摘要:

This study shows that fluorescencein situhybridization (FISH) to thin sections cut from paraffin‐embedded material can lie used to distinguish between groups of melanocytic neoplasms and thus may be useful as an investigational and diagnostic tool. FISH with a probe for a repealed, alpha satellite sequence specific to chromosome 17 was used to investigate the chromosomal composition of dysplastic (or Clark's nevus) and Spitz's nevi and malignant melanomas. Hybridization was to thin (∼6 μm) sections cut from paraffin blocks. The number of signals per nucleus in normal diploid cells is expected to be less than 2 since the sections are thinner than one nuclear diameter. Keratinocytes and lymphocytes m these same sections showed 1–2 signals per nucleus with a mean of 1.2. Dysplastic nevi showed 1–4 hybridization signals per nucleus with a mean of 1.5. Spitz's nevi showed 1–2 signals per nucleus with a mean of 1.3. Melanomas showed 1–6 signals per nucleus with a mean of 2.1. We were thus able to use FISH to demonstrate differences in chromosome numbers between groups of benign and malignant melanocytic neoplasms. Technical improvements in the near future can be expected lo result in more precise estimates of chromo

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00683.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Recently image analysis (IA) and DNA‐cytophotometry (CP) have proved to be useful for the differentiation between benign and malignant melanocytic lesions on paraffin sections. Since, on sections, these procedures are very time‐consuming, we tested in the present study whether LA of imprint specimens, which can be evaluated in less than 30 minutes, might also be sufficient. In 39 malignant melanomas (MM), 18 melanocytic nevi (MN), and 6 dysplastic nevi (ON), 12 different morphometric and DNA cytometric features were determined in 100 randomly selected nuclei. In univariate analysis, 5 features were found to be significantly different between the benign and malignant groups (p<0.0001): mean value (MAREA) and standard deviation (SAREA) of nuclear area and the 80th, 90th, and 95th percentiles of DNA distribution. Using SARKA, the best univariate feature, 82.5% of the cases could be correctly separated. In multivariate analysis with a combination of three features–standard deviation of nuclear area (SAREA), mean DNA value (MDNA), and 95th percentile of DNA distribution (PERC95) ‐ a coned diagnosis was achieved in 89.5% of the cases. Results obtained in the cases of ON indicated an increased proliferation, but did not allow the separation of DN from MM and MN. Since our technique allows a rapid analysis without loss of tissue, which might be important for histological analysis, and the classification rates are equal or still higher than reported in studies on sections, imprints of melanocytic lesions seem to be most appropriate for the calculation of DNA cytometric features as helpful diagnostic criteria in equivocal melanocytic

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00684.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Clinical and histologic features of 44 invasive squamous cell carcinomas of the lip treated by surgical excsion were correlated with metastases and survival. Age, diameter, ulceration, grade, depth of invasion, muscle invasion, mitotic rate, lymphatic‐vascular invasion, and tumor infiltrating lymphocytes were evaluated. Two (4.5%) patients had local recurrence, 10 (23%) had metastases to cervical lymph nodes, and 2 (4.5%) died from complications of extensive spread in the neck. One patient with local recurrence had regional node metastases. Regional metastases were discovered at the lime of (3 patients) or up to 21 (median 8) months after initial diagnosis, correlating with ulceration (P − 0.003), depth of invasion (P − 0.0001), and mitotic rate (P − 0.05) of the primary tumor. Depth exceeding 2.0 mm. was associated with metastasis (P − 0.028), and all carcinomas deeper than 6.0 mm. metastasized. Eight of the 10 patients with regional metastases had no farther disease after treatment through the follow‐up period (median 64 months). Both fatalities were older (median 81 years) men. These results underscore the metastatic potential of invasive squamous cell carcinoma of the lip. Histologic analysis of the primary lesion can be used to identify individu

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00685.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We retrospectively studied 25 cases of cutaneous primary, locally recurrent or metastatic Merkel cell carcinoma to see if expression of the cell surface marker CD44 correlated with metastatic potential. In 3 of 6 cases in which metastasis was documented, CD44 was found on membranes of tumor cells. Three cutaneous lesions associated with local metastasis did not express CD44. Three primary tumors expressed CD44 but had not disseminated at the time of this report; follow‐up after excision of the primary lesion in these cases was less than (5 months. None of the primary or locally recurrent Merkel cell carcinomas followed longer than 6 months (14 of 19 cases) expressed CD44. We conclude that expression of CD44 in Merkel cell carcinoma may eventually be of some value in the assessment of prognosis of cutaneous Merkel cell carcinom

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00686.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A series of 3 cases of acantholytic dermatosis localized to the male genitalia and perineal area with distinct clinical and histological features is presented. These patients did not have a family history of similar disorders and had no evidence of rash elsewhere. Clinically, the eruption was characterized by multiple discrete papules or macerated patches involving the genitalia and the perineum. Histologically, the acantholytic dermatosis had features that resembled both Hailey‐Hailey disease and Darier's disease. Similar clinical and histological findings have been reported in females. To the best of our knowledge, this is the first report of these lesions described confined to the genital and perineal areas in male patients. We agree with other authors that this condition may represent a distinct acantholytic eruption in the perineal area that should be distinguished from other generalized blistering acantholytic dyskeratotic disorders dial may also involve the genitali

