1
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Resseguier J, Nguyen-Chi M, Wohlmann J, Rigaudeau D, Salinas I, Oehlers SH, Wiegertjes GF, Johansen FE, Qiao SW, Koppang EO, Verrier B, Boudinot P, Griffiths G. Identification of a pharyngeal mucosal lymphoid organ in zebrafish and other teleosts: Tonsils in fish? SCIENCE ADVANCES 2023; 9:eadj0101. [PMID: 37910624 PMCID: PMC10619939 DOI: 10.1126/sciadv.adj0101] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023]
Abstract
The constant exposure of the fish branchial cavity to aquatic pathogens causes local mucosal immune responses to be extremely important for their survival. Here, we used a marker for T lymphocytes/natural killer (NK) cells (ZAP70) and advanced imaging techniques to investigate the lymphoid architecture of the zebrafish branchial cavity. We identified a sub-pharyngeal lymphoid organ, which we tentatively named "Nemausean lymphoid organ" (NELO). NELO is enriched in T/NK cells, plasma/B cells, and antigen-presenting cells embedded in a network of reticulated epithelial cells. The presence of activated T cells and lymphocyte proliferation, but not V(D)J recombination or hematopoiesis, suggests that NELO is a secondary lymphoid organ. In response to infection, NELO displays structural changes including the formation of T/NK cell clusters. NELO and gill lymphoid tissues form a cohesive unit within a large mucosal lymphoid network. Collectively, we reveal an unreported mucosal lymphoid organ reminiscent of mammalian tonsils that evolved in multiple teleost fish families.
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Affiliation(s)
- Julien Resseguier
- Section for Physiology and Cell Biology, Departments of Biosciences and Immunology, University of Oslo, Oslo, Norway
| | - Mai Nguyen-Chi
- LPHI, CNRS, Université de Montpellier, Montpellier, France
| | - Jens Wohlmann
- Electron-Microscopy laboratory, Departments of Biosciences, University of Oslo, Oslo, Norway
| | | | - Irene Salinas
- Center for Evolutionary and Theoretical Immunology (CETI), Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | - Stefan H. Oehlers
- A*STAR Infectious Diseases Labs (A*STAR ID Labs), Agency for Science, Technology and Research (A*STAR), 8A Biomedical Grove, Immunos #05-13, Singapore 138648, Singapore
| | - Geert F. Wiegertjes
- Aquaculture and Fisheries Group, Department of Animal Sciences, Wageningen University & Research, Wageningen, Netherlands
| | - Finn-Eirik Johansen
- Section for Physiology and Cell Biology, Department of Biosciences, University of Oslo, Oslo, Norway
| | - Shuo-Wang Qiao
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erling O. Koppang
- Unit of Anatomy, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Bernard Verrier
- Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305, IBCP, CNRS, University Lyon 1, Lyon, France
| | - Pierre Boudinot
- Université Paris-Saclay, INRAE, UVSQ, Virologie et Immunologie Moléculaires, Jouy-en-Josas, France
| | - Gareth Griffiths
- Section for Physiology and Cell Biology, Department of Biosciences, University of Oslo, Oslo, Norway
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2
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Pescia C, Lopez G, Gianelli U, Croci GA. Fibroblastic/cytokeratin-positive interstitial reticular cell tumor of the spleen with indolent behavior: a case report with review of the literature. Virchows Arch 2022:10.1007/s00428-022-03463-9. [DOI: 10.1007/s00428-022-03463-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022]
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3
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Saigo C, Kito Y, Hasegawa M, Nomura S, Mikamo T, Hanamatsu Y, Mori R, Futamura M, Yoshida K, Takeuchi T. Incidental cytokeratin-positive interstitial reticulum cell tumor of the lymph node accompanied by breast cancer: Status of YAP/TAZ expression in tumor cells. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2021.200526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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4
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Extra-nodal Cytokeratin-Positive Interstitial Reticulum Cell Sarcoma Presenting as a Colonic Polyp: Report of a Rare Case with Review of Literature. J Gastrointest Cancer 2021; 51:1034-1038. [PMID: 32124238 DOI: 10.1007/s12029-020-00380-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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5
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Bozic I, Savic D, Lavrnja I. Astrocyte phenotypes: Emphasis on potential markers in neuroinflammation. Histol Histopathol 2020; 36:267-290. [PMID: 33226087 DOI: 10.14670/hh-18-284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Astrocytes, the most abundant glial cells in the central nervous system (CNS), have numerous integral roles in all CNS functions. They are essential for synaptic transmission and support neurons by providing metabolic substrates, secreting growth factors and regulating extracellular concentrations of ions and neurotransmitters. Astrocytes respond to CNS insults through reactive astrogliosis, in which they go through many functional and molecular changes. In neuroinflammatory conditions reactive astrocytes exert both beneficial and detrimental functions, depending on the context and heterogeneity of astrocytic populations. In this review we profile astrocytic diversity in the context of neuroinflammation; with a specific focus on multiple sclerosis (MS) and its best-described animal model experimental autoimmune encephalomyelitis (EAE). We characterize two main subtypes, protoplasmic and fibrous astrocytes and describe the role of intermediate filaments in the physiology and pathology of these cells. Additionally, we outline a variety of markers that are emerging as important in investigating astrocytic biology in both physiological conditions and neuroinflammation.
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Affiliation(s)
- Iva Bozic
- Institute for Biological Research "Sinisa Stankovic", National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Danijela Savic
- Institute for Biological Research "Sinisa Stankovic", National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Irena Lavrnja
- Institute for Biological Research "Sinisa Stankovic", National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia.
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6
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Kaji S, Hiruta N, Sasai D, Nagashima M, Ohe R, Yamakawa M. Cytokeratin-positive interstitial reticulum cell (CIRC) tumor in the lymph node: a case report of the transformation from the epithelioid cell type to the spindle cell type. Diagn Pathol 2020; 15:121. [PMID: 32979929 PMCID: PMC7519525 DOI: 10.1186/s13000-020-01032-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background Cytokeratin-positive interstitial reticulum cells (CIRCs), which are a subgroup of fibroblastic reticular cells (FRCs), are known to be present in the lymph nodes. There have been only a few cases of tumors derived from CIRCs. Case presentation We have reported a new case involving a CIRC tumor in a 75-year-old man and reviewed the literature. The resected mediastinal lymph nodes showed epithelial-like proliferation of large atypical round and polygonal epithelioid cells. The tumor cells expressed CK8, CK18, CAM5.2, AE1/AE3, epithelial membrane antigen, vimentin, fascin, and some FRC markers, which is consistent with the diagnosis of a CIRC tumor. Following chemotherapy, the CIRC tumor was observed to have responded very well and became difficult to confirm on imaging, but a small cell lung carcinoma developed 12 months later. Chemoradiotherapy was performed, but the patient passed away 29 months after the initial diagnosis. The autopsy revealed the recurrence of the CIRC tumor, residual small cell lung carcinoma, and a very small latent carcinoma of the prostate. The relapsed CIRC tumor cells had a spindle shape; they were highly pleomorphic and had invaded the superior vena cava. Conclusion We first reported autopsy findings of CIRC tumors and demonstrated the transformation of the tumor from the epithelioid cell type to the spindle cell type.
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Affiliation(s)
- Sachiko Kaji
- Department of Diagnostic Pathology, Chiba Kaihin Municipal Hospital, 3-31-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan.
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Daisuke Sasai
- Department of Pathology, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Rintaro Ohe
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsunori Yamakawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan
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7
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McLean-Holden AC, Bishop JA. Low Molecular Weight Cytokeratin Immunohistochemistry Reveals That Most Salivary Gland Warthin Tumors and Lymphadenomas Arise in Intraparotid Lymph Nodes. Head Neck Pathol 2020; 15:438-442. [PMID: 32865726 PMCID: PMC8134598 DOI: 10.1007/s12105-020-01215-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022]
Abstract
The nature of the lymphoid stromal component in Warthin tumor and lymphadenoma of the parotid gland has been a controversial topic in salivary gland pathology for decades. Two theories exist: first, that these tumors arise from salivary gland inclusions within intraparotid lymph nodes; and second, that they arise within salivary gland parenchyma and induce tumor-associated lymphoid proliferation (TALP). A recent study demonstrated that low molecular weight cytokeratin is effective in distinguishing salivary gland tumors within lymph nodes from those inducing TALP via identification of extrafollicular reticulum cells, which are only found in true lymph nodes. Twenty-one Warthin tumors and 4 lymphadenomas were retrieved from the archives of the Department of Pathology at University of Texas Southwestern Medical Center. Cam5.2 immunohistochemistry was performed on each case and independently evaluated by two pathologists. Extrafollicular reticulum cells were identified by Cam5.2 immunostaining in 21 of 21 Warthin tumors (100%), and 3 of 4 lymphadenomas (75%). Extrafollicular reticulum cells were consistently localized to the perisinusoidal and paracortical areas of the lesions studied. Extrafollicular reticulum cells were identified via low molecular weight cytokeratin Cam5.2 immunohistochemistry in all of the Warthin tumors and most of the lymphadenomas evaluated. This finding strongly supports the notion that these most if not all of these tumors arise within intraparotid lymph nodes, presumably from salivary gland inclusions entrapped during embryonic development.
