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Rodich S, Garza-Gongora R, So C, Ward R, Zreik R. Epithelioid angiosarcoma of the calf: a case report of an atypical imaging appearance. Skeletal Radiol 2024; 53:989-994. [PMID: 37787920 DOI: 10.1007/s00256-023-04456-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
Angiosarcoma is an uncommon cause of soft tissue malignancy, accounting for approximately 2% of all soft tissue sarcomas. Of these, epithelioid angiosarcoma represents a morphologic subtype, where the malignant endothelial cells demonstrate a predominantly or exclusively epithelioid appearance. Overall, epithelioid angiosarcoma shares similar imaging characteristics to conventional angiosarcoma including a T1 hypointense to isointense and T2 hyperintense mass, which demonstrates avid enhancement, serpentine feeding vessels, and overlying skin thickening on MRI. The case herein describes a case of epithelioid angiosarcoma in a 65-year-old female presenting with an enlarging calf mass and lower extremity pain. Initial imaging features, particularly on MRI, were highly unusual for angiosarcoma which was thus not strongly considered in the initial differential diagnosis. However, once diagnosis of epithelioid angiosarcoma was confirmed following resection, pathologic correlates were utilized to account for the unusual imaging findings retrospectively. The goal of this study is to not only describe an atypical presentation of an uncommon diagnosis but also attempt to rationalize the unexpected imaging findings with gross and microscopic correlates. Further, the utility of radiology-pathology correlation demonstrated in this case may be useful to others when evaluating similar lesions with unexpected MRI characteristics.
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Affiliation(s)
- Sean Rodich
- Baylor Scott & White Health, Temple, TX, USA.
| | | | - Connie So
- Baylor Scott & White Health, Temple, TX, USA
| | | | - Riyam Zreik
- Baylor Scott & White Health, Temple, TX, USA
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2
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Koide R, Shigemasa R, Hashimoto K, Tatsumi Y, Hayashi H, Suzuki T, Wakusawa S. Distribution Analysis of Iron and Copper by STEM-EDX Spectroscopy of Hemosiderin Particles in the Liver of Rats Overloaded With Iron. In Vivo 2024; 38:114-121. [PMID: 38148091 PMCID: PMC10756453 DOI: 10.21873/invivo.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM Our recent studies have indicated that trace copper co-existed with iron in hemosiderin particles of human genetic iron overload. To understand this phenomenon, we analyzed hemosiderin particles in iron-overloaded rat liver by using scanning transmission electron microscopy - energy-dispersive X-ray (STEM-EDX) spectroscopy. MATERIALS AND METHODS Samples for STEM-EDX spectroscopy were prepared from the liver of rats administered an intraperitoneal injection of dextran iron. RESULTS The micro-domain analysis with STEM-EDX spectroscopy showed that dense bodies contained high levels of iron and trace copper. Quantitative analysis of copper levels in the liver specimen using atomic spectrophotometry showed that copper concentration in the liver was not increased by iron overload. These findings suggest that the overload of iron induced distribution of trace copper to hemosiderin particles without changing cellular copper levels. CONCLUSION Co-existence of copper with iron was observed in hemosiderin particles of the liver of an experimental model of iron overload, suggesting that iron overload induced distribution of trace copper into hemosiderin particles.
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Affiliation(s)
- Ryoji Koide
- Division of Medical Laboratory Sciences, Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryota Shigemasa
- Division of Medical Laboratory Sciences, Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Hashimoto
- Division of Medical Laboratory Sciences, Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Technology, Faculty of Medical Sciences, Shubun University, Ichinomiya, Japan
| | - Yasuaki Tatsumi
- Department of Pharmacotherapeutics, Aichi Gakuin University School of Pharmacy, Nagoya, Japan
| | - Hisao Hayashi
- Department of Pharmacotherapeutics, Aichi Gakuin University School of Pharmacy, Nagoya, Japan
| | - Takayoshi Suzuki
- Department of Medical Technology, Faculty of Medical Sciences, Shubun University, Ichinomiya, Japan
| | - Shinya Wakusawa
- Division of Medical Laboratory Sciences, Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan;
- Department of Medical Technology, Faculty of Medical Sciences, Shubun University, Ichinomiya, Japan
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3
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Cao Y, Huang MY, Mao CH, Wang X, Xu YY, Qian XJ, Ma C, Qiu WY, Zhu YC. Arteriolosclerosis differs from venular collagenosis in relation to cerebrovascular parenchymal damages: an autopsy-based study. Stroke Vasc Neurol 2023; 8:267-275. [PMID: 36581493 PMCID: PMC10512076 DOI: 10.1136/svn-2022-001924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND PURPOSE Cerebrovascular parenchymal damage is prevalent in ageing brains; however, its vascular aetiology has not been fully elucidated. In addition to the underlying role of sclerotic arterioles, the correlation between collagenised venules has not been clarified. Here, we aimed to investigate the associations between microvascular injuries, including arteriolosclerosis and venular collagenosis, and related parenchymal damages in ageing brains, to investigate the underlying correlations. METHODS We evaluated arteriolosclerosis and venular collagenosis in 7 regions from 27 autopsy cases with no history of stroke or brain tumour. The correlations between the ratio of arteriolosclerosis, venular collagenosis and the severity of cerebrovascular parenchymal damage, including lacunes, microinfarcts, myelin loss, and parenchymal and perivascular haemosiderin deposits, were assessed. RESULTS Arteriolosclerosis and venular collagenosis became more evident with age. Arteriolosclerosis was associated with lacunes (p=0.004) and brain parenchymal haemosiderin deposits in the superior frontal cortex (p=0.024) but not with leukoaraiosis severity. Venular collagenosis was not associated with the number of lacunes or haemosiderin, while white matter generally became paler with severe venular collagenosis in the periventricular (β=-0.430, p=0.028) and deep white matter (β=-0.437, p=0.025). CONCLUSION Our findings imply an important role for venular lesions in relation to microvessel-related parenchymal damage which is different from that for arteriolosclerosis. Different underlying mechanisms of both cerebral arterioles and venules require further investigation.
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Affiliation(s)
- Yuan Cao
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mei-Ying Huang
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen-Hui Mao
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue Wang
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yuan-Yuan Xu
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiao-Jing Qian
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Chao Ma
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Wen-Ying Qiu
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yi-Cheng Zhu
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Matsche MA, Blazer VS, Pulster EL. White perch health relative to urbanization and habitat degradation in Chesapeake Bay tributaries. II. Hepatic and splenic macrophage aggregates. Dis Aquat Organ 2023; 154:107-130. [PMID: 37410431 DOI: 10.3354/dao03734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Macrophage aggregate (MA) abundance in fish is a useful general biomarker of contaminant exposures and environmental stress. Hepatic and splenic MAs were evaluated in semi-anadromous white perch Morone americana (Gmelin, 1789) from the urbanized Severn River (S) and the more rural Choptank River (C), Chesapeake Bay. Fish were collected from different sites in the annual migratory circuit in each river that corresponded to active spawning in late winter-early spring, summer regenerating, autumn developing, and winter spawning-capable phases. An age-associated progressive increase in the total volume of MAs (MAV) was evident in the liver and spleen. Mean hepatic MAV (range in seasonal means, C: 6.4-23.1 mm3; S: 15.7-48.7 mm3) and mean splenic MAV (C: 7.3-12.6 mm3; S: 16.0-33.0 mm3) differed significantly among seasons and were significantly greater in females and in Severn River fish. Age and river were the most influential factors, suggesting that increased MAV in Severn River fish resulted from chronic exposures to higher concentrations of environmental contaminants. Hepatic MAV was directly related to the relative volume of copper granules in the liver. Less influential factors on splenic MAV included fish condition, trematode infections, and granulomas, indicating possible functional differences in MAs by organ. While organ volumes were strongly linked to gonadosomatic index (GSI) and reproductive phase, the reason for seasonal differences in MAV was less clear. Water temperature, salinity, and dissolved oxygen were not significantly related to MAV, and indicators of reproductive phase (hepatosomatic index and GSI) were significant but less important in explaining variation in MAV.
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Affiliation(s)
- Mark A Matsche
- Maryland Department of Natural Resources, Cooperative Oxford Laboratory, 904 South Morris Street, Oxford, Maryland 21654, USA
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Friedauer L, Foerch C, Steinbach J, Hattingen E, Harter PN, Armbrust M, Urban H, Steidl E, Neuhaus E, von Brauchitsch S. The Acute Superficial Siderosis Syndrome - Clinical Entity, Imaging Findings, and Histopathology. Cerebellum 2023; 22:296-304. [PMID: 35316464 PMCID: PMC9985565 DOI: 10.1007/s12311-022-01387-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
Superficial siderosis is a consequence of repetitive bleeding into the subarachnoid space, leading to toxic iron and hemosiderin deposits on the surface of the brain and spine. The clinical and radiological phenotypes of superficial siderosis are known to manifest over long time intervals. In contrast, this study defines the "acute superficial siderosis syndrome" and illustrates typical imaging and histopathological findings of this entity. We describe the case of a 61-year-old male patient who was diagnosed with a melanoma metastasis in the right frontal cortex in February 2019. Within a few weeks he developed a progressive syndrome characterized by cerebellar ataxia, gait disturbance, signs of myelopathy, and radiculopathy. MRI revealed ongoing hemorrhage from the metastasis into the lateral ventricle and the subarachnoid space. A semiquantitative assessment of three subsequent MRI within an 8-week period documented the rapid development of superficial siderosis along the surface of the cerebellum, the brain stem, and the lower parts of the supratentorial regions on T2*-weighted sequences. The diagnosis of a superficial siderosis was histopathologically confirmed by identifying iron and hemosiderin deposits on the cortex along with astrogliosis. The recognition of this "acute superficial siderosis syndrome" triggered surgical removal of the hemorrhagic metastasis. Based on a single case presentation, we define the "acute superficial siderosis syndrome" as a clinical entity and describe the radiological and histopathological characteristics of this entity. Early recognition of this syndrome may allow timely elimination of the bleeding source, in order to prevent further clinical deterioration.
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Affiliation(s)
- Lucie Friedauer
- Department of Neurology, University Hospital/Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
| | - Christian Foerch
- Department of Neurology, University Hospital/Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Joachim Steinbach
- Department of Neuro-Oncology, University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
- University Cancer Center Frankfurt (UCT), University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Heidelberg, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Patrick N Harter
- University Cancer Center Frankfurt (UCT), University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Heidelberg, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurological Institute (Edinger Institute), University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Moritz Armbrust
- Neurological Institute (Edinger Institute), University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Hans Urban
- Department of Neuro-Oncology, University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
- University Cancer Center Frankfurt (UCT), University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Heidelberg, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eike Steidl
- Institute of Neuroradiology, University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Elisabeth Neuhaus
- Institute of Neuroradiology, University Hospital/Goethe University Frankfurt, Frankfurt am Main, Germany
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt am Main, Germany
| | - Sophie von Brauchitsch
- Department of Neurology, University Hospital/Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt am Main, Germany
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6
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Magaki S, Chen Z, Severance A, Williams CK, Diaz R, Fang C, Khanlou N, Yong WH, Paganini-Hill A, Kalaria RN, Vinters HV, Fisher M. Neuropathology of microbleeds in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). J Neuropathol Exp Neurol 2023; 82:333-344. [PMID: 36715085 PMCID: PMC10025882 DOI: 10.1093/jnen/nlad004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Cerebral microbleeds (CMBs) detected on magnetic resonance imaging are common in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The neuropathologic correlates of CMBs are unclear. In this study, we characterized findings relevant to CMBs in autopsy brain tissue of 8 patients with genetically confirmed CADASIL and 10 controls within the age range of the CADASIL patients by assessing the distribution and extent of hemosiderin/iron deposits including perivascular hemosiderin leakage (PVH), capillary hemosiderin deposits, and parenchymal iron deposits (PID) in the frontal cortex and white matter, basal ganglia and cerebellum. We also characterized infarcts, vessel wall thickening, and severity of vascular smooth muscle cell degeneration. CADASIL subjects had a significant increase in hemosiderin/iron deposits compared with controls. This increase was principally seen with PID. Hemosiderin/iron deposits were seen in the majority of CADASIL subjects in all brain areas. PVH was most pronounced in the frontal white matter and basal ganglia around small to medium sized arterioles, with no predilection for the vicinity of vessels with severe vascular changes or infarcts. CADASIL subjects have increased brain hemosiderin/iron deposits but these do not occur in a periarteriolar distribution. Pathogenesis of these lesions remains uncertain.
