Papillary tumor of the pineal region: Case report and review of the literature

Papillary tumor of the pineal region is a rare neuroepithelial tumor characterized by papillary architecture and epithelial cytology, immunopositivity for cytokeratin and ependymal differentiation. It is considered grade II–III by the World Health Organization and was first described by Jouvet in 2003. We present a 34-year-old male with headaches, blurred vision and normal examination. Radiological study showed a nodulocystic lesion in the pineal region compatible with pineocytoma. Surgery was performed using an infratentorial supracerebellar approach, finding a cystic tumor in the quadrigeminal cistern which was completely resected. Histopathology reported a papillary tumor of the pineal region. The patient made good progress without adjuvant therapy, and after 57 months of follow-up he remained asymptomatic and free of recurrence. A review of the literature was performed to collect all the cases published with gross total resection and no complementary treatment. In conclusion, there is still much to be learned about the pathogenesis, prognosis and management of this tumor.     

Lateral ventricular liponeurocytoma: Review of literature and case illustration

BackgroundLiponeurocytoma is an uncommon tumor of the central nervous system. It is very rare for this tumor to originate within the lateral ventricle. In the context of the rarity of this tumor entity, this review article aims to summarize the clinical, radiological, and pathological features of lateral ventricular liponeurocytoma to facilitate its diagnosis and management.MethodsHere, we conduct a systematic literature review using the Pubmed, Scopus, and Cochrane Library database for all cases of lateral ventricular liponeurocytoma. A case illustration complements this review.ResultsThe described cases from 1997 onward include 14 cases that have been published in full papers in the English literature. Six additional cases are reported in short English abstracts in full non-English papers, and one case was described in a central neurocytoma report. There is a definite male predominance of 70% (14 male) and a mean age of 37 years (range 24–62). Heterogenous enhancement and signals in magnetic resonant images (MRI) are the radiological characteristics. In all reported cases, the presence of lipocytes and fat vacuoles is considered the paramount histopathological feature. Total surgical resection was achieved in 80% (12 out of 15) of the cases. Only two cases (including ours) received radiation therapy. Recurrence was seen in two patients during follow-up that was treated by radiation therapy in one and surgery in the other. The proliferation index is mostly below 5% in all cases, with the Ki-67 range between < 1% to 10%.ConclusionsLateral ventricular liponeurocytoma has been treated effectively by surgical resection in a limited number of cases. The decision for radiation therapy is based on a high proliferation index and tumor recurrence.     

Expression of cytokeratins in human enamel organ

Cytokeratin (CK) is a filament which plays a central role in epithelial tissue and, like the polypeptides of intermediate filaments in general, shows a high degree of tissue specificity. The CK expression patterns of odontogenic epithelia are still poorly described. We studied the distribution of individual CK polypeptides in the human enamel organ at bell stage and in remnants of the dental lamina. Our immunohistochemical study showed that epithelial cells stained for CKs 7, 13, 14 and 19 with slight changes in their pattern during the differentiation phase of odontogenesis. There was negative staining for all other CK polypeptides tested (CKs 8, 10, 16, 17 and 18). Most of the CKs in the enamel organ epithelia did not show differences related to the stage-specific state of differentiation, except for CKs 14 and 19 at the inner enamel epithelium. A strong label for CK 14 was present at the inner dental epithelium at early bell stage, and this was substituted by CK 19 at the late bell stage when the ameloblasts were fully differentiated.     

三种固定液对角蛋白反应的影响

本研究对13例人的正常涎腺经三种固定双固定后的组织标本进行了11种角蛋白单克隆抗体的免疫组化染色.其中5例腮腺和3例颌下腺分别同时用常规Formalin固定,Bouin’s液固定,Carnoy‘s液固定.染色采用ABC法,结果发现:Carnoy固定者,K_8、K_18、K_19和K_8.12的染色效果最好.其导管染色比Bouin‘s和Formalin固定者染色强而明确,尤其K_8和K_8.12不仅在导管中呈现强阳性,而且腺泡也呈阳性;而K_(17)和K_(L1)没有看出明显的染色差别;K_(14)、K_(10)、K_(13)、K_(17)、K_(20)的染色几乎全为阴性,与常规中性缓冲Formalin固定者结果一致.     

Cytokeratin phenotypes at the dento-gingival junction in relative health and inflammation, in smokers and non-smokers

