Areas Of Squamous Metaplasia Research Articles

Dynamic pathomorphological characteristics of the nasolacrimal duct in its stenosis

Pathological description of the process of stenosis of the nasolacrimal duct at its various stages. The material for the study was obtained from the wall of the nasolacrimal duct during surgery in 50 patients whose condition was attributed to the 1st, 2nd or 3rd clinical stage of dacryostenosis. The material was fixed in formalin and sent for pathohistological and immunohistochemical (IHC) studies. In the 1st stage, the integrity of the epithelium of the nasolacrimal duct was preserved, the density of goblet cells was reduced. Seromucinous glands were single in the lamina propria in the area of stenosis. Diffuse lymphoid-plasmacytic infiltration was observed along the periphery of the terminal sections of the glands and in the subepithelial zone. The infiltrate includes CD68+ tissue macrophages and CD20+ and CD3+ lymphocytes, with a predominance of B-lymphocytes over T-lymphocytes. In the 2nd stage, changes in the epithelial layer in the stenosis zone were detected. In the IHC study, only individual leukocytes were observed in these zones, and T cells were found mainly in the subepithelial zone, B cells - deeper, monocytes - evenly in all layers. In the adjacent zones, the picture of the infiltrate corresponded to the 1st stage. In the 3rd stage, fragments of the nasolacrimal duct wall were represented by dense fibrous connective tissue with pronounced atrophic changes, areas of squamous metaplasia or proliferation of the basal layer, goblet cells were not detected. There was no infiltrate in the area of stenosis during IHC study. In the cellular elements of the infiltrate in areas adjacent to the stenosis zone, CD20+ and CD3+ lymphocytes were present in equal proportions, the arrangement in layers corresponded to that of the 2nd stage. The results of the study showed that dacryostenosis is a progressive pathological process associated with the progredient development of chronic productive inflammation in the lacrimal ducts.

Экспрессия цитокератинов реактивно измененного цилиндрического реснитчатого эпителия синоназального тракта при хронических воспалительных процессах

Introduction. Currently, there are limited papers on changes in the pseudostratified ciliated columnar epithelium of the sinonasal tract in chronic inflammatory processes, particularly in basal cell hyperplasia. The latter is similar to dysplasia of varying severity of the stratified squamous nonkeratinized epithelium. Studying of changes in the pseudostratified ciliated columnar epithelium can clarify the histogenesis of various epithelial tumors of the sinonasal tract, including sinonasal papillomas. The research is aimed at studying the cytokeratin profile of reactive cylindrical ciliated epithelium in a chronic nonspecific inflammatory process. Materials and methods. We analyzed surgical materials obtained from 567 patients diagnosed with chronic rhinosinusitis with nasal polyps. We performed an immunohistochemical study in 20 cases using the panel of antibodies to Ki-67, Stathmin, Cytokeratin 7, Cytokeratin 10/13, Cytokeratin 14, Cytokeratin 17, Cytokeratin 18, and Cytokeratin 19. Results. Using hematoxylin and eosin staining, we detected basal cell hyperplasia of different severity in 74% (419 cases). In 13% (73 cases), basal cell hyperplasia was combined with foci of squamous metaplasia. Based on the results, we identified 4 types of morphological changes in the epithelial layer with a specific cytokeratin profile: mild basal cell hyperplasia, moderate basal cell hyperplasia, severe basal cell hyperplasia, and areas of squamous metaplasia. Conclusion. Simultaneous expression of cytokeratins in the areas with severe hyperplasia of basal cells, specific for both simple and compound epithelia, allows us to consider this area to have the highest potential for the development of various epithelial tumors of the sinonasal tract, including various types of sinonasal papillomas. Keywords: basal cell hyperplasia, sinonasal papilloma, pseudostratified columnar ciliated epithelium

Adenomyomatous uterine polyp in a Miniature Pinscher: histologic, immunohistochemical, and clinical aspects.

