Presence Of Mucous Cells Research Articles

Frontal Sinus Mucopyocele Presenting as Purulent Discharge in the Frontal Region Following a Neglected Frontal Fracture: A Case Report and Literature Review

Mucoceles are progressive growths of encapsulated mucus capable of eroding and destroying adjacent bone structures and compressing neighboring organs. They are caused by the presence of mucous cells from the sinus membrane in an undrained space. These mucoceles can become infected, leading to the formation of a mucopyocele. They may manifest many years after the initial trauma to the facial bones, especially those involving the frontal sinuses. The discovery is either fortuitous or secondary to imaging: Computed tomography (CT), magnetic resonance imaging, carried out during an etiological assessment of symptoms such as frontal pain, proptosis, diplopia, nasal obstruction, rhinorrhea. Rarely, purulent discharge through a frontal cutaneous fistula may be the initial sign of a frontal sinus mucocele or mucopyocele. We report a case of mucopyocele of the frontal sinus presenting in the form of purulent discharge at the frontal level following a neglected frontal fracture and present our therapeutic approach.

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA: CASE REPORT

A 62-year-old White female patient presented to the stomatology clinic with a submucosal nodular lesion in a region of the lower right labial mucosa, asymptomatic, well delimited, circumscribed, movable, with a fibrous consistency, measuring 1 cm in diameter, with approximately 1 year of evolution. With the hypothesis of benign salivary gland neoplasm and benign mesenchymal neoplasm, an excisional biopsy was performed. Histologically, proliferation of cells organized in nests, ducts, and cords was observed, showing pale nuclei and evident nucleoli. The presence of mucous cells and cribriform areas and extracellular matrix, sometimes fibrous and other times hyaline, was noted. Immunohistochemically, cells were positive for cytokeratins 7 and 14, S-100, and p63 and focally positive for smooth muscle actin. The cell proliferation index measured by Ki-67 was less than 5%. In view of the clinical and microscopic characteristics, the diagnosis of low-grade polymorphous adenocarcinoma was closed. The patient was referred to the head and neck surgeon.

A tree-based machine learning model to approach morphologic assessment of malignant salivary gland tumors

Malignant salivary gland tumors represent a challenge for pathologists due to their low frequency and morphologic overlap. In recent years machine learning techniques have been applied to the field of pathology to improve diagnostic performance. In the present work, we fitted a machine learning algorithm to approach the diagnosis of malignant salivary gland tumors. Twelve morphologic variables were scored across 115 samples representing the most commonly encountered malignant salivary gland tumors. The sample was randomly split into a discovery and validation set. A recursive partitioning algorithm was used to systematically screen and organize candidate variables into a classification tree using the discovery set. A cross-validation strategy was used to tune the algorithm hyperparameters. Inter-observer concordance was calculated by independent evaluation of 26 randomly selected cases. The five-tiered tree built, required the evaluation of 6 morphological variables. Basaloid appearance, presence of mucous cells, necrosis, cribriform pattern, clear cells and keratinization were selected by the algorithm to build the tree. This diagnostic tool correctly classified 89.9% and 84.6% of the samples in the discovery and validation sets respectively. Misclassification pattern was consistent between both sets. Misclassified tumors belonged to one of three histologic types: epithelial-myoepithelial, polymorphous and mucoepidermoid carcinomas. Other histotypes demonstrated perfect recall in both the discovery and validation sets. Overall inter-observer concordance was good, with median kappa scores between the expert evaluator and training pathologists being 0.81. Overall, our classification tool developed using a recursive partitioning algorithm can effectively guide the morphological approach to malignant salivary gland tumors.

The first evidence of intrinsic epidermal bioluminescence within ray-finned fishes in the linebelly swallower Pseudoscopelus sagamianus (Chiasmodontidae).

External and histological examination of the photophores of the linebelly swallower Pseudoscopelus sagamianus reveal three epidermal layers of cells that form the light-producing and light-transmitting components of the photophores. Photophores among the examined photophore tracts are not significantly different in structure but the presence of mucous cells in the superficial layers of the photophore suggest continued function of the epidermal photophore in contributing to the mucous coat. This is the first evidence of intrinsic bioluminescence in primarily epidermal photophores reported in ray-finned fishes.

Primary Pulmonary Mucoepidermoid Carcinoma: Histopathological and Moleculargenetic Studies of 26 Cases.

