Foamy Cells Research Articles

High M-CSF and IL-13 levels are associated with foamy cell expansion in experimental actinomycetoma by Nocardia brasiliensis. (55.27)

Abstract Foamy cells (FC) have been described in various infectious diseases, and can be usurped by intracellular pathogens for survival. In a mouse model of experimental actinomycetoma induced by Nocardia brasiliensis, FC have been observed at day 3 after inoculation, remaining constant during acute inflammation, and expanding in surface area during chronic disease. These FC seem to be monocytes/macrophages and/or dendritic cells (DC) that accumulate lipid droplets upon infection. Our aim was to elucidate the levels of cytokines known to be involved in the differentiation of macrophages or DC (IL-4, IL-13, M-CSF, and GM-CSF). Female BALB/c mice (8-12 wk) were infected with N. brasiliensis in the left hind foot pad and sacrificed at 0, 0.5, 1, 3, 7, 15, 30 and 60 days of infection (n=5). Biopsies of the left foot pads were homogenized in PBS or Trizol to determine the cytokine concentrations at both the protein and the transcript level by means of ELISA and RT-PCR. We found the highest M-CSF and IL-13 levels during chronic inflammation, when the major expansion of CF occurs. M-CSF and IL-13 have been related with the alternative activation of macrophages. In conclusion: high M-CSF and IL-13 levels coincide with the expansion of CF in an experimental model of actinomycetoma.

Retroperitoneal schwannoma is characterized by a high incidence of cellular type and GFAP‐immunoreactivity

To clarify the clinicopathologic characteristics of retroperitoneal schwannomas, which are sometimes confused with other spindle cell tumors, 27 cases were studied microscopically and immunohistochemically. The 27 cases consisted of 17 females and 10 males, the ages of whom ranged from 31-79 (mean 57.4) years. Gross examination revealed well-demarcated, encapsulated tumors, 3-15 cm (mean 8 cm) in diameter. Microscopic review divided them into 13 cases of cellular/fascicular, 3 of conventional, 6 of intermediate, and 5 of ancient type. Cellular/fascicular schwannomas were composed of cellular fascicles of spindle cells, in which nuclear palisading, Antoni B area and cyst were unclear, while numerous foamy cells were intermingled. Immunohistochemical investigation revealed diffuse, strong positivity for S-100 protein and Sox10 in all tumors studied. In addition, glial fibrillary acidic protein (GFAP) was extensively expressed in 92% of the cellular/fascicular type, while it was less prominent in others. The present study suggests that retroperitoneal schwannoma often occurs in the middle-aged woman, grows to a large size, exhibits cellular/fascicular microscopic features in half of the cases, and may arise from GFAP-positive Schwann cells. The presence of hyalinized vessels and dense infiltration of foamy macrophages as well as diffuse immunoreactivity for S-100 protein and Sox10 are helpful for the differential diagnosis.

Value of clusterin expression in pathologic diagnosis and histogenesis of giant cell tumor of tendon sheath

Analyze the immunophenotype of the different cells in the various subtypes of giant cell tumor of tendon sheath (GCTS) and investigate the value of clusterin in pathological diagnosis and histogenesis of giant cell tumor of tendon sheath. A total of 104 cases of GCTS from the surgical pathology files of Shanghai Jiaotong university affiliated the sixth people's hospital were identified. Immunohistochemistry (IHC) for clusterin, desmin, CD163, CD68, p63, p53, Ki-67 and CD35 was performed on all cases, using EnVision technique. All cases of GCTS were researched, including 44 cases of localized type (L-GCTS), 32 cases of diffused type (D-GCTS), 26 cases of pigmented villonodular synovitis (PVNS) and 2 cases of malignant type. There was a slight female predominance in all these subtypes, and the male to female ratio was about 38:66. L-GCTS usually occured within the small joints (90.9%, 40/44), while D-GCTS, PVNS and M-GCTS commonly occured within the large weight-bearing joints [68.8% (22/32), 100% (26/26) and 2/2 respectively]. Of 74 cases with follow-up, the recurrence rates of L-GCTS, D-GCTS, PVNS and M-GCTS respectively were 30.3% (10/33), 30.4% (7/23), 18.8% (3/16) and 2/2. The different subtypes of GCTS had the same cell components, including the large synovial-like mononuclear cells, the small histiocytoid cells, foamy histiocytes cells, inflammatory cells, fibroblasts and the osteoclast-like multinucleated giant cells. There were obvious differences among immunophenotype of the various cell components in GCTS: the large synovial-like mononuclear cells were strong positive for clusterin, partly positive for desmin and Ki-67, and negative for CD163. The small histiocytoid cells were strong positive for CD163 but negative for clusterin and desmin. The osteoclast-like multinucleated giant cells were strong positive for CD68 but negative for clusterin, CD163 and desmin. Normal synoviocytes were strong positive for clusterin, partly positive for desmin. The number of the large synovial-like mononuclear cells that were positive for clusterin in D-GCTS were more than that in L-GCTS (P < 0.01) and PVNS (P < 0.05). GCTS was synovial tumors, not belonged to the category of fibrohistiocytic lesions. The true tumor cells may be the large synovial-like mononuclear cells, and the number of the cells in the D-GCTS was obviously more than that in L-GCTS and PVNS. This may be the reason that the biological behavior of D-GCTS was more aggressive, destructive and recurrent. Clusterin was an useful marker in pathological differential diagnosis of GCTS.

