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Expression of the human hematopoietic progenitor cell antigen CD34 in vascular and spindle cell tumors.

The human hematopoietic progenitor cell antigen is known as CD34. This antigen is present on normal bone marrow progenitor cells and vascular endothelial cells. We used the monoclonal antibody anti-CD34 and immunoperoxidase staining techniques to evaluate the expression of CD34 in benign and malignant vascular and spindle cell tumors. All of the 42 vascular lesions, except two of three lesions of intravascular papillary endothelial hyperplasia, demonstrated diffuse membraneous staining of moderate to strong intensity of their endothelial cells. Also, normal placentas (five) showed similar staining. All neurofibromas (12), three of five neuromas, and one of four neurilemmomas revealed moderate to strong, diffuse, membraneous staining. Five of eight piloleiomyomas, two of seven angioleiomyomas, and one of five uterine leiomyomas showed focal to diffuse, and weak to moderate, membraneous staining in the smooth muscle component. Six dermatofibrosarcoma protuberans were studied: generalized, strongly positive membraneous staining was present in four. All specimens showed staining of the normal endothelial cells and the cells surrounding the hair follicles (bulge area), sebaceous glands, and eccrine glands. No staining was demonstrated in any of the following fibrohistiocytic tumors: atypical fibroxanthomas (two), fibrous dermatofibromas (23), giant cell tumor of tendon sheath (one), and hemosiderotic dermatofibromas (18). Melanocytic tumors [Spitz nevi (three) and spindle cell superficial spreading malignant melanoma (one)], Merkel cell carcinomas (six), and spindle cell squamous cell carcinomas (two) did not stain with anti-CD34. Glomus tumors (two) and a hemangiopericytoma were also negative except for their vascular channels.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, CD↗

Hu Immunolabeling as a Marker of Neural and Neuroendocrine Differentiation in Normal and Neoplastic Human Tissues: Assessment Using a Recombinant Anti-Hu Fab Fragment.

The recombinant antibody fragment Fab GLN 495 recognizes an epitope shared by members of the neuron-associated Hu protein family (including HuC, HuD, and HelNl). This novel reagent labels the nuclei of neurons throughout the peripheral and central neuraxes and has been shown to recognize pulmonary small cell carcinomas and central nervous system (CNS) tumors of mature neuronal phenotype or neuronogenic differentiating capacity. Using this Fab fragment, we have undertaken a systematic survey of normal human tissues and an assessment of 554 non-CNS tumor samples for immunohistochemical evidence of Hu expression. Adrenomedullary cells, pancreatic islet cells, paraganglial chief cells, isolated adenohypophyseal cells, and spermatogonia were the only nonneuronal normal tissue elements to bind Fab GLN 495. In addition to labeling all 10 small cell carcinomas studied (six of which were extrapulmonary in origin), this recombinant anti-Hu Fab proved immunoreactive with neuroblastomas (four/four), esthesioneuroblastomas (one/one), typical (three/four) and atypical (one/four) pulmonary carcinoids, pancreatic islet cell tumors (two/six), large-cell neuroendocrine carcinoma of lung (one/four), Merkel cell tumors (two/three), medullary carcinomas of the thyroid (four/six), pheochromocytomas (two/four) and paragangliomas (four/four). Nonneural/neuroendocrine tumor labeling was restricted to the neuronal and immature neuroepithelial components of teratomas, to extraskeletal myxoid chondrosarcomas (three/four) and to small subsets of cells within examples of renal rhabdoid tumor (one/four), desmoplastic small cell tumor (one/four), alveolar rhabdomyosarcoma (two/four), Ewing sarcoma/PNET (two/nine), and Wilms tumor (one/four). Immunoreactivity was principally nuclear, with variable cytoplasmic labeling. Our findings support the largely restricted expression of Hu by neural/neuroendocrine neoplasms, suggest a potential role for Fab GLN 495 in the identification of small cell carcinomas irrespective of primary site, and support a recent proposal that at least some extraskeletal myxoid "chondrosarcomas" actually represent neuroendocrine tumors of soft parts. Int J Surg Pathol 8(2):109-117, 2000

Journal Article↗

Development of the tongue and taste disks in Pelobates fuscus.

