Eosinophilic granulomatous polyangiitis with allergic bronchopulmonary aspergillosis as a comorbidity: a case report and literature review / 中华风湿病学杂志

Objective:To explore the clinical characteristics, diagnosis and treatment of allergic bronchopulmonary aspergillosis(ABPA) with eosinophilic granulomatous with polyvasculitis(EGPA) as a comorbidity.Methods:We collected the clinical data of a patient with EGPA who sought treatment with ABPA as a comorbidity. We summarized the diagnosis and treatment process of the patient, and reviewed the literature. After that, we discussed the relationship between the pathogenesis of ABPA and EGPA and the diagnosis and treatment experience.Results:A 61-year-old male patient suffered from repeated coughing, expectoration, hemoptysis, wheezing. His blood eosinophils count and immunoglobulin (Ig)E level were elevated. He was tested positive for aspergillus fumigatus. His Computer Tomography (CT) showed pulmonary nodules and bronchiectasis. He was diagnosed as ABPA. He also suffered limb numbness, sinusitis, and renal dysfunction and was diagnosed as EGPA. His condition improved after treatment with glucocorticoids, immunosuppressants and antifungal agents. We reviewed the relevant literature and retrieved 10 case reports, of which 5 cases were diagnosed as ABPA first and then EGPA, 3 cases were diagnosed as EGPA first and then ABPA, 2 cases were diagnosed simultaneously. We found that there was a certain correlation between them in the pathogenesis, and the main treatment is glucocorticoids, immunosuppressants and antifungal drugs.Conclusion:ABPA with EGPA as a comorbidity is rarely reported, which reminds us that when diagnosing one of the diseases in clinical work, we should be alert to the coexistence of another disease to avoid misdiagnosis.

Pulmonary function and imaging characteristics of acute exacerbation of chronic obstructive pulmonary disease with elevated eosinophils / 中国医学影像技术

Objective: To explore the characteristic differences of clinical data, inflammatory markers, pulmonary function test, impulse oscillometry system (IOS) and CT parameters of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with peripheral blood eosinophils (EOS) ≥300/μl and those EOS<300/μl, in order to provide strategic guidance for treatment. Methods: A total of 357 AECOPD patients were enrolled, including 41 cases in EOS≥300/μl group (study group) and 316 cases in EOS<300/μl group (control group).Then the clinical indicators, such as inflammation indicators from chronic obstructive pulmonary disease (COPD) assessment test (CAT) score and modified medical research council dyspnea scale (mMRC) assessment, traditional lung functions, IOS indicators, lung volume, emphysema index, emphysema density and other imaging parameters were compared between groups. Results: ①Neutrophils ratio in study group was lower than in control group (64.70% vs 73.00%, P<0.001), while fibrinogen lower (3.59 vs 3.97, P=0.031), C reactive protein lower (3.30 mg/L vs 8.63 mg/L, P=0.012) as well as smoking number lower (25 pack/years vs 40 pack/years, P=0.009) in study group were all lower than those in control group. ②RV/TLC in study group was lower than that in control group (51.91% vs 57.44%, P=0.041), whereas R5 (0.56 vs 0.49, P=0.036) and R5%pred (178.65% vs 155.70%, P=0.027) were higher in study group than those in control group. ③Mean pulmonary emphysema density and PD15 in the whole lung, right lung and left lung in study group were all higher than those in control group (all P<0.05), suggesting that patients in control group had more serious pulmonary parenchymal destruction. Conclusion: AECOPD patients with EOS≥300/μl have more significant pulmonary function impairment due to increased airway resistance, in whom emphysema is less severe than those with EOS<300/μl.

