Stratified Squamous Epithelium Research Articles

Imperforate Hymen: Rare Types

When the hymen, a thin membrane of stratified squamous epithelium circumscribing the vaginal introitus, does not spontaneously rupture during neonatal development, it is referred to as an imperforate hymen. An imperforate hymen is a rare cause of primary amenorrhea and can present with obstructive symptoms of the female genital and urinary tracts during the perinatal, pediatric, or adolescent years. Timely diagnosis and prompt treatment are critical. Specific pediatric and gynecologic knowledge and skills are necessary to provide comprehensive, patient-centered care. In addition to the anatomical and physiological aspects of imperforate hymen, its clinical presentation, and potential complications, the psychological impact on affected individuals must be understood. Best practices will ultimately improve patients’ quality of life and reproductive health outcomes. This activity reviews the evaluation and treatment of imperforate hymen and highlights the role of the interprofessional team in improving care for patients with this condition.

A case of esophageal squamous cell carcinoma with epidermization showing a unique morphology.

An 80-year-old woman with a history of endoscopic balloon dilation for esophageal stricture caused by accidental ingestion of caustic soda during infancy presented with dysphagia. Upper gastrointestinal endoscopy revealed a 10-cm-long, highly white, elevated lesion with a feathered appearance. This lesion was determined to be the cause of dysphagia and was completely resected via endoscopic submucosal dissection. Histopathological examination revealed a thick keratin layer on the surface of the stratified squamous epithelium, with a prominent granular layer underneath and some areas showing nuclear atypia. The lesion was diagnosed as a well-differentiated squamous cell carcinoma, pT1a-LPM, derived from epidermoid metaplasia. Cancer genome analysis revealed mutations in TP53 as well as amplification of MYC, FGFR1, chromosome 7, and chromosome 20q. This case suggests that epidermoid metaplasia caused by chronic irritation from an esophageal stricture may have been exacerbated by the dilation procedure.

A Tissue-Engineered Model of T-Cell–Mediated Oral Mucosal Inflammatory Disease

T-cell-mediated oral mucocutaneous inflammatory conditions including oral lichen planus (OLP) are common but development of new treatments aimed at relieving symptoms and controlling OLP progression are hampered by the lack of experimental models. Here, we developed a tissue-engineered oral mucosal equivalent (OME) containing polarised T-cells to replicate OLP pathogenesis. Peripheral blood CD4+ and CD8+ T-cells were isolated, activated and polarised into Th1 and cytotoxic T-cells (Tc). OME were constructed by culturing oral keratinocytes on an oral fibroblast-populated hydrogel to produce a stratified squamous epithelium. OME stimulated with IFN-γ and TNF-α or medium from Th1 cells caused increased secretion of inflammatory cytokines/chemokines. A model of T-cell-mediated inflammatory disease was developed by combining OME on top of a Th1/Tc-containing hydrogel, followed by epithelial stimulation with IFN-γ/TNF-α. T-cell recruitment towards the epithelium was associated with increased secretion of T-cell chemoattractants CCL5, CXCL9 and CXCL10. Histological assessment showed tissue damage associated with cleaved-caspase-3 and altered laminin-5 expression. Treatment with inhibitors directed against JAK, KCa3.1 channels or clobetasol in solution and/or via a mucoadhesive patch prevented cytokine/chemokine release and tissue damage. This disease model has potential to probe for mechanisms of pathogenesis or as a test platform for novel therapeutics or treatment modalities.

