Dako, clone 124) and Ki‐67 antigen (Amac, clone MIB‐1), after antigen retrieval techniques. Morphologically normal epidermal melanocytes expressed BCL‐2, as did nevi and melanomas in virtually all cells. However, whereas the labeling in normal melanocytes and nevus cells showed a uniformly strong reactivity, melanoma cells showed a variable but mainly weak reactivity. Ki‐67 antigen expression was restricted to melanomas. The widespread expression of BCL‐2 suggests that this onco‐protein cannot be involved in the malignant transformation of melanocytic cells. It seems likely that the decreased BCL‐2 expression detected in melanomas may reflect one further step of tumor progres

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00278.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Thebcl‐2proto‐oncogene encodes a protein that protects cells from programmed cell death (apoptosis). High levels of this protein confer a growth advantage to neoplastic cells even in the absence of a high mi to tic rate. This gene is involved in the interchromosomal 14;18 translocation, an abnormality present in more than two‐thirds of follicular lymphomas and in about 25% of other non‐Hodgkin's lymphomas of the lymph nodes. A recent study also demonstrated the presence of high levels ofbcl‐2protein in solid tumors such as squamous cell carcinomas of the lung and related it to a better prognosis. We analyzedbcl‐2protein expression in 20 cases each of basal‐ and squamous‐cell carcinoma and in 5 biopsy specimens of normal skin, using a monoclonal anti‐bcl‐2protein antibody with a standard 3‐step immunoperoxidase technique on routinely fixed, paraffin‐embedded tissue sections. Normal skin showed positive staining of the majority of keratinocytes in the epidermal basal layer.bcl‐2positivity was also observed within the outer root sheath and the mesenchymal cells of the follicular papillae', the clear cells of the eccrine glands, and in some melanocytes at the dermo‐epidermal junction. Neoplastic cells in all cases of basal‐cell carcinoma showed a positive cytoplasmic reaction forbcl‐2All biopsy specimens of squamous‐cell carcinoma were negative. Expression ofbcl‐2protein could also be observed in the majority of peri‐ and intratumoral lymphocytes in both basal‐cell carcinoma and squamous‐cell carcinoma. Our results indicate that protection from apoptosis mediated bybcl‐2protein may be involved in the neoplastic growth mechanism of basal‐cell carcinoma. Further studies are required to detect the molecular basis o

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00279.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

It has recently been reported that atypical fibroxanthoma (AFX) is a predominantly diploid lesion in contrast to malignant fibrous hystiocytoma (MFH) which is usually aneuploid. To test this hypothesis, DNA content quantification was undertaken on Feulgen‐stained cytology and tissue section preparations from 10 cases of AFX by image analysis. The large‐atypical cells which characterize AFX were aneuploid in each case. Smaller spindle‐shaped cells found in this lesion were diploid. The results suggest that AFX is indistinguishable from MFH by DNA content estimation and highlight an advantage of image analysis over (low cyto

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00280.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The association between infection with HSV and the subsequent, development of erythema multiforme is well established, although the role that the virus plays in the pathogenesis of this disorder is not known. HSV DNA has been detected in cutaneous lesions of herpes‐associated erythema multiforme (HAEM), and it has been suggested that the tissue damage seen in these lesions is virus‐specific. In the current, prospective study, we examined biopsies of lesional, non‐involved, and previously involved but healed skin, in addition lo specimens of peripheral blood, from patients with HAEM, for HSV DNA by using the polymerase chain reaction. HSV DNA was detected in lesional skin of 10 of 11 patients compared to 2 of 11 non‐involved skin biopsies obtained at the same time. I ISV was present in 4 of 6 blood specimens obtained during the acute episode. Five patients returned 3 months after the acute episode resolved for biopsies of previously involved skin. HSV was detected in 4 of these 5 biopsies. Thus, the presence of HSV DNA in the skin of pal inns with HAEM appears lo be predominantly in areas of clinical involvement; the virus remains in those cutaneous sites for up to 3 months without evidence of clinical disease; and HSV DNA may be detected in the peripheral blood cells during acute HAEM. Based on these findings, we suggest that the virus plays a role in lesion development, that the skin may function as a site of viral persistence, and that hemalogenous spread of viral DNA may bean important factor in the development

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00281.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

T lymphocytes bearing the γ/δ T‐cell receptor are a rare component of normal human GI epithelium and skin. Recently, however, an unusually high percentage of T lymphocytes with γ/δ receptors has been described in gastrointestinal biopsies from patients with dermatitis herpetiformis, implicating the γ/δ T cell subset in the pathogenesis of this disease. We investigated a possible role for this subset of lymphocytes in the pathogenesis of the cutaneous lesions of dermatitis herpetiformis. Using a standard immunoperoxidase technique, we labelled perilesional skin biopsies from patients with dermatitis herpetiformis and other inflammatory dermatoses with monoclonal antibodies to CDS, CD4, CDS, α/β T cell receptor, γ/δ T cell receptor, and IL‐2 receptor. We found no differences in the percentage of γ/δ positive T lymphocytes in skin lesions of dermatitis herpetiformis as compared to other selected in‐flammatory conditions. These findings suggest that die pathogenesis of the cutaneous lesions of dermatitis herpetiformis is not mediated through γ/δ T cells, and that the cutaneous lesions may develop through mechanisms different from those operative in the gas

