Beatrix Müller

Superficial radiotherapy for patients with basal cell carcinoma: Recurrence rates, histologic subtypes, and expression of p53 and Bcl-2

The histologic subtype of a basal cell carcinoma (BCC) may be an important factor for the success of a certain treatment modality. In the current article, the authors report recurrence rates among patients with BCC after superficial radiotherapy as well as Bcl‐2 and p53 expression levels stratified by BCC subtype.

MIB-1 immunoreactivity correlates with metastatic dissemination in primary thick cutaneous melanoma

BACKGROUND The proliferation rate of transformed cells is a putative prognostic indicator. MIB-1 is a murine monoclonal antibody to a Ki-67 epitope that detects a nuclear antigen found only in proliferating cells. OBJECTIVE The aim of this study was to test for a correlation between MIB-1 immunoreactivity and the metastatic potential of malignant melanoma. METHODS MIB-1 reactivity (% total tumor nuclei) was assessed in 34 formalin-fixed, paraffin-embedded primary cutaneous melanomas and correlated with metastatic potential and overall survival (follow-up, 10.5 +/- 1.8 years). RESULTS Whereas no correlation was found between MIB-1 reactivity and metastases in primary thin cutaneous melanoma (Breslow thickness, < 0.75 mm; mean thickness, 0.39 +/- 0.16 mm), good correlation was found (p = 0.0001) in primary thick cutaneous melanoma (Breslow thickness, > 1.5 mm; mean thickness, 3.0 +/- 1.3 mm). MIB-1 reactivity was 12.3% +/- 7.7% and 0.7% +/- 1.3% with and without metastases, respectively, and was highest in the primary melanomas that later metastasized. However, overall survival in patients with thick cutaneous melanoma and metastases did not correlate with MIB-1 reactivity. CONCLUSION MIB-1 proliferative activity is a useful prognostic indicator in primary cutaneous melanomas thicker than 1.5 mm and may predict the development of metastases.

Persistence of Human Herpesvirus 7 in Normal Tissues Detected by Expression of a Structural Antigen

Human herpesvirus 7 (HHV-7) infection in histologically normal human tissues was investigated by immunohistochemical detection of the 85-kDa tegument phosphoprotein (pp85) encoded by the U14 gene. So far, two cell types were recognized as sites of HHV-7 infection in vivo: CD4+ T lymphocytes, believed to be the site of latent infection, and epithelial cells of salivary glands, the site of productive infection and viral shedding. Unexpectedly, cells expressing the HHV-7 structural antigen were detectable in lungs, skin, and mammary glands. Morphologically and phenotypically, they were distinct from lymphocytes. Liver, kidney, and tonsils were positive, although the number of HHV-7-positive cells was low. Large intestine, spleen, and brain were negative. Different from the current notion of the state of HHV-7 in humans, the results show that a variety of tissues harbor cells at a late stage of infection and suggest that HHV-7 causes a persistent rather than a true latent infection.

Primary cutaneous plasmacytoma: a clinicopathological study of two cases with a long-term follow-up and review of the literature

Background:  Primary cutaneous plasmacytoma (PCP) is a rare type of cutaneous B‐cell lymphoma arising primarily in the skin and derived from clonally expanded plasma cells with a various degrees of maturation and atypia. The disease is rare with only 30 cases reported so far.

HHV-8 DNA Sequences in the Peripheral Blood and Skin Lesions of an HIV-Negative Patient with Multiple Eruptive Dermatofibromas: Implications for the Detection of HHV-8 as a Diagnostic Marker for Kaposi’s Sarcoma

Background: Multiple eruptive dermatofibroma (MEDF) is a rare disorder seen in immunocompromised patients, simulating Kaposi’s sarcoma (KS). Whereas KS is strongly associated with human herpesvirus 8 (HHV-8), the virus has never been detected in MEDF until now. Objective: To present a patient with MEDF who showed no signs of immunodeficiency but was seropositive for HHV-8 antibodies and demonstrated HHV-8 DNA both in the peripheral blood and lesional skin of MEDF. Methods: Clinical, histological and serological investigations were performed as well as polymerase chain reaction (PCR) studies and in situhybridization (ISH). Results: A 35-year-old white man with suspected KS was referred for evaluation of multiple pigmented nodules and patches. Biopsies revealed features of dermatofibroma, superficial fibrosing dermatitis and scar. One of the nodular lesions harbored HHV-8 DNA sequences. A faint amplification product was detected in the superficial fibrosing dermatitis lesion, while no HHV-8 sequences were found in normal skin and scar. Whole-blood samples and serum were positive for HHV-8. None of the skin lesions shown to harbor HHV-8 DNA sequences by nested PCR displayed a signal for HHV-8 RNA by ISH. Repetitive peripheral blood examinations did not reveal any serum antibodies against or antigens of HIV. Serum antibodies against the HHV-8 capsid antigen orf 65.2 were detected. Conclusion: Results of PCR studies and ISH indicate that the presence of HHV-8 in the lesional tissue was probably blood-borne due to viremia and not due to viral replication in tumor cells. The presence of HHV-8 is not fully restricted to KS. The differential diagnosis of KS and its simulators should be based on an integrative analysis of all available clinicopathological and molecular data and should not rely exclusively or predominantly on the presence or absence of HHV-8.