Clinical observation: papillomatosis and cicatricial stricture of the esophagus

Purpose To draw the attention of doctors to one of the rare diseases and neoplasms of the esophagus - papillomatosis. Clinical and pathological features of the combination of papillomatosis and cicatricial stricture of the esophagus in one patient as well as treatment options are discussed. Materials, methods and results A 56-year-old patient complained of dysphagia and odynophagia, shortness of breath. In childhood, he came through a tracheostomy and several sessions of bougienage of the esophagus after a chemical burn of the esophagus. Currently, endoscopic examination revealed cicatricial deformity and narrowing of the lumen to 12 mm in the upper third the esophagus, the mucosa is thickened, with papillomatous growths in the form of longitudinal ridges, the structure of the mucosa has a papillary character. Histological examination of the esophageal mucosa shows hyperplasia of the stratified squamous epithelium in the form of multiple polypoid outgrowths with fibrovascular centers, epithelial dysplasia was not detected. The first session of endoscopic bougienage was performed, but thereafter the patient was unable to continue bougienage or any other treatment. Conclusion There are no standard guidelines for the treatment or monitoring of patients with esophageal papillomatosis. Summarizing information from literary sources and our own experience, we consider endoscopic removal of both local single papillomas of the esophagus and widespread papillomatosis.

Scanning electron microscopy and light microscopy of tongue, fingers, toes, nuptial pad, and humeral gland in Sylvirana nigrovittata (Anura: Ranidae)

The micromorphology and histology of anuran skin, particularly in Thai species, remain relatively understudied. Anurans use their tongues for prey capture and their hands and feet for adhesion and mating, suggesting a close relationship between micro-surface features and histological structure. Information on Sylvirana nigrovittata is particularly limited. This study provides a detailed examination of the micro-surface and histological characteristics of the tongue, fingers, toes, nuptial pad, and humeral gland in S. nigrovittata. Specimens collected from Phu Luang Wildlife Sanctuary in Loei province, northeastern Thailand, were studied using scanning electron microscopy (SEM) for micro-surface features and H&E staining for histological details. SEM micrographs revealed that the tongue was cordate-shaped, with about 75% of its surface covered by filiform papillae and 25% by fungiform papillae housing taste buds. Filiform papillae were trapezoidal, averaging 23.88±5.68 µm in width and 38.83±6.57 µm in length, while fungiform papillae were disc-like, averaging 52.95±14.64 µm in width and 66.70±15.88 µm in length. Digital pads on fingers and toes presented prismatic cells, with fingertip cells averaging 7.09±0.97 µm in width and 11.81±1.24 µm in length, and toe cells averaging 8.40±1.37 µm in width and 11.28±1.63 µm in length. Subdigital surfaces were smoother, containing squamous cells with dimensions of 10.65±3.21 µm in width and 21.29±4.35 µm in length. Subarticular tubercles were composed of prismatic cells with hexagonal or pentagonal surfaces, averaging 10.02±2.85 µm in width and 13.08±1.94 µm in length. Nuptial pad displayed cylindrical structures with dome-like tips, averaging 24.01±3.96 µm in width and 21.16±4.37 µm in length, and feature mucous openings. They consisted of a thick keratinized stratified squamous epithelium and a dense dermis with specialized mucous glands. Humeral gland exhibited rough surfaces with squamous cells and microridges, showing both small and large mucous openings, with average cell dimensions of 16.23±1.70 µm in width and 19.11±2.05 µm in length. Histological analysis confirmed that these structures were predominantly composed of keratinized stratified squamous epithelium, with variations in dermal collagen density and mucous gland distribution. This study enhances our understanding of the skin and gland morphology in S. nigrovittata, highlighting on its anatomical and functional adaptations.

INTRAOSSEOUS EPIDERMOID CYST OF JAW – A case report

Abstract Epidermoid cysts are benign, rare which can occur all throughout the body of an individual. Their occurrence in the oral cavity is rare and is difficult to distinguish from other intraoral cysts. Method A 27-year-old female patient presented with a swelling to the oral and maxillofacial surgery department for the removal of the cystic lesion. Results Based on the clinical and radiographic features the provisional diagnosis was given as odontogenic keratocyst. But the histopathological examination revealed a stratified squamous cystic epithelium with abundant keratin suggestive of an epidermoid cyst. Conclusion This case report presents an uncommon finding in the oral cavity with a history of teeth extraction. Based on these findings even though epidermoid cyst is rare it should be included in the differential diagnosis of radiolucent lesions of the jaws.

