Jornal de Citologia e Histologia

Objective: The objective of this study was to investigate the possibility of an objective index to evaluate the grades of endometrial endometrioid carcinomas by analyzing the spectral values of ultraviolet(UV) and visible(Vis) transmittances, and the degree of UV- absorbing materials influencing nuclear colors using ultraviolet- visible-light microscopic spectroscopy (UV-Vis MS).
Study design: The materials were histological preparations from 4 patients, each with proliferative-phase endometrium (PPE) and grade 1(G1) and grade 3 (G3) of endometrial endometrioid carcinomas. Both spectra were measured in the same 50 nuclei of each specimen.
Results: 1) In the ultraviolet spectrum, transmittance of 260, 280, 300, and 320 nm were decreased in G3 compared to those in G1. All of the ultraviolet absorbing materials increased in G3. 2) In the visible spectrum, 520 nm (purplish red), 540 nm (purple), and 560 nm (violet) in G3 were deeper than all colors in G1, and violet in G3 was lighter than purplish red and purple in G1. 3) The following 3 characteristics were clarified with regard to the relationship between UV-absorbing materials and the violet color based group. 1) In G3, the number of the significant canonical correlation coefficient between ultraviolet light-absorbing materials and the violet color based group was only at one. 2) Purplish red and purple of the nuclei in G3 was strongly influenced by ultraviolet lightabsorbing materials (260-320 nm). 3) Purple and violet in G1 was strongly influenced by light-absorbing materials at 300 nm and 320 nm.
Conclusion: It was indicated that UV-Vis MS analysis could be an objective index to evaluate the grade of endometrial endometrioid cancerby analyzing the spectral values of transmittances of ultraviolet and visible light, and the degree of ultraviolet light- absorbing materials influencing nuclear colors in the same nuclear region.

Background and study aims: Early gastric cancers show gastric and/or intestinal phenotypes with specific mucin production profiles, and the phenotypes can vary with tumor progression. The aim of this study was to evaluate the correlation between tumor invasion patterns and phenotypes in the mucosa and submucosa of early gastric cancers.
Methods: Phenotypic expressions of 44 endoscopically resected gastric cancers with submucosal invasion were evaluated immunohistochemically using MUC5AC and MUC6 as gastric and MUC2 and CD10 as intestinal phenotypic markers.
Results: Cancers were classified into two patterns by invasion pattern: 19 collapsing pattern (C-pattern) tumors had cancer cells that invaded to the submucosa with expansive destruction of the muscularis mucosae, while 25 passing-through pattern (P-pattern) tumors formed focal cancer cell aggregations in the submucosa without massive destruction of the muscularis mucosae. Cancers with C-pattern invasion were likely to show similar phenotypes between the mucosa and submucosa, while phenotypes of cancers with P-pattern invasion were likely to differ between the two layers (rate of the same phenotypes: C-pattern 68% vs. P-pattern 28%, p = 0.008). Of 22 cancers with P-pattern invasion that included the intestinal phenotype component in the mucosa, 13 (59%) expressed the gastric phenotype alone in the submucosa.
Conclusions: Phenotype presentation in the mucosa and submucosa differ by the invasion pattern in early gastric cancer. Tumors with P-pattern invasion are likely to express the gastric phenotype in the submucosa, regardless of phenotype in the mucosa, suggesting that such cancers might achieve submucosal invasion prior to intestinalization occurring in the mucosa.

Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose (18F-FDG-PET) has an important role in the management of lymphoma, but it is important to keep in mind that not only lymphoma but also a number of other pathologic and non-pathologic processes can cause increased tissue FDG uptake. Our case is a rare example when a uterine fibroid caused differential diagnostic problem.

Thyroid gland is a very rare location of non-epithelial tumors (less than 1% of all thyroid tumors) and particularly schwannomas. Only 19 cases have been published in English literature until today. Approximately 25% of schwannomas occur in the head and neck region, most of them in relation to peripheral nerves and to cervical sympathetic chain. We present a case with clinical and sonographic features of a benign thyroid nodule. The diagnosis of schwannoma was established after definitive histopathologic evaluation. With this article we intend to review clinical, radiological and pathological changes associated with this tumor, emphasizing the difficulty in making a preoperative diagnosis.

Researches in the field of cellular and molecular mechanisms of cell variability, based on phenotypic interactions, remain one of the most central and promising problems in modern biology. The current paper proposes a possible model for studying "variability windows" and cell phenotype reprogramming using different somatic cell types (epithelial and mesenchymal cells) as well as different cell culture systems - 2D monolayer, 3D single spheroids and microtissues accompanied with up-to-date live time-lapse microscopy analysis.

