Florica Stăniceanu

Correlations Between the Autolytic Changes and Postmortem Interval in Refrigerated Cadavers.

Abstract Introduction. In forensic pathology the autolytic process has been observed and documented in order to determine the postmortem interval as accurately as possible. The observation and experiments have been carried out on cadavers exposed to environmental conditions – heat, humidity, air currents, soil, water. Methods. For this study hematoxylin and eosin (HE) stained sections of organ samples from 30 autopsied bodies were examined under the microscope. Modifications of tissue and cell structures were noted in correlation with the bodies’ time spent in the Morgue’s mortuary refrigerator until the autopsy was performed, which varied between 24 hours and 22 days. Results. All the organs sampled (lung, heart, liver and pancreas) showed severe autolytic alterations after 5 to 8 days. The most heavily affected was the pancreas, cells within Langherhans islets becoming complete autolyzed at the 36 hours mark. Inside organs, autolytic processes occur at different rates depending on the locations within that organ –deeply or superficial; in the heart after 4 or more days subendocardic myocardium shows less severe autolytic changes than the subepicardial one. Conclusion. Autolytic processes have a delayed onset and a much lower progression rate in a cold controlled environment. Different organs suffer different rates of autolysis in correlation to their structure and enzymatic content.

Correlations Between the Density of Tryptase Positive Mast Cells (DMCT) and that of New Blood Vessels (CD105+) in Patients with Gastric Cancer.

Abstract Mast cells proteases, tryptase and chymase are directly involved in the growth and progression of solid tumors due to their important role in tumor angiogenesis. We examined the density of tryptase positive mast cells and the mean density of new blood vessels in gastric malignant tumors of patients with and without Helicobacter pylori infection, using immunohistochemical staining for tryptase (for mast cells) and CD 105 (for new vessels). Tryptase and CD 105 expression was detected in gastrectomy specimens. In this study, mast cell density correlates with angiogenesis and the growth and progression of gastric cancer. It also shows that the participation of Helicobacter pylori infection in the growth and progress of gastric neoplasia is due to an increase of peritumoral angiogenesis, with subsequent local and distant tumor spread and perivascular growth, but without perineural and nodal involvement.

Neuroimmune cross-talk in Helicobacter pylori infection: analysis of substance P and vasoactive intestinal peptide expression in gastric enteric nervous system

ABSTRACT It is suggested that different neuropeptides are actively involved in the pathogenesis of Helicobacter pylori (H. pylori)-induced gastritis acting as important effectors of the neuroimmune complex interactions, but the available data is limited and contradictory. The aim of this study was to determine whether the chronic infection generates changes in substance P (SP) and vasoactive intestinal peptide (VIP) gastric level and to evaluate the dependence of these potential effects on the degree of bacterial colonization or the severity of the inflammatory infiltrate. Therefore, immunohistochemical tests were performed to examine SP and VIP expression in mucosal nerve endings and myenteric neurons. Both SP and VIP levels were significantly higher in gastric samples of patients infected with H. pylori compared to uninfected individuals, confirming that these neuropeptides are neuroimmune modulators involved in the pathogenesis of H. pylori infection. Although their expression did not correlate with the intensity of mucosal inflammation nor with the bacterial density, we observed a strong association between SP neuronal level and the degree of myenteric ganglionitis, which in turn correlated with the severity of mucosal T-cell infiltration. These findings suggest that the mechanisms of neuroimmune cross-talk depend on some other factors that remain to be determined.

Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides.

Mycosis fungoides is the most common primary T-cell lymphoma of skin. The disease has a protean clinical and histological presentation in its early patch and plaque stages, when distinction from mimicking inflammatory dermatoses is difficult. Since no single criterion is specific enough, a reliable diagnosis in early stages requires integration of clinical, histopathological and molecular findings. In skin biopsies, the most helpful histologic features are the detection of atypical lymphocytes in the epidermis with minimal epidermal changes, basal alignment of lymphocytes along dermal-epidermal junction and formation of Pautrier microabscesses. An aberrant immunophenotype of T cells and molecular detection of a clonal T-cell population are factors that could allow a more specific diagnosis. This work recapitulates and discusses these features from a practical perspective.

Multiple Histological Subtypes of Dermatofibrosarcoma Protuberans Occurring in the Same Tumor

Abstract Dermatofibrosarcoma protuberans (DFSP) represents a low-grade cutaneous sarcoma which may have different histological aspects, presenting as a fibrosarcomatous, pigmented, juvenile, myxoid, atrophic, sclerosing or myoid lesion. Some of these subtypes may occur isolated or in association with one of the others creating hybrid lesions. We present the case of a 66 years old woman having a 4 cm diameter tumor located on the abdominal wall. Histopathological examination of the resection specimen revealed areas of typical DFSP associated with fibrosarcomatous transformation, myoid and myxoid areas. Also, focally, pleomorphic tumor cells and foreign-body type multinucleated giant cells were observed. Immunostains revealed CD34 positivity in typical DFSP and myxoid areas with negative staining of some of the tumor cells in fibrosarcomatous areas and negative staining of myoid areas. Smooth muscle actin was positive in myoid areas. The nature of myoid fascicles in DFSP is a matter of debate, being uncertain whether these represent a type of tumor differentiation or a reactive myoid proliferation. In this particular case, finding the association of myoid cells with blood vessel walls sustains their reactive nature. We present the morphological aspects of the different areas of the tumor with emphasis on differential diagnostic problems and clinical implications. Abstract Dermatofibrosarcomul protuberans reprezintă un sarcom cutanat de grad jos care poate îmbrăca diferite aspecte histopatologice, prezentându-se ca variantă fibrosarcomatoasă, pigmentată, juvenilă, mixoidă, atrofică, sclerozantă sau mioidă. Unele dintre aceste subtipuri pot fi întâlnite izolat sau asociate unele cu celelalte dând naştere unor leziuni hibride. Prezentăm cazul unei paciente în vârstă de 66 de ani, cu o leziune tumorală de 4 cm diametru localizată pe peretele abdominal. Examenul histopatologic al piesei de excizie chirurgicală a relevat arii tipice de DFSP asociate cu arii de transformare fibrosarcomatoasă, arii mioide şi arii mixoide. De asemenea, focal, au fost remarcate celule tumorale cu aspect pleomorf şi celule gigante multinucleate de tip „corp străin”. Testele imunhistochimice au relevat pozitivitate pentru CD34 în ariile de DFSP tipic şi ariile mixoide şi absenţa pozitivităţii în unele celule tumorale fibrosarcomatoase şi în ariile mioide. Natura fasciculelor mioide din DFSP este considerată încă incertă, nefiind sigur dacă acestea reprezintă un tip particular de diferenţiere tumorală sau o proliferare mioidă reactivă. În acest caz particular, observarea asocierii dintre celulele mioide şi pereţii vasculari susţine natura lor reactivă. Prezentăm aspectele morfologice ale diferitelor zone tumorale subliniind problemele de diagnostic diferenţial şi implicaţiile clinice.

Density of Tryptase-Positive Mast Cells Correlated with the Presence of H. pylori in Gastric Neoplasia.

Abstract Background. Gastric cancer continues to be a platoon leader of mortality causes. A significant number of recent studies show direct or indirect involvement of mast cells (MC), with a complex role both pro- and anti-tumor growth. Aim. To objectify the correlations between expression of MC and presence of Helicobacter pylori (HP) infection depending on neoplastic nature of the gastric damage. Subjects and Methods. The study was carried out on archival samples of gastric wall from 30 patients with gastric cancer versus 30 age and sex-matched subjects with gastric surgery for nonneoplastic diseases. The inclusion criteria for the case group were histologically proven stage T3/T4 malignancies with regional lymph node metastases. For each case of the study group, distribution and number of MC tryptase positive (DMC–TP) were analyzed in five different areas from the same gastrectomy specimen: intratumor area, deep and side tumor invasion front, normal gastric tissue sample 5-10 cm or more distant from the tumor and furthest resection margin. Results. Independently of HP infection, the study recorded a significantly lower value of DMC-TP in male patients. In regions with inflammatory lesions and preneoplastic changes and in control cases with non-gastric neoplasia, the DMC-TP level was higher than controls with HP-related inflammatory pathology, thus removing bacterial etiology from the forefront of MC mobilizing causes. Conclusion. The presence of H. pylori infection was not found to cause significant changes in terms of mobilizing mast cells in the gastric wall with advanced tumors, with minimal stage III TNM.