Micro-Raman spectroscopy for optical pathology of oral squamous cell carcinoma

Micro-Raman spectra of formalin-fixed oral squamous normal and carcinoma tissues, stored at room temperature for 2 months, have been recorded. Spectra were recorded both in the epithelial and subepithelial regions of the tissues. No noticeable spectral contamination due to formalin was observed. Very significant differences between spectra of normal epithelial and malignant epithelial samples were found. No such differences in spectra of subepithelial malignant and subepithelial normal samples could be observed. This study shows that spectra from the epithelial region changes drastically because of malignancy-induced biochemical changes in this region. Major differences between normal and malignant spectra seem to arise from the protein composition, conformational/structural changes, and possible increase in protein content in malignant epithelia. The differences between normal epithelial and subepithelial spectra, as expected, arise mainly from the collagen in subepithelial tissue. Principal component analysis of the combined sets of spectra-epithelial and subepithelial, normal and malignant- showed that very good discrimination can be achieved by Raman microspectroscopy. This study thus validates the suitability of formalin-fixed tissues for optical pathology in oral malignancy.

Lichen sclerosus is frequently present in penile squamous cell carcinomas but is not always associated with oncogenic human papillomavirus

BACKGROUND

Penile squamous cell carcinoma (SCC) may occur on pre-existing lesions of lichen sclerosus (LS). However, the prevalence of histological changes of LS in penile SCC is not well established. Moreover, mucosal oncogenic human papillomaviruses (HPVs) are sometimes detected in penile SCC, but have not been systematically sought in LS-associated penile SCC.

OBJECTIVES

To establish the prevalence of LS histological changes and of mucosal oncogenic HPV in a series of patients with penile SCC.

METHODS

Consecutive cases of histologically proven penile SCC from a single university hospital over a 14-year period were retrospectively selected and reviewed. Histological signs of LS were systematically sought. HPV was detected by polymerase chain reaction (PCR) amplification of DNA from paraffin-embedded skin samples using general primers GP5+/GP6+ (allowing detection of mucosal HPV) and oncogenic type 16-, 18-, 31- and 33-specific primers.

RESULTS

Eighteen cases of penile SCC were found. The mean +/- SD age of patients at diagnosis was 67.3 (14.5 years). In eight of 18 (44%) cases, SCC was associated with histological features of LS. Seventeen skin biopsy specimens of SCC (nine without and eight with LS histology) were subjected to PCR amplification for HPV. Mucosal HPV was detected in six of them (35%). Five of nine SCCs without histological features of LS were positive for mucosal HPV: three with HPV type 16 and two with only general primers. In contrast, all eight SCCs associated with LS were negative for oncogenic HPV types, although one was positive with general primers.

CONCLUSIONS

Penile SCC seems to be frequently associated with LS histological changes. As with vulval SCC, we found that non-LS-associated penile SCC tended to be frequently associated with oncogenic HPV infection, whereas LS-associated penile SCC was not. Larger series are needed to confirm this association.

[Pathology in the diagnosis and treatment of palpebral tumors]

The authors stress the role and place of pathology in the diagnosis and treatment of eyelid tumors. After a brief report on the main histological characteristics of eyelid tumors and their classification, the pathological methods are described, with particular attention paid to the technical aspects of frozen sections in palpebral surgery.

AIM

This study reports the main pathological techniques available for use in eyelid tumor surgery. The advantages of frozen sections are reported from a retrospective study of basal-cell carcinomas of the eyelid.

MATERIAL AND METHODS

All basal-cell carcinomas treated at the Reims Hospital from 1985 to 1999 were retrospectively studied. The pathological aspects are reported. Most of the tumors (155/193) were examined with frozen sections. Recurrences are considered.

CONCLUSION

Pathology in eyelid tumor surgery must be taken into consideration. Frozen section examination may eliminate recurrences and limit healthy tissue taken at resection. This method is a very useful tool in this type of surgery. The benefits of the classic Mohs technique can be completed by a technique that is more precisely adapted to the control of the lateral limits of the excision in reconstructions which are often complex.

[Malignant fibrous histiocytoma of the eyelid]

Fibrous histiocytomas, mostly benign, have often been reported in the orbit, but only four lesions have been described on the eyelids, with only one malignant. The authors present a case of malignant fibrous histiocytoma of the eyelid in a 76-year-old woman with a difficult histological diagnosis. Characteristics of this pathology are explained from data in the literature.