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00687.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

To study the temporal and spatial relationship between infiltrating T‐cell subsets or eosinophils and cell adhesion molecules on endothelial cells in skin lesions of atopic dermatitis (AD), we undertook immunohistochemical analysis using monoclonal antibodies against surface markers of T cells, eosinophil granule proteins and cell adhesion molecules. Predominant mononuclear cells in acute and chronic skin lesions were CDS, CD4 and CD45RO positive helper‐inducer/memory T cells. Their number was significantly and strongly correlated with the intensity of E‐selectin expression. Eosinophils and deposition of eosinophil‐derived granule proteins such as eosinophil cationic protein (ECP), major basic protein (MBP) and eosinophil peroxidase (EPO) were found constantly in acute lesions and only occasionally in chronic lesions. The total number of immunoreactive eosinophils and deposits of MBP, EPO and ECP were significantly and strongly correlated with die staining intensity of VCAM‐1. In chronic lesions significant reduction of VCAM‐1 expression paralleled occasional infiltration of eosinophils. Our results demonstrate the possibility that E‐selectin and VCAM‐1 are the critical adhesion molecules for trafficking of memory T cells and eosinophils, respectively, into skin lesions of AD. Persistent expression of the adhesion molecules may be related to prolongation of the sk

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00688.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We describe 5 new cases of striated muscle hamartoma (SMH) and review the 7 cases previously described in the literature. Eleven of the 12 patients had single lesions centrally located on the chin (4), near the ala of the nose (3), on the upper chest (3), and on the upper lip (1). Histologically all of the lesions were characterized by a central core containing bundles and individual fibers of skeletal muscle as well as other mesenchymal elements. The muscle fibers penetrated the dermis among numerous folliculo‐sebaceous structures. Of the 12 cases of SMH, 3 had other associated congenital anomalies including a cleft lip in 1 patient and a thyroglossal duel sinus in another with single lesions, and preauricular sinuses, low‐set ears and bilateral sclerocorneas in the case of multiple SMH. The relationship of SMH with oculocerebrocutaneous syndrome is discussed, and we conclude that at least some of the skin appendages associated with that syndrome are

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00689.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Giant cell lichenoid dermatitis is a recently described dermatosis thought to be an unusual lichenoid drug eruption. It is characterized by a generalized, pruritic, papulosquamous eruption sparing palms, soles, face and mucous membranes. Histopathologic findings include areas of epidermal hyperplasia and atrophy with focal vacuolar alteration of the basal layer, exocytosis and cytoid body formation. The dermis contains a band‐like, mononuclear cell infiltrate at the dermoepidermal junction with admixed cosinophils, plasma cells and large multinucleate cells. The histologic differential diagnosis includes infectious processes, sarcoidosis, lichen nitidus, lupus erythematosus and lichen planus. We report 3 patients with giant cell lichenoid dermatitis, one of whom was subsequently diagnosed as having sarcoidosis. Because giant cell lichenoid dermatitis may resemble sarcoidosis both clinically and histologically, and because cutaneous sarcoid is often associated with systemic involvement, the diagnosis of sarcoid should be strongly considered in patients with giant cell lichenoid dermatiti

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00690.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

It is well known that several dermatoses, such as psoriasis vulgaris and seborrheic dermatitis, present with more extensive and severe disease in patients infected with the human immunodeficiency virus (HIV‐1). Except for one report, however, lichen planus (LP) has not been described in patients with HIV infection. In this report we describe the clinical and morphological features of 3 HIV‐positive patients who presented with extensive hypertrophic LP. To determine if alteration in the immune status in HIV‐positive hosts is reflected in the nature of the infiltrate in LP, we determined the proportion of T‐helper and T‐suppressor cells in the infiltrate in 1 case. The majority of the infiltrating lymphocytes in the dermis were of the T‐helper phenotype. Epidermal lymphocytes, however, were predominantly of the T‐suppressor phenotype. We conclude that LP in HIV‐positive hosts may present with more extensive disease than in immunocompetent hosts. Based on our immunohistochemical studies, we conclude that, similar to immuonocompetent hosts, T‐helper cells are the predominant cells in the dermal infiltrate of LP in HIV‐positive patients. However, in contrast with reports in the literature on LP in immunocompetent hosts, we found that, in the case studied, the epidermal lymphocytes were predominantly of the T

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00691.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

An‐11‐day old girl was seen with brownish nodular lesions scattered over (he body with emphasis on the face and seal). Several lesions had started lo involute. Tissue was studied by histopathology, immunohistopathology, routine electron microscopy, and immuno‐electron microscopy using cryosubstitution and embedding in K4M. Immunohistopathology revealed that the cells of the dermal infiltrate were Langerhans cells. They expressed Leu 6 and HLA‐DR. On routine electron microscopy no Birbeck granules were (bund in the dermal cells. Birbeck granules in epidermal Langerhans cells were deformed and often situated next to laminated dense bodies. The latter expressed Leu 6 and HLA‐DR. on immuno‐electron microscopy. It was concluded that congenital self‐healing reticulohistiocytosis is a benign Langerhans cell disease in which Birbeck granules are transformed to laminated dense bodies and possibly degraded by lyso

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1994.tb00692.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY