Taquipnea persistente como manifestación inicial de hiperplasia de células neuroendocrinas: reporte de un caso clínico / Persistent tachypnea as initial manifestation of hyperplasia of neuroendocrine cells: case report

Se realiza revisión de la literatura y presentación de un caso clínico de Hiperplasia de Células Neuroendocrinas en paciente lactante masculino que inicia su padecimiento a los 3 meses de vida con dificultad respiratoria caracterizada por retracciones subcostales y taquipnea persistente, posterior-mente a los 8 meses de edad se agrega hipoxemia respirando aire ambiente que requiere uso de oxígeno suplementario continuo. Tiene antecedente de tres hospitalizaciones, con diagnóstico de Bronquiolitis y Neumonía atípica, realizándose panel viral respiratorio con reporte negativo. El paciente persiste con sintomatología respiratoria a pesar de tratamientos médicos, por lo que se deriva a neumología pediátrica, unidad de enfermedad pulmonar intersticial del lactante, iniciando protocolo de estudio, se realiza tomografía tórax de alta resolución, que evidencia imágenes en vidrio despulido en lóbulo medio y región lingular, además de atrapamiento aéreo. Se concluye el diagnóstico de Hiperplasia de Células neuroendocrinas con base a la clínica y hallazgos tomográficos. La Hiperplasia de Células Neuroendocrinas es una patología pulmonar intersticial poco frecuente, cuyo diagnóstico es clínico y radiológico, en la minoría de los casos se requiere biopsia pulmonar para confirmación. Puede ser fácilmente confundida con otras enfermedades respiratorias comunes, por lo que es importante sospecharla para realizar un diagnóstico precoz. La mayor parte de los casos evolucionan con declinación de los síntomas, mejorando espontáneamente en los primeros años de vida.

A review of the literature and presentation of a clinical case of Neuroendocrine Cell Hyperplasia in a male infant patient who begins his condition at 3 months of age with respiratory distress characterized by subcostal retractions and persistent tachypnea is presented. After 8 months of age hypoxemia is added requiring continuous oxygen therapy. He has a history of three hospitalizations, with a diagnosis of bronchiolitis and atypical pneumonia, respiratory viral panel has a negative report. The patient persists with respiratory symptoms despite medical treatments, so it is referred to pediatric pulmonology, initiating study protocol for interstitial lung disease of the infant. A high resolution chest tomography is performed, which evidences images in polished glass in the middle lobe and lingular region, in addition to air entrapment. The diagnosis of neuroendocrine cell hyperplasia is concluded based on clinical and tomographic findings. Neuroendocrine Cell Hyperplasia is a rare interstitial pulmonary pathology, whose diagnosis is clinical and radiological. Lung biopsy is required only in the minority of cases for confirming diagnosis. It can be easily confused with other common respiratory diseases, so it is important to suspect it to make an early diagnosis. Most cases evolve with decline in symptoms, improving spontaneously in the first years of life.

Association between substance P and chronic prostatitis in rat model / 中华泌尿外科杂志

Objective To explore the correlation between prostate neuroendocrine cells and chronic prostatitis via substance P (SP) detection.Methods Forty SPF-level SD male rats in two months old were randomized into two groups:the chronic prostatitis model group and the control group,20 in each.The model was induced by castration surgery under aseptic condition and post-castration injection of 17-β estrogen for 1 month duration.The control group was done by injection of 0.9％ NS without castration surgery.Making sure that the chronic prostatitis model was made successfully,then SP quantification in the 2 groups was analyzed via ELISA and immunohistochemical staining.Results The difference of SP in the 2 groups was significant (P =0.009) and SP was expressed highly in the model rats compared with controls.Conclusion The relationship between prostate neuroendocrine cells and chronic prostatitis is notable,maybe they participate in progress of chronic prostatitis.

Parallel determination of NeuroD1, Chromogranin-A, KI67 and androgen receptor expression in surgically treated prostate cancers

PURPOSE: Neuroendocrine differentiation is a hallmark of prostate cancer. The aim of our study was the detection of the parallel expression of neuroendocrine related markers using a prostate tissue microarray (TMA). MATERIALS AND METHODS: Our study was aimed at detecting the parallel expression of NeuroD1, Chromogranin-A (ChrA), Androgen Receptor (AR) and Ki-67 by immunohistochemistry on prostate cancer tissue microarray. The data was analyzed using SAS version 8.2 (SAS Inc, Cary, NC). The relationships between NeuroD1, ChrA and AR expressions and patients' characteristics were investigated by multivariate logistic regression analysis. Progression and Overall Survival (OS) distributions were calculated using Kaplan-Meier method. RESULTS: Tissue reactivity for NeuroD1, ChrA and AR concerned 73 percent, 49 percent and 77 percent of the available cases, respectively. Regarding overall survival, there were 87 deaths and 295 patients alive/censored (6 years of median follow-up). Seventy-seven disease progressions occurred at the median follow-up 5.4y. A significant correlation between NeuroD1, ChrA and AR expression was observed (p < 0.001 and p < 0.03, respectively). Additionally, ChrA was strongly associated in multivariate analysis to Gleason score and Ki67 expression (p < 0.009 and p < 0.0052, respectively). Survival analysis showed no association between markers neither for overall nor for cancer-specific survival. CONCLUSIONS: The results highlight that NeuroD1, Chromogranin-A and Androgen Receptor are strongly associated, however their expression does not correlate with overall survival or disease progression.

