Squamous Metaplastic Cells Research Articles

Influence of smear quality on the rate of detecting significant cervical cytologic abnormalities.

To determine the correlation between cervical smear quality and the rate of detecting significant epithelial abnormalities. Smear quality was assessed routinely in a series of 68,328 cervical spatula and spatula/brush combination smears received by our laboratory during 1993. Quality was assessed using a semiquantitative method, evaluating the presence of endocervical cells, metaplastic squamous cells, endocervical mucus and overall squamous cellularity. Smear quality was graded as unsatisfactory, poor (18,680 smears), fair (9,739 smears) or good (39,909 smears); unsatisfactory smears were eliminated from the analysis. There was a highly significant correlation between smear quality and the rate of detecting significant epithelial abnormalities (chi 2=127.52, df=2, P<.001). Smear quality is an important issue. Many significant abnormalities are potentially missed because of poor smear quality.

Cervical Intraepithelial Neoplasia in Jordan: A Ten Year Retrospective Cytoepidemiologic Study

Occurrence of cervical intraepithelial neoplasia (CIN) was studied in 10,659 females attending obstetric and gynecology clinics in Jordan. The frequency rate of intraepithelial neoplasia was 1.1% in 7743 Jordanian females and 2916 non-Jordanian residents of younger age during the period from 1982 to 1991 inclusive. The incidence rate in 2649 Jordanian females, selected because they attended only for routine checkup, was 49 per 100,000. There were 121 CIN cases which were graded into Grade I (21%), II (48%) and III (31%) respectively. Histological grading correlated with cytology in 70% of the cases while in the remaining 30%, cytologic underrating by one grade was noted; evidence against any overdiagnosis of CIN in our series. Study of the human papillomavirus (HPV) was outside the scope of this effort. However, circumcision in male partners and marital status were associated with a lower frequency of CIN. Age at marriage and average duration, parity, breast feeding, the contraceptive pill, socioeconomic status and menstrual disorders showed no relationship to the frequency of CIN in our patients. Any differences in the latter between Jordanian and non-Jordanian females are believed due to cultural factors. Conization in 27 cases proved effective at 30 months' follow-up. Occurrence of CIN in Jordanian females appears substantial although much lower than that seen in high incidence zones, while its incidence in the general female population remains to be determined. This study shows for the first time the value of Papanicolaou (Pap) smears in Jordanian females over 20 years of age with special emphasis on those over 35 years of age attending obstetric and gynecology clinics.

High grade squamous cervical lesions following negative Papanicolaou smears: false-negative cervical cytology or rapid progression.

The cervical cytologic finding of a high grade squamous intraepithelial lesion (HGSIL) or carcinoma shortly following a negative smear is unusual. To determine if such cases are due to screening errors, inadequate sampling, or rapidly progressive lesions, a review of negative smears (immediately preceding a diagnosis of HGSIL or carcinoma by at most 2 yr) was performed on 17 patients (all such patients in our 1990-92 files, representing 6% (17/290) of such diagnoses). The time between negative smear and positive result averaged 9.3 mo. Eighty-eight percent of these patients had prior histories of a cytologic abnormality. Upon review, 16 of 17 "negative" smears contained a cytologic abnormality. Atypical immature squamous metaplastic type cells (AISMTs) were found in 11 of 16 cases, atypical squamous cells or slight dysplasia were found in 5 of 16, HGSIL was found in 5 of 16, and atypical cells of undetermined type and origin were noted in 1 of 16. Combinations of the above diagnoses were present in 6 of 16 cases. The number of abnormal cells per slide was estimated, with < 10 cells in 1 case, < 50 in 4 cases, 50-100 in 7 cases, 100-200 in 3 cases, and > 200 in 1 case. In this study, screening and/or evaluation errors were the dominant cause of false-negative cytologic diagnoses, with AISMTs accounting for the most commonly missed or misinterpreted cells. These cells are small and have hyperchromatic nuclei with elevated nucleus to cytoplasmic ratio and nuclear irregularities.

