Intimal sarcoma of the abdominal aorta and common iliac arteries presenting as epithelioid angiosarcoma of the skin: a case report

Intimal sarcoma (IS) is the most common type of sarcoma of the aorta. IS tumor emboli can involve various organs, including the skin. However, a limited number of IS cases with an initial presentation of skin metastasis has been reported. Cutaneous metastasis as a form of epithelioid angiosarcoma (EAS) has not been well described. Herein, we present a 61-year-old Japanese man with an initial presentation of EAS of the skin, followed by multiple metastases to the skin as a form of EAS prior to detection of IS of the infrarenal aorta and common iliac arteries. In our case, the IS was CD31 and cytokeratin positive but did not express CD34 and factor VIII-related antigen. The EASs in our case exhibited diffuse CD31 expression, and focal factor VIII-related antigen and cytokeratin expression were observed throughout the tumor, including the neoplastic vascular structure; CD34 expression was not identifiable. IS metastasis to the skin has been documented as a form of angiosarcoma. However, IS metastasis has not been well described as a form of EAS. Our case could prove a morphological change from IS to EAS. Given the rarity of primary cutaneous EAS, it is recommended that primary sites other than the skin should be thoroughly investigated when EAS of the skin is encountered.     

A morphometric study of suprarenal gland development in the fetal period

Purpose

The present study’s purpose was to examine the morphometric development of the suprarenal gland using anatomic dissection methods during the fetal period.

Methods

This study was performed on 172 human fetuses (76 males and 96 females) and 344 fetal suprarenal glands obtained from ages 9–40?weeks of gestation with no external pathology or anomaly. Fetuses were divided into 4 groups between gestational ages as follows: Group 1, 9–12?weeks (first trimester); Group 2, 13–25?weeks (second trimester); Group 3, 26–37?weeks (third trimester); and Group 4, 38–40?weeks (full term). Also, the fetuses were grouped into monthly cohorts: 9–12?weeks 3rd month, 13–16?weeks 4th month, 17–20?weeks 5th month, 21–24?weeks 6th month, 25–28?weeks 7th month, 29–32?weeks 8th month, 33–36?weeks 9th month, and 37–40?weeks 10th month. The suprarenal glands were dissected in the abdominal cavity. The dimensions (width, length, and thickness), volumes and weights of the suprarenal glands were evaluated. The ratio of the fetal suprarenal gland weight/fetal body weight, the ratio of the fetal suprarenal gland volume/fetal kidney volume, and the ratio of the fetal suprarenal gland dimensions/fetal kidney dimensions were evaluated.

Results

Mean values and standard deviations of all parameters according to gestational weeks and trimesters were calculated. It is found that all parameters increase with gestational age. There was significant correlation between gestational age and all parameters (p?p?>?0.05). There was no difference between the right and left sides of parameters except the thickness of the suprarenal glands. The left suprarenal glands were thicker than the right. The ratio of suprarenal volumes to kidney volumes was determined, and we observed that the ratio decreased during the fetal period.

Conclusions

We believe that the results obtained from this study will be beneficial in understanding the development of suprarenal glands and also contribute to future studies in obstetrics, perinatology, and fetopathology.     

Development of spleen during the fetal period

Objective This study was aimed to determine the location and development of the spleen in the human fetuses. Materials and methods The study was carried on 141 dead human fetuses aged between 9 and 40 weeks with no marked pathology and anomaly in the years 2002–2003. The location of spleen with the neighboring structures, the existence of accessory spleens, notches on the borders, fissures on the surfaces, major ligaments and the shape of spleen and its hilum were established. The spleen was completely observed intraperitoneally (except at the hilum), in the left hypochondrium throughout the fetal period. The length, width, thickness, weight, volume, and the hilum dimensions of spleen were measured. Results The dimensions, weight, and volume of the spleen were increased with the gestational age, and positive significant correlations were determined (P < 0.001). There was no difference between sexes in all parameters (P > 0.05). The length of the spleen has ranged between 3.1 and 35.6 mm, between 9 weeks old and 40-week-old fetuses, respectively. One or more accessory spleens have been found in 14% of cases. Conclusion The measurements and location of the spleen according to the gestational age were determined by the present study. The expression of morphometric parameters of the spleen at different gestational ages can be used in determination of pathologies of the spleen and may also contribute to future studies on this issue.     

Development of the vermiform appendix during the fetal period

This study aimed to determine the location and development of the vermiform appendix (VA) in terms of morphometry. It was carried out on 80 human fetuses that exhibited neither external pathology nor anomaly and whose gestational ages were between 10 and 40 weeks. The location of the VA and cecum was established. Total VA diameter, lumen diameter, wall thickness, serosa, muscularis and mucosa thickness were measured on microscope slides. The VA was almost always observed in the subcecal region during the fetal period. The length of the VA and the attachment length of the meso-appendix to the VA increased with the gestational age. Lymphocyte aggregation was first seen at the 17th week of the fetal period. Positive and meaningful correlation was found between gestational age and morphometric parameters of the VA. A significant difference was found between the genders in the thickness of mucosa, which was larger in girls (p<0.05). When the proximal, median and distal parts were compared, the thickness of serosa between the proximal and distal parts was also significantly different (p<0.05). The present study has revealed that the VA matures in the second trimester during the fetal period. Furthermore, the morphologic development of the VA is almost uniform from the proximal to distal part.This study was presented as an oral presentation at the Meeting of the Anatomical Society of Turkey, 25–30 October 1999, Antalya, Turkey     

Development of villus absorptive cells in the human fetal small intestine: a morphological and morphometric study

We describe the sequential ultrastructural changes in villus absorptive cells of human fetal small intestine between 9 and 22 weeks of gestation. In concert with villus formation at 9 to 10 weeks, a complex membranous system designated the apical tubular system appeared in the apical cytonous system designated the apical tubular system appeared in the apical cytoplasm of absorptive cells. The apical tubular system consisted of deep invaginations of plasma membrane and membrane-bounded vesicles and tubules. Some elements of this system were characterized by linear arrays of particles on the inner (luminal) membrane leaflet. After villus formation, many lysosomal elements designated "meconium corpuscles" also appeared in the apical cytoplasm. Modified morphometric studies suggested that both the apical tubular system and the lysosomal elements were more extensively developed in the distal than in the proximal intestine, were most abundant at 15 to 17 weeks, and decreased by 18 to 22 weeks. Morhpometry also showed an inverse relationship between the relative surface density of the apical tubular system and microvillus membrane, suggesting the possible derivation of elements of the former from the apical plasma membrane. Exposure of intestine to ferritin for 8 to 40 minutes in vitro revealed ferritin in elements of the apical tubular system of 12- to 20-week fetuses. There was no evidence of transport of ferritin across absorptive cells. Distinctive membranous bodies composed of convoluted membrane-bound cisternae separated by narrow channels of cytoplasmic matrix were seen in the Golgi region and apical cytoplasm of fetal absorptive cells between 14 and 22 weeks. In a single 22-week fetus, there was marked proliferation of smooth endoplasmic reticulum, a decrease in cytoplasmic glycogen and loss of most lysosomal and apical tubular elements in the proximal but not the distal intestine. Thus, by the end of the second trimester, the structure of absorptive cells in proximal intestine was remarkably similar to absorptive cells in adult intestine.     

Multiple variations in the paired arteries of the abdominal aorta

Variations in the origin of arteries in the abdomen are very common. The arteries that show frequent variations include the celiac trunk, renal arteries, and gonadal arteries. We observed multiple variations in a 45-year-old male cadaver. The variations found on the left side were: one accessory renal artery, two testicular arteries, and middle suprarenal and inferior phrenic arteries that branched from the celiac trunk. On the right side, the inferior phrenic and middle suprarenal arteries arose from the right renal artery.     

A morphometric study of the human endometrial stroma during the peri-implantation period

In this study we have examined the human endometrial stromal cell population in well-timed biopsies during the peri-implantation period, using traditional stereological techniques. This paper reports data obtained from 16 women of known fertility who underwent endometrial biopsies at known times after the luteinizing hormone (LH) surge (four each at LH + 2, LH + 4, LH + 6 and LH + 8). The average stromal cell nuclear diameter increased in size throughout the period of study (P less than 0.01), with a significant decrease (P less than 0.05) in the nuclear profile axial ratio. This suggests that the nuclei were increasing in size and becoming more rounded. There was a dramatic increase (P less than 0.01) in the rounded. There was a dramatic increase (P less than 0.01) in the packing density between LH + 2 and LH + 6; this is likely to be due, at least in part, to the glands filling up with secretory products and so compressing the intervening stroma. A substantial decrease (P less than 0.01) was seen in the packing density between LH + 6 and LH + 8. This corresponds to the time when stromal oedema is thought to be maximal.     

A morphometric study of the human endometrial stroma during the peri-implantation period

In this study we have examined the human endometrial stromal cell population in well-timed biopsies during the peri-implantation period, using traditional stereological techniques. This paper reports data obtained from 16 women of known fertility who underwent endometrial biopsies at known times after the luteinizing hormone (LH) surge (four each at LH + 2, LH + 4, LH + 6 and LH + 8). The average stromal cell nuclear diameter increased in size throughout the period of study (P less than 0.01), with a significant decrease (P less than 0.05) in the nuclear profile axial ratio. This suggests that the nuclei were increasing in size and becoming more rounded. There was a dramatic increase (P less than 0.01) in the packing density between LH + 2 and LH + 6; this is likely to be due, at least in part, to the glands filling up with secretory products and so compressing the intervening stroma. A substantial decrease (P less than 0.01) was seen in the packing density between LH + 6 and LH + 8. This corresponds to the time when stromal oedema is thought to be maximal.     