The clinical significance of diagnosis and therapy in patients with adult bronchial asthma by fractional exhaled nitric oxide levels / 中国基层医药

Objective@#To evaluate the sensitivity and specificity of exhaled nitric oxide in the diagnosis and therapy of bronchial asthma.@*Methods@#From January 2016 to December 2017, 87 patients diagnosed with bronchial asthma in Luoyang Central Hospital Affiliated to Zhengzhou University were selected as asthma group , and 40 healthy people were selected as healthy control group at the same term.The levels of FeNO, FEV1/pred, peripheral blood EOS count, ACT score, percentage of sputum EOS were measured.@*Results@#The positive rate of FeNO was 56.3%(49/87) in the asthma group, which in the healthy control group was 5.0%(2/47). The fractional exhaled nitric oxide level of reexamined patients before treatment [(70.9±53.6)ppb] was higher than that after treatment[(12.2±8.7)ppb], and the difference was statistically significant(t=4.323, P=0.001). The fractional exhaled nitric oxide level in the asthma group [(42.4±42.5)ppb] was higher than that in the healthy control group [(9.4±5.8)ppb], and the difference between the two groups was statistically significant(t=2.871, P=0.001). The fractional exhaled nitric oxide level was positively correlated with peripheral blood EOS count (r=0.376, P=0.000) and ACT score (r=0.361, P=0.001), but had no correlation with FEV1/pred (r=-0.111, P=0.306) and sputum EOS (r=-0.036, P=0.805).@*Conclusion@#The measurement of fractional exhaled nitric oxide levels has an important clinical significance in the diagnosis of bronchial asthma.And it has a guiding significance for the evaluation of the therapeutic effect of bronchial asthma.

Analysis of clinical features of 40 cases with asthma-chronic obstructive pulmonary overlap syndrome / 中国基层医药

Objective@#To analyze the clinical characteristics of patients with asthma-chronic obstructive pulmonary overlap syndrome (ACOS).@*Methods@#From January 2015 to December 2017, 40 patients with ACOS, 40 patients with asthma and 40 patients with chronic obstructive pulmonary disease(COPD) in Zhoushan Hospital were collected.The general information, laboratory test indicators, lung function test indicators and FEV1 mutation after bronchodilator test were compared among the three groups.@*Results@#There were statistically significant differences in age[(45.36±5.27) vs. (54.45±4.69) vs. (67.57±5.18), F=9.334, P=0.004], the proportion of smoking patients (92.50% vs. 75.00% vs. 60.00%, χ2=11.550, P=0.003), and the proportion of family history of asthma (7.50% vs. 20.00% vs. 30.00%, χ2=6.562, P=0.038) among the patients with ACOS, asthma and COPD.The percentage of eosinophils in peripheral blood [(8.46±0.94)% vs. (6.13±0.78)% vs. (3.75±0.45)%, F=11.626, P=0.001] and the serum IgE levels [(353.41±45.74)IU/mL vs. (252.65±30.45)IU/mL vs. (155.26±22.77)IU/mL, F=7.605, P=0.001] were decreased in turn, the differences were statistically significant.The FEV1/FVC% and FEV1% pred in the ACOS group were lower than those in the asthma group [(54.26±6.86)% vs. (72.43±8.52)%, t=10.506, P=0.001 and (50.35±6.22)% vs. (62.60±7.52)%, t=7.939, P=0.001], however, there were no significant differences compared with the COPD group[(54.26±6.86)% vs. (53.88±7.25)%, t=0.241, P=0.810 and (50.35±6.22)% vs. (50.56±6.46)%, t=0.148, P=0.883]. The proportion of small airway dysfunction in the ACOS group was higher than that in the asthma group (82.50% vs. 57.50%, χ2=5.952, P=0.015), however, there was no statistically significant difference compared with COPD group(82.50% vs. 85.00%, χ2=0.092, P=0.762). The RV/TLC% in the ACOS group was higher than that in the asthma group [(46.71±5.31)% vs. (32.46±4.52)%, t=12.924, P=0.001], however, there was no statistically significant difference compared with the COPD group [(46.71±5.31)% vs. (46.92±5.75)%, t=0.170, P=0.866]. The DLCO% in the ACOS group was lower than that in the asthma group [(64.37±4.66)% vs (82.62±4.53)%, t=17.760, P=0.001], but higher than that of the COPD group [(64.37±4.66)% vs. (51.25±4.35)%, t=13.017, P=0.001]. After bronchodilator test, the FEV1 mutation rate of the ACOS group was higher than that of the COPD group [(20.86±2.05)% vs. (6.52±0.55)%, t=42.730, P=0.001], but there was no statistically significant difference compared with the asthma group [(20.86±2.05)% vs. (21.13±2.14)%, t=0.576, P=0.566].@*Conclusion@#Compared with asthma patients, the age of ACOS patients is older, the percentage of peripheral blood eosinophils and the level of serum IgE are lower, the pulmonary ventilation function is lower, the airway dysfunction is more significant, the residual volume is more significant, the lung diffuse function is lower, acidic granulocyte airway inflammation is mild.But compared with patients with COPD, the age of ACOS patients is younger, the percentage of peripheral blood eosinophils and serum IgE levels are higher, the lung diffuse function is higher, and acidic granulocyte airway inflammation is heavier.