Study of HHV‐8 DNA sequences in archival biopsies from lesional skin of Kaposi's sarcoma, various mesenchymal tumors and related reactive conditions

Background: HHV‐8 has been identified as the causative agent of Kaposis sarcoma (KS) and some lymphoproliferative disorders. In addition, there are anecdotal reports on the presence of HHV‐8 in other tumors, especially cutaneous epithelial and mesenchymal neoplasms. The aim of the study was to ascertain the value of identification of HHV‐8 viral DNA sequences in routinely processed, formalin‐fixed, paraffin‐embedded tissues for the diagnosis of Kaposis sarcoma and other mesenchymal tumors.

c-myc Is not useful as prognostic immunohistochemical marker in cutaneous melanoma

Background: Several studies indicate that immunohistochemical detection of the c-myc oncogene might serve as an additional prognostic marker in malignant melanoma. Objective: To study c-myc expression in paraffin-embedded cutaneous melanoma and to correlate to metastatic potential and onset of metastases. Methods: Cytoplasmic c-myc protein expression was visualized using the APAPP method, and reactivity (percent total tumor cells stained) was assessed in 62 formalin-fixed paraffin-embedded primary cutaneous melanomas (21 not metastasizing, mean Breslow 3.0 ± 2.9 mm, 41 metastasizing, mean Breslow 3.1 ± 3.0 mm) and 24 metastases of the same patients. Results: There was no significant difference of c-myc reactivity in cutaneous melanoma who did not metastasize (n = 21, c-myc reactivity 32.7 ± 19.3%, follow-up 10.6 ± 1.8 years) and primaries who metastasized (n = 41, c-myc reactivity 27.7 ± 22.4%, p = 0.29). This finding was independent of the thickness of the primary and was found within thin cutaneous melanoma with a Breslow <0.75 mm (range 0.24–0.65 mm, n = 20, c-myc reactivity 29.1 ± 15.7%, p = 0.32) or within thick cutaneous melanoma with a Breslow >1.5 mm (range 1.6–11 mm, n = 41, c-myc reactivity 29.6 ± 23.8%, p = 0.46). No correlation of c-myc expression between thin cutaneous melanoma, thick cutaneous melanoma (p = 0.83) or metastasizing primaries and their metastases (n = 24, c-myc reactivity 29.3 ± 22%) was found (p = 0.64). The time period until development of first metastasis did not correlate with the percentage of cells expressing c-myc in the primary (p = 0.56). Conclusion: c-myc expression is independent of metastatic potential and onset of metastases and, therefore, does not serve as a prognostic immunohistochemical marker in primary cutaneous melanoma.

Primary subcutaneous follicular centre cell lymphoma with involvement of the galea: a case report and short review of the literature.

Summary Primary cutaneous follicular centre cell lymphoma (FCCL) is a distinct subtype of cutaneous lymphoma that originates from germinal centre cells. Histologically, the disease is typified by a bottom‐heavy infiltrate with a diffuse or follicular growth pattern situated in the mid or deep dermis. In some cases, the neoplastic infiltrate may involve the underlying subcutaneous tissue, but so far primary subcutaneous FCCL has not been reported. We report the first case of primary FCCL located primarily in the deep subcutis with extension into the galea and review the literature on primary subcutaneous B‐cell lymphomas.

Tumor-infiltrating T cells in primary cutaneous B-cell lympho-proliferative disorders

Background: Tumor‐infiltrating lymphocytes (TILs) are considered to play an important role in the antitumoral immune response. The presence and percentage of CD8‐positive tumor‐infiltrating T cells have been shown to correlate with differentiation and prognosis in various neoplasms. The aim of this study was to determine the number of CD8‐positive T cells in various primary cutaneous B‐cell lymphoproliferative disorders and to evaluate its correlation with the histological type of tumor.