Role of macrophage scavenger receptors in atherosclerosis

Accumulating evidence indicates that atherosclerosis is a chronic inflammatory disease. The key innate immune cells that are involved in the pathogenesis of atherosclerosis are circulating monocytes and plaque macrophages. Complex interplay between immune and metabolic processes results in pathological activity of these cells. The best understood pathological process mediated by macrophages is their inability to process modified lipoproteins properly resulting in the formation of foamy cells, which are a dangerous component of atherosclerotic plaques. Key molecules involved in the recognition and processing of modified lipoproteins are scavenger receptors (SR). This is a large family of surface expressed structurally heterogeneous receptors with a broad spectrum of endogenous and exogenous ligands. The common functional feature of SR is internalisation of extracellular components and targeting them for lysosomal degradation. However, these relatively simple functions can have complex consequences, since they are linked to diverse specific signalling pathways and to other membrane transport pathways. Moreover, scavenger receptors can co-operate with other types of receptors increasing the variability of the macrophage response to multiple extracellular ligands. At least some SRs respond to modified lipoproteins by amplification of inflammation and accumulation of macrophages in the plaque, while some SRs may support tolerogenic reactions. Outcome of different SR activities will be the decision of monocytes and macrophage to guard homeostatic balance, support atherosclerosis progression and plaque instability by inflammatory reactions, or support rapid fibrotic processes in the plaque that stabilise it. Despite the accumulating knowledge about the molecular mechanisms of scavenger receptor action, their role in the progression of atherosclerosis remains controversial. The activities of scavenger receptors that can contribute to each of these processes are a subject of current review.

Pathological Features of Salivary Gland Cysts in a Shiba Dog with GM1 Gangliosidosis: A Possible Misdiagnosis as Malignancy

Salivary gland cysts are often concurrent with GM1 gangliosidosis in Shiba dogs. Although the etiology is unknown, these cysts may be misdiagnosed as malignant due to the accumulation of foamy cells. The present study investigated the cytological, histopathological, immunohistochemical and electron microscopic characteristics of salivary gland cysts in a Shiba dog affected with GM1 gangliosidosis. The salivary gland masses were surgically enucleated and examined clinicopathologically and pathologically in a 7-month-old Shiba dog with GM1 gangliosidosis. Many large cells with rich cytoplasm including vacuoles of various sizes, i.e., foamy cells, were observed in stamp smears from the cut-surface of the masses and histopathologically in major parts of the cyst wall. Some of these foamy cells presented features similar to a spider-web appearance. The foamy cells were confirmed to have originated from macrophages based on marked immunohistochemical expression of vimentin, HLA-DR, lysozyme and Iba1. An ultrastructural study demonstrated electron-dense vesicular structures in the vacuolated cells. Therefore, the masses were diagnosed pathologically as benign salivary gland cysts with accumulation of foamy cells. In conclusion, the histopathological features of the salivary gland cysts in this Shiba dog were similar to those of lipoma and/or liposarcoma. In such cases, immunohistochemical and ultrastructural examinations were useful in the differential diagnosis. Practitioners, clinical pathologists and pathologists should take GM1 gangliosidosis into consideration when they encounter salivary gland cysts in Shiba dogs.