IntroductionPulmonary mucoepidermoid carcinoma (PMEC) is an uncommon neoplasm of the lung and the main salivary gland-type lung carcinoma. The aims of this study were to review the clinicopathological and immunohistochemical features of PMEC and characterize the genetic events in PMEC.MethodsWe reviewed the pathology cases in our hospital and found 34 initially diagnosed PMEC cases, 26 of which were confirmed as PMEC after excluding 8 cases of MEC-like pulmonary carcinoma. The clinicopathological characteristics of the 26 PMEC cases and the 8 cases of MEC-like pulmonary carcinoma were retrospectively reviewed. MAML2 rearrangement was detected by fluorescence In Situ Hybridization (FISH). Immunostains of ALK, calponin, collagen IV, CK7, EGFR, HER2, Ki-67, Muc5Ac, p63, p40, and TTF-1 were performed. DNA was extracted from 23 cases of PMEC. Mutation profiling of the EGFR, KRAS, BRAF, ALK, PIK3CA, PDGFRA, and DDR2 genes were carried out using next-generation sequencing (NGS), Sanger sequencing, and quantitative polymerase chain reaction (QPCR) in 9 successfully amplified cases.ResultsTwenty-six cases of PMEC (18 low-grade, 8 high-grade) included 13 men and 13 women aged 12–79 years. Twenty-two cases had a central/endobronchial growth pattern, and 4 cases had a peribronchial growth pattern. Immunohistochemically, CK7, Muc5Ac, p40, and p63 were positive in all cases (26/26);EGFR was positive in 11 cases (11/26); TTF-1, Calponin, HER2 and ALK were negative in all cases (0/26). MAML2 rearrangement was identified in 12 of 18 PMEC cases. No mutations were detected in any of the 7 genes in the 9 cases that qualified for mutation analysis. Twenty-three PMEC patients had follow-up information with a median interval of 32.6 months. Both the 5- and 10-year overall survival rates (OS) were 72.1%, and a high-grade tumor was an adverse prognostic factor in PMEC. There were 8 cases of MEC-like pulmonary carcinoma aged 36–78 years: 2 cases were located in the bronchus, and 6 cases were located in the lung. p63 and TTF-1 were positive in all cases (8/8), p40 was positive in 5 cases (5/8), and ALK was positive in 5 cases (5/8). No cases of MAML2 rearrangement were detected, but there were 5 cases of ALK rearrangement.ConclusionsPMEC is a primary malignant pulmonary tumor with a relatively good prognosis that is historically characterized by the presence of mucous cells and a lack of keratinization. There are distinct differences between PMEC and MEC-like pulmonary carcinoma in tumor location preference, immunophenotype, and molecular genetics, and the differential diagnosis is critical due to the therapeutic and prognostic considerations.

Histopathologic, immunophenotypic and cytogenetic features of pulmonary mucoepidermoid carcinoma

Pulmonary mucoepidermoid carcinoma is an uncommon but distinctive manifestation of mucoepidermoid carcinoma. Pulmonary mucoepidermoid carcinoma occurs in adults and children and can cause diagnostic problems, especially in small biopsies. Few studies have characterized the histologic and immunophenotypic features of pulmonary mucoepidermoid carcinoma. t(11;19)(q21;p13) is considered disease-defining for mucoepidermoid carcinoma; its significance in pulmonary mucoepidermoid carcinoma warrants further study. Forty three pulmonary mucoepidermoid carcinomas were re-reviewed and graded according to the Brandwein grading system for mucoepidermoid carcinoma. Four cases were excluded because of a split opinion between pathology report and re-review. These cases were negative for MAML2 rearrangement by FISH. TTF-1, napsin A, p40 and p63 immunostains were scored: 0 (negative), 1 (1–25% tumor cells), 2 (26–50%), 3 (51–75%) or 4 (>75%). FISH to detect MAML2 rearrangement used a MAML2-11q21 break-apart probe. Thirty nine pulmonary mucoepidermoid carcinoma (4 low, 30 intermediate, 5 high grade) contained mucous, epidermoid and intermediate cells and lacked keratinization and in situ carcinoma of the overlying epithelium. All cases with available gross description (n=22) had a central/endo- or peribronchial location. All 25 cases tested for immunohistochemistry were positive (scores 1–4) for p63; 23 also expressed p40. In six cases, the p63 score was higher than p40. TTF-1 and napsin were uniformly negative in all 25 cases. MAML2 rearrangement was identified by FISH in each of the 24 cases tested (3 low, 19 intermediate, 2 high grade). Clinical history was available in 29 patients (15 men) (median age, 48 years) with follow-up in 24 (median, 8.4 years). Five patients died of unrelated causes; one developed metastatic pulmonary mucoepidermoid carcinoma. In conclusion, features helpful in distinguishing pulmonary mucoepidermoid carcinoma from other lung cancers include its central/endo- or peribronchial location together with the presence of mucous cells, p63 expression, lack of keratinization and MAML2 rearrangement. TTF-1 and napsin are typically not expressed.

