S-100 Immunohistochemical Staining Research Articles

Single-system pulmonary langerhans cell histiocytosis with only tracheobronchial involvement: a case report

BackgroundPulmonary Langerhans cell histiocytosis (PLCH) only with airway involvement manifested as diffuse thickening of the tracheobronchial walls is rare.Case report A 26-year-old male was admitted to the hospital with progressive wheezing, cough, and a source of blood in sputum after activity. He had no history of smoking. Chest computed tomography showed airway stenosis of different degrees with tracheobronchial wall thickening, and fiberoptic bronchoscopy demonstrated multiple nodular neoplasms in tracheobronchial, while the pulmonary parenchyma was normal. The patient’s condition partially improved after excision of partial lesions by fiberoptic bronchoscope. Histopathological results showed that CD1a and S-100 immunohistochemical staining was positive, and the molecular pathological results suggested that the BRAF V600E mutation, thus confirming the diagnosis of PLCH. The treatment of partial resection and systemic chemotherapy is effective. ConclusionsThe possibility of PLCH needs to be considered when diffuse tracheobronchial lesions without lung parenchyma involvement are encountered, which provides experience for early clinical diagnosis and adequate treatment.

Relationship Between Mechanoreceptors in the Posterior Cruciate Ligament and Patient Age or Osteoarthritis Severity.

Mechanoreceptors in the posterior cruciate ligament (PCL) can produce proprioception, which is an important reason why patients choose cruciate-retaining total knee arthroplasty (TKA). The number of mechanoreceptors in the PCL of patients with knee osteoarthritis (OA) is unknown. To provide a theoretical basis for estimating the number of mechanoreceptors in the PCL by evaluating the relationship between this number and patient age or OA severity. Cross-sectional study; Level of evidence, 3. An overall 28 PCLs from patients with knee OA were collected at the time of TKA and grouped according to patient age (group A, 60-69 years [n = 8]; group B, 70-79 years [n = 12]; group C, ≥80 years [n = 8]) and OA based on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (group I, ≤80 [n = 8]; group II, 81-120 [n = 10]; group III, >120 [n = 10]). Hematoxylin and eosin and S-100 immunohistochemical staining were performed on the slices near the tibial attachment of the PCL, and the number of mechanoreceptors in each slice was counted. Multifactor analysis of variance was used to evaluate the relationship between the number of mechanoreceptors and patient age or WOMAC score. The number of mechanoreceptors (mean ± SD) in groups A, B, and C was 24.00 ± 15.19, 30.92 ± 11.41, and 23.38 ± 11.39, respectively, with no significant between-group differences. The number of mechanoreceptors in groups I, II, and III was 43.50 ± 4.99, 25.00 ± 5.27, and 15.20 ± 5.61, with significant differences between groups I and II, groups I and III, and groups II and III (P < .001 for all). In patients with knee OA, age had no significant effect on mechanoreceptor count, but the number of mechanoreceptors in the PCL decreased significantly with higher (worse) WOMAC score. These findings suggest that in patients of any age with high WOMAC scores, there may be little value as it relates to knee proprioception in performing a PCL-retaining TKA.

Effect of folic acid coated-crosslinked urethane-doped polyester elastomer nerve conduit on promoting the repair of long distance peripheral nerve injury in rats

To investigate the effect of folic acid coated-crosslinked urethane-doped polyester elastomer (fCUPE) nerve conduit in repairing long distance peripheral nerve injury. Thirty-six 3-month-old male Sprague Dawley rats weighing 180-220 g were randomly assigned to 3 groups, each consisting of 12 rats: CUPE nerve conduit transplantation group (group A), fCUPE nerve conduit transplantation group (group B), and autologous nerve transplantation group (group C), the contralateral healthy limb of group C served as the control group (group D). A 20-mm-long sciatic nerve defect model was established in rats, and corresponding materials were used to repair the nerve defect according to the group. The sciatic function index (SFI) of groups A-C was calculated using the Bain formula at 1, 2, and 3 months after operation. The nerve conduction velocity (NCV) of the affected side in groups A-D was assessed using neuroelectrophysiological techniques. At 3 months after operation, the regenerated nerve tissue was collected from groups A-C for S-100 immunohistochemical staining and Schwann cell count in groups A and B to compare the level of nerve repair and regeneration in each group. At 3 months after operation, the nerve conduits in all groups partially degraded. There was no significant adhesion between the nerve and the conduit and the surrounding tissues, the conduit was well connected with the distal and proximal nerves, and the nerve-like tissues in the conduit could be observed when the nerve conduit stents were cut off. SFI in group A was significantly higher than that in group C at each time point after operation and was significantly higher than that in group B at 2 and 3 months after operation ( P<0.05). There was no significant difference in SFI between groups B and C at each time point after operation ( P>0.05). NCV in group A was significantly slower than that in the other 3 groups at each time point after operation ( P<0.05). The NCV of groups B and C were slower than that of group D, but the difference was significant only at 1 month after operation ( P<0.05). There was no significant difference between groups B and C at each time point after operation ( P>0.05). Immunohistochemical staining showed that the nerve tissue of group A had an abnormal cavo-like structure, light tissue staining, and many non-Schwann cells. In group B, a large quantity of normal neural structures was observed, the staining was deeper than that in group A, and the distribution of dedifferentiated Schwann cells was obvious. In group C, the nerve bundles were arranged neatly, and the tissue staining was the deepest. The number of Schwann cells in group B was (727.50±57.60) cells/mm 2, which was significantly more than that in group A [(298.33±153.12) cells/mm 2] ( t=6.139, P<0.001). The fCUPE nerve conduit is effective in repairing long-distance sciatic nerve defects and is comparable to autologous nerve grafts. It has the potential to be used as a substitute material for peripheral nerve defect transplantation.