Immunohistochemical localization of syndecan-1 in normal and pathological human uterine cervix.

Expression of syndecan-1, a cell surface proteoglycan that binds growth factors and extracellular matrix components, was studied in normal and pathological human uterine cervix using immunohistochemical methods. Normal cervical squamous epithelium showed positive staining for syndecan-1 in all cell layers, except the basal cell layer, whereas endocervical columnar epithelium stained weakly. In non-neoplastic reactive lesions, metaplastic squamous cells were positive for syndecan-1, whereas columnar cells showed weak or negative staining. In cervical condylomas, cells showing koilocytotic atypia were positive for syndecan-1. The progression of cervical intraepithelial neoplasia (CIN) grade I to grade III was associated with reduced syndecan-1 expression and localization of syndecan-1 to more superficial cell layers. In squamous cell carcinomas (SCCs), syndecan-1 expression correlated with histological differentiation, being absent from most poorly differentiated tumours. The results suggest that loss of syndecan-1 from atypical cells is an early event during cervical carcinogenesis and show a close association of syndecan-1 expression with preserved epithelial morphology and differentiation.

Expression of transforming growth factor-alpha in the normal cervix and in benign and malignant lesions of the uterine cervix.

To investigate the expression and distribution of transforming growth factor-alpha (TGF-alpha) in the normal cervix and in benign and malignant lesions of the uterine cervix. Immuno-histochemical reactivity with a monoclonal antibody against TGF-alpha was examined in tissue specimens from 15 normal cervices, six cervical polyps, four cervical condylomata acuminata, 34 cervical intra-epithelial neoplasias, 35 invasive squamous cell carcinomas, five adenocarcinomas, and three mixed adenosquamous carcinomas. Normal squamous cells of the exocervix were found to be negative for TGF-alpha immunoreactivity, whereas reserve cells and metaplastic squamous cells in the transformation zone were positive for TGF-alpha. Although TGF-alpha immuno-reactivity was variable in the cervical condylomas, most cases of cervical intra-epithelial neoplasia with or without koilocytotic atypia were negative for TGF-alpha. In the invasive carcinomas, however, TGF-alpha immuno-reactivity was observed in 17 out of the 35 cases of squamous carcinoma, and in all cases of adeno- and adenosquamous carcinomas. In addition, intense TGF-alpha immuno-reactivity was found in clinically advanced tumours. These results suggest that the expression of TGF-alpha is associated with squamous metaplasia in the normal cervix, and that TGF-alpha may play an important role in cervical carcinogenesis, especially in its progression.

Quality control study on negative gynecological cytology in Mexico.

An external evaluation of the quality of diagnosis of gynecological cytology specimens (Papanicolaou or "Pap" tests) in the Cytopathological Laboratory at the Mexico General Hospital was performed, with evaluation of 6,011 Pap tests randomly selected from 31,378 Pap studies previously reported as negative during 1988-1989. These tests were part of the early detection program for cervical cancer run by the Ministry of Health of Mexico City. A quality index for specimens was constructed based on the presence of endocervical cells, mucus, and squamous metaplastic cells. The index of false negatives for the diagnosis of cervical neoplasm in this sample which correspond to diagnostic error by the examiner was 0.18% (11). The constructed quality index revealed that 64.1% of specimens were low quality. The correlation between diagnostic error and low quality was .87. Results indicate that laboratories participating in early detection programs for cervical cancer in developing countries need to implement (1) external evaluation programs for Pap diagnosis; (2) permanent training programs in registration; and (3) monitoring procedures for collection, fixation, and transportation of cytologic materials.