In the tadpole of Pelobates fuscus the process of tongue formation starts at the 32nd developmental stage. In more advanced stages (older than 38th) fast anterior and faucial growth of the tongue fold has been observed. This process is accompanied by the development of the gustatory organs. The dorsal surface of the tongue fold, smooth at the beginning, in older tadpoles (developmental stages 36-39th) forms protrusions in which gustatory organs of the taste disk type (TDs) develop. In the 41 st tadpole developmental stage anlages of TDs are formed by elongated cells, located more or less perpendicularly to the surface of the tongue. The diameter of the sensory area of a TD at the 45th developmental stage amounts to 94 microm, while in metamorphosed individuals it reaches 130-140 microm. At the base of a TD the presence of basal cell morphologically similar to that of Merkel cell was observed at the 42nd developmental stage of a tadpole. Fully developed afferent synaptic connections in the sensory epithelium of a TD were found starting from the 44th developmental stage. Single synaptic vesicles with an electron-dense core were observed in gustatory cells as early as at the 41 st developmental stage of the tadpole. From the observations reported here it can be inferred that in Pelobates fuscus development of both the tongue and TDs is similar to that already described in the representatives of the Rana genus.

Animals↗

[Changes in the expression of prekeratins with molecular weight of 55 and 40 kD in monolayer epithelium during skin morphogenesis in rats].

It has been shown by indirect immunofluorescence using monoclonal antibodies against adult rat simple epithelial prekeratins with the molecular weight of 55 kD (PK55) and 40 kD (PK40) that PK55 was expressed in the covering ectoderm until the 11th day of the antenatal period. PK55 expression markedly increased in ectodermal cells lining the heart region, with PK40 appearing in the same cells on day 11. Beginning from the 16th day gradual loss of both prekeratins started with the parallel formation of squamous differentiated epidermis. These proteins were retained in the outer layers of peridermal cells and in some cells of the basal layer (probably Merkel cells). PK55 was re-expressed on the 18th day in cells migrating into dermal layer during hair folliculi formation. PK55 disappeared again in mature folliculi. Thus, a correlation between distinct morphogenetic events and PK55 and PK40 expression has been found.

Animals↗

Immunohistochemical comparison of cutaneous lymphadenoma, trichoblastoma, and basal cell carcinoma: support for classification of lymphadenoma as a variant of trichoblastoma.

Cutaneous lymphadenoma is an uncommon basaloid epithelial tumor of uncertain histogenesis, most recently classified as a variant of trichoblastoma. Because characteristic immunohistochemical findings have been reported in trichoblastomas, we evaluated the staining patterns of five cutaneous lymphadenomas and compared the results to those of ten trichoblastomas and ten nodular basal cell carcinomas (BCCs), using antibodies to cytokeratin 20 (CK20), bcl-2, and CD34. In addition, because lymphadenomas contain intraepithelial S100-positive putative Langerhans cells, we compared staining of all tumor groups for S100 protein and CD1a. We also attempted to corroborate recent reports of CD30-positive activated lymphocytes in lymphadenomas. We identified CK20-positive Merkel cells in 3/5 lymphadenomas, 7/10 trichoblastomas, and none of the BCCs. Staining for bcl-2 accentuated the peripheral epithelial layer in all lymphadenomas and in 3/10 trichoblastomas, while the remaining trichoblastomas and all BCCs stained diffusely. There was stromal staining with CD34 in two lymphadenoma, 4 trichoblastomas, and 3 BCCs. All lymphadenomas featured numerous intraepithelial S100-positive cells which were also positive for CD1a in three cases tested. In addition, 8/10 trichoblastomas and 2/10 BCCs contained modest numbers of cells labelling for S100 and CD1a. Two of three lymphadenomas contained rare single cells resembling histiocytes faintly positive for CD30, and similar cells labelled for CD68. We conclude that the similar staining patterns of lymphadenomas and trichoblastomas support the classification of lymphadenoma as a variant of trichoblastoma. Staining with CD34 does not reliably distinguish between these tumors and BCCs. Lymphadenomas, trichoblastomas, and BCCs may all contain Langerhans' cells. The relationship between these cells and the striking lymphoid infiltrates seen in lymphadenomas is not clear. In our cases, the CD30-positive cells in lymphadenomas appear to represent histiocytes rather than activated lymphocytes.

Adenolymphoma↗

Somatostatin receptor scintigraphy and therapy of neuroendocrine (APUD) tumors of the head and neck.

Through the development of somatostatin scintigraphy with the labeled somatostatin analog Indium111-Octreotide, it has recently become possible to accurately diagnose primary tumors of the APUD system as well as their metastases, since these tumors usually have somatostatin receptors. Experience with this method is already available for endocrine and exocrine tumors of the gastrointestinal tract, neuroendocrine and breast tumors, small cell bronchial carcinomas and certain lymphomas. In the present study, this new diagnostic technique was used for the first time in various head and neck tumors (carcinoid of the larynx, Merkel cell tumor, glomus tumor of the carotid and glomus jugulare tumor). Concurrently, some of these tumors shown by this diagnostic method to be somatostatin receptor positive were treated using the somatostatin analog Octreotide, a therapeutic approach new for the ENT-specialty. Our initial results prove that the detection of the ENT tumors which we studied by means of receptor scintigraphy is reliable. The preliminary results of this Octreotide therapy show a growth inhibitory effect, especially for those tumors of the head and neck which are inoperable or are difficult to approach surgically.

Adult↗

The sensory innervation of primate eyelid.

The skin of primate eyelid contains three distinctive sensory nerve terminals. Small down hairs have a collar of lanceolate terminals that are formed by ramifications of the six to eight myelinated afferent fibers. Extensions of Schwann-cell cytoplasm form masses of cytoplasmic lamellae associated with these terminals. Every large hair or eyelash contains a large pilo-Ruffini as well as sparse lanceolate terminals. The eyelash Ruffini corpuscle resembles those of monkey facial guard hairs, sinus hairs, and joint capsules of the cat and pigeon. Sparse lanceolate terminals present between the Ruffini corpuscle and eyelash external root sheath resemble those of vellus hairs. On rare occasion Merkel cells are present in the hair follicle external root sheath above the sebaceous gland. Merkel touch spots, or Tastscheiben, are located between contiguous eyelashes as small rete pegs containing several Merkel cell-neurite complexes innervated by one or two myelinated afferent fibers. The function of this array of sensory terminals is presumed to represent an extensive mechanism of protection for the cornea and globe. On the basis of studies reported to date we can conclude that the Ruffini corpuscles (and related receptors) are the ubiquitous mechanoreceptors of cutaneous and musculoskeletal systems in birds as well as mammals.

Animals↗

Metastatic disease to the parotid gland.

OBJECTIVES: The purpose of this study was to review the clinico-pathologic findings and outcome of patients with metastasis to the parotid lymph nodes and gland. METHODS: Retrospective study. Thirty-four out of 520 patients with a parotid mass treated at our institution met the criteria for this study. Age, gender, clinical findings, histopathology, treatment. and outcome were analyzed. RESULTS: Twenty-three patients had metastases to parotid lymph nodes from a squamous cell carcinoma of the skin, seven from a cutaneous malignant melanoma after a mean interval of 15 months, two from a ductal breast carcinoma, one with a metastatic disease from a rhabdomyosarcoma of the lower limb, and one from a Merkel cell carcinoma. The 5-year cause-specific and absolute survival for squamous cell carcinoma was 64% and 48% respectively and 71% and 57% for malignant melanomas. CONCLUSIONS: Metastatic disease to the parotid gland is mostly caused by squamous cell carcinoma. Despite combined treatment modalities long-term survival remains poor.

Aged↗

[Detection of somatostatin receptors in tumors in the area of the head and neck and their clinical importance].

The development of a radiolabelled somatostatin analogue Indium-111-Pentetreotide makes the detection of somatostatin receptor-bearing tumours by scintigraphic techniques possible. The existence of high-affinity binding sites for somatostatin has been described previously for most endocrine active tumours of the gastroenteropancreatic system (GEP), malignant lymphomas, small cell lung carcinomas, a subgroup of breast tumours and several types of neuroendocrine related human tumours. Using this new diagnostic tool we investigated some head and neck tumours of neuroendocrine origin (carcinoid of larynx, Merkel cell carcinoma, paragangliomas) with the newly developed radiolabelled somatostatin analogue Indium-111-Pentetreotide whether in vivo visualisation of somatostatin receptors might be possible. In cases not accessible for surgery but with a positive receptor status we started a specific therapy with the somatostatin analogue octreotide. The preliminary results suggest that this new isotopic scanning technique in a diagnostic tool and a predictive method for an effective therapy of those head and neck tumours which revealed highly specifically a positive receptor status. The therapeutical results using the somatostatin analogue octreotide indicate that this new concept is an ideal therapeutic strategy for those neuroendocrine head and neck tumours which cannot be controlled by surgical procedures.

Adult↗

Nonpulmonary small cell carcinomas of extragenital origin metastatic to the ovary.

Seven small cell carcinomas of extragenital and extrapulmonary origin that metastasized to the ovary are described. The tumors occurred in women who were 21-77 years of age (mean, 49 years) and were discovered at, or close to, the time of presentation. The primary sites were the intestine (three cases), thymus (two cases), and inguinal skin (one case), and in one case it was undetermined. The ovarian tumors, four of which were bilateral, ranged from 1.2 to 25 cm in diameter (mean, 11 cm). Microscopic examination showed typical features of small (oat) cell carcinoma in six cases; one neoplasm resembled a small cell carcinoma of intermediate cell type and contained rare glands. On immunohistochemical examination, six of six tumors stained for cytokeratin, five of five for neuron-specific enolase, two of six for chromogranin, and none of four for vimentin. The primary cutaneous tumor was a Merkel cell carcinoma. The patient with that case died at 8 months. Two patients with intestinal tumors died at 1 and 2 months, and one is free of disease at 4 years after receiving chemotherapy. Both patients with mediastinal tumors received chemotherapy; one died at 11 months and one had brain metastases at 5 months and was lost to follow-up. The final case is recent. The differential diagnoses in these cases include primary ovarian small cell carcinomas of hypercalcemic and pulmonary types and various other small cell malignant tumors metastatic to the ovary. Consideration of a variety of clinical and pathologic features should enable these important distinctions to be made.

Adult↗

Diverse dependencies of developing Merkel innervation on the trkA and both full-length and truncated isoforms of trkC.

This study demonstrates that innervation dependent on two different neurotrophin tyrosine kinase (trk) receptors can form the same types of sensory endings (Merkel endings) in the same target (Merkel cells of vibrissa follicles). Some endings transiently express trkA during their initial development, whereas others express trkC throughout their development. Consequently, elimination of kinase domains of either trkA or trkC each result in a partial loss of Merkel endings, whereas absence of kinase domains of both receptors results in a total loss. At the onset of Merkel ending development, at least one kinase-lacking trkC isoform is transiently expressed on all the follicle cells, while neurotrophin 3 is transiently expressed only in the cells at the middle third of the follicle where the Merkel endings and cells develop. This transient non-neuronal expression of truncated trkC is essential for development of any Merkel endings, whereas some Merkel endings and cells still begin to develop in the absence of neurotrophin 3. Therefore, truncated trkC plays a more important role in the development of this innervation than kinase forms of trkA or trkC or of NT3, the only known ligand for trkC receptors.

Animals↗

Structure of the sensory innervation of the anal canal in the pig. A light- and electron-microscopical study.