VEGFA-modified DPSCs combined with LC-YE-PLGA NGCs promote facial nerve injury repair in rats

ObjectiveThe aim of this research was to investigate the effect of vascular endothelial growth factor A (VEGFA)-overexpressing rat dental pulp stem cells (rDPSCs) combined with laminin-coated and yarn-encapsulated poly(l-lactide-co-glycolide) (PLGA) nerve guidance conduit (LC-YE-PLGA NGC) in repairing 10 mm facial nerve injury in rats. Study DesignrDPSCs isolated from rat mandibular central incisor were cultured and identified in vitro and further transfected with the lentiviral vectors (Lv-VEGFA). To investigate the role and mechanisms of VEGFA in neurogenic differentiation in vitro, semaxanib (SU5416), Cell Counting Kit-8 (CCK-8), real-time quantitative polymerase chain reaction (qPCR) and Western blotting were performed. Ten-millimeter facial nerve defect models in rats were established and bridged by LC-YE-PLGA NGCs. The repair effects were detected by transmission electron microscopy (TEM), compound muscle action potential (CMAP), immunohistochemistry and immunofluorescence. ResultsExtracted cells exhibited spindle-shaped morphology, presented typical markers (CD44+CD90+CD34−CD45−), and presented multidirectional differentiation potential. The DPSCs with VEGFA overexpression were constructed successfully. VEGFA enhanced the proliferation and neural differentiation ability of rDPSCs, and the expression of neuron-specific enolase (NSE) and βIII-tubulin was increased. However, these trends were reversed with the addition of SU5416. This suggests that VEGFA mediates the above effects mainly through vascular endothelial growth factor receptor 2 (VEGFR2) binding. The LC-YE-NGC basically meet the requirements of facial nerve repair. For the in vivo experiment, the CMAP latency period was shorter in DPSCS-VEGFA-NGC group in comparison with other experimental groups, while the amplitude was increased. Such functional recovery correlated well with an increase in histological improvement. Further study suggested that VEGFA-modified DPSCs could increase the myelin number, thickness and axon diameter of facial nerve. NSE, βIII-tubulin and S100 fluorescence intensity and immunohistochemical staining intensity were significantly enhanced. ConclusionVEGFA-modified rDPSCs combined with LC-YE-PLGA NGCs have certain advantages in the growth and functional recovery of facial nerves in rats.

Is the long head of the biceps related to anterior shoulder pain? A histopathological study

Objectives. Pathologies of the long head of the biceps have been viewed as a source of anterior shoulder pain and disability. Thus, we performed a histopathological and immunohistochemical examination of the biceps tendon with regard to the neuronal structure, the number of mechano[1]receptors and immunohistochemical types, to investigate the relationship of these factors with pain. Materials and Methods. This is a single-center prospective comparative study, on 11 patients divided into Group A (n=5) and Group B (n=6). Patients who underwent arthroplasty due to Neer type[1]4 proximal humeral fractures were selected as the control group (Group A). Group B consisted of patients with chronic anterior shoulder pain who underwent subpectoral biceps tenodesis during arthroscopic rotator cuff repair. The long head of biceps tenodesis was performed in all patients. Results. Hyalinization in the tendon was observed in 2 patients of group B. Chondroid degeneration was found in one patient with hyalinization. Inflammation, calcification, or matrix formation were not detected in any patients. Normal nerve fibers were observed around the tendon in 9 patients with S-100 immunohistochemical staining. In 1 patient, weak staining was observed in the nerve sheath with EMA immunohistochemical stain. No tactile body was detected. Conclusions. We did not observe any histo[1]pathological findings that could be considered the cause of pain in the two groups. Biomolecular and biomechanical studies, in addition to microscopic studies, are needed to explain why the biceps is a potential source of pain.

Distinguishing Gastrointestinal Leiomyomas From Muscularis Propria in Biopsy Specimens by Differential Expression of S100 Immunohistochemical Stain.