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Affiliation(s)
- Shino Magaki
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Zesheng Chen
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Alyscia Severance
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Christopher K Williams
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Ramiro Diaz
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Chuo Fang
- Department of Neurology, University of California-Irvine School of Medicine, Irvine, California, USA
| | - Negar Khanlou
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - William H Yong
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Annlia Paganini-Hill
- Department of Neurology, University of California-Irvine School of Medicine, Irvine, California, USA
| | - Rajesh N Kalaria
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Harry V Vinters
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
- Department of Neurology, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
- Brain Research Institute, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine, Los Angeles, California, USA
| | - Mark Fisher
- Department of Neurology, University of California-Irvine School of Medicine, Irvine, California, USA
- Department of Pathology and Laboratory Medicine, University of California-Irvine School of Medicine, Irvine, California, USA
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Vali SW, Lindahl PA. Low-temperature Mössbauer spectroscopy of organs from 57Fe-enriched HFE (-/-) hemochromatosis mice: an iron-dependent threshold for generating hemosiderin. J Biol Inorg Chem 2023; 28:173-185. [PMID: 36512071 PMCID: PMC9981716 DOI: 10.1007/s00775-022-01975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/26/2022] [Indexed: 12/15/2022]
Abstract
Hereditary hemochromatosis is an iron-overload disease most often arising from a mutation in the Homeostatic Fe regulator (HFE) gene. HFE organs become overloaded with iron which causes damage. Iron-overload is commonly detected by NMR imaging, but the spectroscopic technique is insensitive to diamagnetic iron. Here, we used Mössbauer spectroscopy to examine the iron content of liver, spleen, kidney, heart, and brain of 57Fe-enriched HFE(-/-) mice of ages 3-52 wk. Overall, the iron contents of all investigated HFE organs were similar to the same healthy organ but from an older mouse. Livers and spleens were majorly overloaded, followed by kidneys. Excess iron was generally present as ferritin. Iron-sulfur clusters and low-spin FeII hemes (combined into the central quadrupole doublet) and nonheme high-spin FeII species were also observed. Spectra of young and middle-aged HFE kidneys were dominated by the central quadrupole doublet and were largely devoid of ferritin. Collecting and comparing spectra at 5 and 60 K allowed the presence of hemosiderin, a decomposition product of ferritin, to be quantified, and it also allowed the diamagnetic central doublet to be distinguished from ferritin. Hemosiderin was observed in spleens and livers from HFE mice, and in spleens from controls, but only when iron concentrations exceeded 2-3 mM. Even in those cases, hemosiderin represented only 10-20% of the iron in the sample. NMR imaging can identify iron-overload under non-invasive room-temperature conditions, but Mössbauer spectroscopy of 57Fe-enriched mice can detect all forms of iron and perhaps allow the process of iron-overloading to be probed in greater detail.
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Affiliation(s)
- Shaik Waseem Vali
- Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, USA
| | - Paul A Lindahl
- Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, USA.
- Department of Chemistry, Texas A&M University, College Station, TX, 77843-3255, USA.
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Liu T, Wang L, Zhang S, Han H, Du K, Chen X, Zhao Z, Zhao L, Xie J, Zhao L, Peng Z, Zhu T, Huang Q. Prediction of outcomes for symptomatic spinal cavernous malformation surgery: a multicenter prospective clinical study. Eur Spine J 2023; 32:1326-1333. [PMID: 36829066 DOI: 10.1007/s00586-023-07585-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/23/2023] [Accepted: 02/04/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE Clinical outcome of spinal cavernous malformation (SCM) varies because of its unclear natural history, and reliable prognostic prediction model for SCM patients is limited. The aim of the present study was to investigate potential factors that predict one-year neurological status in postoperative patients with SCM. METHODS This was a multicenter prospective observational study in consecutive patients with SCMs. SCMs treated microsurgically between January 2015 and January 2021 were included. Outcome was defined as the American Spinal Injury Association Impairment Scale (AIS) grade at one year after operation. Multivariable analyses were used to construct the best predictive model for patient outcomes. RESULTS We identified 268 eligible SCM patients. Neurological outcome had worsened from preoperative baseline in 51 patients (19.0%) at one year. In the multivariable logistic regression, the best predictive model for unfavorable outcome included symptom duration ≥ 26 months (95% CI 2.80-16.96, P < 0.001), size ≤ 5 mm (95% CI 1.43-13.50, P = 0.010), complete intramedullary (95% CI 1.69-8.14, P = 0.001), subarachnoid hemorrhage (95% CI 2.92-12.57, P < 0.001), AIS B (95% CI 1.91-40.93, P = 0.005) and AIS C (95% CI 1.12-14.54, P = 0.033). CONCLUSIONS Admission size of the lesion, morphology, symptom duration, AIS grade and the presence of subarachnoid hemorrhage were strong outcome predictors regarding prognostication of neurological outcome in postoperative patients with SCMs. A decision to surgically remove a symptomatic SCM should be justified by systematic analysis of all factors potentially affecting outcome.
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Affiliation(s)
- Tong Liu
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China
| | - Lichao Wang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shizhong Zhang
- Department of Neurosurgery, The Affiliated Taian City Centeral Hospital of QingDao University, Qingdao, Shandong, China
| | - Hao Han
- Department of Neurosurgery, Jining No 1 People's Hospital, Neurosurgery, Jining, Shandong, China
| | - Kangjie Du
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Chen
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China
| | - Zilong Zhao
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China
| | - Liwen Zhao
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China
| | - Jiapeng Xie
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China
| | - Lu Zhao
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhijun Peng
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tao Zhu
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China
| | - Qiang Huang
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road in Heping District, Tianjin, 300052, China.
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9
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Lin J, Guan M, Liao Y, Zhang L, Qiao H, Huang L. An old thrombus may potentially identify patients at higher risk of poor outcome in anterior circulation stroke undergoing thrombectomy. Neuroradiology 2023; 65:381-390. [PMID: 36269335 DOI: 10.1007/s00234-022-03069-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/12/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE To investigate thrombus age and its association with clinical and procedural parameters in patients with acute ischemic stroke (AIS) due to anterior circulation occlusions. METHODS The thrombi of 107 consecutive AIS patients with occlusions in anterior circulation large-arteries were collected during mechanical recanalization. By hematoxylin-eosin staining analysis, thrombi were classified as fresh (< 3 days) or old (≥ 3 days) according to the hemosiderin positivity. Old thrombi were further classified as thrombi with focal hemosiderin or diffuse hemosiderin according to their predominant distribution. Neuro-interventional data and clinical outcomes were compared based on thrombus age. RESULTS We identified fresh thrombi in 29 patients and old thrombi in 78 patients. Compared with patients with fresh thrombi, patients with old thrombi were associated with (i) a longer mechanical recanalization time (p = 0.027), (ii) a higher percentage of fibrin/platelets and leukocytes (all p = 0.02) and a lower percentage of erythrocytes (p = 0.001), and (iii) less favorable clinical outcomes at discharge (p = 0.019) and 90 days later (OR = 2.76, 95% CI = 1.09-6.99, p = 0.032). Furthermore, 18 (16.8%) of all patients had focal hemosiderin in old thrombi, which was independently linked to a poor clinical outcome 90 days later (adjusted OR = 5.37, 95% CI = 1.14-25.28, p = 0.034). CONCLUSION The presence of old thrombi, particularly those with focal hemosiderin, may aid in identifying patients with acute ischemic anterior circulation stroke who are at a higher risk of poor clinical outcome at 3-month follow-up.
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Affiliation(s)
- Jia'xing Lin
- Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, Guangzhou, 510630, China
| | - Min Guan
- Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, Guangzhou, 510630, China
| | - Yu Liao
- Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, Guangzhou, 510630, China.,Department of Pathology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Liang Zhang
- Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, Guangzhou, 510630, China
| | - Hong'yu Qiao
- Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, Guangzhou, 510630, China
| | - Li'an Huang
- Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, Guangzhou, 510630, China.
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Ali N, Shah AA, Rakshan I. Clinical Scenario and Imaging with Illustrations of Giant Cell Tumor of Bone: A Retrospective Analysis. Arch Bone Jt Surg 2022; 10:60-66. [PMID: 35291246 PMCID: PMC8889423 DOI: 10.22038/abjs.2021.50922.2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 04/03/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND The giant cell tumour of the bone has a spectrum of clinical-radiological presentation. This study aims to describe this varied presentation in our institution. METHODS This retrospective study was conducted on twenty-nine pathologically labelled cases of giant cell tumours of the bone. The medical records for their clinical presentation and diagnostic imaging studies were studied and evaluated. RESULTS Mean age of the patients at presentation was 35.3±12.9 years. Pain, local swelling and restricted joint function were seen in 93 %, 58.6 % and 52 % patients, respectively. The cortical breach was seen in 15 (51.7 %) and 22 (75.9 %) lesions on plain radiographs and CT images, respectively. 14(48.3 %) cases had soft tissue invasion on MRI at presentation. 26 (89.7 %) lesions were located within 1 cm from the articular cartilage. The solid tumour component was hypo to iso-intense in signal intensity in 27 (93.1 %) lesions in T1 weighted and 21 (72.4 %) in T2 weighted images. 14 (48.3 %) had hyperintense cystic areas, and fluid-fluid levels, suggestive of aneurysmal bone cysts, were seen in 4 (13.8 %) cases on T2 weighted images. Hypo-echoic nodular areas in solid tumour component, suggestive of hemosiderin deposits, were present in 3 (10.3 %) lesions on T1 and T2 weighted images. CONCLUSION The tumour classically presents as an epiphysial-metaphyseal, eccentric, expansile, lytic lesion in a skeletally mature patient. The MRI picture is variable and the surgeon should have a sound knowledge of these variations to obtain a biopsy sample from a proper site of the lesion and to avoid misdiagnosis especially of a primary ABC.
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11
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Kitaura H, Hiraishi T, Itoh Y, Oishi M, Fujii Y, Fukuda M, Kakita A. Reactive astrocytes contribute to epileptogenesis in patients with cavernous angioma. Epilepsy Res 2021; 176:106732. [PMID: 34332257 DOI: 10.1016/j.eplepsyres.2021.106732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Patients with cavernous angioma (CA) often suffer from severe epilepsy, and surgical resection is often performed to attenuate these epileptic seizures. Several studies have suggested that surgical removal of the surrounding hemosiderin-pigmented tissues adjacent to CA achieves better seizure control than restricted lesionectomy. Pathological examination of the resected foci reveals not only hemosiderin pigmentation but also various degrees of inflammatory change, such as hemosiderin-laden macrophages, gliosis and fibrosis. However, there is some controversy regarding the epileptogenic potential of these regions due to the uncertain nature of the mechanisms contributing to these histopathological changes. METHODS To investigate the correlations between neuron hyperexcitability and evident pathological changes, we performed ex vivo flavoprotein fluorescence imaging using surgically resected epileptogenic foci surrounding CA. The mirror surfaces of the tissues used for the physiological experiment were also subjected to morphological examination. RESULTS Hemosiderin-laden macrophages and many gemistocytic astrocytes were observed in the area adjacent to CA, where horizontal spreading excitations were detected significantly more frequently. Outside these areas, we found fine granular iron deposits and only a few fibrillary astrocytes, and weakly propagating excitations were detected. Furthermore, areas of enhanced activation were more clearly correlated with the glial proliferation index than with iron deposition. CONCLUSION These results suggest that the epileptogenesis in patients with CA may be based on a biological process, such as alteration of glial function, rather than direct chemical reactions involving iron deposition.
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12
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Dhinakaran S, Mahadevan A, Unchagi A, Kulkarni GB, Nagappa M, Chickabasaviah YT, Sankaran BP, Taly AB, Shankar SK. Is Perls Prussian Blue Stain for Hemosiderin a Useful Adjunct in the Diagnosis of Vasculitic Neuropathies? Neurol India 2021; 69:140-146. [PMID: 33642286 DOI: 10.4103/0028-3886.310064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Perls Prussian blue stain (PPB) for hemosiderin, a marker of vascular injury is often employed as an adjunct in the diagnosis of vasculitic neuropathies. However, inflammation/vascular injury is also seen in leprosy, immune mediated, paraproteinemic, diabetic neuropathies, etc. The frequency of detection of hemosiderin in these neuropathies and its utility in diagnosis of vasculitis has not been explored. Objective We evaluated 208 peripheral nerve biopsies for hemosiderin deposits by PPB stain in vasculitis (78) and compared with inflammatory/immune neuropathies [leprous neuritis-32, chronic inflammatory demyelinating polyneuropathy (CIDP)-15, paraproteinemic neuropathies (POEMS)-12, diabetic neuropathy-37] and nonimmune neuropathies [Charcot-Marie-Tooth (CMT) disease-15, vitamin B12 deficiency-7, and ischemic neuropathy in aged-12)]. Results Hemosiderin deposits were most frequent in vasculitis (48.72%) [59.2% in systemic; 43.1% in nonsystemic vasculitides] and enhanced the sensitivity of diagnosis in "probable" vasculitis (34.48%) that lacked transmural inflammation. Hemosiderin was also detected in infectious/immune-mediated neuropathies (leprous neuritis-56%, POEMS-33.3%, diabetes-18.9%) but absent in CMT, B12 deficiency, and ischemic neuropathy. Hemosiderin deposits involved epineurium in vasculitis, compared to endoneurial/perineurial location in leprosy and perineurial in POEMS and diabetic neuropathy. The sensitivity of detection was high in vasculitic neuropathy (49.35%) compared to other inflammatory neuropathies (22.3%) (P < 0.05) with high specificity (77.69% [positive predictive value (PPV)-56.71%; negative predictive value (NPV)-71.6%]. The specificity increased to 89% if leprous neuropathy was excluded, with PPV-77.5% while NPV dropped to 68.5%. Conclusion These findings suggest that PPB stain for detection of hemosiderin is a useful adjunct in diagnosis of vasculitic neuropathy with high specificity but low sensitivity.
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Affiliation(s)
- Sathiyabama Dhinakaran
- Department of Neuropathology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Asha Unchagi
- Department of Neuropathology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Girish B Kulkarni
- Department of Neurology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Madhu Nagappa
- Department of Neurology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Yasha T Chickabasaviah
- Department of Neuropathology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Bindu P Sankaran
- Department of Neurology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - Arun B Taly
- Department of Neurology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
| | - S K Shankar
- Department of Neuropathology, National Institute of Mental Health Neurosciences, Bangalore, Karnataka, India
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13
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Taguchi S, Hidaka S, Yanai M, Ishioka K, Matsui K, Mochida Y, Moriya H, Ohtake T, Kobayashi S. Renal hemosiderosis presenting with acute kidney Injury and macroscopic hematuria in Immunoglobulin A nephropathy: a case report. BMC Nephrol 2021; 22:132. [PMID: 33858363 PMCID: PMC8048362 DOI: 10.1186/s12882-021-02334-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/02/2021] [Indexed: 11/19/2022] Open
Abstract
Background Macroscopic hematuria-associated acute kidney injury (AKI) is a well-known complication of immunoglobulin A (IgA) nephropathy. In such cases, intratubular obstruction by red blood cell (RBC) casts and acute tubular necrosis are mainly observed pathologically. Herein, we report the case of a patient with IgA nephropathy presenting with AKI following an episode of macrohematuria. The patient presented with severe renal tubular hemosiderosis and acute tubular necrosis and without any obvious obstructive RBC casts. Case presentation A 68-year-old woman, who was diagnosed with IgA nephropathy on renal biopsy 6 years ago, was admitted to our hospital after an episode of macroscopic glomerular hematuria and AKI following upper respiratory tract infection. Renal biopsy showed mesangial proliferation of the glomeruli, including crescent formation in 17 % of the glomeruli, and acute tubular necrosis without obvious hemorrhage or obstructive RBC casts. The application of Perls’ Prussian blue stain showed hemosiderin deposition in the renal proximal tubular cells. Immunofluorescence showed granular mesangial deposits of IgA and C3. Based on these findings, she was diagnosed with acute tubular necrosis with a concurrent IgA nephropathy flare-up. Moreover, direct tubular injury by heme and iron was considered to be the cause of AKI. She was treated with intravenous pulse methylprednisolone followed by oral prednisolone. Thereafter, the gross hematuria gradually faded, and her serum creatinine levels decreased. Conclusions IgA nephropathy presenting with acute kidney injury accompanied by macrohematuria may cause renal hemosiderosis and acute tubular necrosis without obstructive RBC casts. Hemosiderosis may be a useful indicator for determining the pathophysiology of macroscopic hematuria-associated AKI. However, renal hemosiderosis may remain undiagnosed. Thus, Perls’ Prussian blue iron staining should be more widely used in patients presenting with hematuria.
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Affiliation(s)
- Shinya Taguchi
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan. .,Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004, Yokohama, Japan.
| | - Sumi Hidaka
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
| | - Mitsuru Yanai
- Department of Pathology, Sapporo Tokushukai Hospital, 1-1-1 Oyachi-higashi, Atsubetsu-ku, 004-0041, Sapporo, Hokkaido, Japan.,Hokkaido Renal Pathology Center, IT-FRONTBuilding, 28-196, N9W15, Chuo-ku, 060-0009, Sapporo, Hokkaido, Japan
| | - Kunihiro Ishioka
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
| | - Kenji Matsui
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
| | - Yasuhiro Mochida
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
| | - Hidekazu Moriya
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
| | - Takayasu Ohtake
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
| | - Shuzo Kobayashi
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, 247-8553, Kamakura, Kanagawa, Japan
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Consul N, Javed-Tayyab S, Morani AC, Menias CO, Lubner MG, Elsayes KM. Iron-containing pathologies of the spleen: magnetic resonance imaging features with pathologic correlation. Abdom Radiol (NY) 2021; 46:1016-1026. [PMID: 32915270 DOI: 10.1007/s00261-020-02709-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/17/2020] [Accepted: 07/25/2020] [Indexed: 12/13/2022]
Abstract
Systemic and non-systemic pathologies that involve iron deposition within the spleen have characteristic features on MRI due to the susceptibility properties of deposited iron, or hemosiderin. These lesions will have signal loss on longer echo sequences due to the T2* effect when evaluated with dual-echo gradient-echo sequences. The pathophysiology of systemic and localized iron sequestration disease processes can elucidate an underlying diagnosis based on these imaging features in conjunction with clinical information.
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Affiliation(s)
- Nikita Consul
- Department of Diagnostic Radiology, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Sidra Javed-Tayyab
- Department of Radiology, Memorial-Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ajaykumar C Morani
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | | | - Meghan G Lubner
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, Madison, WI, 53726, USA
| | - Khaled M Elsayes
- Department of Diagnostic Radiology, Mayo Clinic, Scottsdale, AZ, USA.
- Department of Radiology, Unit 1473, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
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15
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Franco-Belussi L, Jones-Costa M, Salla RF, Souza BFS, Pinto-Vidal FA, Oliveira CR, Silva-Zacarin ECM, Abdalla FC, Duarte ICS, De Oliveira C. Hepatotoxicity of the anionic surfactant linear alkylbenzene sulphonate (LAS) in bullfrog tadpoles. Chemosphere 2021; 266:129014. [PMID: 33250231 DOI: 10.1016/j.chemosphere.2020.129014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
The liver of anurans play an important role in metabolism, including detoxification, the biotransformation of molecules, and the storage of metabolites. Surfactants are part of domestic and industrial effluents. The effects of linear alkylbenzene sulfonate (LAS) on anuran liver remain unknown, however, some studies have evaluated the effects of LAS on the skin, gills, heart, testes, and liver of fishes. Here, we tested the hypothesis that LAS is hepatotoxic, promoting morphometric alterations in hepatocytes along with inflammation in the tissue, altering hepatic catabolism. We evaluated the effects of a LAS concentration that is considered environmentally safe in Brazilian inland waters on the liver of Lithobates catesbeianus tadpoles, including studies on morphology, morphometry, immunology, and metabolism. LAS exposure promoted enlargement of liver sinusoids and vacuolization of hepatocytes. Exposure to LAS also increased the area of mast cells and melanomacrophages (MMs). Additionally, LAS exposure increased hemosiderin inside MMs, suggesting alterations in the catabolism and storage of iron. Hepatocyte size increased after exposure to LAS, suggesting cytotoxic effects. Integrative analyses (i.e., morphometric, metabolic, and immunological) demonstrated hepatotoxic effects of LAS. These types of studies are key to understanding the negative effects of these substances on tadpole health, as these liver alterations impair anuran homeostasis.
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Affiliation(s)
- Lilian Franco-Belussi
- Laboratório de Fisiologia da Conservação (LAFISC), Universidade Federal de São Carlos (UFSCar), Sorocaba, São Paulo, Brazil; Departamento de Biologia, Universidade Estadual Paulista (UNESP), São José do Rio Preto, São Paulo, Brazil; Laboratório de Patologia Experimental (LAPEx), Instituto de Biociências (INBIO), Universidade Federal de Mato Grosso do Sul, UFMS, Campo Grande, Mato Grosso do Sul, Brazil.
| | - Monica Jones-Costa
- Laboratório de Fisiologia da Conservação (LAFISC), Universidade Federal de São Carlos (UFSCar), Sorocaba, São Paulo, Brazil
| | - Raquel Fernanda Salla
- Laboratório de Fisiologia da Conservação (LAFISC), Universidade Federal de São Carlos (UFSCar), Sorocaba, São Paulo, Brazil
| | - Bruno Fernando Santos Souza
- Laboratório de Fisiologia da Conservação (LAFISC), Universidade Federal de São Carlos (UFSCar), Sorocaba, São Paulo, Brazil
| | - Felipe Augusto Pinto-Vidal
- Laboratório de Fisiologia da Conservação (LAFISC), Universidade Federal de São Carlos (UFSCar), Sorocaba, São Paulo, Brazil; RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, Pavilion A29, 625 00 Brno, Czech Republic
| | - Cristiane Ronchi Oliveira
- Laboratório de Fisiologia da Conservação (LAFISC), Universidade Federal de São Carlos (UFSCar), Sorocaba, São Paulo, Brazil
| | | | - Fabio Camargo Abdalla
- Laboratório de Biologia Estrutural e Funcional, Universidade Federal de São Carlos, Sorocaba, São Paulo, Brazil
| | | | - Classius De Oliveira
- Departamento de Biologia, Universidade Estadual Paulista (UNESP), São José do Rio Preto, São Paulo, Brazil
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Meshkat S, Ebrahimi P, Tafakhori A, Taghiloo A, Shafiee S, Salimi A, Aghamollaii V. Idiopathic superficial siderosis of the central nervous system. Cerebellum Ataxias 2021; 8:9. [PMID: 33632336 PMCID: PMC7908722 DOI: 10.1186/s40673-021-00133-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/16/2021] [Indexed: 12/05/2022]
Abstract
Background Regardless of the cause of the superficial siderosis (SS) disease, which is bleeding, the source of bleeding cannot be found in some cases. Case presentation In this article, we report two cases with idiopathic SS. Case 1 presented with bilateral hearing loss, cognitive impairment, sleep disturbances, and tremors. Case 2 presented with sensory neural hearing loss, ataxia, and spastic paraparesis. In both cases, brain MRI indicated evidence of SS. CT myelogram and SPECT with labeled RBC couldn’t help finding the source of occult bleeding. Conclusion SS is a rare central nervous system disease caused by the deposition of hemosiderin in the brain and spinal cord, which results in the progression of neurological deficits. The cause of this hemorrhage is often subarachnoid haemorrhage, intracranial surgery, carcinoma, arteriovenous malformation, nerve root avulsion, and dural abnormality. The condition progresses slowly and, by the time diagnosis is confirmed, the damage is often irreversible. In our cases, brain MRI clarified the definitive diagnosis, but we could not find the source of bleeding. SS should be considered in cases with ataxia and hearing loss, even if no source of bleeding is found.
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Affiliation(s)
- Shakila Meshkat
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurology, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnia Ebrahimi
- Department of Psychiatry, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Iranian Center of Neurological Research (ICNR), Tehran University of Medical Sciences, Tehran, Iran
| | - Aidin Taghiloo
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajad Shafiee
- Department of Neurosurgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Salimi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vajiheh Aghamollaii
- Department of Neurology, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Matsche MA, Blazer VS, Pulster EL, Mazik PM. Biological and anthropogenic influences on macrophage aggregates in white perch Morone americana from Chesapeake Bay, USA. Dis Aquat Organ 2021; 143:79-100. [PMID: 33570042 DOI: 10.3354/dao03555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The response of macrophage aggregates in fish to a variety of environmental stressors has been useful as a biomarker of exposure to habitat degradation. Total volume of macrophage aggregates (MAV) was estimated in the liver and spleen of white perch Morone americana from Chesapeake Bay using stereological approaches. Hepatic and splenic MAV were compared between fish populations from the rural Choptank River (n = 122) and the highly urbanized Severn River (n = 131). Hepatic and splenic MAV increased with fish age, were greater in females from the Severn River only, and were significantly greater in fish from the more polluted Severn River (higher concentrations of polycyclic aromatic hydrocarbons, organochlorine pesticides, and brominated diphenyl ethers). Water temperature and dissolved oxygen had a significant effect on organ volumes, but not on MAV. Age and river were most influential on hepatic and splenic MAV, suggesting that increased MAV in Severn River fish resulted from chronic exposures to higher concentrations of environmental contaminants and other stressors. Hemosiderin was abundant in 97% of spleens and was inversely related to fish condition and positively related to fish age and trematode infections. Minor amounts of hemosiderin were detected in 30% of livers and positively related to concentrations of benzo[a]pyrene metabolite equivalents in the bile. This study demonstrated that hepatic and splenic MAV were useful indicators in fish from the 2 tributaries with different land use characteristics and concentrations of environmental contaminants. More data are needed from additional tributaries with a wider gradient of environmental impacts to validate our results in this species.
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Affiliation(s)
- Mark A Matsche
- Maryland Department of Natural Resources, Cooperative Oxford Laboratory, 904 South Morris Street, Oxford, Maryland 21654, USA
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Nag S, Chen EY, Johnson R, Tamhane A, Arfanakis K, Schneider JA. Ex vivo MRI facilitates localization of cerebral microbleeds of different ages during neuropathology assessment. Free Neuropathol 2021; 2:2-35. [PMID: 37284642 PMCID: PMC10209859 DOI: 10.17879/freeneuropathology-2021-3638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/12/2021] [Indexed: 06/08/2023]
Abstract
Cerebral microbleeds (CMBs) identified by in vivo magnetic resonance imaging (MRI) of brains of older persons may have clinical relevance due to their association with cognitive impairment and other adverse neurologic outcomes, but are often not detected in routine neuropathology evaluations. In this study, the utility of ex vivo MRI in the neuropathological identification, localization, and frequency of CMBs was investigated. The study included 3 community dwelling elders with Alzheimer's dementia, and mild to severe small vessel disease (SVD). Ex vivo MRI was performed on the fixed hemisphere to identify CMBs, blinded to the neuropathology diagnoses. The hemibrains were then sliced at 1 cm intervals and 2, 1 or 0 microhemorrhages (MH) were detected on the cut surfaces of brain slabs using the routine neuropathology protocol. Ex vivo imaging detected 15, 14 and 9 possible CMBs in cases 1, 2 and 3, respectively. To obtain histological confirmation of the CMBs detected by ex vivo MRI, the 1 cm brain slabs were dissected further and MHs or areas corresponding to the CMBs detected by ex vivo MRI were blocked and serially sectioned at 6 µm intervals. Macroscopic examination followed by microscopy post ex vivo MRI resulted in detection of 35 MHs and therefore, about 12 times as many MHs were detected compared to routine neuropathology assessment without ex vivo MRI. While microscopy identified previously unrecognized chronic MHs, it also showed that MHs were acute or subacute and therefore may represent perimortem events. Ex vivo MRI detected CMBs not otherwise identified on routine neuropathological examination of brains of older persons and histologic evaluation of the CMBs is necessary to determine the age and clinical relevance of each hemorrhage.
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Affiliation(s)
- Sukriti Nag
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, ILUnited States
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, ILUnited States
| | - Er-Yun Chen
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, ILUnited States
| | - Ryan Johnson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, ILUnited States
| | - Ashish Tamhane
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, ILUnited States
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, ILUnited States
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, ILUnited States
| | - Julie. A Schneider
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, ILUnited States
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, ILUnited States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, ILUnited States
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Deguchi K, Honjo N, Takata T, Touge T, Masaki T. Flail arm syndrome mimic caused by hemosiderin deposition in the anterior horn. Acta Neurol Belg 2020; 120:1487-1489. [PMID: 32885346 DOI: 10.1007/s13760-020-01489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Kazushi Deguchi
- Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
| | - Naomi Honjo
- Department of Neuroradiology, Osaka Neurosurgical Hospital, Kagawa, Japan
| | - Tadayuki Takata
- Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Tetsuo Touge
- Department of Health Sciences, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
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20
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Takahashi H, Kawashima A, Inoue A, Kozaka K, Potretzke TA, Froemming AT, Boorjian SA, Humphreys MR, Takahashi N. Hemosiderin deposition in papillary renal cell carcinoma and its potential to mask enhancement on MRI: analysis of 110 cases. Eur Radiol 2020; 30:6033-41. [PMID: 32518984 DOI: 10.1007/s00330-020-06994-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/16/2020] [Accepted: 05/28/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To evaluate the relationship between imperceptible T1 enhancement of papillary renal cell carcinoma (pRCC) on MR and intratumoral hemosiderin deposition. METHODS One hundred ten pRCCs (≤ 7 cm) were evaluated by MR with in- and opposed-phase spoiled gradient echo (GRE) and T1-weighted spoiled GRE with fat suppression before and after contrast. Hemosiderin deposition was assessed by SIindex and Dindex on in- and opposed-phase images. SIindex and Dindex are calculated as (SIin - SIopp)/(SIin) × 100, where SIin and SIopp are tumor signal intensities on in- and opposed-phase images and (Din)/(Dopp), where Din and Dopp are tumor diameters on in- and opposed-phase images, respectively. The degree of tumor enhancement was classified as grade 1 (no), grade 2 (subtle), or grade 3 (definite). Tumor enhancement on CT was assessed when available. RESULTS Five (5%), 10 (9%), and 95 (86%) tumors were categorized as grades 1, 2, and 3 enhancement, respectively. The mean SIindex was - 33.9, - 25.3, and 1.00, whereas the mean Dindex was 1.26, 1.05, and 1.00 in tumors with grades 1, 2, and 3 enhancement, respectively. Tumors with grade 1 enhancement had significantly lower SIindex (p = 0.001) and higher Dindex (p = 0.005) than those with grade 3 enhancement. Among six tumors with grade 1 or 2 enhancement and available CT, four tumors showed > 20 HU enhancement. CONCLUSIONS pRCC with no subjective enhancement on contrast-enhanced MR showed hemosiderin deposition evident by lower SIindex and higher Dindex. Hemosiderin deposition might mask the tumor enhancement on MR. KEY POINTS • 5% of papillary renal cell carcinoma showed imperceptible enhancement on contrast-enhanced MR. • Hemosiderin deposition in papillary renal cell carcinoma might mask the tumor enhancement on contrast-enhanced MR due to T2/T2*-shortening effects. • A renal lesion with extensive hemosiderin deposition but no perceptible enhancement on MR should be considered suspicious for papillary renal cell carcinoma.
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Manrique WG, Pereira Figueiredo MA, Charlie-Silva I, Antonio de Andrade Belo M, Dib CC. Spleen melanomacrophage centers response of Nile tilapia during Aeromanas hydrophila and Mycobacterium marinum infections. Fish Shellfish Immunol 2019; 95:514-518. [PMID: 31682998 DOI: 10.1016/j.fsi.2019.10.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
In order to understand the pathophysiology of melanomcrophage centers (MMCs) formation during the tilapia defense response to bacterial infections, the present study evaluated the response, in terms of area, number and pigment constitution, of splenic MMCs of Oreochromis niloticus subjected to intraperitoneal (i.p.) infection with Aeromonas hydrophila and Mycobacterium marinum. Eighty-four fish (396.9 ± 21.0 g) were randomly distributed into twelve plastic tanks (300 L), to constitute three treatments with 28 animals each: control group (inoculated with PBS); Infected with A. hydrophila (1 × 107 UFC mL-1); Infected with M. marinum (1 × 106 UFC mL-1). The spleen was collected in seven fish per treatment on the 3rd, 7th, 14th and 21st day post-infection (DPI). The results revealed the participation of MMCs in the defense response of tilapia during bacterial infection by A. hydrophila and M. marinum, since there was an increase in the number and size of these cell aggregates. Variation of pigment accumulation with significant increase of hemosiderin, in infected tilapias by A. hydrophila, bacteria responsible for causing hemolytic anemia in fish was also found. On the other hand, M. marinum-infected tilapia had high amount of melanin in MMCs. In general, mycobacterial infections are notoriously difficult to treat, being characterized as a chronic disease. These findings demonstrate different strategies of fish response during the evolution of these bacterial diseases.
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Affiliation(s)
- Wilson Gómez Manrique
- São Paulo State University, Jaboticabal Campus, São Paulo, Brazil; Federal University of Rondônia, Department of Veterinary Medicine, Rolim de Moura Campus, Rondônia, Brazil.
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Harada TL, Nakashima K, Uematsu T, Sugino T, Nishimura S, Takahashi K, Tadokoro Y, Hayashi T, Watanabe J, Nakamoto S. Imaging features of breast cancer with marked hemosiderin deposition: A case report. Eur J Radiol Open 2019; 6:302-306. [PMID: 31641684 PMCID: PMC6796500 DOI: 10.1016/j.ejro.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 11/26/2022] Open
Abstract
A 63-year-old woman was referred to our hospital for breast cancer treatment. She had a large HER2-positive breast tumor on her left breast, and received neoadjuvant chemotherapy. After treatment, a shrunk spiculated mass with calcification-like high density was detected on mammography, and MRI revealed a large strong susceptibility artifact. Surgical specimen analysis attributed these imaging features to a large marked hemosiderin deposition. This case is herein reported due to its rarity and to the importance of acknowledging that this large marked hemosiderin depositions can present as a calcification-like high density on mammography and shows large susceptibility artifact on MRI imaging.
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Affiliation(s)
- Taiyo L Harada
- Division of Breast Imaging and Breast Interventional Radiology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Kazuaki Nakashima
- Division of Breast Imaging and Breast Interventional Radiology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Takayoshi Uematsu
- Division of Breast Imaging and Breast Interventional Radiology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Takashi Sugino
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Seiichirou Nishimura
- Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Kaoru Takahashi
- Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Yukiko Tadokoro
- Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Tomomi Hayashi
- Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Junichiro Watanabe
- Division of Breast Oncology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
| | - Shogo Nakamoto
- Division of Breast Oncology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan
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Zhang L, Li Z, Deng X, Li J, Li T, Lv Y. Tylvalosin administration in pregnant sows attenuates the enlargement and bluish coloration of inguinal lymph nodes in newborn piglets. Res Vet Sci 2019; 125:148-152. [PMID: 31228738 DOI: 10.1016/j.rvsc.2019.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
In the porcine industry, some piglets show slightly enlarged and bluish inguinal lymph nodes. However, the causative factors for these signs and prevention of these signs remain unclear. Tylvalosin is a broad-spectrum antibiotic with an immunomodulatory function. This study was aimed at evaluating the effect of tylvalosin on the abovementioned signs. Thus, fifteen 90-day pregnant sows were divided into an untreated control group and 0.1 and 0.2 g/kg feed tylvalosin-treated groups until delivery. Forty-five piglets on day 2 after birth (15 each group) were blooded, then oxidative stress, serum cytokine levels, routine blood analysis, and effect of sera on macrophage phagocytic activity were examined. Fifteen piglets on day 2 after birth (5 in each group) were euthanized and pathological changes in the inguinal lymph nodes were observed. The untreated piglets showed hemorrhage, hemosiderin accumulation, and increased macrophages in the inguinal lymph nodes. However, tylvalosin administration in sows alleviated these signs in their piglets; increased total antioxidant capacity and serum glutathione levels; decreased serum IL-1β, TNF-α, and IL-10 levels; improved the percentages of neutrophils and lymphocytes in the blood; and increased the body weight of the weaning piglets. In addition, the serum of newborn piglets also showed enhanced RAW264.7 macrophage phagocytic activity. These results demonstrated that tylvalosin administration in pregnant sows attenuates the enlargement and bluish coloration of inguinal lymph nodes in newborn piglets.
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Affiliation(s)
- Lili Zhang
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Zhiyao Li
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Xiaohong Deng
- ECO-BIOK Animal Health, English-Chinese Joint Venture of Two Public Stock Companies, Shanghai 200042, China
| | - Jiansheng Li
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Taomei Li
- ECO-BIOK Animal Health, English-Chinese Joint Venture of Two Public Stock Companies, Shanghai 200042, China
| | - Yingjun Lv
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China.
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Derle E. Iron chelation in treatment of superficial siderosis. Iran J Neurol 2018; 17:195-6. [PMID: 31210906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tatsumi Y, Kato A, Kato K, Hayashi H. The interactions between iron and copper in genetic iron overload syndromes and primary copper toxicoses in Japan. Hepatol Res 2018; 48:679-691. [PMID: 29882374 DOI: 10.1111/hepr.13200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/13/2018] [Accepted: 05/24/2018] [Indexed: 02/08/2023]
Abstract
Iron and copper are trace elements essential for health, and iron metabolism is tightly regulated by cuproproteins. Clarification of the interactions between iron and copper may provide a better understanding of the pathophysiology and treatment strategy for hemochromatosis, Wilson disease, and related disorders. The hepcidin/ferroportin system was used to classify genetic iron overload syndromes in Japan, and ceruloplasmin and ATP7B were introduced for subtyping Wilson disease into the severe hepatic and classical forms. Interactions between iron and copper were reviewed in these genetic diseases. Iron overload syndromes were classified into pre-hepatic iron loading anemia and aceruloplasminemia, hepatic hemochromatosis, and post-hepatic ferroportin disease. The ATP7B-classical form with hypoceruloplasminemia has primary hepatopathy and late extra-hepatic complications, while the severe hepatic form is free from ATP7B mutation and hypoceruloplasminemia, and silently progresses to liver failure. A large amount of iron and trace copper co-exist in hepatocellular dense bodies of all iron overload syndromes. Cuproprotein induction to stabilize excess iron should be differentiated from copper retention in Wilson disease. The classical form of Wilson disease associated with suppressed hepacidin25 secretion may be double-loaded with copper and iron, and transformed to an iron disease after long-term copper chelation. Iron disease may not be complicated with the severe hepatic form with normal ferroxidase activity. Hepatocellular dense bodies of iron overload syndromes may be loaded with a large amount of iron and trace copper, while the classical Wilson disease may be double-loaded with copper and iron.
