RESUMO
Melanocytic nevi can undergo clinical and histopathologic changes during pregnancy, as well as after various forms of surgical and nonsurgical trauma. We report the case of a 9-month postpartum 29-year-old female who presented to her dermatologist with a clinically worrisome nevus. This nevus had been treated with liquid nitrogen by her primary care physician 6 months prior to presentation. Histopathologic evaluation revealed a crowded proliferation of atypical melanocytes at the dermal-epidermal junction overlying a scar. The dermal component contained scattered mitotic figures. A combined MART-1, tyrosinase and Ki-67 immunohistochemical study showed foci of increased melanocytic proliferation. These atypical features were interpreted as associated with both the prior cryotherapy, as well as her recent pregnancy. Knowledge of the clinical context in evaluating difficult melanocytic lesions is essential.
Assuntos
Crioterapia , Nevo Pigmentado/patologia , Adulto , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Antígeno MART-1/metabolismo , Melanócitos/patologia , Antígenos Específicos de Melanoma/metabolismo , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/terapia , Nevo Pigmentado/ultraestrutura , Nitrogênio/efeitos adversos , Nitrogênio/uso terapêutico , Gravidez , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Antígeno gp100 de MelanomaRESUMO
Nephrogenic systemic fibrosis (NSF) is a novel disease entity described over the past 10 years. NSF is a progressive systemic fibrosing disorder that occurs arguably exclusively in patients with impaired renal function who have been exposed to gadolinium-containing contrast agents. As no single clinical or histopathologic finding is diagnostic of NSF, a careful review of the cumulative characteristics of each case is essential in making a correct diagnosis. The spectrum of histologic variants of NSF continues to expand, including a report of NSF mimicking erythema nodosum and several case reports of NSF with giant cells and calcification. We report an additional case of NSF with the uncommon pathologic features of granulomatous and lymphocytic inflammation in the fibrous septae similar to erythema nodosum.
Assuntos
Meios de Contraste/efeitos adversos , Gadolínio/efeitos adversos , Granuloma/patologia , Falência Renal Crônica/patologia , Dermopatia Fibrosante Nefrogênica/patologia , Adulto , Diagnóstico Diferencial , Eritema Nodoso/diagnóstico , Granuloma/induzido quimicamente , Humanos , Falência Renal Crônica/etiologia , Imageamento por Ressonância Magnética/efeitos adversos , Masculino , Dermopatia Fibrosante Nefrogênica/induzido quimicamente , Pele/efeitos dos fármacos , Pele/patologiaRESUMO
Regulators of apoptosis are thought to work in concert, but the molecular interactions of this process are not understood. Here, we show that in response to cell death stimulation, survivin, a member of the inhibitor of apoptosis (IAP) gene family, associates with another IAP protein, XIAP, via conserved baculovirus IAP repeats. Formation of a survivin-XIAP complex promotes increased XIAP stability against ubiquitination/proteasomal destruction and synergistic inhibition of apoptosis, which is abolished in XIAP(-/-) cells. Therefore, orchestration of an IAP-IAP complex regulates apoptosis.
