Black Nodule Research Articles

Secretory Structures in Vegetative and Floral Organs of Hypericum perfoliatum

Hypericum L, the largest genus of Hypericaceae comprising ca. 484 species of shrubs and perennial and annual herbs, is worldwide in a large variety of habitats in subtropical and temperate areas. Hypericum species, namely H. perforatum (St. John’s wort) the most representative species of the genus, have been used in folk medicine thought the centuries for a large number of ailments. Nowadays, it is well known the therapeutic potentialities of their main compounds, hypericin, pseudohypericin and hyperforin, which justify its clinical use. Despite the intense phytochemical and pharmacological research conducted in Hypericum species during the last decades, morpho-anatomical studies on the glands that produce the bioactive compounds are scarce and fragmented, only H. perforatum was studied in detail. As part as an ongoing project on Hypericum glands, the present research aims to provide information about the morphology, anatomy and histochemistry of the secretory structures present on the aerial organs of H. perfoliatum, one of the seventeen species of Hypericum that occur wild in Portugal.The types of glandular structures and their pattern of distribution on the leaves and flowers were studied by light (MO) and scanning electron microscopy (SEM). Samples for SEM were fixed with glutaraldehyde, dehydrated in a graded acetone series, critical-point dried and coated with gold. For general anatomy samples were fixed in the same fixative and embedded in Leica historesin®. Histochemical tests and standard control procedures were carried out in fresh material to localize in situ the main chemical classes of compounds present in the secretion. Observations were carried out Observations were carried out on a JEOL T220 scanning electron microscope and with a Leica DM-2500 microscope.The aerial organs of H. perfoliatum present four different types of secretory structures (idioblasts, translucent glands, ducts and black nodules), that can occur exclusively in a specific organ or in more than one organ. Tanniniferous secretory cells are frequent in the epidermis, as well as in the ground parenchyma of all organs, where they are scattered together with crystal idioblasts containing druses of calcium oxalate. Translucent glands are spheroidal subepidermical glandular pockets delimited by two or three cell layers of fattened and densely-stained cells (Fig. 1A). They are typically found in the leaves, giving them a perforated appearance. Two types of secretory ducts, cavities that differ from translucent glands in the length, are present in the vegetative and floral organs. Type A ducts have a narrow lumen delimited by four secretory epithelial cells and occur associated to the phloem in all aerial organs with exception of stamens (Fig. 1B, arrow). Type B ducts have a wider lumen, are generally limited by ten thin-walled secretory cells surrounding by a sheath of thick-walled cells and are located in the parenchyma of sepals, petals and ovary. Black nodules are clusters of cells lacking a central intercellular space (lumen), surrounded by one or two-layers of flat cells of a delimiting sheath (Fig. 1C). The inner cells are large, irregular, tightly packed and filled with a dark red stained content. Spheroidal black nodules are found punctuating the leaf margins and in the connective tissue of the stamen (Fig. 1D), whereas long-shaped black nodules are distributed across the lamina of bracts, sepals and petals. Peculiar glandular emergences, which look like peduncular black nodules, are present along the margin of the bracts and sepals. They consist of a multicellular peduncle and a dark-red multicellular secretory head-a black nodule (Fig. 1E). Histochemical tests showed that translucent glands secreted essential oils rich in phenolic compounds (flavonolic aglycones), ducts produce oleoresins and nodules contain essentially hypericin. In mature organs, the disorganization of the inner cells of the nodules seems to form a large intercellular space, a lumen.All these secretory structures were also found in H. perforatum with exception of peduncular black nodules, that was only reported in H. elodes, but not studied in detail. The obtained results allow as speculating that nodules may be primitive multicellular structures, relics of an evolutionary process, that give rise to cavities, internal secretory structures that stores secretion material in intercellular spaces.The authors acknowledge the funding by Fundação para a Ciência e Tecnologia through the project FCT PEst-OE/EQB/LA0023/2011.