A 14-y-old Miniature Pinscher bitch was admitted to a veterinary clinic because of inappetence and a distended abdomen; ultrasound examination revealed a fluid-filled uterus with a single 1-cm hyperechoic nodule in its lumen. Ovariohysterectomy was performed. Grossly, the uterine horns were distended irregularly and asymmetrically, and the uterine lumen contained 200-300 mL of brown watery fluid. A single white polypoid 0.9-cm diameter nodule was present at the site of the distended uterine horn and arose from the endometrium with a narrow stalk. Histologically, the polyp consisted of dense, smooth muscle fascicles admixed with glandular components; its surface was covered by simple cuboidal epithelium with areas of squamous metaplasia. The myomatous cells expressed the myogenic markers smooth muscle actin and desmin. We interpreted the mass as an adenomyomatous uterine polyp, which is a rare variant of an endometrial polyp.

CLINICAL AND HISTOPATHOLOGIC FEATURES OF PLEOMORPHIC ADENOMA: A CASE REPORT

A benign neoplasm classified as a mixed tumor, the histopathologic aspect consists of a dual proliferation and a mixture of cells with myoepithelial and ductal characteristics in a myxoid, mucoid, and chondroid stroma. a 25-year-old male patient attended the clinic of pathology, stomatology, and radiology of the Faculty of Dentistry of Universidade Federal de Minas Gerais complaining of increased volume on the right side of the palate with an approximate extension of 50 mm in the region of the maxillary posterior teeth. He did not report painful symptoms and declared that he had always lived with the lesion in his mouth. After diagnostic hypotheses of benign glandular tumor and mucoepidermoid carcinoma, the patient underwent incisional biopsy. Histopathologic examination showed proliferating ovoid cells, arranged in cords, forming ductile structures, and also plasmacytoid cells and areas of squamous metaplasia. The stroma consisted of fibrous, cellular, and vascularized connective tissue. After confirming the diagnosis of pleomorphic adenoma, the patient remains under follow-up care. Support: FAPEMIG. A benign neoplasm classified as a mixed tumor, the histopathologic aspect consists of a dual proliferation and a mixture of cells with myoepithelial and ductal characteristics in a myxoid, mucoid, and chondroid stroma. a 25-year-old male patient attended the clinic of pathology, stomatology, and radiology of the Faculty of Dentistry of Universidade Federal de Minas Gerais complaining of increased volume on the right side of the palate with an approximate extension of 50 mm in the region of the maxillary posterior teeth. He did not report painful symptoms and declared that he had always lived with the lesion in his mouth. After diagnostic hypotheses of benign glandular tumor and mucoepidermoid carcinoma, the patient underwent incisional biopsy. Histopathologic examination showed proliferating ovoid cells, arranged in cords, forming ductile structures, and also plasmacytoid cells and areas of squamous metaplasia. The stroma consisted of fibrous, cellular, and vascularized connective tissue. After confirming the diagnosis of pleomorphic adenoma, the patient remains under follow-up care. Support: FAPEMIG.

Histopathology and Immunophenotyping of Congenital Lacrimal (Anlage) Fistulae.

To report the histopathological and immuno histochemical features of congenital lacrimal fistulae. Retrospective chart review of all patients who underwent a fistulectomy for congenital lacrimal fistulae, over a 3-year period from a single surgeon's (M.J.A.) database, were included in the study. A detailed lacrimal system evaluation was performed, and intraoperative findings were documented. The excised fistulae were studied using hematoxylin and eosin and periodic acid-Schiff staining. Immunophenotyping was performed using CD3, CD5, CD10, and CD20. Twelve excised fistulae of 12 patients were studied. The mean age at presentations was 5.3 years (range, 3-11 years). The deeper parts of the fistulae were lined with hypertrophied stratified squamous epithelium similar to canalicular tissue in 83.3% (10/12), reflecting its origin from the canalicular tissue, and 16.7% (2/12) originated from the lacrimal sac and were lined with columnar epithelium with areas of squamous metaplasia. The subepithelial areas showed presence of fibrosis and chronic inflammatory infiltrate. The infiltrates were lymphoplasmacytic and were positive for CD3, CD5, and CD20 and negative for CD10 immunostaining. Hypertrophied stratified squamous lining was the commonest finding. Immunophenotyping revealed features of chronic inflammatory infiltrate composed of a mixture of both T and B lymphocytes. Histopathological analysis of fistulae may be of adjunctive value in determining the origin of the anlage.

Clear cell myoepithelial carcinoma of salivary glands showing EWSR1 rearrangement: molecular analysis of 94 salivary gland carcinomas with prominent clear cell component.

