Hisae Satomi

Intramuscular metastasis from malignant melanoma: MR findings

Abstract We present a rare case of intramuscular metastasis from malignant melanoma. The lesion showed intermediate to high signal intensity on T1-weighted magnetic resonance (MR) images and mixed signal intensities containing high and low signals on T2-weighted images. The signal intensity on T1-weighted images, which is due to the paramagnetic effect of melanin, is a characteristic MR finding of this entity.

Lack of Progesterone Receptor Expression in Extramammary Paget's Disease

Surgical specimens from 4 men and 5 women (aged 59 ‐ 92 years) with extramammary Paget’s disease were examined for PR expression, 6 were of in situ and 3 of invasive carcinoma, of which 2 had lymph node swelling. One breast carcinoma specimen was used as a positive control. The PR content in this control was measured with enzyme immunoassay (5), which revealed 468 fmol/mg protein, and this specimen was thus used as a positive control. None of the 9 extramammary Paget’s disease patients had either underlying sweat gland adenocarcinoma or a primary carcinoma of other organs. The formalin-fixed, paraffin-embedded tissue specimens and positive control specimens, were cut into 5-mm sections and then deparaffinized. The sections were incubated for 30 min in 1% hydrogen peroxide to block any endogenous peroxidase activity. After blocking with normal goat serum, the sections were incubated with rabbit polyclonal anti-PR antibody (C-19, Santa Cruz, CA, USA) or mouse monoclonal anti-OR antibody (C-314, Santa Cruz, CA, USA) at a concentration of 2 mg/ml. The sections were subsequently treated with secondary antibody using the Vectastain ABC-Peroxidase kit (Vector, CA, USA) followed by staining with the Vector VIP peroxidase substrate kit (Vector, CA, USA), and were then counterstained with methyl green.

Psoriasis vulgaris and acute guttate psoriasis in a family

A 33‐year‐old man (Case 1) developed scaling and erythema on the extensor side of his extremities, head, and back, 3 years before his first visit to our hospital. The lesions spread out to form several plaques and became persistent ( Fig. 1a ). Serum antistreptolysin O (ASO) was within the normal range and a pharyngeal culture showed normal flora. Histologic findings were compatible with psoriasis vulgaris ( Fig. 1b ). Topical steroid therapy was effective; however, scaling and erythema persisted.

Immunohistochemical detection of erbB-4 expression in extramammary Paget's disease.

Sir, Extramammary Pagets disease occurs in the anogenital region, the axilla or, most commonly, the vulva (1). It occurs more frequently in women than in men and usually starts in the ¢fth decade or after. In a proportion of cases, an underlying sweat gland adenocarcinoma or a primary carcinoma of another organ, such as the rectum, urethra or cervix uteri, is found. However, in other cases it occurs primarily in the epidermis as carcinoma in situ. A number of studies have shown that ampli¢cation of the c-erbB-2 gene occurs frequently in various human tumours, such as breast cancer (2) and salivary gland adenocarcinoma (3), and is usually associated with a poor prognosis. Expression of c-erbB-2 was also examined and an intense membrane staining was observed in the intra-epidermal Paget cells of mammary and extramammary Pagets diseases (4 ^ 6). The erbB-4 gene encodes a 180 kDa transmembrane tyrosine kinase, the cytoplasmic kinase domain of which exhibits 79% and 77% identity with epidermal growth factor receptor and c-erbB-2, respectively (7). Expression of erbB-4 is observed at the highest levels in breast carcinoma cell lines, normal skeletal muscle, heart and brain (7). To examine whether erbB-4 is expressed in tumour cells of extramammary Pagets disease, we performed immunohistochemical staining of erbB-4 protein using the anti-erbB-4 polyclonal antibody.