Jornal de Citologia e Histologia

Mucinous carcinoma of the male breast is an uncommon malignant breast neoplasm and its diagnoses remain difficult. It is probably due to such a low rate of breast cancer cases that men tend to be diagnosed at an older age than women and with a later stage of the disease. We describe a case of a 69-year-old male who displayed a palpable lump in his right axilla several years ago, showing signs of cutaneous adnexal mucinous adenocarcinoma after biopsy. After six years and several clinical examination and systemic investigation without results, the patient underwent to fine needle aspiration cytology and subsequently a biopsy of a mass with irregular margins in the retroareolar region of his right breast. The final diagnosis was of a mixed mucinous breast cancer with neuroendocrine differentiation. The tumor cells phenotype showed Synaptophisin (+), CEA (+/-), CK-20 (-), CK-7 (+), TTF-1 (-), estrogen receptor (-), progesterone (-) and HER 2 (++). These results were unusual for a mucinous male breast carcinoma. In the presence of a lesion in the axillary area with no specific primary origin, breast cancer should never be ruled out, even in the absence of clinical evidence and with an immunohistochemical pattern not indicative of mammary origin.

Objective: Reaching women in rural China is one of the major public health problem today and even though various methodologies were introduced they had limited or no success. The goal of our study was to investigate the usefulness of DNA quantitative assessment (ploidy) in comparison with conventional cytology (LBC) and HPV testing and its possible role in the clinical practice for rural women. Methods: In collaboration with Shanxi Women and Children Health Center we finished a study in Shanxi Province (3300 women) using Image cytometer. Each women underwent HPV testing, liquid based cytology screening (LBC) using manual and semi-automated analysis based on DNA ploidy and EA50 staining (on the same slide). All positive cases by any method were invited for colposcopy and biopsy. Results: Our results showed that DNA ploidy in combination with EA50 have superior performance in comparison with LBC or HPV method. Conclusion: Automated combined qualitative and quantitative image cytometry is a very good candidate for screening in low resource settings in China where the conventional cytology or LBC reading cannot be performed due to the lack of adequate infrastructure and trained cytotechnologists or cytopathologists. Furthermore digitalization of images open a door for data transfer and cloud computing which in turn can improve access to proper medical care in rural China.

The Keloid is a fibroproliferative anomaly of the cutaneous connective tissue secondary to dysregulation in the skin healing and repair process, occurring in susceptible individuals. It is characterized by excessive collagen and glycoprotein deposition in the dermis following any local irritation, inflammation, burn, incision or injury, thereby leading to a cosmetically unaesthetic, aberrant and exuberant scar formation extending well beyond the boundaries of the original wound. It usually presents as firm nodules, often pruritic and painful, which do not regress spontaneously. The condition presents quite a therapeutic challenge owing to its unpredictably aggressive nature, frequent invasion of adjacent normal dermis, occasional appearance of satellite lesions in nearby non-traumatized tissue and a remarkable tendency for recurrence following removal.

Various combinations of Pressure therapy, intralesional steroid therapy and surgery have shown promising results in the treatment of auricular keloids. We report on a young Indian female, aged 19 years, who developed bilateral auricular keloids subsequent to earlobe piercing, which was successfully managed by careful and atraumatic surgical excision alone.

This study was undertaken to evaluate the effects of protein hydrolysate prepared from lentil and buffalo whey proteins on body weight and histopathology of alloxan induced diabetic rats. Seventy two male albino rats were randomly divided into non-diabetic, diabetic untreated and diabetic treated with lentil or buffalo whey protein hydrolysates with or without yogurt. Experimental diabetes was induced by a single intraperitoneal (i.p) administration of alloxan (120 mg/kg body weight). Histopathological analyses were conducted on the liver and kidney tissues after 28 day of experiment. While the body weight was significantly decreased in the diabetic control group, there were no significant difference in diabetic treated group (P<0.05). Destruction of the liver architecture of the hepatocytes in the diabetic group showed the signs of steatosis, fibrosis and inflammation in the central vein and blood vessels. In the kidney, intestinal nephrites and mesangial proliferation and formation of cast material were observed. Yoghurt-containing lentil protein hydrolysate contained in yogurt appeared to have remarkable effect to prevent damage in liver and kidney histology caused by diabetes.

