Nodular osteochondrogenic activity in soft tissue surrounding osteoma in neurogenic para osteo-arthropathy: morphological and immunohistochemical study.

BACKGROUND: Neurogenic Para-Osteo-Arthropathy (NPOA) occurs as a consequence of central nervous system injuries or some systemic conditions. They are characterized by bone formation around the main joints. METHODS: In order to define some biological features of NPOAs, histological and immunohistological studies of the soft tissue surrounding osteoma and Ultrasound examination (US) of NPOA before the appearance of abnormal ossification on plain radiographs were performed. RESULTS: We have observed a great number of ossifying areas scattered in soft tissues. US examination have also shown scattered ossifying areas at the early stage of ossification. A high osteogenic activity was detected in these tissues and all the stages of the endochondral process were observed. Mesenchymal cells undergo chondrocytic differentiation to further terminal maturation with hypertrophy, which sustains mineralization followed by endochondral ossification process. CONCLUSION: We suggest that periosteoma soft tissue reflect early stage of osteoma formation and could be a model to study the mechanism of osteoma formation and we propose a mechanism of the NPOA formation in which sympathetic dystony and altered mechanical loading induce changes which could be responsible for the cascade of cellular events leading to cartilage and bone formation.

Acquired delta-storage pool deficiency associated with idiopathic myelofibrosis.

A 73-year-old woman complained of easy bruising, as a consequence of prolonged bleeding time despite normal platelet counts. Platelet aggregation profile, mepacrine fluorescence test, flow cytometry and transmission electron microscopy studies led to the diagnosis of delta-storage pool deficiency (SPD) A few months later, she developed hyperleucocytosis with immature granulocytes and erythroblasts. The presence of bone marrow fibrosis and clonal cytogenetic abnormalities led to the diagnosis of idiopathic myelofibrosis (IM). Association between SPD and IM has never been reported. The pathogenesis of this unusual association remains unclear and may involve proliferation of abnormal monoclonal stem cells with differentiation into activated megakaryocytes associated with impaired dense granule development and increased cytokines release which may be. involved in myelofibrosis.

Megakaryocyte dense granule components are sorted in multivesicular bodies.

Recent studies suggest that multivesicular bodies are an intermediate stage in the formation of alpha-granules. In contrast, the kinetics and mode of appearance of dense granules during megakaryocytic maturation has remained poorly understood. Immunoelectron microscopy was used to monitor the appearance of dense granular markers (granulophysin and serotonin) on cryosections of human megakaryocytes (MKs) cultured from CD34(+) precursors. The monitoring was done on days 8 and 13 of culture. The data suggest that dense granules appear in immature MKs early during their maturation, concomitantly with alpha-granule formation. In MKs of intermediary maturation stage, granulophysin was mainly localized within dense granules and multivesicular bodies (MVBs), which were also labeled for serotonin. This study provides evidence that granulophysin is a dense granule marker in human MKs and that MVBs are an intermediary stage of dense granule maturation and probably constitute a sorting compartment between alpha-granules and dense granules. (Blood. 2000;95:4004-4007)

Platelet and megakaryocyte dense granules contain glycoproteins Ib and IIb-IIIa.

Platelets contain two main types of secretory organelles, the dense granules and the alpha-granules. P-selectin, a specific receptor for leukocytes that is present in the alpha-granule membrane, has also been demonstrated to be associated with the dense granule limiting membrane, showing that a relationship exists between these two types of secretory granules. We have previously shown that the plasma membrane receptors glycoproteins (Gp) IIb-IIIa and Ib are also present in the alpha-granule membrane. To document further the composition of the dense granule membrane, we have used immunoelectron microscopy in the present work to determine if the dense granule membrane also contains these glycoproteins. First, the cytochemical method of Richards and Da Prada (J Histochem Cytochem 25:1322, 1977), which specifically enhances dense body electron density, was combined with immunogold-labeled anti-Gp IIb-IIIa or anti-Gp Ib antibody. A consistent and reproducible labeling for Gp IIb-IIIa, but less for Gp Ib, was found in the membrane of platelet dense granules. Subsequently, double immunogold labeling was performed on frozen thin sections of resting platelets using antibodies directed against the dense body components granulophysin or P-selectin, followed by anti-Gp IIb-IIIa or anti-Gp Ib. Consistent labeling for Gp IIb-IIIa and weaker labeling for Gp Ib were detected in dense bodies. The possibility that the granulophysin-positive structures could be lysosomes was excluded by the presence of P-selectin. Immunogold labeling of isolated dense granule fractions confirmed these results. Identical findings were made on human cultured megakaryocytes using double immunolabeling. In conclusion, this study demonstrates the presence of Gp IIb-IIIa and Gp Ib on the dense granule membrane. This observation provides additional evidence of similarities between the alpha-granule and dense granule membranes and raises the possibility of a dual mechanism responsible for the formation of dense granules similar to that of alpha-granules, ie, endogenous synthesis as well as endocytosis from the plasma membrane.