Spindle-shaped Cells Research Articles

Pathological Study of Untreated Intraretinal Gliosis Surgically Excised via Pars Plana Vitrectomy.

To evaluate the pathological process of intraretinal glioses by investigating mass tissues resected from untreated eyes with intraretinal glioses. Five patients with intraretinal gliosis without previous conservative treatment were included. All patients underwent pars plana vitrectomy. The mass tissues were excised and processed for pathological study. During surgery, we observed that the intraretinal gliosis mainly affected the neuroretina and the retinal pigment epithelium was not affected. Pathological examination revealed that all intraretinal glioses consisted of different proportions of hyaline vessels and hyperplastic spindle-shaped glial cells. In one case, the intraretinal gliosis was mainly composed of hyaline vascular components. In another case, the intraretinal gliosis showed a predominance of glial cells. The intraretinal glioses in the other three cases had both vascular and glial components. The proliferated vessels showed different amounts of collagen deposits against different backgrounds. Vascularized epiretinal membrane was found in some intraretinal glioses. Intraretinal glioses affected the inner retinal layer. Hyaline vessels were the most characteristic pathological changes; the proportion of proliferative glial cells varied in different intraretinal glioses. The natural course of intraretinal gliosis may involve the proliferation of abnormal vessels in the early stage, which then gradually become scarred and are replaced by glial cells.

Glycoprotein M6A upregulation detected by transcriptome analysis controls the proliferation of keloidal fibroblasts.

Hypertrophic scars and keloids are fibroproliferative disorders caused by abnormal wound healing. Their exact cause has not been found, but abnormalities during the wound healing process including inflammatory, immune, genetic, and other factors are thought to predispose an individual to excessive scarring. In the present study, we performed transcriptome analysis of established keloid cell lines (KEL FIB), focusing on gene expression analysis and fusion gene detection for the first time. For gene expression analysis, fragments per kilobase per million map read values were calculated, which were validated by real-time PCR and immunohistochemistry. Fusion genes were predicted by transcriptome sequence, and validated by Sanger sequence and G-banding. As a result, GPM6A was shown in the expression analysis to be upregulated in KEL FIB compared with normal fibroblasts. The GPM6A upregulation in KEL FIB was confirmed by real-time PCR, and GPM6A messenger ribonucleic acid expression was consistently significantly elevated in the tissues of hypertrophic scar and keloid compared to normal skin. Immunohistochemistry also revealed that the number of fibroblast-like spindle-shaped cells positive for GPM6A was significantly increased in keloidal tissues. GPM6A inhibition by small interfering ribonucleic acid significantly reduced the number of KEL FIB. On the other hand, although we hypothesized that fusion genes are involved in the pathogenesis of keloids, the transcriptome analysis could not prove the presence of fusion genes in KEL FIB. Taken together, GPM6A upregulation may have an inducible effect on cell proliferation in keloidal fibroblasts. GPM6A can be a novel therapeutic target in hypertrophic scars and keloids. The inflammatory nature may be more prominent in the pathogenesis of keloids, rather than being skin tumors, as proposed by Ogawa et al. Future studies using several cell lines will be required.

Primary epithelioid hemangioendotheliomas and angiosarcomas of the pleura: a clinicopathological and immunohistochemical analysis of 13 cases

Thirteen cases of primary epithelioid hemangioendotheliomas (EHE) and epithelioid angiosarcomas (EA) of the pleura are presented. The patients were 7 men and 6 women between the ages of 34 and 65 years (mean: 47 years). The patients presented with non-specific symptoms of cough, dyspnea, and chest pain. Diagnostic imaging revealed the presence of either diffuse pleural thickening or pleural nodules involving the serosal surfaces. Open surgical biopsies were obtained in all cases. Histologically, eight tumors were characterized by the presence of a cellular proliferation composed of medium-sized epithelioid cells embedded in a myxohyaline stroma and a variable spindle cell component. Cellular atypia was mild to moderate and mitotic activity ranged from 1 to 2 per 2mm2. Immunohistochemical stains for vascular markers, including CAMTA1 were positive, confirming a diagnosis of EHE. Five cases of epithelioid angiosarcomas were characterized by a neoplastic cellular proliferation admixed with areas of necrosis and hemorrhage and characterized by medium-sized epithelioid to spindle-shaped cells with eosinophilic cytoplasm, round to oval nuclei and prominent nucleoli. In addition, marked cytologic atypia and a mitotic activity ranging from 3 to 5 per 2mm2 were identified. Immunohistochemical studies demonstrated positive staining for vascular markers; however, CAMTA1 was negative. Clinical follow-up obtained in eleven cases showed that all patients had died within 30 months post diagnosis. The current study highlights that even though it may be important to histologically separate EHE from EA for academic purposes, primary pleural origin of these tumors appears to portent an aggressive clinical behavior.

EXTRANEURAL PERINEURIOMA OF THE MANDIBLE - A CASE REPORT

A 36-year-old female patient was referred to a private clinic presenting an asymptomatic, intraosseous lesion in the posterior right mandible. Itraoral examination revealed no significant alteration. X-rays and cone-beam computed tomography exams revealed a well-defined, radiolucent, hypodense lesion with a sclerotic border in the right side of the mandible. The tumor appeared to cause fusiform enlargement of the mandibular canal. After an incisional biopsy, histopathological analysis revealed a proliferation of slender, spindle-shaped cells with long cell processes arranged in storiform and short-fascicular patterns. The findings were suggestive of extraneural perineurioma. Immunohistochemical reactions for S100, EMA, and Glut-1 antigens confirmed the diagnosis. The tumor was resected under general anesthesia. Follow-up is still ongoing. Funding: CAPES/Brazil; FAPEMIG/Brazil; CNPq/Brazil. A 36-year-old female patient was referred to a private clinic presenting an asymptomatic, intraosseous lesion in the posterior right mandible. Itraoral examination revealed no significant alteration. X-rays and cone-beam computed tomography exams revealed a well-defined, radiolucent, hypodense lesion with a sclerotic border in the right side of the mandible. The tumor appeared to cause fusiform enlargement of the mandibular canal. After an incisional biopsy, histopathological analysis revealed a proliferation of slender, spindle-shaped cells with long cell processes arranged in storiform and short-fascicular patterns. The findings were suggestive of extraneural perineurioma. Immunohistochemical reactions for S100, EMA, and Glut-1 antigens confirmed the diagnosis. The tumor was resected under general anesthesia. Follow-up is still ongoing. Funding: CAPES/Brazil; FAPEMIG/Brazil; CNPq/Brazil.

BROWN TUMORS IN THE JAWS AS THE FIRST CLINICAL SIGN OF HYPERPARATHYROIDISM

Brown tumor of hyperparathyroidism is a bone lesion that results from abnormal bone metabolism. Our study describes a case of a 26-year-old man presenting clinically facial deformity and bone expansion in the jaws. Cone-beam computed tomography exhibited an expansive, ill-defined multilocular hypodense lesion in the maxilla, and a well-defined unilocular hypodense lesion in the mandible. Medical history was not contributive. An incisional biopsy was done, and histopathological analysis of both lesions displayed abundant osteoclast-type multinucleated giant cells intermingled with ovoid and spindle-shaped mononuclear cells in a fibrovascular background, suggestive of central giant cell lesions. Laboratory examination revealed elevated serum levels of parathyroid hormone and calcium, and a decreased level of phosphorus. Based on clinical, radiologic, microscopic, and biochemical findings, the diagnosis was brown tumor of hyperparathyroidism. The patient had undergone excision of right lower parathyroid and had a partially significant reduction in the jaws’ tumors after 6 months of follow-up. Brown tumor of hyperparathyroidism is a bone lesion that results from abnormal bone metabolism. Our study describes a case of a 26-year-old man presenting clinically facial deformity and bone expansion in the jaws. Cone-beam computed tomography exhibited an expansive, ill-defined multilocular hypodense lesion in the maxilla, and a well-defined unilocular hypodense lesion in the mandible. Medical history was not contributive. An incisional biopsy was done, and histopathological analysis of both lesions displayed abundant osteoclast-type multinucleated giant cells intermingled with ovoid and spindle-shaped mononuclear cells in a fibrovascular background, suggestive of central giant cell lesions. Laboratory examination revealed elevated serum levels of parathyroid hormone and calcium, and a decreased level of phosphorus. Based on clinical, radiologic, microscopic, and biochemical findings, the diagnosis was brown tumor of hyperparathyroidism. The patient had undergone excision of right lower parathyroid and had a partially significant reduction in the jaws’ tumors after 6 months of follow-up.

