bromochloroacetic-acid and Granuloma

Topics: Animals; Diagnosis, Differential; Foreign Bodies; Gout; Granuloma; Hair; Humans; Insecta; Keratins; Lipids; Oils; Plants; Silicon Dioxide; Skin; Skin Diseases; Sutures; Tattooing

Topics: Granuloma; Humans; Keratins

Keratin granulomas in the peritoneum are a rare finding with multiple etiologies and can be especially challenging for both the pathologist and the surgeon when these lesions are grossly visible. We report a case of a unique frozen section diagnostic scenario of evaluation of keratin granulomas in the peritoneum of a 47-year-old woman in the setting of multiple potential culprits: endometrial endometrioid adenocarcinoma following fertility sparing treatment, and a concurrent dermoid cyst. We discuss the various etiologies of keratin granulomas in the peritoneum, mechanism of their formation, diagnostic significance, as well as implications of fertility sparing treatments. To the best of our knowledge, this is the only case of keratin granulomas in the peritoneum with multiple distinct potential pathologic culprits as well the only case following fertility sparing treatment.

Topics: Biomarkers; Carcinoma, Endometrioid; Dermoid Cyst; Diagnosis, Differential; Endometrial Neoplasms; Female; Frozen Sections; Granuloma; Humans; Keratins; Middle Aged; Ovarian Neoplasms; Peritoneal Diseases

Peritoneal keratin granulomatosis is a rare tumor-like lesion caused by deposition of tumor-produced keratin. It may be associated with endometrial or ovarian endometrioid adenocarcinoma, atypical polypoid adenomyoma of the endometrium, or ruptured mature teratomas of the ovary. We present 2 cases of peritoneal keratin granulomatosis associated with FIGO (International Federation of Gynecology and Obstetrics) stage 1 endometrial adenocarcinoma. This entity can mimic advanced-stage disease clinically and radiologically, as it did in those cases, and constitutes a diagnostic pitfall that pathologists and surgeons must be aware.

Topics: Aged; Biopsy; Carcinoma, Endometrioid; Diagnosis, Differential; Endometrial Neoplasms; Endometrium; Female; Granuloma; Humans; Hysterectomy; Keratins; Peritoneal Diseases; Peritoneum; Salpingo-oophorectomy

The present study aimed to describe and characterize the cellular components during the evolution of chronic granulomatous inflammation in the teleost fish pacus (P. mesopotamicus) induced by Bacillus Calmette-Guerin (BCG), using S-100, iNOS and cytokeratin antibodies. 50 fish (120±5.0 g) were anesthetized and 45 inoculated with 20 μL (40 mg/mL) (2.0 x 10(6) CFU/mg) and five inoculated with saline (0,65%) into muscle tissue in the laterodorsal region. To evaluate the inflammatory process, nine fish inoculated with BCG and one control were sampled in five periods: 3rd, 7th, 14th, 21st and 33rd days post-inoculation (DPI). Immunohistochemical examination showed that the marking with anti-S-100 protein and anti-iNOS antibodies was weak, with a diffuse pattern, between the third and seventh DPI. From the 14th to the 33rd day, the marking became stronger and marked the cytoplasm of the macrophages. Positivity for cytokeratin was initially observed in the 14th DPI, and the stronger immunostaining in the 33rd day, period in which the epithelioid cells were more evident and the granuloma was fully formed. Also after the 14th day, a certain degree of cellular organization was observed, due to the arrangement of the macrophages around the inoculated material, with little evidence of edema. The arrangement of the macrophages around the inoculum, the fibroblasts, the lymphocytes and, in most cases, the presence of melanomacrophages formed the granuloma and kept the inoculum isolated in the 33rd DPI. The present study suggested that the granulomatous experimental model using teleost fish P. mesopotamicus presented a similar response to those observed in mammals, confirming its importance for studies of chronic inflammatory reaction.

Topics: Animals; Disease Models, Animal; Fishes; Granuloma; Keratins; Muscles; Mycobacterium bovis; Nitric Oxide Synthase Type II; S100 Proteins

Topics: Carcinoma, Endometrioid; Cytodiagnosis; Female; Granuloma; Humans; Hysterectomy, Vaginal; Keratins; Middle Aged; Uterine Hemorrhage

Mycobacterium kansasii disease was diagnosed in an 85-year-old woman admitted to the hospital for cough and gradually worsening breathlessness. Transbronchial biopsy indicated either non-necrotizing granulomata or bronchiolitis obliterans organizing pneumonia (BOOP). She was cured with combined therapy of specific anti-mycobacterial medications and systemic steroids. To our knowledge, this is the first report of M. kansasii non-tuberculous mycobacterium disease with a BOOP-like pattern on lung biopsy.

Topics: Aged, 80 and over; Bronchi; Cryptogenic Organizing Pneumonia; Female; Granuloma; Humans; Immunohistochemistry; Keratins; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Pleural Effusion; Tomography, X-Ray Computed

We present a 69-year-old woman with a chief complaint of postmenopausal bleeding. She was diagnosed as having an endometrioid adenocarcinoma by biopsy, and underwent a total abdominal hysterectomy. At the time of surgery, granulation tissue-like nodules were found on the peritoneal serosa of the uterus. In the intraoperative cytology of peritoneal washing, atypical cells were noted. The intraoperative frozen section of the peritoneal nodule revealed granulation tissue with proliferating mesothelial cells. Microscopic examination of the permanent section showed keratin granulomas without viable adenocarcinoma cells on the serosal surface of the ovaries, fallopian tubes and broad ligaments. Postoperative chemotherapy was administered. She has been alive with no evidence of recurrence for 6 months postoperatively. It should be noted that the prognosis of cases in peritoneal keratin granuloma without viable cancer cells is favorable, and that the histological examination is essential for its diagnosis.

Topics: Aged; Antineoplastic Agents; Carcinoma, Endometrioid; Chemotherapy, Adjuvant; Endometrial Neoplasms; Female; Granuloma; Humans; Hysterectomy; Immunohistochemistry; Keratins; Peritoneal Diseases

Hair cortex comedo was described originally in an article detailing 2 cases of a comedo-like clinical lesion that was histologically a keratinous plug with cornification similar to the cortex of the hair shaft. We have collected retro- and prospectively a series of 34 cases of hair cortex comedo. In our series, there was a slight female predominance (Male:Female of 1:1.4), and the mean patient age was 28.8 years. All lesions were solitary, distributed mainly on the head and neck or trunk, and were described clinically as a blue subcutaneous papule or nodule with "cyst" as the most common clinical differential diagnosis. Histologic examination showed a solitary, vertically oriented, uniformly sized oval nodule of compact laminated corneocytes sitting in a patulous invagination lined by epithelium similar to the infundibulum, isthmus, or combinations of them; rarely matrical epithelium was identified. Entrapped melanin (30/34 cases), shadow cells (16/34 cases), and calcification (12/34 cases) were identified commonly. Remnants of a surrounding follicle were noted in 15 cases, with infundibular epithelium in 9 of the cases, isthmic epithelium in 3, and matrical or supramatrical epithelium (or both) in 3. There was an associated dense granulomatous infiltrate in the majority of the cases (25/34). Although hair cortex comedo was thought originally to be a variant of dilated pore of Winer, we believe that these distinctive lesions, which are characterized histopathologically by a uniformly sized vertically oriented dermal plug of laminated corneocytes with entrapped melanin and surrounding granulomatous inflammation, are likely derived from matrical or supramatrical cells (or both).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcinosis; Child; Child, Preschool; Diagnosis, Differential; Epithelial Cells; Female; Granuloma; Hair Diseases; Hair Follicle; Humans; Keratins; Male; Melanins; Middle Aged; Missouri; Predictive Value of Tests; Prospective Studies; Retrospective Studies; Young Adult

Topics: Aged, 80 and over; Antibodies, Monoclonal; Carcinoma, Squamous Cell; Diagnosis, Differential; Granuloma; Humans; Keratins; Male; Mucin-1; Skin Neoplasms

We present a 65-year-old man with a giant epidermal cyst extending from sole to dorsum of the foot by penetrating the interosseous muscles. This epidermal cyst extending from the sole to the dorsum of the foot was big and an extremely rare lesion.