For centuries, histology has maintained its remarkable place in the medical curriculum. However, its teaching has been influenced by the new technological advancement that has reshaped medicine teaching into a more modern student-friendly form. Since its inception in the 18th century, the discipline of histology has progressed hand in hand with the advancements in microscopy and microscopic technologies, including immunohistochemistry. In the traditional curriculum of USA medical schools, especially after the first Flexner’s report of 1910, histology was considered as very essential topic for a physician studying the “Art and Science” of medicine. In this era, the teaching relied more on the light microscope and to some extent on the electron microscope. However, the field nowadays, after the second Flexner’s report, which stressed the importance of integrating clinical topics in the curriculum, is shifting towards the use of more electronic resources for teaching. Such new resources rely on information technology and electronic imaging modalities which are considered to be more student-friendly, time efficient, consistent in conveying the images, promote self-learning and are less costly. In fact, in the last 25 years, most universities started relying on virtual microscopy with limited use of the light microscopy by the students. Such an approach facilitated curricular integration of histology into histopathology and provided the opportunity to promote self-learning and clinical relevance. In the era of competency-based curriculum, histology remains an essential and indispensable basic science in the integrated modules

Introduction: Thyroid gland is one of the most important endocrine organs and almost all cells of the body are target sites for its hormones. Electromagnetic field became progressively more common constituent of the general and workplace environments.
Aim of work: To evaluate the effect of low frequency electromagnetic fields (LF-EMF) on the structure and function of the thyroid gland and to evaluate their reversibility and role of vitamin E.
Materials and Methods: Forty five adult male albino rats were equally divided into four groups; group I (control group), group II: rats were exposed to 50 Hz EMF for 1 month, group III: rats were received vitamin E just before EMF exposure for the same period and group IV (recovery group). At the time of sacrifice, blood samples were collected to estimate TSH, T3 and T4 levels. Thyroid gland specimens were processed for microscopic examination. The heights of follicular epithelium, collagen fiber area % were morphometrically estimated and statistically analyzed.
Results: Exposed group showed significant decline T3 and T4 levels together with significant increase in TSH level as compared to other groups. Histologically, this group showed congestion and dilatation of blood capillaries, cellular infiltration, follicular disintegration and vacuolar degeneration of some follicular cells. Other apoptotic follicular cells appeared with condensed chromatin or desquamated. The epithelial height and connective tissue area also affected. Vitamin E improves the biochemical and histological picture of thyroid gland (group III). Recovery group (IV) had variable alteration as compared to other groups.
Conclusion: LF-EMF has very serious effect on thyroid gland and vitamin E could have a protective role against this tissue damage.

Background: This study investigates the effect of Atmospheric Pressure Plasma Jet (APPJ) on cytogenetic instability and transcription of genes associated with propagation of chronic myelogenous leukemia (CML).
Material and methods: Blood samples were collected from six patients with CML and compared with control group. The first three cases were in accelerated phase (AP-CML) resistant to imatinib and nilotinib drugs. The others partially responded and returned to chronic phase (CP-CML). Triple blood cultures for each case were exposed to single dose of plasma, with treatment times of 40, 80, and 120 sec. Mitotic phases, indices and abnormalities, as well transcription levels of P53, caspase-3 and BcL-2 genes were detected before and after plasma jet exposure.
Results and conclusion: The data showed that the exposure to APPJ caused remission of the mitotic indices and give a significant increase in the arresting of chromosome instabilities by induction of different mitotic checkpoints and express of sticky and condensed chromosomes which ended by apoptosis and necrosis processes. Additionally, the same events detected for the transcriptional levels of P53, caspase-3 and Bcl-2 genes.

In this investigation, testes of 20 donkeys ranging from birth to maturity were studied. The postnatal morphologic and morphometric characteristics of donkey’s seminiferous epithelium during the postnatal period were studied. The volume percentage of the tubular compartment (Seminiferous tubules) was about 12.76% in neonates, progressively increased with postnatal age, reaching about 78.42% of the testicular parenchyma in mature donkeys. The seminiferous tubules measured about 205 μm in diameter, and their lining epithelium was about 73.7 μm in height in mature animals. The supporting (Sertoli) and germ cells (gonocytes) were the main components of the seminiferous cord or (tubules). The supporting type gradually decreased in number from neonates through suckling to the premature and mature stages, while they started to acquire the morphological characteristics of mature cells in late suckling period. The gonocytes maintained the same morphological characteristics during the neonatal and suckling periods; however, they showed a slight increase in number during the latter stage. In addition, dividing germ cells were frequently observed. The germ cells were mostly demonstrated in a central position within the testicular cords of neonatal donkeys. In suckling animals, some gonocytes started to contact the basement membrane, whereas in late suckling period, most of germ cells in contact with basement membrane. In premature donkeys, the gonocytes arranged in 2-3 layers between the supporting cells. In addition, the lumination of the seminiferous cords occurred in 1.5 year. The germ cells could be distinguished to spermatogonia, and primary, as well as secondary spermatocytes. Spermatids, at different stages of transformation, were also detected within some seminiferous tubules. In adults, the semniferous cords became more coiled and were totally luminated. All kinds of germ cells could be observed within the seminiferous epithelium, representing the complete seminiferous cycle and spermatogenesis is completed by 2 years of age. The present study provides baseline information for further experiment or quantitative studies exploring normal development of the testis and hormonal regulation of Sertoli cells, spermatogonial stem cells and spermatogenesis in donkey and other related species.