A distinct histopathological variant of a malignant melanoma with perivascular pseudorosettes: A case report

Although a rare condition, rosette formation in malignant melanoma has been previously documented. The present study describes the second documented case of malignant melanoma with perivascular pseudorosettes. A 38-year-old male presented with a black nodule on his back. Histopathological study revealed diffuse proliferation of neoplastic cells in the dermis and subcutis. A section of the tumor (~30%) was composed of a conventional malignant melanoma component. The remaining area was comprised of medium-sized polygonal cells with slightly eosinophilic cytoplasm and small-to-medium, round nuclei. Melanin pigment was rarely observed. A noteworthy observation was the presence of perivascular pseudorosette formations, which were characterized by their radial arrangement around the blood vessels, with a perivascular, anuclear zone. Immunohistochemically, the neoplastic cells were diffusely positive for S-100 protein and Melan-A and focally positive for HMB-45. Clinicopathological analyses of cases of malignant melanoma with rosette formations revealed that the types of rosette included the Homer-Wright type (two cases), perivascular pseudorosettes (two cases) and an unclassifiable type (one case). Immunohistochemical analysis is a useful method for forming a diagnosis as Melan-A or HMB-45 are generally expressed in all cases. Rosette formation in malignant melanoma is a distinct histopathological variant and may be an under-recognized phenomenon. Therefore, its recognition is significant for obtaining an accurate diagnosis of malignant melanoma.

Apocrine Hidrocystoma of the Cheek

Apocrine Hidrocystoma of the Cheek

Malignant melanoma with preserved hairs: A snap shot could suggest the development from an acquired melanocytic nevus

63-year-old man presented with a dome-shaped, black nodule on his right forehead, where hairs were preserved. The black surface tone measured 7 mm in diameter and spread irregularly from the periphery of the nodule. He had been conscious of the preceding, black macule for approximately 50 years. A snap shot of the patient in adolescence showed a tiny, black macule, which was a few millimeters in diameter. Histological examination demonstrated irregular proliferation of melanoma cells from the epidermis to the dermis. Partially, there were well-circumscribed, oval nests composed of nevus cells in the acanthotic epidermis and follicles. Nevus cells were also seen in the dermal component, presenting a burnt-out appearance. In this case, the small final size, the preserved hairs and the snap shot suggested a preceding, acquired melanocytic nevus. Malignant melanoma could arise from acquired melanocytic nevus.

Congenital pigment synthesizing melanoma of the scalp

The pigment synthesizing melanoma, so-called animal type melanoma, is a rare variant of melanoma that is characterized by prominent melanin production and an unpredictable prognosis. Congenital onset of this melanoma is exceedingly rare. A 2-month-old Korean girl had a black nodule and a satellite black macule on the scalp which were noticed at birth. She received a surgical resection 3 months later because of rapidly growing lesions and the histopathologic features of a pigment synthesizing melanoma. Two months later, she returned with cervical area swelling, and the excised multiple lymph nodes showed metastatic malignant melanoma. The exact origin and pathogenesis of congenital pigment synthesizing melanoma is different from the more common forms of melanoma and remains poorly understood.

Case of cutaneous malignant melanoma surviving 16 years with late recurrence

Late recurrence, defined as that occurring 10 or more years after diagnosis, is an unusual event in cutaneous malignant melanoma (MM). A 59-year-old woman presented with a black nodule measuring 10 mm x 9 mm on the sole of her right foot. She was diagnosed with MM and the tumor was totally excised with 5 cm of the normal surrounding skin. Eleven years after the operation, five in-transit metastases were found in her right limb. They were all excised and beta-interferon (IFN-beta) was injected into the skin around the postoperative scars. However, numerous new in-transit skin metastases have been emerging every year in her right limb. Fifty-four in-transit skin metastases have so far been found. Recently, there have been few in-transit metastases. All in-transit metastatic lesions were excised and local IFN-beta injections were conducted continuously. There is no evidence of metastases to the internal organs or lymph nodes. This report describes this case with a brief review of the published work concerning the rare late recurrences of MM.