The aim of this study was to assess the thickness of the scars on the left arm of a female third-degree burn patient through ultrasonic examination in order to investigate the use of 25-mm Hg pressure garments, which are a key treatment for burns. The patient was injured with third-degree burns more than 10 years ago. Sixteen scars were examined. The resulting Pearson correlation of the forearm and upper arm was 0.138 (weak correlation; R²=0.0191). Therefore, in this case, all data points fell on a straight line with a positive (upward) slope. This result indicated different thicknesses for the upper arm and forearm third-degree burn scars; this result displays different thickness for the upper arms and forearm the third degree burn scars; the scars did not spread evenly due to the loading capacity of different parts of body instead of the pressure by pressure garment.
This paper provides accurate information to manufacturers, therapists, and tailors regarding measurements for pressure garments. The results suggest that burn scars should be subject to appropriate pressure on the basis of medium scar height to avoid increasing scars and to stabilise burns, validating the hypothesis that 25 mmHg is not the optimal pressure for female patients with third-degree burns on the left arm and that the optimal pressure should be based on the patient’s burns and wound area. To our knowledge, this is the first study to correlate the thickness of third-degree burns through ultrasound scan.

Background: Wound healing is a highly ordered dynamic process associated with inflammation at early stages and with permanent scarring at late stages. Scars could be disfiguring and could advance to be hypertrophic or keloid scars, this would have a strong physical and psychological impact on the patients afterward. The role of inflammatory mediators which could be pro- or anti-inflammatory, pro-or antifibrotic was the focus of wound healing research for decades and the balance between them is the key factor determining the outcome of healing.
Aims: In this study, we investigate the correlation and the interrelation between the pro-inflammatory Cyclooxygenase-2 (COX-2) and the pro fibrotic (TGF-Beta-1) in an in vivo model of incisional dermal wound healing and the effect of a selective COX-2 inhibiton the progression of repair and scar formation.
Materials and methods: Adult male Sprague-Dawley rats received four full thickness dermal wounds. a selective COX-2 inhibitor was applied to the wounds immediately postwounding twice daily for two days. Wounds and scars were then harvested and at different time points and processed for COX-2 and TGF Beta-1 immunostaining and for collagen staining. Immunoreactivity was semi quantified using Image J.
Results: We have shown upregulation of COX-2, co-upregulation and colocalization of TGF-Beta-1 and COX-2 two days postwounding during the inflammatory phase. Celecoxib application significantly inhibited both COX- 2 (P<0.01) and TGF Beta-1 (P<0.001). It improved wound healing microscopically and macroscopically, through reducing inflammatory cell infiltrate, granulation tissues formation and early closure of the incision. Additionally, there was marked improvement in the postwounding scarring. There was a significantly (P<0.01) correlation between COX-2 and TGF Beta-1 (Pearson Correlation=0.94).
Conclusion: The overall effect of COX-2 inhibitor was shortening of the inflammatory phase of wound healing with subsequent minimization of the associated tissue destruction and consequently improvement of the scar quality. COX-2 inhibitors regulate inflammatory phase of the wound. They could regulate collagen deposition by
regulating the produc-tion of the pro fibrotic TGF Beta-1 production, through autocrine/paracrine effect. Therefore, early application of COX-2 inhibitors to wounds immediately after injury/surgery could enhance the repair and improve the quality of scar.

Radiation-induced osteosarcomas (RIOS) after nasopharyngeal carcinomas are rare complication of radiotherapy and are associated with poor prognosis. Few cases are reported in the literature. Case report: We report a case of radiation-induced osteosarcoma involving the proximal humerus in a patient treated with radiotherapy for nasopharyngeal carcinoma (NPC) nine years ago. Surgical treatment could not be performed, and the patient received induction chemotherapy. He died from disease spread after three cycles. Conclusion: RIOS after treatment of NPC is very aggressive complication. Only a regular follow up of treated patient allow early detection of these tumors and best chances of survival.

Alveolar bone regeneration therapy is critical to retain the teeth and proper occlusion. Currently, alveolar bone loss is treated surgically using bone grafts or artificial bone, both of which carry the risk of complications, such as post-operative infection. A new, non-surgical therapy would help to improve patient safety levels and treatment success. Alveolar bone is always proceeding remodelling, and this makes it difficult for the clinicians and researchers to evaluate alveolar bone tissues after some regenerative treatments. In our previous studies, we developed a system for bone regeneration using non-viral bone morphogenetic protein (BMP) gene-expression plasmid vectors and in vivo electroporation for the ectopic bone formation in rat skeletal muscles. Here, we used bone morphometric analyses using calcein and tetracycline labelling in rats to evaluate changes in alveolar bone with our BMP gene-transfer system. We concluded that BMP-2/7 gene transfer to the periodontal tissues was an optimal therapy for the alveolar bone regeneration.

The pancreas is an uncommon site of metastases of small cell lung carcinoma. Pancreatic metastasis occurs toward the end stage of disease. Few cases only were reported in the literature. This case presents a 56 year-old man diagnosed with disseminated small cell lung carcinoma to multiple sites including pancreas. The current paper is presented in order to increase the awareness of this relatively rare condition.

