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CyclinD1 Is Useful to Differentiate Langerhans Cell Histiocytosis From Reactive Langerhans Cells. Am J Dermatopathol 2019; 41:188-192. [DOI: 10.1097/dad.0000000000001250] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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McCarthy AJ, Soofi ME, Mujeeb I, Chetty R. Langerhans cell histiocytosis of the gastrointestinal tract. DIAGNOSTIC HISTOPATHOLOGY 2018; 24:154-159. [DOI: 10.1016/j.mpdhp.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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3
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p53 Is a Helpful Marker in Distinguishing Langerhans Cell Histiocytosis From Langerhans Cell Hyperplasia. Am J Dermatopathol 2017; 39:726-730. [DOI: 10.1097/dad.0000000000000778] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Leon-Castillo A, Chrisinger JSA, Panse G, Samdani RT, Ingram DR, Ravi V, Prieto VG, Wang WL, Lazar AJ. Index report of cutaneous angiosarcomas with strong positivity for tyrosinase mimicking melanoma with further evaluation of melanocytic markers in a large angiosarcoma series. J Cutan Pathol 2017; 44:692-697. [DOI: 10.1111/cup.12968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/21/2017] [Accepted: 05/22/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Alicia Leon-Castillo
- Pathology Service; Hospital Universitario Marques de Valdecilla; Santander Spain
| | - John S. A. Chrisinger
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Gauri Panse
- Department of Pathology; Yale University; New Haven Connecticut
| | - Rashmi T. Samdani
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Davis R. Ingram
- Department of Translational Molecular Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Vinod Ravi
- Department of Sarcoma Medical Oncology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Victor G. Prieto
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
- Department of Dermatology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Wei-Lien Wang
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
- Department of Translational Molecular Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Alexander J. Lazar
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
- Department of Translational Molecular Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
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Swain SK, Das A, Sahoo S, Baisakh MR, Sahu MC. An unusual presentation of extranodal Rosai-Dorfman disease threatening the airway. Auris Nasus Larynx 2015; 43:197-9. [PMID: 26188562 DOI: 10.1016/j.anl.2015.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/23/2015] [Accepted: 06/26/2015] [Indexed: 11/26/2022]
Abstract
Rosai-Dorfman disease (RDD) is a rare benign systemic histiocytic proliferation, characterized by massive lymph node enlargement and sometimes associated with extranodal involvement. Even though it is considered as a benign disease, fatalities can occur due to its unusually large size and its location. Our case highlighting a primary extranodal site of vallecula, which is extremely rare and not reported in literature before. It presented with almost complete obstructing the oropharyngeal airway creating a life threatening situation, needed emergency tracheostomy.
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Affiliation(s)
- Santosh K Swain
- Department of Otorhinolaryngology, IMS and SUM Hospital, Siksha "O" Anusandhan University, K8, Kalinganagar, Bhubaneswar 751003, Odisha, India.
