Distribution of Histologic Subtypes of Basal Cell Carcinoma by Facial Aesthetic Unit and Subunit / 대한피부과학회지

BACKGROUND: Surgical removal and reconstruction in basal cell carcinoma(BCC) located in the face is important both functionally and cosmetically, however, evaluation of clinical and histological characteristics of BCC in view of dermatologic surgery is not enough. OBJECTIVE: To assess the anatomic distribution of primary and recurrent BCCs, and of histological subtypes based on facial aesthetic units and subunits. And to establish their importance and their application to the dermatologic surgery field. METHODS: We reviewed patients' charts to extract clinical data and reexamined their histologic patterns on the excised specimen, classifying then into 5 categories and mapped the anatomical location of the histologic subtype on schematic drawings of the facial the aesthetic unit and subunit. RESULTS: The location of occurrence in BCCs were on the junctional lines, nose, periorbital area respectively. Of 60 cases occurred in H-zone, 48 cases(80%) occurred in T-zone, and of 9 recurrent cancers occurred in H-zone, 7 cases occurred in T-zone. Among the 5 histologic subtypes, the nodular type was the most common on each of the aesthetic units. And in the junctional lines, the nodular type occurred in almost all cases. The nodulomorpheic type occurred relatively more on forehead, nose and infraorbital area of the cheek. CONCLUSION: We confirmed the relationship between the clinical, histological characteristics and facial aesthetic unit and subunit. And we also proved that T-zone was the most dangerous zone.

Distribution of S-100 Protein Positive Dendritic Cell and its Correlation with Degree of Malignancy in Gastric Carcinoma

The present study was performed in order to investigate the correlation among the number of T zone histiocytes, the clinicopathologic parameters and the patient's survival. The subjects in this study were 131 advanced gastric carcinomas including 86 follow-up cases and 41 early gastric carcinomas. The infiltration of T zone histiocytes into tumor tissues was investigated using the immunohistochemical method with andti s-100 protein, nd the data obtained were evaluated statistically. T zone histiocytes were scattered among the cancer cells and in areas formed clusters within the cancer stroma. These cells were abundantly present in tumor tissues and around lymphoid follicles but were rarely seen in surrounding normal stomach tissue. Analysis of the number of T zone histiocytes showed no correlation between the number of T zone histiocytes and the clinicopathologic features except the degree of lymphocytic infiltration within the advanced and the early gastric carcinomas. Survival of the patients with a marked infiltration of T zone histiocytes in stage III was longer than that with mild infiltration of T zone histiocytes, but there was no statistical significance(P value=0.084). Multivariate regressio analysis revealed that the depth of invasion(P value=0.0074) and the lymphocytic infiltration(P value=0.0152) were the important prognostic factors. The results indicate that good prognosis is expected in cases with less deep invasion and high lymphocytic infiltration, and that the number of T zone histiocytes is in proportio to the degree of lymphocyte infiltration within the tumor, although not directly correlated with the patient's survival.

An Immunohistochemical Study of Proliferative Disorders of Histiocytes

ln an attempt to clarify the dual origin histiocytes and to reclassify histiocytic proliferative disorders according to their immunohistochemical properties, normal histiocytes and histiocytes in selected proliferative disorders were stained using the peroxidase-antiperoxidase method for lysozyme, 1-antichymotrypsin and for S-100 protein. The proliferated histocytes of cosinophilic granutoma and Letterer-siwe disease were strongly immunoreactive for S-100 protein. In histiocytic medullary reticulosis (HMR) and in histiocytic lymphoma, all three markers were found within the tumor cells. ln fibrous histiocytoma and in juvenile xanthogranuloma, only a few weakly immunoreactive cells for S-100 protein were observed. lnflammatory malignant fibrous histiocytoma(MFH) (Xanthosarcoma) and xanthoma were immunoreactive for 1-antichymotrypsin and lysozyme respectively. ln MFH of the storiform -pleomorphic type and in atypical fibroxanthoma, stains using all of the histiocytic markers were negative. These results suggest that eosinophilic granuloma. Letterer-Siew disease, fibroxanthoma and juvenile xanthogranloma are proliferative disorder of T-zone histiocytes; HMR and histiocytic lymphoma are those of pluripotential stem cells capable of dual histiocytic differentiation; xanthoma and xanthosarcoma are monocytic proliferative disease; and MFH of the storiform-pleomorphic type and atypical fibroxanthoma are not true histiocytic diseases.