Diagnostic challenge of parotid multifocal adenomatous oncocytic hyperplasia: A case report

@#Parotid glands have diverse histological findings thanks to abundant different types of cells presence in the gland. Our routine fine needle aspiration cytology might be inaccurate and misleading in cases where there are cell changes due to ongoing concurrent infection and chronic sialadenitis, which might have mimicked tumoural changes. We highlighted a rare case of multiple florid benign hyperplasia of oncocytic cells of the parotid gland that manifest as parotid swelling. The characteristic multifocality of the lesion and high rate of recurrences, although not a known malignant entity, resulting in a significant shift in the treatment plan for the patient.

Analysis of clinical features of 40 cases with asthma-chronic obstructive pulmonary overlap syndrome / 中国基层医药

Objective To analyze the clinical characteristics of patients with asthma-chronic obstructive pulmonary overlap syndrome (ACOS).Methods From January 2015 to December 2017,40 patients with ACOS,40 patients with asthma and 40 patients with chronic obstructive pulmonary disease (COPD) in Zhoushan Hospital were collected.The general information,laboratory test indicators,lung function test indicators and FEV1 mutation after bronchodilator test were compared among the three groups.Results There were statistically significant differences in age[(45.36 ±5.27) vs.(54.45 ±4.69) vs.(67.57 ±5.18),F=9.334,P=0.004],the proportion of smoking patients (92.50％ vs.75.00％ vs.60.00％,x2 =11.550,P =0.003),and the proportion of family history of asthma (7.50％ vs.20.00％ vs.30.00％,x2 =6.562,P =0.038) among the patients with ACOS,asthma and COPD.The percentage of eosinophils in peripheral blood [(8.46 ± 0.94) ％ vs.(6.13 ± 0.78) ％ vs.(3.75 ±0.45) ％,F =11.626,P =0.001] and the serum IgE levels [(353.41 ± 45.74) IU/mL vs.(252.65 ± 30.45) IU/ mL vs.(155.26 ± 22.77) IU/mL,F =7.605,P =0.001] were decreased in turn,the differences were statistically significant.The FEV1/FVC％ and FEV1％ pred in the ACOS group were lower than those in the asthma group [(54.26 ± 6.86) ％ vs.(72.43 ± 8.52) ％,t =10.506,P =0.001 and (50.35 ± 6.22) ％ vs.(62.60 ± 7.52) ％,t =7.939,P =0.001],however,there were no significant differences compared with the COPD group [(54.26 ± 6.86)％ vs.(53.88 ±7.25)％,t =0.241,P =0.810 and (50.35 ±6.22)％ vs.(50.56 ±6.46)％,t =0.148,P =0.883].The proportion of small airway dysfunction in the ACOS group was higher than that in the asthma group (82.50％ vs.57.50％,x2 =5.952,P =0.015),however,there was no statistically significant difference compared with COPD group(82.50％ vs.85.00％,x2 =0.092,P =0.762).The RV/TLC％ in the ACOS group was higher than that in the asthma group [(46.71 ± 5.31) ％ vs.(32.46 ± 4.52) ％,t =12.924,P =0.001],however,there was no statistically significant difference compared with the COPD group [(46.71 ± 5.31)％ vs.(46.92 ± 5.75)％,t =0.170,P =0.866].The DLCO％ in the ACOS group was lower than that in the asthma group [(64.37 ±4.66) ％ vs (82.62 ± 4.53) ％,t =17.760,P =0.001],but higher than that of the COPD group [(64.37 ± 4.66) ％ vs.(51.25 ± 4.35) ％,t =13.017,P =0.001].After bronchodilator test,the FEV1 mutation rate of the ACOS group was higher than that of the COPD group [(20.86 ± 2.05) ％ vs.(6.52 ± 0.55) ％,t =42.730,P =0.001],but there was no statistically significant difference compared with the asthma group [(20.86 ± 2.05)％ vs.(21.13 ±2.14)％,t =0.576,P=0.566].Conclusion Compared with asthma patients,the age of ACOS patients is older,the percentage of peripheral blood eosinophils and the level of serum IgE are lower,the pulmonary ventilation function is lower,the airway dysfunction is more significant,the residual volume is more significant,the lung diffuse function is lower,acidic granulocyte airway inflammation is mild.But compared with patients with COPD,the age of ACOS patients is younger,the percentage of peripheral blood eosinophils and serum IgE levels are higher,the lung diffuse function is higher,and acidic granulocyte airway inflammation is heavier.