This study examines the presence of the EWSR1 rearrangement in a variety of clear cell salivary gland carcinomas with myoepithelial differentiation. A total of 94 salivary gland carcinomas with a prominent clear cell component included 51 cases of clear cell myoepithelial carcinomas de novo (CCMC), 21 cases of CCMCs ex pleomorphic adenoma (CCMCexPA), 11 cases of epithelial-myoepithelial carcinoma (EMC), 6 cases of EMC with solid clear cell overgrowth, and 5 cases of hyalinizing clear cell carcinoma of minor salivary glands. In addition, 10 cases of myoepithelial carcinomas devoid of clear cell change and 12 cases of benign myoepithelioma were included as well. All the tumors in this spectrum were reviewed, reclassified, and tested by fluorescence in situ hybridization (FISH) for the EWSR1 rearrangement using the Probe Vysis EWSR1 Break Apart FISH Probe Kit. The EWSR1 rearrangement was detected in 20 of 51 (39%) cases of CCMC, in 5 of 21 (24%) cases of CCMCexPA, in 1 of 11 (9%) cases of EMC, and in 4 of 5 (80%) cases of hyalinizing clear cell carcinoma. The 25 EWSR1-rearranged CCMCs and CCMCexPAs shared similar histomorphology. They were arranged in nodules composed of compact nests of large polyhedral cells with abundant clear cytoplasm. Necrosis, areas of squamous metaplasia, and hyalinization were frequent features. Immunohistochemically, the tumors expressed p63 (96%), cytokeratin CK14 (96%), and S100 protein (88%). MIB1 index varied from 10% to 100%, with most cases in the 20% to 40% range. Clinical follow-up information was available in 21 cases (84%) and ranged from 3 months to 15 years (mean 5.2 y); 4 patients were lost to follow-up. Ten patients are alive with no evidence of recurrent or metastatic disease in the follow-up period from 3 months to 15 years (mean 5 y), 3 patients are alive with recurrent and metastatic disease, and 8 died of disseminated cancer 9 months to 16 years after diagnosis (mean 6 y). Lymph node metastasis appeared in 5 patients within 5 months to 4 years after diagnosis (mean 22 mo), distant metastases were noted in 7 patients with invasion of orbit (2 cases), and in 1 case each metastasis to the neck soft tissues, liver, lungs, mediastinum, and thoracic vertebra was noted. We describe for the first time EWSR1 gene rearrangement in a subset of myoepithelial carcinomas arising in minor and major salivary glands. The EWSR1-rearranged CCMC represents a distinctive aggressive variant composed predominantly of clear cells with frequent necrosis. Most EWSR1-rearranged CCMCs of salivary glands are characterized by poor clinical outcomes.

MAML2 rearrangement in Warthin’s tumour: a fluorescent in situ hybridisation study of metaplastic variants

Warthin's tumour (WT) is a common benign lesion of the major salivary glands. The nature of WT remains controversial, with particular regard to the presence of clonal chromosomal abnormalities, including the t(11;19) translocation involving the CRTC1 and MAML2 genes, that have been identified in both WT and mucoepidermoid carcinoma. In this study, we focused our attention on metaplastic WT variants, and we conducted a fluorescent in situ hybridisation (FISH) analysis for the presence of MAML2 gene rearrangement. Dual-colour FISH analysis was performed on paraffin-embedded sections of eight WTs showing metaplastic changes (five with squamous metaplasia, two with mucinous metaplasia and one with both) using a MAML2 break-apart probe. Presence of split signals indicative of gene rearrangement was identified in a subset of cells in areas of squamous metaplasia in two samples of WT. No rearrangement was observed in the oncocytic epithelium, in lymphocytes and in areas of mucinous metaplasia. The presence of a small subpopulation of cells carrying MAML2 rearrangement in areas of squamous metaplasia within WT could predispose these lesions to malignant transformation in mucoepidermoid carcinoma and could represent a molecular link between the two entities.

