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Pateras IS, Igea A, Nikas IP, Leventakou D, Koufopoulos NI, Ieronimaki AI, Bergonzini A, Ryu HS, Chatzigeorgiou A, Frisan T, Kittas C, Panayiotides IG. Diagnostic Challenges during Inflammation and Cancer: Current Biomarkers and Future Perspectives in Navigating through the Minefield of Reactive versus Dysplastic and Cancerous Lesions in the Digestive System. Int J Mol Sci 2024; 25:1251. [PMID: 38279253 PMCID: PMC10816510 DOI: 10.3390/ijms25021251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/28/2024] Open
Abstract
In the setting of pronounced inflammation, changes in the epithelium may overlap with neoplasia, often rendering it impossible to establish a diagnosis with certainty in daily clinical practice. Here, we discuss the underlying molecular mechanisms driving tissue response during persistent inflammatory signaling along with the potential association with cancer in the gastrointestinal tract, pancreas, extrahepatic bile ducts, and liver. We highlight the histopathological challenges encountered in the diagnosis of chronic inflammation in routine practice and pinpoint tissue-based biomarkers that could complement morphology to differentiate reactive from dysplastic or cancerous lesions. We refer to the advantages and limitations of existing biomarkers employing immunohistochemistry and point to promising new markers, including the generation of novel antibodies targeting mutant proteins, miRNAs, and array assays. Advancements in experimental models, including mouse and 3D models, have improved our understanding of tissue response. The integration of digital pathology along with artificial intelligence may also complement routine visual inspections. Navigating through tissue responses in various chronic inflammatory contexts will help us develop novel and reliable biomarkers that will improve diagnostic decisions and ultimately patient treatment.
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Affiliation(s)
- Ioannis S. Pateras
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Ana Igea
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
- Mobile Genomes, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Ilias P. Nikas
- Medical School, University of Cyprus, 2029 Nicosia, Cyprus
| | - Danai Leventakou
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Nektarios I. Koufopoulos
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Argyro Ioanna Ieronimaki
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
| | - Anna Bergonzini
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Alfred Nobels Allé 8, 141 52 Stockholm, Sweden;
- Department of Molecular Biology and Umeå Centre for Microbial Research (UCMR), Umeå University, 901 87 Umeå, Sweden;
| | - Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Republic of Korea;
| | - Antonios Chatzigeorgiou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Teresa Frisan
- Department of Molecular Biology and Umeå Centre for Microbial Research (UCMR), Umeå University, 901 87 Umeå, Sweden;
| | - Christos Kittas
- Department of Histopathology, Biomedicine Group of Health Company, 156 26 Athens, Greece;
| | - Ioannis G. Panayiotides
- 2nd Department of Pathology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (D.L.); (N.I.K.); (A.I.I.); (I.G.P.)
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Koizumi G, Hayashi A, Takigawa A, Yamada R, Murata T, Shimizu K, Watanabe M, Arai N. Novel Histopathological Findings of Micro Bone Fragments and Epithelial Response in the Oral Mucosa in Bisphosphonate-Related Osteonecrosis of the Jaw. J Investig Med High Impact Case Rep 2024; 12:23247096241258076. [PMID: 38818904 PMCID: PMC11143842 DOI: 10.1177/23247096241258076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/22/2024] [Accepted: 05/11/2024] [Indexed: 06/01/2024] Open
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) occurs in the jawbone and interfacing oral mucosa of patients treated with bisphosphonates. Herein, we report novel histopathological findings in the oral mucosa of a surgical specimen obtained from a 61-year-old man with BRONJ. The resected jawbone and adjacent oral mucosa were separated for histological examination. The mucosal tissue was examined using Von Kossa staining and immunohistochemical (CK5/6, p63) staining of non-decalcified paraffin sections. Pseudoepitheliomatous hyperplasia (PEH), a microscopic feature of the mucosal epithelium in BRONJ, was observed in soft tissue specimens, concomitant with inflammatory cell infiltration. Von Kossa staining revealed small fragments of necrotic bone, tens to hundreds of micrometers in size, scattered within the connective tissues; the PEH forefront contacted some of the bone fragments. Immunohistochemical staining demonstrated that occasionally, the PEH not only contacted but also encompassed the bone fragments. To our knowledge, this is the first report of presence of micro bone fragments and their association with PEH in the oral mucosa in BRONJ.