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00282.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study examines the utility of objective histopathological studies in the evaluation of adult patients with erythroderma. A series of 56 skin biopsies, from 40 erythrodermic patients, was reviewed sequentially by 4 Canadian dermatopathologists who were unaware of clinical details of the cases. The final diagnosis (gold standard), in each instance, had already been determined by others, based on clinicopathologic data and response to therapy. Direct comparison revealed that the mean accuracy of I he histopathological diagnoses was 53% (range: 48‐(i6%). a favorable result in view of the difficulty of the task at hand. Additional points of information which evolved from the study are as follows: (i) identification, by microscopy alone, of spongiolic dermatitis, cutaneous T‐cell lymphoma and psoriasis, as underlying causes of eryihroderma was more successful than that of drug eruptions and pilyriasis rulira pilaris; (ii) the1 epidermotropism which characterizes cutaneous T‐cell lymphoma may be mistaken for inflammatory interface changes seen in drug eruptions and vice versa, thus constituting a pitfall in diagnosis; (iii) finally, it appears dial submission of multiple simultaneous biopsies, rather than a single specimen, from patients with erythroderma would be likely to enhance the accuracy of histopathological diag

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00283.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Tenascin is a large extracellular matrix glycoprotein which is widely distributed in normal, hyperplastic and neoplastic tissues. Its function is unknown but it has been associated with the epithelial‐stromal interactions, such as cell adhesion and movement which take place, e.g. in morphogenesis, cellular proliferation and neoplasia. In this study, we investigated tenascin expression in 70 benign, dysplastic and malignant melanocytic tumors by using immunohistochemistry and monoclonal anti‐tenascin L43DB7C8 antibody on paraffin sections. In all types of benign nevi, both intradermal, compound and functional, there was a moderate expression of tenascin at the dermoepidermal junction and in the papillary dermis. In dysplastic nevi, the fibrotic areas in the papillary clermis also showed a moderate staining for tenascin. Invasive malignant melanomas showed the strongest expression of tenascin. In addition to the staining at the dermo‐epidermal junction and in the papillary clermis, there was a variable expression of tenascin in the reticular dermis. Intracyloplasmic tenascin was detected both in primary melanomas and melanoma metastases. In conclusion, we have shown that tenascin expression is moderately increased in benign and dysplastic melanocytic tumors and greatly increased in malignant melanomas and melanoma metastases. The function of tenascin may be related to the cellular‐stromal interactions and it is possibly associated with the proliferation and spread of the melanocytic

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00284.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Cutaneous lupus erythematosus (LE), polymorphous light‐eruption (PMLE), lymphocytic infiltration of Jessner (LIJ), and cutaneous lymphoid hyperplasia (CLH) are often difficult to differentiate from ok‐ another by light microscopic examination. We conducted an immunohistochemical analysis of the mononuclear cell infiltrates in 13 LE, 12 PMLE, 10 LIJ, and 13 CLH with various antibodies. Antibodies L26, UCHL1, and S100 achieved statistically significant differences among the lour diseases, but because of the overlaps in the number of UCHL1 (+) T cells and S100 protein (+) cells in individual cases, these two antibodies were not useful. Only (11,11 could be distinguished from LE, PMLE, and LIJ by a greater number of CD20(+) B cells. The latter three' conditions could not be differentiated. Contrary to previous reports, plasmacyloid‐monocytes were not found to be increased in LIJ for the differentiation of the latter from LE and PMLE. Our results support the conclusion that CLH is a reactive lymphoid hyperplastic process with proliferation of both ft and T cells, whereas the T cell was the predominant cell type in the infiltrates of LE, PMLE, and LIJ, indicating that they were related to T cell disorders. The histiocyte was only a minor component cell. The plasmacytoid monocyle in general was not significantly present in all four conditions, but relatively more plasmacytoid monocytes were present i

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00285.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Cutaneous granulomatous vasculitis is an uncommon histopathologic finding that has been associated with lymphoproliferative disorders, systemic vasculitis, autoimmune inflammatory diseases, and infection. To define further the concept of cutaneous granulomatous vasculitis and to emphasize its clinical importance, we reviewed biopsy material from 8 patients seen from 1985 through 1992. All biopsies showed evidence of blood vessel damage with fibrinoid change or hemorrhage (or both) and granulomatous inflammation in and around vessel walls. Special stains for microorganisms were negative in all cases. Associated medical disorders included neuropathy (2 patients), sarcoid‐like disease (2), systemic vasculitis (1), lymphoma and suspected lymphoma (1 each), and associated herpes simplex virus (1). T‐cell gene‐rearrangement studies were negative in a patient with suspected lymphoma. Granulomatous cutaneous vasculitis is most commonly associated with lymphoma and systemic vasculitis. In selected cases, infection should be considered as an underlying

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00286.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY