ABSTRACT
Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine carcinoma of the skin, arising from pluripotent precursors of Merkel cells. The tumor most frequently affects head and neck of elderly patients. It increases with sun exposure and after immunosuppression and organ transplantation. Because of a possible viral association, interest in MCC has escalated. A new polyomavirus, Merkel cell polyomavirus (MCPyV), was identified and associated to MCC. In support of this hypothesis, we report three new clinical cases of MCC in which we detected MCPyV by immunohistochemistry and provide an update on current thinking about the MCC.
Subject(s)
Carcinoma, Merkel Cell/diagnosis , Polyomavirus Infections/diagnosis , Skin Neoplasms/diagnosis , Tumor Virus Infections/diagnosis , Aged , Aged, 80 and over , Carcinoma, Merkel Cell/pathology , Female , Humans , Immunohistochemistry/methods , Merkel cell polyomavirus/isolation & purification , Polyomavirus Infections/pathology , Polyomavirus Infections/virology , Skin Neoplasms/pathology , Skin Neoplasms/virology , Tumor Virus Infections/pathology , Tumor Virus Infections/virologySubject(s)
Nevus, Sebaceous of Jadassohn/pathology , Skin Neoplasms/pathology , Adult , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/surgery , Cystadenoma/diagnosis , Cystadenoma/pathology , Cystadenoma/surgery , Epidermal Cyst/diagnosis , Epidermal Cyst/pathology , Epidermal Cyst/surgery , Female , Follow-Up Studies , Humans , Nevus, Sebaceous of Jadassohn/diagnosis , Nevus, Sebaceous of Jadassohn/surgery , Sebaceous Gland Neoplasms/diagnosis , Sebaceous Gland Neoplasms/pathology , Sebaceous Gland Neoplasms/surgery , Skin Neoplasms/diagnosis , Skin Neoplasms/surgery , Syringoma/diagnosis , Syringoma/pathology , Syringoma/surgeryABSTRACT
Latency period in cutaneous leishmaniasis was very rarely studied so far. We describe three patients, aged 71, 50 and 32 years, respectively, who contracted cutaneous leishmaniasis in Sicily. In all patients, clinical diagnosis was confirmed by histopathological examination and polymerase chain reaction: the latter was positive for Leishmania infantum in two patients and Leishmania canis in one. All cases were characterized by a very long period of latency, ranging from 11 to 16 months. These cases suggest that latency time of cutaneous leishmaniasis acquired in Sicily may be sometimes very long. The reasons of this latency time are unknown: latency depends neither by the involved species of sandflies and Leishmania nor by the immunological response of the patients: all laboratory tests, including immunological ones, were normal.
Subject(s)
Leishmania/isolation & purification , Leishmaniasis, Cutaneous/diagnosis , Adult , Aged , Animals , Antiprotozoal Agents/administration & dosage , Biopsy , Cryotherapy , Female , Humans , Injections, Intralesional , Leishmania infantum/isolation & purification , Leishmaniasis, Cutaneous/therapy , Male , Middle Aged , Organometallic Compounds/administration & dosage , Polymerase Chain Reaction , Psychodidae , Sicily , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: The determination of clonality has proven to be a useful adjunct to the diagnosis of cutaneous lymphocytic infiltrates. It is considered particularly helpful for the distinction of mycosis fungoides (MF) and inflammatory dermatoses. OBJECTIVES: To verify the sensitivity of the polymerase chain reaction (PCR)-heteroduplex analysis of T-cell receptor gamma-chain gene (TCRgamma) rearrangements in patients with MF and to establish whether a clinicopathological re-evaluation of lesions previously unclassified or considered to be non-neoplastic entities but found to be monoclonal allowed the recognition of additional cases of MF. METHODS: Included in the study were 116 patients, seen at our Institute from April 2002 to September 2003 and tested for TCRgamma rearrangements. Thirty-six patients were affected by clinically and histopathologically proven MF, while the remaining 80 cases had not been classified or had been classified as non-neoplastic entities. The sensitivity of the molecular analysis was determined on the basis of the results obtained in the 36 patients with MF. The 29 cases of the second series of patients found to be monoclonal were clinically and histopathologically re-evaluated. RESULTS: Clonal rearrangements were found in 87.5% of patients with plaque stage MF and in 20% of those with patch stage MF. The clinicopathological re-evaluation allowed us to reclassify 15 of 29 monoclonal cases of the second series of patients as MF. CONCLUSIONS: The study showed that the PCR-heteroduplex technique can determine a high percentage of monoclonality only in plaque stage MF. However, in spite of the low sensitivity of the method, several cases previously unrecognized could be reclassified as MF when their clinical and histopathological features were re-evaluated taking into account the clonality of the lymphocytic infiltrate.
