CYTOLOGICAL INDICES IN CHILDREN WITH GINGIVITIS

CYTOLOGICAL INDICES IN CHILDREN WITH GINGIVITISMelnyk V.S., Horzov L.F.Development of gingivitis in children with fixed orthodontic appliances (FOA) is an urgent problem of today's periodontology, requiring elaboration of new methods that would give an opportunity not only to diagnose but also to predict the course of periodontitis in a given population. The investigation was conducted in patients with catarrhal and hypertrophic gingivitis during the treatment by FOA. It was established that cellular composition of gum mucosa undergoes cytosospecific alterations, which is manifested by qualitative changes of gingival epitheliocytes. In this case the indices of pathological shift point to the clinical and morphological form of the diagnosed inflammatory process in the gums. Conclusion. The maximal intensity of the inflammatory process in the gums takes 3 months of using FOA while the cytological criteria in this observation period are the functional state of segmental leukocytes and the alterative changes of intermediate cells in the form of foamy cytoplasm in children with catarrhal gingivitis. In children with hypertrophic gingivitis cytological adjustment indices are destructive changes in the epithelial cells, which manifests itself as the appearance of the naked core elements and signs of necrobiosis against the background of a large number of segmental leukocytes. Keywords: gingivitis, epithelial cells, fixed orthodontic appliances, cytological indicators, children. ЦИТОЛОГІЧНІ ПОКАЗНИКИ У ДІТЕЙ З ГІНГІВІТОМ.Мельник В.С., Горзов Л.Ф.Мета. Розвиток гінгівіту у дітей з фіксованими ортодонтичними конструкціями є актуальною проблемою сучасної пародонтології і вимагає розробки нових методів, які дадуть можливість не тільки діагностувати, але й прогнозувати перебіг захворювань тканин пародонта у даного контингенту пацієнтів. Результати. Дослідження проводилося у пацієнтів з катаральним і гіпертрофічним гінгівітом під час лікування незнімними ортодонтичними апаратами. Встановлено, що клітинний склад слизової оболонки ясен піддається цитоспецифічній перебудові, що проявляється в якісних змінах ясенних епітеліоцитів. В цьому випадку показники патологічного зсуву вказують на клініко-морфологічну форму діагностованого запального процесу в яснах. Висновок. Максимальної інтенсивності запальний процес в яснах набуває на 3 місяць користування незнімними ортодонтичними апаратами, при цьому цитологічними критеріями в даний термін спостережень є функціональний стан сегментоядерних лейкоцитів і альтеративні зміни проміжних клітин в вигляді піноподібної цитоплазми у дітей з катаральним гінгівітом. У дітей з гіпертрофічним гінгівітом індикаторами цитологічної перебудови є деструктивні зміни епітеліоцитів, що проявляється появою голоядерних елементів і ознак некробіозу на тлі великої кількості сегментоядерних лейкоцитів, частина з яких лізовані.Ключові слова: гінгівіт, епітеліальні клітини, фіксовані ортодонтические апарати, цитологічні показники, діти. ЦИТОЛОГИЧЕСКИЕ ПОКАЗАТЕЛИ У ДЕТЕЙ С ГИНГИВИТОМ.Мельник В.С., Горзов Л.Ф.Цель. Развитие гингивита у детей с фиксированными ортодонтическими апаратами является актуальной проблемой современной пародонтологии и требует разработки новых методов, которые дадут возможность не только диагностировать, но и прогнозировать ход заболеваний пародонта у данного контингента пациентов. Результаты. Исследование проводилось у пациентов с катаральным и гипертрофическим гингивитом во время лечения несьемной ортодонтической аппаратурой. Установлено, что клеточный состав слизистой оболочки десны подвергается цитоспецифическим изменениям, что проявляется в качественных изменениях десневых эпителиоцитов. В этом случае показатели патологического сдвига указывают на клинико-морфологическую форму диагностированного воспалительного процесса в деснах. Выводы. Максимальной интенсивности воспалительный процесс в десне приобретает на 3 месяц пользования несьемной ортодонтической апаратуры, при этом цитологическими критериями в данный термин наблюдений является функциональное состояние сегментоядерных лейкоцитов и альтеративные изменения промежуточных клеток в виде пенообразного цитоплазмы у детей с катаральным гингивитом. У детей с гипертрофическим гингивитом индикаторами цитологической перестройки являются деструктивные изменения эпителиоцитов, что проявляется появлением голоядерних элементов и признаков некробиоза на фоне большого количества сегментоядерных лейкоцитов, часть из которых лизированных.Ключевые слова: гингивит, эпителиальные клетки, фиксированные ортодонтические апараты, цитологические показатели, дети.