Interpreting small biopsy specimens or fine-needle aspirations of gastrointestinal tract (GI) smooth muscle lesions may be challenging when the differential diagnosis includes leiomyoma vs muscularis propria (MP). We evaluated the utility of S100 staining in distinguishing GI leiomyomas from MP. A search was conducted in our laboratory information system for cases of leiomyomas arising within the GI tract (2004-2021). Site-matched controls containing MP were selected (2018-2020). Five high-power fields (hpf) were counted on S100 immunohistochemical stains by two pathologists in the resections and by three different blinded pathologists in the biopsy specimens and analyzed. The median S100 count was 2.5/5 hpf in leiomyoma resection cases (n = 38), which was significantly lower than the median count of 548/5 hpf in MP (n = 19) with a P value of <.0001. The median S100 count in biopsy specimens (n = 16) was 1.2/5 hpf and within the expected range of 1 to 104/5 hpf (minimum-maximum value) established by the leiomyoma resections. S100 counts in the normal MP were significantly higher than those observed in leiomyomas (P < .001). S100 staining can aid in distinguishing a leiomyoma from MP in the GI tract, which is especially helpful when evaluating cases with limited sampling.

S1697 Biliary Schwannoma in a Post-Liver Transplant Patient Presenting as Biliary Obstruction

Introduction: Schwannomas are benign, mesenchymal-derived neoplasms which present as solid, slow growing tumors. They can rarely be observed in the gastrointestinal (GI) tract, with very limited reports of them occurring in the biliary system. In this case, we describe a bile duct schwannoma in a post-liver transplant patient. Case Description/Methods: A 77-year-old man with a history of alcohol-related cirrhosis with hepatocellular carcinoma treated with orthotopic liver transplantation 16 years prior, and end stage renal disease on hemodialysis presented with jaundice. Labs demonstrated new elevations in his liver enzymes: AST 181 U/L, ALT 189 U/L, alkaline phosphatase 625 U/L, total bilirubin (TB) 7.9 mg/dL, and direct bilirubin 5.0 mg/dL. A magnetic resonance cholangiopancreatography was performed and demonstrated a 16 x 15 x 11 mm enhancing mass causing abrupt narrowing of the mid common bile duct (CBD) with upstream duct dilation to 10 mm ( Figure A) without other discrete mass identified. A follow-up endoscopic ultrasound confirmed a hypoechoic mass in the mid CBD and fine needle biopsy was obtained. An endoscopic retrograde cholangiopancreatography was subsequently performed, which demonstrated a severe biliary stricture at the level of the prior biliary anastomosis which was treated with balloon dilation and placement of a covered metal stent. The procedure was complicated by post-sphincterotomy bleed and mild post-ERCP pancreatitis. His liver enzymes failed to improve, and his TB progressively worsened to 23.3 mg/dL. Pathology returned showing a low-grade spindle cell tumor (Figure B), with staining positive for S100 (Figure C) and negative for CD117 and desmin, consistent with a diagnosis of schwannoma. Surgical intervention was not pursued, in line with his goals of care, and he was ultimately transitioned to comfort-oriented care and passed 5 days after admission. Discussion: Schwannomas are rare neoplasms which can arise from the nonepithelial wall of the GI tract containing nerve fibers. They are composed of highly cellular spindle cells which stain positive for vimentin (marker of mesenchymal origin) and S100 protein (marker of nerve sheath origin), and negative for CD117 (marker of GI stromal tumors) and desmin (muscle cell marker). Neoplasms can often be suspected in late presentations of post-transplant biliary obstruction. To our knowledge, this is the first case report of a biliary schwannoma occurring at the site of a biliary anastomosis in a liver transplant patient.Figure 1.: A) MRCP T1-weighted coronal image demonstrating a 16 x 15 x 11 mm enhancing mass with diffusion restriction (yellow arrow) at the mid common bile duct causing an abrupt biliary stricture with upstream dilation, B) 10x magnification H&E showing spindled, wavy nuclei in a fibroblastic stroma consistent with a spindle cell neoplasm in a background of unremarkable columnar biliary epithelium, C) 10x magnification S100 immunohistochemical stain showing diffuse nuclear and granular cytoplasmic positivity consistent with nerve sheath origin.

Construction of hematoxylin-eosin, immunohistochemistry, and EBER-ISH methodology after trichloroisocyanuric acid treatment in melanin-containing tissues.