Asymptomatic solitary papilloma of the bronchus: review of occurrence in Japan

A case of solitary papilloma of the bronchus is described, and 15 other cases occurring in Japan are reviewed. A 57 year old asymptomatic male was referred to our hospital because many squamous metaplastic cells with moderate atypia were observed in sputum cytology, twice in 3 months. The chest X-ray showed no abnormal findings. Endoscopic examination revealed a polypoid tumour at the bifurcation of the right B6a and B6b. The tumour was removed completely by endoscopic biopsy, and histological findings showed squamous papilloma. There has been no evidence of recurrence for 3 yrs. We are not aware of a previously reported case of bronchial papilloma without symptoms or abnormal shadow on chest X-ray. Considering the fact that malignant change was reported in only one case in Japan, and that there is a possibility of cancer subsequently developing at another location in the lung which might also require resection, lobectomy should be avoided if the tumour can be removed completely through endoscopy. If the lesion is limited to a small area in the bronchus, conservative treatment such as photodynamic therapy and/or yttrium aluminium garnet (YAG) laser vaporization might be sufficient to obtain a complete cure.

Recovery of tracheal epithelium following high frequency ventilation at low inspired humidity

We used scanning electron microscopy (SEM) and light microscopy (LM) to study the recovery of tracheal epithelium in newborn lambs damaged by high frequency flow interrupted ventilation (HFFIV) at low inspired humidity (30%). Newborn lambs were mechanically ventilated for 6 h, allowed to recover and subsequently killed at 2, 7 or 14 days. The recovery of the trachea above and below the tip of the endotracheal tube (ETT) was studied at these time periods and compared to a control non-intubated group and a group killed immediately after 6 h of ventilation. Above and below the ETT, SEM and LM revealed deciliation to be greatest 2 days after ventilation. The damaged tracheal mucosa had converted to non-ciliated epidermoid squamous metaplastic cells. Recovery was not complete by 14 days, although the squamous cells had already differentiated into goblet and ciliated columnar epithelial cells. No difference was seen in the rate of recovery of the tracheal mucosa above or below the tip of the ETT.

唾液腺の上皮成長因子（ＥＧＦ）に関する研究 ヒト唾液腺組織のＥＧＦとＥＧＦ受容体

Epidermal growth factor (EGF) stimulates the growth and differentiation of normal and tumor tissues after binding to its receptor (EGFR). To study the correlation between histological malignancy of salivary gland tumors and expression of EGFR or EGF, we investigated immunohistochemical expressions of EGFR and EGF in normal salivary glands and salivary gland tumors (n=136).In normal salivary glands (parotid, submaxillary, sublingual and minor salivary glands), EGFR and EGF were detected in ductal segments of intercalated, striated, and excretory ducts, but not in acinar cells. In salivary gland tumors, EGFR and EGF were positive in luminal tumor cells and squamous metaplastic cells in pleomorphic adenoma, tumor cells in adenolymphoma, epidermoid tumor cells in mucoepidermoid tumor, luminal tumor cells of tubular pattern in adenoid cystic carcinoma, and all tumor cells in adenocarcinoma and epidermoid carcinoma. But they were negative in acinic cell tumor, mucous tumor cells in mucoepidermoid tumor, tumor cells of cribriform pattern and outer tumor cells of tubular pattern in adenoid cystic carcinoma.EGFR and EGF are positive in duct-like arrangement cells of pleomorphic adenoma and adenolymphoma, which are considered to be well differentiated. On the other hand EGFR and EGF positive cells the arrangement of which is not similar to duct structures like adenocarcinoma or epidermoid carcinoma are thought to have more potential for growth. The EGFR positive rate is 100% in adenocarcinoma and epidermoid carcinoma which have a poor prognosis. The synchronous expression of EGFR and EGF may play some biological role in tumor proliferation by an autocrine mechanism.

Squamous metaplasia in hormonallytreated prostatic cancer significance during follow-up

A prospective study of 59 hormonally treated prostatic cancer cases was undertaken during follow-up with sequential transrectal palpation and fine-needle aspiration. At initiation of therapy patients' ages ranged from forty-eight to eighty-two years (median, 68 years). The usual follow-up interval was 6 +/- 3 months, and follow-up periods ranged from six months to one hundred twenty months (median 48 months). The cytologic findings were categorized under four cytologic response types and palpation findings under five response grades. Four different degrees of squamous metaplasia (1+, 2+, 3+, 4+) were observed in smears, depending on semiquantitative determination of squamous metaplastic cells in relation to the total amount of benign and malignant epithelial cells in the smear. There were 341 follow-up observations in which both transrectal fine-needle aspiration cytology and palpation were done. In 306 of these, cytologic findings were found to be adequate. Comparison of squamous metaplasia with cytologic response types revealed a highly significant difference between the benign state and recurrence/frank malignancy. This was also true when frequency of squamous metaplasia was compared with palpatory response grades. It was found that squamous metaplasia can be a valuable adjunct to other cytomorphologic changes such as shrinkage of tumor cell size and decrease in size of nucleoli or its disappearance, in determining response to hormonal therapy.

Immunohistochemical localization of ras p21 in ameloblastoma.

The expression of ras p 21 and its histological localization on 13 ameloblastomas has been immunohistochemically studied using monoclonal antibody NCC-RAS-001 as the primary antibody. The ras p 21 was detected in 10/13 (76.9%) ameloblastomas; 3/5 (60.0%) were of the follicular and 7/8 (87.5%) of the plexiform type. In addition, ras p 21 was also detected in the cytoplasm of metaplastic squamous cells. The result suggested that ras p21 may be closely related to the proliferation and the development of tumor cells in ameloblastoma.

Plastic or Cast Bronchitis?

Sir .—I read with interest the article by Perez-Soler 1 in the September 1989 issue of AJDC . In 1985 my coauthors and I 2 described, under the rubric bronchitis, five children from the United States, Japan, and Saudi Arabia who expectorated large, branching, bronchial casts. Four of our five patients had histories of wheezing or allergy. In clinical respects our patients appear to be similar to those of Perez-Soler, with the exception of our patient 1, an 8-year-old boy with tricuspid atresia who was neither allergic nor asthmatic. Our other patients were all aged 5 years or younger. A prominent feature of casts in Perez-Soler's series was the presence of metaplastic squamous epithelial cells. In our patients the casts were predominantly mucoid material with variable quantities of inflammatory cells. Are plastic and Perez-Soler's cast bronchitis the same condition, or do the differing compositions of the casts serve to

The histological and immunohistochemical evidence of squamous metaplasia from the myoepithelial cells in the breast

Squamous metaplasia in the breast is well documented. However, the putative cell of origin for the squamous epithelium is not clear. This paper describes a case of fibroadenoma of the breast with myoepithelial hyperplasia and squamous metaplasia. The histological finding of transition between myoepithelial cells and squamous cells and the immunohistochemical expressions of actin and S-100 in the metaplastic squamous cells support the myoepithelial origin of squamous epithelium in the breast.

Lymphoepithelial Cysts of the Salivary Glands: Histologic and Cytologic Features

Fourteen cases of surgically excised lymphoepithelial cysts (13 from the parotid gland and 1 from the submandibular gland) were reviewed for diagnostic histologic features. They showed squamous epithelium-lined cysts within lymph nodes. Lymphocytes, histiocytes, and plasma cells were found in the walls of the cysts. Multinucleated giant cells were present in four cases. The five patients tested for human immunodeficiency virus (HIV) infection were positive, both by enzyme-linked immunosorbent assay (ELISA) and Western Blot. Fine-needle aspiration (FNA) was performed on five cases (two were confirmed histologically). Diff-Quik-stained smears showed a proteinaceous background and a mixed population of lymphocytes, histiocytes, plasma cells, and metaplastic squamous cells. When the above cytologic findings are present on fine-needle aspiration of a major salivary gland lesion, the diagnosis of lymphoepithelial cyst should be considered.