A panel of antibodies for identifying squamous metaplasia in endobronchial biopsies from smokers

Toxic injury can induce squamous metaplasia of respiratory epithelium, which normally is pseudostratified. Terminally differentiated squamous epithelial cells have a flattened, elongated appearance. During differentiation, they have an intermediate phenotype that is difficult to identify and distinguish from tangentially cut columnar cells in tissue sections from endobronchial biopsies, whose small size makes orientation difficult. The aim of our study was to develop a panel of antibodies that could be employed to distinguish normal epithelium from metaplastic epithelium and would be suitable for use on endobronchial biopsies. Nasal polyp tissue and tonsil tissue, which have pseudostratified and squamous epithelia, respectively, were collected from surgical cases and embedded in glycol methacrylate resin. Cut sections were stained immunohistochemically with a panel of antibodies to cytokeratins (CK), whose expression varies with epithelial type and stage of differentiation, and involucrin, a marker of terminal squamous differentiation. Squamous epithelium stained positively for CK5/6, CK13 and involucrin. In the pseudostratified epithelium, basal cells exhibited weak staining for CK13 and strong staining for CK5/6, and columnar cells exhibited strong immunoreactivity for CK7, CK8 and CK18. Application of this panel to endobronchial biopsies from smokers enabled areas of squamous metaplasia to be distinguished from tangentially sectioned epithelium.

Equine Testicular Lesions Related to Invasion by Nematodes

Nematodes of the genuses Strongylus and Setaria are able to erratically migrate to the equine testis and provoke characteristic inflammatory changes. Moreover, the presence of living parasites in scrotal testes is a scarce finding in which only the tracts and related lesions may be observed. In a 20-year experience of equine testes observed in abattoirs, 13 cases of atypical inflammatory lesions in scrotal testes were collected. On opening of the vaginal cavity, hydrocele was consistantly observed, and the Morgagni's appendix was enlarged, prominent, and reddish. Large, elongated, or irregular prominent red to yellow areas were visible on the testicular or epididymal serosa. Edematous enlargement of the epididymal head or tail was occasionally observed. In two cases, the described lesions were detected together with nematodes of the species Setaria equina, free and viable or encapsulated in the visceral and parietal layers of the tunica vaginalis, confirming the hypothesized cause. Histologically, the serosal lesions were interpreted as parasitic tracts, characterized by hemorrhage and leukocyte infiltrates in recent lesions or by granulation tissue with numerous macrophages in elderly ones. In the latter, areas of squamous metaplasia could be observed in the appendix testis and in the epididymal duct. Associated microscopic lesions included diffuse periorchitis, lymphocytic interstitial orchitis with mild to severe degeneration of seminiferous tubules, and vasculitis, epididymitis, and sperm granuloma.

Extensive Squamosu Metaplasia Mimicking Squamous Cell Carcinoma in Fibroadenoma

We report a fibroadenoma with extensive squamous metaplasia in the breast. A 21-year-old woman presented with a mass of the left breast. Breast ultrasonography showed a 1.8×1.7 cm sized, well-circumscribed mass in left subareolar region. The mass was excised. Grossly, the mass was well circumscribed and the cut surfaces were grayish-white in color and elastic in consistency. Microscopically, the breast lesion showed the histological features of fibroadenoma. There were areas of extensive squamous metaplasia seen as isolated clusters or involving duct. But some metaplastic clusters surrounded by fibrous stroma were compressed and distorted and separation of cells into isolated clusters mimicked invasive carcinoma. Co-expression of CK 5/6, high molecular weight CK and p63 in areas of squamous metaplasia and normal myoepithelial cells supported myoepithelial cell origin of metaplastic cells.

Wingless-type Protein-1 (Wnt-1) Expression in Primary Conventional and Unicystic Ameloblastomas and Their Recurrent Tumors