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Affiliation(s)
- Gaku Koizumi
- Department of Oral and Maxillofacial Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akinobu Hayashi
- Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akira Takigawa
- Department of Oral and Maxillofacial Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Rina Yamada
- Department of Oral and Maxillofacial Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Taku Murata
- Department of Oral and Maxillofacial Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kasumi Shimizu
- Department of Oral and Maxillofacial Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masatoshi Watanabe
- Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Naoya Arai
- Department of Oral and Maxillofacial Surgery, Mie University Graduate School of Medicine, Tsu, Japan
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Sandoval C, Araujo G, Sosa W, Avalos S, Silveira F, Corbett C, Zúniga C, Laurenti M. In situ cellular immune response in non-ulcerated skin lesions due to Leishmania (L.) infantum chagasi infection. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200149. [PMID: 33708246 PMCID: PMC7909480 DOI: 10.1590/1678-9199-jvatitd-2020-0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background Skin lesions of patients affected by non-ulcerated cutaneous leishmaniasis
(NUCL) caused by L. (L.) infantum chagasi are characterized
by lymphohistiocytic inflammatory infiltrate associated with epithelioid
granuloma and scarce parasitism. However, the in situ
cellular immune response of these patients is unclear. Therefore, the aim of
the present study was to characterize the cellular immune response in the
skin lesions of patients affected by NUCL. Methods Twenty biopsies were processed by immunohistochemistry using primary
antibodies to T lymphocytes (CD4, CD8), NK cells, B lymphocytes,
macrophages, nitric oxide synthase and interferon-gamma. Results Immunohistochemistry revealed higher expression of all cellular types and
molecules (IFN-γ, iNOS) in the dermis of diseased skin compared to the skin
of healthy individuals (p < 0.05). Morphometric analysis performed in the
skin lesions sections showed the predominance of CD8+ T
lymphocytes in the mononuclear infiltrate, followed by macrophages, mostly
iNOS+, a response that could be mediated by IFN-γ. Conclusion Our study improves knowledge of the cellular immune response in
non-ulcerated or atypical cutaneous leishmaniasis caused by L. (L.)
infantum chagasi in Central America and pointed to the pivotal
participation of CD8+ T lymphocytes in the host defense
mechanisms against the parasite in patients with NUCL.
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Affiliation(s)
- Carmen Sandoval
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Gabriela Araujo
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Wilfredo Sosa
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil.,Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Sara Avalos
- Master Program in Infectious and Zoonotic diseases, School of Microbiology, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Fernando Silveira
- Department of Parasitology, Evandro Chagas Institute, Secretariat of Health Surveillance, Ministry of Health, Belém, PA, Brazil.,Institute of Tropical Medicine, Federal University of Pará, Belém, PA, Brazil
| | - Carlos Corbett
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Concepción Zúniga
- Department of Health Surveillance, School Hospital, Tegucigalpa, Honduras
| | - Marcia Laurenti
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
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Wipf A, Wipf H, Miller D. Sweet syndrome with pseudocarcinomatous hyperplasia: A case report and review of the literature. J Cutan Pathol 2019; 46:520-527. [DOI: 10.1111/cup.13436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Angela Wipf
- Department of DermatologyUniversity of Minnesota Minneapolis Minnesota
| | - Heidi Wipf
- Department of DermatologyUniversity of Minnesota Minneapolis Minnesota