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Affiliation(s)
- Anne C. McLean-Holden
- grid.267313.20000 0000 9482 7121Department of Pathology, University of Texas Southwestern Medical Center, 6201 Harry Hines Blvd, Dallas, TX 75390 USA ,grid.189967.80000 0001 0941 6502Department of Pathology, Emory University, Atlanta, GA USA
| | - Justin A. Bishop
- grid.267313.20000 0000 9482 7121Department of Pathology, University of Texas Southwestern Medical Center, 6201 Harry Hines Blvd, Dallas, TX 75390 USA
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8
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Willard-Mack CL, Elmore SA, Hall WC, Harleman J, Kuper CF, Losco P, Rehg JE, Rühl-Fehlert C, Ward JM, Weinstock D, Bradley A, Hosokawa S, Pearse G, Mahler BW, Herbert RA, Keenan CM. Nonproliferative and Proliferative Lesions of the Rat and Mouse Hematolymphoid System. Toxicol Pathol 2020; 47:665-783. [PMID: 31526133 DOI: 10.1177/0192623319867053] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The INHAND Project (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative changes in rats and mice. The purpose of this publication is to provide a standardized nomenclature for classifying changes observed in the hematolymphoid organs, including the bone marrow, thymus, spleen, lymph nodes, mucosa-associated lymphoid tissues, and other lymphoid tissues (serosa-associated lymphoid clusters and tertiary lymphoid structures) with color photomicrographs illustrating examples of the lesions. Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous lesions as well as lesions induced by exposure to test materials. The nomenclature for these organs is divided into 3 terminologies: descriptive, conventional, and enhanced. Three terms are listed for each diagnosis. The rationale for this approach and guidance for its application to toxicologic pathology are described in detail below.
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Affiliation(s)
| | - Susan A Elmore
- Thymus subgroup lead.,National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Johannes Harleman
- Lymph node subgroup lead.,Neoplasm subgroup leads.,Independent Consultant, Darmstadt, Germany
| | - C Frieke Kuper
- Associated lymphoid organs subgroup lead.,Independent Consultant, Utrecht, the Netherlands
| | - Patricia Losco
- General hematolymphoid subgroup lead.,Independent Consultant, West Chester, PA, USA
| | - Jerold E Rehg
- Spleen subgroup leads.,Neoplasm subgroup leads.,Saint Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Jerrold M Ward
- Spleen subgroup leads.,Neoplasm subgroup leads.,Global VetPathology, Montgomery Village, MD, USA
| | | | - Alys Bradley
- Charles River Laboratories, Tranent, Scotland, United Kingdom
| | - Satoru Hosokawa
- Eisai Co, Ltd, Drug Safety Research Laboratories, Ibaraki, Japan
| | | | - Beth W Mahler
- Experimental Pathology Laboratories, Research Triangle Park, NC, USA
| | - Ronald A Herbert
- National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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9
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Wen F, Xia Q, Zhang H, Shia H, Rajesh A, Wu Y, Yang Y, Yang Z. Resistin Activates p65 Pathway and Reduces Glycogen Content through Keratin 8. Int J Endocrinol 2020; 2020:9767926. [PMID: 32508919 PMCID: PMC7251471 DOI: 10.1155/2020/9767926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/28/2020] [Accepted: 04/11/2020] [Indexed: 01/27/2023] Open
Abstract
Resistin is associated with metabolic syndrome and inflammatory conditions. Many studies have suggested that resistin inhibits the accumulation of glycogen; however, the exact mechanisms of resistin-induced decrease in glycogen content remain unclear. Keratin 8 is a typical epithelial intermediate filament protein, but numerous studies suggest a vital role of K8 in glucose metabolism. However, it is still not known whether K8 participates in the mediation of resistin-induced reduction of cellular glycogen accumulation. In this study, we found that resistin upregulated expression of the p65 subunit of NF-κB, which led to the promotion of K8 transcriptional expression; in turn, the expression of K8 inhibited glycogen accumulation in HepG2 cells.
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Affiliation(s)
- Fengyun Wen
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471000, Henan, China
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Qiao Xia
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Hui Zhang
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471000, Henan, China
| | - Haipeng Shia
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471000, Henan, China
| | - Amin Rajesh
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, 36849-5501 Auburn, Alabama, USA
| | - Yanling Wu
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Yi Yang
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Zaiqing Yang
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471000, Henan, China
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10
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Low Molecular Weight Cytokeratin Immunostaining for Extrafollicular Reticulum Cells is an Effective Means of Separating Salivary Gland Tumor-Associated Lymphoid Proliferation from True Lymph Node Involvement. Head Neck Pathol 2019; 14:593-597. [PMID: 31541432 PMCID: PMC7413935 DOI: 10.1007/s12105-019-01080-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/14/2019] [Indexed: 10/26/2022]
Abstract
Tumor-associated lymphoid proliferation (TALP) is a well-recognized lymphocytic reaction that is commonly associated with certain salivary gland tumors. A salivary carcinoma with TALP may be confused for true lymph node involvement by that tumor, constituting a potential pitfall in tumor staging that may result in unnecessary therapeutic intervention or erroneous prognostication for patients. True lymph nodes harbor populations of extrafollicular reticulum cells (ERCs), which can be highlighted by low molecular weight cytokeratin immunohistochemistry. We sought to determine whether low molecular weight cytokeratin Cam5.2 immunostaining may be utilized to differentiate true lymph node involvement by salivary gland tumors from TALP. The surgical pathology archives of the University of Texas Southwestern Medical Center was searched for cases of salivary gland neoplasms exhibiting either TALP or true lymph node involvement. Hematoxylin and eosin-stained sections were examined. Cases were classified on the basis of a definitive lymph node capsule and subcapsular sinus, as seen on routine histologic evaluation. Low molecular weight cytokeratin Cam5.2 immunostaining was performed and evaluated on all cases. Twenty-three salivary gland carcinomas with TALP and 16 carcinomas involving a lymph node (14 carcinomas metastatic to regional lymph nodes and 2 carcinomas arising from benign lymph node inclusions) were identified. Numerous Cam5.2-positive ERCs were identified within the nodal tissue of all true lymph nodes involved by carcinoma (16 of 16 cases), while Cam5.2-positive ERCs were completely absent in all cases of salivary gland lesions with TALP (0 of 23 cases) (100% vs. 0%, p < .0001, Fisher's Exact). Utilization of low molecular weight cytokeratin Cam 5.2 immunostaining for ERCs is a highly useful tool for distinguishing true lymph node involvement by salivary gland carcinomas from TALP. This strategy may be useful in identifying genuine nodal metastasis in histologically ambiguous cases, and to avoid erroneously upstaging tumor with TALP as nodal metastasis with the resulting prognostic and therapeutic implications. Moreover, low molecular weight cytokeratin immunostaining may be useful in confirming the rare examples of salivary gland tumors arising from intranodal salivary gland inclusions.
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11
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Abstract
The vimentin gene (
VIM) encodes one of the 71 human intermediate filament (IF) proteins, which are the building blocks of highly ordered, dynamic, and cell type-specific fiber networks. Vimentin is a multi-functional 466 amino acid protein with a high degree of evolutionary conservation among vertebrates.
Vim
−/− mice, though viable, exhibit systemic defects related to development and wound repair, which may have implications for understanding human disease pathogenesis. Vimentin IFs are required for the plasticity of mesenchymal cells under normal physiological conditions and for the migration of cancer cells that have undergone epithelial–mesenchymal transition. Although it was observed years ago that vimentin promotes cell migration, the molecular mechanisms were not completely understood. Recent advances in microscopic techniques, combined with computational image analysis, have helped illuminate vimentin dynamics and function in migrating cells on a precise scale. This review includes a brief historical account of early studies that unveiled vimentin as a unique component of the cell cytoskeleton followed by an overview of the physiological vimentin functions documented in studies on
Vim
−/− mice. The primary focus of the discussion is on novel mechanisms related to how vimentin coordinates cell migration. The current hypothesis is that vimentin promotes cell migration by integrating mechanical input from the environment and modulating the dynamics of microtubules and the actomyosin network. These new findings undoubtedly will open up multiple avenues to study the broader function of vimentin and other IF proteins in cell biology and will lead to critical insights into the relevance of different vimentin levels for the invasive behaviors of metastatic cancer cells.
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Affiliation(s)
- Rachel A Battaglia
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
| | - Samed Delic
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
| | - Harald Herrmann
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany.,Institute of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Natasha T Snider
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
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12
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Venturi M, Pilloni L. Non-specific labeling of macrophages with anti-cytokeratin 20 (SP33) in the evaluation of nodal micrometastasis from Merkel cell carcinoma: A pitfall for metastasis. J Cutan Pathol 2018; 46:88-90. [PMID: 30288773 DOI: 10.1111/cup.13367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/10/2018] [Accepted: 09/28/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Michela Venturi
- Section of Dermatology, "Mario Aresu" Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Luca Pilloni
- Section of Pathology, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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13
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Abstract
Cytokeratins, which comprise a multigene family of 20 related polypeptides (CKs 1–20), are constituents of the intermediate filaments of epithelial cells, in which they are expressed in various combinations depending on the epithelial type and the degree of differentiation. Of these, CK 19 (400 amino acids; 44.1 kilodaltons) is an example of a widely distributed CK, being expressed in various epithelia, including many simple epithelia. In contrast, the recently identified CK 20 (424 amino acids; 48.6 kilodaltons) is essentially confined to gastrointestinal epithelia, the urothelium and Merkel cells. The differential expression of individual CKs in various types of carcinomas makes them useful markers for histopathological carcinoma subtyping, providing relevant information concerning the differentiation and origin of carcinomas, especially when tumors first present as metastases. The CKs that are of particular value for differential diagnosis include CK 20, as it is mainly expressed in carcinomas derived from CK 20-positive epithelia; it is also found in bile-tract, pancreatic and mucinous ovarian adenocarcinomas, being absent in most other carcinomas. In certain carcinoma types, the changes in the expression of individual CKs that may occur during tumor progression could be of prognostic relevance. It remains to be established whether the serological detection of fragments of not only widely distributed but also more restrictedly expressed CKs may provide useful serological tumor markers in the future.
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Affiliation(s)
- R Moll
- Institute of Pathology, University of Mainz, Germany
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14
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A 2-Step Laemmli and Antigen Retrieval Method Improves Immunodetection. Appl Immunohistochem Mol Morphol 2017; 24:436-46. [PMID: 26067142 DOI: 10.1097/pai.0000000000000203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Detection by immunohistochemistry of antigens relies on reproducibly optimal preanalytical and analytical variables such as fixation conditions, antigen retrieval (AR), and the resolutive power of the detection system. There is a need to improve immunodetection on routinely fixed and embedded material, particularly for scarcely represented but relevant antigens. We devised a 2-step method and applied it to a panel of antigens of common use for diagnosis, prognosis, individualized therapy use, or research. The first step consists of a 10 minutes. Incubation at 95°C with a modified Laemmli extraction buffer. This was followed by a traditional AR method. Detection of the vast majority of antigens was improved over a simple AR with preservation of tissue integrity, as shown by quantitative image analysis. The mechanism underlying the improved detection may be controlled denaturation followed by heat-mediated retrieval, a method we dubbed "antigen relaxing" and which will improve routine detection of scarce antigens in formalin-fixed, paraffin-embedded material.
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15
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Olson NJ, Perry AE, Linos K. Cytokeratin-positive fibroblastic reticular cell: a pitfall for dermatopathologists assessing lymph nodes for Merkel cell carcinoma. J Cutan Pathol 2016; 43:1231-1233. [DOI: 10.1111/cup.12796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 06/02/2016] [Accepted: 08/09/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Nicholas J Olson
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth; Department of Pathology; Lebanon NH USA
| | - Ann E Perry
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth; Department of Pathology; Lebanon NH USA
| | - Konstantinos Linos
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth; Department of Pathology; Lebanon NH USA
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16
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Li H, Shen P, Liang Y, Zhang F. Fibroblastic reticular cell tumor of the breast: A case report and review of the literature. Exp Ther Med 2015; 11:561-564. [PMID: 26893647 DOI: 10.3892/etm.2015.2922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 11/18/2015] [Indexed: 01/16/2023] Open
Abstract
Fibroblastic reticular cells (FBRCs) are basic mesenchymal cells that belong to the dendritic cell family. Primary extranodal FBRC tumor (FRCT) cases are rare, with only 19 cases reported in the literature thus far. However, none of these cases originated in the breast tissue. To the best of our knowledge, the present study reported the first FRCT case of the breast in a 57-year-old woman. The patient complained of a painless mass that was located in the right breast and was ~3.5×2.5 cm in size. The patient underwent modified radical mastectomy subsequent to the diagnosis of FRCT after analysis of the lumpectomy specimen. Pathological examination revealed that the tumor was mainly composed of oval and spindle cells, and was infiltrated with lymphocytes and plasma cells. The tumor cells were immunoreactive for vimentin and negative for CD21, CD35 and S-100 protein. Six axillary lymph nodes were found to have been involved. Following surgery, the patient received four cycles of mesna, doxorubicin, ifosfamide and dacarbazine regimen chemotherapy (70 mg adriamycin day 1; 2.0 g ifosfamided days 1-3; 0.4 g dacarbazine day 1-3), which cycled every 21 days. The patient was uneventfully followed-up for 20 months following chemotherapy. In conclusion, the present study reported what appeared to be the first case of primary breast FRCT. The diagnosis, treatment and prognosis details presented in this study will help improve the diagnosis of the disease.
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Affiliation(s)
- Hongmei Li
- Department of Pathology, Ninghai Maternity and Child Care Hospital, Ninghai, Zhejiang 315600, P.R. China
| | - Pingrong Shen
- Department of Gynaecology and Obstetrics, Ninghai Maternity and Child Care Hospital, Ninghai, Zhejiang 315600, P.R. China
| | - Yun Liang
- Department of Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
| | - Feng Zhang
- Department of Surgery, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
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17
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Bösmüller H, Klenske J, Bonzheim I, Scharpf M, Rieger N, Quintanilla-Fend L, Fend F. Cytokeratin-positive interstitial reticulum cell tumor: recognition of a potential "in situ" pattern. Hum Pathol 2015; 49:15-21. [PMID: 26826404 DOI: 10.1016/j.humpath.2015.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/11/2015] [Accepted: 10/02/2015] [Indexed: 11/15/2022]
Abstract
Cytokeratin-positive interstitial reticulum cell (CIRC) tumor is a very rare accessory cell neoplasm of lymphoid organs derived from fibroblastic reticulum cells, which originate from mesenchymal stem cells. We describe the histologic, immunophenotypical, and molecular features of a CIRC tumor in a 67-year-old woman who underwent hysterectomy, bilateral adnexectomy, and pelvic lymphadenectomy for endometrial carcinoma. An enlarged pelvic node contained circumscribed neoplastic infiltrates in perifollicular and interfollicular areas consisting of large cells arranged in a reticular pattern with nuclear atypia, atypical mitoses, and apoptosis, but without glandular architecture or disruption of overall architecture. The atypical infiltrate coexpressed cytokeratin and vimentin, partially CD68, CD163, and lysozyme, but lacked markers of endometrial carcinoma, consistent with a diagnosis of CIRC tumor. Despite the obviously neoplastic cytological features, immunostains revealed the circumscribed and noninvasive pattern of the lesion, possibly representing an early "in situ" stage of CIRC tumor.
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Affiliation(s)
- Hans Bösmüller
- Department of Pathology, University Hospital of Tübingen, D-72076 Tübingen, Germany.
| | - Julia Klenske
- Department of Gynecology and Obstetrics, Zollernalb-Klinikum, D-72458 Albstadt, Germany
| | - Irina Bonzheim
- Department of Pathology, University Hospital of Tübingen, D-72076 Tübingen, Germany
| | - Marcus Scharpf
- Department of Pathology, University Hospital of Tübingen, D-72076 Tübingen, Germany
| | - Naomi Rieger
- Department of Pathology, University Hospital of Tübingen, D-72076 Tübingen, Germany
| | | | - Falko Fend
- Department of Pathology, University Hospital of Tübingen, D-72076 Tübingen, Germany
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Goto N, Tsurumi H, Takami T, Futamura M, Morimitsu K, Takata K, Sato Y, Yoshino T, Adachi S, Saito K, Yamakawa M. Cytokeratin-positive fibroblastic reticular cell tumor with follicular dendritic cell features: a case report and review of the literature. Am J Surg Pathol 2015; 39:573-80. [PMID: 25768257 DOI: 10.1097/pas.0000000000000362] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Fibroblastic reticular cell (FRC) neoplasms, which are one of the histiocyte tumor types, are very rare. Here we report a cytokeratin (CK)-positive FRC neoplasm having features of follicular dendritic cells in a 54-year-old woman with right axillary lymph node swelling. The resected lymph node showed multiple nodular aggregations simulating and replacing normal follicles. The tumor cells had a uniform, large and oval to polygonal shape, abundant cytoplasm, and various sizes of nuclei with central eosinophilic nucleoli and coarse nuclear chromatin. They were positive for CK AE1/AE3+CAM5.2, CK7, tenascin C, l-caldesomone, and CD21, weakly positive for S100, and negative for CD1a. Ultrastructurally, the tumor cells had long interdigitating microvillus-like cell processes and oval to elongated vesicular nuclei. In addition, the intercellular spaces contained accumulations of collagen, and some tumor cells had desmosomal-like junctions. These findings suggest that the present case is a CK-positive FRC tumor with follicular dendritic cell features.
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Affiliation(s)
- Naoe Goto
- Departments of *Hematology §Breast and Molecular Oncology, Gifu University Graduate School of Medicine †Department of Internal Medicine, Gihoku Kosei Hospital ‡Tokai Clinic, Gifu ∥Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ¶Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama #Department of Diagnostic Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan
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Steiniger BS, Wilhelmi V, Seiler A, Lampp K, Stachniss V. Heterogeneity of stromal cells in the human splenic white pulp. Fibroblastic reticulum cells, follicular dendritic cells and a third superficial stromal cell type. Immunology 2014; 143:462-77. [PMID: 24890772 DOI: 10.1111/imm.12325] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 05/22/2014] [Accepted: 05/27/2014] [Indexed: 12/28/2022] Open
Abstract
At least three phenotypically and morphologically distinguishable types of branched stromal cells are revealed in the human splenic white pulp by subtractive immunohistological double-staining. CD271 is expressed in fibroblastic reticulum cells of T-cell zones and in follicular dendritic cells of follicles. In addition, there is a third CD2711- and CD271+/) stromal cell population surrounding T-cell zones and follicles. At the surface of follicles the third population consists of individually variable partially overlapping shells of stromal cells exhibiting CD90 (Thy-1), MAdCAM-1, CD105 (endoglin), CD141 (thrombomodulin) and smooth muscle α-actin (SMA) with expression of CD90 characterizing the broadest shell and SMA the smallest. In addition, CXCL12, CXCL13 and CCL21 are also present in third-population stromal cells and/or along fibres. Not only CD27+ and switched B lymphocytes, but also scattered IgD++ B lymphocytes and variable numbers of CD4+ T lymphocytes often occur close to the third stromal cell population or one of its subpopulations at the surface of the follicles. In contrast to human lymph nodes, neither podoplanin nor RANKL (CD254) were detected in adult human splenic white pulp stromal cells. The superficial stromal cells of the human splenic white pulp belong to a widespread cell type, which is also found at the surface of red pulp arterioles surrounded by a mixed T-cell/B-cell population. Superficial white pulp stromal cells differ from fibroblastic reticulum cells and follicular dendritic cells not only in humans, but apparently also in mice and perhaps in rats. However, the phenotype of white pulp stromal cells is species-specific and more heterogeneous than described so far.
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Affiliation(s)
- Birte S Steiniger
- Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
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Suárez-Vilela D, Izquierdo FM, Riera-Velasco JR, Burgo PMD. T-cell/histiocyte-rich large B-cell lymphoma with zonal expansion of fibroblastic reticulum cells and infiltration by a subpopulation of myeloperoxidase positive histiocytes. Pathol Res Pract 2014; 210:1167-70. [PMID: 25042387 DOI: 10.1016/j.prp.2014.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 05/24/2014] [Accepted: 06/19/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Dimas Suárez-Vilela
- Department of Anatomía Patológica, Hospital Valle del Nalón, Polígono de Riaño, S/N, 33920 Riaño, Langreo, Asturias, Spain
| | - Francisco Miguel Izquierdo
- Department of Anatomía Patológica, Complejo Asistencial Universitario de León, Altos de la Nava s/n, 24008 León, Spain.
| | - Jose Ramón Riera-Velasco
- Department of Anatomía Patológica, Hospital Valle del Nalón, Polígono de Riaño, S/N, 33920 Riaño, Langreo, Asturias, Spain
| | - Patricia Morales-Del Burgo
- Department of Anatomía Patológica, Hospital Valle del Nalón, Polígono de Riaño, S/N, 33920 Riaño, Langreo, Asturias, Spain
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Karim Z, Saravana R, Shenjere P, Reid F. Fibroblastic Reticulum Cell Tumor of Spleen: A Case Report. Int J Surg Pathol 2013; 22:447-50. [PMID: 24220998 DOI: 10.1177/1066896913509009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fibroblastic reticulum cells (FBRCs) belong to a major subtype of stromal support cells in the lymphoid system and rarely give rise to tumors. We report a case of fibroblastic reticulum cell tumor arising in the spleen. The tumor was clinically and radiologically mistaken for a metastatic deposit in the spleen. Microscopically the tumor was composed of spindle cells arranged in fascicles and storiform pattern. The cells had oval to elongated vesicular nuclei and pale eosinophilic cytoplasm with indistinct cell borders. There were admixed inflammatory cells, including large numbers of plasma cells. The tumor cells were positive for smooth muscle actin, desmin, AE1/AE3, and MNF116. They were negative for S100, CD1a, CD21, CD23, CD34, CD31, and CD35 among other markers. The morphological features and immunoprofile of this rare tumor in comparison to the few cases reported in the literature are discussed along with the positive reaction with cytokeratins and their relationship to the smaller subset of FBRCs, the cytokeratin-positive interstitial reticulum cells in the spleen.
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Suárez-Vilela D, Izquierdo FM, Méndez-Alvarez JR, Escobar-Stein J. Neoplasms of dendritic cells: related cell origins and diagnostic markers. Fibroblastic reticulum cells and fibroblastic reticulum cell tumors show several immunophenotypic profiles. Hum Pathol 2012; 43:1530-1; author reply 1531-2. [PMID: 22835743 DOI: 10.1016/j.humpath.2012.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Accepted: 04/19/2012] [Indexed: 10/28/2022]
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Mescoli C, Albertoni L, Pucciarelli S, Giacomelli L, Russo VM, Fassan M, Nitti D, Rugge M. Isolated tumor cells in regional lymph nodes as relapse predictors in stage I and II colorectal cancer. J Clin Oncol 2012; 30:965-71. [PMID: 22355061 DOI: 10.1200/jco.2011.35.9539] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Lymph node (LN) involvement is the most important prognostic factor in colorectal cancer (CRC), and pN-positive status identifies patients who require adjuvant chemotherapy. Approximately 15% to 20% of patients without nodal metastases (pN0) develop recurrent disease. In this study, we tested the prognostic significance of isolated tumor cells (ITCs) in LNs of patients with pN0 CRC (stages I and II). PATIENTS AND METHODS ITCs in LNs regional to CRC were assessed in 312 consecutive patients with pN0 CRC who were followed up clinically and/or endoscopically for at least 6 months after surgery (mean, 67 months; median, 64 months; range, 8 to 102 months). LNs were dissected from gross surgical specimens according to a standardized protocol (with a mean of 17 LNs per patient; range, five to 107 LNs). In all, 5,313 pN0 LNs were collected and assessed by using cytokeratin immunostaining in two serial histology sections from each LN, which amounting to a total of 10,626 specimens. The correlation between ITC status and cancer recurrence was tested by using univariate and multivariate statistics. RESULTS ITCs were documented in 185 of 312 patients (59%). CRC relapsed in 31 of 312 patients (10%), and 25 of 31 recurrences (81%) were documented among ITC-positive patients. CRC recurrence rates among ITC-positive and ITC-negative patients were 14% (25 of 185 patients) and 4.7% (six of 127 patients), respectively. In both univariate and multivariate analyses, ITC status was the only variable significantly associated with cancer relapse (Cox model; hazard ratio, 3.00; 95% CI, 1.23 to 7.32; P = .013). CONCLUSION In patients with pN0 CRC, cancer relapse was significantly associated with ITCs in regional LNs. ITCs should be considered among the clinicobiologic variables that identify high-risk patients who can benefit from adjuvant chemotherapy.
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SUÁREZ DIMAS, IZQUIERDO FRANCISCOMIGUEL, MÉNDEZ JOSERAMÓN, ESCOBAR JULIANA, CABEZA ANGELES, JUNCO PILAR. Tumor of fibroblastic reticular cells of lymph node coincidental with an undifferentiated endometrial stromal sarcoma. Report of a case with distinctive immunophenotype and Kikuchi-like necro-inflammatory response. APMIS 2011; 119:216-20. [DOI: 10.1111/j.1600-0463.2010.02712.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Kwon JE, Yang WI, Kim HK, Kwon KW, Kwon TJ, Choi EC, Lee KG. Cytokeratin-positive interstitial reticulum cell sarcoma: a case report with cytological, immunohistochemical, and ultrastructural findings. Cytopathology 2009; 20:202-5. [DOI: 10.1111/j.1365-2303.2008.00634.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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Yaman E, Gonul II, Buyukberber S, Ozturk B, Akyurek N, Coskun U, Kaya AO, Yildiz R, Sare M, Kitapci M. Metastatic fibroblastic reticulum cell sarcoma of the liver: pathological and PET-CT evaluation. Pathology 2009; 41:289-92. [DOI: 10.1080/00313020902756329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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28
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Moll R, Sievers E, Hämmerling B, Schmidt A, Barth M, Kuhn C, Grund C, Hofmann I, Franke WW. Endothelial and virgultar cell formations in the mammalian lymph node sinus: endothelial differentiation morphotypes characterized by a special kind of junction (complexus adhaerens). Cell Tissue Res 2008; 335:109-41. [PMID: 19015886 DOI: 10.1007/s00441-008-0700-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 09/15/2008] [Indexed: 12/25/2022]
Abstract
The lymph node sinus are channel structures of unquestionable importance in immunology and pathology, specifically in the filtering of the lymph, the transport and processing of antigens, the adhesion and migration of immune cells, and the spread of metastatic cancer cells. Our knowledge of the cell and molecular biology of the sinus-forming cells is still limited, and the origin and biological nature of these cells have long been a matter of debate. Here, we review the relevant literature and present our own experimental results, in particular concerning molecular markers of intercellular junctions and cell differentiation. We show that both the monolayer cells lining the sinus walls and the intraluminal virgultar cell meshwork are indeed different morphotypes of the same basic endothelial cell character, as demonstrated by the presence of a distinct spectrum of general and lymphatic endothelial markers, and we therefore refer to these cells as sinus endothelial/virgultar cells (SEVCs). These cells are connected by unique adhering junctions, termed complexus adhaerentes, characterized by the transmembrane glycoprotein VE-cadherin, combined with the desmosomal plaque protein desmoplakin, several adherens junction plaque proteins including alpha- and beta-catenin and p120 catenin, and components of the tight junction ensemble, specifically claudin-5 and JAM-A, and the plaque protein ZO-1. We show that complexus adhaerentes are involved in the tight three-dimensional integration of the virgultar network of SEVC processes along extracellular guidance structures composed of paracrystalline collagen bundle "stays". Overall, the SEVC system might be considered as a local and specific modification of the general lymphatic vasculature system. Finally, physiological and pathological alterations of the SEVC system will be presented, and the possible value of the molecular markers described in histological diagnoses of autochthonous lymph node tumors will be discussed.
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Affiliation(s)
- Roland Moll
- Institute of Pathology, Philipps University of Marburg, 35033 Marburg, Germany.
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Affiliation(s)
- Bruno Kyewski
- Division of Developmental Immunology, Tumor Immunology Program, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, D-69120 Germany.
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30
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Occult disseminated tumor cells in lymph nodes of patients with gastric carcinoma. A critical appraisal of assessment and relevance. Langenbecks Arch Surg 2008; 394:105-13. [DOI: 10.1007/s00423-008-0369-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 06/10/2008] [Indexed: 12/22/2022]
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Abstract
The keratins are the typical intermediate filament proteins of epithelia, showing an outstanding degree of molecular diversity. Heteropolymeric filaments are formed by pairing of type I and type II molecules. In humans 54 functional keratin genes exist. They are expressed in highly specific patterns related to the epithelial type and stage of cellular differentiation. About half of all keratins—including numerous keratins characterized only recently—are restricted to the various compartments of hair follicles. As part of the epithelial cytoskeleton, keratins are important for the mechanical stability and integrity of epithelial cells and tissues. Moreover, some keratins also have regulatory functions and are involved in intracellular signaling pathways, e.g. protection from stress, wound healing, and apoptosis. Applying the new consensus nomenclature, this article summarizes, for all human keratins, their cell type and tissue distribution and their functional significance in relation to transgenic mouse models and human hereditary keratin diseases. Furthermore, since keratins also exhibit characteristic expression patterns in human tumors, several of them (notably K5, K7, K8/K18, K19, and K20) have great importance in immunohistochemical tumor diagnosis of carcinomas, in particular of unclear metastases and in precise classification and subtyping. Future research might open further fields of clinical application for this remarkable protein family.
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Cytokeratin-positive interstitial reticulum cell tumors of lymph nodes: a case report and review of literature. Chin Med J (Engl) 2008. [DOI: 10.1097/00029330-200804010-00016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Scheunemann P, Stoecklein NH, Rehders A, Bidde M, Metz S, Peiper M, Eisenberger CF, Schulte Am Esch J, Knoefel WT, Hosch SB. Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma. Langenbecks Arch Surg 2007; 393:359-65. [PMID: 17704938 DOI: 10.1007/s00423-007-0215-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 07/16/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Occurrence of tumor relapse is frequent in patients with pancreatic cancer despite the absence of residual tumor detectable at primary surgery and in histopathological examination. Therefore, it has to be assumed that current tumor staging procedures fail to identify minimal amounts of disseminated tumor cells, which might be precursors of subsequent metastatic relapse. The aim of this study was to assess the prognostic impact of minimal tumor cell spread detected in lymph nodes classified as "tumor-free" in routine histopathologic evaluation. MATERIALS AND METHODS A total of 154 "tumor-free" lymph nodes from 59 patients with pancreatic cancer who underwent intentionally curative tumor resection were examined by immunohistochemistry for disseminated tumor cells. RESULTS Fifty (32.5%) of the "tumor-free" lymph nodes obtained from 36 (61%) patients displayed disseminated tumor cells. Multivariate survival analysis revealed that the presence of disseminated tumor cells in "tumor-free" lymph nodes is an independent prognostic factor for both a significantly reduced relapse-free survival (p = 0.03) and overall survival (p = 0.02). CONCLUSIONS The frequent occurrence and prognostic impact of immunohistochemically identifiable disseminated tumor cells in lymph nodes of patients with operable pancreatic cancer supports the need for a refined staging system of excised lymph nodes, which should include immunohistochemical examination.
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Affiliation(s)
- Peter Scheunemann
- Department of General Surgery, Heinrich-Heine University, University Hospital Düsseldorf, Düsseldorf, Germany.
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Cserni G. What is a positive sentinel lymph node in a breast cancer patient? A practical approach. Breast 2007; 16:152-60. [PMID: 17081752 DOI: 10.1016/j.breast.2006.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Revised: 07/29/2006] [Accepted: 07/31/2006] [Indexed: 10/24/2022] Open
Abstract
Sentinel lymph node (SN) biopsy has become increasingly used for the staging of breast carcinoma, resulting in the upstaging of this disease, and this has led to concerns with regard to what should be considered a positive SN. Factors influencing the positive staging of an SN include metastasis size, the method used for metastasis detection, the definition of metastasis and the individual pathologist. Until evidence to the contrary emerges, an SN should be considered positive if metastases (nodal involvement >0.2mm in the largest dimension) are detected in it by histology. A target size should be identified, and SNs, as the most likely sites of nodal metastases, should be searched systematically to find (nearly) all of the targeted metastases. The European guidelines for SN assessment have set two such target sizes: as a minimum, all metastases >2mm should be identified, and optimally all micrometastases should also be sought.
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Affiliation(s)
- Gábor Cserni
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyiri ut 38, H-6000 Kecskemét, Hungary.
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Scheunemann P, Stoecklein N, Rehders A, Bidde M, Metz S, Peiper M, Eisenberger C, Schulte Am Esch J, Knoefel W, Hosch S. Frequency and prognostic significance of occult tumor cells in lymph nodes in patients with adenocarcinoma of the papilla of Vater. HPB (Oxford) 2007; 9:135-9. [PMID: 18333129 PMCID: PMC2020782 DOI: 10.1080/13651820601090646] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Occurrence of tumor relapse is frequent in patients with carcinoma of the papilla of Vater despite the absence of residual tumor detectable at primary surgery. Therefore it has to be assumed that current tumor staging procedures fail to identify minimal amounts of tumor cells disseminated to secondary organs, which might be precursors of subsequent metastatic relapse. The aim of the study was to assess the frequency and prognostic impact of minimal tumor cell spread in lymph nodes classified as 'tumor-free' in routine histopathologic evaluation. MATERIALS AND METHODS A total of 41 'tumor-free' lymph nodes from 23 patients with adenocarcinoma of the papilla of Vater who underwent curative tumor resection (R0) were examined by immunohistochemistry with the monoclonal anti-EpCAM antibody Ber-EP4 for minimal disseminated tumor cells. RESULTS Twelve (29.3%) of the 41 'tumor-free' lymph nodes obtained from 9 (39.1%) of the 23 patients displayed EpCAM-positive cells. Kaplan-Meier survival analysis revealed that patients with EpCAM-positive cells in lymph showed a clearly reduced relapse-free and overall survival compared with patients without such cells. However, these differences were not statistically significant (p = 0.13 for relapse-free survival, p = 0.11 for overall survival). DISCUSSION Immunohistochemical assessment may refine the staging of resected lymph nodes in patients with carcinoma of the papilla of Vater. However, the presence of minimal disseminated tumor cells in lymph nodes had no significant impact on the prognosis in these patients.
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Affiliation(s)
- P. Scheunemann
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - N.H. Stoecklein
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - A. Rehders
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - M. Bidde
- Department of General Surgery, University-Hospital Hamburg-EppendorfGermany
| | - S. Metz
- Department of General Surgery, University-Hospital Hamburg-EppendorfGermany
| | - M. Peiper
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - C. Eisenberger
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - J. Schulte Am Esch
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - W.T. Knoefel
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
| | - S.B. Hosch
- Department of General Surgery, Heinrich-Heine-UniversityDüsseldorfGermany
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Abstract
Lymph nodes are traditionally regarded as having three compartments, the cortex, paracortex and medulla. B and T cells home to separate areas within these compartments, interact with antigen presenting cells, and undergo clonal expansion. This paper provides structural and functional details about how the lymph node brings lymphocytes and antigen presenting cells together. The concept of the lymphoid lobule as the basic functional and anatomic unit of the lymph node is developed and utilized to provide a framework for understanding lymph node pathobiology. Understanding the histomorphologic features of the lymphoid lobule and the role of the reticular meshwork scaffolding of the lymph node and how these related to the cortex, paracortex and medulla provides a unique approach to understanding lymph node structure and function.
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Vega F, Coombes KR, Thomazy VA, Patel K, Lang W, Jones D. Tissue-Specific Function of Lymph Node Fibroblastic Reticulum Cells. Pathobiology 2006; 73:71-81. [PMID: 16943687 DOI: 10.1159/000094491] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Accepted: 03/28/2006] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE We present the first characterization of the cytokine expression pattern of lymph node fibroblastic reticulum cells (FRC), which are the stromal cells responsible for maintaining the highly structured nodal reticular fiber framework. METHODS Microarray expression profiles of cultured nodal FRC and dermal fibroblasts (DF) were compared as well as their response to TNF, IL-4, IL-6 and IL-13, cytokines responsible for intranodal stromal activation. RESULTS Hierarchical clustering of FRC and DF short-term culture samples revealed genes that were differentially expressed in FRC and DF. Identified differently regulated genes were confirmed by RNase protection analysis, PCR or immunohistochemistry. At earlier culture time points, FRC showed higher levels of several chemokines, including CCL2/MCP-1, and cytokines, e.g. IL-6, whereas several genes related to the production of extracellular matrix and angiogenesis were preferentially expressed in early DF cultures. By 60 days in culture, FRC and DF showed similar expression patterns consistent with homogenization of specialized stromal subsets. FRC and DF showed nearly identical transcriptional responses to exogenous TNF stimulation. CONCLUSIONS Cultured FRC showed an overall transcriptional profile similar to cultured DF, including parallel responsiveness to TNF, but with differences in the expression of chemotactic chemokines, which reflect their biological roles.
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Affiliation(s)
- Francisco Vega
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Mescoli C, Rugge M, Pucciarelli S, Russo VM, Pennelli G, Guido M, Nitti D. High prevalence of isolated tumour cells in regional lymph nodes from pN0 colorectal cancer. J Clin Pathol 2006; 59:870-4. [PMID: 16603645 PMCID: PMC1860462 DOI: 10.1136/jcp.2005.036350] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The prevalence of isolated tumour cells (ITCs) in regional lymph nodes from colorectal cancer (CRC) is controversial and has never been prospectively assessed in large groups of consecutive patients. pN0 early-relapsing CRC can be explained by lymph node-ITC. AIM To assess the prevalence of ITCs in regional lymph nodes from 309 consecutive patients with pN0M0 (pathological (p)-tumour-node-metastasis (TNM) staging system) CRCs. PATIENTS AND METHODS ITCs were assessed by immunohistochemistry (MNF116 monoclonal antibody (1:100); Dako, Glostrup, Denmark) in two serial histological sections obtained from 5016 mesenteric lymph nodes from 309 patients with pN0 CRCs (mean number of lymph nodes per patient = 16.2; p-TNM stage 0, n = 25; p-TNM stage I, n = 123; and p-TNM stage II (A+B), n = 161). Tumour histology, vascular cancer invasion and pathological stage were also recorded. RESULTS ITCs were detected in the regional lymph nodes of 156 of 309 (50.5%) patients with CRC, mostly in nodes located within 3 cm from the neoplasia. ITC status correlated with (a) tumour p-TNM stage (Pearson's chi(2): p<0; ordered logistic regression: odds ratio (OR) = 4.6; 95% confidence interval (CI) = 2.88 to 7.33; p<0) and (b) pT value (Pearson's chi(2): p = 0; ordered logistic regression: OR = 4.9; 95% CI = 3.1 to 7.7; p<0). By multivariate analysis, including p-TNM stage, vascular invasion and ITC status, both stage (OR = 5.1; 95% CI = 2.9 to 8.9; p<0) and vascular invasion (OR = 4.2; 95% CI = 1.94 to 8.98; p<0) were found to be independent variables associated with ITC+ lymph nodes. CONCLUSION More than 50% of pN0-CRC patients have ITCs in the mesenteric lymph nodes. ITC status is significantly correlated with cancer stage and vascular cancer invasion. The clinicopathological effect of ITC remains to be prospectively evaluated.
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Affiliation(s)
- C Mescoli
- Department of Diagnostic Sciences & Special Therapies, Pathology Unit, Istituto Oncologico Veneto-IRCCS, Università degli Studi di Padova, Padova, Italy
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Viale G, Mastropasqua MG, Maiorano E, Mazzarol G. Pathologic examination of the axillary sentinel lymph nodes in patients with early-stage breast carcinoma: current and resolving controversies on the basis of the European Institute of Oncology experience. Virchows Arch 2005; 448:241-7. [PMID: 16362823 DOI: 10.1007/s00428-005-0103-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 10/17/2005] [Indexed: 10/25/2022]
Abstract
Several controversial aspects of sentinel lymph node biopsy (SLNB) for patients with early-stage, node-negative breast carcinoma have been dealt with and resolved in the past decade since its introduction. Unfortunately, however, there is still no consensus on how best to examine sentinel lymph nodes (SLN) histologically. As a consequence, the protocols for SLN examination are remarkably variable in different institutions, leading to a very poor reproducibility of the data stemming from investigations on series of patients whose SLNs have been evaluated according to diverse protocols. Patient outcomes, however, can be optimised only by standardization of the whole procedure of SLNB, with particular reference to the histopathologic scrutiny. Lack of a standardized histopathologic protocol likely derives also from the uncertainties about the clinical implications of minimal lymph node involvement (isolated tumour cells and micrometastases) with regard both to the risk of additional metastases to non-sentinel lymph nodes of the same basin and to the prognostic value for patients' survival. This review aims at highlighting some of the controversial issues of the histopathologic examination of the SLNs, including the number of sections and cutting intervals, the use of immunohistochemistry and the role of molecular biology assays.
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Affiliation(s)
- Giuseppe Viale
- Department of Pathology and Laboratory Medicine, European Institute of Oncology, Via Ripamonti, 435, Milan, Italy.
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Biering H, Bauditz J, Brenner N, Stein H, Lochs H, Strasburger CJ. Primary neuroendocrine carcinoma of inguinal lymph node. HORMONE RESEARCH 2005; 64:16-9. [PMID: 16088203 DOI: 10.1159/000087191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2004] [Accepted: 04/26/2005] [Indexed: 11/19/2022]
Abstract
Ninety-seven percent of neuroendocrine carcinomas are located in the gastrointestinal tract or in the bronchopulmonary tree. Inguinal lymph nodes as the primary tumor site for neuroendocrine carcinoma represent a very unusual location, and have only been described in 2 patient series in the literature. A 64-year-old, previously healthy, Caucasian female presented with a 2-month history of an enlarged inguinal lymph node on the right side. The removed lymph node showed histological and immunohistochemical characteristics of neuroendocrine differentiation (positive for synaptophysin, cytokeratin 20, neuron-specific enolase and chromogranin A). Although extensive investigations including repeated CT and NMR scans, classical endoscopy, wireless capsule endoscopy of the small intestine, octreotide- and MIBG scintigraphy were performed, no other primary tumor was found. Furthermore, there was no evidence of Merkel cell carcinoma on dermatological examinations. A possible explanation for the presence of neuroendocrine carcinomas within the lymph nodes is malignant transformation of preexisting intranodal epithelial nests, which have previously been described in lymph nodes located close to the salivary glands, thyroid gland, breast tissue and pancreas. Since the surgical removal of the affected lymph node, the patient has now been disease-free for 42 months. We therefore consider our case to represent a primary undifferentiated neuroendocrine carcinoma in an inguinal lymph node.
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Affiliation(s)
- H Biering
- Division of Clinical Endocrinology, Department of Medicine for Gastroenterology, Hepatology and Endocrinology, Campus Mitte, Charité-Universitatsmedizin Berlin, Germany
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Nonaka D, Birbe R, Rosai J. So-called inflammatory myofibroblastic tumour: a proliferative lesion of fibroblastic reticulum cells? Histopathology 2005; 46:604-13. [PMID: 15910591 DOI: 10.1111/j.1365-2559.2005.02163.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The term inflammatory pseudotumour was originally used in a generic fashion for any lesion which simulated a neoplastic condition at a clinical, macroscopic and microscopic level but which was thought to have an inflammatory/reactive pathogenesis. In more recent times, the term has been employed in a more restrictive sense for a mass lesion characterized microscopically by the proliferation of a spindle cell component against a heavy inflammatory infiltrate of mixed composition but usually with a predominance of mature lymphocyte and plasma cells. The spindle cell component has generally been regarded as being of mesenchymal nature and having morphological and phenotypical features consistent with fibroblasts or myofibroblasts, the latter cell being clearly preferred over the former in the more resent reports. The term inflammatory myofibroblastic tumour (IMFT) is the one currently favoured, which proposes the myofibroblastic nature of the process. It is the purpose of this review to bring forth some evidence that the neoplastic spindle cell component of IMFT may be instead derived from the subtype of cells of the accessory immune system that have been variously called fibroblastic reticulum cells, myoid cells, and dictyocytes.
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Affiliation(s)
- D Nonaka
- Department of Pathology, National Cancer Institute (Istituto Nazionale Tumori), Milan, Italy.
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Grossmann KS, Grund C, Huelsken J, Behrend M, Erdmann B, Franke WW, Birchmeier W. Requirement of plakophilin 2 for heart morphogenesis and cardiac junction formation. ACTA ACUST UNITED AC 2004; 167:149-60. [PMID: 15479741 PMCID: PMC2172504 DOI: 10.1083/jcb.200402096] [Citation(s) in RCA: 205] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Plakophilins are proteins of the armadillo family that function in embryonic development and in the adult, and when mutated can cause disease. We have ablated the plakophilin 2 gene in mice. The resulting mutant mice exhibit lethal alterations in heart morphogenesis and stability at mid-gestation (E10.5–E11), characterized by reduced trabeculation, disarrayed cytoskeleton, ruptures of cardiac walls, and blood leakage into the pericardiac cavity. In the absence of plakophilin 2, the cytoskeletal linker protein desmoplakin dissociates from the plaques of the adhering junctions that connect the cardiomyocytes and forms granular aggregates in the cytoplasm. By contrast, embryonic epithelia show normal junctions. Thus, we conclude that plakophilin 2 is important for the assembly of junctional proteins and represents an essential morphogenic factor and architectural component of the heart.
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Affiliation(s)
- Katja S Grossmann
- Max Delbrueck Center for Molecular Medicine (MDC), D-13092 Berlin, Germany
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Abstract
Reactive gliosis is a prominent result of many types of insult to the central nervous system (CNS) and leads to the formation of glial scar that impedes the regeneration of axons. The intermediate filament protein vimentin is found in pathology of the CNS, mainly in the vicinity of injuries to the CNS. In the present study we investigated the role of vimentin in the formation of glial scars in vitro and in vivo by using immunohistochemistry, Western blot analysis, and in situ hybridization. In vitro experiments showed that the intensity of immunofluorescent labeling for vimentin and glial fibrillary acidic protein (GFAP) was consistently decreased in astrocytes after transfection with a retrovirus carrying antisense complementary DNA (cDNA) for vimentin. Transfection also inhibited the growth of astrocytes and decreased the expression of vimentin mRNA. In vivo studies demonstrated that transfection with the retrovirus carrying the antisense cDNA vimentin inhibited the upregulation of vimentin and GFAP in stab wounds in rat cerebrum. These results suggest that vimentin may play a key role in the formation of glial scars in the CNS.
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Affiliation(s)
- Jiangkai Lin
- Department of Neurosurgery, Southwest Hospital, College of Medicine, Third Military Medical University, Chongqing, The People's Republic of China.
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Viale G, Sonzogni A, Pruneri G, Maffini F, Masullo M, Dell'Orto P, Mazzarol G. Histopathologic examination of axillary sentinel lymph nodes in breast carcinoma patients. J Surg Oncol 2004; 85:123-8. [PMID: 14991883 DOI: 10.1002/jso.20024] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The axillary sentinel lymph node biopsy (SLNB) has gained increasing popularity as a novel surgical approach for staging patients with breast carcinoma and for guiding the choice of adjuvant therapy with minimal morbidity. Patients with negative SLNB represent a subset of breast carcinoma patients with definitely better prognosis, because their pN0 status is based on a very thorough examination of the sentinel lymph nodes (SLNs), with a very low risk of missing even small micrometastatic deposits, as compared with routine examination of the 20 or 30 lymph nodes obtained by the traditional axillary clearing. The histopathologic examination of the SLNs may be performed after fixation and embedding in paraffin, or intraoperatively on frozen sections. Whatever is the preferred tracing technique and surgical procedure, the histopathologic examination of each SLN must be particularly accurate, to avoid a false-negative diagnosis. Unfortunately, because of the lack of standardised guidelines or protocols for SLN examination, different institutions still adopt their own working protocols, which differ substantially in the number of sections cut and examined, in the cutting intervals (ranging from 50 to more than 250 microm), and in the more or less extensive use of immunohistochemical assays for the detection of micrometastatic disease. Herein, a very stringent protocol for the examination of the axillary SLN is reported, which is applied either to frozen SLN for the intraoperative diagnosis, and to fixed and embedded SLN as well.
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Affiliation(s)
- Giuseppe Viale
- University of Milan School of Medicine, European Institute of Oncology, Milan, Italy.