Successful Treatment of Xanthoma Disseminatum with Combined Lipid Lowering Agents

Dear editor: Xanthoma disseminatum (XD) is a rare, benign, normolipidemic mucocutaneous xanthomatosis of unknown etiology1. Many therapeutic options such as surgical excision, laser ablation, electrodessication, systemic medications, and radiotherapy are available, but treatment is challenging2. We present a male XD patient who showed marked improvement with combination of lipid lowering agents. A 37-year-old Asian male presented with 5-year history of numerous asymptomatic yellow-brownish papules distributed on face and flexural areas (Fig. 1). Laboratory investigations revealed normal lipid levels. Three years prior to visiting our clinic, he was diagnosed as XD associated with central diabetes insipidus in other hospital, and treated with daily cyclophosphamide and desmopressin acetateg. However, while the diabetes insipidus improved, there was no effect on the XD. Intermittent CO2 laser ablation and electrodessication reduced the number of lesions temporarily, but new lesions appeared continually. Owing to the persistence and spread of refractory cutaneous lesions, a combination of rosiglitazone 4 mg daily, simvastatin 10 mg daily and fenofibrate 200 mg daily treatment was initiated in our hospital. Eight weeks after beginning medication, the patient reported an improvement of cutaneous lesions such as notable reduction of size, brownish color change and flattening. After 1 year, the lesions improved more than a half and the marked improvement persisted 2 years since then (Fig. 2). Fig. 1 Multiple well-defined yellow-brownish various sized papulonodular skin lesions on right axilla (A), eyelids (B), and buttock (C). Fig. 2 Markedly flattened yellow-brownish papulonodules on both axillae (A: right, B: left) after 1 year of lipid-lowering agents in combination. Most of xanthomatous disorders reflect elevated lipid levels. It is thought that lipoproteins permeate the vessel walls and then develop foam cells. However, contrary to other xanthomatous disorders, XD patients have normal serum lipid levels. One suggested hypothesis is that the secondary accumulations of cholesterol develop after primary proliferation of histiocytes1. This is supported by the histopathologic findings of XD in that the foam cells are rare and scalloped macrophages dominant in early stage, but well-developed lesions show a mixture of scalloped cells, foamy cells, and inflammatory cells3. Foamy cells could be induced by increased uptake, synthesis and decreased efflux of lipid, and the cytokines from the inflamed intima could also be triggering factors4. Therefore, reducing the inflammation of the lesion and inhibiting the subsequent formation of foam cells could be an important therapeutic goal in XD. For these reasons, we previously attempted to use lipid lowering agent monotherapy in a small number of XD patients, but we saw no improvement. Thus, we attempted to use a combination of three lipid lowering agents, PPARγ, statins, and fenofibrate, modifying suggestions by Eisendle et al.5. PPAR γ inhibits the production of macrophage-induced inflammatory cytokines as well as reducing adipogenic action of macrophage by inducing reverse cholesterol transport6. Statins are known to decrease inflammation and to inhibit the production of precursors to cholesterol synthesis4. Fenofibrate, the final combination agent, activates PPARα and improves high density lipoprotein functions such as reverse cholesterol transport and anti-inflammatory activity7. Though the use of combination therapy of lipid lowering agents is still rare in dermatologic fields except in one reported case in XD with partial remission5, there are several articles reporting a superior effect of combination therapy on the treatment of hyperlipidemia7,8. The mechanism of combination treatment of XD is still ambiguous; we thought it may result from decreased inflammation and reduced formation of foam cells. Before visiting our clinic, our patient's lesions showed little change after treatment and new lesions appeared continually. However, after only 8 weeks of lipid lowering agents combination therapy, the lesions were flattened, decreased in the size, and no more new lesions appeared. Therefore, we thought this patient improved with combination therapy. To our knowledge, it is a unique case of a successful outcome with combination therapy of lipid lowering agents in the treatment of XD. In our opinion, this is a promising therapy for the treatment of XD recalcitrant to other treatments.

The Tuberculous Granuloma: An Unsuccessful Host Defence Mechanism Providing a Safety Shelter for the Bacteria?

