Sarcomatoid carcinoma associated with small cell carcinoma of the urinary bladder: a series of 28 cases

Publication date: Available online 19 August 2017
Source:Human Pathology
Author(s): Yuly Ramirez Urrea, Jonathan I. Epstein
The association of sarcomatoid carcinoma (SC) with small cell carcinoma (SCC) has not been systematically studied. We identified 39 consult cases between 2001–2016 with available slides for review in 28 cases. There were 19 men and 9 women [mean age: 78years (51–89)]. In 26 (92.8%) cases, the sarcomatoid component had nonspecific malignant spindle cells, 4 (14%) chondrosarcoma, 2 (7%) myxoid sarcomatous, 1 (3.5%) osteosarcoma, and 1 (3.5%) rhabdomyosarcoma. The predominant component was in 11 (39%) cases SCC, 6 (21%) urothelial carcinoma, 3 (10%) sarcomatoid, and 8 (29%) equal sarcomatoid and SCC. There were 3 morphological groups: group 1 [18/28 (64%)] showed a gradual transition from SCC to other components; group 2 [5/28 (18%) had an abrupt transition from SCC to other components; and in group 3 [5/28 (18%)], the SCC was separate from other components. In Group 1, 12 (66%) cases of SCC showed a gradual transition to sarcomatoid areas, 3 (17%) to urothelial carcinoma, and in 3 (17%) cases to multiple components including squamous cell carcinoma, urothelial carcinoma, and sarcomatoid. Mortality did not differ based on pathological Groups. The 36-month actuarial risk of death was 64.3%. The multitude of different components in these tumors is further evidence of the remarkable ability of carcinoma of the bladder to show divergent differentiation with in some cases gradual transition between SCC and other elements including sarcomatoid. Greater recognition of this entity with chemotherapy targeted to the various histological elements may have important therapeutic implications.

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Anatomical study of the palatine aponeurosis: application to posterior palatal seal of the complete maxillary denture

Abstract

The palatine aponeurosis is a thin, fibrous lamella comprising the extended tendons of the tensor veli palatini muscles, attached to the posterior border and inferior surface of the palatine bone. In dentistry, the relationship between the “vibrating line” and the border of the hard and soft palate has long been discussed. However, to our knowledge, there has been no discussion of the relationship between the palatine aponeurosis and the vibrating line(s). Twenty sides from ten fresh frozen White cadaveric heads (seven males and three females) whose mean age at death was 79 years) were used in this study. The thickness of the mucosa including the submucosal tissue was measured. The maximum length of the palatine aponeurosis on each side and the distance from the posterior nasal spine to the posterior border of the palatine aponeurosis in the midline were also measured. The relationship between the marked borderlines and the posterior border of the palatine bone was observed. The thickness of the mucosa and submucosal tissue on the posterior nasal spine and the maximum length of the palatine aponeurosis were 3.4 mm, and 12.2 mm on right side and 12.8 mm on left, respectively. The length of the palatine aponeurosis in the midline was 4.9 mm. In all specimens, the borderline between the compressible and incompressible parts corresponded to the posterior border of the palatine bone.

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Lymphatic drainage of lung segments in the visceral pleura: a cadaveric study

Abstract


Purpose

Although peribronchial lymphatic drainage of the lung has been well characterized, lymphatic drainage in the visceral pleura is less well understood. The objective of the present study was to evaluate the lymphatic drainage of lung segments in the visceral pleura.


Methods

Adult, European cadavers were examined. Cadavers with a history of pleural or pulmonary disease were excluded. The cadavers had been refrigerated but not embalmed. The lungs were surgically removed and re-warmed. Blue dye was injected into the subpleural area and into the first draining visceral pleural lymphatic vessel of each lung segment.


Results

Twenty-one cadavers (7 males and 14 females; mean age 80.9 years) were dissected an average of 9.8 day postmortem. A total of 380 dye injections (in 95 lobes) were performed. Lymphatic drainage of the visceral pleura followed a segmental pathway in 44.2% of the injections (n = 168) and an intersegmental pathway in 55.8% (n = 212). Drainage was found to be both intersegmental and interlobar in 2.6% of the injections (n = 10). Lymphatic drainage in the visceral pleura followed an intersegmental pathway in 22.8% (n = 13) of right upper lobe injections, 57.9% (n = 22) of right middle lobe injections, 83.3% (n = 75) of right lower lobe injections, 21% (n = 21) of left upper lobe injections, and 85.3% (n = 81) of left lower lobe injections.


Conclusion

In the lung, lymphatic drainage in the visceral pleura appears to be more intersegmental than the peribronchial pathway is—especially in the lower lobes. The involvement of intersegmental lymphatic drainage in the visceral pleura should now be evaluated during pulmonary resections (and especially sub-lobar resections) for lung cancer.