Intermediate filament expression in non-neoplastic pituitary cells

Fifty-one non-neoplastic human pituitary glands, including examples with Crooke's hyalinization or amyloidosis, were examined by an immunoperoxidase method using antibodies to keratin, vimentin, neurofilaments (NFs), glial fibrillary acidic protein (GFAP), desmin, actin, S-100 protein and a variety of pituitary hormones. It was confirmed that most of the epithelial cells in the pituitary gland express keratin immunoreactivity. These cells included endocrine cells in the anterior lobe, endocrine cells and squamous metaplastic cells in the pars tuberalis, columnar and ciliated epithelia forming follicular structures and salivary-type epithelium in the pars intermedia, and anterior lobe cells infiltrating the posterior lobe. This study also demonstrated that keratin and NFs may be co-expressed in endocrine cells in the pituitary anterior lobe, that keratin, vimentin and GFAP may be co-expressed in the epithelial cells forming cyst-like follicle in the pars intermedia, and that vimentin and GFAP may be co-expressed in folliculo-stellate cells and pituicytes. In addition, the GFAP and S-100 protein-negative high columnar epithelium in the pars intermedia tended to be positive for adrenocorticotropic hormone and melanocyte stimulating hormone, while the low columnar epithelium with the co-expression of GFAP and S-100 protein was negative for pituitary hormones.

Evolution of metaplastic squamous cells of alveolar walls in pulmonary fibrosis produced by paraquat

Sequential histologic, ultrastructural, immunohistochemical and morphometric studies were made of the evolutional changes of metaplastic and regenerating alveolar epithelial cells in monkeys from 3 days to 8 weeks after paraquat administration. In the early proliferative phase, many alveoli were lined by single-layered and stratified squamous epithelium and bronchiolized epithelium (i.e., presumably derived from bronchi and bronchioles). The regenerating epithelial cells had well developed bundles of actin-like filaments, which were arranged parallel to the basal surfaces of the cells and were associated with zonulae adherentes; these cells also had intermediate filaments and some desmosomes, but lacked basement membranes, hemidesmosomes and anchoring fibrils. They covered either denuded, wavy and disrupted original epithelial basement membranes or areas of developing intraalveolar fibrosis. In zones of squamous epithelial cell metaplasia associated with intraalveolar fibrosis, fibronexus-like structures appeared to be responsible for the initial adhesion of the cells to the underlying connective tissue. In later phases, single-layered and stratified squamous epithelial cells disappeared, and only bronchiolized epithelial cells, with hemidesmosomes and anchoring fibrils on their basal surfaces, were found in fibrotic alveoli. Although bronchiolized and squamous metaplastic epithelial cells are generally thought to be formed as late events in pulmonary damage, such cells play an important role in early, temporary repair of damaged alveoli.

Inhalation toxicity of chromium dioxide dust to rats after two years exposure

Rats were exposed by inhalation to chromium dioxide (CrO 2) dust at design concentrations of 0, 0.5 (stabilized and unstabilized, respectively) or 25 mg m −3 (stabilized) for 6 h day −1, 5 days week −1 for 2 years. No dust-exposure-related pathological changes were observed, other than lung lesions, in all exposed rats. There were no significant differences in pulmonary response between unstabilized and stabilized CrO 2 at the 0.5 mg m −3 exposure level. The lungs showed minute dust deposition in the alveoli adjacent to the alveolar ducts, but maintained an intact general architecture. The pulmonary responses satisfied the biological criteria for a nuisance dust. At 25 mg m −3, dust deposition was sharply confined to the alveoli in the alveolar duct region. Alveolar walls enclosing dust-laden macrophage (dust cell) aggregates were thickened with hyperplastic Type II pneumocytes and slightly collagenized fibrosis. Alveoli adjacent to the terminal bronchioles were lined with bronchiolar epithelium (alveolar bronchiolarization). In addition, lungs showed foamy macrophage response, cholesterol granulomas, alveolar proteinosis, and minute fibrotic pleurisy. These pulmonary lesions occurred predominantly in female rats. Of 108 female rats, six developed keratin cysts and two had cystic keratinizing squamous cell carcinoma (CKSCC). None of 106 male rats had either a keratin cyst or a CKSCC. The lung tumors developed from metaplastic squamous cells in the areas of alveolar bronchiolarization in the alveolar duct region. The lung tumors were well differentiated and devoid of characteristics of true malignancy. The CKSCC is an experimentally-induced, unique tumor type and is different from the type of spontaneous lung tumor seen in man or animals. The relevance to man of this type of lung tumor appears to be negligible.