Feline Digital Phaeohyphomycosis due to Exophiala jeanselmei

The black nodule measuring 1 cm in diameter developed in the base of nail of an 8-year-old Japanese domestic male cat. Histological examination of the excised nodule revealed a granulomatous lesion extending from the epidermis to adjacent bone. The lesion was consisted of diffuse infiltration of macrophages with epithelioid cells and multinucleated giant cells. These macrophages contained a few to numerous yeast-like brown pigmented fungus cells with a spherical shape and dark thick wall. The PCR amplification with universal primers of the 28S ribosomal RNA gene yielded a 628-bp fragment and the direct sequence confirmed that the diagnosis of the lesion was phaeohyphomycosis caused by the pathogenic dematiaceous fungus, Exophiala jeanselmei.

Linear Basal Cell Carcinoma in an Asian Patient

Linear basal cell carcinoma (BCC), which has a ratio of its long and short axes of more than 3: 1, is a distinct clinical entity among BCC. We report the first case report of a linear BCC in an Asian patient. An 87 year-old woman presented with an ulcerated black nodule, 15×5mm (3: 1), on her nasojungal fold of the right lower eyelid. The tumor was excised with 5 mm safety margin. The pathological examination confirmed the tumor was a BCC with a clear margin. Diagnosis of a linear BCC is based on its morphological features and occurrence along the wrinkle line, which needs to be also considered in Asian.

Ecthyma Gangrenosum in a Patient With Toxic Epidermal Necrolysis

Toxic epidermal necrolysis and Stevens-Johnson syndrome are a spectrum of disease characterized by a delayed hypersensitivity reaction that involves the skin and mucous membranes and typically is associated with either recent upper respiratory infection or with certain medications. Ecthyma gangrenosum is a rare necrotizing vasculitis that most commonly affects immunocompromised and burn patients and is often a sequela of Pseudomonas aeruginosa bacteremia. The cutaneous lesions of ecthyma gangrenosum are characterized by an erythematous halo surrounding a dark gray or black nodule. P. aeruginosa preferentially invades the venules, resulting in secondary thrombosis of the arterioles, tissue edema, and separation of the epidermis. Management of ecthyma gangrenosum includes systemic treatment with antipseudomonal antibiotics and débridment of the lesions, as well as improving the patient's immune status if possible. We present a case of a patient admitted to the burn unit for toxic epidermal necrolysis who developed pseudomonal bacteremia with ecthyma gangrenosum.

Verruciform xanthoma‐like phenomenon in seborrheic keratosis

Verruciform xanthoma is xanthomatous dermal infiltrate in a proliferating epidermal lesion and is an uncommon phenomenon. It has been reported in various neoplastic or inflammatory conditions. We report a 72-year-old man who had an asymptomatic 1-cm black nodule on his abdomen. Histopathology showed a typical acanthotic type of seborrheic keratosis characterized by basaloid keratinocyte proliferation and pseudohorn cysts. Many aggregated xanthomatized cells were seen in dermal papillae within the acanthotic epithelium. Papillomatosis, parakeratosis, and neutrophil infiltrates, the histologic features of typical verruciform xanthoma, were not seen. The foamy cells were positive for CD-68 and vimentin and negative for cytokeratin and S-100. No human papillomavirus DNA was found by nested polymerase chain reaction. The blood lipid profile was normal. The presence of verruciform xanthomatous change in seborrheic keratosis provides further evidence that verruciform xanthoma may be a reactive phenomenon occurring in common skin disorders.

Keratinizing Squamous Epithelium Associated with Syringocystadenoma Papilliferum Differentiates towards Infrainfundibulum: Case Report with Immunohistochemical Study of Cytokeratins

We describe a case of Syringocystadenoma papilliferum (SCAP) with keratinizing squamous epithelium in a 26-year-old female presenting with a dark brown to black nodule on her forehead. After surgical excision, the specimen was examined immunohistochemically using antibodies against cytokeratin (CK) 1, 8, 10, 14, 17, 18 and 19. Within the keratinizing squamous epithelium, CK1, 10, 14 and 17 were present, whereas the other CKs were absent. Based on CK expression, keratinizing squamous epithelium in SCAP seems to differentiate towards the infrainfundibulum.