Topics: Aged; Epidermal Cyst; Foot Diseases; Granuloma; Humans; Keratins; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Skin

We discuss here five cases of epithelioid sarcoma (ES) with final diagnosis established after reexamination of initial findings. Problems with differential diagnosis of these neoplasms arise since their microscopic picture may simulate several other pathological conditions such as non-neoplastic granulomatous reactions, squamous cell carcinomas and adenocarcinomas, melanomas and soft tissue sarcomas with epithelioid component. Final ES diagnosis requires presence of cytokeratin, EMA and vimentin in neoplastic cells, as confirmed by immunohistochemical reactions. Differential diagnosis is also helped by concurrent cytology assessment that allows recognizing more easily such characteristic features as presence of plasmacytoid or spindle-shaped cells.

Topics: Adenocarcinoma; Adult; Aged; Antigens, CD34; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Granuloma; Humans; Immunohistochemistry; Keratins; Male; Melanoma; Middle Aged; Mucin-1; S100 Proteins; Sarcoma; Soft Tissue Neoplasms; Vimentin

Topics: Diagnosis, Differential; Female; Granuloma; Humans; Keratins; Magnetic Resonance Imaging; Middle Aged; Vaginal Diseases; Vaginal Neoplasms

There has been no report on useful immunohistological markers for epithelioid sarcoma (ES) so far. The purpose of this study is to evaluate the positivity and specificity of CA125 as a marker for the correct diagnosis of ES.. This study was performed in 11 patients with ES (nine men and two women; distal type: 10 cases; proximal type: one case), 78 patients with other soft tissue tumors and nine with benign granulomas. The other soft tissue tumors consisted of six synovial sarcomas, six clear cell sarcomas, eight leiomyosarcomas, six rhabdomyosarcomas, five malignant peripheral nerve sheath tumors, ten malignant fibrous histiocytomas, 17 desmoid tumors, 14 liposarcomas, six squamous cell carcinomas (cutaneous SCC of the distal extremities), two rheumatoid nodules and seven foreign body granulomas. Immunohistochemical analysis for CA125 was performed for these 89 soft tissue tumors and nine granulomas using a labeled streptavidin biotin method. Immunohistochemical analysis of epithelial membrane antigen, cytokeratin, carcinoembrionic antigen, vimentin and CD34 was performed only for the 11 ES patients.. CA125 was strongly expressed in 10 out of the 11 ES patients. EMA, cytokeratin and vimentin were also positive in all the cases. CEA was positive in two of the 11 patients. Immunohistochemical study in six ES patients showed expression of CD 34. The other 78 soft tissue tumors and nine granulomas did not express CA125.. This study clearly revealed the specificity and positivity of CA125 in ES. These data indicate that CA125 may be a useful tumor marker for diagnosing ES.

Topics: Adolescent; Adult; Antibodies, Monoclonal; Antigens, CD34; Biomarkers, Tumor; CA-125 Antigen; Carcinoembryonic Antigen; Carcinoma, Squamous Cell; Female; Granuloma; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Mucin-1; Rhabdomyosarcoma; Sarcoma; Sarcoma, Clear Cell; Sarcoma, Synovial; Sensitivity and Specificity; Soft Tissue Neoplasms

