摘要:

In the skin, separation of selected lymphomas from lymphoid hyperplasia can be challenging. The authors examined 45 cutaneous lymphomas, excluding mycosis fungoides (26 small lymphocytic or mixed tumors; 19 large‐cell lymphomas), 10 “atypical” lesions, and 40 lesions of presumed lymphoid hyperplasia, comparing morphologic attributes of such proliferations with their immunophenotypes in paraffin sections. The object of this study was to determine whether immunologic data obtained from routinely‐processed specimens could be used to further objectify morphologic interpretations. Features favoring lymphonia included a lesional epicenter in the lower clermis or subcutis; poor circumscription of lymphoid aggregates; and dissection of lymphoid cells between collagen bundles. Immunostains included antibodies to CD20, CD43, CD45, CD45RO, CD45RA, CD68, proliferating cell nuclear antigen (PCNA), and MB2. Eleven of 26 small lymphocytic or mixed‐cell lymphomas and 3 of 10 “atypical” cases demonstrated an abnormal immunophenotype, including co‐expression of CD43 and CD20 or non‐physiological CD45RA distribution. In contrast, none of 40 cases with benign features manifested aberrant antigen expression. Thirty‐one of 37 cases in which 75% of the cells typed as B lymphocytes showed malignant morphologic features, 5 were “atypical” and possibly lymphomatous, and only one had benign features. PCNA stains showed greater positivity of the lymphoid nuclei in Lymphomas, and a labeling index of<30% was correlated with malignancy in this context. These observations indicate that immunostaining may provide useful adjunctive information in distinguishing benign from malignant cutaneous lymphoid proliferations in paraffin sections.Ritter JH, Adesokan PN, Fitzgibbons JF, Wick MR. Paraffin section immunohistochemistry as an adjunct to morphologic analysis in the diagnosis of cutaneo

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00717.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Nucleolar organizer regions (NORs) are loops of ribosomal DNA (rDNA) in the nucleolus and are associated with acidic proteins. They are seen in routinely processed paraffin sections by using a one‐step colloidal silver (Ag) staining method; they appear as black dots termed “AgNORs”. The quantitative assay of AgNORs has been used to differentiate benign from malignant neoplasms. Melanocytic lesions differ significantly in AgNOR counts between malignant melanoma and nevi. However, conflicting results have been reported as to AgNORs' prognostic value in melanoma. A recent study showed AgNOR counts to be a more accurate prognostic indicator than Breslow's thickness. In this study, we counted the AgNORs in 26 patients with primary cutaneous melanomas (CMM) between 2.0 mm and 2.5 mm thick. Of these, 14 are alive without disease (AN) at 5 years after diagnosis (group 1), and 12 are dead of disease (DD) in less than 5 years (group 2). The AgNORs were scored in 30 nuclei per tumor, and the means were calculated. For group 1, the mean number of AgNORs per nucleus was 6.88, ranging from 3.73 to 12.70. For group 2, the mean number was 6.97, ranging from 3.63 to 11.67. Statistical analysis using analysis of variance (ANOVA) showed no significant difference between the groups (p=0.33). In our study, AgNOR counts did not prove to be of prognostic value in malignant melanoma.Ronan SG, Farolan MJ, McDonald A, Manaligod JR, Das Gupta TK. Prognostic significance of nucleolar organizer regions (NORs) in malignant mel