Anatomical, histological, and scanning electron microscopic features of the esophagus and crop in young and adult domestic pigeons (Columba livia Domestica)

BackgroundPigeons (Columba livia) are mainly raised as a source of animal protein, racing, leisure and as an experimental animal. The present study investigated the morphology of the esophagus in the young and adult domestic pigeon, Columba livia domestica.MethodsTen young and ten adult, normal, and healthy pigeons were collected from the local breeders. Samples from different parts of esophagus and crop were examined grossly, by stereomicroscopy, scanning and light microscopy.ResultsThe esophagus consisted of a long cervical part, a crop, and a short thoracic part. The crop was represented by a thin-walled outpouching with two lateral diverticula. The mucosa presented wavy fine folds in the cervical esophagus, irregular folds in the lateral diverticula giving it a corrugated appearance, and prominent longitudinal folds with several gland openings in the middle and lower parts of the crop, as well as in the thoracic esophagus. The density of gland openings was higher in adult pigeons than that in young pigeons. The mucosa of the esophagus was lined by non-keratinized stratified squamous epithelium. The shape, height, and branching of the mucosal folds differed between young and adult pigeons. Mucous-secreting alveoli were detected in the middle part of the crop as well as in the thoracic esophagus, but not in the cervical esophagus or lateral diverticula of the crop.ConclusionThe variations between the young and adult pigeons suggest a functional adaptation of adult pigeons to their diet compared to young pigeons.

352. A RARE CASE OF ESOPHAGEAL EPIDERMOID METAPLASIA: A POTENTIAL PRECURSOR TO ESOPHAGEAL MALIGNANCY

Abstract A 62-year-old woman with medical history of fibromyalgia and depression was referred to the gastroenterology consultation due to dysphagia for solids for the past 3 months. She had previously performed an upper endoscopy which revealed an esophageal lesion, interpreted as a papillomatous lesion. Upper endoscopy was repeated, showing a whitish, irregular, semi-elevated and hemi-circumferential lesion between 16 and 19cm from the incisors (Figure A and B). Biopsies were performed. Histology revealed a stratified squamous epithelium with mild inflammation, with spongiosis, hyperorthokeratosis and a prominent granular cell layer. This was consistent with esophageal epidermoid metaplasia (Figures C and D). No dysplasia or carcinoma was noted. Esophageal epidermoid metaplasia is a rare condition described only in case reports and small series. It is thought that may be sporadically associated with esophageal squamous cell carcinoma. Endoscopically, this entity might have different appearances such as white plaques, altered texture, keratotic patches, sloughing, granularity, nodularity, furrows, decreased vascularity, and lacy appearance. We report this case to raise awareness for this entity and its association with dysplasia and esophageal cancer. Therefore, in the case of esophageal epidermoid metaplasia lesions a close follow-up or endoscopic treatment may be warranted. Patient is currently on endoscopic surveillance every one year to screen for early dysplasia.

Pathologic Status of Tissue Around the Malleus Handle Tip in Endoscopic Tympanoplasty: Potential Impact on Surgical Decisions.

Objectives: To avoid postoperatively acquired cholesteatoma, whether there was any squamous epithelial tissues residue around the tip of the malleus handle, and the need to remove these tissues were explored. Methods: This prospective study enrolled 197 patients who underwent endoscopic tympanoplasty. A postoperative pathological evaluation of the tissue around the tip of the malleus handle was performed to determine the presence of squamous epithelium. Analyzed correlation of epithelial remnants with exposure of malleus handle and microbial infection of middle ear. Results: The detection rate of squamous epithelial retention around the tip of the malleus handle differed significantly among patients with adhesive otitis media (AdOM), acquired cholesteatoma, and chronic suppurative otitis media (CSOM). The detection rate was significantly higher in the acquired cholesteatoma group than in the AdOM and CSOM groups (P < .001). The rate of squamous epithelial retention around the tip of the malleus handle was not significantly associated with microbial infection of the middle ear, the surgical side (P = .672), dry or wet ear status (P = .702), or exposure of the malleus handle (P = .06). Conclusions: In patients with acquired cholesteatoma, AdOM, or COM with severe tympanic sclerosis, the tissue around the tip of the malleus handle should be removed completely. For patients with simple COM, that is, without tympanic sclerosis or keratinizing stratified squamous epithelium at the edge of the perforation, the tissue can be retained.

