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Volume 3, Problème 5 (2012)

Rapport de cas

Epithelial-Myoepithelial Carcinoma of Parotid Gland: A Cytological Challenge with Histological Correlation

Iván Fernández-Vega, Nelson Fuentes-Martínez, Guillermo E Mendoza, Jorge Santos-Juanes and Florentino Fresno-Forcelledo

Background: Epithelial-Myoepithelial Carcinoma (EMC) is a rare type of malignant tumor of salivary gland accounting for less than 1.5% of all salivary neoplasms. Differential diagnosis of this tumor is complicated, especially by cytological examinations. Case: We present the case of an 86-year-old female who presented clinically with a bulky lesion behind her right ear. Fine needle aspiration cytology with immunocytochemistry has been performed and the patient was diagnosed with a biphasic neoplasm, epithelial-myoepithelial, highly suggestive of EMC. She underwent a wide surgical excision and diagnostic was confirmed by histological examinations, which showed a tumor composed of ducts with double cell lining surrounded by a basement membrane in a sclerotic stroma. Immunohistochemistry was carried on to highlight the biphasic cell pattern. The patient is free of disease after 20 months of surgical procedure. Conclusion: Although there isn’t any antibody that confirms the diagnosis of EMC, due to the difficulty to make a correct diagnostic of this lesion by cytology, we have highly recommended the use of immunocytochemistry assay as an important tool to confirm the double-cell pattern, which in together with a clinical course may help in the diagnostic of EMC. Cytology and histology correlation are rarely reported.

article de recherche

Caffeic Acid Phenethyl Ester Prevents Mesengial Cell Apoptosis by Suppressing p38MAPK Signal

Emine Mamal, Murat Basar, Hafize Uzun and Ismail Seckin

Background: Nitric oxide (NO), synthesis from L-arginine by Nitric oxide synthesizes (NOS) at kidney mesangial cells and involved in functional kidney defects such as acute kidney failure, inflammatory nephritis, diabetic nephropathy. CAPE (Caffeic acid phenethyl ester) is natural antioxidant which has anti-inflammatory, anti-tumor affects. In this study we investigated effects of NO on rat kidney and therapeutic and protective effects of CAPE. Methods: We used albino Wistar rats, weigh 150-200. Our experimental groups: 1) Control 2) L-arginine-given group 3) Preventative group (L-arginine and CAPE administered together) 4) Therapeutic group (after L-arginine administration; CAPE administered 7 days) (n=10/per group). Kidney tissues harvested and cortex region divided into two in order to perform western blot and immunohistochemistry. p38MAPK and active caspase-3 levels investigated with western blot and we performed p38MAPK immunohistochemistry. Differences between groups were calculated by means of one-way ANOVA and p<0.05 were considered to be statistically significant. Results: In L-arginine applied group p38MAPK level increased significantly, when compared to control and preventative group (p<0.001). On the other hand there were no statistical significance between control and preventative group (p<0.057). Additionally p38MAPK level increased in therapeutic group compared to control and preventative group (p<0.001). Moreover, in L-arginine-given group active caspase-3 level significantly increased compared to control and preventative group (p<0.05). However, active caspase-3 level in preventative group significantly decreased compared to therapeutic group (p<0.05). Conclusions: These results suggest that excess NO generation activates p38MAPK signaling pathway and triggers apoptosis in the kidney mesangial cells. Additionally, CAPE inhibits L-arginine’s effect and prevents mesangial cell apoptosis.

Rapport de cas

Tuberculosis of Thyroid Gland Presenting as Abscess

Veena Gupta, Ekta Boombak, Parul Tanwar, Hemant Yadav and Rajeev Sen

Tuberculosis of thyroid gland is an extremely rare clinical entity. It is very rare even in countries with a high prevalence of tuberculosis. It is rare to suspect a thyroid swelling or nodule as being tuberculous on clinical examination, unless it has destroyed the gland and formed an abscess in a patient with known pulmonary tuberculosis. We present a case of thyroid tuberculosis presenting as a solitary nodule and diagnosed on FNAC.

Article spécial

3D Imaging of Fine Needle Aspirates Using Optical Projection Tomographic Microscopy

Kenny F Chou, Qin Miao, Ryan L Coe and Eric J Seibel

Conventional Fine Needle Aspiration Biopsy (FNAB) requires minimal tissue sampling and causes minor tissue trauma. For these reasons, it is widely used to diagnose many types of cancers. However, the utility of FNA is limited, due to the lack of sensitivity and loss of structural information. This preliminary study introduces a new type of Three- Dimensional (3D) cytological imaging, Optical Projection Tomographic Microscopy (OPTM) that has the potential to reduce errors in FNAB analysis. We first demonstrate the functionality of OPTM, a microscopic imaging method that produces high resolution 3D images of single cell specimens in absorption mode, to perform multi-cellular imaging of cells stained with hematoxylin. Then, we use OPTM to image entire FNAB-like specimens in their three-dimensional form without experiencing errors from overlapping cells, choice of focal plane, and sampling. Our methods show success in generating volumetric data of large density of cells inside a cylindrical tube representative of FNA specimen within a 23-gauge needle. This 3D imaging technique may be applied to thin core needlebiopsyspecimens in the future, which may allow the preservation of tissue microstructure in FNAB specimens.

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