| | - Daniel Miller
- Department of DermatologyUniversity of Minnesota Minneapolis Minnesota
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The Role Played by Growth Factors TGF-β1, EGF and FGF7 in the Pathogeny of Oral Pseudoepitheliomatous Hyperplasia. CURRENT HEALTH SCIENCES JOURNAL 2017; 43:246-252. [PMID: 30595884 PMCID: PMC6284842 DOI: 10.12865/chsj.43.03.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/27/2017] [Indexed: 11/18/2022]
Abstract
Pseudoepitheliomatous hyperplasia is an epithelial proliferation that develops in the dermis or lamina propria. It is a lesion associated to another pathology, which appears as a response to a great variety of infectious, neoplastic, inflammatory or traumatic stimuli. The etiopathogeny of this lesion is not clear yet. Therefore, we performed an immunohistochemical study on a group of 20 cases of pseudoepitheliomatous hyperplasia cases associated with inflammatory and neoplastic conditions, by investigating TGFβ1 (Beta growth and transformation factor), EGF (Epidermal growth Factor), and FGF7 (Fibroblast growth factor) expressions during in its development. The TGF-β1 expression was recorded in all the layers of the oral hyperplastic epithelium, going from the basal to the superficial layers, but with a different immunoreactive pattern, according to the region. Our study showed the absence of EGF immunoexpression in the carcinomatous proliferation areas associated to pseudoepitheliomatous hyperplasia and an almost exclusive presence in the hyperplasia lesions associated with inflammatory conditions (in about 30% of the investigated lesions) of a expression varying from poor to moderate for EGF. According to our investigations, we observed the presence of an immunolabeling for FGF7 in 80% of the investigated cases of pseudoepitheliomatous hyperplasia, a maximum of intensity being observed within the cases associated with inflammatory conditions.
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Park S, Kanayama K, Kaur K, Tseng HCH, Banankhah S, Quje DT, Sayre JW, Jewett A, Nishimura I. Osteonecrosis of the Jaw Developed in Mice: DISEASE VARIANTS REGULATED BY γδ T CELLS IN ORAL MUCOSAL BARRIER IMMUNITY. J Biol Chem 2015; 290:17349-66. [PMID: 26013832 DOI: 10.1074/jbc.m115.652305] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Indexed: 11/06/2022] Open
Abstract
Osteonecrosis of the jaw (ONJ), an uncommon co-morbidity in patients treated with bisphosphonates (BP), occurs in the segment of jawbone interfacing oral mucosa. This study aimed to investigate a role of oral mucosal barrier γδ T cells in the pathogenesis of ONJ. Female C57Bl/6J (B6) mice received a bolus zoledronate intravenous injection (ZOL, 540 μg/kg), and their maxillary left first molars were extracted 1 week later. ZOL-treated mice (WT ZOL) delayed oral wound healing with patent open wounds 4 weeks after tooth extraction with characteristic oral epithelial hyperplasia. γδ T cells appeared within the tooth extraction site and hyperplastic epithelium in WT ZOL mice. In ZOL-treated γδ T cell null (Tcrd(-/-) ZOL) mice, the tooth extraction open wound progressively closed; however, histological ONJ-like lesions were identified in 75 and 60% of WT ZOL and Tcrd(-/-) ZOL mice, respectively. Although the bone exposure phenotype of ONJ was predominantly observed in WT ZOL mice, Tcrd(-/-) ZOL mice developed the pustule/fistula disease phenotype. We further addressed the role of γδ T cells from human peripheral blood (h-γδ T cells). When co-cultured with ZOL-pretreated human osteoclasts in vitro, h-γδ T cells exhibited rapid expansion and robust IFN-γ secretion. When h-γδ T cells were injected into ZOL-treated immunodeficient (Rag2(-/-) ZOL) mice, the oral epithelial hyperplasia developed. However, Rag2(-/-) ZOL mice did not develop osteonecrosis. The results indicate that γδ T cells are unlikely to influence the core osteonecrosis mechanism; however, they may serve as a critical modifier contributing to the different oral mucosal disease variations of ONJ.