Immunosuppressive Action of Deoxynivalenol of Thymus in Chickens

Abstract Deoxynivalenol (DON, vomitoxin) is a type B-trichothecene, naturally occurring contaminants of animal feed, being implicated in several mycotoxicoses in farm livestock. This mycotoxin occurs predominantly in grains such as wheat, barley, oats, rye, and maize, and less often in rice, sorghum, and triticale. Deoxynivalenol is potent nefrotoxic, hepatotoxic and immunosuppressant. High doses of trichothecenes promote rapid onset of leukocyte apoptosis (programmed cell death), which is manifested as immunosuppression. The study aimed to prove the immunosuppressant action of deoxynivalenol in chickens experimentally treated each day, from the 7th day of life, using 5,4 mg/kg b.w in E group for 28 days (since 35 days of life). Histopathology studies of thymus were made on 7th, 14th, 21st and 28th days of experiment. In E group small lesions of thymus were observed even after 7th day of poisoning but intense lesions, hydropic degeneration, necrotic foci and moderate lymphoid depletion was observed after the 14th and 21st day of poisoning. After 28th day a marked proliferation of stromal cells in the reticulum network, in medulla zone, presence of mucous cells, small mucous cysts and haemorages were observed.

Re-Evaluating Historic Cohort of Salivary Acinic Cell Carcinoma with New Diagnostic Tools

Mammary analogue secretory carcinoma (MASC) was recently identified as a distinct salivary gland neoplasm, morphologically resembling intercalated duct cell predominant acinic cell carcinoma (AciCC). To determine how frequently MASC has mimicked an intercalated duct cell predominant AciCC, we reviewed AciCC diagnosed from 1956 to 1975. Nine AciCC consecutively diagnosed in that period were identified. Based on morphologic examination, one case diagnosed as AciCC in a male patient in 1960 was re-classified as MASC [confirmed by fluorescence in situ hybridization (FISH) showing ETV6 translocation]. Another case diagnosed as AciCC of the palate in a female patient in 1975 was re-classified as mucoepidermoid carcinoma (based on the lack of acinar differentiation, presence of mucous cells, and confirmed by FISH showing MAML2 translocation). In this proof-of-principle study, we show that 1 in 9 cases historically designated as AciCC represents a MASC. "Intercalated duct cell predominant AciCC", especially among male patients, most likely represent examples of MASC. For anatomic sites outside of the parotid glands, broader differential diagnoses should be considered before accepting morphologic variants of AciCC as the final diagnosis.

Comprehensive Histologic Analysis of ALK-Rearranged Lung Carcinomas

A subset (1% to 5%) of non-small-cell lung carcinomas harbors the EML4-ALK fusion gene. Data from previous studies on the histomorphology of ALK-rearranged lung cancer are inconsistent, and the specific histologic parameters that characterize this subset and how accurately such parameters predict underlying ALK abnormality remain uncertain. To answer these questions, we performed a comprehensive histologic analysis of 54 surgically resected, extensively sampled ALK-rearranged lung carcinomas and compared them with 100 consecutive resections of ALK-wild-type lung cancers. All 54 cases showed at least a focal adenocarcinoma component, and 3 and 2 cases had additional squamous and sarcomatoid differentiation, respectively. Solid or acinar growth pattern, cribriform structure, presence of mucous cells (signet-ring cells or goblet cells), abundant extracellular mucus, lack of lepidic growth, and lack of significant nuclear pleomorphism were more common in ALK-positive cancers. Two recognizable constellations of findings, a solid signet-ring cell pattern and a mucinous cribriform pattern, were present at least focally in the majority (78%) of ALK-positive tumors, but were rare (1%) in ALK-negative tumors. Multivariate analysis showed that a combination of these 2 patterns was the most powerful histologic indicator of ALK rearrangement. Characteristic histologies were present both in primary sites and in metastases. Thus, histologic findings may help to identify cases for ALK testing. However, none of the histologic parameters were completely sensitive or specific to ALK rearrangement, and histomorphology should not replace confirmatory molecular or immunohistochemical studies. ALK-positive cancers commonly showed coexpression of thyroid transcription factor-1 and p63, and its significance is currently unclear.