One of the main features of the immune response to M. Tuberculosis is the formation of an organized structure called granuloma. It consists mainly in the recruitment at the infectious stage of macrophages, highly differentiated cells such as multinucleated giant cells, epithelioid cells and Foamy cells, all these cells being surrounded by a rim of lymphocytes. Although in the first instance the granuloma acts to constrain the infection, some bacilli can actually survive inside these structures for a long time in a dormant state. For some reasons, which are still unclear, the bacilli will reactivate in 10% of the latently infected individuals, escape the granuloma and spread throughout the body, thus giving rise to clinical disease, and are finally disseminated throughout the environment. In this review we examine the process leading to the formation of the granulomatous structures and the different cell types that have been shown to be part of this inflammatory reaction. We also discuss the different in vivo and in vitro models available to study this fascinating immune structure.

The Role and Clinical Significance of High-Sensitivity C-Reactive Protein in Cardiovascular Disease

The Role and Clinical Significance of High-Sensitivity C-Reactive Protein in Cardiovascular Disease

Xanthogranulomatous inflammatory reaction associated with endoscopic mucosal resections of gastric and colonic cancer

Background and aim: Xanthogranulomatous inflammatory reaction (XGI) is a rare diagnosis in the gastrointestinal tract. It could be misinterpreted as an invasive cancerous lesion. The pathogenesis of XGI in the gastrointestinal tract (GIXGI) is not well understood. We clinicopathologically studied six cases of GIXGI associated with endoscopic biopsy, mucosal resection, and submucosal dissection of gastric and colonic adenocarcinoma. Methods: Immunohistochemical, special histochemical stains, and tuberculosis-polymerase chain reaction (PCR) were performed. All radiological images and medical records of the patients were reviewed. Results: All cases showed XGI with foamy histiocytes, lymphocytes, and foreign body-type giant cells, which were positive for CD68 and negative for CD117, S-100, and cytokeratin. Acid-fast, Gomori's methenamine silver, periodic acid Schiff stains, and nontuberculous Mycobacterium and Mycobacterium tuberculosis-PCR were also negative. Two of four gastric adenocarcinomas were suspected to be advanced gastric cancer by computed tomography staging. However, the microscopic examination revealed only XGI with a mucosal carcinoma or without any residual tumor cells in the gastric wall. Conclusions: GIXGI may simulate advanced carcinoma clinicoradiologically. GIXGI should be included in the differential diagnosis in the case suggestive of a rapid transition to advanced gastrointestinal carcinoma within 12 weeks from the preoperative endoscopic procedure.

Normolipidaemic xanthomatosis with systemic involvement of the skin, bone and pharynx

Conflict of interest: none declared. We report a case of a patient with normolipidaemic xanthomatosis of the fingers, which spread rapidly to other parts of the body. A 61‐year‐old Japanese woman presented with a 2‐month history of multiple small nodules on the fingers. She reported that these lesions had appeared about 2 weeks after surgical resection of a pharyngeal tumour, histologically diagnosed as a xanthoma, and they had rapidly extended over all the fingers. The patient had no family history of premature coronary heart disease or xanthomatosis. On physical examination, reddish‐orange, dome‐shaped, raised small nodules and papules were seen scattered on the patient’s fingers, forehead and earlobes (Fig. 1a). On histological examination of a biopsy taken from a nodule, foamy cells, with a diffuse pattern of distribution from the superficial dermis to the subcutaneous tissue, were seen (Fig. 1b). In addition, individual foamy cells were present in the overlying epidermis. Granulomas, Touton giant cells and necrobiotic areas were not detected. Immunohistochemical studies showed that the foamy cells were positive for CD68 and negative for S‐100 protein.

Case of interstitial lung disease possibly induced by exposure to iron dust

Interstitial lung diseases are primarily attributable to occupational or environmental exposures to dusts and irritants. We report on a case of interstitial lung disease, possibly secondary to iron exposure. Our male patient presented with cough and shortness of breath of more than 20 years’ duration after his occupational exposure had ended. A chest radiograph showed patchy shadows throughout both lower fields, and computed tomography showed ground-glass-like opacification, with fibrosis in the lower lobes. A lung biopsy revealed foamy cells in the alveolar spaces, with bronchiolitis obliterans. Microelemental analysis showed an increased level of iron in the lung tissue. After treatment with N-acetyl cysteine effervescent tablets, the patient’s symptoms gradually improved. This probable case of iron-induced interstitial lung disease suggests the importance of obtaining a patient’s history of occupational and environmental exposures for the sake of an accurate diagnosis.