[Factors of recurrence of basal cell carcinomas of the eyelid]

Basal cell carcinomas of the eyelids can recur, although these recurrences are uncommon. In this retrospective study, all basal cell carcinomas treated at Reims Regional Hospital since 1985 were studied to determine the frequency of recurrence and the factors for recurrence.

MATERIAL

and methods: All basal cell carcinomas treated at Reims Regional Hospital since 1985 were studied. A total of more than 200 patients had been operated on for basal cell carcinoma during this period. Those with orbital extension or a location on 2 eyelids were excluded. Epidemiological factors such as sex, age, tumor location, tumor size, and treatment were noted. Recurrences were uncommon, presenting in ten patients. These recurrences were studied in relation to the existing epidemiological data and the treatment provided, particularly the histological results.

DISCUSSION

Basal cell carcinomas located on only 1 eyelid or 1 canthus can usually be treated with one surgical intervention. Extemporaneous histological study can preclude a local recurrence in most cases, but in some cases the condition may recur some years later. Factors favoring recurrence are difficult to determine.

CONCLUSION

The authors report the number of recurrences after surgical treatment of basal cell carcinomas of the eyelids. The recurrences are relatively uncommon when the treatment has been done with extemporaneous histological examination of the resected edges. These recurrences arise particularly in relatively young patients with no other obvious risk factor.

[Laparoscopic diagnosis of stenosing eosinophilic jejuno-ileitis]

INTRODUCTION

Eosinophilic gastroenteritis of unknown origin could be isolated or integrated in idiopathic hypereosinophilic syndrome. Clinical expression is variable since the lesion may affect any area of the gastrointestinal tract and any layer of the wall.

EXEGESIS

A 25-year-old male patient had digestive symptoms such as peritoneal, obstructive and diarrheal signs, associated with blood eosinophilia, giving evidence for eosinophilic jejuno-ileitis. Computer tomography revealed an extensive obstruction of the jejuno-ileum and thickening of the intestinal wall. The diagnosis was obtained using laparoscopy and controlled wedge biopsy, which showed a predominantly external infiltration of the intestinal wall by eosinophils. The disease evolution was favorable with corticosteroid therapy.

CONCLUSION

Worrying and persistent digestive symptomatology, associated with blood eosinophilia, particularly when intestinal wall infiltration is revealed by computer tomography, should lead one to perform a laparoscopy to guide a surgical biopsy of the intestinal wall.

[Hygiene, architecture and autopsy]

The 24(th) August 1998 decree related to technical prescriptions applicable to hospital mortuaries, to be enacted as of September 11(th) 2001, compels hospital administrations and involved personnel to consider architectural concepts of autopsy room. Nevertheless, the technical prescriptions of this decree seem to be inadequate because an autopsy room requires specific functional and technical organization such as adequate flooring, adapted air-conditioning system and plumbing and of course appropriate autopsy tables. Due to imminent enactement of accreditation procedures, it is likely that in the near future, autopsies will only be performed in centres combining scientific competence and sanitary requirements.

Human DNA topoisomerase I inhibitory activities of synthetic polyamines relation to DNA aggregation

DNA aggregation by polyamines has acquired importance as a prerequisite for the cellular uptake of DNA for gene therapy. Intracellular polyamines are constitutive components of mammalian cells and their availability is critical for cell proliferation. Interference of polyamine biosynthesis by synthetic polyamines leads to cytotoxicity. Optimization of the polyamine structural parameters is necessary to control their DNA aggregation, cytotoxic or enzyme inhibitory activities. We designed two series of tetra- and hexamines and compared their human DNA topoisomerase I (top1) inhibitory effects with the DNA aggregation properties. We show that hexamines are more efficient inhibitors of DNA relaxation by top1 than tetramines and that they suppress the top1-mediated DNA cleavage while tetramines do not. The DNA aggregation abilities within two series of polyamines correlate with the length of their central methylene chain. By contrast, the top1 inhibition within two series does not show the same correlation but demonstrates a threshold inhibitory effect on going from the (CH(2))(12) to the (CH(2))(14) central chain. We show further that the structures of DNA aggregates formed by polyamines with the (CH(2))(10-12) or with the (CH(2))(14-16) chains are very different. The first are a fluid cholesteric-type phases, whereas the second are well-structured aggregates similar to columnar liquid crystals with high packing density of DNA duplexes. The structures of polyamines-induced DNA aggregates are proposed to be crucial for top1 catalysis. The structure-function correlation described here may serve as a guide for rational design of polyamines with desired DNA-aggregation or anti-top1 activities.