Histogenesis of the cornea in sheep fetuses

In this study, 36 samples of sheep fetuses at different ages were used. After preparation and determination of age, the samples were immediately fixed and subjected to gross anatomy and histology examination. In addition to routine H&amp;E staining, two specific staining methods, Verhoeff and Masson's trichrome, were used in the histological study. The results showed that the corneal forming layer completely loses its contact with the lens and posterior layers and the eyelid ridges start to emerge at around 30 days of gestation. However, the cornea becomes fully differentiated in the second month of gestation and only undergoes growth stages in subsequent ages. From the beginning, the cornea in sheep fetuses is formed as a horizontal ellipse, with its inner curvature larger than its outer curvature. The growth process in terms of dimensions, including longitudinal diameter, transverse diameter, and corneal height, shows a regular ascending trend with increasing age. The upper and lower eyelids fuse in early second month and separate again in late third month. The third eyelid appears at approximately 120 days of gestation in the inner angle of the eye. The outer epithelial covering of the cornea changes from simple cuboidal to stratified squamous epithelium. With increasing age, the matrix is strengthened both in terms of cellular components (fibroblasts) and fibers (collagen). Additionally, an increase in elastic fibers is noticeable in the late fetal stages. The Descemet's membrane appears as an inner limiting membrane beneath the inner epithelial covering in early second month and also undergoes growth with increasing age. Descemet's membrane lacks elastic fibers. Bowman's layer or the outer limiting membrane was not observed in this animal. Masson's trichrome staining confirms the growth of collagen fibers, while Verhoeff staining confirms the growth of elastic fibers with increasing age.

CITED1 expression in odontogenic cysts

BackgroundOriginating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts.Material and method40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software.ResultOdontogenic keratocysts was imaged with 6–8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways.ConclusionsPositive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts.

Epidermoid Cyst arising within an Intrapancreatic Accessory Spleen [ECIPAS] mimicking a pancreatic mucinous cystic neoplasm-a case report with literature review

Background: Accessory spleens are congenital embryological aberrations usually found within the splenic hilum with no clinical significance. An Intra Pancreatic Accessory Spleen (IPAS) is an uncommon benign pancreatic lesion encountered clinically. The occurrence of an Epidermoid Cyst arising within an IPAS (ECIPAS) is exceedingly rare and is often misdiagnosed as a pancreatic pathology such as mucinous cystic neoplasm, cystic degeneration within a solid tumor such as a neuroendocrine tumor, or a lymph node. Case report: A 68-year-old male presented with intermittent post-prandial abdominal pain for over 2 years. Abdominal computer tomography identified a 5.2 cm calcified cyst within the pancreatic tail and a mucinous pancreatic neoplasm/pancreatic pseudocyst was considered in the differential diagnosis. The results of endoscopic ultrasound and fine needle aspiration were indeterminate. Due to persistent abdominal pain, the patient underwent a laparoscopic distal pancreatectomy with splenectomy. A gross examination of the distal pancreatic/splenectomy specimen confirmed a well-demarcated cystic lesion with brownish fluid within the pancreatic tail. Microscopic examination revealed a nonpathological pancreas separated by a fibrous capsule with a large cyst arising within an intrapancreatic accessory spleen. The cyst was lined with multilayered non-keratinized stratified squamous epithelium positive for pancytokeratin, CA 19-9, CK5/6, and p63 with no lymphocytic infiltrates and absent hair/ dermal appendages confirming an epidermoid cyst. CD8 outlined the dendritic network of the littoral cells of the splenic tissue in the cyst wall. Post-operative follow-up at 6 weeks was uneventful. Conclusion: The preoperative diagnosis of ECIPAS is extremely difficult as this entity shares overlapping radiological features with other cystic lesions such as mucinous pancreatic cysts. It is important for anatomic pathologists to recognize and consider the intrapancreatic compartment as a possible site for accessory spleen. As histopathology is the final determinant of this diagnosis, increased clinical awareness with an accurate diagnosis of this entity may prevent patients from unnecessary surveillance and/or extensive oncological-based surgical resection.

