RESUMEN
BACKGROUND AND PURPOSE: Recent studies have suggested that wall enhancement of unruptured intracranial aneurysms in high-resolution MR imaging might serve as an imaging biomarker for higher risk of rupture. Histologic studies have revealed a possible association among inflammatory processes, degeneration, and destabilization of the aneurysm wall preceding rupture. Understanding the histologic condition underlying aneurysm wall enhancement could be an important step toward assessing the value of this method for risk stratification. We present our observations of aneurysm wall enhancement in MR vessel wall imaging and underlying histologic changes. MATERIALS AND METHODS: We reviewed records of patients with an unruptured middle cerebral artery aneurysm who underwent MR vessel wall imaging before aneurysm clipping. Contrast enhancement of the aneurysm wall was dichotomized into either none/faint or strong. Histologic analysis included myeloperoxidase stain for detection of inflammatory cell invasion and CD34 stain for assessment of neovascularization and vasa vasorum. RESULTS: Thirteen aneurysms were included. Five aneurysms showed strong wall enhancement. Among these, myeloperoxidase staining revealed inflammatory cell infiltration in 4. Three showed neovascularization. In 2 aneurysms, vasa vasorum were present. Seven aneurysms did not show wall enhancement; 1 had only mild enhancement. None of these bore evidence of inflammatory cell invasion or neovascularization, and they all lacked vasa vasorum. CONCLUSIONS: Wall enhancement in MR vessel wall imaging is associated with inflammatory cell invasion, neovascularization, and the presence of vasa vasorum. Enhancement does not occur when histologic signs of inflammation are absent. Our results support the hypothesis that MR vessel wall imaging could provide valuable information for risk stratification.
Asunto(s)
Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/patología , Imagen por Resonancia Magnética/métodos , Neuroimagen/métodos , Adulto , Anciano , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/patología , Femenino , Humanos , Inflamación/diagnóstico por imagen , Inflamación/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Sclerosing angiomatoid nodular transformation (SANT) is a benign lesion of the spleen which can be cured by splenectomy. In the literature about 45 cases have been reviewed. Although it is defined by the morphological details, data regarding surgical therapy are scarce. To the best of our knowledge, a laparoscopic approach has not been published before. We investigated in one case of SANT the feasibility of a laparoscopic approach. Histological investigations confirmed the diagnosis of a SANT which was resected in toto. This report shows that the laparoscopic splenectomy is a feasible, safe and effective method for treatment of SANT.
Asunto(s)
Histiocitoma Fibroso Benigno/cirugía , Laparoscopía/métodos , Esplenectomía/métodos , Enfermedades del Bazo/cirugía , Anciano , Femenino , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/patología , Humanos , Imagen por Resonancia Magnética , Bazo/patología , Enfermedades del Bazo/diagnóstico , Enfermedades del Bazo/patología , Procedimientos Quirúrgicos Ultrasónicos/métodos , UltrasonografíaRESUMEN
A 55-year-old man was referred to our department with bleeding from a painless tumor located at the left parietal region of the head which had been progressively growing for a period of 2 years. Physical examination showed a fist-sized pediculated mass overlying the left parietal region and the auricle. The partly livid and ulcerated surface of the tumor was interspersed with light-yellow chalky material. The mass was totally excised. Infiltration of the skull was not observed. Histopathological examination led to the diagnosis of a giant pilomatricoma. Pilomatricoma is a rare, benign skin neoplasm that originates from hair matrix cells and is most frequently located in the head and neck region.