Inappropriate treatment at early stage of wound could result in the formation of pseudoepitheliomatous granuloma (PEG). The correlation of abnormal transdifferentiation of epithelial cells to immunologic cells and the occurrence of PEG lesion was investigated.. Morphological change of epithelial tissue was observed with histopathology in 11 specimens of PEG lesions and 6 specimens of normal skins from PEG edge (PEG-N) from 11 patients with damaged skin. The expression characteristics and distribution of pan-cytokeratin (CKp), IV type collagen, laminin (LM), epithelial cadherin (E-Cad), beta-catenin (beta-Cat), focal adhesion kinase (FAK), stem cell factor (SCF) and its receptor-c-Kit, proliferating cell nuclear antigen(PCNA), and cluster of differentiation-14 (CD14), CD68 and mast cell tryptase (MCT) in PEG were detected with the immunohistochemical and the indirect immunofluorescent double-staining.. In comparison with PEG-N, epithelial tissue take on squamous metaplasia, and stroma was infiltrated with intensive microvessels and inflammatory cells in the PEG lesion. Poor epithelial basal layer constitution, basal polarization, and migration of basal cells to stroma could be observed. In the ultrastructure, the loose intercellular junction of basal cells and the increased nucleus/cytoplasm ratio and intercellular space could be observed, neonatal monocytoid cells and macrophages and mast cells as a exuviate-like manner brooded from cytoplasm of original epithelial cells and basement membrane. protein expression of CKp and E-Cad by basal cells was significantly decreased, and the IV type collagen and LM protein could not be found in basement membrane of identical locus. By contrast, the immunoreactivity of beta-Cat and FAK was apparently increased. In addition, CD14(+) monocytes, CD68(+) macrophages, MCT(+) mast cells and CD68(+)/MCT(+) cells with various size, and these cells of stronger immuno-staining of SCF, c-Kit and PCNA antigen could be found in epithelial tissue and stroma.. Epithelial cells in PEG related to wound are characteristized by transdifferentiation of epithelial cells to immunologic cells, wich may be associated with local infectious and inflammatory reaction, ultimately resulting in enhancement the ratio of beta-Cat/E-Cad signal and activation SCF-c-Kit signal pathway. The phenomena of transdifferentiation epithelial cells in the PEG lesion will help to recognize of the neoplatic immune and trauma repair mechanism.

Topics: Adolescent; Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; beta Catenin; Burns; Cadherins; Cell Differentiation; Child; Child, Preschool; Collagen Type IV; Cytoskeletal Proteins; Epithelial Cells; Female; Fluorescent Antibody Technique, Indirect; Focal Adhesion Kinase 1; Focal Adhesion Protein-Tyrosine Kinases; Granuloma; Humans; Immunohistochemistry; Infant; Keratins; Laminin; Lipopolysaccharide Receptors; Male; Middle Aged; Protein-Tyrosine Kinases; Proto-Oncogene Proteins c-kit; Serine Endopeptidases; Skin; Stem Cell Factor; Trans-Activators; Tryptases

Topics: Aged; Biopsy, Fine-Needle; Bronchiectasis; Carcinoma; Carcinoma, Basal Cell; Diagnosis, Differential; Female; Giant Cells; Granuloma; Humans; Immunohistochemistry; Keratins; Lymph Nodes; Lymphatic Metastasis; Nasopharyngeal Neoplasms; Neoplasms, Multiple Primary; Skin Neoplasms

Topics: Adolescent; Antibodies, Monoclonal; Brain; Brain Neoplasms; Germinoma; Granuloma; Humans; Immunohistochemistry; Keratins; Magnetic Resonance Imaging; Male; Mucin-1

From a series of 100 consecutive breast carcinomas with axillary lymph node metastases, two cases of necrotic granulomas in the nodes are presented. Lymph nodes in each case were characterized by areas of necrosis surrounded by a palisade of cells resembling histiocytes as seen in a rheumatoid nodule. Although the initial impression was that of a reactive granuloma, when immunostained for keratin and EMA, the areas of necrosis showed positive staining for keratin and EMA in a cytoplasmic pattern. The surrounding palisade of cells stained with histiocyte markers, while the necrotic area itself was negative. Staining for both estrogen and progesterone markers was also negative. Staining of nine lymph nodes with caseating granulomas not associated with carcinoma with the same panel of antibodies revealed no staining except for irregular, noncellular staining with EMA. This pattern of necrosis in axillary lymph nodes from two cases of breast carcinoma was interpreted as evidence of necrotic metastatic tumor cells. Necrosis in axillary lymph nodes associated with invasive breast cancer should arouse suspicion for metastasis.