This study investigated the effects of trichloroisocyanuric acid (TCCA) on the bleaching and morphology of melanin-containing pathological sections. The pathological sections of 27 patients with high melanin content were bleached with 0.5% potassium permanganate, 10% hydrogen peroxide, and different concentrations of TCCA. Significant differences were found among the blank control group, 1% TCCA group (P < 0.0001). The hematoxylin–eosin (HE) score of the "recovery pH" HE staining group after treatment with 1% TCCA was similar to that of the "Conventional HE" scheme group (P > 0.05). The morphological diagnostic scores of 50 cases of pathological sections with different melanin content before and after TCCA bleaching were compared. The results showed a significant difference in the diagnostic score between the middle- and high-melanin content groups before and after 1% TCCA bleaching (P < 0.05). Immunohistochemical staining was performed on meningeal melanoma tissue. For this, 8% TCCA solution was used to remove melanin after Ki67, S100, and β-catenin immunohistochemical staining. After bleaching with TCCA, the staining and positioning of each marker with different localization were accurate and the background was clear. The same results were also shown with EBER-ISH. This study concluded that 1% TCCA could be used for HE staining of pathological sections containing melanin, and "restore pH" HE scheme as the staining method after TCCA melanin removal. Further, 8% TCCA was used for bleaching after immunohistochemical DAB staining. Melanin can be completely removed, and sections can meet diagnostic needs.

Evaluation of S-100 immunostaining in the demonstration of nerve changes in tuberculoid and borderline tuberculoid leprosy - A descriptive, prospective and retrospective analytical study

S-100 immunohistochemical staining may detect nerve involvement in early stages of tuberculoid spectrum of leprosy. This study investigated the use of S-100 in early diagnosis of the tuberculoid and borderline tuberculoid leprosy and compared its sensitivity with hematoxylin and eosin (HE) stains in discerning the nerve involvement.To study the different histopathological patterns of nerve involvement in tuberculoid and borderline tuberculoid leprosy on S-100 immunostaining and also to compare the sensitivity of HE stain with S-100 immunostain in discerning the nerve involvement in these cases.This was a descriptive, prospective and retrospective analytical study, which included patients with tuberculoid spectrum of leprosy. Histopathological examination (HPE) and immunohistochemical (IHC) analysis were performed on all skin biopsies using HE stain and S-100 immunostain, respectively. Then the sensitivities of both the stains in discerning the nerve involvement were calculated and the data was analyzed using SPSS software version 22 by applying chi-square test.The study included a total of 58 patients [tuberculoid (n=28), borderline tuberculoid (n=30)]. The mean age was 43 yrs. The most common clinical manifestation was hypopigmented patches (n=40, 70%) with loss of sensation (n=39, 68.3%). HPE revealed 36 cases with well-defined granulomas, 22 cases with ill-defined granulomas and 41 cases with nerve destruction. IHC analysis showed four different patterns of nerve damage (fragmented, n=32; infiltrated and fragmented, n=14; infiltrated, n=10; intact, infiltrated and fragmented; n=1). The sensitivity and positive predictive value (PPV) of HE staining in delineating the nerve involvement were 68.96% and 100%, respectively. Whereas, the sensitivity and PPV of S-100 IHC were 100% each.Less number of cases.Use of S-100 IHC along with HPE aids in early, accurate and confirmatory diagnosis.

The Characteristics and Distribution of Nerve Plexuses in the Dartos Fascia From Concealed Penis Children.

The purpose of this study is to analyze the nerve plexus distribution in dartos fascia of concealed penis (CP). A total of 28 CP patients met ASA categories I and II were included, with median age of 3.5 years (8 months−5 years). During the surgery, tissue samples of dartos fascia at points 3, 6, 9, and 12 o'clock of the penile shaft were collected. Standard hematoxylin and eosin (H&E) staining and S-100 immunohistochemical staining were used to analyze the nerve plexus distribution among different positions. The number of nerve plexuses in superficial fascia collected at the 6 o'clock position of the penile shaft was the most abundant among four positions (median 7.25, range 1–24). The abundant nerve plexuses in the dartos fascia of CP patients, especially at the 6 o'clock position, indicate that the surgery on the preputial frenulum should avoid damage to the dartos fascia, as it might be related to maintain the erection and sexual function in adolescence.