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00718.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Integrins constitute a group of transmembrane proteins which mediate cell‐cell and cell‐matrix interactions. Previous studies have shown both increased and decreased expression of integrins in relation to malignancy and invasion. In the present study, we investigated integrin distribution in cutaneous tumors by using monoclonal antibodies on frozen tissue sections. Antibodies to integrin subunits αv, α3, α4, α5, α6, β1 and β3 were used. The study was designed to explore (i) the association between integrin expression and the tumor type, and (ii) the effect on the integrin expression of the location of the tumor, i.e. whether it grows intraepidermally or within various compartments of the dermis (papillary or reticular). (β1, β3 and α3 were strongly or moderately expressed in the epithelial and stromal cells of basal cell carcinomas (BCC), seborrheic keratoses, solar keratoses, dermatofibromas (DF), and showed a variable expression in the nevic cells of benign and dysplas‐tic nevocellular nevi. αv and in α5 appeared strongly expressed in the stromal cells of BCC and DF, while only a focal, often weak staining was seen in nevic cells and in the epithelial cells of BCCs. In some nevocellular nevi, they were only expressed, together with α4, in the deep‐seated nevic cells in the reticular dermis. aL6 was expressed by minor cells of BCCs and nevocellular nevi only within the dermo‐epidermal junction. In seborrheic keratosis and solar keratosis a basement membrane‐associated staining pattern for α6 was seen in the basal cell layer, with focal discontinuities in solar keratosis. In conclusion, the results indicate a wide expression of various types of integrins in cutaneous tumors. The expression is distinctly tumor‐type and cell‐type dependent but is also influenced e.g. by the depth of the stromal infiltration in BCC (α6) and in nevocellular tumors (αv, 4, 5, 6, β3), probably reflecting adaptation to the variable microenvironmental influences.Tuominen H, Junttila T, Karvonen J, Kallioinen M. Cell‐type related and spatial variation in the expressio

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00719.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

DNA‐cytometry and immunohistochemistry with the anti‐p53 antibody DO‐I was performed in 24 keratoacanthomas (KA) and 21 squamous cell carcinomas (SCC) (13 well‐differentiated, 8 moderately differentiated) to establish the possible value of these methods for the differential diagnosis of both epithelial tumors. Aneuploidy was detected in 1 (4%) KA and 12 (57%) SCC (p0.05; not significant). However, quantification of p53expression by evaluating both the intensity of immunostaining and the number of cells with over‐expression by means of an immunoreactivity score (IRS) showed significant differences (p<0.05). There was no correlation of p53over‐expression and aneuploidy in the tumors examined. The analysis of ploidy and immunostaining with anti‐p53antibodies may give useful additional information regarding the differential diagnosis of SCC and KA, if only aneuploidy or a high IRS are considered.Pilch H, Weiss J, Heubner C, Heine M. Differential diagnosis of keratoacanthomas and squamous cell carcinomas: diagnostic value of DNA image cytometry a

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00720.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Ten keratoacanthomas with both proliferative and regressive histologic features along with 10 well‐differentiated squamous cell carcinomas were examined using immunohistochemistry for the expression ofbcl‐2, a protooncogene recently recognized to be involved in protecting cells from undergoing apoptosis. The squamous cell carcinomas had a modest but diffuse staining pattern, while the proliferative keratoacanthomas stained only at the basal cells and only rare cells stained positively in the regressive keratoacanthomas. The degree and pattern of staining suggest a loss ofbcl‐2expression with tumor maturity in keratoacanthoma and a possible role in their ultimate involution.Sleater JP, Beers BB, Stephens CA, Hendricks JB. Keratoacanthoma: A deficient squamous cell carcinoma? Study ofbcl‐2exp

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00721.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Syringolymphoid hyperplasia with alopecia is an uncommon skin disorder described in 1969 by Sarkany. Since then only three additional cases have been reported, all in the European literature. We present a 59‐year‐old man with two persistent hyperpigmented hairless patches of 13 years duration. Biopsy specimens revealed characteristic hyperplastic changes of the eccrine glands and ducts and a dense lymphocytic infiltrate surrounding eccrine structures with “syringotropism”. Perifollicular lymphocytic infiltration and changes consistent with follicular mucinosis and mycosis fungoides were also present. Imunophenotyping and gene rearrangement studies showed I he cells to be primarily of the T helper phenotype with rearrangement of I he surface receptor gene.Tomaszewski M‐M, Lupton GP, Krishnan J, Welch M, James WD. Syringolymphoid hyperplasia with alopecia: A ca

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00722.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We report a case of sclerosing B‐cell lymphoma involving the skin. The patient is a 43‐year‐old man who came to our institution with a 4‐year history of multinodular masses in the back. A thoracic CT scan demonstrated subcutaneous masses with extension to the posterior parietal pleura and compression of several epidural spaces. An incisional biopsy was performed and demonstrated an infiltrative process in the lower dermis composed of interconnected thick sclerosing bands forming compartments around groups of large neoplastic cells. These neoplastic cells were shown to be B lymphocytes using immunohistochemical stains. A diagnosis of diffuse sclerosing B‐cell lymphoma, large cell type, was made. Our case is reported to alert dermatologists and dermatopathologists lo the occurrence of this neoplasm in the skin which could be confused with a deep inflammatory process or other neoplastic conditions.Cruz‐Ramon JG, Blodgett. TP, Puthuff DL, Wilkin JK, Pellegrini AE. Sclerosing B‐cell lymphoma invol