Background: Although tamoxifen has well documented oestrogen-like effects in the endometrium and ectocervical squamous epithelium, its effects on the endocervix are poorly documented.
Case report: We report a case of an 88 year-old woman who presented with postmenopausal bleeding after receiving tamoxifen for 16 months following a diagnosis of Grade 2 invasive and in situ carcinoma of breast. Endometrial biopsy was performed revealing either atypical hyperplasia or adenocarcinoma. She underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph gland sampling. Histopathological examination of the uterus showed an endometrioid carcinoma (FIGO Grade 2) at the endometrium. In addition, there was extensive florid endocervical microglandular hyperplasia.
Conclusion: Endocervical microglandular hyperplasia is usually seen in woman of reproductive age, particularly in association with pregnancy and contraceptive use. It is unusual in postmenopausal woman and its presence in this 88 year-old tamoxifentreated patient implicates tamoxifen as a course of endocervical microglandular hyperplasia in this instance.

External auditory canal osteomas are found to be rare benign bony neoplasms that are usually unilateral and solitary. Symptoms are rare that includes hearing loss, tinnitus, vertigo and pain. Diagnosis is based on clinical examination, radiographic imaging and histopathology. We describe a case of 26-year-old male with a complaint of aural fullness for one week associated with decreased hearing. On physical examination, the posterior wall of right auditory canal was completely occluded by a mass, which was fixed. On histopathological examination, hematoxylin and eosin stained slides revealed a mass of cancellous bone surfaced by stratified squamous epithelium. Fibrovascular channels were seen with small vessels.

Biliary cystadenomas with ovarian like mesenchymal stroma are rare benign cystic neoplasms of liver which have premalignant potential. A 58-year-old woman presented for the evaluation of a 3.6 cm cyst compressing the hepatic duct, jaundice and abnormal liver enzymes. Endoscopic retrograde cholangiopancreatography (ERCP) and stent placement provided symptomatic improvement. The patient was successfully treated by laparoscopic common bile duct excision with cholecystectomy choledochoduodenostomy.

Here, we describe the alterations of excitatory neurotransmitters (dopamine, serotonin, noradrenaline, acetylcholine), glutamate and GABA (a presynaptic inhibitory neurotransmitter) in the brain areas (brainstem, hypothalamus, hippocampus) involved in bipolar disorder. The coherence between the pituitary hypothalamicadrenocortical axis and the existing neurotransmitter alterations is pointed out. Neural networks are described in the concerned brain areas, including the neurotransmitters and the depending subreceptors, on which the prophylactic drugs exert their effects. A survey of the commonly used prophylactic drugs is also given.

The cerebral ganglia of tropical earthworms, Metaphire houlleti, Metaphire posthuma (Megascolecidae), Eutyphoeus gammiei (Octochaetidae) and Eudrilus eugeniae (Eudrilidae) revealed mainly two categories of neurosecretory cells (NSCs) – A cells and B cells. Thick cortical tier of A cells stained intensely with AF and were differentiated into A1, A2 and A3 types on the basis of their shape, size and location. The sub-cortical B cells, lying close to the neuropile stained lightly with AF. While the axons of A1 cells discharged neurosecretory material (NSM) beneath the perineurium, those of A2, A3 and B cells generally transported NSM at the margin of the neuropile forming “accumulation zone”. Our present study revealed that in earthworms, in absence of any well-defined neurohaemal organ, there was a phenomenal deposition of NSM in the “accumulation zone” or tissue spaces beneath the highly vascular perineurium from where the secretion readily entered the capillaries by diffusion to meet the physiological demand of the animal.

Thymoma is a rare malignancy of unknown etiology. Thymoma is exceedingly uncommon in children and young adults. A cytologic diagnosis of thymoma is extremely challenging as the tumor is uncommon and aspirates are infrequently encountered. With this case report, we want to emphasize the importance of the fine needle aspiration cytology in the diagnosis of this rare neoplasm.