SCHWANNOMA OF THE UPPER LIP IN A YOUNG PATIENT: AN UNUSUAL PRESENTATION

Schwannoma (SW), also known as neurilemmoma, is a slow-growing benign neoplasm that originates from Schwann cells. It usually appears as a solitary lesion in the 3rd and 5th decades of life, with no sex predilection. A 16-year-old girl presented an asymptomatic multilobular tumor, measuring 20 × 10 mm, covered by healthy mucosa, located on the right upper lip mucosa. Patient reported that lesion initiated after a trauma to the region causing tooth fracture four years ago. Medical history was not contributive. The possibilities of foreign body reaction and salivary gland tumors were raised. Occlusal and panoramic radiographs showed no alteration, and an incisional biopsy was performed. Histopathological analysis revealed an encapsulated lesion comprised of spindle-shaped cells arranged predominantly in a palisade, involving amorphous eosinophilic areas compatible with the diagnosis of SW. A complete surgical excision was performed, and the patient showed no recurrence after 10 months of follow-up. Support: CAPES. Schwannoma (SW), also known as neurilemmoma, is a slow-growing benign neoplasm that originates from Schwann cells. It usually appears as a solitary lesion in the 3rd and 5th decades of life, with no sex predilection. A 16-year-old girl presented an asymptomatic multilobular tumor, measuring 20 × 10 mm, covered by healthy mucosa, located on the right upper lip mucosa. Patient reported that lesion initiated after a trauma to the region causing tooth fracture four years ago. Medical history was not contributive. The possibilities of foreign body reaction and salivary gland tumors were raised. Occlusal and panoramic radiographs showed no alteration, and an incisional biopsy was performed. Histopathological analysis revealed an encapsulated lesion comprised of spindle-shaped cells arranged predominantly in a palisade, involving amorphous eosinophilic areas compatible with the diagnosis of SW. A complete surgical excision was performed, and the patient showed no recurrence after 10 months of follow-up. Support: CAPES.

RECURRENT ODONTOGENIC FIBROMYXOMA OF SUBMANDIBULAR AND LEFT TEMPORAL REGION: A CASE REPORT

Odontogenic myxofibroma (OM) is a benign odontogenic tumour of maxillofacial bone with locally aggressive behaviour. It is thought to arise from the odontogenic ectomesenchyme of dental pulp or periodontal ligament. Odontogenic myxofibroma typically presents as painless slow growing tumour with high recurrence rates ranges from 10% to 45%. A case of recurrent odontogenic myxofibroma of submandibular, left preauricular and left temporal region presented in this case report. An 11-year-old Malay girl complaint of a painless, gradually progressive firm swelling on the lower left side of the jaw for 6 months duration. On clinical examination revealed firm swelling from the left angle of the mandible to the left parasymphysis area. A dental panoramic radiograph and computed tomography (CT) scan of the head and neck showed expansile lesion at left posterior mandible causing thinning and erosion of the mandibular cortex, multiloculated with tooth germ of 38 within and displaced inferiorly. Histopathological examination revealed stellate to spindle shape cells dispersed in a myxoid background. A final diagnosis of odontogenic myxofibroma has been made. Hence, left segmental mandibulectomy with condyle disarticulation was done via a submandibular approach. Unfortunately, a year later she had recurrence at bilateral submandibular region extending to left preauricular and left temporal region associated with pain and unable to close her mouth. Multiple surgery was carried out beginning with removal of the tumour at the bilateral submandibular region followed by removal of tumour at left temple. The operations were uneventful. However, tumour excision in the left preauricular region is yet to be performed pending magnetic resonance imaging (MRI) investigation to evaluate the soft tissue extension prior to surgical planning.

