An Unusual Case of Genital Lesion: A Vulvar Syringoma

Objective: Syringoma is a benign adnexal neoplasm of sweat gland, usually presenting as extra-genital lesions, while vulvar localization is rare. Moreover, syringoma is an uncommon vulvar neoplasms.

Case report: A 44-year-old woman with previous diagnosis of duodenal gastrointestinal stromal tumour, underwent a local surgical excision for an isolated, painful, vulvar lesion. The specimen was submitted for histological examination.

A vulvar syringoma was diagnosed.

Conclusion: We describe this case according on its rarity and atypical presentation as well; therefore, vulvar neoplasms encompass many differential diagnoses, among which the incidence rate of syringoma is very low. Although its rarity, syringoma should be included among the differential diagnosis for vulvar neoplasm.

Genotyping of Different Pseudomonas Aeruginosa Morphotypes Arising from the Lower Respiratory Tract of a Patient Taken to an Intensive Care Unit

Pseudomonas aeruginosa is an opportunistic pathogen and an ubiquitous environmental bacterium. Fifty-seven days after hospitalization, we isolated three distinct P. aeruginosa morphotypes (smooth, rough and mucoid) from the lower respiratory tract of a patient admitted to a Cardiology Intensive Care Unit (ICU). Moreover, a group of nine colony variants, arising from the three P. aeruginosa isolates growing in laboratory growth media, were also isolated. The resulting 12 isolates were characterised for antibiotic resistance profile and subjected to genotypic analysis by fluorescent-Amplified Fragment Length Polymorphism (f-AFLP) and automated repetitive extragenic palindromic-PCR (rep-PCR) fingerprinting. The three smooth, rough and mucoid morphotypes presented different antibiotic resistance profiles and genotyping analysis showed that they belonged to distinct clones, indicating that at day 57 after the admission the patient was simultaneously colonized by three distinct P. aeruginosa isolates. On the other hand, the nine colony variants presented heterogeneous antibiotic resistance profiles and clustered together with the three parental isolates. The understanding of the link between genotype plasticity and antibiotic resistance may contribute to improving our knowledge of this life-threatening pathogen.

Transgenic expression of a fungal endo-polygalacturonase increases plant resistance to pathogens and reduces auxin sensitivity

Polygalacturonases (PGs), enzymes that hydrolyze the homogalacturonan of the plant cell wall, are virulence factors of several phytopathogenic fungi and bacteria. On the other hand, PGs may activate defense responses by releasing oligogalacturonides (OGs) perceived by the plant cell as host-associated molecular patterns. Tobacco (Nicotiana tabacum) and Arabidopsis (Arabidopsis thaliana) plants expressing a fungal PG (PG plants) have a reduced content of homogalacturonan. Here, we show that PG plants are more resistant to microbial pathogens and have constitutively activated defense responses. Interestingly, either in tobacco PG or wild-type plants treated with OGs, resistance to fungal infection is suppressed by exogenous auxin, whereas sensitivity to auxin of PG plants is reduced in different bioassays. The altered plant defense responses and auxin sensitivity in PG plants may reflect an increased accumulation of OGs and subsequent antagonism of auxin action. Alternatively, it may be a consequence of perturbations of cellular physiology and elevated defense status as a result of altered cell wall architecture.

Targeted modification of homogalacturonan by transgenic expression of a fungal polygalacturonase alters plant growth

Pectins are a highly complex family of cell wall polysaccharides comprised of homogalacturonan (HGA), rhamnogalacturonan I and rhamnogalacturonan II. We have specifically modified HGA in both tobacco (Nicotiana tabacum) and Arabidopsis by expressing the endopolygalacturonase II of Aspergillus niger (AnPGII). Cell walls of transgenic tobacco plants showed a 25% reduction in GalUA content as compared with the wild type and a reduced content of deesterified HGA as detected by antibody labeling. Neutral sugars remained unchanged apart from a slight increase of Rha, Ara, and Gal. Both transgenic tobacco and Arabidopsis were dwarfed, indicating that unesterified HGA is a critical factor for plant cell growth. The dwarf phenotypes were associated with AnPGII activity as demonstrated by the observation that the mutant phenotype of tobacco was completely reverted by crossing the dwarfed plants with plants expressing PGIP2, a strong inhibitor of AnPGII. The mutant phenotype in Arabidopsis did not appear when transformation was performed with a gene encoding AnPGII inactivated by site directed mutagenesis.

Granular cell tumor of the hypopharynx treated by endoscopic CO(2) laser excision: report of two cases

BACKGROUND

Granular cell tumor (GCT), or Abrikossoff's tumor, is an unusual lesion probably arising from Schwann cells. It is frequently found in the head and neck region, where the tongue is the most commonly affected site. Involvement of the hypopharynx is exceedingly rare because, to the best of our knowledge, only four cases have been reported in the literature.

METHODS

We describe hypopharyngeal GCT in two women aged 29 and 52 years, respectively.

RESULTS

In the first patient, preoperative diagnostic examination, including endoscopy, CT, and MRI scan, was suggestive of a benign lesion arising from the posterior wall of the hypopharynx. In the second patient, a previous biopsy of the postcricoid area performed elsewhere suggested a diagnosis of well-differentiated squamous cell carcinoma, and CT scan staged the lesion as T1 N0. In both cases, treatment included surgical excision under microlaryngoscopy with CO(2) laser. The histopathologic study of the specimens, supported by immunohistochemical techniques, determined the lesions to be a GCT. The postoperative course was uneventful, and the patients were discharged 12 and 2 days after surgery, respectively. Both patients were asymptomatic without evidence of recurrence when last seen 2 years and 4 months after surgery, respectively.

CONCLUSIONS

GCT should be included in the differential diagnosis of submucosal hypopharyngeal lesions. Endoscopy and radiologic imaging do not display any typical finding suggestive of the diagnosis, which can be based only on histologic findings. Resection of the tumor, when technically feasible, should be performed under microlaryngoscopy with the CO(2) laser, which makes it possible to work in a bloodless field with minimal thermal damage and reduction of scarring and postoperative edema.