Topics: Axilla; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Lobular; Diagnosis, Differential; Female; Granuloma; Histiocytes; Humans; Immunoenzyme Techniques; Keratins; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Mucin-1; Necrosis

We report two cases of small pleural nodules showing the distinctive histologic appearance of adenomatoid tumor. Both lesions were discovered incidentally during surgery in patients undergoing lung resection for unrelated intrapulmonary masses: lung carcinoma in one case and histoplasmosis in the other. The tumors were composed of a focal proliferation of epithelioid cells forming vacuoles and tubular spaces in a fibrous stroma, as seen in adenomatoid tumors from other sites. The differential diagnosis in both cases included metastatic signet ring cell carcinoma. The mesothelial nature of the lesions was supported by immunohistochemical and ultrastructural evidence. The tumor cells in both cases were positive for cytokeratin but negative for carcinoembryonic antigen and LeuM1. One case was also negative for BER-EP4, B72.3, CD34, and Factor VIII. Electron microscopy in this case demonstrated well-developed basal laminae, desmosomes, and numerous slender microvilli along the luminal surfaces of the tumor cells. Adenomatoid tumors are regarded as a benign variant of mesothelioma. Despite the abundance of mesothelial cells in the pleura, adenomatoid tumors are apparently extremely rare in this location. Separation from malignant lesions such as adenocarcinoma and epithelioid hemangioendothelioma is important.

Topics: Adenomatoid Tumor; Aged; Basement Membrane; Breast Neoplasms; Carcinoma, Ductal, Breast; Cell Nucleus; Cytoplasm; Desmosomes; Female; Granuloma; Humans; Immunohistochemistry; Keratins; Lung Diseases; Microscopy, Electron; Microvilli; Middle Aged; Neoplasms, Second Primary; Pleural Neoplasms

Granulomatous interstitial nephritis is a rare condition whose pathogenesis is poorly understood. Of 203 renal biopsies performed between 1974 to 1994 in which interstitial nephritis was the predominant change, granulomata occurred in 12. The authors reviewed the records of these patients and performed immunopathologic and immunohistochemical studies in their biopsies to characterize the phenotype of infiltrating cells. The authors used markers for T cells, B cells, and macrophages, and determined whether they were activated through assessment of upregulation of HLA-DR molecules. Additionally, the authors attempted to delineate whether or not tubules contributed to giant cell formation through assessment of intermediate filament for keratins and macrophage markers in epithelioid cells. Drug (aspirin, gentamycin, or combination of drugs), infection (Echerichia coli or various organisms), and sarcoidosis accounted for granulomatous inflammation in three patients each, Wegener's granulomatosis and oxalosis resulting from intestinal bypass in one patient each, and in one patient the possible cause could not be determined. Except for biopsies of granulomatous inflammation resulting from infection, in which neutrophils predominated, in all other biopsies, T cells and macrophages made up most of the inflammatory cell infiltrate. HLA-DR was upregulated in mononuclear cells infiltrating the interstitium and was expressed in proximal tubular cells and endothelial cells in all but biopsies of patients with sarcoidosis. In no instance was there evidence that tubules contributed epithelial cells to giant cell formation. These findings are consistent with the notion that granulomatous interstitial nephritis is a cell-mediated form of tissue injury in which T cell-macrophage seem to play a major role.

Topics: Adult; Aged; Female; Granuloma; Granuloma, Giant Cell; HLA-DR Antigens; Humans; Immunophenotyping; Keratins; Lymphocyte Activation; Male; Middle Aged; Nephritis, Interstitial

In this study 27 transbronchial biopsy specimens obtained from patients with clinical and/or laboratory features suggestive for sarcoidosis were analysed with conventional morphology and immunohistochemistry comparing the sensitivity and reproducibility of the two methods. A limited panel of monoclonal antibodies recognizing epitopes resistant to conventional fixation and embedment procedures were used (CD45R0, CD68, anti-cheratin, anti-collagen IV). All specimens were independently observed by two different pathologists. On the basis of the recognition of bona-fide noncaseating granulomas, 9 cases were uniformly judged as positive, 10 cases as negative, but 8 cases were considered doubtful. Immunohistochemical analysis reliably demonstrated the presence of epithelioid cells in 3 of these cases and absence in 5. These data suggest that the use of a limited immunohistochemical analysis can significantly improve histological diagnosis of sarcoidosis on small transbronchial biopsies using conventional routine material.