Objectives: The objective of this paper was to study the levels of cellular hypoxia, apoptosis controlling factors in relation to the value of kidney function impairment and to evaluate possible protective effects of the treatment with antioxidant agent tocopherol in pediatric patients with nephrotic syndrome.
Background: Hypoxia-related disorders play an important role in irreversible tissue damage via activation of certain secondary processes.
Methods: An examination of renal biopsies of 53 patients (aged 10 to 15 years) with nephrotic syndrome was done. Conventional clinical investigations, immunohistochemistry, immunoblotting were used in this study.
Results: We show that nephrotic patients reveal a high level of marker of cellular hypoxia HIF-1α and its dependence on the level of kidney function impairment and proteinuria. The progression of the sclerosis as a sign of irreversible kidney damage is accompanied by gradual increase in expression of proapoptotic factor Bax. Applied treatment composes conventional scheme and tocopherol showed an improvement in hypoxia level, proapoptotic factor Bax expression.
Conclusion: Hypoxia-induces disorders in nephrotic children presented by disturbances in apoptosis controlling system can be attenuated by the antioxidants application

Rhinoscleroma (Scrofulous lupus, scleroma) is an infectious disease caused by a Gram negative bacillus Klebsiella rhinoscleromatis. This is a chronic granulomatous disease which commonly involves the nose and upper respiratory tract, but can involve the oral cavity and soft tissues of the lips. The present case was reported as the presentation was with a mass lesion in the right upper lip and philtrum causing nasal obstruction in a 30 year old man. The lesion clinically simulated a malignant lesion. The histopathological examination revealed granulation tissue with plasma cells and Mikulicz’s cells.

Primary plasma cell leukemia is a rare and aggressive form of plasma cell neoplasm characterized by the presence of circulating plasma cells in peripheral blood. Here, we report an interesting case of a patient with primary plasma cell leukemia, who was diagnosed during postoperative period after surgery for acute appendicitis. After the appendectomy, the patient developed leukocytosis of 41.2×109/L with a high number of circulating plasma cells (32.5×109/L). The immunophenotypic analysis of leukemic plasma cells indicated the following antigen profile: CD138⁺⁺⁺, CD38⁺⁺⁺, IgMc⁺, CD56¯ and CD20⁻. Electrophoresis showed a monoclonal IgG component of 5810 mg/dL, and diagnosis of primary plasma cell leukemia was established. After the induction chemotherapy with cyclophosphamide, bortezomib and dexamethasone, the patient achieved partial response with regression of hepatomegaly and decreased pleural effusion. Nevertheless, the patient died of sepsis. Therapy with proteasome inhibitors and stem cell transplantation may also provide increased survival and improve the prognosis of patients with primary plasma cell leukemia.

This study examined the morphology and histology of the adult laughing dove tongue from birds of both sexes and compared the results those reported in the literature concerning other bird species. The tongue of the adult laughing dove has an elongated triangular shape and a median groove. Both dorsal and ventral lingual surfaces were covered by keratinized stratified squamous epithelium, which decreased in thickness and degree of keratinization, when progressing toward the root. The dorsal surface of the lingual apex and body showed desquamated epithelial cells with differences in size, shape and appearance of these cells according to their location on the tongue. The openings of lingual glands were observed on the ventrolateral surface of the caudal half of the body of the tongue. A narrow rim of fibrous connective tissue beneath the epithelium surrounding the central lingual core was composed of a single cartilaginous plate and skeletal muscle bundles. Large conical papillae were located symmetrically between the body and root of the tongue. An additional row of conical papillae were located behind the previously mentioned row. The ventral aspect of the tongue was free from any papillae but had numerous shallow folds in addition to a row of three openings for lingual salivary glands.

Oncocytic papillary cystadenomas are rare benign salivary gland neoplasms. Minor salivary glands are frequent localization for this neoplasm. We report a case of oncocytic papillary cystadenoma of the parotid gland, occurring in a 53-year-old male as a slowly growing, well defined cystic nodule of 1.5 cm in diameter. Fine needle aspiration (FNA) was performed by using 25-gauge needle by the (cyto) pathologist. Few small sheets of epithelial and oncocytic degenerative cells with extensive granular debris on the background were observed on FNA smears. Few tabular or petal form, non-birefringent crystalloids were noted in the background of scanty cellular specimens composed predominantly of oncocytic cells. On histopathology, unilocular cystic lesion with papillary structures lined by oncocytic cells and tyrosine-rich crystalloids within the lumen were identified. In conclusion, oncocytic papillary cystadenoma is uncommon benign tumor in the parotid gland and can be accompanied by tyrosine-rich crystalloids. It is useful to be familiar with the type of the crystalloid as they may help in differentiating benign and malignant lesions. To the best of authors' knowledge, this is the second reported case of oncocytic papillary cystadenoma with crystalloids with cyto-histo correlation.