OBJECTIVES: The cells of the junctional epithelium (JE) provide and maintain the epithelial attachment, and remain morphologically and phenotypically distinct from oral sulcular (OSE) and external oral epithelia (EOE), from which they may be regenerated de novo. Expression of cytokeratins (CK) in human epithelia has been shown to be highly site-specific, implying a functional role. The aims of this study were to differentiate between the cyto-keratin profiles of JE, OSE, EOE and pocket epithelia (PE) in health and disease, in smokers and non-smokers.
MATERIALS AND METHODS: The cytokeratin profiles of 40 samples of healthy and clinically inflamed human gingival tissue taken from 15 smokers and 25 non-smokers were studied by immunocytochemistry. Cryostat sections of fresh frozen gingival tissues were stained with a panel of monoclonal antibodies (mAb) and visualised by a biotin-Streptavidin-peroxidase complex technique.
RESULTS: JE and PE expressed an identical range of cytokeratins irrespective of the inflammatory or smoking status, with the exception of CK4 expression, which tended to be increased in smokers. The OSE and EOE expressed non-cornifying and cornifying differentiation cytokeratins respectively, but in the presence of inflammation, both these epithelia showed increased expression of CK19 at a basal level in association with expression of one or more of the simple cytokeratins. JE/PE expressed CK17 in external layers only, approximating the tooth surface. All epithelia expressed CK6,16 the markers of high cell turnover.
CONCLUSIONS: CK19 was a consistent differentiation marker for JE and PE.Expression of CK8,18 was enhanced by inflammation. CK4 expression increased in association with smoking. Markers of differentiation were not always co-expressed equally within a pair. Pairs were not always completely mutually exclusive with frequent co-localisation.     

细胞角蛋白14在牙齿软组织萌出通道中的组织学定位

目的牙齿萌出时,源于成釉器的缩余釉上皮与口腔上皮细胞融合为上皮团形成牙齿的软组织萌出通道,本研究对细胞角蛋白14在这一过程中的表达进行组织学定位,从而探讨其可能作用。方法不同发育期SPF级BALB/c小鼠9只。循环内固定后分别双侧下颌骨10%EDTA脱钙30d,常规脱水包埋,近远中向5μm连续切片,行苏木精-伊红和免疫组化染色。PV免疫组化两步法检测细胞角蛋白14和细胞增殖核抗原在各组织的表达。结果牙齿萌出过程中口腔上皮对细胞角蛋白14呈现时空特异性表达,非牙齿萌出部位的口腔上皮仅基底层阳性表达细胞角蛋白14,而萌出牙齿冠方的口腔上皮阳性表达则较广泛;缩余釉上皮在牙齿萌出过程中始终阳性表达细胞角蛋白14,而且伴随缩余釉上皮和口腔上皮融合的发生,缩余釉上皮的外层细胞和口腔上皮的基底层和基底上层细胞呈现细胞角蛋白14强阳性表达。结论细胞角蛋白14与牙齿萌出软组织通道的形成密切相关,可作为缩余釉上皮相关研究的上皮性标记物。     

Clinicopathological features of low-grade malignant endolymphatic sac tumors

Background

Low-grade malignant endolymphatic sac tumor (ELST) is a rare neoplasm, occurring in the inner ear and invading the temporal bone. This study aims to investigate the clinicopathological features of low-grade malignant ELSTs.

肿瘤标志物联合检测在肺癌诊断中价值

目的 探讨联合检测血清癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原(carbohydrate antigen,CA)19-9、CA125、神经元特异性烯醇化酶(neuron specific enolase,NSE)、细胞角蛋白19片段(cytokeratin 19 fragments,CYFRA21-1)、鳞状上皮细胞癌相关抗原(squamous cell carcinoma antigen,SCC)对肺癌的诊断价值.方法 肺腺癌患者102例(腺癌组)、肺鳞癌患者60例(鳞癌组)、肺小细胞癌患者36例(小细胞癌组)和95例体检健康者(对照组),检测4组血清CEA、CA19-9、CA125、NSE、CYFRA21-1、SCC水平,统计4组6项指标的阳性率,计算6项指标单独及联合检测诊断肺癌的灵敏性和特异性.结果 腺癌组血清CEA、CA19-9、CA125、NSE、CYFRA21 1和SCC阳性率分别为67.6％、28.4％、52.0％、58.8％、51.0％、14.7％,鳞癌组分别为33.3％、11.7％、41.7％、43.3％、65.0％、40.0％,小细胞癌组分别为44.4％、16.7％、13.9％、75.0％、36.1％、2.8％,对照组分别为1.1％、0、0、5.3％、2.1％、2.1％,除SCC阳性率在小细胞肺癌组与对照组比较差异无统计意义(P＞0.05)外,腺癌组、鳞癌组、小细胞癌组6项指标阳性率均高于对照组(P＜0.05),腺癌组CEA、CA125阳性率高于鳞癌组和小细胞癌组(P＜0.05),小细胞癌组NSE阳性率高于腺癌组和鳞癌组(P＜0.05),鳞癌组SCC阳性率高于腺癌和小细胞癌组(P＜0.05);血清CEA、CA19-9、CA125、NSE、CYFRA21-1和SCC单项指标诊断肺癌的敏感性分别为52.5％、21.0％、41.5％、56.5％、52.0％、20.0％,均低于6项指标联合检测(91.5％)(P＜0.05).结论 血清CEA、CA19-9、CA125、NSE、CYFRA21-1、SCC6在肺癌诊断及分型诊断中均有一定价值,联合检测6项肿瘤标志物可提高肺癌诊断的敏感性.