Odontogenic myxoma: Literature review

The odontogenic myxoma (OM) is a locally aggressive and infiltrating benign tumor that originates from the odontogenic ectomesenchyme. It represents the third most prevalent odontogenic tumor. It presents a predilection for the female sex, affecting the first and fourth decade of life. Clinically it is asymptomatic, however, it can generate facial asymmetry, causing an expansion of the bone cortices, dental displacement, root resorption. Radiographically, odontogenic myxoma generally presents a multilocular radiographic pattern that can vary in appearance, including "soap bubble", "honeycomb" and "tennis racket" or "sunbeam" shapes. In histological studies, the odontogenic myxoma is observed to be composed of stellate to spindle-shaped cells wrapped in an abundant extracellular matrix rich in mucin, without encapsulation and that may contain epithelial residues. Treatment is variable and corresponds to the size of the lesion. Well, there are conservative treatments focused on curettage or radical treatments and in the same way the recurrence of this lesion will depend on the type of treatment. The objective of this article is to evaluate demographic aspects such as age; location; prevalence; clinical, radiographic and histological analysis; treatment, results and recurrence.

Embryonic Stem Cells Can Generate Oral Epithelia under Matrix Instruction.

We aimed to investigate whether molecular clues from the extracellular matrix (ECM) can induce oral epithelial differentiation of pluripotent stem cells. Mouse embryonic stem cells (ESC) of the feeder-independent cell line E14 were used as a model for pluripotent stem cells. They were first grown in 2D on various matrices in media containing vitamin C and without leukemia inhibitory factor (LIF). Matrices investigated were gelatin, laminin, and extracellular matrices (ECM) synthesized by primary normal oral fibroblasts and keratinocytes in culture. Differentiation into epithelial lineages was assessed by light microscopy, immunocytochemistry, and flow cytometry for cytokeratins and stem cell markers. ESC grown in 2D on various matrices were afterwards grown in 3D organotypic cultures with or without oral fibroblasts in the collagen matrix and examined histologically and by immunohistochemistry for epithelial (keratin pairs 1/10 and 4/13 to distinguish epidermal from oral epithelia and keratins 8,18,19 to phenotype simple epithelia) and mesenchymal (vimentin) phenotypes. ECM synthesized by either oral fibroblasts or keratinocytes was able to induce, in 2D cultures, the expression of cytokeratins of the stratified epithelial phenotype. When grown in 3D, all ESC developed into two morphologically distinct cell populations on collagen gels: (i) epithelial-like cells organized in islands with occasional cyst- or duct-like structures and (ii) spindle-shaped cells suggestive of mesenchymal differentiation. The 3D culture on oral fibroblast-populated collagen matrices was necessary for further differentiation into oral epithelia. Only ESC initially grown on 2D keratinocyte or fibroblast-synthesized matrices reached full epithelial maturation. In conclusion, ESC can generate oral epithelia under matrix instruction.