| | - Alok Das
- Department of Otorhinolaryngology, IMS and SUM Hospital, Siksha "O" Anusandhan University, K8, Kalinganagar, Bhubaneswar 751003, Odisha, India
| | - Sangeeta Sahoo
- Department of Anesthesia, IMS and SUM Hospital, Siksha "O" Anusandhan University, K8, Kalinganagar, Bhubaneswar 751003, Odisha, India
| | - Manas R Baisakh
- Department of Pathology, Apollo Hospital, Bhubaneswar, Odisha, India
| | - Mahesh C Sahu
- Central Research Laboratory, IMS and SUM Hospital, Siksha "O" Anusandhan University, K8, Kalinganagar, Bhubaneswar 751003, Odisha, India
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Vanchinathan V, Mizramani N, Kantipudi R, Schwartz EJ, Sundram UN, Sundram UN. The vascular marker CD31 also highlights histiocytes and histiocyte-like cells within cutaneous tumors. Am J Clin Pathol 2015; 143:177-85; quiz 305. [PMID: 25596243 DOI: 10.1309/ajcprhm8czh5emfd] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES While useful in diagnosing angiosarcomas, CD31 can also highlight histiocytes within soft tissue tumors and lead to errors in diagnosis. We sought to determine how often CD31 highlights cutaneous histiocytomas and histiocytoma mimics. METHODS We examined eight epithelioid cell histiocytomas (ECHs), 12 xanthogranulomas (XGs), nine cases of Langerhans cell histiocytosis (LCH), eight reticulohistiocytomas, 11 xanthomas, 29 atypical fibroxanthomas, nine granular cell tumors, four cases of angiolymphoid hyperplasia with eosinophilia, nine intradermal Spitz nevi, and nine angiosarcomas with antibodies directed against CD31, CD34, CD163, and factor VIII. RESULTS CD31 marked cells in three of 12 XGs, four of nine cases of LCH, one of eight reticulohistiocytomas, one of 11 xanthomas, 10 of 29 atypical fibroxanthomas, four of four cases of angiolymphoid hyperplasia with eosinophilia, nine of nine angiosarcomas, zero of nine granular cell tumors, and zero of eight ECHs. CD34 and factor VIII were negative in all nonvascular cases. CONCLUSIONS Our results indicate that CD31 can mark lesional cells and imitate vascular tumors in cutaneous histiocytomas and histiocytoma mimics, an error that can be avoided by using a panel of antibodies.
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Affiliation(s)
- Vijay Vanchinathan
- Departments of Pathology, Stanford University Medical Center, Stanford, CA
| | - Neda Mizramani
- Departments of Pathology, Stanford University Medical Center, Stanford, CA
| | - Ramya Kantipudi
- Departments of Pathology, Stanford University Medical Center, Stanford, CA
| | - Erich J. Schwartz
- Departments of Pathology, Stanford University Medical Center, Stanford, CA
| | - Uma N. Sundram
- Departments of Pathology, Stanford University Medical Center, Stanford, CA
- Departments of Dermatology, Stanford University Medical Center, Stanford, CA
| | - Uma N Sundram
- From the Departments of Pathology, Stanford University Medical Center, Stanford, CA. From the Departments of Dermatology, Stanford University Medical Center, Stanford, CA.
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7
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Gui X, Zhou Y, Eidus L, Falck V, Gao ZH, Qin L. Is pneumatosis cystoides intestinalis gas-distended and ruptured lymphatics? Reappraisal by immunohistochemistry. Arch Pathol Lab Med 2014; 138:1059-66. [PMID: 25076294 DOI: 10.5858/arpa.2013-0145-oa] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Pneumatosis cystoides intestinalis (PCI) is a condition with multiple gas-filled cysts within the bowel wall, associated with diverse background diseases. Its pathogenesis is still a mystery. Some previous observations scattered in the literature have suggested an association of the cystic spaces in PCI with the lymphatics. OBJECTIVE To further investigate whether PCI results from the ballooning of gas-filled lymphatic channels. DESIGN We did immunostaining of podoplanin, a mucoprotein preferentially expressed in lymphatic endothelial cells, in 13 cases (8 men, 5 women; age range, 18-80 years) of PCI. Ten cases were diagnosed in resected segments of bowel and 3 in biopsies. Pneumatosis was seen in the right side of the colon (9 cases), transverse colon (1 case), sigmoid colon (1 case), and small bowel (2 cases). In addition, immunostaining for CD31, calretinin, WT1, CD68, smooth muscle actin, desmin, vimentin, and cytokeratins was also performed for comparison and correlation. RESULTS A strong immunopositivity of podoplanin was seen in a condensed linear structure in the pericystic interstitium in 100% of the cases, but was not seen in the overlying giant and flat cells that were all CD68-positive histiocytes. Meanwhile, the podoplanin-expressing structure was negative for calretinin and WT1, which ruled out the possible mesothelial origin. There were coexistent variable immunopositivity of smooth muscle actin, which suggests an admixture of myofibroblasts. These findings indicated that the PCI cases were gas-distended lymphatics with the lymphatic epithelium ruptured and embedded in the reactive histiocytes and giant cells. CONCLUSION Our findings support the lymphatic theory about the pathogenesis of PCI.