The clinical significance of diagnosis and therapy in patients with adult bronchial asthma by fractional exhaled nitric oxide levels / 中国基层医药

Objective To evaluate the sensitivity and specificity of exhaled nitric oxide in the diagnosis and therapy of bronchial asthma.Methods From January 2016 to December 2017,87 patients diagnosed with bronchial asthma in Luoyang Central Hospital Affiliated to Zhengzhou University were selected as asthma group ,and 40 healthy people were selected as healthy control group at the same term.The levels of FeNO,FEV1/pred,peripheral blood EOS count,ACT score,percentage of sputum EOS were measured.Results The positive rate of FeNO was 56.3% (49/87) in the asthma group,which in the healthy control group was 5.0% (2/47).The fractional exhaled nitric oxide level of reexamined patients before treatment [(70.9 ± 53.6) ppb] was higher than that after treatment[(12.2 ± 8.7)ppb],and the difference was statistically significant(t=4.323,P=0.001).The fractional exhaled nitric oxide level in the asthma group [( 42. 4 ± 42. 5 ) ppb] was higher than that in the healthy control group [( 9. 4 ± 5.8)ppb],and the difference between the two groups was statistically significant(t=2.871,P=0.001).The frac-tional exhaled nitric oxide level was positively correlated with peripheral blood EOS count (r=0.376,P=0.000) and ACT score (r=0.361,P=0.001),but had no correlation with FEV1/pred (r= -0.111,P=0.306) and sputum EOS ( r = -0.036,P =0.805). Conclusion The measurement of fractional exhaled nitric oxide levels has an important clinical significance in the diagnosis of bronchial asthma.And it has a guiding significance for the evaluation of the therapeutic effect of bronchial asthma.

The application of serum total IgE and fractional exhaled nitric oxide levels in guiding asthma-chronic obstructive pulmonary disease overlap syndrome / 中国医师进修杂志

Objective To provide clues for the diagnosis standard, laboratory examination and pathological mechanism of asthma and chronic obstructive pulmonary disease overlap syndrome(ACOS) by detecting the levels of serum total IgE, fractional exhaled nitric oxide (FeNO) and peripheral blood oxyphil cells in asthma, chronic obstructive pulmonary disease (C0PO) and ACOS. Methods A prospective randomized trial based on hospital was conducted. According to the diagnostic criteria and inclusion criteria, 40 asthma patients(asthma group), 25 cases of patients with COPD(COPD group)and 37 cases of ACOS patients(ACOS group)were collected continuously, and 40 healthy persons(healthy control group) were as the research object. General data and biochemical indexes were tested in each group. The levels of serum total IgE, FeNO and peripheral blood oxyphil cells in each group were observed and compared.The correlation between serum total IgE and other biochemical parameters were analyzed by Pearson correlation analysis. Results The level of total serum IgE in asthma group was significantly higher than that in other groups(P<0.05),and the level of total serum IgE in ACOS group was the second(P<0.05).The level of total serum IgE in healthy control group and COPD group had no significant difference(P>0.05).The level of FeNO in four groups had significant difference(P<0.05), and the level of FeNO in ACOS group and asthma group had significant difference compared with that of COPD group (P < 0.05). The level of peripheral blood oxyphil cells in asthma group, ACOS group, COPD group was significantly higher than that in healthy control group (P < 0.05), and the change of ACOS group was the best obviously.Conclusions Serum total IgE, FeNO and peripheral blood oxyphil cells are specific detection index in ACOS.Combined detection can help to identify ACOS, asthma and COPD, also reveal the presence of airway inflammation in the pathogenesis of ACOS, and can provide the basis for clinical diagnosis, treatment and prevention.