Npc1 deficiency in the C57BL/6J genetic background enhances Niemann–Pick disease type C spleen pathology

Niemann–Pick type C (NPC) disease is an autosomal recessive neurovisceral lipid storage disorder. The affected genes are NPC1 and NPC2. Mutations in either gene lead to intracellular cholesterol accumulation. There are three forms of the disease, which are categorized based on the onset and severity of the disease: the infantile form, in which the liver and spleen are severely affected, the juvenile form, in which the liver and brain are affected, and the adult form, which affects the brain. In mice, a spontaneous mutation in the Npc1 gene originated in the BALB/c inbred strain mimics the juvenile form of the disease. To study the influence of genetic background on the expression of NPC disease in mice, we transferred the Npc1 mutation from the BALB/c to C57BL/6J inbred background. We found that C57BL/6J -Npc1 −/− mice present with a much more aggressive form of the disease, including a shorter lifespan than BALB/c -Npc1 −/− mice. Surprisingly, there was no difference in the amount of cholesterol in the brains of Npc1 −/− mice of either mouse strain. However, Npc1 −/− mice with the C57BL/6J genetic background showed striking spleen damage with a marked buildup of cholesterol and phospholipids at an early age, which correlated with large foamy cell clusters. In addition, C57BL/6J Npc1 −/− mice presented red cell abnormalities and abundant ghost erythrocytes that correlated with a lower hemoglobin concentration. We also found abnormalities in white cells, such as cytoplasmic granulation and neutrophil hypersegmentation that included lymphopenia and atypias. In conclusion, Npc1 deficiency in the C57BL6/J background is associated with spleen, erythrocyte, and immune system abnormalities that lead to a reduced lifespan.

Progressive renal failure despite long-term biweekly enzyme replacement therapy in a patient with Fabry disease secondary to a new α-galactosidase mutation of Leu311Arg (L311R)

A 37-year-old Japanese man affected by Fabry disease secondary to a novel mutation of Leu311Arg (L311R) in α-galactosidase demonstrated progressive renal failure despite biweekly enzyme replacement therapy (ERT) for approximately 10 years. Kidney biopsy revealed foamy glomerular epithelial cells, compatible with the typical pathologic features of Fabry disease. The patient entered a phase III study of Replagal (agalsidase alfa) in 2001, allowing him to continue ERT with biweekly dosing for almost 10 years. During 2 years of that period, he was continued on Fabrazyme (agalsidase beta) biweekly dosing. His estimated GFR was calculated to decrease by 9.9 mL/min/1.73 m(2) per year. Patients with Fabry disease have been reported to have a mean decrease in GFR of 12.2 ± 8.1 mL/min/1.73 m(2) per year. This result suggests that biweekly ERT is only mildly effective at preventing loss of kidney function.

Mammary adenoma with sebaceous differentiation in a dog

The current report describes a complex canine mammary adenoma with a rare histological feature characterized by sebaceous differentiation of tumor cells. A 13-year-old, mixed-breed, intact female dog had mammary tumors on the right mammary chain. Histologically, one of the masses was composed of bilayered ductal structures with luminal epithelial cells together with basaloid or myoepithelial cell components. Within the tumor, there were a number of lobules and nests of large foamy cells associated with basaloid reserve-like cells similar to sebaceous gland. Squamous metaplasia was also seen within the tumor. Immunohistochemical staining indicated that the tumor cells with sebaceous differentiation were positive for cytokeratin (CK)14 and that the associated basaloid reserve-like cells were positive for p63. In contrast, other luminal epithelial tumor cells were positive for CK18 and CK19, but not for CK14 and p63. The myoepithelial cells were positive for α-smooth muscle actin and p63. The expression of p63 in both sebaceous basaloid reserve-like cells and myoepithelial cells, and their structural continuity within the tumor tissue, suggested a common origin of these 2 components.