A Cytohistologic Correlation of Mucoepidermoid Carcinoma: Emphasizing the Rare Oncocytic Variant

It is well-known that the morphological variability of mucoepidermoid carcinoma (MEC) of the salivary glands may lead to interpretative difficulties on fine-needle aspiration (FNA) diagnosis. In this study we identify morphologic features that may be useful in the FNA diagnosis of MEC. The cohort included 23 cases of MEC; cytology and histology slides were reviewed and assessed for % cystic component, extracellular mucin, mucous and intermediate cells, oncocytes, cells with foamy/clear cytoplasm, keratinized cells and lymphocytes. On FNA 12/23 (52%) cases were diagnosed as consistent with or suggestive of MEC; 6/23 (26%) as salivary gland neoplasm and 5/23 (22%) as no tumor seen. The cystic component was ≥50% in 18/23 (78%) and <50% in 5 cases. The features prevalent in FNA and histology were: mucous cells (96% and 91%), extracellular mucin (91% both), intermediate cells (100 and 83%), lymphocytes (96 and 78%) and cells with foamy/clear cytoplasm (74% both). Oncocytes were seen in 43 and 22% and keratinized cells in 48 and 13% cases. Cases with oncocytes and lymphocytes were interpreted as favor Warthin's tumor on FNA. Presence of mucous cells, cells with foamy/clear cytoplasm, intermediate cells and lymphocytes in a mucinous background are diagnostic indicators of MEC; presence of oncocytes should not refrain from diagnosing MEC in FNA specimens.

Morphological and histochemical changes in the secretory granules of mucous cells in the early postnatal mouse parotid gland.

It has previously been known that the developing parotid glands in humans and rats contain mucous cells in their terminal clusters and acini, but these cells disappear within a short period of time. Using rat parotid glands, IKEDA and AIYAMA (1997, 1999) suggested that the mucous cells might change into serous cells in the early postnatal period, but it is uncertain whether mucous cells appear only in the developing parotid gland of a few species such as humans and rats, or whether the cell transformation actually occurs. To clarify these points, the present study investigated the developing mouse parotid glands. Light microscopy showed cells with secretory granules that stained extensively with PAS and alcian blue in the terminal clusters of a 1-day-old mouse parotid gland. Mucous cell numbers in the terminal clusters and the acini reached a peak on day 5 and decreased on day 7. By day 10, the mucous cells had disappeared altogether. Thus, the presence of mucous cells in the developing mouse parotid gland was confirmed. Electron microscopy showed granules of low-electron-density and bipartite granules in the mucous cells. Bipartite granules and highly electron-dense granules sometimes co-existed in a single cell. Immuno-electron microscopy revealed a positive reaction for amylase to the low-electron-density granules and the low-electron-density portions of the bipartite granules, in addition to the highly electron-dense granules and the electrondense cores of the bipartite granules. No mucous cells with nuclei displaying characteristics of apoptosis were recognizable. Lectin histochemistry both at the light and electron microscopic levels showed that the secretory granules in the mouse parotid gland mucous cells had sugar residues similar to those of the mature serous granules. These findings demonstrate that mucous cells appear in the early postnatal mouse parotid gland, and that almost all of these cells may be converted into serous cells.

Immunoreactive POMC-derived peptides and cytokines in the chicken thymus and bursa of Fabricius microenvironments: age-related changes.

Changes from hatching to the involutive stage in the thymus and bursa of Fabricius of Gallus domesticus were studied. Pro-opiomelanocortin (POMC)-derived peptides and cytokines were also tested by immunocytochemical procedures. Thymic histological modifications appeared at 3 months and involved an increase in connectival argyrophilic reticular fibres, a proliferation of non-epithelial cells in the reticulum network, the presence of mucous cells and small mucous cysts, and an increase in the number of eosinophilic and myoid cells. A clear distinction between the cortex and the medulla was lost. Immunoreactive POMC-related molecules and cytokines were demonstrated in thymic cells from 4-day-old chicken, and their number increased with ageing. These molecules were expressed in a few single epithelial cells and in interdigitating cells. With ageing, the number of immunoreactive interdigitating cells also increased, and these appeared in an activated phase. Histological modifications in the bursa of Fabricius appeared at 2 months and concerned a folding of the interfollicular surface epithelium covering the bursal plicae and a reduction in lymphoid follicle-associated epithelium. Fibrous tissue gradually increased, and large mucoid cysts were evident. The expression of POMC-derived peptide-and cytokine-like molecules differed during the development and involution phases of the organ. Cells of follicle associated epithelium and dendritic reticular cells of lymphoid follicles were immunoreactive to beta-endorphin between 4 days and 2 months, while ACTH-, alpha-MSH- and cytokine-like molecules were observed in follicles after 2 months. The findings indicate a physiological role of these molecules during the growth and involution of the two organs.