Histological Subgroups in Classic Kaposi Sarcoma: A Preliminary Study

Background and Design: Kaposi sarcomas (KS) are vascular tumors with a low malignant potential which include overlapping infectious, immunologic, and neoplastic processes. Recently, many histological subtypes have been defined. Material and Method: In the present study, 151 cutaneous classic KS lesions in 56 patients were retrospectively evaluated with regard to histological subtypes. Determination of the subtypes was based on the predominant histopathological component in the lesion. We examined changes in epidermis and dermis along with intratumoral inflammatory response characteristics in the lesions. By defining histopathological variants of the cases, differences regarding subtypes were investigated. Results: Cases that bear the ordinary characteristics of KS and those that can not be classified otherwise, comprised 82..8% of the study group. Twenty-six cases showed consistency with the subtypes outlined in the literature in terms of their histopathological properties. The most common histological subtype was the lymphangiectatic variant in 7.3% of the cases. Bullous (2.6%), lymphangioma like (2.6%), intravascular (2%), and pyogenic granuloma like (2%) variants were less common. The most uncommon histological subtype was micronodular (0.6%) type. Lymphangiectatic, bullous, intravascular, and pyogenic granuloma like variants were frequently observed in the nodular stage of KSs. Lympangioma like changes were seen to be present in the early KS lesions. Lymphangiectatic type was oftenly associated with bullous component, whereas pyogenic granuloma like type demonstrated superficial ulceration and intense inflammatory response. Lymphangioma like and intravascular types exhibited a characteristic appearance, while other variants were accompanied by components belonging to different subtypes. Conclusion: In KS, histopathological subtypes can develop as a result of different pathological processes. The next stage of the current study, which is one of the largest case series in the literature, will be investigation of the clinical and prognostic characteristics of the variants

Cavernous Hemangioma-Like Kaposi Sarcoma: Histomorphologic Features and Differential Diagnosis

Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant

The comparison of vessels in elective and spontaneous abortion decidua in first trimester pregnancies: Importance of vascular changes in early pregnancy losses

Background. To determine whether adequate trophoblastic migration and maternal placental perfusion occurs in cases of early pregnancy loss, we compared vessels in elective abortion decidua with those in spontaneous abortion decidua. Methods. Elective abortion decidua at 5-11 weeks ( n =40) were compared with spontaneous abortion decidua at 5-12 weeks ( n =25). Also normal late secretory endometrial biopsy specimens ( n =10) were examined. The cross-sections of veins and arteries were counted in 25 elective and 15 spontaneous abortion materials. The number of the veins that contain trophoblastic fragments and the number of the spiral arteries converted by trophoblasts were determined. Statistical significance by Mann-Whitney U and Spearman's correlation test was p <0.05. Results. All sets of decidua had dilated veins, but no secretory endometrium did. The ratio of converted spiral arteries to nonconverted arteries was much more in elective abortion decidua (113/938, 12.04%) than in spontaneous abortion decidua (11/511, 2.15%) ( p <0.001). Conclusions. The presence of converted arteries, dilated veins, and intravenous trophoblastic fragments in decidual specimens were evidence of intervillous circulation and placental perfusion by maternal circulation in the first trimester. Also the insufficient conversion of the arteries in spontaneous abortions might be responsible for many cases of early pregnancy loss. © 2006 Taylor & Francis

Dış kulakta Kaposi sarkomu: Olgu sunumu

Bu makalede, 36 yaşındaki sağlıklı bir erkek hastada kulak kepçesinde saptanan Kaposi sarkomu suuldu. Hastanın sol kulağında üç aydır var olan nodüler lezyon için predispozan herhangi bir faktör belirlenemedi. Lezyon tümüyle çıkarıldı. Histolojik ve immünhistolojik bulgular Kaposi sarkomu ile uyumluydu. Serolojik analizlerde anti-HIV ile anti-sitomegalovirüs IgM ve IgG antikorları negatif bulundu. Kan sayımı normaldi. Lökosit altgruplarınm sayımı ve immünglobulin elektroforezi normal sonuçlar verdi. İki yıllık izlem dönemi içinde hastada lezyon nüksü, yeni lezyon gelişimi, ya da HIV sero-konversiyonu gözlenmedi. İlgili literatürlerin taranmasında, kulak kepçesinde Kaposi sarkomuna ait soliter lezyonun bildirildiği genç sağlıklı bir olguya rastlamadık.We presented a case of Kaposi's sarcoma that occurred in the external ear of a 36-year-old Caucasian man. He was otherwise healthy without a history of any predisposing factors. He had a nodular lesion in the left ear, of three-month duration. The lesion was excised completely. Histologic and immunohistologic findings were consistent with a diagnosis of Kaposi's sarcoma. Serologic analyses were negative for anti-HIV antibody and anti-cytomegalovirus IgM and IgG and blood count was normal. Differential count of leucocytes and immunoglobulin electrophoresis were normal. During a two-year follow-up, no recurrences, development of new lesions, or HIV seroconversion were detected. To our knowledge, this case is the first to report a solitary lesion of Kaposi's sarcoma occurring in the helix of the ear in a healthy young patient