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00723.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We encountered a patient who complained of many small papules on the neck, shoulders, upper chest and upper back. Biopsy specimens showed complete loss of elastic fibers in the upper dermis including papillary dermis, whereas those of the mid dermis were intact. Electron microscopy revealed that assembly of component fibrils of elastic fibers was loose, and electron dense substance was aggregated in the spaces between these loosely bound subunit Fibrils or along the periphery of abnormal fibers. Dermal phagocytes engulfed abnormal as well as normal elastic fibers. Upper dermal elastolysis is a clinical and histopathological entity different from mid‐dermal elastolysis. Ultrastructural changes of the former are essentially similar to those of the latter but much more severe. It is suggested that activated elastophagocytosis of dermal phagocytes may play a role in this disease.Hashimoto K, Tye MJ. Upper dermal elastolysis: A comparative study with mid‐dermal elastoly

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00724.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Cutaneous carcinoma histopathologically resembling nasopharyngeal carcinoma has been termed lymphoepithelioma‐like carcinoma of the skin. We present an additional example of this rare cutaneous neoplasm that was located on the left temple of an 83‐year‐old woman. Serology for Epstein‐Barr virus was negative, and exploration of the nasopharyngeal region disclosed no abnormalities. Histopathologically, the neoplasm consisted of a relatively well‐circumscribed, dermal‐hypodermal nodule composed of irregular aggregates of epithelial cells with vesicular nuclei, some of them in mitosis, and scant cytoplasm. A dense lymphocytic infiltrate was present within the neoplastic aggregates, obscuring the epithelial component, and at scanning magnification, the lesion closely resembled cutaneous lymphoma or pseudolymphoma. There was local sebaceous differentiation. Immunohistochemistry showed positivity in the epithelial component for AE1/AE3 and AEB‐903 cytokeratins and negativity for 8–18 cylokeratins. The inflammatory infiltrate was positive for leukocyte common antigen, UCHL‐1, L‐26, Leu‐22, and OPD‐4 in variable proportions. Scattered cells within this inflammatory infiltrate were also positive for S‐100 protein, vimentin, HAM‐56, and MAC‐387.In situhybridization investigations for the presence of Epstein‐Barr virus genomic DNA yielded negative results. Lymphoepithelioma‐like carcinoma of the skin is a distinct cutaneous neoplasm of unknown histogenesis, although some foci of adnexal differentiation have been found in some specimens. The possibility of cutaneous metastasis from occult nasopharyngeal carcinoma should be ruled out.Requena L, Sánchez Yus E, Jiménez E, Roo E. Lymphoepithelioma‐like carcinoma of the skin: A light‐mi

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00725.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Cutaneous meningeal tumors are rare and can pose a diagnostic problem. We present a case of a 12‐year‐old girl with a family history of von Recklinghausen's disease. The patient was asymptomatic until the age of 11, when she developed two lesions on the head, both diagnosed as plexiform neurofibroma. Subsequently, she presented with a subcutaneous nodule on the left posterior occipital scalp which was excised. On histology, the tumor was composed of spindle‐shaped cells with diffuse and nested patterns. A whorled configuration of the cells, with occasional giant cells and psammoma bodies, was present. There was no evidence of connection between the tumor and the underlying tissues. Immunohistochemical studies were positive for epithelial membrane antigen, vimentin, and weakly for neuron‐specific enolase. Cytokeratin, S‐100 protein, and muscle markers were negative. Based on these features, the diagnosis of cutaneous meningioma was made. An MRI examination failed to detect any communication between the tumor site and the meninges; however, asymptomatic bilateral acoustic neuromas were identified. This case, besides being of interest as a primary cutaneous meningioma, also documents a unique combination of findings, i.e., plexiform neurofibroma, meningioma, and cerebellopontine acoustic neuromas, which should alert the clinician to a forme fruste presentation of von Recklinghausen's disease.Argenyi ZB, Thieberg MD, Hayes CM, Whitaker DC. Primary cutaneous meningioma associated with von Recklinghausen'

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00726.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY