Adipocyte-Like Differentiation in a Posttreatment Embryonal Rhabdomyosarcoma.

We describe a 16-year-old boy with rhabdomyosarcoma, consistent with embryonal subtype, of the lower extremity who received systemic neoadjuvant chemotherapy and subsequent excision. Microscopic sections of the postchemotherapy excision demonstrated diffuse, prominent, and immature adipocyte-like differentiation, in addition to skeletal muscle differentiation. Adipocyte-like differentiation was confirmed by a combination of positive Oil Red O and adipophilin immunohistochemical staining. To our knowledge, this represents the first report of an unusual phenomenon of differentiation of a soft tissue rhabdomyosarcoma into adipocyte-like cells after chemotherapy

Adipocyte-Like Differentiation in a Posttreatment Embryonal Rhabdomyosarcoma.

We describe a 16-year-old boy with rhabdomyosarcoma, consistent with embryonal subtype, of the lower extremity who received systemic neoadjuvant chemotherapy and subsequent excision. Microscopic sections of the postchemotherapy excision demonstrated diffuse, prominent, and immature adipocyte-like differentiation, in addition to skeletal muscle differentiation. Adipocyte-like differentiation was confirmed by a combination of positive Oil Red O and adipophilin immunohistochemical staining. To our knowledge, this represents the first report of an unusual phenomenon of differentiation of a soft tissue rhabdomyosarcoma into adipocyte-like cells after chemotherapy

Clinicopathologic features of de novo non-alcoholic steatohepatitis in the post-transplant setting.

BackgroundNon-alcoholic steatohepatitis (NASH) has become an increasingly recognized problem in patients after orthotopic liver transplant. The aims of this study were to compare the clinicopathologic features of recurrent and de novo NASH.MethodsFrom 1995 to 2016, we performed a retrospective review of patients with a histological diagnosis of non-alcoholic steatohepatitis made more than 6 months after liver transplant at University of California, San Francisco. The cases were categorized into de novo (n = 19) or recurrent steatohepatitis (n = 37).ResultsHepatitis C virus (HCV) infection-related cirrhosis was the most common etiology of transplantation in de novo NASH (78% of cases, n = 29). There was no difference in glycogenosis or presence of grade 3 steatosis. More recurrent NASH biopsies had small ballooned hepatocytes (62.5% of cases) compared to de novo NASH (26.7%) (p = 0.03), and were less likely to show prominent portal inflammation (5% versus 40.5%, p = 0.0049). The diagnosis of recurrent NASH was made significantly sooner after transplantation than the diagnosis of de novo NASH (2.8 years versus 4.8 years, p = 0.02).ConclusionsOverall, our results support that recurrent NASH demonstrates distinct clinicopathologic features compared to de novo NASH arising in the post-transplant setting

Endotracheal intubation in mice via direct laryngoscopy using an otoscope.

Mice, both wildtype and transgenic, are the principal mammalian model in biomedical research currently. Intubation and mechanical ventilation are necessary for whole animal experiments that require surgery under deep anesthesia or measurements of lung function. Tracheostomy has been the standard for intubating the airway in these mice to allow mechanical ventilation. Orotracheal intubation has been reported but has not been successfully used in many studies because of the substantial technical difficulty or a requirement for highly specialized and expensive equipment. Here we report a technique of direct laryngoscopy using an otoscope fitted with a 2.0 mm speculum and using a 20 G intravenous catheter as an endotracheal tube. We have used this technique extensively and reliably to intubate and conduct accurate assessments of lung function in mice. This technique has proven safe, with essentially no animal loss in experienced hands. Moreover, this technique can be used for repeated studies of mice in chronic models

Endotracheal Intubation in Mice <em>via</em> Direct Laryngoscopy Using an Otoscope

Mice, both wildtype and transgenic, are the principal mammalian model in biomedical research currently. Intubation and mechanical ventilation are necessary for whole animal experiments that require surgery under deep anesthesia or measurements of lung function. Tracheostomy has been the standard for intubating the airway in these mice to allow mechanical ventilation. Orotracheal intubation has been reported but has not been successfully used in many studies because of the substantial technical difficulty or a requirement for highly specialized and expensive equipment. Here we report a technique of direct laryngoscopy using an otoscope fitted with a 2.0 mm speculum and using a 20 G intravenous catheter as an endotracheal tube. We have used this technique extensively and reliably to intubate and conduct accurate assessments of lung function in mice. This technique has proven safe, with essentially no animal loss in experienced hands. Moreover, this technique can be used for repeated studies of mice in chronic models