S2028 A Rare Case of Esophageal Granular Cell Tumor

INTRODUCTION: Granular cell tumors (GCTs) are rare soft tissue neoplasms thought to originate from Schwann cells. Usually they are found in skin and subcutaneous tissue of the head and neck, particularly inside the mouth (70%). Gastrointestinal (GI) tract GCTs are very uncommon, occurring in only 6-10% of all cases. Esophageal GCTs account for only 30-60% of this subset. Given their rarity, esophageal GCTs are not well reported in the literature. We describe a patient who underwent an esophagogastroduodenoscopy (EGD) for abdominal pain and nausea and was found to have a 1 cm GCT in her proximal/mid esophagus. CASE DESCRIPTION/METHODS: A 48 year old African American female with history of gastro-esophageal reflux disease (GERD) presented to GI clinic for months of abdominal pain associated with nausea despite taking 40mg daily Omeprazole and as needed Calcium Carbonate. She was afebrile and hemodynamically stable. Her abdomen was non-tender to palpation. An EGD was scheduled to rule out endoscopic causes of her symptoms. Her EGD revealed a 1 cm firm, mobile nodule in her upper/mid esophagus (Figure 1). The rest of the esophagus, stomach, and duodenum were otherwise normal. Biopsy of the nodule revealed esophageal granular cell tumor, confirmed by S100 immunohistochemical staining. The tumor was excised by endoscopic mucosal resection (EMR) (Figure 2). Repeat histology revealed possible incomplete resection of the tumor, as it extended to deep and lateral specimen margins. An endoscopic ultrasound (EUS) expert is currently reviewing the case to determine whether the patient should have an EUS versus a repeat EGD next. DISCUSSION: Esophageal GCTs were first described in 1926 by Abrikossoff. They are most commonly reported in African American women around 40-60 years of age. Endoscopically they appear as firm, smooth intramural lesions with normal overlying mucosa. EUS determines their malignancy potential by assessing tumor size, location, depth of invasion, and lymph node involvement. Esophageal GCTs often stain positive for periodic acid-Schiff, nestin, S100, and CD68 given their neurologic origin. Although the vast majority of esophageal GCTs are benign, with fewer than 40 (< 2%) malignant cases noted in the literature, malignant cases tend to be aggressive. Esophageal GCTs that cause symptoms, have malignant features, or are greater than 1-2cm in diameter should be removed by EMR or endoscopic submucosal dissection. High suspicion and detailed workup are needed so that providers do not miss this rare entity.Figure 1.: Endoscopic view of a single 1 cm localized, firm, mobile nodule with normal overlying mucosa in the upper/mid esophagus at 25 cm from incisors.Figure 2.: Removal of the nodule by single-piece polypectomy.

Primary intraosseous Rosai-Dorfman disease: a clinicopathological analysis of fourteen cases

Objective: To investigate the clinicopathological characteristics, histogenesis, immunophenotypes and molecular genetic features of primary intraosseous Rosai-Dorfman disease (RDD) for improving diagnostic accuracy and differential diagnosis. Methods: This retrospective study included 14 RDD cases diagnosed from January 2009 to January 2019 at Beijing Jishuitan Hospital, China. The immunohistochemical staining for S-100, cyclin D1, CD1a and CD207 expression was analyzed. The BRAF V600E and KRAS mutation analyses were performed using the Scorpions amplification refractory mutation system (ARMS) fluorescence quantitative PCR. Results: There were 6 female and 8 male patients, aged from 2 to 64 years (mean 31.4 years). All of the 14 cases occurred in the bone without lymph node disease, while one patient developed additional lesions within vertebra and nasal cavity. Radiographically, the lesions were lytic with sclerotic margins. Histologically, the lesions percolated through the medullary cavity in an infiltrative fashion and alternating hyper- and hypo-cellular regions of histiocytic clusters (seen as alternating dark and light zones at low magnification). Large histiocytes also showed emperipolesis. Some cases had areas of fibrosis and dense lymphoplasmacytic infiltrates. There were vasculitis and an increased number of plasma cells in the cases involving multiple sites. One case showed concurrence of RDD and Langerhans cell histiocytosis(LCH) with inconspicuous increase of Langerhans histiocytes. Immunohistochemical staining showed that the large histiocytes were positive for S-100, CD68 and CD163 in all cases. The nuclear immunoreactivity for cyclin D1 was observed in 13 of the 14 cases. S-100, CD1a and CD207 were positive in the case with concurrence of RDD and LCH. ARMS-PCR results showed that BRAF V600E mutation was observed in the cases with concurrence of RDD and LCH, while there were no KRAS mutations (7/7). Follow-up information was available for 12 patients and ranged from 9 to 49 months. Three of the 12 patients experienced recurrences after the first surgery. Conclusions: Primary intraosseous RDD is rare, and its concurrence with LCH is a very rare phenomenon. Its clinical symptoms, imaging, and pathological manifestations need to be distinguished from other bone lesions. The molecular detection of BRAF V600E and the nuclear expression of cyclin D1 mutations can be used for the diagnosis and differential diagnosis of RDD.

Childhood Langerhans cell histiocytosis: a disease with many faces.