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Affiliation(s)
- Yasuaki Tatsumi
- Department of Medicine, Aichi-Gakuin University, School of Pharmacy, Nagoya, Japan
| | - Ayako Kato
- Department of Medicine, Aichi-Gakuin University, School of Pharmacy, Nagoya, Japan
| | - Koichi Kato
- Department of Medicine, Aichi-Gakuin University, School of Pharmacy, Nagoya, Japan
| | - Hisao Hayashi
- Department of Medicine, Aichi-Gakuin University, School of Pharmacy, Nagoya, Japan
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Abstract
Context: “Dark circles” are esthetic concerns that can affect individuals of any age, gender, or race. They can be familial, physiological, or associated with various medical illnesses. Aim: To study the clinicopathological correlation of periorbital hyperpigmentation. Patients and Methods: Fifty patients affected with periorbital melanosis (POM) were enrolled for the study after obtaining informed consent. Details regarding history, demographic data, and physical examination of POM were recorded, and a 2-mm punch skin biopsy was taken from the affected skin under local anesthesia and stained with hematoxylin and eosin (H and E), Fontana Masson (Melanin), Perls Prussian blue (Hemosiderin). Results: Twenty-three (46%) patients with POM had history of chronic illness before developing POM; 18% patients were atopic, 16% had jaundice, 18% had associated pigmentary demarcation lines (PDL) of type F and G, 8% had acanthosis nigricans, 22% patients had anemia, 16% patients gave positive family history of POM, and menstrual irregularity was seen in 16%. Histopathology revealed dermal melanin deposition with melanophages along with predominantly increased epidermal melanin and melanin in vellus follicular epithelium. Prussian blue for hemosiderin was negative in all cases. Conclusions: The study has elicited the multifactorial origin of POM; females are affected more than males. Dermal melanin deposition is a constant feature. Hemosiderin is not found in POM. Increased pigmentation of the vellus follicular epithelium is a feature of POM.
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Affiliation(s)
- Chitra S Nayak
- Department of Dermatology, T. N. M. C. and B.Y.L. Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Atul S Giri
- Department of Dermatology, T. N. M. C. and B.Y.L. Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Uddhao S Zambare
- Department of Dermatology, T. N. M. C. and B.Y.L. Nair Ch. Hospital, Mumbai, Maharashtra, India
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Abd-Elkareem M, Abou Khalil NS, Sayed AH. Hepatotoxic responses of 4-nonylphenol on African catfish (Clarias gariepinus): antixoidant and histochemical biomarkers. Fish Physiol Biochem 2018. [PMID: 29516258 DOI: 10.1007/s10695-018-0485-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
4-Nonylphenol (NP) toxicity in fish attracts much attention due to its ability in targeting several organs; however, the researches regarding its potential hepatotoxicity are conflicting and still require further investigation. Therefore, the objective of this study is to focus on this issue from the histophysiological point of view using NP intoxicated African catfish (Clarias gariepinus) as a model of hepatotoxicity. Twelve adult fish (6 per group) were divided into two groups; the first was considered as a control and the second was exposed to NP dissolved in water at a dose of 0.1 mg/kg BW for 3 weeks. A significant reduction in the hepatic alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase levels was observed in NP-exposed fish. Concerning the oxidant/antioxidant balance, a significant depletion in superoxide dismutase, catalase, and glutathione peroxidase was found along with a significant elevation in total peroxide and malondialdhyde. The histopathological examination of the hepatic tissues revealed that NP had marked hepatotoxic effects including hepatitis, centrilobular and focal hydropic and fatty degeneration, fatty change (steatosis), hepatic coagulative necrosis, and nuclear alterations in addition to apoptosis of hepatocytes and necrosis of endothelial cells. Depletion of the glycogen and increased in pigments (lipofuscin and hemosiderin) content in the hepatocytes were also recorded. Hemosiderosis and proliferation of the connective tissue around the blood vessels and branches of bile ducts and in the portal areas were also observed. In light of these findings, it was concluded that NP has a well-defined hepatotoxic impact paving the road towards other studies to investigate other detrimental cyto-physiological influences of this aquatic pollutant.
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Affiliation(s)
- Mahmoud Abd-Elkareem
- Anatomy, Histology and Embryology Department, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt
| | - Nasser S Abou Khalil
- Medical Physiology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Alaa H Sayed
- Zoology Department, Faculty of Science, Assiut University, Assiut, 71516, Egypt.
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Alkatan HM, Al Otaibi M, Maktabi AMY, Aljaedi H, Elkhamary SM, Al-Faky Y, Alsuhaibani AH. Clinical, radiological and histopathological characteristics of surgically removed orbital hematic cysts: A case series. Saudi J Ophthalmol 2018; 32:45-51. [PMID: 29755271 PMCID: PMC5943833 DOI: 10.1016/j.sjopt.2018.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Hematic cyst is a rare orbital condition that has a wide range of clinical presentation and is characterized pathologically by lack of endothelial lining. Purpose To correlate clinical and radiological features of hematic cysts, to tissue diagnosis, and investigate the possible etiology behind this condition, its relation to trauma and other interesting histopathological findings. Methods Retrospective case series at King Khaled Eye Specialist Hospital (KKESH) and King Abdulaziz University Hospital (KAUH) of all orbital lesions with tissue findings supporting the clinical and/or radiological diagnosis of hematic cyst. Results A series of 13 cases was studied, 8 males and 5 females. Age ranged from 2 to 84 years with a median of 54. Most cases presented with proptosis (76.9%) and limitation of eye movements (69.2%). History of trauma was confirmed in only 2/13. The clinical diagnosis of hematic cyst was made prior to surgery in 38.4%. Magnetic Resonance Imaging (MRI) confirmed the presence of blood in the orbit in 7/7. Surgical intervention was the mainstay of treatment. Histopathologically, these lesions demonstrated variable constituents including blood break-down products (hemosiderin), macrophages, mononuclear inflammatory cells, hemorrhage, absent endothelial lining, reactive fibrosis and capsule-like formation. Cholesterol clefts with typical granulomas and multinucleated giant cells were present in 2 cases. A clue to an underlying vascular lesion was found histopathologically in 30.8%. None of the patients developed recurrence or long-term complications with an average follow up period of 1 year. Conclusion Hematic cyst is a challenging clinical diagnosis that can be aided by radiological examination and histopathological confirmation. Trauma does not seem to play a major role while presence of a pre-existing vascular lesion with spontaneous hemorrhage may be an etiologic factor. Associated cholesterol granuloma is an interesting controversial finding. Surgical intervention is curative with possible persisting motility disturbance and/or the eye deviation and worse prognosis in post-traumatic cases.
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Affiliation(s)
- Hind M Alkatan
- Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia.,Department of Pathology, King Saud University-Medical City, Riyadh, Saudi Arabia
| | | | - Azza M Y Maktabi
- Pathology and Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Diagnostic Imaging Department, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Hamad Aljaedi
- Department of Pathology, King Saud University-Medical City, Riyadh, Saudi Arabia
| | - Sahar M Elkhamary
- Diagnostic Imaging Department, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Yasser Al-Faky
- Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia
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Sumbria RK, Grigoryan MM, Vasilevko V, Paganini-Hill A, Kilday K, Kim R, Cribbs DH, Fisher MJ. Aging exacerbates development of cerebral microbleeds in a mouse model. J Neuroinflammation 2018; 15:69. [PMID: 29510725 PMCID: PMC5840821 DOI: 10.1186/s12974-018-1092-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/07/2018] [Indexed: 01/12/2023] Open
Abstract
Background Cerebral microhemorrhages (CMH) are commonly found in the aging brain. CMH are also the neuropathological substrate of cerebral microbleeds (CMB), demonstrated on brain MRI. Recent studies demonstrate the importance of systemic inflammation in CMH development, but the relationships among inflammation, aging, and CMH development are not well-defined. In the current study, we hypothesized that the pathogenesis of inflammation-induced CMH in mice differs by age. Methods We studied young (3 months, n = 20) and old (18 months, n = 25) C57BL/6 mice injected with low-dose lipopolysaccharide (LPS; 1 mg/kg, i.p.) or saline at 0, 6, and 24 h. Seven days after the first LPS/saline injection, brains were harvested, sectioned, and stained with hematoxylin and eosin (H&E) and Prussian blue (PB) to estimate acute/fresh and sub-acute CMH development, respectively. The relationships between microglial/macrophage activation (ionized calcium-binding adapter molecule-1), astrocyte activation (glial fibrillary acidic protein), blood-brain barrier (BBB) disruption (brain immunoglobulin G), aging, and CMH development were examined using immunohistochemistry. Results Aging alone did not increase spontaneous H&E-positive CMH development but significantly increased the number, size, and total area of LPS-induced H&E-positive CMH in mice. LPS- and saline-treated aged mice had significantly larger PB-positive CMH compared with young mice, but the total area of PB-positive CMH was increased only in LPS-treated aged mice. Aged mice had significantly increased microglial/macrophage activation, which correlated with H&E- and PB-positive CMH development. Aged mice treated with LPS had significantly increased astrocyte activation and BBB disruption compared with young LPS-treated mice. Conclusions Aging makes the brain more susceptible to inflammation-induced CMH in mice, and this increase in CMH with aging is associated with microglial/macrophage activation.
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Affiliation(s)
- Rachita K Sumbria
- Department of Biopharmaceutical Sciences, School of Pharmacy, Keck Graduate Institute, Claremont, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | | | - Vitaly Vasilevko
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | | | - Kelley Kilday
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Ronald Kim
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA, USA
| | - David H Cribbs
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Mark J Fisher
- Department of Neurology, University of California, Irvine, CA, USA. .,Department of Pathology and Laboratory Medicine, University of California, Irvine, CA, USA. .,Department of Anatomy and Neurobiology, University of California, Irvine, CA, USA. .,UC Irvine Medical Center, 101 The City Drive South, Shanbrom Hall, Room 121, Orange, CA, 92868, USA.
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van Wyk AC, van Zyl H, Rigby J. Colonic perineurioma (benign fibroblastic polyp): case report and review of the literature. Diagn Pathol 2018; 13:16. [PMID: 29463272 PMCID: PMC5819702 DOI: 10.1186/s13000-018-0694-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 02/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal perineuriomas are uncommon benign mucosal-based proliferations of mesenchymal cells that express perineurial markers, often associated with colonic crypts displaying a serrated/hyperplastic architecture. The vast majority of cases arise distal to the splenic flexure and have been described as sessile polyps. Using molecular analysis, BRAF mutations have been demonstrated in the serrated crypt epithelium. We report a new case of perineurioma presenting as a pedunculated polyp in the transverse colon, with prominent hemosiderin deposits in the uninvolved lamina propria that separated the perineurial proliferation from the surface epithelium, a previously unreported histological finding. By using immunohistochemistry, we demonstrated the presence of BRAF V600E mutated protein in the serrated crypt epithelium. In addition, a review of the literature on colorectal perineurioma is provided. CASE PRESENTATION A 5 mm pedunculated polyp was removed from the transverse colon of a 42 year old man who presented with epigastric pain, weight loss and rectal bleeding. A proliferation of uniform plump spindled cells expanded the lamina propria and separated serrated colonic crypts. The epithelial component closely resembled microvesicular hyperplastic polyp. Immunohistochemical stains for epithelial membrane antigen (EMA), glucose transporter 1 (GLUT1) and collagen IV were positive in the stromal proliferation. A mutation-specific monoclonal antibody directed against BRAF V600E showed positive cytoplasmic staining in the serrated crypt epithelium but not in the perineurial proliferation. Conspicuous hemosiderin deposition was seen in the inflamed lamina propria between the perineurial proliferation and the surface epithelium. CONCLUSION Although the majority of colorectal perineuriomas occur in the sigmoid colon and rectum and are described as sessile polyps, colorectal perineurioma can present as a pedunculated polyp proximal to the splenic flexure as described in this case. Conspicuous hemosiderin deposition can be seen in the superficial lamina propria. BRAF mutations are limited to the serrated crypt epithelium.