Indeterminate Cell Histiocytosis in a Pediatric Patient: Successful Treatment with Thalidomide

The 15-year-old male patient presented several 2-6mm large livid reddish-yellowish, shiny, compact papules on the head, trunk and extremities, which had developed within the last 4months. Histology showed normal epidermis with dense dermal infiltrate of histiocytes accompanied by few eosinophils, Touton or foamy giant cells. The histiocytes were S100 positive, CD1a negative and did not contain Birbeck granules ultrastructurally. Chest X ray, EEG, skull MRI did not show pathology. Opthalmology, neurology, oto-rhino-laryngology did not reveal alterations. Based upon the clinical symptoms and the histopathology, the diagnosis of indeterminate cell histiocytosis was confirmed. Cryotherapy and cauterization did not stop the progression of the disease, however, under thalidomide treatment no new symptoms developed and the lesions healed with pigmentation.

Intracytoplasmic Lipid Accumulation in Apocrine Carcinoma of the Breast Evaluated With Adipophilin Immunoreactivity

Although apocrine carcinoma is a distinct histologic entity, there is no immunohistochemical marker to confirm apocrine differentiation with high sensitivity and specificity, and its differential cytologic characteristics are still not fully clarified. Despite the foamy cytoplasm of some apocrine carcinomas and the existence of lipid in the normal apocrine gland, intracytoplasmic lipid in apocrine carcinomas has not been fully explored. By using immunohistochemistry for adipophilin, which is a specific marker of lipid accumulation that can be applied to paraffin sections, we examined intracytoplasmic lipid in apocrine carcinomas. Twenty-four of 26 (92%) apocrine carcinomas and 38 of 116 (33%) nonapocrine carcinomas contained intracytoplasmic lipid. The frequency of adipophilin-positive cases was significantly higher in apocrine carcinomas compared with nonapocrine carcinomas (P<0.01). The positive cell rate per tumor ranged from 10% to 70% (mean, 29%) for apocrine carcinomas. The staining density was heterogeneous from cell to cell. There was no difference in the staining pattern of adipophilin between apocrine ductal carcinoma in situ and invasive apocrine carcinoma or between eosinophilic cells and foamy cells. Sporadic or mosaic distribution of adipophilin-positive cells throughout the tumor and microvesicular or fine granular cytoplasmic staining with heterogeneous density were characteristic features of apocrine carcinoma. Although intracytoplasmic lipid was identified in most apocrine carcinomas, none of the apocrine carcinomas contained prominent intracytoplasmic lipid in >90% of the tumor cells; thus, the criteria for lipid-rich carcinoma was not fulfilled. However, the immunohistochemical study suggests that lipid-rich carcinomas are closely related to apocrine carcinomas.

Fine‐needle aspiration features of paraduodenal pancreatitis (groove pancreatitis): A report of three cases

Chronic pancreatitis is notorious for mimicking both the clinical and radiologic presentation of pancreatic carcinoma. Paraduodenal pancreatitis is believed to result from focal chronic pancreatitis which affects the minor papilla of the duodenum. Currently, there is limited information available regarding the cytologic features of paraduodenal pancreatitis. In this study, we report the cytologic features of three patients with paraduodenal pancreatitis who had EUS-guided FNAs of the pancreas. The cytologic features were highly variable between cases, likely due to sampling of the various components of paraduodenal pancreatitis. The most common findings were spindled stromal cells, foamy cells, and granular debris. Although most often interpreted as negative for malignancy, the sampling of an area with abundant spindle cells or Brunner gland hyperplasia can mimic neoplasia. Careful attention to the clinical history and radiologic description can help to prevent over-diagnosis on FNA.