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Lucioni M, Boveri E, Rosso R, Benazzo M, Necchi V, Danova M, Incardona P, Franco C, Viglio A, Riboni R, Lazzarino M, Magrini U, Canevari A, Paulli M. Lymph node reticulum cell neoplasm with progression into cytokeratin-positive interstitial reticulum cell (CIRC) sarcoma: a case study. Histopathology 2003; 43:583-91. [PMID: 14636259 DOI: 10.1111/j.1365-2559.2003.01725.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS To detail on sequential biopsies the morphological and immunohistochemical features of a case of primary lymph nodal fibroblastic reticulum cell (FBRC) tumour which progressed into a clinically aggressive cytokeratin-positive interstitial reticulum cell (CIRC) sarcoma. METHODS AND RESULTS A 70-year-old female underwent surgical excision of an enlarged submandibular lymph node. The nodal architecture was effaced by a neoplastic proliferation of medium to large cells, round to oval to spindle in shape, growing in a storiform pattern. The tumour stained for vimentin, CD68, factor XIIIa, alpha1-antitrypsin, fascin and actin. Dendritic and endothelial cell markers were negative. A diagnosis of FBRC tumour was made by combining pathological and clinical data. The patient received no therapy but 5 months later the tumour relapsed, exhibiting a deceptively pleomorphic cytology, phenotypic changes (strong cytokeratin positivity), intense p53 expression and aggressive clinical course with fatal outcome. In-situ hybridization for Epstein-Barr virus was negative. CONCLUSIONS We speculate that the morphological changes and p53 expression of the relapsing neoplasm might reflect tumour cell dedifferentiation, in keeping with the aggressive clinical course. The intense p53 expression suggests that this oncoprotein might also play a role in reticulum cell tumorigenesis.
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Affiliation(s)
- M Lucioni
- Pathology Section, Department of Human Pathology, I.R.C.C.S. Policlinico S. Matteo, University of Pavia, Italy
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Schuerfeld K, Lazzi S, De Santi MM, Gozzetti A, Leoncini L, Pileri SA. Cytokeratin-positive interstitial cell neoplasm: a case report and classification issues. Histopathology 2003; 43:491-4. [PMID: 14636276 DOI: 10.1046/j.1365-2559.2003.01738.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AIMS Tumours of dendritic/accessory cell origin are rare neoplasms arising in lymph nodes. Among these, tumours derived from cytokeratin-positive interstitial reticulum cells (CIRCs), a subset of fibroblastic reticulum cells, are reported even less frequently. The International Lymphoma Study Group (ILSG) has recently proposed a classification for tumours of histiocytes and accessory dendritic cells in which CIRC tumours are not included. We report a case of a CIRC tumour arising in a submandibular lymph node of a 66-year-old male. METHODS AND RESULTS The neoplasm was composed of spindle cells with elongated or round nuclei, prominent nucleoli and abundant cytoplasm. These cells were arranged in a diffuse fascicular and vaguely whorled pattern. The tumour cells stained diffusely for S100, vimentin, desmin, lysozyme, and focally for CD68 and cytokeratins 7, 8, 18, CK-AE1 and CK-pool. Electron microscopy was performed for further evaluation on samples taken from the paraffin block; this revealed cytoplasmic projections and rudimentary cell junctions. CONCLUSIONS Histopathologist should be aware of the existence of tumours deriving from CIRCs, as these cases may be misdiagnosed as metastatic carcinoma. Careful clinical and pathological evaluation is necessary to exclude this possibility.
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Affiliation(s)
- K Schuerfeld
- Department of Human Pathology and Oncology, Siena University, Siena, Italy
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Salto-Tellez M, Kong SL, Leong APK, Koay ESC. Intrinsic variability in the detection of micrometastases in lymph nodes for re-staging of colorectal cancer. effect of individual markers and tissue samples. Eur J Cancer 2003; 39:1234-41. [PMID: 12763211 DOI: 10.1016/s0959-8049(03)00231-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this study, we investigated whether (a) carcinoembryonic antigen (CEA), cytokeratin-20 (CK-20) and guanylyl cyclase C (GCC) are clinically useful markers for the molecular detection of submicroscopic metastases in colorectal cancer (CRC) and (b) whether overexpression of CEA, CK-20 and GCC can be reliably detected in formalin-fixed, paraffin-embedded tissues as well as frozen lymph nodes. We studied 175 frozen lymph nodes and 158 formalin-fixed, paraffin-embedded lymph nodes from 28 cases of CRC. CEA or CK-20 or GCC-specific polymerase chain reaction (PCR) was carried out on mRNA transcripts extracted from the nodal tissues. Ten out of 11 Dukes' B CRC cases had detectable CEA and CK-20 while 6 out of 11 Dukes' B CRC cases had detectable GCC. In general, the difference of re-staged cases when comparing frozen and paraffin-embedded samples was marked; the only statistically significant correlation between frozen and paraffin tissue was for the CEA marker. Our results indicated a high incidence (>50%) of detecting micrometastases in histologically-negative lymph nodes at the molecular level.
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Affiliation(s)
- M Salto-Tellez
- Department of Pathology, National University of Singapore, 10 Kent Ridge Crescent, Singapore 119260, Singapore
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Hofmann T, Riesenberg R, Buchner A, Zimmermann W, Hofstetter A, Oberneder R. Disseminated tumor cells in bone marrow of patients with transitional cell carcinoma: immunocytochemical detection and correlation with established prognostic indicators. J Urol 2003; 169:1303-7. [PMID: 12629348 DOI: 10.1097/01.ju.0000054917.31718.cd] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Previous investigations have demonstrated the prognostic value of disseminated cytokeratin positive cells in bone marrow of patients with breast, gastric, colon and prostate cancer. We evaluated the potential of an immunocytochemical assay, using a monoclonal antibody against cytokeratin 18 (CK 18), for the detection of disseminated tumor cells in bone marrow aspirates of patients with transitional cell carcinoma. MATERIALS AND METHODS Bone marrow aspiration was performed preoperatively on 128 patients with transitional cell carcinoma of various stages and on 27 controls with nonmalignant disease. Cytospin preparations of mononuclear bone marrow cells were incubated with a monoclonal anti-CK 18 antibody and stained using the alkaline phosphatase anti-alkaline phosphatase technique. RESULTS Of the patients with transitional cell carcinoma 29.7% and none of the controls had a CK 18 positive bone marrow result. A significant correlation between the incidence of CK 18 positive cells in bone marrow and invasive transitional cell carcinoma (p <0.01), lymph node involvement (p <0.01), medium/high grade transitional cell carcinoma (p <0.01) and tumor progression in recurrent transitional cell carcinoma (p <0.05) was demonstrated. Furthermore, the mean number of CK 18 positive cells in bone marrow aspirates of patients with stage M+ and/or N+ disease was nearly 3 times as high as that of patients without clinically evident metastatic disease (10.4 versus 3.8 CK 18 positive cells per patient). CONCLUSIONS A significant correlation between the incidence of CK 18 positive bone marrow results in patients with transitional cell carcinoma and established risk factors could be demonstrated in our study. Further prospective followup studies should be performed to determine the prognostic value of these findings.
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Affiliation(s)
- Thomas Hofmann
- Department of Urology, Klinikum Grosshadern, Luwig-Maximilians University of Munich and Staedtisches Krankenhaus Muenchen-Bogenhausen, Munich, Germany
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Maiorano E, Mazzarol GM, Pruneri G, Mastropasqua MG, Zurrida S, Orvieto E, Viale G. Ectopic breast tissue as a possible cause of false-positive axillary sentinel lymph node biopsies. Am J Surg Pathol 2003; 27:513-8. [PMID: 12657937 DOI: 10.1097/00000478-200304000-00012] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Epithelial inclusions representing ectopic breast tissue are uncommonly seen in axillary lymph nodes. The extensive histopathologic examination of axillary sentinel lymph nodes of patients with breast carcinoma may increase the chances to encounter tiny foci of ectopic breast tissue, which may be misinterpreted as (micro)metastatic disease and lead to unwarranted completion of axillary dissection and to inaccurate staging and improper adjuvant treatments for the patients. Here we report on seven cases of ectopic breast tissue in axillary sentinel lymph nodes. In three cases there were coexistent micrometastases, and in the remaining cases the ectopic tissue was not associated with metastatic disease. The ectopic breast tissue showed remarkably varied morphologic features, including apocrine metaplasia and proliferative changes indistinguishable from those occurring in sclerosing adenosis and florid epithelial hyperplasia of the breast. A peripheral layer of myoepithelial cells was consistently detected in the ectopic glands and ducts. Besides awareness and purely morphologic criteria, a false-positive identification of these inclusions as metastatic carcinoma may be avoided by the use of immunohistochemical reactions for the localization of specific markers of the myoepithelial cell component, which is associated with the ectopic breast tissue.
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Affiliation(s)
- Eugenio Maiorano
- Department of Pathological Anatomy and Genetics, University of Bari, Bari, Italy
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