Melanin pigmented oncocytic metaplasia of the nasopharynx

A case of melanin pigmented oncocytic metaplasia is reported. A 62-year-old man presented with a history of discomfort of the ear of a 2 weeks’ duration. Nasoscopic examination revealed a black nodule of about 5 mm at the left Eustachian opening, and several black spots were discovered around the bilateral torus tubarius. The nodule was biopsied to determine the histology. Microscopically, there were oncocytic cells with abundant pigmented granules showing glandular pattern. Such a pigmented variant of benign oncocytic lesion is very rare.

皮下に大型嚢腫様構造を呈した特異な基底細胞癌の１例

A 61-year-old man had noticed a nodule on his right thigh a few years ago. As the nodule gradually became larger, he visited our hospital. He had a black nodule on his right thigh which had a smooth surface and subucutaneous induration. Wide resection of the nodule was performed. Histologically, the nodule and the wall of the subcutaneous cystic structure consisted of basaloid cells. Our case was a peculiar cystic type of BCC and we discussed the pathogenesis of large cystic structures. [Skin Cancer (Japan) 2004; 19:195-197]

外陰部悪性黒色腫の治療経験

A 73-year-old woman was referred to our hospital with a complaint of a black nodule on her vulva. Bilateral inguinal lymph nodes were palpable. The diagnosis of malignant melanoma of the vulva was made on clinical features. We performed a wide local excision immediately circumferentially to a distance of 2cm from the nodule and a bilateral ilio-inguinal lymph node dissection, including subcutaneous tissue between the nodule and the inguinal lymph nodes. We reconstructed the urethral orifice and vaginal orifice with the residual skin flaps. At present, 9 months after surgery, no recurrence has been noted, and no distant metastases have been observed. She has no difficulty in urination. We consider this method is effective for a moderate vulvar defect. [Skin Cancer (Japan) 2004; 19: 233-237]

高齢者に生じた陰茎悪性黒色腫の１例

We report a case of penile malignant melanoma that was treated with partial penectomy. A 93-year-old man noticed a black nodule within a pigmented macule on his glans penis. There was no palpable inguinal lymphadenopathy.Histopathologically, it was malignant melanoma with a Breslow's tumor thickness of 6mm and Clark level 5 invasion. Staging with a computerized tomography showed no evidence of metastasis. Partial penectomy with a 3cm skin margin from the pigmented macule was performed. The patient was in good condition and without evidence of local recurrence or metastasis for eight months. Bilateral inguinal lymphnode metastases, which were found nine months after the operation, were treated by a local injection of interferon-beta. The quality of life of the patient has been well maintained as high as before the operation. [Skin Cancer (Japan) 2003; 18: 308-311]

下顎部に生じたＡｄａｍａｎｔｉｎｏｉｄ Ｂａｓａｌ Ｃｅｌｌ Ｃａｒｃｉｎｏｍａの１例

We report a rare case of adamantinoid basal cell carcinoma (BCC). A 75-year-old woman presented with a 7×7mm black nodule with bloody crust on her right jaw. The tumor was totally excised. Histopathological examination revealed that the tumor mass was mainly situated in the upper to deep dermis and in contact with the epidermis. At the periphery of the tumor, there were typical solid BCC nests, but within the majority of lobules, intercellular spaces were widened and cells were connected by stellate stretched thin cytoplasm. From these findings, this tumor was diagnosed as an adamantinoid BCC. [Skin Cancer (Japan) 2002; 17 : 221-224]