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Affiliation(s)
- Abraham Christoffel van Wyk
- Division of Anatomical Pathology, National Health Laboratory Service, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.
| | - Hennie van Zyl
- Department of Surgery, Karl Bremer Hospital, Cape Town, South Africa
| | - Jonathan Rigby
- Division of Anatomical Pathology, National Health Laboratory Service, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
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K N L, Venkataranganna M, Gowtham Raj G, Patil H, Dave H. Augmentation of antioxidant and iron(III) chelation properties of tertiary mixture of bioactive ligands. J Trace Elem Med Biol 2018; 45:114-124. [PMID: 29173467 DOI: 10.1016/j.jtemb.2017.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/22/2017] [Accepted: 10/05/2017] [Indexed: 01/08/2023]
Abstract
The excess of iron in plasma and cellular compartment pose direct and indirect toxic effects. In the present investigation, we proposed additive function of nutritional bioactive ligands in combination which has shown enhanced antioxidant and iron(III) chelation property. The optimal interaction and in vitro antioxidant activity of tertiary mixture comprising of curcumin+quercetin+gallic acid was validated by central composite design (CCD) based on ferric reducing antioxidant power assay (FRAP). The additive denticity of nutritional bioactive ligands was investigated by UV-vis, FTIR & MALDI-TOF-MS analysis, which has given substantial evidence for the formation of tris-bidentate [curcumin-quercetin-gallic acid-Fe(III)] co-ordination complex. The in vivo proof of concept of the hypothesis was tested in iron intoxicated male wistar rats intoxicated with iron dextran. Co-administration curcumin+quercetin+gallic acid (CQG) exhibit dose dependent response & found effective in subsiding acute iron intoxication both at plasma and cellular level, evaluated by studies including serum ferritin, ICP-OES, lipid peroxidation and histopathology studies among others. Thus, we conclude that in vitro and in vivo studies supported our hypothesis to deduce additive function nutritional ligands to counteract direct and indirect effects of iron(III).
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Affiliation(s)
- Lokesh K N
- Ramaiah Institute of Technology, Bangaluru, 560054, Karnataka, India; Visvesvaraya Technological University, Belgavi, 590018, Karnataka, India.
| | | | - Gunti Gowtham Raj
- Connexios Life Sciences Pvt Ltd, Bangaluru, 560078, Karnataka, India
| | - Hansraj Patil
- Connexios Life Sciences Pvt Ltd, Bangaluru, 560078, Karnataka, India
| | - Hardik Dave
- Connexios Life Sciences Pvt Ltd, Bangaluru, 560078, Karnataka, India
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Stabile A, Di Lazzaro V, Colosimo C, Piazza F, Ferrarese C, DiFrancesco JC. Idiopathic infratentorial superficial siderosis of the central nervous system: case report and review of literature. Neurol Neurochir Pol 2017; 52:102-106. [PMID: 29122310 DOI: 10.1016/j.pjnns.2017.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
The superficial siderosis (SS) of the central nervous system (CNS) is a rare condition characterized by a wide range of neurological manifestations directly linked to an acquired iron-mediated neurodegeneration. First described more than 100 years ago, only recently SS has been divided into two distinct entities, according to the distribution of iron deposition in the CNS: cortical superficial siderosis (cSS) and infratentorial superficial siderosis (iSS). Here we describe an adult case of iSS, with detailed clinical and radiological features. Moreover, we extensively review the literature of SS, particularly focusing on the pathogenesis, clinical-radiological classification, diagnostic algorithm and treatment options of this rare condition.
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Affiliation(s)
- Andrea Stabile
- Department of Neurology, ASST San Gerardo Hospital, Monza, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
| | - Cesare Colosimo
- Radiology and Neuroradiology Unit, Diagnostic Imaging Area, Fondazione Policlinico Universitario A. Gemelli, Institute of Radiology, School of Medicine, Catholic University, Rome, Italy
| | - Fabrizio Piazza
- Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Ferrarese
- Department of Neurology, ASST San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Jacopo C DiFrancesco
- Department of Neurology, ASST San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
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Etchebehere RM, Almeida ECS, Santos CDT, Micheletti AMR, Leitão AS. Sarcomatous transformation of a hemosiderotic fibrohistiocytic lipomatous tumor: a case report. Rev Bras Ortop 2017; 52:366-369. [PMID: 28702400 PMCID: PMC5497010 DOI: 10.1016/j.rboe.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/14/2016] [Indexed: 11/19/2022] Open
Abstract
Hemosiderotic fibrohistiocytic lipomatous tumors are rare neoplasms that were first described in 2000. Initially considered a benign lipotamous lesion of the soft tissues, nowadays they are considered to be a locally aggressive tumor. They occur mainly in the foot and ankle of women in their fifth and sixth decades, although they may be found in any place in the lower limbs and, more rarely, in other parts of the body. Histologically, hemosiderotic fibrohistiocytic lipomatous tumors consist of a mixture of mature adipose tissue, fusiform cell fascicles, macrophages that often contain cytoplasmic hemosiderin, mononuclear inflammatory infiltrate, and stroma that may be focally myxoid. Local recurrence is observed in nearly one-third of all cases. There is no consensus in the literature whether this tumor is a part of a spectrum that comprises pleomorphic hyalinizing angiectatic tumors and myxoinflammatory fibroblastic malignant tumors, or if it is an independent entity. The authors report a case of a neoplasia after a diagnosis of a hemosiderotic fibrohistiocytic lipomatous tumor in a 38-year-old woman, with two recurrences and later sarcomatous transformation. An immunohistochemical study indicated myofibroblastic differentiation of a malignant neoplasm. To the best of the authors’ knowledge, there are only few reported cases of malignant transformation in hemosiderotic fibrohistiocytic lipomatous tumors.
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Affiliation(s)
- Renata Margarida Etchebehere
- Universidade Federal do Triângulo Mineiro (UFTM), Hospital de Clínicas, Serviço de Patologia Cirúrgica, Uberaba, MG, Brazil
- Corresponding author.
| | - Elia Cláudia Souza Almeida
- Universidade Federal do Triângulo Mineiro (UFTM), Hospital de Clínicas, Serviço de Patologia Cirúrgica, Uberaba, MG, Brazil
| | | | - Adilha Misson Rua Micheletti
- Universidade Federal do Triângulo Mineiro (UFTM), Hospital de Clínicas, Serviço de Patologia Cirúrgica, Uberaba, MG, Brazil
| | - Antônio Sebastião Leitão
- Universidade Federal do Triângulo Mineiro (UFTM), Hospital de Clínicas, Serviço de Patologia Cirúrgica, Uberaba, MG, Brazil
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Hayashi H, Tatsumi Y, Wakusawa S, Shigemasa R, Koide R, Tsuchida KI, Morotomi N, Yamashita T, Kumagai K, Ono Y, Hayashi K, Ishigami M, Goto H, Kato A, Kato K. Inclusion bodies of aggregated hemosiderins in liver macrophages. Med Mol Morphol 2017; 50:205-10. [PMID: 28631037 DOI: 10.1007/s00795-017-0163-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hemosiderin formation is a structural indication of iron overload. We investigated further adaptations of the liver to excess iron. Five patients with livers showing iron-rich inclusions larger than 2 µm were selected from our database. The clinical features of patients and structures of the inclusions were compared with those of 2 controls with mild iron overload. All patients had severe iron overload with more than 5000 ng/mL of serum ferritin. Etiologies were variable, from hemochromatosis to iatrogenic iron overload. Their histological stages were either portal fibrosis or cirrhosis. Inclusion bodies were ultra-structurally visualized as aggregated hemosiderins in the periportal macrophages. X-ray analysis always identified, in addition to a large amount of iron complexes including oxygen and phosphorus, a small amount of copper and sulfur in the mosaic matrixes of inclusions. There were no inclusions in the control livers. Inclusion bodies, when the liver is loaded with excess iron, may appear in the macrophages as isolated organella of aggregated hemosiderins. Trace amounts of copper-sulfur complexes were always identified in the mosaic matrices of the inclusions, suggesting cuproprotein induction against excess iron. In conclusion, inclusion formation in macrophages may be an adaptation of the liver loaded with excess iron.
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Mohan S, Ho T, Kjarsgaard M, Radford K, Borhan ASM, Thabane L, Nair P. Hemosiderin in sputum macrophages may predict infective exacerbations of chronic obstructive pulmonary disease: a retrospective observational study. BMC Pulm Med 2017; 17:60. [PMID: 28403845 PMCID: PMC5389091 DOI: 10.1186/s12890-017-0408-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 04/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background Infective exacerbations of COPD are common and are accompanied by neutrophilic bronchitis in sputum. Increased respiratory iron content has been associated with respiratory tract infection, though it is unclear if this represents a predisposing factor for infection or the sequelae of inflammation. Iron overload, as assessed in the airways, may be an important biomarker for recurrent infective exacerbations of COPD. The purpose of our study was to determine if hemosiderin in sputum macrophages is related to infective exacerbations of COPD. Methods We undertook a retrospective observational study of 54 consecutive patients who presented with an exacerbation of COPD and had sputum examined including assessment for hemosiderin in alveolar macrophages. The relation between infective exacerbations in the previous two years and the percent of hemosiderin-positive macrophages was analyzed with linear regression. To account for the non-parametric distribution of infective exacerbations, negative binomial regression modelling was used to account for other covariates. Results The percent of hemosiderin positive alveolar macrophages (hemosiderin index), analyzed parametrically and non-parametrically, demonstrated a significant correlation with increasing numbers of infective exacerbations in the previous two years. In a multivariate regression analysis, hemosiderin index was an independent predictor of infective exacerbations. COPD patients with raised hemosiderin index (≥20%) had higher levels of sputum IL-6 compared to patients with lower levels (<20%). Conclusions High hemosiderin index in sputum alveolar macrophages measured at the time of AECOPD may be related to the frequency of infective exacerbations of COPD.
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Affiliation(s)
- Sindu Mohan
- Division of Respirology, St Joseph's Healthcare and Department of Medicine, McMaster University, Hamilton, ON, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada
| | - Terence Ho
- Division of Respirology, St Joseph's Healthcare and Department of Medicine, McMaster University, Hamilton, ON, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada
| | - Melanie Kjarsgaard
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada
| | - Katherine Radford
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada
| | - A S M Borhan
- Department of Health Research Methods, McMaster University, Hamilton, ON, Canada
| | - Lehana Thabane
- Department of Health Research Methods, McMaster University, Hamilton, ON, Canada
| | - Parameswaran Nair
- Division of Respirology, St Joseph's Healthcare and Department of Medicine, McMaster University, Hamilton, ON, Canada. .,Firestone Institute for Respiratory Health, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
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Yoshida K, Hayashi H, Wakusawa S, Shigemasa R, Koide R, Ishikawa T, Tatsumi Y, Kato K, Ohara S, Ikeda SI. Coexistence of Copper in the Iron-Rich Particles of Aceruloplasminemia Brain. Biol Trace Elem Res 2017; 175:79-86. [PMID: 27272717 DOI: 10.1007/s12011-016-0744-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/11/2016] [Indexed: 12/14/2022]
Abstract
The interaction between iron and copper has been discussed in association with human health and diseases for many years. Ceruloplasmin, a multi-copper oxidase, is mainly involved in iron metabolism and its genetic defect, aceruloplasminemia (ACP), shows neurological disorders and diabetes associated with excessive iron accumulation, but little is known about the state of copper in the brain. Here, we investigated localization of these metals in the brains of three patients with ACP using electron microscopes equipped with an energy-dispersive x-ray analyzer. Histochemically, iron deposition was observed mainly in the basal ganglia and dentate nucleus, and to lesser degree in the cerebral cortex of the patients, whereas copper grains were not detected. X-ray microanalysis identified two types of iron-rich particles in their brains: dense bodies, namely hemosiderins, and their aggregated inclusions. A small number of hemosiderins and most inclusions contained a significant amount of copper which was enough for distinct Cu x-ray images. These copper-containing particles were observed more frequently in the putamen and dentate nucleus than the cerebral cortex. Coexistence of iron and copper was supported by good correlations in the molecular ratios between these two metals in iron-rich particles with Cu x-ray image. Iron-dependent copper accumulation in iron-rich particles may suggest that copper recycling is enhanced to meet the increased requirement of cuproproteins in iron overload brain. In conclusion, the iron-rich particles with Cu x-ray image were found in the ACP brain.