Mutational analysis of BRAFV600E in a case of sialadenoma papilliferum of oral cavity

Abstract This case report presents a rare benign salivary gland tumour called sialadenoma papilliferum. It comprises 3 to 5% of head and neck tumours and about 1% of all minor salivary gland tumours. The focus is on discussing the BRAFV600E mutation analysis and exploring its clinical implications, along with delving into the histopathological differentials. We documented a 73-year-old male, who had a white patch in the left retromolar trigone region for 6 months. The tumour was excised with a clinical diagnosis of verrucous lesion. Microscopic examination revealed exophytic hyperplastic parakeratotic stratified squamous epithelium and endophytic ductal papillary proliferation. The BRAFV600E mutation was present in the patient. Subsequent regular follow-ups were conducted, revealing no recurrence of the condition. This case underscores the pivotal role of BRAFV600E analysis as an invaluable diagnostic tool when confronted with the intricacies of intraoral salivary gland neoplasms.

The mucocutaneous junction and its associated nerves, immunoreactive cells and changes with age: a review with novel observations from human fetal and cadaveric specimens

The mucocutaneous junction (MCJ) is a specific site located at body orifices such as the mouth, nose, eyelid, vulva, prepuce, and anus. The present study was conducted to reassess the MCJ in terms of 1) cytokeratin expression, 2) the distribution of immunoreactive cells, 3) nerves and their terminals, and 4) differences between near-term fetuses and adults. For cadaveric specimens after long-term preservation, cytokeratin 14 was useful for identification of the MCJ. In near-term fetuses, routine histology clearly demonstrated the putative MCJ due to transient, thick stratification of the squamous epithelium. This was most evident in the oral mucosa and less evident in the palpebral skin. In the anus and eyelid, the MCJ developed from highly proliferative epithelia of the anal sinus and meibomian gland, independent of the growing skin and mucosa. In elderly individuals, the MCJ was expanded in the nose and anus possibly as a result of mechanical stimuli, and was apparently connected to a hemorrhoid venous plexus. At the vulva and prepuce, a morphology intermediate between pseudostratified columnar and stratified squamous epithelia was evident. Except for the vulva and prepuce, corpusclelike nerve terminals were sandwiched between the dermal papillae and epidermis, whereas nerves arranged in parallel exhibited free ends beneath the mucosa. At the anus, the myenteric autonomic nerve plexus disappeared slightly orad to the MCJ. Langerhans cells were richly distributed in the skin stratum spinosum, while suppressive T lymphocyte clusters were present in the lamina propria mucosae. General rules and site-specificity of the MCJ were reviewed.

Curcumin in Turmeric (Curcuma longa L.) for Treatment of Oral Lichen Planus: A Narrative Review

Background: Turmeric (Curcuma longa L.) has long been used as a traditional medicine. The primary active component of turmeric is curcumin. It has potential anti-inflammatory effects and high antioxidant activity. Curcumin contained in turmeric has been reported as an effective treatment for Oral lichen planus (OLP). OLP is a chronic autoimmune, inflammatory disease of the oral mucosa associated with systemic disease. This disease involves the skin and mucous membranes (mucocutaneous) of stratified squamous epithelium. Purpose: This narrative review conducted on Google Scholar, PubMed, Research Gate, and ScienceDirect databases aims to study the effectiveness of curcumin contained in Turmeric (C. longa L.) in OLP treatment. Review(s): OLP is a condition of the oral mucosa that is a chronic autoimmune mucocutaneous disease. As many as 0.5% to 2.2% of cases of OLP occur in the adult population. Systemic and topical corticosteroid drugs are usually used to treat OLP. However, the use of these drugs has many side effects, so it needs searching for a new active substance to treat OLP. Curcumin is a hydrophobic polyphenol extracted from the rhizome of the herb Curcuma longa (turmeric), which has a low molecular weight. The repeated use of steroids can cause side effects that cause atrophy of the mucosa and candidiasis. One natural product that is superior to corticosteroids is curcumin. This is due to curcumin's anti-inflammatory, antioxidant, and chemopreventive properties in several diseases. Conclusion: This review suggests that OLP treatment using curcumin in Turmeric (C. longa L.) is effective because curcumin exhibits antioxidant, anti-inflammatory, antimicrobial, and anticarcinogenic activities, as well as immunomodulatory properties.