Oncocytic Renal Cell Carcinoma with Tubulopapillary Growth Having a Fat Component

We report a rare case of oncocytic renal cell carcinoma (RCC) with tubulopapillary growth in the background of tuberculous end-stage kidney disease. Histology of the renal mass consisted of oncocytic cells forming solid, thin tubules and rare papillae. The tumor had abundant eosinophilic oncocytic cells containing occasional cytoplasmic Mallory body-like hyaline globules and a tiny focus of clear cells with intervening mature fat. Both the oncocytic cells and clear cells were immunoreactive for a-methylacyl-CoA racemase, vimentin, pancytokeratin, and CD10, and negative for transcription factor E3, CD15, human melanoma black 45, and c-kit. Mallory body-like hyaline globules were positive for CAM 5.2 and periodic acid-Schiff with or without diastase. Ultrastructurally, the tumor cells had abundant cytoplasmic mitochondria. The present case is a rare case of oncocytic RCC with tubulopapillary growth pattern. The case is unique in that the tumor was mixed with fat component, which is not common in RCC and thus can lead to misdiagnosis.

Case of Incidental Oncocytic Adrenocortical Neoplasm / 대한내과학회지

Adrenal oncocytomas are very rare. Because most of them are benign and nonfunctioning, they are detected incidentally. Here, we report a case of nonfunctioning benign adrenocortical oncocytoma located in the left adrenal gland in a 54-year-old man who presented with no symptoms. The tumor was 4.5 x 3 x 3 cm in size and was predominantly composed of oncocytes, which exhibited abundant eosinophilic granular cytoplasm and were arranged with a nested or diffuse architecture without capsular or vascular invasion. Nuclear atypia and mitotic figures were not observed. A discussion of this case and a review of recent updates in the literature are presented. In patients with adrenocortical oncocytomas, treatment is similar to that for adrenocortical neoplasia. However, due to the risk of over-diagnosis of malignancy, and the better clinical outcomes associated with adrenocortical oncocytoma, more attention should be paid to the diagnosis of adrenocortical oncocytoma.

Melanotic Oncocytic Metaplasia of the Nasopharynx: A Report of Three Cases and Review of the Literature

Melanotic oncocytic metaplasia of the nasopharynx is a rare condition which is characterized by the presence of usually a small, brown to black colored pigmented lesion around the Eustachian tube opening. Although it is a benign lesion, it may be clinically misdiagnosed as malignant melanoma. Microscopically, melanotic oncocytic metaplasia is a combination of oncocytic metaplasia of the epithelium of the gland and melanin pigmentation in its cytoplasm. In our present study, we report three cases of melanotic oncocytic metaplasia of the nasopharynx. All the three cases occurred in men and were presented as multiple black pigmented lesions around the torus tubarius. Microscopically, mucous glands with diffuse oncocytic metaplasia and numerous black pigments were observed. No cellular atypia was observed. Immunohistochemically, the scattering of S-100 protein-positive, and human melanoma black 45-negative dendritic melanocytes was evident. This is the first report of cases of melanotic oncocytic metaplasia of the nasopharynx in Korea.

Large Oncocytic Adrenocortical Tumor with Uncertain Malignant Potential

Oncocytoma is a neoplasm consisting of oncocytes that is found in the salivary gland, kidney, and thyroid. Adrenocortical oncocytoma is particularly uncommon, and most cases reported are benign and nonfunctioning. Here, we report a 20 cm adrenal mass associated with necrosis that was identified as an oncocytic adrenocortical tumor with uncertain malignant potential through histopathological evaluation after its resection.