Traumatic neuromas: A histopa thologic and immunohistochemical study

WOS: 000254120800004Objective: Traumatic neuroma is an exuberant, probably nonneoplastic proliferation of a nerve occurring in response to injury or surgery. We studied six cases of traumatic neuroma with light microscopic, histochemical and immunohistochemical methods to assess the cellular compositions of these lesions. Material and Methods: Sections from the formalin-fixed parafin-embedded tissues were stained with hematoxylin-eosin, Gomori's trichrome, Verhoeff elastica-von Gieson, reticuline, and S-100 protein, Epithelial Membrane Antigen, CD34 and CD68. Results: All cases revealed large numbers of small and haphazardly arranged regenerating nerve fascicles within a densely collagenous and fibroblastic stroma. A focal chronic mononuclear cell inflammatory reaction was observed in three cases. In all cases, Gomori's trichrome revealed collagen. Axonal morphology was detected in nerve fibers histochemically by reticulin. In all cases, fascicles were stained diffusely with S-100 protein, and Epithelial Membrane Antigen showed a positive reaction in a thin band of cells surrounding the fascicles in three of the cases. CD34 positive cells were present in five cases. CD68 expressing cells were present in only in two specimens. Conclusion: In traumatic neuromas, specific staining of fascicles with S-100 protein, perineural cells reactive for Epithelial Membrane Antigen and the presence of CD34 positive cells may contribute to our understanding of their pathogenesis and differentiation of these lesions from mimickers

Radyolojik bulgularıyla suprasternal yerleşimli dermoid kist: Olgu sunumu

A congenital cystic mass was detected at the suprasternal notch of a seven-month-old male infant. After radiologic examinations including ultrasonography, computed tomography, and magnetic resonance imaging, the cyst was excised and diagnosed as a dermoid cyst. Dermoid cysts of the head and neck are rare lesions, but a midline location is characteristic for these congenital masses. To our knowledge, only two reports have been published, which were similar to our case in localization. Dermoid cysts should be included in the differential diagnosis of midline cysts

Prostat adenokarsinomunda gleason skor ile nükleer boyut ve şekil faktörleri arasındaki ilişki

Amaç: Bu çalışmada, bilgisayar destekli görüntü analiz sistemi kullanılarak prostatik adenokarsinom hücre nükleuslarının boyut ve şekil özellikleri değerlendirilmiş, sonuçlar olguların Gleason skorları ile karşılaştırılmıştır. Yöntem ve Gereç: Görüntü analiz sistemi kullanılarak, 130 (% 77’si iğne biyopsi ve % 23’ü prostatektomi materyali) prostat adenokarsinomunun histolojik kesitlerinde yuvarlaklık faktörü, elipslik indeksi, alan, uzunluk ve perimetreyi içeren nükleer morfometrik parametreler değerlendirilmiştir. Morfometrik sonuçlar ile Gleason skorları arasındaki ilişki korelasyon analizi ile saptanmıştır. Bulgular: Tüm materyaller arasında Gleason skor ile ortalama nükleer alan (r = 0,516, P = 0,01), ortalama nükleer uzunluk (r = 0,298, P = 0,01) ve ortalama nükleer perimeter (r = 0,303, P = 0,01) arasında ilişki saptanmıştır. Organ iğne biyopsi grubunda ise Gleason skor ile ortalama nükleer alan (r = 0,522, P = 0,01), ortalama nükleer uzunluk (r = 0,398, P = 0,01) ve ortalama nükleer perimeter (r = 0,432, P = 0,01) ilişkili bulunmuştur. Prostatektomi grubunda Gleason skor ile ortalama nükleer alan (? = 0,619, P = 0,01) ve ortalama yuvarlaklık faktörü (? = ?0,425, P = 0,05) arasında ilişki tespit edilmiştir. Sonuç: Nükleer boyut ve şekil faktörleri, özellikle ortalama nükleer alan Gleason skor ile ilişkili bulunmuştur. Nükleer boyut ve şekil ölçümü, prostatik adenokarsinomun patolojik durumunun değerlendirilmesine katkı sağlayabilir.Aim: The aim of this study was to assess the size and shape characteristics of prostatic adenocarcinoma cell nuclei using a computer-assisted analysis system, and to compare the results with the Gleason score. Materials and Methods: Morphometric nuclear parameters, such as roundness factor, form ellipse, area, length, and perimeter, were evaluated based on specimen slides of 130 prostatic adenocarcinoma cases (77% needle biopsies and 23% prostatectomy specimens) using a computerized image analysis system. Correlation analysis between Gleason score and morphometric results was performed. Results: The Gleason score was correlated with mean nuclear area (r = 0.516, P = 0.01), mean nuclear length (r = 0.298, P = 0.01), and mean nuclear perimeter (r = 0.303, P = 0.01) for all specimens. In the needle biopsy group the Gleason score was correlated with mean nuclear area (r = 0.522, P = 0.01), mean nuclear length (r = 0.398, P = 0.01), and mean nuclear perimeter (r = 0.432, P = 0.01), whereas in the prostatectomy group the Gleason score was correlated only with mean nuclear area (&amp;#963; = 0.619, P = 0.01) and mean nuclear roundness factor (&amp;#963; = &amp;#8722;0.425, P = 0.05). Conclusions: Nuclear size and shape factors, especially mean nuclear area, were concordant with the Gleason score. Nuclear size and shape assessment may aid in the evaluation of the pathological status of prostatic adenocarcinoma