Hiperplasia de células neuroendócrinas pulmonares difusas com obstrução ao fluxo aéreo / Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia accompanied by airflow obstruction

A hiperplasia de células neuroendócrinas pulmonares difusas com obstrução ao fluxo aéreo é uma lesão pulmonar rara. Todos os casos publicados foram diagnosticados por biópsia pulmonar cirúrgica. Apenas três casos relatados apresentavam opacidades intersticiais difusas na TCAR. Nós relatamos três casos adicionais desta entidade. Todos eram mulheres, com obstrução leve ou moderada ao fluxo aéreo. No primeiro caso, uma biópsia transbrônquica, associada com dados de imagem foram considerados suficientes para o diagnóstico. Um padrão em mosaico foi observado nos três casos, mas no terceiro um infiltrado pulmonar difuso foi também observado. Em casos muito raros, o aspecto na TCAR pode simular aquele encontrado em outras doenças pulmonares intersticiais.

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia with airflow obstruction is a rare form of lung injury. All of the reported cases have been diagnosed by surgical lung biopsy. Only three of the reported cases presented with diffuse interstitial lung opacities on HRCT scans. We report three additional cases of this entity. All of the patients were female and presented with mild-to-moderate airflow obstruction. In the first case, transbronchial biopsy and imaging data were sufficient to make the diagnosis. Although the HRCT scans of all three cases revealed a mosaic pattern, that of the third patient also revealed diffuse interstitial infiltrate. In extremely rare cases, HRCT findings can simulate those seen in other interstitial lung diseases.

Expression patterns of neuroendocrine cells in the duck thymus / 中国兽医学报

The expression patterns of 5-hydroxytryptamine(5-HT),gastrin(Gas),β-endorphin(End),somatostatin(SS),vasoactive intestinal peptide(VIP),glucagon(Glu) and neuropeptide Y(NPY)-positive cells in the duck thymus were studied by the immunohistochemical method associated with image analysis.The result shows that these 7 kinds of neuroendocrine cells with strong intensity were differentially detected in the duck thymus.The End-positive cells were abundantly expressed in the thymic cortex,whereas the Gas,5-HT,SS,VIP,Glu and NPY ones were more frequent in the medullary and around the corticomedullary junction.Except Glu,the other 6 kinds of neuroendocrine substances with various intensity were expressed in the cells of thymic corpuscles.The observation demonstrated that the duck thymus is not only a primary lymphatic organ,but also has important neuroendocrine functions.The End-positive cells in the thymus may play crucial roles in the development of immature T-lymphocytes.The neuroendocrine cells with a predominant distribution in the medulla and around the corticomedullary junction might facilitate exerting their influence via an endocrine,autocrine or paracrine pathways on the function of mature T-cells.The possible roles of thymic corpuscles are also discussed.

Expression of Neuroendocrine Cells in Benign Prostatic Hyperplasia and the Effect of Dihydrotestosterone / 대한비뇨기과학회지

PURPOSE: Neuroendocrine (NE) cells of the prostate are considered to be involved in the pathogenesis of benign prostate hyperplasia (BPH). By a comparative analysis of NE cell density in BPH tissue of men who were either exposed to or not exposed to 5alpha-reductase inhibitor, we investigated the relationship between NE cells and BPH, and the effect of androgen deprivation on NE cells. MATERIALS AND METHODS: Prostate tissue specimens, obtained from 30 men by transurethral resection of the prostate or radical cystoprostatectomy, were used. Of the 30 patients, 10 had a prostate smaller than 25 ml (normal control), the other 20 had a prostate larger than 40ml, 10 of who had taken 5alpha-reductase inhibitor (finasteride) for 3 months before surgery (androgen blockade group), and 10 who had not (BPH group). The distribution of NE cells in the prostate was examined using the anti-chromogranin A (CgA) antibody, and the density of the CgA-positive cells was compared by an optical dissector method. Immunoblotting was performed using the neuron specific enolase (NSE) antibody. A Mann-Whitney U test was used in a statistical analysis. RESULTS: Most of the CgA-positive NE cells were localized between the acinar epithelial cells. The mean numbers of CgA-positive NE cells per acinus in the normal controls and the BPH groups were 1.67+/-0.78 and 4.45+/-2.54, respectively, and the difference was statistically significant (p<0.05). However, the mean number of CgA-positive NE cells in the androgen blockade group, was 4.93+/-2.17, which was similar to the BPH group. In a NSE immunoblotting study, a distinct band was observed in the BPH and androgen blockade groups, but the density of the band was higher in the androgen blockade group. CONCLUSIONS: Our results suggest that NE cells may be involved in the hyperplastic process of BPH. Inhibition of dihydrotestosterone, caused by the oral administration of the 5alpha-reductase inhibitor, failed to induce any significant change in the NE cells, probably due to the incomplete androgen blockade.

Proliferation and apoptosis of neuroendocrine cells in ovarian epithelial tumors / 中国病理生理杂志

AIM: The purpose of this study was to observe the morphological features of neuroendocrine cells(NECs),their proliferation and apoptosis in ovarian epithelial tumors,and to discuss their biological and clinical significance.METHODS: 79 specimens of ovarian epithelial tumor samples were collected,of them 20 benign,18 boderline,41 milignant tumors,and 22 normal ovaries were investigated immunohistochemically.Chromogranin A was used to detect NECs and their proliferation and apoptosis were examined by double-label staining of chromogranin A and Ki67 or TUNEL.RESULTS: The positive rate of CgA,distribution and staining intensity in ovarian epithelial tumors were higher than those in normal ovary.NECs showed various shapes with neuronoid protuberances stretching to the neighboring cells or basement membrane.Occasionally,they might touch together.No TUNEL positive coexpression in all NECs was observed by double-label staining,but some NECs were coexpressed with Ki67.CONCLUSION: NECs of ovarian epithelial tumors like cancer cells showed a proliferation,but no apoptosis.Their secretion might promote their neighboring non-NECs to proliferate and prevent them from apoptosis.