Proliferation and differentiation of pituitary corticotrophs during the fetal and postnatal period: a quantitative immunocytochemical study

 To study the proliferation and differentiation of pituitary corticotrophs, we administered bromodeoxyuridine (BrdU) to pregnant rats at 15.5–21.5 days of gestation and to rat pups at 3, 7, and 28 days after birth. The pituitary sections of fetuses and pups were consecutively immunostained with anti-BrdU and anti-adrenocorticotropic hormone (ACTH) to detect proliferating cells and corticotrophs, respectively. The number of cells labeled with BrdU, ACTH, or both were counted. The diameters of their nuclei and the volume of the pituitary were measured. The BrdU-positive cells were around 76,000–96,000/mm³ during the period studied. The corticotrophs were first detected in the fetus at 15.5 days and they increased during the fetal and postnatal periods. The double-labeled cells were first detected in the 17.5-day fetus. They increased markedly at 19.5 days and comprised about one-quarter of the corticotrophs that increased in 24 h at this stage. These results indicate that: (1) at 15.5–18.5 days the corticotrophs were derived almost exclusively from undifferentiated cells; (2) during the later fetal and early postnatal periods, the proliferation of existing corticotrophs contributed, at least in part, to their increase; (3) About 1/20 of proliferating cells differentiated to corticotrophs when their increase was required. Accepted: 5 October 1999     

Anatomosurgical study of the superficial and deep circumflex iliac arteries

Summary An anatomical study of the superficial and deep circumflex iliac arteries in 43 formalin-fixed cadavers is presented. The origin, calibre, course, branches, symmetry and variations of the vessels are pointed out as well as their special features related to surgical applications.

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Etude anatomochirurgicale des artères circonflexes iliaques superficielle et profonde: bases anatomiques de la confection du lambeau libre iliaque composé cutanéo-osseux

Résumé Une étude anatomique des artères circonflexes iliaque superficielle et profonde est effectuée sur 43 cadavres formulés. L'origine, le calibre, le trajet, les branches, la symétrie et les variations des vaisseaux sont mis en évidence ainsi que leurs caractères particuliers en vue d'une application chirurgicale.

     

The density of muscularized pulmonary arteries in normal lungs: a morphometric study

In a series of 24 subjects who ranged in age from 2.5 months to 50 years and who were not suffering from cardiac or pulmonary disease, the density of muscularized pulmonary arteries was established in relation to their diameter. The number of arteries per unit area of lung tissue was corrected to account for various states of lung expansion of or collapse. The density of pulmonary arteries decreased rapidly during the first few years of life, then more gradually during the first two decades of life. Concomitantly, the diameter of the smallest muscularized arterial branches increased with age. These findings indicate that, even after completed development of lung tissue, there is a retraction of media in the sense that small arterioles lose their media, a process that continues until early adulthood. The values thus obtained may serve as a standard for comparison when the pulmonary arterial density is studied in cases of pulmonary hypertension in which it reportedly is greatly diminished.     

The development of fetal pylorus during the fetal period

Objective  The objective of this study was to explore the localization of the pylorus, its macroscopic and microscopic development and relationship with neighboring structures. Materials and methods  The study is carried out on 160 human fetuses aged between 9 and 40 weeks of gestation. Abdomen was divided into four quadrants by horizontal and vertical planes passing through the umbilicus. Topographical localization of the pylorus in reference to these quadrants and its distance were determined. Pylorus was divided into pre-pyloric, pyloric, and post-pyloric regions. Starting from the pre-pyloric end, serial sections spanning whole pyloric part were obtained. Wall thickness, the thickness of the muscular coat were measured under light microscope using sections stained with hematoxylin eosin. Sections with the thickest muscular coat were considered as the region where pyloric sphincter was. Findings  Pylorus was located in the right upper quadrant, on the median plane and in the left upper quadrant. There was a significant relation between the thickness of the muscular coat in the stomach, duodenum and the pyloric region and gestational age. In the region of the pyloric sphincter, the rate of increase in the thickness of the muscular coat was higher in the first and the first half of the second trimesters than term fetuses. Conclusion  We believe that data obtained in the present study will contribute to the assessment of development of the pyloric region in intra-uterine cases.     

Development of the rat respiratory neuron network during the late fetal period

We studied developmental changes in respiratory-like C4 activity and respiratory-related neurons in the ventrolateral medulla (VLM) of brainstem-spinal cord preparations from rat fetuses after embryonic day 16 (E16). In addition to respiratory nerve activity, non-respiratory activity was recorded from the C4 ventral root of preparations before E19. The burst duration of respiratory nerve discharge increased markedly at E19/20. Subtypes of neurons similar to newborn respiratory neurons were found in preparations with prolonged burst duration (more than 400 ms) after E20. These subtypes were not evident in preparations with short burst duration (less than 300 ms) before E19. About 60% of the inspiratory neurons in E17-19 preparations produced voltage-dependent burst activity, which was preserved in low Ca(2+)/high Mg(2+) synaptic blockade solution. In about 11% of the inspiratory neurons of E18-19 preparations, activation of one neuron induced activation of the inspiratory neuron network and generation of a full C4 inspiratory burst. The present findings suggest that respiratory neuron networks mature functionally to the level of the neonatal respiratory neuron networks during gestation period E19/20. Potentiation of synaptic interaction between respiratory neurons, causing developmental changes in the burst pattern, might be involved in the maturation process during late fetal stages.