Subject(s)
Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor/genetics , Mycosis Fungoides/genetics , Skin Neoplasms/genetics , Diagnosis, Differential , Heteroduplex Analysis/methods , Humans , Mycosis Fungoides/diagnosis , Mycosis Fungoides/pathology , Neoplasm Staging , Polymerase Chain Reaction/methods , Sensitivity and Specificity , Skin Neoplasms/diagnosis , Skin Neoplasms/pathologySubject(s)
Anti-Anxiety Agents/adverse effects , Flunitrazepam/adverse effects , Leg Ulcer/chemically induced , Staphylococcal Infections/diagnosis , Substance Abuse, Intravenous/complications , Adult , Anti-Anxiety Agents/administration & dosage , Diagnosis, Differential , Flunitrazepam/administration & dosage , Humans , Injections, Intravenous , Leg Ulcer/complications , Leg Ulcer/pathology , Male , Necrosis , Staphylococcal Infections/complications , Staphylococcal Infections/pathology , Staphylococcus aureus/isolation & purificationABSTRACT
We report a case of cutaneous mixed tumor (CMT) composed of tubular branching structures lined by cells with apocrine characteristics. In addition, an apocrine duct in the outer sheath of an hair follicle was connected to the mixed tumor, a previously unreported finding. Follicular and sebaceous differentiation have been described in CMT, leading some observers to suggest the existence of an apocrine type of CMT and its presumed differentiation toward the folliculo-sebaceous-apocrine unit (FSAU). Our case demonstrated continuity of an apocrine duct in the FSAU and lends support to the previous speculations about the histogenesis of apocrine type of CMT.
Subject(s)
Apocrine Glands/pathology , Apolipoproteins , Glycoproteins , Membrane Transport Proteins , Skin Neoplasms/pathology , Sweat Gland Neoplasms/pathology , Apocrine Glands/chemistry , Apolipoproteins D , Biomarkers, Tumor/analysis , Carrier Proteins/analysis , Female , Hair Follicle/chemistry , Hair Follicle/pathology , Humans , Immunohistochemistry , Middle Aged , S100 Proteins/analysis , Sebaceous Glands/chemistry , Sebaceous Glands/pathologyABSTRACT
We report a case of cutaneous mixed tumor (CMT) composed of tubular branching structures lined by cells with apocrine characteristics. In addition, an apocrine duct in the outer sheath of an hair follicle was connected to the mixed tumor, a previously unreported finding. Follicular and sebaceous differentiation have been described in CMT, leading some observers to suggest the existence of an apocrine type of CMT and its presumed differentiation toward the folliculo-sebaceous-apocrine unit (FSAU). Our case demonstrated continuity of an apocrine duct in the FSAU and lends support to the previous speculations about the histogenesis of apocrine type of CMT.
Subject(s)
Apocrine Glands/pathology , Apolipoproteins , Glycoproteins , Membrane Transport Proteins , Skin Neoplasms/pathology , Apocrine Glands/chemistry , Apolipoproteins D , Biomarkers, Tumor/analysis , Carrier Proteins/analysis , Female , Hair Follicle/pathology , Humans , Immunohistochemistry , Middle Aged , Nose Neoplasms/chemistry , Nose Neoplasms/pathology , S100 Proteins/analysis , Sebaceous Glands/pathology , Skin Neoplasms/chemistryABSTRACT
We report a patient with multiple apocrine hidrocystoma (cystadenoma) which was characterized by bilateral distribution of the lesions on the eyelids. The disease is benign, but it may be a marker of two rare inherited disorders, the Schöpf-Schulz-Passarge syndrome and a peculiar form of focal dermal hypoplasia.
Subject(s)
Eyelid Neoplasms/pathology , Hidrocystoma/pathology , Sweat Gland Neoplasms/pathology , Female , Humans , Middle AgedABSTRACT
The current view that coexpression of intermediate filaments (IFs) must be considered a bizarre and unpredictable phenomenon, which seriously jeopardizes the use of their localization in diagnostic applications, is critically reviewed in light of the evidence so far acquired by investigations in vivo and in vitro. A less dogmatic approach, which considers IF expression the result of a series of interactions between cells and their microenvironment instead of a function of their histogenesis, not only justifies the complex variety of coexpressions observed in normal and neoplastic tissues but also confirms the usefulness of IF expression in diagnostic applications and offers new opportunities for investigations, with special regard to immunoelectron microscopy.