Telocytes and ezrin expression in normal-appearing tissues adjacent to urothelial bladder carcinoma as predictors of invasiveness and recurrence

Recurrence and progression rates vary widely among different histological subtypes of bladder cancer (BC). Normal-appearing mucosa in non-muscle invasive bladder cancer and muscle-invasive bladder cancer in cystoscopy and histopathology is a factor in staging and treatment. Telocytes (TCs) are spindle-shaped cells that connect with other cell types allowing communication though cytoskeletal signaling. They are involved in tissue regeneration and pathogenesis of diseases and cancer. In this study, 12 normal-appearing tissues from urinary bladder with BC, both invasive and non-invasive were evaluated in patients who had either trans-urethral resection of bladder tumor or cystectomy. In each case, cystoscopy, intraoperative inspection, and histopathology all confirmed the absence of cancerous elements. Five patients with neurogenic bladder were used as a control group. Immunohistochemistry revealed that c-Kit + cells were intensively distributed in bladder layers from BC samples, while they were seldom detected in the control group. Ultrastructural examination of reprocessed tissue showed an intense distribution of TCs and telopodes in the submucosa and between smooth muscle cells in BC. Telopodes were numerous, arborizing, and intercommunicating. Whereas TCs and telopodes were scarce in the neurogenic bladder. Also, cancerous tissue had the highest expression level of ezrin protein, and this level gradually decreased as we moved away from the tumor. Our finding of TCs number in normal-appearing tissues in conjunction with ezrin expression may compete invasiveness and possibly a trail to reduce recurrence rates.

Inflammatory fibroid polyp: A series of 29 cases and a systematic review of the literature

An inflammatory fibroid polyp (IFP) of the gastrointestinal tract is a localized, benign mesenchymal lesion consisting of spindle-shaped stromal cells, eosinophilic granulocytes, and some lymphocytes and plasma cells. The discovery of a frequent mutation of the platelet-derived growth factor receptor A (PDGFRA) gene was the first hint of a gene-regulating process in IFPs. The aim of this study was to investigate the interaction of inflammatory processes and the role of mutation and expression of the PDGFRA gene in the development of IFPs for the first time. We used immunohistochemistry to analyze the composition of inflammatory cells and next generation sequencing (NGS) to provide a broad overview of gene mutations.We report on 29 cases of IFP. The mean age, gender differences, and localization were compatible with the literature. Spindle cell histomorphology was present in 79% of cases showing a typical onion skin-like perivascular arrangement and significantly high CD34 positivity (p = 0.002, Fisher’s exact test). Eosinophilic granulocytes were present in an average density of 60 ± 49/high power field (HPF) (range: 15–200), and there was a significantly higher rate of IFPs larger than 2 cm in size (p = 0.018, Wilcoxon test). All but one cases could be analyzed by NGS. Mutations were observed in 17 cases (60.7%), including 13 (46.4%) mutations in the PDGFRA gene. Among the gastric lesions, mutations were found in exon 18 of the PDGFRA gene with amino acid exchange (Asp842Val) for eight out of 10 cases and in exon 12 in two cases. All three cases in the small intestine revealed mutation of the PDGFRA gene in exon 12. We found no PDGFRA mutation in our colonic cases. PDGFRA expression was significantly correlated with mutations of the same gene (p = 0.005, Fisher’s exact test) and especially with mutations in exon 12 of the same gene (p < 0.001, Fisher’s exact test). Interestingly, three of our cases (10.3%) without mutation or expression of the PDGFRA gene revealed an unusually high concentration of IgG-positive plasma cells (average: 140 ± 26/HPF, range: 110–160) and IgG4-positive plasma cells (average: 87 ± 21/HPF, range: 60–100). For comparison, an IgG4/IgG ratio of more than 0.4 is commonly observed in IgG4-related diseases. Our molecular results were in accordance with 113 genetically analyzed cases published to date. There was a correlation between the IFP site and mutation variants of the PDGFRA gene. IFPs were localized in the stomach in 49.1% of cases, in the small intestine in 47.3%, and in the colon in 3.6%. Exon 12 of the PDGFRA gene was mutated in 41.1% of cases and primarily occurred in the small intestine (82.6%). Exon 18 was mutated in 22.3% of cases and primarily occurred in the stomach (80.0%). The mutated codon interval 566–571 in exon 12 and codon 842 in exon 18 were compatible, as observed in a gastrointestinal stromal tumor. Conclusively, the correlation between mutation and expression of the PDGFRA gene points to different pathways in IFPs. Additionally, our data hint at a morphological but not genetic overlap between IFPs and IgG4-related pseudotumors.