Pleomorphic xanthoastrocytoma: MR imaging findings in 19 patients

Pleomorphic xanthoastrocytoma (PXA) is a rare and special type of astrocytoma which occurs in childhood and adolescence, and usually with a favorable prognosis. Since its initial description, PXA cases have been reported infrequently in the literature, mostly as single cases or small series. To review the imaging characteristics of PXA. MR imaging findings of 19 pathologically confirmed PXAs were retrospectively analyzed and correlated with the clinical and pathological features. The clinical presentation in 18 patients included: dizziness (8); headache (9); and epilepsy (8). One patient was asymptomatic. On MR imaging, the tumors were located in the brain surface (17), thalamus (1) or deep in the right frontal lobe (1). The tumors were cystic (4), mixed cystic-solid (7), or solid (8) with well-defined (11) or poorly-defined borders (8). Peritumoral edema was marked (8), mild (9) or absent (2). Cystic components of tumors were hypointense on T1- and hyperintense on T2-weighted images whereas the solid components of tumors were hypointense or isointense on T1- and slightly hyperintense on T2-weighted images. There was marked (10), moderate (7) or no (2) contrast enhancement in the solid tumors with surrounding leptomeningeal enhancement (7). The tumors were located in the frontal lobes (8), temporal lobes (7), occipital lobe (1), cerebellum (1), thalamus (1), and sellar region (1). Histologically, 18 tumors were classified as WHO grade 2 comprising of pleomorphic giant cells, spindle cells and foamy cells. One PXA with anaplastic features was composed of pleomorphic polygonal cells and spindle cells, and with high mitotic activity ( ≥5 mitoses per 10 HPF). Immunohistochemical reactions to glial fibrillary acidic protein (GFAP) were positive in all 19 cases. The pathological appearances of PXA are distinctive. MR imaging could display the morphologic features exactly, and has important diagnostic value for PXA.

A Histopathological and Immunohistochemical Study on the Effects of the Resin Fragments of the Abutment Construction in the Periodontal Tissues in Healthy (m+/m+) and Diabetic Model Mice (db/db)

The materials of high molecular compounds have been widely used in the field of dental clinics. Although preparation of the tooth abutment and contamination of the metal fragments are known to cause the discoloration and injury in the periodontal tissues in the field of crown and bridge prosthodontic clinics, the changes by the precipitation of composite resin fragments have not been fully clarified, yet. In addition, diabetes mellitus has recently been increased because of an advanced age, life style and conditions, and also, the patients with diabetes have increased in dental clinics. Therefore, the present study was undertaken the histopathological, histochemical and immunohistochemical analyses, in order to elucidate the changes of the periodontal tissues by injecting the composite resin fragments. The histopathological reactions of the periodontal tissues in both healthy (m+/m+) and diabetic (db/db) mice were also compared. Histopathologically, neutrophil infiltration was remarkably observed around the fragments of the composite resin at 3 days after the injection, and then, the formation of the granulation tissues with appearance of macrophages (foamy cells) at 7 and 14 days in m+/m+. Multinuclear giant cells were also observed at 14 days in m+/m+. In db/db, neutrophil infiltration was not so remarkable at 3 days, and relatively increase of the infiltration was observed at 7 days, and formation of the granulation tissues with appearance of the foamy cells at 14 days. The numbers of the mast cells, indicated metachromasia with toluidine blue pH 2.5 staining, peaked at 3 days and then decreased at 7 and 14 days in m+/m+, whereas the peak of the mast cells was at 7 days in db/db. Immunohistochemically, the peak cell rate of CD68-positive macrophage was found at 3 days after the injection, and the rate decreased at 7 and 14 days in m+/m+, whereas the rate gradually increased and showed the peak at 14 days after the injection in db/db. The peak of the cell rate of matrix metalloproteinase-2-positive macrophage was observed at 3 days, and the rates tended to gradually decrease at 7 and 14 days after the injection in m+/m+, whereas lower cell rate without peak point was recognized at each day in db/db. These results suggested that db/db showed delay of the process of biological reactions for the foreign bodies of the composite resin fragments compared to m+/m+. Furthermore, the delay of the reaction depended on the inhibition for the fibrosis accelerated by macrophages and mast cells.

Relationship between CD36 expression, foamy cell aggregates in renal interstitium and serum cholesterol level

我们既往的研究结果显示肾间质泡沫细胞的形成与蛋白尿的严重程度和血清胆固醇水平有关[1].Alport综合征患者血脂水平明显低于其他病理类型的肾小球疾病患者,但其泡沫细胞浸润的发生率却显著高于其他患者;另外膜增生性肾小球肾炎(MPGN)患者与局灶节段硬化性肾小球病(FSGS)患者相比两组间血清胆固醇水平差异无统计学意义,但两者泡沫细胞发生率却有显著差异[1]。