Histochemical and immunohistochemical investigation of the number and localization of mast cells in the feline tongue.

This is the first study to describe the subtypes, number and distribution of mast cells (MC) in cat tongue by histochemical and immunohistochemical methods. Six male adult felines' tongue tissue samples consist of the study's material. Samples were fixed in 10% formaldehyde. MC number and distribution in the feline tongue were assessed using toluidine blue. Also, sections taken from blocks were stained in alcian blue/safranin O (AB/SO) combined dyes to determine the MC subtypes. The Streptavidin biotin complex method using anti-chymase and anti-tryptase primary antibodies was used for immunohistochemistry. Metachromatic MCs were mainly observed in the lamina propria close to the multilayered keratinized stratified squamous epithelium. The high number of MCs in this region may be because the dorsal surface of the tongue plays an essential role in the defence system of tongue tissue and, thus, of the body as a whole. Additionally, the number of MCs stained with AB (+) (1.7 ± 0.08) in the feline tongue was statistically higher than those with SO (+) (0.18 ± 0.02). This might be interpreted as an indication that MC heterogeneity may be due not only to their staining properties but also to their localization. It is also conceivable that the high histamine content may be a factor in this. Tryptase-positive MCs were found in the loose connective tissue around blood vessels, between the glands, as solitary cells, or in groups of several cells. Chymase-positive MCs were observed more individually rather than in groups. Moreover, chymase-positive MCs were detected to be located in the filiform papillae subepithelial and in the blood vessels' immediate vicinity. Animals often lick themselves to clean themselves and promote healing. For this reason, it is very important to protect the tongue, which is in direct contact with the external environment, against foreign agents. Considering both the functional and protective properties of the tongue, we concluded that MCs may play a role in oral cavity immunity and protective effect.

Ingestion of fishing gear and Anisakis sp. infection in a beached Indo-Pacific finless porpoise (Neophocaena phocaenoides) in the Jeju Island, Republic of Korea: findings from post-mortem computed tomography and necropsy

BackgroundHuman fishing activities have significantly affect environmental concern for marine ecosystems, conservation of marine mammals, and human health. Coastal cetaceans are highly vulnerable to ingestion of fishing gear, bycatching, or entanglement, all of which can be fatal for these animals. In particular, certain coastal dolphins and porpoises are heavily impacted by fishing gear such as angling gear or stownet, as their food often overlap with the target fish species of human fisheries.Case presentationThis study presents a case of an Indo-Pacific finless porpoise (Neophocaena phocaenoides) beached on the coast of Jeju Island, Republic of Korea, with ingestion of fishing gear and severe Anisakis infection. Although this species inhabits waters ranging from the Persian Gulf to Taiwan, several stranded carcasses have been reported on Jeju Island in recent years. Post-mortem computed tomography revealed a bundle of four fishing hooks in the forestomach, along with nylon lines and steel lines with connectors, which were assumed to be angling gear for Jeju hairtail (Trichiurus lepturus). Further necroscopic investigation revealed that the forestomach contained a large number of Anisakis spp. (Nematoda: Anisakidae). Histological examination revealed a thickened forestomach wall with pinpoint and volcanic ulcerations, a thickened layer of stratified squamous epithelium, and infiltrated stroma in the squamous epithelium.conclusionsThis study emphasizes the urgent need to address the impact of fishing activities on marine mammals, marine litter pollution, and the bycatch problem in Korean seawater. In addition, the occurrence of N. phocaenoides in seawater around Jeju Island should be raised in future geographical ecology or veterinary pathology studies and when its distribution is updated.