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Affiliation(s)
- Xianyong Gui
- From the Department of Pathology and Laboratory Medicine, University of Calgary, Calgary Laboratory Services, Calgary, Alberta, Canada (Drs Gui, Eidus, and Falck); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Zhou); the Department of Pathology, McGill University, Montreal, Montreal, Quebec, Canada (Dr Gao); and the Department of Pathology, Weill Cornell Medical College, Cornell University, New York, New York (Dr Qin)
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8
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Tidwell WJ, Googe PB. Tissue histiocyte reactivity with CD31 is comparable to CD68 and CD163 in common skin lesions. J Cutan Pathol 2014; 41:489-93. [DOI: 10.1111/cup.12327] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 03/02/2014] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- W. James Tidwell
- Department of Medicine; University of Tennessee Graduate School of Medicine; Knoxville TN USA
| | - Paul B. Googe
- Knoxville Dermatopathology Laboratory; Knoxville TN USA
- Department of Pathology, University of Tennessee Graduate School of Medicine; Knoxville TN USA
- Department of Pathology, Vanderbilt University; Nashville TN USA
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Ioannidis I, Manolakis C, Laurini JA, Roveda KP, de Melo S, Avery B, Boudreaux CW. Rectal extranodal Rosai-Dorfman disease diagnosed by EUS-FNA: a case report and review of the literature. Diagn Cytopathol 2014; 43:40-4. [PMID: 24554599 DOI: 10.1002/dc.23112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 12/04/2013] [Accepted: 01/09/2014] [Indexed: 11/06/2022]
Abstract
Rosai-Dorfman disease (RDD), also known as "sinus histiocytosis with massive lymphadenopathy," only rarely involves the gastrointestinal (GI) tract. Therefore, this unusual site of presentation can be challenging for the pathologist. We present a case of RDD manifesting as a rectal submucosal mass associated with rectal bleeding in a 54 year old woman. The diagnosis was made on cytologic preparations obtained through endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and subsequently confirmed by biopsy. To our knowledge, this is the first time extranodal RDD of the GI tract has been diagnosed by EUS-FNA. A review of previously published cases of GI RDD is presented to increase awareness of this exceptional presentation.
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Affiliation(s)
- Ioannis Ioannidis
- Department of Pathology, University of South Alabama Medical Center, Mobile, Alabama
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A rapidly recurring cutaneous xanthogranuloma-like histiocytic tumor: a diagnostic challenge. Am J Dermatopathol 2013; 35:e60-2. [PMID: 23291584 DOI: 10.1097/dad.0b013e31827b763f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Xanthogranuloma (XG) is a benign cutaneous histiocytic tumor occurring mainly in young children. Onset in adulthood is rarely observed. We encountered an unusual case of an XG-like cutaneous tumor on the scalp of a 50-year-old man. The tumor recurred with multiple satellite nodules soon after surgical excision. This unusual clinical behavior has not previously been described for XG and caused a diagnostic challenge; it was unclear whether the tumor was an atypical XG or a malignant dermal tumor mimicking an XG. Our analyses favored an XG-like dermal histiocytic tumor. A longer follow-up and reports of similar cases will reveal its true nature.
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Abstract
A relatively large number of new endothelial markers that can assist in the diagnosis and classification of endothelial and vascular neoplasms have become available over the past few years. The expression of these markers, however, differs considerably among the various tumors. A selection of markers that have potential diagnostic utility or are of current interest among pathologists are reviewed and compared with some of the more traditional markers that have been employed in diagnostic pathology.
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Shulman S, Katzenstein H, Abramowsky C, Broecker J, Wulkan M, Shehata B. Unusual presentation of Rosai-Dorfman disease (RDD) in the bone in adolescents. Fetal Pediatr Pathol 2011; 30:442-7. [PMID: 22026579 DOI: 10.3109/15513815.2011.618873] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Rosai-Dorfman disease (RDD), or sinus histiocytosis with massive lymphadenopathy (SHML), is a rare idiopathic histiocytic disorder. The usual presentation of RDD is painless bilateral cervical lymphadenopathy. Extranodal RDD with lymphadenopathy occurs in almost 50% of patients but extranodal RDD, without lymphadenopathy, is very rare. Isolated RDD in the bone occurs in only 2% of patients but it is histologically similar to its nodal counterpart. There are only 14 previously reported cases of RDD in the bone without lymph node involvement in children. Here we describe two new patients--one with rib and lung involvement and the other with multi-osseous involvement.
