Penile Mucosa Research Articles

Pathologic features of epidermoid carcinoma of the penis. A prospective study of 66 cases.

We report a whole-organ-section pathologic study of 66 cases of epidermoid carcinoma of the penis. Specimens were divided into three compartments: glans (G), coronal sulcus (COS), and foreskin (F) with 24, 4, and 12 histologic sections each. Four types of carcinomas were found: (a) superficially spreading (42%), a biphasic infiltrating and extensive carcinoma in situ usually involving more than one compartment and radially growing along the surface of G, BPS, F, or even urethra; (b) vertical growth (32%), unifocal high-grade, deeply invasive neoplasms with minimal or no carcinoma in situ component; (c) verrucous (18%), low-grade papillary or endophytic; and (d) multicentric (8%), two or more independent primary tumors separated by non-neoplastic mucosa. Inguinal lymph node metastasis were found in 82, 42, and 33% of pathologic types vertical growth, superficially spreading, and multicentric carcinomas, respectively; verrucous tumors did not show metastasis. The morphologic diversity of penile cancer may be related to different causative factors. Metastatic involvement suggests a distinctive biological behavior of the tumor. The widespread extension of superficially spreading and multicentric carcinomas to anatomical compartments indicate penile mucosa as one "field" prone to malignant transformation. These findings may be important for the selection of appropriate therapy and emphasize the need for a close follow-up of patients undergoing less than a complete removal of the three compartments.

Estrogen and progesterone receptors in cervical human papillomavirus related lesions

According to recent studies showing that human papillomavirus (HPV) infections can be influenced by sex steroid hormones, we performed estrogen (ER) and progesterone (PgR) receptor assays in fresh frozen biopsies of genital-HPV-related lesions. Seventy-three women with normal cervix, condyloma, low- and high-grade CIN and squamous carcinoma were evaluated in comparison with 15 persons with vulvar and 9 with penile papillomavirus-associated lesions. HPV genotypes were determined by dot-blot hybridization. Non-cervical lesions did not express HR. Condyloma on squamous metaplasia of the cervix and high-grade CIN expressed high levels of HR, particularly PgR (mean 4,086 and 4,518 fmoles/g tissue, respectively). Cervical squamous carcinoma expressed very low concentrations of PgR in a limited number of cases. High levels of PgR were correlated with high-grade CIN (p less than 0.05), HPV16-18-associated lesions (p less than 0.01) and ER were correlated to HPV6-11-related lesions (p less than 0.01). The levels were independent of age, cycle stage and oral contraception. Morphological localization of PgR, using an immunocytochemical method using a monoclonal antibody (MAb) (PR-ICA), showed intense homogeneous staining in the nuclei of the stromal fibroblasts underlying dysplastic epithelium and condyloma on squamous metaplasia. These results suggest that, under in vivo conditions, sex steroid hormones, particularly progesterone, may act indirectly on HPV-infected epithelial cells and be implicated as co-factors in HPV-related cervical neoplasia. They could explain the relative predisposition to malignant transformation of the cervix as compared with vulvar and penile mucosa.

The afferent innervation of the face of sheep and goats

The sensory innervation of the maxillary hairy skin and buccal mucous membrane was studied in anaesthetised sheep and goats. An electrophysiological technique isolated 47 single afferent units from the infraorbital nerve under chloralose or halothane anaesthesia. Mechanoreceptors of hairy skin were located in association with the following features: sinus hairs (n = 9); central primary hairs (n = 18); clear marginal hairs (n = 7) and skin-not-hair (n = 3). Units responded to hair tip displacement of 35 to 50 microm. Afferent units were also located in the mucous membrane of the cheek either associated with conical papillae (n = 8), or unassociated with papillae (n = 1). Receptor responses associated with hairs were classified as rapidly adapting (n = 18) and slowly adapting (n = 18) mechanoreceptor responses during sustained hair deflection. Seven mechanoreceptors of hairy skin and mucous membrane were excited by a fall in surface temperature. Two specific cold thermoreceptors were found: one in hairy skin and one in the mucous membrane. These units had phasic discharges during abrupt thermal depression and static discharges at constant surface temperatures. All afferent units had myelinated axons as indicated by their conduction velocities (range 20 to 57 m sec-1, mean 34 m sec-1). It is concluded that the mechanoreceptors identified had similarities with those of other mammalian species and some distinct differences. An interesting feature of mechanoreceptors in the buccal mucosa was their cold sensitivity. They therefore shared characteristics with mechanoreceptors in the penile mucosa of the ram and tongue of the sheep.

Measurement of immunoglobulins in reproductive tract fluids of bulls

Seminal, seminal vesicular, urethral and preputial fluids from bulls of two different age groups were assessed for quantitative differences in immunoglobulins. Selected markers were measured in individual samples to differentiate locally derived immunoglobulins from those present as a result of trauma or secretions from other accessory glands. Immunoglobulin levels in reproductive tract fluids from older bulls (5–6 years) were higher than those of younger bulls (3–4 years) and preputial fluids contained the highest concentration of immunoglobulins of all fluids examined. Similarities existed, however, among all fluids in the relative concentrations of immunoglobulins. IgG was generally in highest concentration, though the predominant subclass varied. A marked predominance of IgG 2 over IgG 1 occurred in preputial fluid samples of older bulls. IgA was in second highest concentration, and levels were often equal to or greater than those in serum. IgM was in low concentration and occasionally undetectable. IgG/IgA ratios did not exceed 5 in most of the reproductive fluids, whereas serum ratios were usually over 100. Proportional contents of albumin and immunoglobulin in reproductive tract fluids by comparison with those in serum indicated that substantial quantities of IgG as well as IgA were synthesized locally or derived by selective transport. Increased numbers of plasma cells in the lamina propria of the preputial and penile mucosa of older bulls were correlated with higher immunoglobulin concentrations in preputial fluid from older bulls, suggesting that differences in local synthesis were responsible.

Erythroplasia of Queyrat. A clinicopathologic and histochemical study.

Observations from 100 men with erythroplasia of Queyrat (EQ) indicate that the disease is a distinct clinicopathologic entity. Because of the bowenoid histologic features, some observers believe that EQ is Bdwen's disease (BD) of the penile mucosa. Analysis of data from patients with EQ and BD show differences with regard to race, ethnic origin, sex, age, duration, anatomic site, number of lesions, family history, arsenic content of lesions, associated cancer, and cause of death. When compared with BD, EQ shows a significant lack of association with systemic cancer, and the patients die from cardiovascular disease and other causes. Surgical excision is the treatment of choice for EQ, although adequate electrodesiccation and curettage, and topical fluorouracil have given satisfactory results. Phallectomies should only be done when there is deep invasive squamous cell carcinoma in the lesion. Factors in the pathogenesis of EQ may be anatomic environmental carcinogens in uncircumcised men.