Topics: Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biopsy; Collagen; Granuloma; Humans; Immunohistochemistry; Keratins; Leukocyte Common Antigens; Lung; Lung Diseases; Reproducibility of Results; Sarcoidosis, Pulmonary; Sensitivity and Specificity

Nasopharyngeal carcinoma (NPC) can provoke a local granulomatous reaction which may cause diagnostic difficulty. To further elucidate this possible diagnostic pitfall, 47 cases who were initially diagnosed as tuberculosis or granulomatous inflammation were reexamined; 7 cases (15%) were found to have NPC. In a routine histological stain, residual malignant tumor cells could be identified in 2 cases. In the remaining 5 cases, malignant tumor cells could only be accurately identified after careful examination. Immunohistochemical staining for keratin easily demonstrated the residual tumor cells engulfed in a granulomatous lesion in all 7 cases. This finding suggests that an immunohistochemical stain for keratin is useful and should be performed for any nasopharyngeal biopsy showing granulomatous lesion with suspicion of malignancy, particularly in countries where NPC is prevalent. The overall 5-year survival rate among these NPC patients was 83%, a most favorable outcome, which suggests that a granulomatous reaction may reflect a favorable local host, and a cell-mediated immune response.

Topics: Adult; Carcinoma; Female; Follow-Up Studies; Granuloma; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Nasopharyngeal Neoplasms; Prognosis

The immunohistological characteristics of retraction pockets, cholesteatoma matrix and granulomatous tissue were compared in 14 samples from pediatric cholesteatoma. The junction between epidermis and the middle ear mucosa appeared as the most inflammatory area, displaying the characteristics of delayed type hypersensitivity. CD1 + Langerhans cells were observed in all epidermic areas, but expressed class II molecules only in the vicinity of polymorphonuclear infiltrates. Numerous mast cells and IgA producing cells were also observed, suggesting that defenses from the mucosal immune system are summoned and contribute to the pathogenesis of cholesteatoma.

Topics: Adolescent; Antigen-Presenting Cells; Child; Child, Preschool; Cholesteatoma; Ear, Middle; Female; Fluorescent Antibody Technique; Granuloma; Humans; Immunoglobulins; Keratins; Langerhans Cells; Male; Otitis Media; T-Lymphocyte Subsets

Twenty-two cases of keratin granulomas of the peritoneum associated with endometrioid adenocarcinoma with squamous differentiation of the endometrium, the ovary, or both, and with an atypical polypoid adenomyoma of the endometrium were reviewed. Follow-up data were available in 18 cases. Twelve patients were well and disease free 13 months to 15.2 years postoperatively; one patient died of unrelated disease 21 years postoperatively; three patients were tumor free with a short duration of follow-up; one patient, who had a stage Ic ovarian tumor, died of pulmonary embolism during the treatment of recurrent tumor 1 year after operation; and a final patient, who had been followed for 3 months after operation for stage IV disease, was alive with residual tumor. At least six patients with stage I carcinomas were treated with postoperative irradiation because the granulomas had raised a suspicion of advanced disease. Follow-up data on the patients in this series suggest that peritoneal keratin granulomas have no prognostic significance and should be distinguished from viable tumor implants on microscopic examination.

Topics: Adenocarcinoma; Adult; Aged; Endometriosis; Female; Follow-Up Studies; Granuloma; Humans; Keratins; Middle Aged; Neoplasms, Multiple Primary; Ovarian Neoplasms; Peritoneal Diseases; Uterine Neoplasms

Topics: Adenocarcinoma; Douglas' Pouch; Female; Granuloma; Humans; Keratins; Middle Aged; Peritoneal Diseases; Uterine Neoplasms

An extremely rare solitary mast cell tumor of the lung was studied histologically, immunohistochemically, and ultrastructurally. The histologic features of the tumor included nodular growth of well-differentiated mast cells and clear cells with no granules. The current case is the third case of a solitary mast cell tumor (granuloma) of the lung in the literature. Clinicopathologic features of this tumor are compared with the other two cases reported previously in the international literature, and the nature of the clear cells is discussed.

Topics: alpha 1-Antitrypsin; Antigens, Neoplasm; Apoproteins; Diagnosis, Differential; Granuloma; Humans; Keratins; Lung Neoplasms; Male; Mast Cells; Mast-Cell Sarcoma; Membrane Glycoproteins; Middle Aged; Mucin-1; Muramidase; Neoplasm Proteins; Pulmonary Surfactant-Associated Proteins; Pulmonary Surfactants

Sixty odontogenic keratocysts were clinically, radiographically, and histologically examined to determine whether any significant relationships existed between the radiographic appearance of the odontogenic keratocyst (unilocular versus multilocular) and its corresponding clinical and histologic features. The odontogenic keratocysts identified as multilocular appeared to be larger, contain a more severe inflammation, and exhibit the presence of cholesterol granulomas more often than those identified as unilocular.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cholesterol; Female; Granuloma; Humans; Jaw Diseases; Keratins; Male; Middle Aged; Odontogenic Cysts; Radiography

The L1 antigen is a major cytosol component of human granulocytes that may also be expressed by macrophages and epithelial cells. Its epidermal and dermal occurrence was investigated in formalin-fixed routine biopsy material from eleven different inflammatory skin disorders. Localization was performed with a rabbit antiserum to L1 applied in an unlabeled antibody peroxidase-antiperoxidase method. L1 antigen was not found in normal skin except in epithelial cells of pilosebaceous units. However, epidermal L1 antigen was demonstrated in every biopsy specimen from lupus erythematosus, lichen planus, dermatitis herpetiformis, and atopic dermatitis, whereas granuloma annulare test results were usually negative. The occurrence of dermal L1 antigen depended on the composition of the inflammatory infiltrate; specimens rich in neutrophilic granulocytes (e.g., dermatitis herpetiformis) were particularly strongly stained. Extracellular dermal staining was also seen, especially in areas adjacent to accumulation of positive leukocytes. The varying epidermal occurrence of L1 antigen in skin diseases probably signified different degrees of proliferative activity of the epithelial cells and could apparently not be ascribed to uptake from the dermis.

Topics: Adolescent; Antigens, Surface; Child; Child, Preschool; Dermatitis; Epidermis; Epithelium; Granuloma; Histocompatibility Antigens Class II; HLA-DR Antigens; Humans; Infant; Keratins; Leukocyte L1 Antigen Complex; Skin

Epithelioid sarcoma (ES) occasionally may be confused, both clinically and histologically, with isolated necrobiotic granulomas (ING), leading to misdiagnosis and potential mismanagement of these conditions. We studied 11 cases of ES and 11 of ING (6 examples of deep granuloma annulare and 5 of rheumatoid nodule) immunohistochemically, in an attempt to determine whether they could be diagnostically separated by such means. Monoclonal antibodies to cytokeratin polypeptides (CK), epithelial membrane antigen (EMA), and leukocyte common antigen (LCA) were applied to formalin-fixed, paraffin-embedded sections in each case, using the avidin-biotin-peroxidase complex technique. All ES cases stained positively for CK, and 6 expressed EMA, while examples of ING were non-reactive for these antigens. Conversely, the large epithelioid histiocytic cells in cases of ING were immunoreactive with anti-LCA, whereas no case of ES displayed this determinant in tumor cells. In the latter lesions, reactive peritumoral inflammatory cells were LCA-positive, but were readily distinguished from neoplastic cells on morphological grounds, as well as by their negativity with anti-CK and anti-EMA. Based on these data, it is concluded that immunohistologic stains for epithelial and hematopoietic antigens are valuable in the conclusive diagnostic separation of epithelioid sarcoma and necrobiotic granulomas.

Topics: Adolescent; Adult; Aged; Antigens, Surface; Child; Child, Preschool; Diagnosis, Differential; Epithelium; Female; Granuloma; Histocompatibility Antigens; Humans; Immunoenzyme Techniques; Keratins; Leukocyte Common Antigens; Male; Middle Aged; Sarcoma; Skin Diseases; Skin Neoplasms

Large cholesterol cysts were found in revision surgery in six patients with previous ear surgery one to 28 years ago. The cysts mimicked brain herniation in open cavities, filled the mastoid and ear canal in closed cavities, or caused postauricular swelling. Bone around the cysts was soft and granulomatous. Secretory cells were scarce in the epithelial lining of the lumen, but subepithelial glands were frequent. Cholesterol granulomas and hemosiderin-laden macrophages were present inside the wall. The cyst lining and the glands under it showed cytokeratin staining typical for simple and glandular epithelia. Antiprekeratin antibodies showed no decoration of the lining but reacted positively with the meatal skin. These findings prove that respiratory-type epithelium separated from an aerated middle ear does not undergo changes into keratin-forming epithelium.