The role of preoperative PSA level in prostate cancer

Background: PSA levels between 0-4 ng/ml is generally accepted as normal range, there is no world widely accepted cut-off value. PSA level is most commonly used for determining patients to whom needle biopsy should be performed. Authors aimed to investigate the relationship between preoperative PSA level and histopathological features.Methods: Ninety prostatic adenocarcinoma cases diagnosed between January 2013 and January 2018 and treated by RP were included. Patients had no measurement of PSA before the operation were excluded from the study. Patients were grouped according to preoperative PSA as low-risk (<10 ng/ml), medium-risk (10-20 ng/ml) and high-risk (>20 ng/ml). The relations between all of the histopathological parameters were analyzed in addition to the preoperative PSA levels.Results: The mean age and preoperative PSA level was found as 64.16, and 12.33, respectively. The presence of EPE and tumour positive base margin showed significant relation among PSA groups as well as the presence of lymphovascular invasion and the involvement of the seminal vesicles. Intracytoplasmic mucin and foamy cytoplasm was more common in low-risk PSA group and the difference was significant.Conclusions: PSA level is one of the most commonly used marker for predicting high risk patients before the operation however it may also show relation with various histopathological factors that have effect on the prognosis of prostatic adenocarcinoma.

Expanding the Phenotype of ALK-positive Histiocytosis: A Report of 2 Cases

ALK-positive histiocytosis is a recently described rare histiocytic proliferative disorder of early infancy. When infants present with anemia, thrombocytopenia, and hepatosplenomegaly, this entity should be included in the differential diagnosis along with hemophagocytic lymphohistiocytosis, metabolic/storage diseases, hematopoietic malignancies, and autoimmune thrombocytopenia. We report 2 new cases of ALK-positive histiocytosis, one with kidney involvement and the other with extensive bone marrow involvement in addition to an overt liver disease. Renal involvement by ALK-positive histiocytosis has not been reported. The infiltrating histiocytes in this case showed Rosai–Dorfman disease-like morphology including emperipolesis. The histiocytes in the second case with extensive bone marrow involvement had foamy cytoplasm initially suggesting storage disease. Our 2 cases highlight previously unrecognized diversity of ALK-positive histiocytosis in clinical manifestation, organ involvement, and cytomorphologic features and further elucidate the diagnostic challenges of this rare entity.

The cytopathologic features of mammary analog secretory carcinoma and its mimics

Mammary Analogue Secretory Carcinoma (MASC) is a newly recognized neoplasm of the salivary gland, first described in 2010. This tumor harbors a unique translocation, t(12;15)(p13;q25) that results in the fusion of ETV6 with NTRK3 which produces a transformative chimeric tyrosine kinase. To date, few cases of MASC sampled by fine needle aspiration have been reported. Cytologically, MASC can be confused with other oncocytic salivary gland tumors, including Warthin-tumor, acinic cell carcinoma (AciCC) and mucoepidermoid carcinoma. It is characterized by a monomorphic population of lesional cells with round nuclei, prominent nucleoli and abundant, eosinophilic foamy cytoplasm; forming papillary groups with transgressing vessels. Though, based on cytomorphology alone, the definite diagnosis can be challenging, in conjunction with available clinical clues (i.e. male patient, extra-parotid site) MASC should be included in the differential diagnosis of FNA specimens diagnosed as oncocytic salivary gland neoplasms or suspicious for AciCC. Here we present a case of MASC with FNA sampling at our institution.