Langerhans cell histiocytosis (LCH) is a group of diseases characterized by the proliferation and accumulation of Langerhans cells. Clinical presentations of LCH vary widely. A PubMed search was conducted using Clinical Queries with the key term "Langerhans cell histiocytosis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. This paper is based on, but not limited to, the search results. Generally, patients with LCH can be divided into two groups based on the extent of involvement at diagnosis, namely, single-system LCH and multisystem LCH. The involvement may be unifocal or multifocal. Patients with isolated bone lesions typically present between 5 and 15years of age, whereas those with multisystem LCH tend to present before 5years of age. The clinical spectrum is broad, ranging from an asymptomatic isolated skin or bone lesion to a life-threatening multisystem condition. Clinical manifestations include, among others, "punched out" lytic bone lesion, seborrheic dermatitis-like eruption, erythematous/reddish-brown crusted/scaly papules/maculopapules/plaques/patches, and eczematous lesions, diabetes insipidus, hepatosplenomegaly, cytopenias, lymphadenopathy, and an acute fulminant disseminated multisystem condition presenting with fever, skin rash, anemia, thrombocytopenia, lymphadenopathy, and hepatosplenomegaly. The diagnosis is clinicopathologic, based on typical clinical findings and histologic/immunohistochemical examination of a biopsy of lesional tissue. Positive CD1a, S100, and/or CD207 (Langerin) immunohistochemical staining of lesional cells is required for a definitive diagnosis. Watchful waiting is recommended for patients with skin-only LCH. Patients with symptomatic or refractory skin-only LCH may be treated with topical tacrolimus/corticosteroids, topical nitrogen mustard, oral methotrexate, or oral hydroxyurea. The current recommended first-line therapy for patients with multisystem LCH is 12months therapy with prednisone and vinblastine. Mercaptopurine is added for patients with risk organ involvements. Because of the broad spectrum of clinical manifestations and the extreme diversity of disease, LCH remains a diagnostic dilemma. Morphological identification of LCH cells and positive immunochemical staining with CD1a, S100, and/or CD207 (Langerin) of lesional cells are necessary for a definitive diagnosis.

Comparative Histological Study on the Preventive Role of Acarbose and Calcipotriol/Betamethasone in Mouse Model of Psoriasis-Like Skin Inflammation Induced by Imiquimod

Introduction: Psoriasis is an autoimmune skin disorder that is symptomized by erythema and scaling. Recently, imiquimod (IMQ) has been used to induce skin inflammation in mice to create a psoriasis model.Aim of the Work: To assess the possible preventive potential of acarbose on psoriasis-like skin inflammation induced by IMQ in adult male mice, and to compare it to calcipotriol/betamethasone applied on the same psoriasis mouse model.Materials and Methods: Thirty four BALB/c mice were classified as the following groups: I(Control), II(IMQ): IMQ-model with topically applied Aldara cream, ІII(Acarbose): IMQ-model treated with Glucobay orally, ІV(Calcipotriol/Betamethasone): IMQ-model treated with Calcipoheal-Cort ointment and V(Acarbose+Calcipotriol/Betamethasone): IMQ-model treated with both Glucobay and Calcipoheal-Cort combined. Haematoxylin & Eosin stain and S100 immunohistochemical staining were performed along with electron microscopic study of skin sections. Mean epidermal thickness and mean number of S100 immuno-positive keratinocytes were measured and measurements were statistically analyzed.Results: Group II mice showed psoriasis-like signs of skin inflammation. Groups III and IV mice showed less signs of inflammation which were markedly attenuated by combination of both of the treatments. Group II demonstrated significant acanthosis and abundant infiltrates of inflammatory cells in the dermis and significantly numerous S100 immuno-positive keratinocytes. Groups III and IV showed significant improvement of these changes which were markedly diminished in group V as it showed almost normal histological structure.Conclusion: Acarbose had an overall beneficial effect on psoriasis-mimicking mouse model triggered by IMQ, almost comparable to that demonstrated by calcipotriol/betamethasone. However, combination of both treatments exerted a more powerful therapeutic effect.

Comparison of systematically combined detergent and nuclease‐based decellularization methods for acellular nerve graft: An ex vivo characterization and in vivo evaluation

Little consensus exists regarding which decellularization technique best removes the cellular components while maintaining structural integrity. We aimed to identify the most efficient and safest decellularization method by combining previously established chemical (detergent based) and biological (nuclease based) methods in a systematic manner. Sixty sciatic nerves were harvested from Sprague-Dawley rats and prepared in 120 nerve fragments with 1-cm length. Nerve fragments were randomly divided into six groups and decellularized with six different methods: A, nonionic detergent+amphoteric detergent; B, nonionic detergent+anionic detergent; C, anionic detergent+amphoteric detergent; D, nonionic detergent+nuclease; E, amphoteric detergent+nuclease; and F, anionic detergent+nuclease. The remaining cellular components were evaluated with H&E, DAPI, and S-100 immunohistochemical staining, and DNA content was measured in each sample. The remaining extracellular matrix (ECM) integrity was evaluated with H&E, Masson's trichrome, periodic acid-Schiff, Luxol fast blue, and laminin immunohistochemical staining, and collagen content was measured in each sample. The amphoteric detergent+nuclease method was the best protocol for both cell removal and ECM preservation. In the in vivo study, the nerve allograft that was decellularized with amphoteric detergent+nuclease showed an inferior recovery rate based on the tibialis anterior muscle weight to autograft, but considerable recovery was observed. In conclusion, among the possible systematic combinations of detergent- and nuclease-based methods, the combination of amphoteric detergent and nuclease is currently the most suitable for nerve decellularization in terms of adequate cell removal and sufficient preservation of the ECM.