Background: Renal ischemia-reperfusion injury (IRI) is a major cause of acute renal injury and leads to multiorgan dysfunction especially liver injury. Stem cell therapy has been used effectively in treatment of renal IRI.
Aim of the work: To investigate the possible therapeutic effect of BM-MSC therapy on the remotely affected liver in a rat model of renal IRI and the mechanisms involved in this effect.
Methods: Rats were divided into 3 groups; the sham-operated control group, the renal IRI group: bilateral renal IRI for 45 minutes followed by reperfusion, and BM-MSCs-injected group: rats were subjected to renal IRI and then received a single intravenous (iv) injection of BM-MSCs immediately after reperfusion. At the different time-points (days 1, 3, and 5) of the study, serum urea, creatinine, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were estimated. Livers were removed and were divided: some specimens were homogenized for assessment of oxidant and antioxidant parameters, and other specimens were used for paraffin embedding for histological and immunohistochemical study.
Results: Renal IRI resulted in a significant increase in serum levels of urea, creatinine, AST, ALT, and hepatic tissue levels of malondialdehyde (MDA) which attenuated on days 3 and 5 after BM-MSCs injection. MDA showed an early significant decrease in the BM-MSCs-injected group at day 1. Reduced glutathione (GSH) showed a significant decrease in the IRI sub-groups while BM-MSCs-injected sub-groups showed significantly higher levels of GSH on days 1, 3 and 5. Tissue sections showed that labeled BM-MSCs were engrafted into liver tissue. The IRI subgroups showed marked destruction of liver tissue e.g. disrupted lobular architecture, marked hepatocellular ballooning and cytoplasmic vaculations, and marked recruitment of the inflammatory cells with vascular congestion. While in the BM-MSCs-injected subgroups, there were gradual regeneration and restoration of lobular architecture, reduced degenerated cells, decreased congestion, and minimal inflammatory cell infiltration. By day 5, most hepatocytes had more or less normal appearance, arranged in cords with preserved general architecture and lacking evidence of major morphological injury. In addition, BM-MSCs significantly attenuated the liver immunohistochemical expression of tumor necrosis factor-alpha (TNF-α).
Conclusion: BM-MSCs protects against the remote liver injury induced by renal IRI through early inhibition of inflammatory cell recruitment, inflammatory reactions, suppressing oxidative stress and lipid peroxidation, and rapid restoration of cellular and architectural integrity of the liver. This provides another important basis for the therapeutic concept of BM-MSCs in treatment of renal IRI by adding a beneficial effect on decreasing the remote liver injury besides considering it as a promising treatment in renal IRI.

Background: Distinguishing the histological subtype of lung cancer is extremely important because chemotherapy agents may have different chemotherapeutic effects in different histological subtypes. This study retrospectively evaluated the characteristic differences in the cytomorphological and radiological features of nonsmall cell lung cancer.
Methods: This study population included 50 lung cancer patients who were diagnosed based on bronchoscopic biopsy findings and underwent surgery from April 2011 to May 2016. Cyotological specimens (Papanicolaou’s staining) were separately analyzed by two experienced cytotechnicians. The associations between the clinicopathological data, as well as the preoperative radiological features on computed tomography (CT) and positron emission tomography (PET) and cytomorphological analyses were analyzed.
Results: Forty-five specimens were analyzed (adenocarcinoma [ADC] [n=38], squamous cell carcinomas [SQCC] [n=7]). The ADCs were cytomorphologically sub-classified as follows: acinar (n=25), solid (n=10), lepidic (n=2) and papillary (n=1). Among specimens with a solid pattern of ADC, there was a significantly greater percentage of samples with a necrotic background (50%), predominant 3D clusters (100%) and conspicuous nucleoli (80%) compared to specimens with a nonsolid pattern of ADC. The CT images of patients with solid ADC (90%) and SQCC (100%) tended to show solid nodules on CT. On PET, the maximum standardized uptake values at 120 minutes in solid ADC and SQCC were significantly higher in comparison to nonsolid ADC (12.8 ± 6.1 and 17.2 ± 7.3 versus 8.9 ± 4.4, respectively).
Conclusions: The differentiation of the cytomorphological characteristics might predict the values of radiological features, and thereby provide information that can be used when determining the treatment strategies.

Diabetic mastopathy (DM) is a pathological entity of recent description, it is rare and benign; occurring in young patients with type I diabetes, or having an autoimmune disease. Clinically, she simulates breast cancer. Radiological examinations are not very informative. The diagnosis of certainty is histological. Through an observation of (DM) occurred in a diabetic patient, under insulin for 14 years and carrying multiple degenerative complications, we recall the clinical aspects, radiological and evolutionary of this affection