Eugenia Altamirano

Extrahepatic biliary atresia with cartilaginous metaplasia in the gallbladder remnants

Extrahepatic biliary atresia (EBA) is a chronic inflammatory process leading to fibrous obliteration of the biliary tree. Cartilaginous metaplasia within the remaining walls of the biliary main ducts in EBA has been reported once, although as cartilage heterotopia. A similar finding is presented here, but in the gallbladder of an infant with the full-blown manifestations of EBA; it is proposed that the alteration results from metaplasia of local connective tissue. Also of note is the complete disappearance of smooth muscle cells in the walls of the biliary tree in EBA, a fact which seems to be missing in the description of the pathology in these cases.

Small bowel gastric metaplasia: a report of three cases in children

Aims: To report three children displaying gastric metaplasia antral pyloric type of the small bowel mucosa. Methods: Analysis of clinical, histopathological and immunohistochemical data. Results: The first patient was a 14-year-old girl with history of chronic intestinal pseudo-obstruction and chronic jejunitis; the second patient was a 6-year-old girl with a long-lasting jejunostomy; and the third patient was a 5-year-old girl with ileal–rectal anastomosis. The foci of gastric metaplasia were obvious with H&E-stained sections. The cells at the gastric metaplasia mucosa proved to be MUC-1 and sialyl-Tn positive by immunohistochemistry and they were in a pattern that was different from that of the adjacent mucosa; the cells were autofluorescent in H&E-stained sections. Conclusions: Gastric metaplasia of the small bowel mucosa in these cases seems to have resulted from chronic inflammation and persistent regenerative activity. This has rarely been reported outside Crohn disease, and if ever in children.

Endothelial cells of intramuscular (infantile) hemangioma express glut1.

Glut1 is a marker of infantile hemangioma, and its positivity has resulted in defining this tumor at several sites (eg, skin, breast, salivary glands, liver, and placenta). We herein report on the presence of Glut1 positivity in the endothelial cells of 2 examples of intramuscular hemangioma, a peculiar tumor considered to be most probably congenital. The finding expands the sites where infantile hemangioma may be recognized and suggests that this intramuscular variety should be renamed intramuscular infantile hemangioma. An additional previously unreported finding was the presence of a strong membranous pattern of staining for Glut1 in the intralesional fat cells, a known component of the tumor, which parallels that of another endothelial marker, namely CD34. These findings could prove useful for diagnostic purposes in small biopsies.

Lymphatic vessels in the thyroid gland of children

Summary For the first time, to our knowledge, we report a peculiar histological finding in the thyroid glands of children, namely the presence of empty, elongated, tortuous, retraction-like spaces apparently dissecting the interstitial tissue. The availability of D2-40, an immunohistochemical marker for lymphatic endothelial cells, allowed us to identify these spaces as intraparenchymatous lymphatic capillaries. This phenomenon was evident at the periphery where they blended with marginal lymphatic vessels.