SUBGEMMAL NEUROGENOUS PLAQUE: REPORT OF 11 CASES AND REVIEW OF THE LITERATURE

Objective Subgemmal neurogenous plaques are subepithelial neural structures usually located along the posterolateral border of the tongue. Often associated with the taste buds, they are mostly asymptomatic, but occasionally patients present with pain or a burning sensation. Our objective for this study is to assess previous cases of this entity and contribute eleven new cases to the literature. Findings We performed a retrospective analysis of the archived cases from the Department of Pathology, The Mount Sinai Hospital, New York. A detailed search was performed using the PowerPath (Sunquest) laboratory information system, which consisted of a review of all cases received from the year 2013 to 2017. 11 cases were found to be diagnosed as subgemmal neurogenous plaque. All cases were located in the tongue. The lesions showed a female predilection with a mean age of 51.7 years. These findings are consistent with previous published studies. In cases with S-100 immunohistochemical staining (8/11), S-100 confirmed the diagnosis. According to the clinical histories provided, the majority (6/11) were asymptomatic, mass-forming lesions, two cases were red/white lesions with no associated pain or burning sensations, one case presented as tongue pain and two cases lacked clinical information. Conclusion Subgemmal neurogenous plaque is a common entity which has been previously misinterpreted as a neurofibroma, neuroma, ganglioma and even squamous cell carcinoma. Proper diagnosis requires histopathological examination. It is important to create awareness among current students and residents in addition to practicing pathologists about this entity. Our study is consistent with other studies performed to date and contributes a further reinforcement and addition to the current literature. We also recommend a larger and more diversified study of this entity for the future.

Histological study on the safety of the controllable ileostomy with pipe

To investigate the safety of the controllable ileostomy with pipe in view of histology. Twenty-eight Beagle dogs undergoing controllable ileostomy with pipe were studied. The special fistula tube with balloon was placed into the hole locating at the cecal root opposing the mesenteric side, and fixed by double knot compression method. The fistula tube was removed 14 days after surgery, then the safety of the procedure was preliminarily evaluated by gastrointestinal radiography and anatomical observation. The small intestine tissue at the compression suture was used as the experimental segment, and the small intestine tissue at the proximal non-compression suture was used as the control segment. The histological staining and the immunohistochemical staining of S-100 protein, c-kit protein and α-smooth muscle actin(α-SMA) protein between two segment were compared, while quantitative comparison of myenteric plexus, intestinal Cajal cell(ICC) and smooth muscle cells in intestinal wall was carried out. After removal of fistula tube at 14 days postoperative, the dogs were normal in feeding and defecation. The digestive tract radiography showed that the intestine was patent without obvious stenosis and obstruction. The dogs were dissected 21 days after operation. The abdominal sinus ostium was well healed and the internal sinus was well formed. Under gross inspection, blood supply, morphology and motor function of experimental intestine segment were similar from the proximal and distal segments of control intestine. S-100 immunohistochemical staining showed that the morphology and distribution of S-100 protein positive cells and "blank area" cells in the experimental and control segments were consistent. Myenteric plexus counting showed that the experimental segment was 3.62±1.82/field and the control segment was 3.27±1.62/field, whose difference was not statistically significant(t=1.30, P=0.20). Immunohistochemical staining of c-kit showed that the distribution of c-kit positive cells in both segments was consistent. Counting of the number of ICCs in myenteric plexus revealed that experimental segment was 2.96±2.57/plexus, and control segment was 2.49±1.80/plexus without significant difference(t=1.81, P=0.07). Immunohistochemical staining of α-SMA showed that the morphology and distribution of smooth muscle cells in whole intestinal wall(muscle layer, longitudinal muscle, ring muscle) in experimental and control segments were consistent. The average absorbance(A) value of α-SMA staining in ring muscle layer was detected and quantified. The experimental segment was 0.15±0.03 and control segment was 0.14±0.04 without significant difference(t=1.16, P=0.25). The technique of controllable ileostomy with pipe is safe in view of histology, which may replace the traditional protective ileostomy.

Atypical Vascularity Within a Schwannoma.

We report on the unusual presentation of a schwannoma. Aside from the aberrant dorsolateral anatomical presentation, ultrasonography revealed not only peripheral vascularity but also internal vascularity. Internal vascularity often suggests a malignant process as opposed to a benign one; however, in the presented case, the diagnosis of a benign lesion was confirmed with S100 immunohistochemical staining. In this study, we review the literature on this pathology and present an uncommon presentation of a benign nerve tumor.

