Expression of HLA-G in hemangioma and its clinical significance

Transarterial arterial sclerosing embolization for the treatment of propranolol-resistant subglottic hemangioma: Feasibility and effificacy

Purpose

To assess the effectiveness and safety of transcatheter arterial sclerosing embolization (TASE) for the treatment of subglottic hemangiomas that did not respond appreciably to propranolol.

Materials and Methods

This study was a retrospective analysis. Of the 101 patients with subglottic hemangiomas admitted to our center, 10 (4 male and 6 female) patients were included in this study. All these patients underwent arterial embolization using Pingyangmycin and polyvinyl alcohol particles (300-500 μm). All patients were examined 1 month after the last treatment and monthly thereafter.

Results

TASE treatment was technically successful in all patients. Ten lesions were located in the subglottic region. The blood supply included the superior thyroid artery, brachiocephalic trunk, facial artery, and ascending pharyngeal arteries. The median maximal diameter of the hemangiomas significantly decreased from 8.5 mm before treatment to 2 mm after TASE (P <.05). The degree of laryngeal obstruction improved in all patients. No serious complications were noted. One patient developed fever postoperatively, and three patients had a mild cough.

Conclusions

For even subglottic hemangiomas with suboptimal efficacy of propranolol, TASE significantly reduced the size of hemangiomas with minimal adverse effects. It had a positive effect on the improvement of airway stenosis caused by subglottic hemangioma with poor effect of oral propranolol.

Detection of p53 and Bcl-2 expression in cutaneous hemangioma through the quantum dot technique

Hemangioma is one of the most common types of infantile vascular benign tumor. The aim of the present study was to investigate the role of B-cell lymphoma 2 (Bcl-2) and tumor protein p53 (p53) in the proliferation and apoptosis of hemangioma cells. A total of 38 paraffin-embedded hemangioma specimens (16 males and 22 females) and another 5 paraffin-embedded healthy surrounding tissue samples, collected between January 2007 and December 2010, were obtained from the Department of Pathology at Renmin Hospital of Wuhan University (Wuhan, China). Immunohistochemistry, hematoxylin and eosin staining, and quantum dot double staining were used to detect the expression of proliferating cell nuclear antigen (PCNA), Bcl-2 and p53 in hemangioma and healthy surrounding skin tissue samples. All hemangioma specimens were classified into proliferative or the involuting stage hemangioma according to Mulliken's criteria and their expression of PCNA. The results of the quantum dot double staining were analyzed using a multi-spectral imaging system. One-way analysis of the variance and the Student-Newman-Keuls q test were performed to statistically analyze the data. There were 24 cases of proliferative stage and 14 cases of involuting stage hemangioma among the specimens. Immunohistochemical analysis results indicated a high expression of Bcl-2 and p53 in proliferative stage hemangioma tissue samples, and low expression in involuting stage hemangioma and healthy tissue samples. Statistical analysis of the results from quantum dot double staining demonstrated that the expression of Bcl-2 and p53 in proliferative hemangioma was significantly increased compared with that in involuting stage specimens (P<0.05) and healthy tissue samples (P<0.05). No significant difference in Bcl-2 and p53 expression was identified between the involuting hemangioma and healthy surrounding tissue samples. The higher expression of Bcl-2 and p53 in proliferative hemangioma suggests that Bcl-2 may cause an imbalance between endothelial cell proliferation and apoptosis through the inhibition of endothelial cell apoptosis. Furthermore, p53 may promote the proliferation of endothelial cells in proliferative hemangioma.

Vertebral hemangiomas in the thoracic spine of multiple sclerosis patients are connected with fewer demyelinating lesions at the same level. Possible impact on pathophysiology and clinical course

OBJECTIVES

Mechanisms of angiogenesis regulate multiple sclerosis (MS) lesions' evolution, displaying both neuroprotective and harmful effects. Factors traditionally considered as purely angiogenic, like vascular endothelial growth factor (VEGF), exert complex heterogenous actions on both neural and vascular malformation-derived tissues. Aim of this retrospective study was to examine, for the first time, potential associations between the presence of common vascular malformations, like vertebral hemangiomas (VHs), and several clinico-radiological MS parameters.

METHODS

236 MS patients who were followed in our Outpatient Clinic were recruited in this study. Outcome measures concerned demographics, disease-derived variables, and MS-lesions' distribution in VHs - positive and negative patients. All data were collected retrospectively. Potential correlations were assessed with univariate statistical analyses (p = 0.05), followed by multivariate regression models, for purposes of confounder-effects elimination.

RESULTS

VH presence showed significant negative correlations with presence of MS lesions in the thoracic (p = 0.005 for thoracic VHs), but not the cervical cord. Trends towards negative associations of VH presence with subtentorial MS lesions and positive family history for MS were also observed.

DISCUSSION

Our observations suggest that VH presence may reduce the risk of thoracic demyelinating lesions in MS patients. They could be explained as part of a multifaceted angiogenic process, concomitantly enhancing neural repair and abnormal hemangioma vascularization.

Multispectral Imaging

The field of anatomic pathology has changed significantly over the last decades and, as a result of the technological developments in molecular pathology and genetics, has had increasing pressures put on it to become quantitative and to provide more information about protein expression on a cellular level in tissue sections. Multispectral imaging (MSI) has a long history as an advanced imaging modality and has been used for over a decade now in pathology to improve quantitative accuracy, enable the analysis of multicolor immunohistochemistry, and drastically reduce the impact of contrast-robbing tissue autofluorescence common in formalin-fixed, paraffin-embedded tissues. When combined with advanced software for the automated segmentation of different tissue morphologies (eg, tumor vs stroma) and cellular and subcellular segmentation, MSI can enable the per-cell quantitation of many markers simultaneously. This article covers the role that MSI has played in anatomic pathology in the analysis of formalin-fixed, paraffin-embedded tissue sections, discusses the technological aspects of why MSI has been adopted, and provides a review of the literature of the application of MSI in anatomic pathology.