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Affiliation(s)
- Sil Park
- From the Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics and Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, California 90095
| | - Keiichi Kanayama
- From the Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics and the Department of Periodontology, Asahi University School of Dentistry, Gifu 501-0296, Japan, and
| | - Kawaljit Kaur
- Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, California 90095
| | - Han-Ching Helen Tseng
- Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, California 90095
| | - Sina Banankhah
- From the Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics and
| | - Davood Talebi Quje
- From the Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics and
| | - James W Sayre
- the Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California 90095
| | - Anahid Jewett
- Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, California 90095
| | - Ichiro Nishimura
- From the Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics and Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, California 90095,
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Ling YH, Zhu CM, Wen SH, Luo RZ, Li P, Cao Y, Rao HL, Lin SX, Cai MY. Pseudoepitheliomatous hyperplasia mimicking invasive squamous cell carcinoma in extranodal natural killer/T-cell lymphoma: a report of 34 cases. Histopathology 2015; 67:404-9. [PMID: 25619876 DOI: 10.1111/his.12656] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/19/2015] [Indexed: 11/28/2022]
Abstract
AIMS Pseudoepitheliomatous hyperplasia (PEH) is defined as a pattern of epidermal reaction. However, it has not yet been extensively documented in extranodal natural killer/T-cell lymphoma (ENKTL). The aim of our study was to analyse a series of ENKTLs concomitant with PEH mimicking squamous cell carcinoma (SCC). METHODS AND RESULTS We analysed 34 cases of ENKTL with PEH. In our study, the incidence of PEH was 3.8% in ENKTLs diagnosed over a 13-year period. All 34 cases presented with PEH, appearing as tongue-like projections of squamous epithelium into the underlying submucosa/dermis with variable depths and jagged borders. The keratinocytes sometimes showed a minor degree of cytological atypia, mostly in the stratum basale, and keratinocyte necrosis was absent. Atypical mitoses and a high nuclear/cytoplasmic ratio were absent. The submucosa and the squamous cell cords were also permeated by atypical lymphocytes. CONCLUSIONS ENKTL can be associated with PEH, and the atypical lymphoid cell population can be highly subtle, and therefore may be easily mistaken for SCC, leading to inappropriate therapy. A correct diagnosis requires awareness and recognition of this pitfall by recognizing the associated conditions listed above, which distinguish PEH from SCC.
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Affiliation(s)
- Yi-Hong Ling
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Chong-Mei Zhu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Shi-Hong Wen
- Department of Anaesthesiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rong-Zhen Luo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Peng Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Yun Cao
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Hui-Lan Rao
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Su-Xia Lin
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Mu-Yan Cai
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
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Adenovirus-mediated expression of keratinocyte growth factor promotes secondary flap necrotic wound healing in an extended animal model. Aesthetic Plast Surg 2013; 37:1023-33. [PMID: 23949128 DOI: 10.1007/s00266-013-0200-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 07/16/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND No effective treatments have been found for flap necrosis. Animal models that focus on the initial flap viability are inappropriate for necrotic wound studies. Keratinocyte growth factor (KGF) promotes keratinocyte proliferation with stronger activity and fewer complications and thus may be useful for necrotic flap wound healing. METHODS Rats with modified flap necrosis were randomly divided into four groups. An adenoviral vector expressing KGF was injected subdermally in the back of the animals after necrosis began. The expression and effect of KGF was assessed by real-time polymerase chain reaction, enzyme-linked immunoassay, and transwell, and wound healing was monitored. RESULTS The plasmid and adenovirus were able to express KGF and stimulate epithelial cell growth (p = 0.029). Histology showed that the necrosis healed fastest in the KGF administration group than in the control groups (p < 0.01). The adenovirus-mediated KGF (Ad-KGF) group had the thickest epithelium on days 15 (p = 0.044) and 25 (p = 0.014). The KGF level in the blood serum soared 10 and 15 days postoperatively (p < 0.01) but returned to baseline by day 25 (p = 0.561). The KGF mRNA levels in vivo increased dramatically in the Ad-KGF group (p = 0.037). CONCLUSIONS The extended flap model is applicable in necrotic wound study. Keratinocyte growth factor can promote secondary necrotic flap wound healing, and administration of KGF can be achieved by an adenoviral vector.