Identification of features of metaplastic cells in sputum for the detection of squamous‐cell carcinoma of the lung

Digitized images of 1,556 squamous metaplastic cells from the sputum of 15 patients with confirmed squamous-cell carcinoma of the lung and 13 subjects without apparent neoplasia were analyzed to determine if features existed within these relatively normal cells that could be used to differentiate between the two populations. Results indicate that such marker features do exist. A cross-validation study using an additional 465 cells confirmed the conclusion that squamous metaplastic cells from patients with squamous-cell carcinoma of the lung do differ from those of subjects without cancer. While such marker features alone are not reliable enough to assist pathologists in the diagnosis of squamous-cell carcinoma of the lung, they might, in sufficient numbers, be used to identify patients for whom follow-up testing would be advised.

Immunohistochemical expression of epidermal growth factor receptor in salivary gland tumours

Immunohistochemical localization of epidermal growth factor receptor (EGFR) in normal salivary glands and tumours (108 cases) was studied using a monoclonal antibody. In the normal salivary glands, EGFR was occasionally detected in ductal segments of intercalated, striated, and excretory ducts, but not in acinar cells. The frequency of positive EGFR staining in salivary gland tumours was not high: pleomorphic adenoma, 33.8%; mucoepidermoid tumour, 25.0%; adenolymphoma, 44.4%; and sialoadenocarcinoma, 66.6%. Pleomorphic adenomas showed positive staining for EGFR on the luminal side of luminal cells and in squamous metaplastic cells of tumour tissue. Some modified myoepithelial cells were also reactive whereas outer spindle tumour cells were unstained. Adenolymphomas regularly exhibited positive EGFR staining in the cell membrane; mucoepidermoid carcinoma displayed positive staining in cell membranes in epidermoid tumour cells and cytoplasmic staining in mucous-secreting tumour cells. Sialocarcinomas revealed cell membrane staining and whole cytoplasmic staining for EGFR. The immunohistochemical localization of EGFR could be classified into two types, one the cell membrane-positive type found in epithelial tumour cells, and the second the cytoplasmic positive type seen in normal ductal cells, the luminal tumour cells of pleomorphic adenomas and mucous-secreting tumour cells.

Immunohistochemical expression of MAM-3 and MAM-6 antigens in salivary gland tumours

MAM-3 and MAM-6 antigens of human milk fat globule membrane were detected immunohistochemically in 93 cases of salivary gland tumours as well as in normal glands. The antigens were visualized in 10% formalin-fixed paraffin sections. MAM-3 (MoAbs 115G3, 67D11) antigen was distributed in intercalated and striated duct cells of the normal salivary glands, and in luminal tumour cells and squamous metaplastic cells of pleomorphic adenomas. In pleomorphic adenomas the frequency of positive staining with MoAb 67D11 (54/67; 80.6%) was higher than that with MoAb 115G3 (36/67; 53.7%). MAM-6 (MoAbs 115D8, 115F5) antigen was expressed in luminal and lateral borders of serous acinar cells and ductal of the normal glands, and also in luminal borders of tubulo-ductal and glandular structures of salivary gland tumours. Ductal basal cells were characterized by existence of positive staining for MAM-6 antigen, in adenolymphomas MAM-6 antigen was restricted to the basal tumour cells. Some mucous cells of mucoepidermoid tumours were stained specifically with MoAb 115G3, and epidermoid cells of mucoepidermoid carcinomas manifested MAM-6 antigen staining. Immunohistochemical localization of MAM-6 antigen resembled that of epithelial membrane antigen (EMA) detected with MoAb.