Psoriasis risk genes of the late cornified envelope-3 group are distinctly expressed compared with genes of other LCE groups

Deletion of the late cornified envelope (LCE) genes LCE3B and LCE3C has recently been identified as a risk factor for psoriasis. Expression of 16 LCE genes of LCE groups 1, 2, 3, 5, and 6 was examined in vivo and in vitro. Quantitative PCR demonstrated that moderate to high LCE expression was largely confined to skin and a few oropharyngeal tissues. Genes of the LCE3 group demonstrated increased expression in lesional psoriatic epidermis and were induced after superficial injury of normal skin, whereas expression of members of other LCE groups was down-regulated under these conditions. Immunohistochemistry and immunoelectron microscopy demonstrated that LCE2 protein expression was restricted to the uppermost granular layer and the stratum corneum. Stimulation of in vitro reconstructed skin by several psoriasis-associated cytokines resulted in induction of LCE3 members. The data suggest that LCE proteins of groups 1, 2, 5, and 6 are involved in normal skin barrier function, whereas LCE3 genes encode proteins involved in barrier repair after injury or inflammation. These findings may provide clues to the mechanistic role of LCE3B/C deletion in psoriasis.     

Continuous growth of mean tumor diameter in a subset of grade II gliomas

Serial magnetic resonance images of 27 patients with untreated World Health Organization grade II oligodendrogliomas or mixed gliomas were reviewed retrospectively to study the kinetics of tumor growth before anaplastic transformation. Analysis of the mean tumor diameters over time showed constant growth. Linear regression, using a mixed model, found an average slope of 4.1mm per year (95% confidence interval, 3.8-4.4mm/year). Untreated low-grade oligodendrogliomas or mixed gliomas grow continuously during their premalignant phase, and their pattern of growth can be predicted within a relatively narrow range. These findings could be of interest to optimize patients management and follow-up.     

Transitional carcinoma of the ureter with osseous metaplasia of the stroma: a case report

Transitional cell carcinoma with osseous metaplasia of the stroma is a rare variant of urothelial carcinoma which must be distinguished from sarcomatoid carcinoma. We report here a further observation of this tumor variant, in a very unusual location, the ureter, in order to underline the radiological and pathological characteristics useful for the correct diagnosis, and to point out the problems of differential diagnosis. The diagnosis was made in an 85-year-old patient, presenting with chronic right lombalgias. Imaging studies showed a calcified thickening of the right ureter, associated with a major dilatation of the right excretory cavities and a parenchymal atrophy of the right kidney. A right nephro-ureterectomy was performed. Macroscopical examination showed an ossified, ill-limited tumor, measuring 4 cm in diameter, infiltrating the right ureteral wall. At histological examination, the lesion was identified as a high grade transitional cell carcinoma with extensive osseous metaplasia of the stroma. There was no evidence for a sarcomatous component (absence of mesenchymal cell proliferation, absence of mitosis in stromal cells). An early locoregional recurrence was observed three months after surgery. Our case report underlines the radiological and histological features of a rare variant of transitional cell carcinoma, which may be diagnosed by pre-operative imaging studies and which must be distinguished from a highly aggressive sarcomatoid carcinoma.     

Amphicrine carcinoma of the pancreas. Report of two cases

Amphicrine carcinomas are rare tumors defined by the presence of tumor cells showing evidence of both exocrine and endocrine differentiation. We here report two cases of amphicrine carcinomas of the pancreas, an exceedingly rare localization for this type of tumors. Diagnosis was made in respectively, a 32-year-old woman and a 66-year-old man; tumors measured 7 and 3 cm in diameter; metastatic dissemination was present in both cases. The first patient, treated by surgery and chemotherapy, is alive, without disease progression, after 26 months; the second patient deceased early after the diagnosis. In both cases, the first diagnosis considered at cytological and histological examination was endocrine carcinoma. The amphicrine nature of the lesion was ascertained by the combined demonstration of mucus staining and chromogranin A expression in the same cells. In one case, the amphicrine nature of tumor cells was confirmed by the ultrastructural examination. The identification of the amphicrine nature of an apparently endocrine tumor is of relevance, because of the poor prognosis of amphicrine carcinomas as compared to endocrine carcinomas and the requirement for aggressive therapy.