Detection and localization of a Ca2+-ATPase activity in Toxoplasma gondii

Toxoplasma gondii, the agent causing toxoplasmosis, is an obligate intracellular protozoan parasite. A calcium signal appears to be essential for intracellular transduction during the active process of host cell invasion. We have looked for a Ca2+-transport ATPase in tachyzoites and found Ca2+-ATPase activity (11-22 nmol Pi liberated/mg protein/min) in the tachyzoite membrane fraction. This ATP-dependent activity was stimulated by Ca2+ and Mg2+ ions and by calmodulin, and was inhibited by pump inhibitors (sodium orthovanadate or thapsigargin). We used cytochemistry and X-ray microanalysis of cerium phosphate precipitates and immunolabelling to find the Ca2+, Mg2+-ATPase. It was located mainly in the membrane complex, the conoid, nucleus, secretory organelles (rhoptries, dense granules) and in vesicles with a high calcium concentration. Thus, Toxoplasma gondii possesses Ca2+-pump ATPase (Ca2+, Mg2+-ATPase) as do eukaryotic cells.

Immunohistochemical study of thrombospondin and its receptors alpha root of beta 3 and CD36 in normal thyroid and in thyroid tumours

AIM

To describe the pattern of distribution of thrombospondin (TSP1) and its receptors, alpha root of beta 3 integrin and CD36, in normal human thyroid tissue and to compare their expression in different benign and malignant thyroid conditions.

METHODS

Immunohistochemistry was used to study TSP1 and its receptors in 40 surgical thyroidectomy specimens (normal parenchyma, 7; follicular adenoma, 4; multinodular goitre, 13; papillary carcinoma, 6; follicular carcinoma, 8; anaplastic carcinoma, 2).

RESULTS

In the normal thyroid parenchyma, there was weak expression of TSP1 limited to the vessels with no staining of the extracellular matrix. In goitres, the expression of TSP1 was more pronounced in areas of fibrosis, with staining of alpha root of beta 3 on thyrocytes located in the vicinity. In thyroid adenomas, expression of TSP1 was slightly enhanced compared with normal tissue, located in the basement membrane of vessels. In papillary carcinomas, TSP1 was abundant in the desmoplastic stroma with a cytoplasmic distribution of alpha root of beta 3 integrin in thyrocytes. In follicular carcinomas, TSP1 was less abundant in the extracellular matrix, limited to the vessels of the stroma with a weaker expression of alpha root of beta 3 on thyrocytes than in papillary carcinomas. In anaplastic carcinomas, TSP1 was only present in the numerous capillaries of the stroma, with a marked positivity for alpha root of beta 3 in one case. No immunostaining of thyrocytes is observed with CD36.

CONCLUSIONS

These results suggest the importance of the interaction between alpha root of beta 3 integrin and TSP1 during remodelling of the matrix in fibrous goitres with areas of early sclerosis comparable with wound healing. In papillary carcinomas, the overexpression of TSP1 restricted to the stroma suggests protective effects against tumour progression.

Comparison of benzo[a]pyrene DNA adduct formation in the skin of two strains of mice selected for resistance (DBA/2) or susceptibility (C3H/HeN) to contact dermatitis

Two strains of mice were selected for resistance (DBA/2) or susceptibility (C3H/HeN) to contact dermatitis. Benzo[a]pyrene-DNA adduct formations was compared in the two mouse strains by a postlabeling procedure to determine if there was a significant effect. Results showed that adduct profiles in DBA/2 and C3H/HeN dermis were qualitatively similar. The total binding levels were higher in DBA/2 mice on the d 2 and the d 10. DNA adduct formation has been shown to inversely correlate with skin allergy induction. Data suggest that the expression of the genes responsible for the differences in responsiveness to chemical induced contact dermatitis in mouse may play an important role in benzo[a]pyrene-DNA adduct formation.