Lipoid Pneumonia in a Gas Station Attendant

The exogenous lipoid pneumonia, uncommon in adults, is the result of the inhalation and/or aspiration of lipid material into the tracheobronchial tree. This is often confused with bacterial pneumonia and pulmonary tuberculosis due to a nonspecific clinical and radiologic picture. It presents acutely or chronically and may result in pulmonary fibrosis. We describe here a case of lipoid pneumonia in a gas station attendant who siphoned gasoline to fill motorcycles; he was hospitalized due to presenting with a respiratory infection that was hard to resolve. The patient underwent bronchoscopy with bronchoalveolar lavage, which, on cytochemical (oil red O) evaluation, was slightly positive for lipid material in the foamy cytoplasm of alveolar macrophages. Due to his occupational history and radiographic abnormalities suggestive of lipoid pneumonia, a lung biopsy was performed to confirm the diagnosis. The patient was serially treated with segmental lung lavage and showed clinical, functional, and radiological improvement.

Multiple Reticulohistiocytomas in an 88-year-old Man: a Case Report

Solitary and multiple reticulohistiocytomas, often referred to as diffuse cutaneous reticulohistiocytosis, that are generally restricted to skin, must be differentiated from multicentric reticulohistiocytosis. Multicentric reticulohistiocytosis is a rare histiocytic proliferative disease affecting joints, skin and mucous membranes, while arthropathy usually precedes skin and mucosal involvement. Other organs may also be involved, and 20% of patients have an associated internal malignancy. Multicentric reticulohistiocytosis has been reported to be associated with autoimmune diseases and malignancies. We present an 88-year-old man, with a sudden eruption of asymptomatic, firm, skin to brown colored papules and nodules, 6 to 17 mm in diameter, localized on forehead, arms, legs, and buttocks. There were no symptoms of joint or other organ involvement. Clinical and dermoscopic characteristics pointed to reticulohystiocytomas. Multiple excision biopsies of different tumors were performed and histopathology reports confirmed the diagnosis. In the case presented, reticulohistiocytosis was limited to the skin, exhibiting multiple reticlohistiocytomas with typical clinical, dermoscopic and rather peculiar histopathology presentation. Apart from this, some histologic features were seen in early lesions of multicentric reticulohistiocytosis, such as multinuclear cells dissociating collagen fibers with pale eosinophilic and foamy cytoplasm. Besides surgical excisions, no other treatment options were done. Laboratory and other tests showed no presence of extracutaneous illness, and no autoimmune or paraneoplastic processes. At one year follow up, the remaining tumors were of the same size, but there were no recurrences at excision sites, no signs of disease progression or systemic involvement. Since diffuse cutaneous reticulohistiocytosis without arthropathy as well as isolated reticulohistiocytomas have been described, in some cases of multiple reticulohistiocytomas even without systemic symptoms and signs, multicentric reticulohistiocytosis should be considered with an appropriate follow up. In such cases, skin lesions have the same histological features as lesions in multicentric reticulohistiocytosis, but they are not associated with joint problems or neoplasms.