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Gonadal morphogenesis and establishment of the germline in the phyllostomid bat Sturnira lilium

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Publication date: Available online 18 August 2017
Source:Acta Histochemica
Author(s): Tania Janeth Porras-Gómez, Adriana Martínez-Juárez, Norma Moreno-Mendoza
In vertebrates such as the mouse and the human, primordial germ cells (PGCs) arise at the base of the allantois and are carried to the epithelium of the posterior intestine, to later migrate to the primordial gonads. In the case of bats, almost nothing is known about this process. To clarify the dynamics of PGCs during gonadal morphogenesis in the phyllostomid bat Sturnira lilium, the proteins for the Ddx4, Sox9 and Mis genes were detected in the gonads of embryos at different stages of development. We identified 15 stages (St) of embryonic development in Sturnira lilium. We found that the formation of the genital ridge and the establishment of the undifferentiated gonad take place between stages 11 and 14. The onset of morphological differentiation in the gonad is first detected in the male gonads at St17. The first PGCs in meiosis are detected in the ovary at St19, whereas in the testicles, the PGCs were in mitotic arrest. Structural changes leading to testicular and ovarian development in Sturnira lilium are observed to be similar to those described for the mouse; however, differences will be established concerning the time taken for these processes to occur.

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MULTINODULAR AND VACUOLATING NEURONAL TUMOURS IN EPILEPSY: DYSPLASIA OR NEOPLASIA?

Abstract

Multinodular and vacuolating neuronal tumour (MVNT) is a new pattern of neuronal tumour included in the recently revised WHO 2016 classification of tumours of the CNS. There are fifteen reports in the literature to date. They are typically associated with late onset epilepsy and a neoplastic versus malformative biology has been questioned. We present a series of ten cases and compare their pathological and genetic features to better characterised epilepsy associated malformations including focal cortical dysplasia type II (FCDII) and low-grade epilepsy associated tumours (LEAT). Clinical and neuroradiology data were reviewed and a broad immunohistochemistry panel was applied to explore neuronal and glial differentiation, interneuronal populations, mTOR pathway activation and neurodegenerative changes. Next generation sequencing was performed for targeted multi-gene analysis to identify mutations common to epilepsy lesions including FCDII and LEAT. All of the surgical cases in this series presented with seizures, and were located in the temporal lobe. There was a lack of any progressive changes on serial pre-operative MRI and a mean age at surgery of 45 years. The vacuolated cells of the lesion expressed mature neuronal markers (neurofilament/SMI32, MAP2, synaptophysin). Prominent labelling of the lesional cells for developmentally regulated proteins (OTX1, TBR1, SOX2, MAP1b, CD34, GFAPδ) and oligodendroglial lineage markers (OLIG2, SMI94) was observed. No mutations were detected in the mTOR pathway genes, BRAF, FGFR1 or MYB. Clinical, pathological and genetic data could indicate that MVNT aligns more with a malformative lesion than a true neoplasm with origin from a progenitor neuro-glial cell type showing aberrant maturation. This article is protected by copyright. All rights reserved.

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HIPPOCAMPAL SCLEROSIS, HIPPOCAMPAL NEURON LOSS PATTERNS AND TDP-43 IN THE AGED POPULATION

Abstract

Hippocampal neuron loss is a common neuropathological feature in old age with various underlying aetiologies. Hippocampal sclerosis of aging (HS-Aging) is neuropathologically characterized by severe CA1 neuronal loss and frequent presence of transactive response DNA-binding protein of 43kDa (TDP-43) aggregations. Its aetiology is unclear and currently no standardized approaches to measure HS-Aging exist. We developed a semi-quantitative protocol, which captures various hippocampal neuron loss patterns, and compared their occurrence in the context of HS-Aging, TDP-43, vascular and tau pathology in 672 brains (TDP-43 staining n=642/672, 96%) donated for the population-based Cambridge City over-75s Cohort and the Cognitive Function and Ageing Study. HS-Aging was first evaluated independently from the protocol using the most common criteria defined in literature, and then described in detail through examination of neuron loss patterns and associated pathologies. 34 (5%) cases were identified, with a maximum of five pyramidal neurons in each of over half CA1 fields-of-view (x200 magnification), no vascular damage, no neuron loss in CA2-CA4, but consistent TDP-43 neuronal solid inclusions and neurites. We also report focal CA1 neuron loss with vascular pathology to affect predominantly CA1 bordering CA2 (Fisher’s exact, p=0.009), whereas neuron loss in the subicular end of CA1 was associated with TDP-43 inclusions (Fisher’s exact, p<0.001) and high Braak stage (Fisher’s exact, p=0.001). Hippocampal neuron loss in CA4-CA2 was not associated with TDP-43.

We conclude that hippocampal neuron loss patterns are associated with different aetiologies within CA1, and propose that these patterns can be used to form objective criteria for HS-Aging diagnosis. Finally, based on our results we hypothesize that neuron loss leading to HS-Aging starts from the subicular end of CA1 when it is associated with TDP-43 pathology, and that this neurodegenerative process is likely to be significantly more common than “end-stage” HS-Aging only. This article is protected by copyright. All rights reserved.

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Primary intraosseous squamous cell carcinoma – A rare odontogenic malignancy

Arush Thakur, Jagdish V Tupkari, Tabita Joy, Ajas A Gogri

Journal of Oral and Maxillofacial Pathology 2017 21(2):320-320

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare epithelial odontogenic malignancy affecting the jaws, especially in elderly population. It is a rare lesion, because very few cases of PIOSCC have been reported in the literature with not much of research done on this particular entity. In the present article, we report a case of PIOSCC with detailed discussion of clinical, radiographic and histopathologic features along with review of literature.

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