Comparisom of different methods of determination of eosinophil cells / 中国基层医药

Objective To comparisom five methods of detection of eosinophil cells,in order to analyze the precision of the five methods.Methods The eosinophil cells of 100 patients were tested by using microscope、BC T5difft and flow cytometry are(0.249 ±0.112) × 109/L,(0.253 ±0.105) × 109/L,(0.252 ±0.103) × 109/L,(0.256 ±0.104) × 109/L and(0.259 ±0.101) × 109/L.There are no statistical differences(F = 1.225,P＞0.10)among the five methods.Conclusion The results of the five methods are all accurate;the automatic analyzer method and the flow cytometry method are simple and repeatable,but the equipment and reagents are more expensive;the microscope direct counting method is more complicated and less repeatable.

Clinical value of the interleukin-19 level in peripheral blood of patients with bronchial asthma / 中国医师进修杂志

Objective To study the level of interleukin(IL)-19 in peripheral blood of patients with asthma and investigate its importance.Methods Serum samples were obtained from 45 asthmatic patients (acute attack group and catabasis group) and 45 subjects (control group).The level of IL-19 and IgE in peripheral blood was respectively determined with ELJSA.The accurate number of eosinophile granulocyte (EOS) in peripheral blood was counted with cytoanalyze.Results The levels of IL-19,IgE and the quantity of EOS were (327.92 ± 245.79) ng/L,(260.48 ± 108.77) kU/L,(498.29 ± 96.46) x 107L in acute attack group,(165.54 ± 114.76) ng/L,(164.33 ± 59.08) kU/L,(224.67 ± 86.28) x 106/L in catabasis group,and (49.67 ±40.48) ng/L,(68.12 ± 25.70) kU/L,(31.84 ± 28.27) x 106/L in control group.Compared with control group,the levels of IL-19,IgE and the quantity of EOS in acute attack group and catabasis group were obvious higher than those in control group (P < 0.05).The level of IL-19 and the quantity of EOS in acute attack group were higher than those in catabasis group (P <0.05),but there was no significant difference in the level of IgE between acute attack group and catabasis group (P > 0.05).Furthermore,the results of correlation analysis showed that the level of IL-19 positively correlated with the level of IgE and the quantity of EOS respectively (r = 0.826 >0.738,P< 0.05).Conclusions The ascending degree of the IL-19 level is different during various periods of asthma.It may be inferred that IL-19 can play an important role in the pathogenesis of asthma,and observing the change of the IL-19 level dynamically is useful in diagnosing asthma and monitoring patient's condition.

Oncocytoma and Oncocytic Carcinoma of the Salivary Glands, Single Institute Experience

BACKGROUND: Oncocytic neoplasms of the salivary glands are rare and the differential diagnosis between oncocytic carcinomas (OCs) and oncocytomas is difficult. We present 5 cases of oncocytoma and 3 cases of OC of the salivary glands with clinicopathological and immunohistochemical comparisons. METHODS: Eight cases of oncocytic neoplasms diagnosed at Asan Medical Center between 1998 and 2009 were reviewed for clinical data and histological features. Immunohistochemical staining for epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (Her-2), c-kit, p53, and Ki-67 was done. RESULTS: Cytological differences between oncocytomas and OCs were not obvious, but unequivocal infiltrative growths were identified in 3 cases, rendering the diagnosis of oncocytic carcinoma. When the remaining cases were classified as oncocytomas, there was no difference in age, size, and clinical symptoms between oncocytomas and OCs. Two of 3 OCs showed strong membranous expression of c-kit, but all oncocytomas were negative. The proportion of p53-positive cells was larger in OCs than oncocytomas. Her-2 or EGFR expression was absent, and Ki-67 labeling indices were less than 1% in all cases. CONCLUSIONS: An infiltrative growth pattern, strong membranous expression of c-kit, and an increased proportion of p53-positive cells are features that can differentiate OCs from oncocytomas of the salivary glands.