[Dermoid cysts. Epidemiology, clinical and anatomo-pathologic aspects, therapeutic management]

We retrospectively analyzed a series of 17 tumors suggestive of dermoid cysts operated on from January 1, 1991, through November 30, 1997. Mean patient age was 3.68 years. The periorbital localization predominated. Two cases of intraorbital localizations required lateral and medial orbitotomy. Surgical treatment was given in all other cases. We observed no complication nor recurrence.

[How to optimize lymph node dissection in colorectal cancers. A technique for simple and efficacious clarification]

Studies relating to the prognosis of colorectal carcinomas insist on the quality of mesocolic examination and on the frequency of metastases in minute lymph nodes. The aim of our study was to evaluate an easy, rapid and new clearance method recently described by Koren et al. Twenty-one surgical specimens for colorectal carcinomas have been investigated. After lymph node examination with the traditional method, the mesocolic fat was immersed in a clearing solution. After 6 hours, lymph nodes stood out as white chalky nodules, and were dissected. By the traditional method 182 lymph nodes were detected and 89 additional lymph nodes after clearing. In one case, the detection of a metastasis in lymph node after clearing allowed to upstage the tumour from Dukes B (N0) to Dukes C (N+). This easy and inexpensive method allows the detection of minute lymph nodes and helps to establish a more accurate staging.

[What is the contribution of aspiration cytology?]

Aspiration cytology of thyroid nodules is essentially designed to determine the benign nature of the nodule in order to avoid purely diagnosis surgery. It is reliable in the diagnosis of anaplastic papillary and medullary carcinomas and most lymphomas, but is more problematical for the diagnosis of the benign or malignant nature of Hürthle cell tumours and certain vesicular tumours, in which cytology reveals a suspicious, doubtful or undetermined appearance. However, whether they are unambiguous or doubtful, fine needle aspiration cytology results help the surgeon to define the therapeutic strategy under the best possible conditions. A therapeutic approach is proposed, based on the formulation of aspiration cytology results into benign, malignant, suspicious and inadequate.

A method for simultaneous quantification of monoclonal antibody Ki-67 and DNA content by flow cytometry. Application to breast carcinomas

OBJECTIVE

To seek a method assessing Ki-67 immunostaining and DNA content by flow cytometry simultaneously.

STUDY DESIGN

The murine monoclonal antibody Ki-67 (Ki) identifies a nuclear protein complex expressed by all nonquiescent tumor cells. Since the antigen detected by Ki is quite labile in most fixation and embedding protocols, a new method for simultaneous quantification of nuclear Ki immunofluorescence and DNA content by flow cytometry was developed. Unfixed, solid tumor cells are permeabilized only with saponin to preserve Ki antigen. The percentage of Ki-positive cell subpopulations calculated by subtraction of the related aspecific fixation histogram gives optimal results more rapidly than by cytogram analysis. Application to breast carcinoma shows the feasibility of the method.

RESULTS

Significant correlations between Ki staining and the S-phase fraction were observed. Mean Ki labelling rates of aneuploid tumors were significantly higher than those of the diploid tumors, and significant differences between histologic types were found.

CONCLUSION

This technique can be considered a fast, sensitive and optimal method to evaluate the proliferative activity of breast carcinomas and possibly of other solid tumors in a department of pathology.

Quantitative immunolocalization of a P29 protein (GRA7), a new antigen of toxoplasma gondii

Ultrastructural localization of a P29 protein of Toxoplasma gondii was examined on thin sections by an immunogold technique using a P29 antigen-specific monoclonal antibody (5-241-178). Immunolocalization of the P29 protein in extracellular tachyzoites demonstrated that this antigen was present in the dense granules. Thus, we have identified this P29 antigen as the seventh protein (GRA7) to be localized to the dense granules of T. gondii. P29 immunolocalization in intracellular tachyzoites demonstrated association of this antigen with the parasite membrane complex, tubular elements of the intravacuolar network, and with the parasitophorous vacuolar membrane. Our immunolabeling data suggest trafficking of the P29 (GRA7) antigen from the dense granule via the intravacuolar network to the parasitophorous vacuolar membrane on invasion of the tachyzoite into the host cell. (J Histochem Cytochem 46:1411-1421, 1998)

[Incidental discovery of asymptomatic Loeffler fibroplastic endocarditis. Report of a case]

The authors report a case of fibroplastic endocarditis discovered during echocardiography in an asymptomatic patient in the context of assessment of systematized electrocardiographic modifications. The diagnosis, strongly suspected on the basis of the cardiac MRI findings, was finally confirmed by endocardial biopsy.