Topics: Adult; Aged; Bone Cysts; Cholesterol; Epithelium; Female; Granuloma; Hemosiderin; Humans; Keratins; Macrophages; Male; Mastoid; Middle Aged

Sixty consecutive cases of dermis-fat grafts for anophthalmic socket reconstruction were reviewed to examine the frequency, severity, and management of postoperative complications. In seven patients, the conjunctiva failed to resurface the graft and central ulceration developed. Ten cases resulted in enophthalmos. Two patients developed keratinized sockets with chronic discharge and desquamation. Three patients required excision of conjunctival granulomas. One patient developed a primary graft infection. A donor site hematoma occurred in one patient. Secondary surgical intervention was required in ten patients. Nine complications in eight patients were managed in the office; five complications in four patients were observed and subsequently resolved without surgical intervention. Most complications occurred in patients with severely traumatized sockets who had undergone extensive earlier ocular surgery, or who had a systemic disease contributing to defective wound healing.

Topics: Adipose Tissue; Adult; Aged; Anophthalmos; Child; Conjunctiva; Conjunctival Diseases; Eye Diseases; Granuloma; Hematoma; Humans; Infant; Keratins; Middle Aged; Postoperative Complications; Skin Transplantation; Surgery, Plastic; Surgical Wound Infection; Ulcer

The pathogenesis of granulation tissue that arises periodically around artificial Eustachian tubes was elucidated by histologic examination of 15 cases of tube granuloma. All cases showed the presence of a keratin foreign-body granuloma. The implanted squames incited a foreign-body type of granulomatous reaction and produced a friable vascular exuberant mass that surrounded the artificial Eustachian tube. Histologically, the tube granuloma was characterized by the presence of irregular ovoid slit-like spaces that contained keratin squames, and it was surrounded by foreign-body giant cells.

Topics: Adult; Aged; Child; Child, Preschool; Eustachian Tube; Female; Foreign Bodies; Granuloma; Humans; Keratins; Male; Prostheses and Implants

Four cases of well-differentiated adenocarcinoma with squamous metaplasia (so-called adenocanthoma) of the uterus were associated with granulomatous inflammation of the pelvic peritoneum. The inflammation was the result of a foreign-body response to keratin that desquamated from the surface of the tumor and was carried to the peritoneal cavity through the lumen of the Fallopian tubes. The absence of viable neoplastic cells and favorable follow-up examinations in these patients indicate that the presence of peritoneal keratin granulomas in association with endometrial adenoacanthoma should not be regarded as an indicator of metastatic spread.

Topics: Adenocarcinoma; Aged; Female; Granuloma; Humans; Keratins; Middle Aged; Peritoneal Diseases; Uterine Neoplasms

Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Granuloma; Head and Neck Neoplasms; Humans; Keratins; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Skin Neoplasms

Topics: Administration, Topical; Anti-Inflammatory Agents; Colistin; Ear Canal; Ear Diseases; Ear Neoplasms; Granuloma; Hydrocortisone; Keratins; Neomycin; Otitis Externa; Polyps; Quaternary Ammonium Compounds

Topics: Gingivectomy; Gingivoplasty; Granuloma; Humans; Keratins; Periodontitis; Postoperative Complications; Recurrence; Subgingival Curettage; Suppuration; Surgical Wound Infection; Tooth Mobility; Wound Healing

Topics: Adult; Breast Neoplasms; Diagnosis, Differential; Female; Granuloma; Humans; Keratins; Male; Mastitis; Metaplasia; Pregnancy

Topics: Adult; Aged; Carcinoma, Squamous Cell; Esophageal Neoplasms; Female; Granuloma; Humans; Keratins; Laryngeal Neoplasms; Male; Middle Aged; Mouth Neoplasms; Radium; Skin Diseases; Urinary Bladder Neoplasms; Uterine Cervical Neoplasms

Topics: Dermoid Cyst; Female; Granuloma; Humans; Keratins; Laparoscopy; Medical Records; Neoplasms; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Peritoneum; Teratoma