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Affiliation(s)
- Sarah Shulman
- Department of Pathology , Children's Healthcare of Atlanta, Atlanta, Georgia 30322, USA
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Abstract
Cutaneous reactive angiomatosis is an unusual benign vascular disorder of the skin usually associated to systemic diseases. It is characterized by lobular or diffuse proliferation of small blood vessels with hyperplasia of endothelial cells, pericytes, and sometimes histiocytes. We report a 59-year-old man with asymptomatic erythematous-violaceous patches on back, palms, and elbows for 9 months. Laboratory examination revealed changes consistent with B-chronic lymphocytic leukemia. Cutaneous biopsy showed a predominantly lobular small blood vessel proliferation in dermis with pericytic hyperplasia and mild perivascular lymphoplasmacytic infiltrate. Spontaneous involution of lesions occurred after 6 months. A second biopsy performed at the beginning of clinical involution showed a less prominent vascular component with perivascular giant cells with coexpression of CD68 and CD 31. To our knowledge, this is the first case of cutaneous reactive angiomatosis with documented histopathological findings of clinical involution.
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15
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Flucke U, Fischer HP. [Pathology along the liver sinusoids: intrasinusoidal findings]. DER PATHOLOGE 2008; 29:27-36. [PMID: 18210115 DOI: 10.1007/s00292-007-0961-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pathological findings in the liver sinusoids are mostly caused by extrahepatic or systemic diseases. Unclear fever, hepatosplenomegaly, portal hypertension or a mild elevation of liver enzymes are reasons for a liver biopsy leading to path-breaking diagnoses. Reactive intrasinusoidal lymphocytosis, especially with Epstein-Barr virus infections, has to be differentiated from predominantly intrasinusoidal lymphoproliferative malignancies. Intrasinusoidal megakaryocytes can be the first sign of a myeloproliferative or myelodestructive disease. Intrasinusoidal carcinosis and melanomatosis might present radiologically without tumor lesions and are easily overlooked histologically, in particular, if the critical cells have a similar size to hepatocytes. This also applies for intrasinusoidal storing macrophages. Gaucher's disease type I, and some other subtypes of inborn storage diseases might present for the first time in adulthood by hepatomegaly and Kupffer cell hypertrophy. Accompanying perisinusoidal fibrosis and immunohistochemical staining (CD68) can help to detect the large pale intrasinusoidal macrophages. In immunocompromized patients with fever, particular attention must be paid to intracellular agents, especially atypical mycobacteria and yeasts in non-granulomatous nested or dispersed Kupffer cells. Leishmaniasis with amastigotes in macrophages is accompanied by reactive sinusoidal plasmocytosis.
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Affiliation(s)
- U Flucke
- Institut für Pathologie, Universität Bonn, 53127, Bonn
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Ohsaki H, Nakamura M, Kagawa A, Yamanushi TT, Kushida Y, Haba R, Hirakawa E. Fine needle aspiration cytology of an enlarged inguinal lymph node. Cytopathology 2007; 19:389-93. [PMID: 18070121 DOI: 10.1111/j.1365-2303.2007.00527.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Ohsaki
- Department of Medical Technology, Laboratory of Pathology, Kagawa Prefectural College of Health Sciences, Kagawa, Japan.