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Affiliation(s)
- Kunihiro Yoshida
- Department of Brain Disease Research, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan.
| | - Hisao Hayashi
- Department of Medicine, Aichi Gakuin University School of Pharmacy, Nagoya, Japan
| | - Shinya Wakusawa
- Department of Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryota Shigemasa
- Department of Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryoji Koide
- Department of Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Ishikawa
- Department of Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuaki Tatsumi
- Department of Medicine, Aichi Gakuin University School of Pharmacy, Nagoya, Japan
| | - Koichi Kato
- Department of Medicine, Aichi Gakuin University School of Pharmacy, Nagoya, Japan
| | - Shinji Ohara
- Department of Neurology, Matsumoto Medical Center, Matsumoto, Japan
| | - Shu-Ichi Ikeda
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
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Castellani RJ, Mojica G, Perry G. The Role of the Iron Stain in Assessing Intracranial Hemorrhage. Open Neurol J 2016; 10:136-142. [PMID: 27857815 PMCID: PMC5090778 DOI: 10.2174/1874205x01610010136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/07/2016] [Accepted: 07/26/2016] [Indexed: 11/22/2022] Open
Abstract
The timing of the breakdown of red blood cells and organization of hemorrhage has significance in the catabolism of heme and the processing of iron, but also has a practical application in terms of assigning, or attempting to assign, a time course with respect to traumatic events (e.g. contusions and hemorrhages). Attempts to date contusions, however, have generally been unsuccessful by macroscopic observation, whereas the microscopic observations provide broad data but are also anatomically imprecise as a function of time. Intracranial lesions are of particular significance with respect to the timing of organizing hemorrhage given the acute, and often life-threatening nature of the hemorrhages, and the medicolegal investigation into potential crimes. Of concern is that the Prussian Blue reaction for iron, a relatively straightforward histochemical reaction that has been in use for over 150 years, is sometimes suggested as a diagnostic test for chronicity. Therefore, this study examined the utility of the Prussian Blue iron stain in living patients with intracranial hemorrhages and well-defined symptom onset, to test whether the presence of Prussian Blue reactivity could be correlated with chronicity. It was found that out of 12 cases with intracranial hemorrhage, eight cases showed at least focal iron reactivity. The duration from symptom onset to surgery in those eight cases ranged from < 24 hours to more than 3 days. Of those cases with no iron reactivity, the duration from symptom onset to surgery ranged from < 24 hours to six days. In conclusion, the Prussian Blue reaction was unreliable as an indicator of timing in intracranial hemorrhage. The use of the Prussian blue reaction as an independent indicator of chronicity is therefore not valid and can be misleading. Caution is indicated when employing iron staining for timing purposes, as its only use is to highlight, as opposed to identify, pre-existing lesions. With respect to brain lesions, the Prussian blue reaction should not be used in place of the clinical timing of the neurologic decline, or clinical data that is otherwise more accurate and less susceptible to false positive results.
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Affiliation(s)
- Rudy J Castellani
- University of Maryland School of Medicine, Baltimore, Maryland, USA; Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | | | - George Perry
- College of Sciences, University of Texas, San Antonio, Texas, USA
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Sumbria RK, Grigoryan MM, Vasilevko V, Krasieva TB, Scadeng M, Dvornikova AK, Paganini-Hill A, Kim R, Cribbs DH, Fisher MJ. A murine model of inflammation-induced cerebral microbleeds. J Neuroinflammation 2016; 13:218. [PMID: 27577728 PMCID: PMC5006574 DOI: 10.1186/s12974-016-0693-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/20/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cerebral microhemorrhages (CMH) are tiny deposits of blood degradation products in the brain and are pathological substrates of cerebral microbleeds. The existing CMH animal models are β-amyloid-, hypoxic brain injury-, or hypertension-induced. Recent evidence shows that CMH develop independently of hypoxic brain injury, hypertension, or amyloid deposition and CMH are associated with normal aging, sepsis, and neurodegenerative conditions. One common factor among the above pathologies is inflammation, and recent clinical studies show a link between systemic inflammation and CMH. Hence, we hypothesize that inflammation induces CMH development and thus, lipopolysaccharide (LPS)-induced CMH may be an appropriate model to study cerebral microbleeds. METHODS Adult C57BL/6 mice were injected with LPS (3 or 1 mg/kg, i.p.) or saline at 0, 6, and 24 h. At 2 or 7 days after the first injection, brains were harvested. Hematoxylin and eosin (H&E) and Prussian blue (PB) were used to stain fresh (acute) hemorrhages and hemosiderin (sub-acute) hemorrhages, respectively. Brain tissue ICAM-1, IgG, Iba1, and GFAP immunohistochemistry were used to examine endothelium activation, blood-brain barrier (BBB) disruption, and neuroinflammation. MRI and fluorescence microscopy were used to further confirm CMH development in this model. RESULTS LPS-treated mice developed H&E-positive (at 2 days) and PB-positive (at 7 days) CMH. No surface and negligible H&E-positive CMH were observed in saline-treated mice (n = 12). LPS (3 mg/kg; n = 10) produced significantly higher number, size, and area of H&E-positive CMH at 2 days. LPS (1 mg/kg; n = 9) produced robust development of PB-positive CMH at 7 days, with significantly higher number and area compared with saline (n = 9)-treated mice. CMH showed the highest distribution in the cerebellum followed by the sub-cortex and cortex. LPS-induced CMH were predominantly adjacent to cerebral capillaries, and CMH load was associated with indices of brain endothelium activation, BBB disruption, and neuroinflammation. Fluorescence microscopy confirmed the extravasation of red blood cells into the brain parenchyma, and MRI demonstrated the presence of cerebral microbleeds. CONCLUSIONS LPS produced rapid and robust development of H&E-positive (at 2 days) and PB-positive (at 7 days) CMH. The ease of development of both H&E- and PB-positive CMH makes the LPS-induced mouse model suitable to study inflammation-induced CMH.
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Affiliation(s)
- Rachita K Sumbria
- Department of Biopharmaceutical Sciences, School of Pharmacy, Keck Graduate Institute, Claremont, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | | | - Vitaly Vasilevko
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | | | - Miriam Scadeng
- Department of Radiology, University of California, San Diego, CA, USA
| | | | | | - Ronald Kim
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA, USA
| | - David H Cribbs
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Mark J Fisher
- Department of Neurology, University of California, Irvine, CA, USA. .,Department of Pathology and Laboratory Medicine, University of California, Irvine, CA, USA. .,Department of Anatomy and Neurobiology, University of California, Irvine, CA, USA. .,UC Irvine Medical Center, 101 The City Drive South, Shanbrom Hall, Room 121, Orange, CA, 92868, USA.
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Abstract
Iron, particularly hemosiderin, is a commonly observed pigment in cytology. Many pigments appear green to blue to black, making differentiation of pigment types difficult. While cytologic clues such as erythrophagia can help determine whether pigment is iron, Perl's Prussian Blue stain is used to highlight iron when these clues are not present. Other special stains can identify similar pigments such as copper. Identification of pigments is important as it directs cytologic interpretation, thus directly influencing patient diagnosis. This paper also presents basic iron metabolism, iron disorders in small animals, and laboratory assessment of iron disorders.
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Affiliation(s)
- Lauren B Radakovich
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1644 Campus Delivery, Fort Collins, CO 80523, USA
| | - Christine S Olver
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1644 Campus Delivery, Fort Collins, CO 80523, USA.
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Ryu SM, Kim ES, Kim SK, Lee SH, Eoh W. Superficial Siderosis of the Central Nervous System Originating from the Thoracic Spine: A Case Report. Korean J Spine 2016; 13:83-6. [PMID: 27437021 PMCID: PMC4949175 DOI: 10.14245/kjs.2016.13.2.83] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 12/13/2022]
Abstract
Superficial siderosis of the central nervous system(SSCNS) is a rare disease characterized by hemosiderin deposition on the surface of the central nervous system. We report a case of SSCNS originating from the thoracic spine, presenting with neurological deficits including, sensorineuronal hearing loss, ataxia, and corticospinal and dorsal column tract signs. The patient underwent dural repair with an artificial dural patch. Clinical findings were elicited by neurological examination, imaging studies, and intraoperative findings, and these were addressed through literature review.
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Affiliation(s)
- Sung Mo Ryu
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Sang Kim
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Kook Kim
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun-Ho Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Whan Eoh
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Pérez-Iglesias JM, Franco-Belussi L, Moreno L, Tripole S, de Oliveira C, Natale GS. Effects of glyphosate on hepatic tissue evaluating melanomacrophages and erythrocytes responses in neotropical anuran Leptodactylus latinasus. Environ Sci Pollut Res Int 2016; 23:9852-61. [PMID: 26856864 DOI: 10.1007/s11356-016-6153-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
Glyphosate (GLY) is the most used herbicide worldwide and its effects on anurans are well known. Pollutants can cause physiological and morphological effects. Therefore, this study evaluated the effects of GLY on hepatic melanomacrophages as a response to environmental stressors. Three treatments were exposed to different concentrations of pure GLY (100, 1000, and 10,000 μg g(-1), respectively), and there was also a control group. After the experimental time, liver and blood were analyzed. Melanomacrophages (MMCs) were located between the hepatocyte cordons, close to sinusoids. GLY increased the melanin area in MMCs of Leptodactylus latinasus exposed since lowest concentration until highest concentration. GLY also changed the occurrence of hepatic catabolism pigments into melanomacrophages and erythrocyte nuclear abnormalities; therefore, it can interfere with the hepatic metabolism. In conclusion, GLY promotes alterations in the hepatic tissue and erythrocyte nuclear abnormalities. Furthermore, MMCs may be useful as morphological responses of GLY effects.
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Affiliation(s)
- Juan Manuel Pérez-Iglesias
- PROICO 9401, Área Zoología, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, Chacabuco 917, San Luis, 5700, Argentina
- Centro de Investigaciones del Medio Ambiente, Departamento de Química, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, CONICET, La Plata, Argentina
| | - Lilian Franco-Belussi
- Department of Biology, São Paulo State University (UNESP), IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, São José do Rio Preto, 15054-000, São Paulo, Brazil
| | - Liliana Moreno
- PROICO 9401, Área Zoología, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, Chacabuco 917, San Luis, 5700, Argentina
| | - Susana Tripole
- PROICO 9401, Área Zoología, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, Chacabuco 917, San Luis, 5700, Argentina
| | - Classius de Oliveira
- Department of Biology, São Paulo State University (UNESP), IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, São José do Rio Preto, 15054-000, São Paulo, Brazil.
| | - Guillermo Sebastián Natale
- PROICO 9401, Área Zoología, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, Chacabuco 917, San Luis, 5700, Argentina
- Centro de Investigaciones del Medio Ambiente, Departamento de Química, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, CONICET, La Plata, Argentina
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Frimberger D, Malm-Buatsi E, Kropp BP, Aston CE, Godiwalla SY, Palmer BW. Reliance of preoperative scrotal examination versus final operative findings in the evaluation of non-palpable testes. J Pediatr Urol 2015; 11:255.e1-5. [PMID: 25979218 DOI: 10.1016/j.jpurol.2015.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 03/13/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The current study evaluates whether the preoperative scrotal examination in children with non-palpable testes is sufficient in all cases or if laparoscopy is necessary to confirm the examination findings. Are the findings different amongst physicians depending on their level of experience? MATERIALS AND METHODS This retrospective study was done between October 2009 and May 2013. Children with non-palpable testes underwent an examination under anesthesia prior to surgery to feel for a testis or nubbin, followed by a diagnostic laparoscopy to validate the scrotal examination. The test was considered correct if the laparoscopic findings supported the scrotal examination. It was considered incorrect if laparoscopy revealed a different finding. RESULTS A total of 74 testes were evaluated. All patients underwent examination under anesthesia by the surgeon and senior resident. The findings were recorded separately. Despite careful examination by experienced surgeons under anesthesia, the scrotal examination was incorrect in 14 patients. Four viable testes would have been missed if laparoscopy had not been performed. CONCLUSION Laparoscopy should be considered in case of palpable scrotal nubbins to ensure no testis is left within the abdominal cavity.
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Falter B, Wiesmann M, Freiherr J, Nikoubashman O, Mull M. Frequency and appearance of hemosiderin depositions after aneurysmal subarachnoid hemorrhage treated by endovascular therapy. Neuroradiology 2015; 57:999-1006. [PMID: 26188767 DOI: 10.1007/s00234-015-1559-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 07/01/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION It is still unclear how often subarachnoid hemorrhage (SAH) leads to chronic hemosiderin depositions. In this study, we aimed to determine the frequency of chronic hemosiderin depositions after aneurysmal SAH in patients who did not undergo surgery. Furthermore, we analyzed typical MRI patterns of chronic SAH and sought to obtain information on the temporal course of MRI signal changes. METHODS We retrospectively analyzed 90 patients who had undergone endovascular treatment for acute aneurysmal SAH. In all patients, initial CT studies and at least one T2*-weighted MRI obtained 6 months or later after SAH were analyzed for the presence and anatomical distribution of SAH or chronic hemosiderin depositions. In total, 185 T2*-weighted MRI studies obtained between 2 days and 148 months after SAH were evaluated (mean follow-up 30.2 months). RESULTS On MRI studies obtained later than 6 months after SAH, subpial hemosiderin depositions were found in 50 patients (55.5%). Most frequent localizations were the parenchyma adjacent to the frontal and parietal sulci and the insular cisterns. While the appearance of hemosiderin depositions was dynamic within the first 3 months, no changes were found during subsequent follow-up. MR signal changes were not only conclusive with subarachnoid hemosiderin depositions but in many cases also resembled those that have been associated with cortical hemosiderosis. CONCLUSIONS T2*-weighted MRI is an effective means of diagnosing prior SAH. Our study suggests that chronic hemosiderin depositions can be found in a considerable number of patients after a single event of subarachnoid hemorrhage.