Uterine angioleiomyoma with disseminated intravascular coagulation: a case report

BackgroundUterine angioleiomyoma is benign tumor that composed of smooth muscle cells and thick-walled vessels. It is a very rare condition reported to present as lower abdominal mass, accompanied by dysmenorrhea and hypermenorrhea. However, its clinical presentation is not known.Case presentationWe report the case of a 44-year-old Japanese woman who developed severe anemia with disseminated intravascular coagulation without obvious external bleeding. The patient had a huge abdominal mass of over 20 cm in size, which was thought to be a uterine tumor. She received daily blood transfusions and her condition improved rapidly after she underwent hysterectomy. Pathological examination of the tumor revealed spindle-shaped cells with little atypia and mitosis, and numerous large vessels with smooth muscle and thrombus in the vessels.ConclusionsUterine angioleiomyoma was identified as the cause of the coagulation abnormality. CCND2 and AR gene amplification was detected in the tumor. Uterine tumors that present with coagulopathy despite a clinical course suggestive of benign disease should undergo differential diagnosis for uterine angioleiomyoma.

Keloidal Collagen May Be Produced Directly by αSMA-positive Cells: Morphological Analysis and Protein Shotgun Analysis.

The cross-sectional study cohort consisted of a convenience series of patients with keloids who underwent surgical excision. Skin pieces (3 mm2) were collected from the keloid center and nearby control skin. Histopathology was conducted with light and electron microscopy and immunohistochemistry. KC composition was analyzed with protein shotgun analysis. Microscopic analyses revealed the ubiquitous close association between KC and αSMA-positive spindle-shaped cells that closely resembled myofibroblasts. Neither KC nor the spindle-shaped cells were observed in the control tissues. Compared with control skin, the collagen fibers in the KC were overall thinner, their diameter varied more, and their spacing was irregular. These features were particularly pronounced in the collagens in the vicinity of the spindle-shaped cells. Protein shotgun analysis did not reveal a specific collagen in KC but showed abnormally high abundance of collagens I, III, VI, XII, and XIV. These findings suggest that KC may be produced directly by myofibroblasts rather than simply being denatured collagen fibers. Because collagens VI and XII associate with myofibroblast differentiation, and collagen XIV associates with local mechanical stress, these collagens may reflect, and perhaps contribute to, the keloid-specific local conditions that lead to the formation of KC.

Impact of cancer-associated fibroblasts on survival of patients with ampullary carcinoma.

Cancer-associated fibroblasts (CAFs) reportedly enhance the progression of gastrointestinal surgery; however, the role of CAFs in ampullary carcinomas remains poorly examined. This study aimed to investigate the effect of CAFs on the survival of patients with ampullary carcinoma. A retrospective analysis of 67 patients who underwent pancreatoduodenectomy between January 2000 and December 2021 was performed. CAFs were defined as spindle-shaped cells that expressed α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP). The impact of CAFs on survival, including recurrence-free (RFS) and disease-specific survival (DSS), as well as prognostic factors associated with survival, was analyzed. The high-α-SMA group had significantly worse 5-year RFS (47.6% vs. 82.2%, p = 0.003) and 5-year DSS (67.5% vs. 93.3%, p = 0.01) than the low-α-SMA group. RFS (p = 0.04) and DSS (p = 0.02) in the high-FAP group were significantly worse than those in the low-FAP group. Multivariable analyses found that high α-SMA expression was an independent predictor of RFS [hazard ratio (HR): 3.68; 95% confidence intervals (CI): 1.21-12.4; p = 0.02] and DSS (HR: 8.54; 95% CI: 1.21-170; p = 0.03). CAFs, particularly α-SMA, can be useful predictors of survival in patients undergoing radical resection for ampullary carcinomas.