Pyrimethamine-sulfadoxine treatment of congenital toxoplasmosis: follow-up of 78 cases between 1980 and 1997. Reims Toxoplasmosis Group

The purpose of this study was to determine the clinical and immunological outcome of 78 children with congenital toxoplasmosis treated with the pyrimethamine-sulfadoxine combination between 1980 and 1997.

METHODS

Children were divided into 3 groups according to the initial duration of treatment (always including folinic acid, 5 mg/week by mouth), as follows: pyrimethamine (1.25 mg/kg every 15 d) + sulfadoxine (25 mg/kg every 15 d) for 12 months (Group 1, 47 children), or for 24 months, with or without prenatal therapy (respectively, Group 2, 19 children, and Group 3, 12 children).

RESULTS

Chorioretinitis occurred in 23% of these 78 children. Four children had unilateral blindness, 1 had mild epileptic fits and 1 had psychomotor retardation. The lowest rate of sequelae were in Groups 2 and 3. Immunological rebounds, generally without clinical repercussions, occurred frequently (90% of cases on average) during, or more often after therapy, regardless of the treatment duration. Treatment was always well tolerated.

CONCLUSIONS

Our current treatment strategy for congenital toxoplasmosis consists of a 24-month course of pyrimethamine-sulfadoxine (Fansidar) combined with folinic acid (Lederfoline). If the prenatal diagnosis is positive, we also prescribe this treatment to the mother until delivery. This combination offers satisfactory compliance, adequate serum concentrations, and good preventive efficacy.

Evaluation of the monoclonal antibody antithyroperoxidase MoAb47 in the diagnostic decision of cold thyroid nodules by fine-needle aspiration

Fine needle aspiration (FNA) of cold thyroid nodules has become the first line diagnostic decision for electing which patients need surgery. In order to improve FNA accuracy, the monoclonal antithyroperoxidase (TPO) antibody (MoAb47) was tested. A total of 554 patients were included in this study and among them, 208 were referred to surgery. The results of FNA compared to the final histological diagnosis revealed a sensitivity and a specificity of 94 and 55% respectively, while the sensitivity and specificity of TPO immunodetection on the same cases reached 98 and 83% respectively. By combining the two methods, the 3 false-negative of FNA and 60% of suspicious cytology corresponding to histological benign lesions were correctly identified by immunocytochemistry. With better results than FNA alone, TPO immunodetection with MoAb47 represents a useful adjunct to conventional cytology for selecting patients for surgery.

[Anatomo-clinical prognostic factors of papillary carcinoma of the thyroid. Multivariate analysis: report of a series of 52 cases]

A retrospective study about 52 cases of papillary thyroid carcinomas was carried out with emphasis on histopathological features. The mean follow up period was 10 years. The survival curves were estimated using the Kaplan-Meier method and compared using the log rank test. The multivariate analysis was performed using the Cox's regression model. In univariate analysis, age, Tp (histopathological extension of the tumor), histological differentiation, VAN score (Vascular invasion nuclear Atypia tumor Necrosis) of Akslen and the LeuM1 expression were significant prognostic factors. In multivariate analysis, the Tp and histological differentiation were associated with high risks of poor outcome.

[Multiple isolated cutaneous myxomas]

INTRODUCTION

Cutaneous myxomas are rare. They are more often single; when they are multiple, they may be one of the component of the Carney's syndrome.

CASE REPORT

We report a case of multiple and isolated cutaneous myxomas arising at 19 year-old. Diagnosis was confirmed by histologic studies. Examination failed to reveal other cutaneous or visceral features.

DISCUSSION

The multiplicity of cutaneous myxomas is an essential element for diagnosis of Carney's syndrome; other components and notably atrial myxomas can appeared over time. Normal visceral explorations don't eliminated the diagnosis, and follow-up including screening echocardiography must be ensured before concluding, as in our case, as multiple and isolated cutaneous myxomas.