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Tronnier M, Vogelbruch M. Atypical fibroxanthoma arising in an area of syringocystadenoma papilliferum associated with nevus sebaceus: positivity of the atypical fibroxanthoma component for CD31. J Cutan Pathol 2007; 34 Suppl 1:58-63. [DOI: 10.1111/j.1600-0560.2007.00735.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gaitonde S. Multifocal, extranodal sinus histiocytosis with massive lymphadenopathy: an overview. Arch Pathol Lab Med 2007; 131:1117-21. [PMID: 17617001 DOI: 10.5858/2007-131-1117-meshwm] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2007] [Indexed: 11/06/2022]
Abstract
CONTEXT This article provides an overview of the major pathologic manifestations of sinus histiocytosis with massive lymphadenopathy, including patient characteristics and current knowledge about its pathogenesis, with an emphasis on multifocal and extranodal presentation. Sinus histiocytosis with massive lymphadenopathy is a rare, nonneoplastic, idiopathic, proliferative histiocytic disorder; recognition of this disorder is important to avoid misinterpretation and subsequent unnecessary treatment. This is especially true for primary extranodal manifestation of this rare disorder. Although accurate diagnosis of this entity requires a correlation of clinical, radiologic, laboratory, and pathologic studies in most cases, it remains a disorder primarily defined by its histopathologic features and pathologic manifestations, which are key to the diagnosis. OBJECTIVE To summarize the scientific literature, provide a concise review, and emphasize the diagnostic histopathologic features of extranodal sinus histiocytosis with massive lymphadenopathy. DATA SOURCES A comprehensive literature review was undertaken to summarize the clinical and pathologic features of this disorder. CONCLUSIONS Sinus histiocytosis with massive lymphadenopathy is characterized by a rare, acquired, nonmalignant proliferation of distinctive histiocytes that present with lymphadenopathy or extranodal disease, primarily in children and young adults. It exhibits a broad range of clinical presentations, thus eliciting a wide differential diagnosis. The diverse clinical manifestations and frequent association with subtle or severe immunologic abnormalities suggest an immune-mediated cause. Additional studies are needed to characterize the interplay between death receptors and cytotoxic mediators and to further elucidate the loss of immune hemostasis that may underlie idiopathic histiocytic proliferations such as this.
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Affiliation(s)
- Sujata Gaitonde
- College of Medicine, Department of Pathology (MC 847), University of Illinois at Chicago, 840 S Wood St, Room 110 CSN, Chicago, IL 60612, USA.
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Rosso R, Lucioni M. Normal and neoplastic cells of brown adipose tissue express the adhesion molecule CD31. Arch Pathol Lab Med 2006; 130:480-2. [PMID: 16594742 DOI: 10.5858/2006-130-480-nancob] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT CD31 (platelet-endothelial cell adhesion molecule-1; PECAM-1), an adhesion molecule involved in the process of angiogenesis, is used as a marker of normal and neoplastic vascularization. During the assessment of angiogenesis and vascular invasion in a thymic carcinoid tumor, we observed unexpected immunostaining for CD31 in perithymic brown fat nests. OBJECTIVE To determine whether CD31 is expressed by normal and neoplastic cells of brown fat, a tissue whose thermogenetic activity depends heavily on high perfusion. DESIGN Formalin-fixed, paraffin-embedded archival tissues were immunostained by the labeled avidin-biotin method using antibodies against CD31 (clones JC70A and 1A10) after retrieval of heat-induced epitopes. Archival tissues included perithymic, periadrenal, axillary, and neck adipose tissue in which were embedded nests of brown fat (n = 15), hibernoma (n = 3), lipoma (n = 6), well-differentiated liposarcoma (n = 4), and myxoid liposarcoma (n = 4). RESULTS Invariably, multivacuolated and univacuolated adipocytes of normal brown fat and hibernomas were intensely positive for the CD31 antigen. The immunostaining "decorated" cell membranes and the membranes of intracytoplasmic vacuoles. No expression of CD31 was found in normal adipocytes of white fat, in neoplastic cells of lipomas, or in multivacuolated lipoblasts of well-differentiated and myxoid liposarcomas. CONCLUSIONS The spectrum of cell types that express CD31 is expanded to include normal and neoplastic brown fat cells. We speculate that the expression of CD31 may play a role in the development and maintenance of the vascular network characterizing this specialized adipose tissue. Moreover, CD31 may inhibit the Bax-mediated apoptosis of brown fat cells. For practical purposes, CD31 may be used as an immunohistochemical marker for distinguishing between white and brown fat and for diagnosing hibernoma in paraffin sections.