The sensory innervation of the anal canal of the pig was investigated by light and electron microscopy. The distribution of the different types of sensory nerve endings correlates with the histology of different zones: (1) After the rectal mucosa there was a zone lined with nonkeratinized stratified squamous epithelium. (2) A middle zone was lined with keratinized stratified squamous epithelium. Here the dermis already showed a papillary and reticular layer. (3) The last zone showed hairy skin with a high hair density. The following nerve endings were found: Free nerve endings reached the stratum superficiale in nonkeratinized squamous epithelium and the stratum granulosum in the keratinized squamous epithelium. Dermal free nerve endings were found in all zones near the epithelium and two different types were identified as those derived from C-fibers and those from A-delta-fibers. Merkel nerve endings showed different features depending on their location. Few Merkel-like cells were found in the epithelium of the anal crypts. Typical Merkel Tastscheiben were located at the base of epithelial ridges or pegs in zones 2 and 3. The number of Merkel cells varied up to 200. The myelinated afferent fiber supplied 10-15 Merkel cells. Merkel cells were also found regularly in the outermost layer of the external rooth sheath of hair follicles at about the same level as perifollicular nerve endings. Lamellated corpuscles were found in the dermis of all zones except the cranial part of zone 1, where the anal crypts are located. Generally they consisted of a central nerve terminal which may be branched. Each terminal was surrounded by an inner core of concentrically arranged lamellae of the terminal Schwann cell and one or several inner cores were included in a capsule of perineural cells. The size of the corpuscle, the regularity of the inner core and the number of capsular layers depended on the location of the corpuscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Anal Canal↗

[Primary neuroendocrine carcinoma of the pavilion of the ear].

We present a case of primary neuroendocrine carcinoma (Merkel cell carcinoma) of the external ear and its treatment. This paper also deals with histogenesis, pathology, clinical findings, diagnosis and treatment of this tumor.

Antineoplastic Combined Chemotherapy Protocols↗

Oblimersen sodium (G3139 Bcl-2 antisense oligonucleotide) therapy in Waldenstrom's macroglobulinemia: a targeted approach to enhance apoptosis.

The components of the apoptotic pathway are targets for anticancer therapy. Bcl-2 protein inhibits apoptosis and confers resistance to treatment with traditional cytotoxic chemotherapy, radiotherapy, and monoclonal antibodies. Oblimersen sodium (G3139, Genasense, Genta Inc, Berkeley Heights, NJ) is an antisense oligonucleotide compound designed to specifically bind to the first six codons of the human bcl-2 mRNA sequence, resulting in degradation of bcl-2 mRNA and subsequent decrease in Bcl-2 protein translation. Oblimersen is the first oligonucleotide to demonstrate proof of principle of an antisense effect in human tumors by the documented downregulation of the target Bcl-2 protein. A growing body of preclinical and clinical evidence suggests that oblimersen synergizes with many cytotoxic and biologic/immunotherapeutic agents against a variety of hematologic malignancies and solid tumors. Randomized clinical trials are currently underway to evaluate the efficacy and tolerability of oblimersen in combination with cytotoxic chemotherapy in chronic lymphocytic leukemia (CLL), multiple myeloma (MM), malignant melanoma, and non-small cell lung cancer. In addition, nonrandomized trials are underway to evaluate oblimersen in non-Hodgkin's lymphoma (NHL), acute myeloid leukemia (AML), and hormone-refractory prostate cancer. Preclinical data support the clinical evaluation of oblimersen in additional tumor types, including chronic myelogenous leukemia, and breast, small cell lung, gastric, colon, bladder (CML), and Merkel cell cancers. Enhancement of the efficacy of anticancer treatments with oblimersen Bcl-2 antisense therapy represents a promising new apoptosis-modulating strategy, and ongoing clinical trials will test this therapeutic approach.

Animals↗

KIT expression reveals a population of precursor melanocytes in human skin.