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Abstract
Cutaneous pseudocarcinomatous hyperplasia is a benign proliferation that can be associated with many nontumoral and tumoral conditions. In the literature, squamous proliferations of different types have been associated with several types of adnexal adenomas. However, we found no reported case of association of hidradenoma papilliferum with pseudocarcinomatous hyperplasia. We had the opportunity of studying this type of an association in a 38-year-old man. The hidradenoma was located deep in the corion of the biopsy and the uppermost squamous epithelium showed a pseudocarcinomatous hyperplasia that focally contacted with the hidradenoma. No atypia was noted in the squamous proliferation. E-cadherin was diffusely expressed by the squamous nests, whereas p53 and Ki-67 were restricted to the basal layer. Cyclin D-1 was expressed in the parabasal layer. Immunohistochemistry of the squamous proliferation was negative for human papillomavirus.
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Viana AG, Domingos PLB, Kaminagakura E, Botelho ACC, Martelli H, Bonan PRF. Immunohistochemical profile of cytokeratins in pseudoepitheliomatous hyperplasia of cutaneous Leishmaniasis. Int J Dermatol 2011; 50:1470-4. [DOI: 10.1111/j.1365-4632.2011.04888.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Pseudoepitheliomatous hyperplasia (PEH) is a benign condition, characterized by hyperplasia of the epidermis and adnexal epithelium, closely simulating squamous cell carcinoma. PEH may be present in a number of conditions characterized by prolonged inflammation and/or chronic infection, as well as in association with many cutaneous neoplasms. Herein, we review different inflammatory, infectious, and neoplastic skin diseases, in which florid epidermal hyperplasia is a prominent histopathologic feature, and introduce a systematic approach in the interpretation of PEH.
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Hokugo A, Christensen R, Chung EM, Sung EC, Felsenfeld AL, Sayre JW, Garrett N, Adams JS, Nishimura I. Increased prevalence of bisphosphonate-related osteonecrosis of the jaw with vitamin D deficiency in rats. J Bone Miner Res 2010; 25:1337-49. [PMID: 20200938 PMCID: PMC3153137 DOI: 10.1002/jbmr.23] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Necrotic bone exposure in the oral cavity has recently been reported in patients treated with nitrogen-containing bisphosphonates as part of their therapeutic regimen for multiple myeloma or metastatic cancers to bone. It has been postulated that systemic conditions associated with cancer patients combined with tooth extraction may increase the risk of osteonecrosis of the jaw (ONJ). The objective of this study was to establish an animal model of bisphosphonate-related ONJ by testing the combination of these risk factors. The generation of ONJ lesions in rats resembling human disease was achieved under the confluence of intravenous injection of zoledronate (ZOL; 35 microg/kg every 2 weeks), maxillary molar extraction, and vitamin D deficiency [VitD(-)]. The prevalence of ONJ in the VitD(-)/ZOL group was 66.7%, which was significantly higher (p < .05, Fisher exact test) than the control (0%), VitD(-) (0%), and ZOL alone (14.3%) groups. Similar to human patients, rat ONJ lesions prolonged the oral exposure of necrotic bone sequestra and were uniquely associated with pseudoepitheliomatous hyperplasia. The number of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick-end label-positive (TUNEL(+)) osteoclasts significantly increased on the surface of post-tooth extraction alveolar bone of the VitD(-)/ZOL group, where sustained inflammation was depicted by [(18)F]fluorodeoxyglucose micro-positron emission tomography (microPET). ONJ lesions were found to be associated with dense accumulation of mixed inflammatory/immune cells. These cells, composed of neutrophils and lymphocytes, appeared to juxtapose apoptotic osteoclasts. It is suggested that the pathophysiologic mechanism(s) underpinning ONJ may involve the interaction between bisphosphonates and compromised vitamin D functions in the realm of skeletal homeostasis and innate immunity.
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Affiliation(s)
- Akishige Hokugo
- The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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