Asunto(s)
Enfermedades del Cabello/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico , Pilomatrixoma/diagnóstico , Cuero Cabelludo , Neoplasias Cutáneas/diagnóstico , Diagnóstico Diferencial , Enfermedades del Cabello/patología , Enfermedades del Cabello/cirugía , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana Edad , Pilomatrixoma/patología , Pilomatrixoma/cirugía , Cuero Cabelludo/patología , Cuero Cabelludo/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
OBJECTIVES: Systemic lupus erythematosus (SLE) is a classical autoimmune disorder characterised by the production of IgG autoantibodies against double-stranded DNA (dsDNA). Activation of Fc gamma R-bearing effector cells by immune complexes (ICs) is a key event in SLE pathogenesis as lupus-prone NZB/NZW F(1) hybrids lacking activating Fc gamma receptors (Fc gamma R) are protected against inflammatory kidney damage despite glomerular deposition of ICs. Moreover, soluble Fc gamma Rs inhibit IC-caused Arthus reaction in vivo. Therefore, recombinant human soluble Fc gamma RII (CD32) was evaluated as a novel therapeutic strategy in lupus-like disease in NZB/NZW F(1) hybrids. METHODS: Binding of husCD32 to murine IgG was studied in vitro by binding to IgG-coated erythrocytes and inhibition of phagocytosis of IgG-opsonised murine erythrocytes. In order to examine therapeutic impact of husCD32 in vivo, female NZB/NZW F(1) mice were treated either from week 16 to 20 ("prophylactic", 150 microg/week husCD32) or continuously from week 24 ("therapeutic"; 100 microg/week husCD32) by subcutaneous injections. Controls received buffered saline. RESULTS: In vitro investigations of husCD32 revealed binding to murine erythrocytes coated with murine IgG. Moreover, husCD32 substantially diminished phagocytosis of murine IgG-opsonised murine red blood cells by peritoneal macrophages indicating disruption of IgG-Fc gamma R interaction. There was a therapeutic efficacy of husCD32 to attenuate lupus pathology indicated by significantly delayed onset of proteinuria and weight loss, reduced histopathological findings, delayed development of anaemia and improved survival by prophylactic application. Therapeutic treatment did not reverse nephritis but significantly prolonged survival despite apparent kidney damage. B cell count, concentration of IgG anti-dsDNA autoantibodies and deposition of glomerular ICs was not significantly affected by the application of husCD32. CONCLUSIONS: The results demonstrate binding properties of husCD32 to ICs in vitro and as a proof-of-principle therapeutic efficacy in inhibiting chronic murine lupus pathology in vivo.
Asunto(s)
Lupus Eritematoso Sistémico/tratamiento farmacológico , Receptores de IgG/uso terapéutico , Animales , Anticuerpos Antinucleares/inmunología , Complejo Antígeno-Anticuerpo/inmunología , ADN/inmunología , Modelos Animales de Enfermedad , Evaluación Preclínica de Medicamentos , Femenino , Inmunoglobulina G/inmunología , Lupus Eritematoso Sistémico/inmunología , Nefritis Lúpica/inmunología , Nefritis Lúpica/patología , Ratones , Ratones Endogámicos NZB , Fagocitosis/inmunología , Proteinuria/inmunología , Proteinuria/prevención & control , Receptores de IgG/inmunología , Proteínas Recombinantes/efectos adversos , Proteínas Recombinantes/uso terapéuticoRESUMEN
Sulfatides are quantitatively prominent glycosphingolipids of rat kidney. In order to gain insight into their possible physiological significance in this organ, and their possible role in Heymann's nephritis, the main sulfatide components were localized immunohistochemically. The antibodies used recognized the sulfatides Sgal1, Stri1, Stri2, and Stet2a. Stri1 epitopes were expressed in the brush border of proximal tubuli, whereas Stri2-specific immuno staining was observed in cortical and medullar collecting ducts. Both Stri1 and Stri2 were also expressed by interstitial cells of the inner medulla. Stet2a was visualized in epithelia of the distal tubules of Henle's loop and the juxtaglomerular apparatus, including the macula densa. The mAb Sulph-I, that recognizes the SO3(-)-3GalbetaAsunto(s)
Riñón/química
, Sulfoglicoesfingolípidos/análisis
, Animales
, Anticuerpos Monoclonales/inmunología
, Especificidad de Anticuerpos
, Reacciones Antígeno-Anticuerpo
, Epítopos/análisis
, Epítopos/química
, Epítopos/inmunología
, Glucolípidos/inmunología
, Sueros Inmunes
, Inmunohistoquímica
, Conejos
, Ratas
, Sulfoglicoesfingolípidos/química
, Sulfoglicoesfingolípidos/inmunología