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Affiliation(s)
- Renato Rosso
- From the Department of Pathology, University of Pavia, IRCCS San Matteo Hospital, Pavia, Italy.
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Abstract
Langerhans cell histiocytosis (LCH) is a proliferative histiocytic disorder of unknown cause originating from dendritic cells. The clinical presentation of LCH is highly variable. Although the features of this disease have been well described in children, they remain poorly defined in adults. Here, we review the current knowledge about adult LCH, focussing on clinical presentation, diagnosis, treatment, and prognosis.
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Affiliation(s)
- Marcus Stockschlaeder
- Institute of Haemostasis and Transfusion Medicine, University Hospital Duesseldorf, Heinrich-Heine-University, Duesseldorf, Germany.
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Hicks J, Flaitz CM. Langerhans cell histiocytosis: current insights in a molecular age with emphasis on clinical oral and maxillofacial pathology practice. ACTA ACUST UNITED AC 2006; 100:S42-66. [PMID: 16037792 DOI: 10.1016/j.tripleo.2005.06.016] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Langerhans cell histiocytosis (LCH) commonly involves the oral and maxillofacial region, and comes to the attention of dental practitioners when a patient presents with orofacial pain and a bony or soft tissue lesion. This is a relatively rare entity, which has made it difficult to investigate the clinical, biologic, and molecular aspects of the disease. Treatment protocols are not well defined, particularly in adults. During the past decade, the Histiocyte Society has formulated various LCH categories, based on risk stratification, and treatment protocols for the pediatric population. Adult trials are currently available through the Histiocyte Society. Although there has been considerable controversy, the neoplastic nature of LCH has been established by demonstrating clonality. LCH symptoms and the development and persistence of LCH lesions have been ascribed to a "chemokine/cytokine storm" due to autocrine and paracrine mechanisms. Discovery of biologic, cytogenetic, and molecular abnormalities in LCH have already affected treatment by providing novel therapeutic targets.
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Affiliation(s)
- John Hicks
- Surgical and Ultrastructural Pathology, Texas Children's Hospital, Houston 77030-2313, USA.
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Abstract
Proliferations of Langerhans cells can be histologically divided into cytologically benign Langerhans cell proliferations, which include the clinical syndromes of Langerhans cell histiocytosis, and cytologically malignant Langerhans cell sarcoma. We report a Langerhans cell sarcoma in a 33-year-old male that arose on the posterior thigh with subsequent regional lymph node involvement. Conventional microscopic, immunohistochemical, and ultrastructural analysis confirmed Langerhans cell differentiation. Aberrant CD31 expression, similar to that described previously in Langerhans cell histiocytosis, was prominent in this tumor, possibly enhancing its migratory capabilities.
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Hargett C, Bassett T. Atypical Presentation of Sinus Histiocytosis With Massive Lymphadenopathy as an Epidural Spinal Cord Tumor. ACTA ACUST UNITED AC 2005; 18:193-6. [PMID: 15800441 DOI: 10.1097/01.bsd.0000137156.44689.c0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sinus histiocytosis with massive lymphadenopathy is a benign lymphoproliferative disorder growing in frequency as awareness of the disease increases. Also known as Rosai-Dorfman disease, it typically presents as painless cervical lymphadenopathy with fever and malaise. A review of the literature reveals approximately 400 cases of extranodal involvement and approximately 44 cases of central nervous system involvement. Less than 10 of the reported central nervous system tumors have presented as an epidural spinal cord tumor. The authors describe the case of a 29-year-old woman with progressive paraplegia and leg pain. Magnetic resonance imaging of the thoracic spine revealed a tumor mass from T5 to T9. The tumor was resected, and the spinal column was stabilized with pedicle screw fixation and fusion. Postoperative treatment was initiated with radiation and physical rehabilitation. The following is a case report with literature review of the entity.
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Kutmah K, Draw A. Rapidly developing Mediastinal Lymphadenopathy. Chest 2004. [DOI: 10.1378/chest.126.4_meetingabstracts.951s-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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