Effect of human adipose-derived stem cells on pressure ulcer healing in mouse

To investigate the effect of human adipose-derived stem cells (hADSCs) on pressure ulcers in mouse. The subcutaneous adipose tissue from voluntary donation was harvested. Then the hADSCs were isolated and cultured by mechanical isolation combined with typeⅠcollagenase digestion. The 3rd generation cells were identified by osteogenic, adipogenic, chondrogenic differentiations and flow cytometry. The platelet rich plasma (PRP) from peripheral blood donated by healthy volunteers was prepared by centrifugation. The pressure ulcer model was established in 45 C57BL/6 mice by two magnets pressurized the back skin, and randomly divided into 3 groups ( n=15). The wounds were injected with 100 μL of hADSCs (1×10 6 cells) transfected with a green fluorescent protein (GFP)-carrying virus, 100 μL human PRP, and 100 μL PBS in hADSCs group, PRP group, and control group, respectively. The wound healing was observed after injection. The wound healing rate was calculated on the 5th, 9th, and 13th days. On the 5th, 11th, and 21st day, the specimens were stained with HE staing, Masson staining, and CD31 and S100 immunohistochemical staining to observe the vascular and nerve regeneration of the wound. In hADSCs group, fluorescence tracer method was used to observe the colonization and survival of the cells on the 11th day. The cultured cells were identified as hADSCs by induced differentiation and flow cytometry. The platelet counting was significantly higher in PRP group than in normal peripheral blood group ( t=5.781, P=0.029). General observation showed that the wound healing in hADSCs group was superior to those in PRP group and control group after injection. On the 5th, 9th, and 13th days, the wound healing rate in hADSCs group was significantly higher than those in PRP group and control group ( P<0.05). Histological observation showed that compared with PRP group and control group, inflammatory cell infiltration and inflammatory reaction were significantly reduced in hADSCs group, collagen deposition was significantly increased, and skin appendage regeneration was seen on the 21st day; at each time point, the expression of collagen was significantly higher in hADSCs group than in PRP group and control group ( P<0.05). Immunohistochemical staining showed that the number of neovascularization and the percentage of S100-positive cells in hADSCs group were significantly better than those in PRP group and control group on the 5th, 9th, and 13th days ( P<0.05). Fluorescent tracer method showed that the hADSCs could colonize the wound and survive during 11 days after injection. Local transplantation of hADSCs can accelerate healing of pressure ulcer wounds in mice and improve healing quality by promoting revascularization and nerve regeneration.

Duodenal Schwannoma: An Incidental Finding on PET Scan

Introduction: Gastrointestinal schwannomas (GS) are benign nerve sheath tumors arising from Auerbach's plexus. They are rare, accounting for 0.4-1% of all submucosal tumors. GS are most common in the stomach followed by small bowel, then colon and rectum. They may be associated with neurofibromatosis or present as isolated lesions. We present an incidental finding of duodenal schwannoma (DS). Case report: A 58 year old male with history of HTN presented as an outpatient for evaluation of an FDG-avid incidental duodenal mass discovered on PET scan. He was initially found to have nontender cervical lymphadenopathy on routine dental exam. He was otherwise asymptomatic and physical exam was unremarkable. He had no significant past surgical, family, or social history. A lymph node biopsy revealed poorly differentiated squamous cell carcinoma (SCC) of unclear origin. He then underwent PET scan, which identified an oral and duodenal lesion. Primary site of cancer was later confirmed as oropharyngeal SCC, for which he underwent modified radical neck dissection and adjuvant chemoradiation. The duodenal lesion was further evaluated with EGD/EUS with FNA. Endoscopically, an 18x12 mm pedunculated, subepithelial lesion with a long, broad-based stalk was seen in the second portion of the duodenum. Sonographically, it appeared mostly hypoechoic with internal hyperechoic, non-shadowing regions. The exact wall layer of origin could not be delineated. FNA revealed a spindle and epithelioid cell neoplasm, which stained positive for S-100 and SOX10, but negative for CD117, DOG-1 and desmin, supporting the diagnosis of DS. Laparoscopic-assisted, minimally-invasive transduodenal resection is currently scheduled.Figure: Endoscopic view of 18x12mm pedunculated duodenal lesion.Discussion: GS is a mesenchymal tumor of the GI tract. Endoscopic and radiologic exams can identify submucosal lesions but cannot differentiate between the types of mesencyhmal tumors. The diagnosis is made histologically, with immunohistochemical staining for S-100 indicating GS. Although benign, schwannomas can demonstrate avid FDG uptake on PET imaging, and may be mistaken for malignant lesions.GS are typically asymptomatic but can present with nonspecific symptoms. Surgical excision or endoscopic submucosal dissection is recommended for large tumors to avoid complications, such as bleeding or bowel obstruction. Endoscopic surveillance is an option for smaller tumors with asymptomatic presentation due to the benign nature of GS.Figure: Sonographic image of the duodenal lesion taken during EUS.Figure: Fine needle aspiration of subepithelial duodenal lesion showing spindle and epithelioid cell neoplasm, favoring schwannoma (A). Tumor cells positive for schwannoma markers S100 (B) and SOX10 (C).