Pyogenic granuloma associated with conjunctival epithelial neoplasia: report of nine cases

2019 ◽  
Vol 103 (10) ◽  
pp. 1469-1474 ◽  
Author(s):  
Martina C Herwig-Carl ◽  
Hans E Grossniklaus ◽  
Philipp L Müller ◽  
Lisa Atzrodt ◽  
Karin U Loeffler ◽  
...  
Keyword(s):  
Demographic Data ◽  
Periodic Acid ◽  
Case Series ◽  
Pyogenic Granuloma ◽  
R0 Resection ◽  
Surgical Removal ◽  
Histopathological Analysis ◽  
Periodic Acid Schiff ◽  
Clinical Appearance ◽  
Complete Surgical Excision

AimsTo systematically describe the clinical and histopathological features of a case series of conjunctival carcinomatous lesions underlying as—and also masquerading—pyogenic granuloma.MethodsNine cases of conjunctival carcinomatous lesions underlying a pyogenic granuloma (which were clinically predominant) were retrospectively identified. Patients’ records were analysed for demographic data, clinical appearance and the postoperative course. Formalin-fixed paraffin-embedded specimens were routinely processed and stained with H&E and periodic acid-Schiff. Immunohistochemical stains for cytokeratin were performed in selected cases.ResultsAll nine tumours were located in the conjunctiva (bulbar, tarsal, limbal conjunctiva) of patients between 44 and 80 years. The lesions exhibited clinical features of pyogenic granuloma which dominated the clinical appearance. Additional features comprised a papillomatous appearance of the adjacent conjunctiva, a more whitish aspect of the lesion and a history of squamous cell carcinoma (SCC) respectively surgery for other entities. Histopathological analysis revealed a carcinomatous lesion (conjunctival intraepithelial neoplasia or SCC) at the base of a classic pyogenic granuloma in all nine cases. Surgical removal (R0 resection) was performed. Three cases received adjuvant mitomycin C or interferon α2b treatment. Two lesions locally recurred within 2 years after initial presentation.ConclusionCarcinomatous lesions may be accompanied by a pyogenic granuloma which may dominate the clinical pictures. As the tumour is usually located at the base of the lesion, a complete surgical excision followed by histopathological analysis is mandatory for each lesion appearing as conjunctival pyogenic granuloma.

scholarly journals Regression of Periocular Basal Cell Carcinoma: A Report of Four Cases with Clinicopathologic Correlation

2019 ◽  
Vol 6 (2) ◽  
pp. 107-114
Author(s):  
Martina C. Herwig-Carl ◽  
Karin U. Loeffler
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Demographic Data ◽  
Periodic Acid ◽  
Case Series ◽  
Lower Eyelid ◽  
Complete Regression ◽  
Periodic Acid Schiff ◽  
Clinical Appearance

Objectives: To describe the spectrum of clinical and histopathological features of a case series of basal cell carcinoma (BCC) with spontaneous regression and to discuss this phenomenon. Method: Four cases of BCC with complete/substantial regression were retrospectively identified. Patients’ records were analyzed for demographic data, clinical appearance, and the postoperative course. Formalin-fixed, paraffin-embedded specimens were routinely processed and stained with hematoxylin and eosin and periodic acid Schiff. Results: Complete (n = 1) or partial (n = 3) regression of BCC was observed in 4 patients. Two lesions at the medial canthus were histologically diagnosed as nodular BCC with significant regression. One lesion at the lower eyelid exhibited a complete regression which did not require surgical intervention. The other lesion at the lower eyelid presenting with ulceration and madarosis was excised. Scar tissue without evidence for a neoplasm was present histologically. Subsequently, the patient developed a recurrence with a histologically proven micronodular BCC. Conclusions: BCC can show spontaneous substantial or complete regression. Histological tumor absence in lesions which are clinically suspicious for a neoplasm can be a hint for a regressive BCC. Recurrences may develop from remaining tumor islands warranting periodical clinical visits in cases of clinically as well as histologically suspected regressive BCC.

scholarly journals The role of histopathology in the diagnosis of dermatophytoses / Značaj patohistološkog nalaza u dijagnostici dermatofitoza

2010 ◽  
Vol 2 (2) ◽  
pp. 45-53 ◽  
Author(s):  
Đorđi Gocev ◽  
Katerina Damevska
Keyword(s):  
Fungal Infection ◽  
Periodic Acid ◽  
False Negative ◽  
Histopathological Analysis ◽  
Unexpected Finding ◽  
Skin Infections ◽  
Specific Staining ◽  
Periodic Acid Schiff ◽  
Skin Reactions ◽  
Pas Staining

Abstract Histopathological analysis is not a routine procedure for diagnosing fungal skin infections. In the histopathological specimens, fungi are visible only when using special stain such as periodic acid-Schiff (PAS). However, histopathological analysis may not be performed in small laboratories. Histopathological characteristics of fungal skin infections are not specific. In all skin biopsy cases, obtained without clinical suspicion of fungal infection, the knowledge of certain, most frequent histopathological reaction patterns, as well as specific histopathological indicators (a diagnostic histopathological “clue”), of certain superficial mycoses e.g., dermatophytoses, may raise a suspicion of fungal infection and warrant a fungal-specific staining. A retrospective analysis of all PAS-stained sections was carried out. All PAS-positive biopsy specimens were assessed for clinical features, histopathological patterns of skin reactions, and presence of histopathological indicators. Our results have shown that out of the total of 361 PAS-stained sections, fungal hyphae were identified in 12 (3.3%) specimens. In 5 (1.4%) cases, the diagnosis of fungal infection was suspected on clinical grounds, while in 7 (1.9%) cases detection of fungi was an unexpected finding. The most frequent type of histopathological pattern was spongiotic, and the most frequent histopathological indicator was the presence of neutrophils within the epidermis. Our results confirm that dermatophytoses may present with clinical and histological non-specific findings. PAS staining represents a relatively cheap and simple fungal-specific staining. It has been suggested that it not only confirms that the selected material is actually invaded, but also reduces the number of false-negative direct reports, where fungi are cultured from a microscopically negative specimen. Apart from a small percentage of positive findings, our results justify the need for routine PAS staining of all clinically and histologically non-specific inflammatory skin conditions.

scholarly journals Recurrent pyogenic granuloma: an update

2015 ◽  
Vol 1 (1) ◽  
pp. 22 ◽  
Author(s):  
Rami A. Al-shiaty ◽  
Bacem A. E. Ottoman
Keyword(s):  
Alcian Blue ◽  
Periodic Acid ◽  
Pyogenic Granuloma ◽  
T Test ◽  
The Other ◽  
Dimensional Structure ◽  
Periodic Acid Schiff ◽  
Fibrous Stroma ◽  
Significant Difference ◽  
Initial Appearance

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Given the fierce controversy about the nature of pyogenic granulomas, starting with its unfitting name and ending up with its ideal treatment modality, this paper tries to numerically identify some predisposing factors of recurrence.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>The literature was initially reviewed and a total of twenty recurrent cases of pyogenic granuloma were contrasted, on one hand, to their initial appearance. On the other hand, all are contrasted to a similar number of normal mucosa using three histochemical stains: Alcian blue, periodic acid-Schiff and Masson’s trichrome.</p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>For all recurrent lesions, all specimens showed myxoid structure histologically even if their initial appearance had possessed a sparse myxoid structure. The age of recurrence has been correlated to the histochemical findings. For the Alcian Blue stain (AB), the value of t-test was 3.808840. The pertaining value of P was 0.000593. The result was significant at P ≤0.05. For the PAS stain, the value of t-test was 3.640327. The value of P was 0.000871. The result was significant at P ≤0.05. In Masson’s trichrome staining, the value of t-test was 3.100816. The value of P was 0.002942. The result was significant at P ≤0.05. Accordingly, all stains showed significant difference in fibrous content in the initial and recurrent lesions. Conversely, the count of both endothelial vessels and inflammatory infiltrates in the recurrent lesions were significantly lower than the primary precursors.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Given that collagen fibers are continually degraded and resynthesized while proteolytic degradation occur outside the cells through the activity of enzymes called  matrix metalloproteinases (MMPs), it is suggested that MMPs -positively expressed by PAS reactions- account for the spacing of the fibrous stroma, allowing for reshaping the three dimensional structure of the connective tissue. Myxoid structures are certainly promoting recurrence either via excessive secretion of hyaluronic acids or unknown mechanisms. The undisputed fact is the presence of myxoid structures in all our reported recurrent cases. Both inflammatory cascade and endothelial proliferation have no vital role in the recurrence according to our morphometric results. Finally, PAS stain should give more details in examining PGs than the other recruited counterparts.</p><p class="abstract"><strong><span lang="EN-US">Keywords: </span></strong><span lang="EN-US">Recurrent pyogenic granuloma, PAS stain, Myxoid structures, Etiopathogensis</span></p><p class="keywords"> </p>

Submucosal Lifting Agent ORISE Gel Remnants Histopathologically Mimic Mucin and Malignancy: A Case Series

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S73-S73 ◽  
Author(s):  
Luke Cypher ◽  
Shaoli Sun ◽  
Erin Forster ◽  
Brenda Hoffman ◽  
David Lewin
Keyword(s):  
Colon Cancer ◽  
Epithelial Cells ◽  
Amorphous Material ◽  
Periodic Acid ◽  
Case Series ◽  
The United States ◽  
Periodic Acid Schiff ◽  
Good Communication ◽  
Gastrointestinal Lesions ◽  
Hematoxylin And Eosin

Abstract Introduction There were an estimated 18.1 million new cancer cases in 2018, with colon cancer being the third most common worldwide. Colon cancer development is an accumulation of mutations resulting in normal epithelial cells transforming into adenomas and then adenocarcinomas. In certain scenarios, endoscopic interventions have gained considerable momentum over invasive surgery as an alternative to manage early gastrointestinal lesions. New techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection allow for removal of large, flat sessile polyps. Successful EMR is dependent on expanding the submucosal space to create adequate lift of the polyp to facilitate tissue capture and to avoid perforation and excess bleeding. ORISE gel (Boston Scientific) is a submucosal lifting agent currently in use in the United States. Methods We present three cases of gastrointestinal specimens obtained using ORISE gel. Histological analysis with hematoxylin and eosin revealed submucosal amorphous deposits that appeared to be mucin. Due to the concern for malignancy, additional stains were performed, including periodic acid–Schiff with diastase digestion (DPAS) to identify mucin. DPAS staining for mucin was negative, indicating the mucinous-appearing amorphous material seen on hematoxylin and eosin staining was not mucin but a likely remnant ORISE gel used during EMR. Additional immunohistochemical stains for epithelial cells (cytokeratin AE1/AE3) were also performed to exclude the presence of infiltrating tumor cells. Conclusion These three cautionary cases reveal the importance of good communication between endoscopists and pathology. In an effort to avoid overdiagnosis and/or the usage of unnecessary additional stains, pathologists should be alerted of ORISE gel usage.

scholarly journals Vascular malformations of central nervous system: A series from tertiary care hospital in South India

2016 ◽  
Vol 07 (02) ◽  
pp. 262-268
Author(s):  
Sudhir Babu Karri ◽  
Megha S. Uppin ◽  
A. Rajesh ◽  
K. Ashish ◽  
Suchanda Bhattacharjee ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Vascular Malformations ◽  
Demographic Data ◽  
Periodic Acid ◽  
Tertiary Care ◽  
Care Hospital ◽  
Periodic Acid Schiff ◽  
Radiological Features ◽  
Risk Of Hemorrhage

ABSTRACT Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs) of central nervous system (CNS). Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG), Masson’s trichrome, periodic acid-Schiff, and Perls’ stains. Morphologically, cavernomas and arteriovenous malformations (AVMs) were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36) presented with seizures, whereas AVM patients (8/12) had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage.

scholarly journals Immunopathological Analysis of a Mouse Model of Arthritis-Associated Scleritis and Implications for Molecular Targeted Therapy for Severe Scleritis

2021 ◽  
Vol 23 (1) ◽  
pp. 341
Author(s):  
Yusuke Nishio ◽  
Hiroko Taniguchi ◽  
Ayaka Takeda ◽  
Junko Hori
Keyword(s):  
Animal Model ◽  
Targeted Therapies ◽  
Plasma Cells ◽  
Case Series ◽  
Histopathological Analysis ◽  
Posterior Scleritis ◽  
Clinical Appearance ◽  
Case Series Study ◽  
Collagen Ii ◽  
Series Study

Scleritis involves inflammation of the sclera, which constitutes 75% of the wall of the eye. This pathology is often seen as an ocular lesion associated with systemic inflammatory diseases. Severe types of scleritis such as posterior scleritis require urgent immunosuppressive treatments, including molecularly targeted therapies to avoid permanent visual impairment. Which molecules should be selected as targets has remained unclear. To clarify the pathogenesis of scleritis and propose appropriate target molecules for therapy, we have established novel animal model of scleritis by modifying the Collagen-II Induced Arthritis (CIA) model. Immunization twice with collagen II emulsified with complete Freund’s adjuvant (CFA) caused arthritis and scleritis. The clinical appearance resembled human diffuse scleritis. Histopathological analysis suggested that macrophages, plasma cells, deposition of immune complexes, and growth of blood and lymphatic vessels are involved in the pathogenesis of CIA-associated scleritis. In addition, we analysed the background diseases of posterior scleritis and responses to molecularly targeted therapies as a case series study. We inferred from both the animal model and case series study that targets should not be T cells, but factors inhibiting macrophage activity such as tumor necrosis factor (TNF) and interleukin (IL)-6, and molecules suppressing antibody-producing cells such as CD20 on B cells should be targeted by molecularly targeted therapies.

scholarly journals Cutaneous Blastomycosis – a case report

2012 ◽  
Vol 4 (3) ◽  
pp. 119-128
Author(s):  
Đuka Ninković Baroš ◽  
Jagoda Balaban ◽  
Svetlana Tomašević Pavlović ◽  
Aleksandra Salapura Dugonjić ◽  
Gorana Popović ◽  
...  
Keyword(s):  
Bosnia And Herzegovina ◽  
Periodic Acid ◽  
Great Majority ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Histopathological Analysis ◽  
Periodic Acid Schiff ◽  
Dimorphic Fungi ◽  
Negative Woman ◽  
Banja Luka

Abstract We present a 46-year-old non-atopic HIV-negative woman from Doboj, Republic of Srpska, Bosnia and Herzegovina, who was referred to the Department of Dermatovenereology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina, with a 3-month long history of an erythematous, large indurated infl amed area on the upper arm. The condition was asymptomatic, immediately following surgical excision of a small tumor. After exlusion of pulmonary blastomycosis and other organ involvement, the diagnosis of primary inoculation cutaneous blastomycosis was made based on clinical presentation and histopathological fi ndings. Histopathology revealed thick-walled, rounded, budding yeasts with broad-based buds that stained pink with periodic acid-schiff (PAS) staining. Itraconazole therapy was initiated at a dose of 2x100 mg/day. After three months of therapy, the dose of itraconazole was increased to 2x200 mg/day during the next three months, and then the dose was reduced to 2x100 mg. Blastomycosis is an uncommon, chronic granulomatous and suppurative mycosis caused by Blastomyces dermatitidis, which belongs to the group of main endemic systemic mycoses and in the great majority of cases represents a primary pulmonary disease. Few sporadic cases have been reported in Europe. There are three forms of blastomycosis: primary cutaneous, pulmonary and disseminated. B. dermatitidis has rarely been isolated from the environment. Wood debris or land close to rivers or subject to fl ooding are considered to be the natural substrate. The fungus can grow in sterile soil in the laboratory, and it is believed that humans get infected by inhaling spores from a saprophytic source. Primary cutaneous blastomycosis is very rare and it is found in farmers and laboratory workers. Human to human transmission does not normally occur. The diagnosis of the skin lesions is made by direct microscopy of skin samples (e.g., pus, scrapings) with 10% potassium hydroxide mount and confi rmed by culture or biopsy. Histopathological analysis provides identifi cation of all the dimorphic fungi. However, this can be complicated by the fact that in some cases they can be morphologically atypical or sterile. In the tissues, B. dermatitidis produces characteristic thick-walled, rounded, refractile, and spherical budding yeasts with broad-based buds. Of the available antimycotic drugs, itraconazole 200 mg/day is probably the most effective, but at least 400 mg/day is redommended initially.

Hepatotoxic effects of melamine exposure from the weaning period in rats: a flow cytometric, electron microscopic, and histopathologic study

2021 ◽  
Author(s):  
Zuleyha Erisgin ◽  
Hasan Serdar Mutlu ◽  
Yavuz Tekelioglu ◽  
Engin Deveci ◽  
Ugur Seker
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Periodic Acid ◽  
Flow Cytometric Analysis ◽  
Control Group ◽  
Albino Rats ◽  
Histopathological Analysis ◽  
Periodic Acid Schiff ◽  
Flow Cytometric ◽  
Transmission Electron