Wingless-type protein (Wnt) is a family of 19 secreted glycoproteins that function as signaling transducers for cell-cell interaction, cell growth and differentiation. Wnt-1, a highly transforming member, has been implicated in tumorigenesis. The aim of this study was to elucidate the role of this cell signaling molecule in the development and progression of primary ameloblastoma and their recurrent tumors. Wnt-1 expression patterns were examined immunohistochemically in 22 primary and 14 recurrent ameloblastomas. These collectively consisted of the following subtypes: conventional (CA) (n=22), desmoplastic (DA) (n=2) and unicystic (UA) (n=12) ameloblastoma. Results demonstrated that CA (n=20/22; 90.9), DA (n=2/2; 100) and UA (11/12; 91.7) showed high Wnt-1 expression percentages. Strong staining intensity for Wnt-1 was observed more frequently in primary CA (n=10/13; 76.9) than in their recurrent counterparts (n=2/9; 22.2) (p 0.05). Keratinizing cells in areas of squamous metaplasia also expressed Wnt-1 more intensely compared to their surrounding polyhedral stellate reticulum-like cells. Tumor islands containing granular cells were also Wnt-1 positive. Present findings confirmed that the Wnt signaling pathway is activated in ameloblastoma. Strong Wnt-1 expression in primary conventional and recurrent unicystic ameloblastoma suggests that Wnt-1 plays a more critical role in these subtypes. Positive expression of Wnt-1 in keratinizing ameloblastomatous tumor epithelium and granular cells complies with the anti-apoptotic properties of Wnt-1. Negative reactivity for Wnt-1 in 3 cases of ameloblastoma suggests that the development and progression of ameloblastoma may occur independent of this cell signaling molecule.

BD ProEx C: A Sensitive and Specific Marker of HPV-associated Squamous Lesions of the Cervix

BD ProEx C (ProEx C) is a recently developed immunocytochemical assay that targets the expression of topoisomerase II-alpha and minichromosome maintenance protein-2, 2 genes shown to be overexpressed in cervical cancers. Recent studies validated this reagent in liquid-based cytology specimens and suggested its usefulness as an adjunct in the diagnosis of challenging cases. Limited information is available on its expression in tissue sections. This study aims to assess ProEx C expression patterns in benign, atypical, and dysplastic lesions of the cervix and to compare these patterns with p16 and Ki67 expression and with the presence of human papilloma virus DNA as determined by in situ hybridization. ProEx C positivity was limited to the basal layers of the epithelium in 75% of benign cervices. In the remaining 25%, staining extended into the lower half of the epithelium particularly in areas of squamous metaplasia and immature squamous metaplasia. In 92% of high-grade dysplasias [cervical intraepithelial neoplasia (CIN) II and III] strong positive staining for ProEx C involved the lower and upper halves of the epithelium. Condylomas and CIN I showed greater variability in staining pattern with ProEx C positivity extending into the upper half of the epithelium in 48% of cases. Statistically significant correlations were noted with presence of human papilloma virus DNA and with p16/Ki67 expression. Atypical squamous metaplasia showed varied staining with 24% being positive. To summarize, ProEx C is a reliable marker for high-grade CIN that can be applied to tissue sections to confirm the diagnosis of high-grade CIN and to triage cases of atypical squamous metaplasia. ProEx C may also have a potential role in triaging patients with low-grade CIN. ProEx C expression patterns are similar to those for p16 and Ki67 with most discrepancies occurring in the CIN I category.

Angiomatoid fibrous histiocytoma with cystic structures of sweat duct origin

Angiomatoid fibrous histiocytoma is an unusual soft tissue tumor, mostly arising in the subcutaneous fibro-adipose tissue of children and young adults and measuring a few centimeters in greatest dimension. Reported herein is a unique case of angiomatoid fibrous histiocytoma containing epithelium-lined cystic structures. This large tumor (12 cm) was located in the subcutaneous tissue of the left leg of a 28-year-old woman. The cystic structures were variably sized and were lined by a double cell layer with areas of squamous metaplasia. Their overall histological features suggested a sweat duct origin. Immunohistochemical stains confirmed such origin, demonstrating an inner epithelial and an outer myoepithelial (smooth muscle actin and cytokeratin 17 positive) cell layer. The present case is illustrative of a mechanism of sweat duct dilatation that may occur during the growth of neoplasms involving the dermis and subcutis, resulting in formation of tumors with unusual histological features.

Colonic Squamous Cell Carcinoma in Ulcerative Colitis: Report of a Case and Review of the Literature

Squamous cell carcinoma (SCC) is a rare neoplasm in the colorectum. A case of SCC rising from an area of squamous metaplasia in the rectum is presented in a patient with long-standing ulcerative colitis and perianal warts. This is the first report in the literature describing the evolution of squamous metaplasia in the colonic mucosa into invasive carcinoma over time. Related literature on colorectal SCC and squamous metaplasia, and their relationships with inflammatory bowel disease and human papilloma virus, is reviewed.