右母指爪部悪性黒色腫 第１背側中手動脈皮弁による再建

A 73-year-old woman presented with a grayish black nodule on the subungual area of her right thumb. The nail plate had disappeared and central ulceration was observed. She was diagnosed as having an acral lentiginous melanoma with a micrometastasis in the sentinel lymph node. To preserve the function of the right thumb, we recommended to her reconstructive operations such as toe transplantation or pollicization, but she refused any surgical procedure with bone reconstruction and regional lymph node dissection. Consequently, we left the metacarpal bone as long as possible and covered it using an island first dorsal metacarpal artery flap from the dorsum of the index finger. The flap completely survived, and no recurrence was observed for 14 months. She can pinch, manipulate chopsticks and hold a cup, although she feels a slight difficulty in fastening buttons. In this paper, we described the anatomy, surgical technique and usage of this flap. [Skin Cancer (Japan) 2002; 17: 26-30]

646 Comparison of Ca and B Deficiency Effects on Growth and Development of Bedding Plants

The margin of error in pinpointing the difference in deficiency symptoms between calcium and boron is high. Several experiments were conducted in the greenhouse to induce as well as to differentiate the exact foliar and root symptoms of Ca and B. The experiments were conducted with modified Hoagland nutrient solutions. The treatments were with or without Ca or B salts for inducing total deficiency symptoms. Symptoms were expressed on the upper part including the growing point of the plant. In absence of Ca, marigold and zinnia plant heights were reduced by 58% and 37%, respectively, from the control. However, the reduction in height was only in the 27% and 25% range for B deficiency. Ca deficiency was noted as a blackened region on the leaf blade (early stage symptoms) which progressed into necrotic spots on the newly formed leaves. Severe necrosis, was observed on the growing point with advanced Ca deficiency. B deficiency results in a leathery and gray color in zinnia, needle like and narrow leaflets in marigold. The leaf blades were brittle in all B deficient species. B deficient plants roots were stiff and leathery and lateral roots possessed black nodule like endings at the tips. The Ca deficient roots expressed less side branching and at the advanced stage the roots were shorter and fewer with severe necrotic symptoms. The above initial and advanced deficiency symptoms appeared earlier in treatments without Ca than B. Images of Ca and B deficiency symptoms, as well as tissue concentration values will be presented.

脂漏性角化症より発生したＳＣＣの１例

Seborrheic keratosis (SK) is common benign skin tumor. But some authors reported malignant transformation of SK.The patient is a 72-year-old man who had noticed a small black nodule on right lower abdomen for 30 years. The nodule was getting larger slowly, but it becomes ulcerative and elevates recently.Histopathologically, this tumor was revieled a deeply invasive squamous cell carcinoma that had developed from the base of a SK. [Skin Cancer (Japan) 2000; 15: 152-154]

中型先天性色素細胞母斑に生じた悪性黒色腫の１例

A 63-year-old Japanese woman was referred to us with a 1-month history of a nodule arising within a lesion of medium-sized congenital melanocytic nevus of the left popliteal region. Physical examination showed a black plaque, 13.6×7.7cm, on the site, and at the periphery of which, a reddish black nodule, 1.8×1.4×0.5cm, was detected.Histopathological examination of the nodule revealed nests of atypical melanocytes in the upper dermis. The overlying epidermis was eroded and no proliferation of atypical melanocytes was found in the epidermis. The plaque lesion histologically showed diffuse proliferation of small nevus cells in the reticular dermis. The border between the atypical melanocytes and the nevus cells was somewhat indistinct. The atypical cells were epithelioid or spindle shaped, and mitotic figures were frequently detected. The atypical cells were stained with an antibody to S-100 protein and some of them were also stained with a HMB-45.This case is malignant melanoma arising from a medium-sized congenital melanocytic nevus. The stage was pT4a N2a M1a (Stage IV).She underwent wide local resection along with subtotal integumentectomy and radical lymph node dissection of her left inguinal area. DAV-feron (DTIC, ACNU, VCR, IFN-β) therapy was administered postoperatively. However, soon later, metastases to lung, bones, and brain developed. She died from the disease on July 9, 1999.