Polycystic ovary syndrome (PCOS) is associated with NASH severity and advanced fibrosis

BackgroundPolycystic ovary syndrome (PCOS) affects 10% of reproductive-aged women, and is marked by irregular menses and high androgens. PCOS is a known risk factor for imaging-confirmed steatosis, and we now aim to evaluate whether PCOS influences histologic severity of non-alcoholic fatty liver disease (NAFLD).MethodsRetrospective study of women ages 18-45&nbsp;years with biopsy-confirmed NAFLD between 2008 and 2019. Metabolic comorbidities were captured within 6&nbsp;months of biopsy. Histologic features of non-alcoholic steatohepatitis (NASH) were independently evaluated by two pathologists blinded to PCOS status.ResultsAmong 102 women meeting study criteria, 36% (n&nbsp;=&nbsp;37) had PCOS; median age was 35&nbsp;years; 27% were white, 6% black, 19% Asian and 47% reported Hispanic ethnicity. Women with PCOS had higher LDL (122 vs 102&nbsp;mg/dL, P&nbsp;=&nbsp;.05) and body mass index(BMI) (38 vs 33&nbsp;kg/cm2 , P&nbsp;&lt;&nbsp;.01). NASH was present in 76% of women with PCOS vs 66% without PCOS (P&nbsp;=&nbsp;.3), and a higher proportion with PCOS had severe ballooning (32% vs 13%, P&nbsp;=&nbsp;.02), presence of any fibrosis (84% vs 66%, P&nbsp;=&nbsp;.06) and advanced fibrosis (16% vs 6%, P&nbsp;=&nbsp;.10). Adjusted for age and BMI, PCOS remained associated with severe hepatocyte ballooning (OR 3.4, 95% CI 1.1-10.6, P&nbsp;=&nbsp;.03) and advanced fibrosis (OR 7.1, 95% CI 1.3-39, P&nbsp;=&nbsp;.02). Among women with advanced fibrosis, median age was 5&nbsp;years younger in those with as compared to those without PCOS (40 vs 45&nbsp;years, P&nbsp;=&nbsp;.02).ConclusionPolycystic ovary syndrome is independently associated with more severe NASH, including advanced fibrosis. Hepatologists should routinely inquire about PCOS in reproductive-aged women with NAFLD, and evaluate for more severe liver disease in this population

Pericytic tumors of the kidney-a clinicopathologic analysis of 17 cases

The pericytic (perivascular myoid cell) family of tumors is a distinctive group of mesenchymal neoplasms encountered in superficial sites and only rarely seen in viscera. The pericytic family subtends a spectrum of lesions, namely, glomus tumors and variants; myopericytoma, including myofibroma; and angioleiomyoma. In light of the contemporary classification of pericytic lesions, we identified and reviewed 17 cases of renal pericytic tumors from the files of 6 referral centers. These tumors presented over an age range of 17 to 76 years (mean 46.7, median 53), with essentially equal male-female ratio. History of hypertension (available in 11 patients) was noted in 7 (64%), which persisted even after surgical resection, including in 2 younger patients (17 and 30 years). The tumors (1.7-11.0 cm) included glomus tumors (n=11); glomangiomyoma (n=1); glomus tumor with atypical features (n=1); and angioleiomyoma (n=1), as well as tumors showing features overlapping pericytic tumor subtypes (n=3). The histomorphology observed in these renal examples closely resembled that of their soft tissue counterparts, a subset with symplastic changes and atypical features, and pericytic immunophenotype. Despite large size and deep site, no progression was identified during a median of 7 months follow-up (1-62 months). In context of prior reported experience, our series identifies a wide morphologic spectrum, including lesions presenting composite morphologies. Taken with the experience of others, our series further corroborates that malignant behavior is rare, and that criteria associated with aggression among soft tissue pericytic tumors may not be predictive for those in the kidney