Unusual presentation of Giant Dermatofibrosarcoma Protuberans

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, soft tissue sarcoma with a low metastatic potential but high rate of recurrence after surgical intervention. This tumor is characterized by a long history of slow growth. DFSP usually occurs on trunk and proximal extremities but rarely touches distal extremities such as hands, fingers, or foot below knees. We present a case of giant DFSP of the distal extremity, with a post-traumatic onset in childhood and a very long course. A 45-year-old patient presented with a tumoral lesion of the foot, evolving since 35 years with an onset at the age of 10 years, after a strong trauma of the 3rd toe. Physical examination revealed a reddish purple polynodular neoplastic lesion with a firm consistency. One of these nodular masses was ulcerated with areas of necrosis. The CT scan did not detect any bone involvement. Magnetic resonance imaging revealed a heterogeneously enhancing mass lesion on the dorsal aspect of the left forefoot. In depth, this mass invaded the dorsal interosseous muscles. The histopathological study was in favor of DFSP, with evidence of spindle-shaped tumor cells arranged in a storiform pattern. On immunohistochemistry (IHC), the cells expressed intense and diffuse CD34 and were negative for Desmin and S-100. The localization or occurrence of DFSP after a long period of trauma should not mislead the diagnosis. A careful histological study with IHC should be carried out in order to set up an appropriate treatment.

Case series of rare primary cardiac sarcomas: A challenging histopathological diagnosis

Primary cardiac sarcomas are rare and histologically diverse, with single tumors able to demonstrate histological heterogeneity. Consequently, they are often misdiagnosed as other common cardiac tumors, such as cardiac myxoma or other metastatic malignancies. Incorrect diagnoses can result in incomplete surgeries, inadequate treatment regimens, and early recurrence. In our experience, based on the diverse histological and cytological characteristics of these tumors, immunostaining panels should be used early on to differentiate the exact tumor type. SMA, CD31, myogenin, ERG, and SOX10 panels are used to identify spindle-shaped or polymorphic cell patterns, while CK, LCA, S100, and desmin panels are used for round and monomorphic cell patterns. Using these panels can help identify the histological type of primary cardiac sarcomas, which is normally a challenge for pathologists.

Chronic PFOA exposure in vitro causes acquisition of multiple tumor cell characteristics in rat liver cells

Perfluorooctanoic acid (PFOA) is tumorigenic in rats and mice and potentially tumorigenic in humans. Here, we studied long-term PFOA exposure with an in vitro transformation model using the rat liver epithelial cell, TRL 1215. Cells were cultured in 10 μM (T10), 50 μM (T50) and 100 μM (T100) PFOA for 38 weeks and compared to passage-matched control cells. T100 cells showed morphological changes, loss of cell contact inhibition, formation of multinucleated giant and spindle-shaped cells. T10, T50, and T100 cells showed increased LC50 values 20%, 29% to 35% above control with acute PFOA treatment, indicating a resistance to PFOA toxicity. PFOA-treated cells showed increases in Matrix metalloproteinase-9 secretion, cell migration, and developed more and larger colonies in soft agar. Microarray data showed Myc pathway activation at T50 and T100, associating Myc upregulation with PFOA-induced morphological transformation. Western blot confirmed that PFOA produced significant increases in c-MYC protein expression in a time- and concentration-related manner. Tumor invasion indicators MMP-2 and MMP-9, cell cycle regulator cyclin D1, and oxidative stress protein GST were all significantly overexpressed in T100 cells. Taken together, chronic in vitro PFOA exposure produced multiple cell characteristics of malignant progression and differential gene expression changes suggestive of rat liver cell transformation.

