Cytomorphologic features of metastatic urothelial carcinoma in serous effusions

Metastatic urothelial carcinoma (UC) to serous effusion (SE) is extremely rare and its cytomorphological features have only been described in case reports. In this study, we searched the pathology database at University of Michigan for SEs due to metastatic UC in the last 20 years. A total of 25 cases from 20 patients with clinically and pathologically confirmed metastatic UC in SEs were retrieved. The specimens consisted of 15 pleural, 8 peritoneal, and 2 pericardial effusions. Smears were reviewed and evaluated for the following features: cellularity, single cells, cell clusters or short cords, cell wrapping, “windows” between the cells, two‐tone cytoplasm, cytoplasmic vacuoles, signet ring cells, nuclear to cytoplasmic (N/C) ratio, nuclear hyperchromasia, irregular nuclear membrane, nuclear centricity, double or multiple nuclei, nucleoli, anaplastic cells and mitosis. Our results showed that UC manifested in SEs predominantly as a single cell population with or without clusters or short cords, and frequently exhibited the “cell wrapping” of two or more cells. Individual UC cell in SEs exhibited nuclear enlargement with increased N/C ratio, irregular nuclear membranes, hyperchromatic coarse chromatin and frequently prominent nucleoli. Double or multinucleated cells, cells with vacuolated cytoplasm or signet ring appearance were also frequently present. Our results demonstrated that while certain features could suggest the diagnosis of UC, the cytomorphological features are not specific and often overlap with those of reactive mesothelium, mesothelioma, metastatic adenocarcinoma, or squamous cell carcinoma in SEs. Accurate diagnosis of UC rests on the combination of clinical history, cytomorphologic features and appropriate immunohistochemical panel. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98804/1/22896_ftp.pd

GABAergic effects on nucleus tractus solitarius neurons receiving gastric vagal inputs. J Pharmacol Exp Ther 286: 736–741

ABSTRACT Single units in the region of the medial nucleus tractus solitarius (NTS), responding to electrical stimulation of gastric vagal fibers, were recorded in an in vitro neonatal rat brainstem-gastric preparation. ␥-Aminobutyric acid (GABA) subreceptor agonists and antagonists were applied to the gastric and brainstem compartments of the bath chamber to evaluate the peripheral gastric and central brainstem GABAergic effects on NTS neuronal activity. The gastric effects of the GABA A receptor agonist muscimol and GABA B receptor agonist baclofen were evaluated on 55 tonic units that received the gastric vagal inputs. For ϳ58% (32 of 55) and 38% (21 of 55) of the units observed, muscimol (30 M; IC 50 ϭ 2.0 M) and baclofen (30 M; IC 50 ϭ 1.5 M) in the gastric compartment induced a concentrationdependent inhibition of 36.2 Ϯ 3.1% (mean Ϯ S.E.) and 31.0 Ϯ 2.9% of the control level of the NTS neuronal activity, respectively. The brainstem effects of muscimol and baclofen were tested on 51 units. For ϳ90% (46 of 51) and 78% (40 of 51) of the units tested, muscimol (30 M; IC 50 ϭ 1.3 M) and baclofen (30 M; IC 50 ϭ 1.1 M) in the brainstem compartment produced a concentration-dependent inhibition of 54.1 Ϯ 3.4% and 48.9 Ϯ 3.5% of the control level, respectively. The remaining NTS units were not affected by these two GABA agonists. Bicuculline (10 M) and saclofen (10 M), the GABA A and GABA B subreceptor antagonists, competitively antagonized the gastric and brainstem effects by muscimol and baclofen, respectively. Our results demonstrated that both GABA A and GABA B receptors in the stomach and brainstem play an important role in activity modulation of the medial NTS neurons receiving gastric vagal inputs in neonatal rats. The NTS is the primary brainstem relay for visceroceptive information from the cardiovascular, respiratory, gastrointestinal and taste systems. A number of neurochemicals in the NTS are critical in coding visceral informatio