Mammary Carcinoma with Sebaceous Differentiation in a Dog

This report describes an invasive mammary carcinoma with a rare distinctive feature characterized by sebaceous differentiation of tumor cells. This tumor occurred in a 10-year-old female mixed breed dog. The patient had two masses in the left fifth mammary gland. Grossly, the masses were firm, whitish to light brown, and superficially ulcerated. On cut surface, they were multilobulated with foci of necrosis. Microscopically, the tumors were composed of two distinctive neoplastic components, intraductal papillary adenocarcinoma and sebaceous carcinoma. The regions of sebaceous tumor were clumped separately, contained well-developed sebaceous cells and keratinized epithelial cells, and were surrounded by few to several layers of basaloid cells. The cells with abundant foamy cytoplasm that resembled sebaceous cells were also found within the intraductal papillary-like nests of mammary carcinoma, providing evidence of sebaceous metaplasia. Sebaceous differentiation in a mammary gland tumor is possible, because skin appendages and ductal apparatus of the mammary gland share a common anlagen. This tumor had an aggressive behavior with lymphatic metastasis. Consequentially, the dog had a poor prognosis.

Xanthelasma or Xanthoma of the Fallopian Tube

We report a case of a 24-year-old woman who presented with abdominal pain, a tense abdomen, and rebound tenderness. A vague, ill-defined mass was palpated, and an ultrasound examination revealed a cystic lesion in the left adnexal region. At laparotomy, a slightly dilated fallopian tube was seen and excised. Light microscopy showed intact fallopian tube mucosa, with a diffuse infiltrate of foam cells in the lamina propria. There were no associated inflammatory cells. The foam cells were positive for CD68 and negative for AE1/AE3. Discontinuous areas of the epithelium also showed epithelial cells with “foamy cytoplasm.” These cells were negative for CD68 but positive for AE1/AE3. To our knowledge, this represents the first case of a fallopian tube xanthelasma that shows a resemblance to lesions encountered in the stomach. Fallopian tube xanthelasma must be distinguished from xanthogranulomatous salpingitis, which is associated with an inflammatory cell infiltrate, often including giant cells. However, this lesion may share pathogenetic similarities with xanthogranulomatous salpingitis, since both processes are mediated by inflammation.

Intrasellar Pleomorphic Xanthoastrocytoma: Case Report

OBJECTIVE AND IMPORTANCE A patient with a primary intrasellar pleomorphic xanthoastrocytoma is described. CLINICAL PRESENTATION A 78-year-old woman experienced slowly progressing bilateral visual disturbance. Analysis of magnetic resonance imaging scans indicated a well-enhanced tumor occupying intra- and suprasellar spaces with displacement of the pituitary gland anteriorly. INTERVENTION Partial resection of the tumor via the transsphenoidal route brought about improvement of the patient's visual disturbance. The tumor was conspicuously pleomorphic and composed of plump to spindle-shaped large and bizarre cells with single or multiple nuclei and lipid-laden foamy cytoplasm. The neoplastic cells were positive for glial fibrillary acidic protein, S-100 protein, and vimentin. The MIB-1 antibody labeling index was very low (&lt;1%) CONCLUSION Pleomorphic xanthoastrocytoma should be included in the differential diagnosis of tumors arising in the posterior hypophysis.

Immunohistochemical Localization of Apolipoprotein B-100 (ApoB-100) and Expression of Glutathione Peroxidase (GSH-PO) in Canine Atherosclerotic Lesions

We used immunohistochemistry to localize canine Apolipoprotein B-100 (CApoB-100) and glutathione peroxidase (GSH-PO) in canine atherosclerotic lesions. CApoB-100 was deposited in the tunica intima and cytoplasms of infiltrating macrophages in early atherosclerotic lesions. In advanced atherosclerotic lesions, the cystic space of the lesions contained a large amount of CApoB-100 immunoreaetive material. Expression of GSH-PO was recognized in the foamy cytoplasm of macrophages and smooth muscle cells in the early and advanced atherosclerotic lesions. These results indicate that expression of GSH-PO is closely associated with the deposition of CApoB-100. In addition, they suggest that, as in human atheromas, low-density lipoprotein (LDL) is peroxidized and changed into modified LDL. Deposition of modified LDL (oxidized or acetylated) may be a critical step in the formation of canine atherosclerotic lesions.