Oral, conjunctival and Auricular Kaposi’s sarcoma in a HIV-negative patient : an unusual presentation

Kaposi’s sarcoma is an unusual multicentric malignant neoplastic disease, that characterized by the proliferation of spindle-shaped cells. This tumor is habitually involving in the skin of the lower extremities. However, it is rarely developing in the mucosa or skin of the head and neck. Herein, we report an uncommon presentation of Kaposi sarcoma affecting auricle,oral and ocula rmucosa in an immunocompetent patient. The diagnosis was made on clinical and histopathological finding.

Biphenotypic Sinonasal Sarcoma: A Genetically Confirmed Case Showing Bone Invasion Accompanying a Non-neoplastic Respiratory Epithelium.

Biphenotypic sinonasal sarcoma is a newly established tumor entity that is associated with distinct clinicopathological findings. Biphenotypic sinonasal sarcoma is a rare, low-grade spindle cell sarcoma that arises in middle-aged females, exclusively in the sinonasal tract. A fusion gene involving PAX3 is detected in most biphenotypic sinonasal sarcomas, which aids in its diagnosis. Here, we report a case of biphenotypic sinonasal sarcoma with its cytological findings. The patient was a 73-year-old woman who presented with purulent nasal discharge and dull pain in the left cheek area. Computed tomography showed a mass extending from the left nasal cavity to the left ethmoid sinus, the left frontal sinus, and the frontal skull base. She underwent a combined transcranial and endoscopic approach for en bloc resection with a safety margin. Histologically, spindle-shaped tumor cells have been thought to proliferate mainly in the subepithelial stroma. Here, nasal mucosal epithelial hyperplasia was noted, and the tumor had invaded the bone tissue accompanying the epithelial cells. Fluorescence in situ hybridization (FISH) analysis showed a PAX3 rearrangement, and next-generation sequencing identified a PAX3::MAML3 fusion. Based on FISH, split signals were observed not in respiratory cells but in stromal cells. This indicated that respiratory cells were non-neoplastic. In the diagnosis of biphenotypic sinonasal sarcoma, the inverted growth of the respiratory epithelium can be a diagnostic pitfall. FISH analysis using a PAX3 break-apart probe is helpful not only for an accurate diagnosis but also for detecting the true neoplastic cells.

Gastroblastoma mimics the embryonic mesenchyme of the foregut: a case report

BackgroundGastroblastoma is a rare gastric tumor composed of epithelial and spindle cell components. The characteristic MALAT–GLI1 fusion gene has only been identified in 5 reported cases. We report the morphological characterization of gastroblastoma with the MALAT1–GLI1 fusion gene in a young Japanese woman.Case presentationA 29-year-old Japanese woman visited Iwate Medical University Hospital with upper abdominal pain. Computed tomography revealed a tumor in expansive lesions involving the gastric antrum. Histologically, we observed a biphasic morphology composed of epithelial and spindle cell components. The epithelial components appeared as slit-like glandular structures with tubular or rosette-like differentiation. The spindle cell components consisted of short spindle-shaped oval cells. Immunohistochemical (IHC) analysis revealed that the spindle cell component was positive for vimentin, CD10, CD56, GLI1, and HDAC2, and focally positive for PD-L1. The epithelial component was positive for CK AE1/AE3, CAM5.2, and CK7, and negative for CK20 and EMA. Both components were negative for KIT, CD34, DOG1, SMA, desmin, S100 protein, chromogranin A, synaptophysin, CDX2, and SS18-SSX. The MALAT-GLI1 fusion gene was detected molecularly.ConclusionsWe report the following new findings with this case: (i) gastric tumors mimic the gastrointestinal mesenchyme in the embryonic period; (ii) nuclear expression of PD-L1 and HDAC2 were observed in the spindle cell component of a gastroblastoma. We speculate that histone deacetylase (HDAC) inhibitors may offer a promising treatment option for gastroblastoma.