Nasopharyngeal cyst of branchiogenic origin: a rare case report

Nasopharyngeal branchial cysts present laterally as well as ascend from the fossa of Rosenmuller and trace superiorly inside the bony immures of the pharyngotympanic tube. Other commonly related disease conditions with respect to nasopharyngeal cyst include the Rathke’s pouch cyst, Thornwaldt cyst from the pharyngeal bursa along with the branchial cleft cyst. Here in our study, we report a case of a 25-year-old male presented with symptoms of snoring for the past 2 years. On zero-degree endoscopic examination, a nasopharyngeal mass was seen arising from the lateral wall of the nasopharynx extending to the oropharynx. Further based on his radiological investigations, a localized non-enhancing nasopharyngeal cystic mass was seen extending from the left lateral wall of nasopharynx to oropharynx and was diagnosed as nasopharyngeal cyst. Thus, the surgical removal of the nasopharyngeal cyst has been performed through a transoral endoscopic technique with no remnants at the surgical site. The histopathological findings revealed stratified squamous epithelium with subepithelial infiltration of lymphoid follicles, thus confirming the diagnosis as branchial cleft cyst. The patient was discharged with no complications and have been periodically advised for a follow-up. Conclusively, the cyst of 2nd branchiogenic origin in the nasopharynx is extremely sporadic and till date, only a small number of cases have been reported.

Keratin 6A Is Expressed at the Invasive Front and Enhances the Progression of Colorectal Cancer

Keratins (KRTs) are intermediate filament proteins in epithelial cells, and they are important for cytoskeletal organization. KRT6A, classified as a type II KRT, is normally expressed in stratified squamous epithelium and squamous cell carcinomas. Little is known about the expression and role of KRT6A in adenocarcinomas. We investigated the clinicopathologic and molecular biological significance of KRT6A in colorectal adenocarcinoma. Immunostaining of colorectal adenocarcinoma cases treated at our institution demonstrated that KRT6A showed significantly stronger expression at the invasive front than that at the tumor center (P < .0001). The high KRT6A–expression cases (n = 47) tended to have a high budding grade associated with significantly worse prognoses. A multivariate analysis revealed that the KRT6A expression status was an independent prognostic factor for overall survival (P = .0004), disease-specific survival (P = .0097), and progression-free survival (P = .0033). The correlation between KRT6A and patient prognoses was also validated in an external cohort from a published data set. To determine the function of KRT6A in vitro, KRT6A was overexpressed in 3 colon cancer cell lines: DLD-1, SW620, and HCT 116. KRT6A overexpression increased migration and invasion in DLD-1 but did not in SW620 and HCT116. In 3-dimensional sphere-forming culture, KRT6A expression enhanced the irregular protrusion around the spheroid in DLD-1. Our findings in this study indicated that KRT6A expression is a valuable prognostic marker of colorectal cancer and KRT6A may be involved the molecular mechanism in the progression of invasive areas of colorectal cancer.

Prımary External Audıtory Canal Cholesteatoma

Abstract External auditory canal (EAC) cholesteatoma is characterized by a bony defect in the auditory canal with a cystic structure lined by keratinizing stratified squamous epithelium and retention of keratin debris. Clinically, patients present with chronic dull pain, otorrhea, or conductive hearing loss. Lamellar keratin debris in a bony defect in the case of an intact tympanic membrane is highly suggestive of external ear canal cholesteatoma. It must be differentiated from keratosis obturans. The locally erosive and indolent nature of cholesteatoma in the bony external ear canal may result in complications due to erosion into adjacent structures such as mastoid cells, semicircular canals, fallopian canal, and temporomandibular joint. The treatment options include conservative therapy and surgery. In this case report, we presented a 75-year-old male with a primary left EAC cholesteatoma underlining the diagnostic and therapeutic features of this rare disease.