Survivin expression in pre-invasive lesions and non-small cell lung carcinoma

Survivin is an inhibitor of apoptosis protein, which is overexpressed in many carcinomas, including lung carcinoma. The aim of this immunohistochemical study was to investigate the role of survivin in the early steps of lung carcinogenesis and non-small cell lung carcinomas (NSCLC), and its relationship with expression of p53 protein, a tumor suppressor gene involved in cell cycle control. In the normal bronchial epithelium, low-grade atypical adenomatous hyperplasia (AAH) and non-neoplastic lung parenchyma adjacent to tumor, survivin was found completely negative. Expression of survivin was detected in the areas of squamous metaplasia and dysplasia as well as high-grade AAH lesions adjacent to tumor. Survivin was expressed in 50 (64%) and p53 in 41 (53%) NSCLC. Survivin expression was significantly correlated with lymph node metastasis (p=0.02). There was no correlation between survivin and p53 expression. The patients with expression of survivin had significantly worse prognosis (Log-rank test, p=0.003). Multivariate Cox regression analysis showed TNM stage (p<0.001) and survivin expression (p=0.003) as independent prognostic indicators. In conclusion, survivin expression might be an early step in lung carcinogenesis. Survivin expression might also be used as a prognostic indicator predicting the worse outcome in NSCLC, and might be a novel target for the treatment of patients with preinvasive lesions of lung and NSCLC.

Expression of RCAS1 in Female Genital Organs

Receptor-binding antigen expressed on a human uterine adenocarcinoma cell line, SiSo (RCAS1), has been reported to be a prognostic factor of various malignant tumors, and it has also been proven to induce apoptosis of lymphoid cells. However, its normal distribution and function have not yet been elucidated. The purpose of this study was to disclose the distribution of RCAS1 expression in normal female genital organs. Immunohistochemical staining using anti-RCAS1 and anti-MIB-1 antibodies was performed on 123 surgical specimens of a histologically normal uterus, ovary, or fallopian tube from 66 patients, and the apoptotic index was determined. In uterine cervical glands, the expression of RCAS1 was seen in 93% of the cases, and it was mainly localized in the superficial cervical glands. Near the areas of squamous metaplasia, RCAS1 was strongly expressed in all samples. In the uterine cervical squamous epithelium, RCAS1 was seen in 84% of cases. In the uterine corpus, RCAS1 was seen in 87% of all cases, and it was mainly expressed in the endometrial glands of basalis layer. There was significant positive correlation between age and RCAS1 expression, but no significant difference was found regarding the endometrial status and RCAS1 expression in endometrium. No significant correlation was found between RCAS1 expression and MIB-1 index/apoptotic index. RCAS1 may affect these metaplastic processes and tumor progression.

Primary Squamous Cell Carcinoma Arising From an Epithelium-Lined Cyst of the Lacrimal Gland

A 66-year-old man presented with a slowly enlarging, nontender left orbital mass of 2 months' duration. CT and MRI showed a left lacrimal gland mass with enhancement and internal irregularity of cystic structures. Histopathologic analysis of the biopsy specimen revealed a squamous cell carcinoma arising from an epithelium-lined cyst. The patient underwent left orbital exenteration followed by radiation treatment. No evidence of tumor recurrence was observed after a follow-up of 30 months. We believe this primary squamous cell carcinoma may have arisen either from preexisting lacrimal duct cyst (dacryops) with areas of squamous metaplasia or, less likely, from a choristomatous epithelium-lined cyst of the lacrimal gland. Although rare, this entity should be included in the differential diagnosis of cystic lesions of the lacrimal gland.

Detection of early squamous metaplasia in bladder biopsies of spinal cord injury patients by immunostaining for cytokeratin 14.