Responses of parathyroid gland, C cells, and plasma calcium and inorganic phosphate levels in rat to sub-lethal heroin administration.

In order to record the effects of heroin on plasma calcium (Ca) and inorganic phosphate (Pi) levels as well as parathyroid gland and C cells, two sub-lethal doses (0.50 LD50 and 0.75 LD50) of the drug were administered intramuscularly in Rattus norvegicus for 30 days. Plasma Ca level of control rats ranged between 9.53±0.32 - 9.88±0.22 mg 100 ml-1 while plasma Pi concentration fluctuated between 4.55±0.18 - 4.71±0.24 mg 100 ml-1. Sub-lethal heroin administration induced progressive increase in plasma Ca level during the first seven days (p <0.001), thereafter the level declined on day 15 and 30. However, plasma Pi level of the heroin-treated rats registered increase with the peak value (p <0.001) on day 30. The treatment elicited degenerative changes in parathyroid gland as evident by cytoplamic vacuolization, presence of more pycnotic nuclei and occurrence of patchy areas among the chief cells. Degenerative changes were also noticed in cristae of mitochondria, Golgi complex and endoplasmic reticulum. There was decrease in chromatin material in the nucleus and loss of hormone granules in the cytoplasm. Oxyphil cells of the heroin-treated rat depicted dilation of endoplasmic reticulum and damaged cristae. Sub-lethal heroin administration in the rat for 30 days induced dilation in endoplasmic reticulum and loss of secretory granules in C cells.

Analysis of the mitochondrial D-loop sequence in a patient with thyroid Hurthle cell carcinoma and sacral bone metastasis / 대한내과학회지

Hurthle cell carcinoma, an oncocytic variant of follicular thyroid carcinoma, has a higher malignancy potential than well differentiated thyroid carcinomas. It has a tendency to metastasize easily to the lungs and bones, although isolated sacral bone metastasis has been rarely reported. Hurthle cell carcinoma has been characterized by increased mitotic activity and abundant abnormal mitochondria, which have profound mitochondrial DNA (mtDNA) alterations. In general, a well-known hypothesis is that genomic alteration, especially microsatellite instability of the mtDNA D-loop, might result in whole mtDNA instability as seen in Hurthle cell carcinoma. Recently, we experienced a case of Hurthle cell carcinoma that presented with extensive sacral bone metastasis. To investigate the relationship between mtDNA genomic instability and metastatic potential in this case, we performed direct sequencing of the mtDNA D-loop in samples extracted from normal thyroid tissue, thyroid carcinoma tissue, and sacral bone metastasis tissue. Here, we describe the results of mtDNA D-loop sequencing and present a literature review.

Thyroglobulin Synthesis of Oxyphilic Cells in Various Types of Neoplastic and Autoimmune Thyroid Diseases

To determine the content of thyroglobulin in oxyphilic cells of the thyroid, which have been considered as non-thyroglobulin producing cells, the degree of stainability of the various oxyphilic cells for thyroglobulin was compared with that of non-oxyphilic follicular cells in either same or different lesion. A total of 13 oxyphilic lesions, including three follicular adenomas containing oxyphilic cell nodules, four pure oxyphilic cell adenomas, and six Hashimoto's thyroiditis were compared with 16 of non-oxyphilic lesions such as, seven follicular adenomas, four chronic lymphocytic thyroiditis, and five Graves' disease. Many oxyphilic cells stained positively for thyroglobulin regardless of their morphologic variation, but less intensely than the usual follicular cells in follicular adenomas, chronic lymphocytic thyroiditis, and Graves' disease. The stainability of oxyphilic cells for thyroglogulin did not show any significant correlation with morphologic features, whereas in follicular adenomas, the non-oxyphilic follicular cells forming microfollicles stained less strongly for thyroglobulin than the same cells lining large mature follicles in a reproducible way. With above findings, we concluded that oxyphilic cells maintain the functional activity in terms of thyroglobulin synthesis, although the content of the thyroglobulin is less than that of non-oxyphilic colloid forming follicular cells.