Human skin is believed to harbor a reservoir population of precursor melanocytes. It has been difficult to identify these putative cells experimentally, because they lack phenotypic features that define mature melanocytes. We have evaluated expression of the KIT tyrosine kinase receptor, which is critical for melanocyte development, as a possible marker of these cells. Sections of human skin were evaluated with single- and double-immunolabeling techniques. KIT-reactive dendritic cells were identified in the basal layer of the epithelia and were most numerous in the follicular infundibula and the rete ridges. These cells were located on the epithelial side of the basement membrane and lacked expression of cytokeratin and mast cell tryptase. The location of the KIT-reactive cells was distinctly different from that of Langerhans cells (identified with anti-CD1a) or Merkel cells (identified with CAM 5.2). Within the epidermis and upper follicular infundibulum the majority of the KIT-reactive dendritic cells also coexpressed TRP-1, a marker present in differentiated melanocytes. In the deeper follicular regions, the coexpression of TRP-1 in the KIT-reactive cells was absent. Throughout the epidermis and follicle, however, the KIT-reactive cells coexpressed BCL-2, a marker known to be increased in melanocytes. Thus, KIT expression reveals a population of intraepithelial cells that have immunophenotypic characteristics of mature melanocytes within the upper epithelial regions, but lack the differentiated melanocytic phenotype within the deeper follicular regions. We propose that these KIT(+), BCL-2(+), and TRP-1(-) cells constitute a precursor melanocyte reservoir of human skin.

Adult↗

Identification of paraneurons by labelling with quinacrine (Atebrin).

Quinacrine (Atebrin), an antimalarial drug that binds to adenine nucleotides, was used to label paraneurons. The drug was dissolved in physiological saline and intraperitoneally injected (rats, mice, guinea pigs) in concentrations of 120 or 200 mg/kg body weight. The animals were killed three days later and paraneurons were studied in the fluorescence microscope aftre freeze drying. Bright fluorescence is observed in adrenomedullary cells, SIF cells, carotid body chief cells, pancreatic islet cells, anterior pituitary cells, pinealocytes, and mast cells. Weak fluorescence occurs in thyroid parafollicular Merkel cells, and a few entero-endocrine cells. It is suggested that quinacrine binds to ATP or related adenine nucleotides which are stored in secretory granules of paraneurons. Varying fluorescence intensity seems to depend on different concentrations of adenine nucleotides within the storage granules, as well as on the different size and number of these granules in various paraneurons. Besides formaldehyde-induced fluorescence of biogenic amines, HCl-basic dye staining methods and electron microscopy, the method is useful to identify and define paraneurons.

APUD Cells↗

Electron microscopy and other ancillary techniques in the diagnosis of small round cell tumors.

The current study disusses a new approach to the group of small round cell tumors (SRCTs) independently of their primary anatomical location. We perform this analysis supported mainly by morphological means and particularly with the help of immunohistochemistry and electron microscopy; the last of which continues to play a decisive role in their differential diagnosis. The microscopical similarity of many of these tumors often makes the diagnosis in routine histology extremely difficult, due to the varying degree of heterogeneity present, and may have important therapeutic and prognostic implications. Thus a correct final diagnosis is mandatory for the clinic. Within the group of tumors that express a dominant or occasional small round cell pattern "SRCT" (neoplasms of the Central Nervous System excluded) are included: Ewing's sarcoma and peripheral neuroectodermal tumor (Es/pPNET) comprising its varieties, neuroblastoma, desmoplastic small round cell tumor, rhabdomyosarcoma, alveolar, solid and embryonal, small cell osteosarcoma, chondrosarcoma, myxoid and mesenchymal, round cell and myxoid liposarcoma, synovial sarcoma (monophasic undiffentiated), primitive malignant peripheral nerve sheath tumor (malignant small cell schwannoma), malignant non-Hogdkin lymphoma, Merkel cell tumor of the skin (small cell carcinoma including neuroendocrine carcinoma). This study discusses in each case not only the histology, supported by immunohistochemistry, but also the main ultrastructural characteristics. We are conscious that in some cases further cytogenetic or molecular biology support may be necessary, when considering the limits of morphology today. Thus, short references on molecular genetics, complementing the structural findings, are given.

Humans↗

Sweat gland tumor with glandular and spindle cell features.

We studied a sweat gland tumor by light and electron microscopy that displayed both well-differentiated glandular areas and an anaplastic spindle cell component suggestive of neuroendocrine differentiation. The Merkel cell or a primitive pleuropotential cell is considered to be the most likely cell of origin for this tumor.

Adenocarcinoma↗