A prospective, immunohistochemical study of bladder biopsies taken from spinal cord injury (SCI) patients. To investigate whether cytokeratin 14 immunostaining may be useful to detect early squamous metaplasia in bladder biopsies from patients with SCI. Southport, United Kingdom. Biopsy of bladder mucosa was taken from adults with SCI, while they underwent an elective therapeutic procedure in the urinary tract. A total of, 54 biopsies, which showed transitional epithelium only with no evidence of squamous metaplasia on routine H&E staining, formed the study group. In all, 22 biopsies, which showed squamous metaplasia on routine H&E staining, acted as controls. All biopsies were benign with no evidence of dysplasia or malignancy. Immunohistochemical staining for cytokeratin 14 was performed on all biopsies in a single batch, using a standard avidin-biotin complex method. All control biopsies showed positive immunostaining for cytokeratin 14 in basal and parabasal cells in areas of squamous metaplasia. Of the 54 biopsies, which showed only transitional epithelium on H&E staining, immunohistochemistry for cytokeratin 14 showed no staining in 47 biopsies. The remaining seven biopsies showed positive immunostaining for cytokeratin 14 in the epithelium, in individual cells or clusters of basal cells, revealing unexpected early squamous metaplasia in these biopsies. Immunostaining for cytokeratin 14 identifies an early phenotypic switch from transitional to squamous epithelium in bladder mucosa. Cytokeratin 14 staining is sufficiently sensitive to identify early squamous metaplasia, which is not yet evident on examination of routine H&E stained sections. This early identification may be of use in alerting physicians to change bladder management regimens to prevent predisposition to recurrent urinary infection and progression of squamous metaplasia. A cost/benefit analysis should be performed to assess the feasibility of routine cytokeratin 14 immunostaining of bladder biopsies from SCI patients.

Expression of cyclin A in endometrial adenocarcinoma and its correlation with proliferative activity and clinicopathological variables.

Cyclin A is known as an S- and G2-M phase regulatory protein and its abnormal expression has been reportedly implicated in cellular proliferation. This study was designed to investigate the correlation of cyclin A expression with tumorigenesis of the endometrium and clinicopathological variables. Immunohistochemical staining using labeled streptavidin-biotin complex was performed on formalin-fixed, paraffin-embedded tissue of normal endometrium (15 cases), endometrial hyperplasia (23 cases), and endometrial adenocarcinoma (endometrioid type) (112 cases). Immunohistochemistry showed that the nuclei of the cells were positive for cyclin A. In normal endometrium, only proliferative phase was focally positive for cyclin A. Cyclin A was also positive for endometrial hyperplasia. Its expression in hyperplasia was significantly more frequent than that of proliferative phase and less than that of endometrioid adenocarcinoma. The labeling index (LI) of cyclin A in endometrioid adenocarcinoma was 16.3+/-6.9 in well-differentiated, 18.3+/-8.8 in moderately differentiated, and 30.2+/-11.8 in poorly differentiated adenocarcinoma, respectively. Cyclin A expression increased significantly more in high histological grades. The area of squamous metaplasia in endometrioid adenocarcinoma was negative for cyclin A. The LI of cyclin A was positively correlated with that of Ki-67 and cyclin-dependent kinase 2. Cyclin A expression was significantly associated with carcinoma without coexisting endometrial hyperplasia and lymphovascular space involvement (LVSI), but not with FIGO stage, myometrial invasion, lymph node metastasis, estrogen receptor, progesterone receptor, and menopause as well as recurrence. Cyclin A expression was involved in the progression to malignancy of the endometrium and was correlated with proliferative activity and prognostic features including histological grade, without coexisting endometrial hyperplasia and LVSI.

Squamous metaplasia of the rectum after argon plasma coagulation

Squamous metaplasia of the rectum occurs only rarely and has been reported in association with chronic inflammation and carcinoma and in one patient who had no other associated disease. 1 David VC. Leukoplakia of the rectum. Arch Pathol. 1938; 26: 151-154 Google Scholar , 2 Dukes CE. The significance of the unusual in the pathology of intestinal tumours. Ann Royal Coll Surg Engl. 1949; 4: 90-103 PubMed Google Scholar , 3 Cabrera A Pickren JW. Squamous metaplasia and squamous-cell carcinoma of the rectosigmoid. Dis Colon Rectum. 1967; 10: 288-297 Crossref PubMed Scopus (33) Google Scholar , 4 Woods WGA. Squamous cell carcinoma of the rectum arising in an area of squamous metaplasia. Eur J Surg Oncol. 1987; 13: 455-458 PubMed Google Scholar , 5 Zirkin RM McCord DL. Squamous cell carcinoma of the rectum: report of a case complicating chronic ulcerative colitis. Dis Colon Rectum. 1963; 6: 370-373 Crossref PubMed Scopus (45) Google Scholar This is a report of the development of squamous metaplasia of the rectum after argon plasma coagulation of a villous adenoma.