Abstract This study aims to investigate the effects of melamine exposure from the weaning period (21st postnatal days in rats) on liver tissue. Female Wistar albino rats (n = 18) were divided into three groups. About 0.1-ml saline was applied to the control group by gavage for 21 days from the postnatal 21st day. The second group was taken 50-mg/kg melamine (in 0.1-ml saline) and the third group was taken 75-mg/kg melamine (in 0.1-ml saline) p.o. On the postnatal 45th day, all rats were sacrificed under anesthesia. Then, liver tissues were cut into three parts and two of them placed in neutral formalin for histopathological and flow cytometric analysis, and one of them placed in 2.5% glutaraldehyde. Histopathological analysis was performed with hematoxylin & eosin, Masson trichrome, periodic acid Schiff stained sections, and also with transmission electron microscopy. Apoptosis (Annexin V positivity) was analyzed by flow cytometry. According to histopathological analysis, hepatocyte damage, sinusoidal dilatation, and inflammatory cell infiltration significantly increased in both melamine groups compared with the control group. Apoptosis significantly increased in the 50 and 75-mg melamine groups compared with the control group. In the results of transmission electron microscopy analysis, there was abnormal chromatin distribution in the hepatocyte nuclei, loss in the cristae of the mitochondria, and organelle loss in large areas in the cytoplasm in both melamine exposure groups. As result, melamine exposure from the weaning period causes liver damage with increasing doses.

scholarly journals Novel inflammatory cell infiltration scoring system to investigate healthy and footrot affected ovine interdigital skin

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5097 ◽  
Author(s):  
Michael Agbaje ◽  
Catrin S. Rutland ◽  
Grazieli Maboni ◽  
Adam Blanchard ◽  
Melissa Bexon ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Scoring System ◽  
Inflammatory Cell ◽  
Periodic Acid ◽  
Inflammatory Cell Infiltration ◽  
Cell Infiltration ◽  
Histopathological Analysis ◽  
Periodic Acid Schiff ◽  
Dichelobacter Nodosus ◽  
Inflammatory Score

Ovine footrot is a degenerative disease of sheep feet leading to the separation of hoof-horn from the underlying skin and lameness. This study quantitatively examined histological features of the ovine interdigital skin as well as their relationship with pro-inflammatory cytokine (IL-1β) and virulent Dichelobacter nodosus in footrot. From 55 healthy and 30 footrot ovine feet, parallel biopsies (one fixed for histology) were collected post-slaughter and analysed for lesions and histopathological analysis using haematoxylin and eosin and Periodic Acid-Schiff. Histological lesions were similar in both conditions while inflammatory scores mirror IL-1β expression levels. Increased inflammatory score corresponded with high virulent D. nodosus load and was significant (p < 0.0001) in footrot feet with an inflammatory score of 3 compared to scores 1 and 2. In addition, in contrast to healthy tissues, localisation of eubacterial load extended beyond follicular depths in footrot samples. The novel inflammatory cell infiltration scoring system in this study may be used to grade inflammatory response in the ovine feet and demonstrated an association between severity of inflammatory response and increased virulent D. nodosus load.

scholarly journals Cystadenocarcinoma simulating hemangiosarcoma of the salivary gland in dog: case report

2011 ◽  
Vol 63 (3) ◽  
pp. 574-578
Author(s):  
C.O. Gamba ◽  
K.A. Damasceno ◽  
C.B. Campos ◽  
E. Ferreira ◽  
G.D. Cassali
Keyword(s):  
Salivary Gland ◽  
Blood Cells ◽  
Periodic Acid ◽  
Morphological Characteristics ◽  
Immunohistochemical Analysis ◽  
Histopathological Analysis ◽  
High Grade ◽  
Periodic Acid Schiff ◽  
Tumor Mass ◽  
Pas Staining

Cystadenocarcinoma is regarded as a rare adenocarcinoma variant in animals. This work reports the case of an 8-year-old female Poodle dog with salivary gland cystadenocarcinoma with morphological characteristics similar to a hemangiosarcoma. Histopathological analysis showed a tumor mass with cystic formations containing a large amount of red blood cells. In order to distinguish these two entities, periodic acid Schiff (PAS) staining and immunohistochemical analysis were carried out with the use of cytokeratin AE1/AE3 (CK) and CD31-specific antibodies. Neoplastic cells were PAS-negative, CK-positive and CD31-negative confirming their epithelial origin. Based on the findings, the diagnosis of high grade cystadenocarcinoma was established.

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