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Affiliation(s)
- Bernhard Falter
- Department of Neuroradiology, University Hospital Aachen RWTH, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Martin Wiesmann
- Department of Neuroradiology, University Hospital Aachen RWTH, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Jessica Freiherr
- Department of Neuroradiology, University Hospital Aachen RWTH, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Omid Nikoubashman
- Department of Neuroradiology, University Hospital Aachen RWTH, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Michael Mull
- Department of Neuroradiology, University Hospital Aachen RWTH, Pauwelsstr. 30, 52074, Aachen, Germany.
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Ono Y, Ishigami M, Hayashi K, Wakusawa S, Hayashi H, Kumagai K, Morotomi N, Yamashita T, Kawanaka M, Watanabe M, Ozawa H, Tai M, Miyajima H, Yoshioka K, Hirooka Y, Goto H. Copper Accumulates in Hemosiderins in Livers of Patients with Iron Overload Syndromes. J Clin Transl Hepatol 2015; 3:85-92. [PMID: 26356991 PMCID: PMC4548355 DOI: 10.14218/jcth.2015.00004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 01/16/2023] Open
Abstract
In biology, redox reactions are essential and sometimes harmful, and therefore, iron metabolism is tightly regulated by cuproproteins. Since the state of copper in iron overload syndromes remains unclear, we investigated whether copper metabolism is altered in these syndromes. Eleven patients with iron overload syndromes participated in this study. The clinical diagnoses were aceruloplasminemia (n=2), hemochromatosis (n=5), ferroportin disease (n=2), and receiving excess intravenous iron supplementation (n=2). Liver specimens were analyzed using a light microscope and transmission electron microscope equipped with an X-ray analyzer. In addition to a large amount of iron associated with oxygen and phosphorus, the iron-rich hemosiderins of hepatocytes and Kupffer cells contained small amounts of copper and sulfur, regardless of disease etiology. Two-dimensional imaging clearly showed that cuproproteins were distributed homogenously with iron complexes within hemosiderins. Copper stasis was unlikely in noncirrhotic patients. The enhanced induction of cuproproteins by excess iron may contribute to copper accumulation in hemosiderins. In conclusion, we have demonstrated that copper accumulates in hemosiderins in iron overload conditions, perhaps due to alterations in copper metabolism.
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Affiliation(s)
- Yukiya Ono
- Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masatoshi Ishigami
- Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Correspondence to: Masatoshi Ishigami, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. Tel: +81-52-744-2169, Fax: +81-52-744-2178, E-mail:
| | - Kazuhiko Hayashi
- Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinya Wakusawa
- Department of Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisao Hayashi
- Department of Medicine, Aichi Gakuin University School of Pharmacy, Nagoya, Japan
| | - Kotaro Kumagai
- Digestive Disease and Lifestyle Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Natsuko Morotomi
- Department of Internal Medicine, Moji Hospital, Kitakyushu, Japan
| | | | - Miwa Kawanaka
- General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan
| | - Minemori Watanabe
- Department of Endocrinology and Diabetes, Okazaki City Hospital, Okazaki, Japan
| | - Hiroaki Ozawa
- Department of Pathology, Okazaki City Hospital, Okazaki, Japan
| | - Mayumi Tai
- Department of Gastroenterology, Fukushima Rohsai Hospital, Fukushima, Japan
| | - Hiroaki Miyajima
- First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kentarou Yoshioka
- Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Toyoake, Japan
| | - Yoshiki Hirooka
- Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidemi Goto
- Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Barbosa JHO, Santos AC, Salmon CEG. Susceptibility weighted imaging: differentiating between calcification and hemosiderin. Radiol Bras 2015; 48:93-100. [PMID: 25987750 PMCID: PMC4433298 DOI: 10.1590/0100-3984.2014.0010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 08/05/2014] [Indexed: 01/14/2023] Open
Abstract
Objective To present a detailed explanation on the processing of magnetic susceptibility
weighted imaging (SWI), demonstrating the effects of echo time and sensitive mask
on the differentiation between calcification and hemosiderin. Materials and Methods Computed tomography and magnetic resonance (magnitude and phase) images of six
patients (age range 41– 54 years; four men) were retrospectively selected. The SWI
images processing was performed using the Matlab’s own routine. Results Four out of the six patients showed calcifications at computed tomography images
and their SWI images demonstrated hyperintense signal at the calcification
regions. The other patients did not show any calcifications at computed
tomography, and SWI revealed the presence of hemosiderin deposits with hypointense
signal. Conclusion The selection of echo time and of the mask may change all the information on SWI
images, and compromise the diagnostic reliability. Amongst the possible masks, the
authors highlight that the sigmoid mask allows for contrasting calcifications and
hemosiderin on a single SWI image.
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Affiliation(s)
- Jeam Haroldo Oliveira Barbosa
- Master, Fellow PhD degree, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto da Universidade de São Paulo (FFCLRP-USP), Ribeirão Preto, SP, Brazil
| | - Antonio Carlos Santos
- PhD, Professor, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Carlos Ernesto Garrido Salmon
- PhD, Professor, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto da Universidade de São Paulo (FFCLRP-USP), Ribeirão Preto, SP, Brazil
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Nussbaum ES, Defillo A, Zelensky A, Pulivarthi S, Nussbaum L. "Microbleeding" from intracranial aneurysms: Local hemosiderin deposition identified during microsurgical treatment of unruptured intracranial aneurysms. Surg Neurol Int 2014; 5:28. [PMID: 24778916 PMCID: PMC3994698 DOI: 10.4103/2152-7806.127967] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 02/02/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND During elective surgery for unruptured aneurysms, we have identified a group of patients with hemosiderin staining of the pial surface immediately adjacent to the aneurysm dome suggesting a remote and unrecognized history of microbleeding from the aneurysm. These cases form the basis for this report. METHODS Medical records of 421 unruptured cerebral aneurysm patients treated surgically between January 2003 and September 2010 were retrospectively reviewed. Patients with a history of prior subarachnoid hemorrhage, craniotomy, or significant closed head injury were excluded from review. Records were reviewed for intraoperative descriptions of hemosiderin deposition in the vicinity of the aneurysm as well as history of headaches, time to presentation, comorbidities, aneurysm characteristics, procedures, and radiologic imaging. RESULTS Local hemosiderin staining immediately adjacent to the aneurysm was identified intraoperatively in 13 cases. Each of these patients had a history of remote atypical headache prior to presentation. Eight of these patients (62%) had aneurysms described as particularly "thin-walled" at the time of surgery. Aneurysm locations included the internal carotid artery (ICA) (54%), middle cerebral artery (MCA) (23%), anterior communicating artery (ACOMMA) (15%), and the anterior cerebral artery (ACA) (8%). More than half (54%) of these patients had a history of smoking, while 31% had hypertension, and 23% had a history of alcohol abuse. Dyslipidemia and family history of aneurysms were present in 15% and hypercholesterolemia was noted in one patient (8%). CONCLUSION We suggest this group of patients had suffered a "microbleed" resulting in local hemosiderin deposition next to the aneurysm. The origins and clinical implications of such microbleeds are unknown and warrant further investigation.
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Affiliation(s)
- Eric S Nussbaum
- National Brain Aneurysm Center at the John Nasseff Neuroscience Institute, United Hospital, Allina Health System, St. Paul, MN, USA ; Minnesota Neurovascular and Skull Base Surgery, Minneapolis, MN, USA
| | | | | | | | - Leslie Nussbaum
- Minnesota Neurovascular and Skull Base Surgery, Minneapolis, MN, USA
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Hackney DN, Tirumala R, Salamone LJ, Miller RK, Katzman PJ. Do placental histologic findings of chorion-decidual hemorrhage or inflammation in spontaneous preterm birth influence outcomes in the subsequent pregnancy? Placenta 2013; 35:58-63. [PMID: 24262136 DOI: 10.1016/j.placenta.2013.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/15/2013] [Accepted: 11/02/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Spontaneous preterm birth (SPTB) is the common endpoint of different underlying etiologies, including chorion-decidual bleeding and inflammation. However, specific histologic findings from a prior pregnancy do not always inform clinical management in subsequent pregnancies secondary to few prior studies having evaluated the relationship between prior pregnancy pathology and subsequent outcomes in patients with SPTB. METHODS Included subjects had: 1) a SPTB with available placental pathology and 2) a subsequent consecutive delivery at >20 weeks gestational age at our institution. For included subjects archived placenta and membrane paraffin blocks from the index SPTB were cut, stained with Prussian Blue and evaluated by a perinatal pathologist for the presence of hemosiderin. The association between histologic findings and subsequent pregnancy outcomes were evaluated through logistic and linear regression. RESULTS A total of 131 subjects were included, of whom 39.7% had a recurrent SPTB. Funisitis at the time of preterm delivery significantly increased the risk of early (<34 weeks) recurrent preterm birth (OR 3.38, p = 0.016), though this may have been confounded by gestational age at delivery. Several histologic features were significantly associated with reductions in birth weight in the subsequent pregnancies, even if they did not increase the risk of recurrent preterm birth. DISCUSSION The presence of chorion-decidual bleeding or inflammation in a prior pregnancy can signal an increased risk in a future pregnancy beyond the recurrent risk of SPTB itself. CONCLUSIONS Placental histologic findings after SPTB maybe associated with differences in birth weight in a subsequent pregnancy.
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Affiliation(s)
- D N Hackney
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY 14642, USA.
| | - R Tirumala
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY 14642, USA.
| | - L J Salamone
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY 14642, USA.
| | - R K Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY 14642, USA.
| | - P J Katzman
- Department of Pathology, University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY 14642, USA.
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Abstract
BACKGROUND Superficial siderosis (SS) is caused by repeated or continuous bleeding into the subarachnoid space that results in iron from hemoglobin (hemosiderin) being deposited on the surface of the brain. Clinically, the condition is characterized by sensorineural deafness, ataxia, and pyramidal signs. However the mechanism of peripheral vestibular disturbance was not revealed. We show the vestibular function of SS patients, and shed light on saccule-inferior vestibular nerve. METHODS Over the past 9 years, 5 patients were definitively diagnosed with SS by MRI in our department. These patients were subjected to balance testing. RESULTS Vestibular evoked myogenic potential (VEMP) was observed in patients who had suffered from SS for a short period but tended to be diminished or absent in patients who had suffered from the condition for a longer period. CONCLUSIONS These findings in SS patients suggest that saccule-inferior vestibular function is maintained at early stages of the disorder. Our study may help to clarify the mechanism of SS.
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Affiliation(s)
- Toru Miwa
- Department of Otolaryngology and Head and Neck Surgery, Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan
| | - Ryosei Minoda
- Department of Otolaryngology and Head and Neck Surgery, Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan
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Abstract
Superficial siderosis of the central nervous system results from deposition of hemosiderin in the subpial layers of the brain and spinal cord. Patients usually present after 40 years of age with progressive ataxia and sensorineural hearing impairment. We present the case of a twelve-year-old boy who had a surgery of the posterior fossa at the age of two years and then developed recurrent headaches, instability of gait, and hearing deficit at around ten years of age. Clinical examination revealed progressive ataxia and mild sensorineural hearing loss. He also had infrequent seizures with mild electroencephalographic abnormality. His serial magnetic resonance imaging (MRIs) showed a progressive deposition of hemosiderin in the cerebellar folia and around the brainstem, confirming a diagnosis of superficial siderosis. This case report draws attention to this rare condition, usually seen in adults, even though rarely it can be seen in children as a chronic sequela of surgery of the posterior fossa.
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Affiliation(s)
- Trupti M Jadhav
- Department of Pediatric Neurology, Jaslok Hospital and Research Centre, Mumbai, India
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50
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Assarzadegan F, Ehsanpour E, Hosseini B, Beladi-Moghadam N, Mansouri B, Hesami O. Superficial siderosis: A rare case of ataxia and otoneurological manifestations. Iran J Neurol 2013; 12:69-71. [PMID: 24250906 PMCID: PMC3829287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 02/15/2013] [Indexed: 12/04/2022]
Abstract
Superficial siderosis (SS) is a rare disease which affects people in all ages and both sexes, but three times more in men. Pathological etiology is deposition of hemosiderin (a product of the breakdown of blood) in leptomeninges, subpial layer, ependymal surface and other parts of central nervous system (CNS) and typically leads to neurological dysfunction and progressive irreversible signs and symptoms. We present a 33-year-old man with complete deafness in left ear, partial hearing loss in right ear, gait imbalance, bilateral frontotemporal throbbing headache and anosmia resulted from superficial siderosis.
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