Masaya Tezuka

Histopathogenesis of inflammatory linear verrucose epidermal naevus: histochemistry, immunohistochemistry and ultrastructure

SummarySkin lesions of three patients with inflammatory linear verrucose epidermal naevus (ILVEN) were examined. Histologically, orthokeratosis and parakeratosis were alternately seen in the acanthotic epidermis. By N-(7-dimethylamino-4-methyl-3-coumarinyl)maleimide staining, the horny cells in the parakeratotic epidermis showed a cytoplasmic SH pattern and a weak membranous SS pattern. The orthokeratotic epidermis revealed an increased involucrin expression, whereas the parakeratotic epidermis showed almost no involucrin expression. Ultrastructurally, in the parakeratotic epidermis, the living keratinocytes had prominent Golgi apparatuses and vesicles in the cytoplasm. In the intercellular spaces in the upper spinous layer through to the lower horny layer, an electron dense, homogeneous substance was deposited. The cytoplasm of the horny cells was filled with keratin filaments and contained remnants of nucleus and cytoplasmic membrane structures, and some lipid droplets. The marginal band formation was incomplete. Most of these ultrastructural abnormalities were not found in the orthokeratotic epidermis. There are both similarities and differences in histopathogenesis of the parakeratotic epidermis between ILVEN and psoriasis. A unique finding was the lack of involucrin expression in the ILVEN parakeratotic epidermis.

Cell kinetic study of human and mouse hair tissues using anti-bromodeoxyuridine monoclonal antibody

To determine sites of cell proliferation in hair tissues, in vitro and in vivo labeling with bromodeoxyuridine (BrdU) and immunohistochemical demonstration of BrdU incorporation sites by anti-BrdU monoclonal antibody were performed on human and mouse hairs and hair follicles. The germinative area of the hair bulb of human anagen hair was divided into three portions: (A) the upper and inner portion, (B) the middle portion and (C) the lowest outer portion. A-cells intermingled with melanocytes, were regarded as germinative cells of the hair cortex. B-cells appeared to develop into Huxleys layer, cuticle of inner root sheath (IRS), and hair cuticle. C-cells seemed to develop into bulbar outer root sheath (ORS), the innermost cell (IMC) layer of the ORS and Henles layer. The suprabulbar portion, where the ORS abruptly increased in thickness, was found to be the fourth main germinative portion (D). The ORS cells, except for the IMCs, seemed to originate mostly from the D-cells. In the late anagen phase, first, C-cells became BrdU negative, then, A- and B-cells gradually turned negative, and finally, D-cells lost their germinative activity. In catagen and telogen hair tissues, BrdU-positive cells were found in the two outer cell layers in the ORS. The structure of anagen hair tissues seems to be maintained by the coordinated mitotic activities of characteristically distributed germinative cells of various hair cell layers. The sequential cessation of mitotic activity of these cells is associated with the morphological changes from anagen through catagen to telogen. These findings were common to both human and mouse hair tissues.

Investigation of germinative cells in generating and renewed anagen hair apparatus in mice using anti-bromodeoxyuridine monoclonal antibody

To elucidate the cell kinetics in generating and renewed anagen hair apparatus in mice, S-phase cells in dorsal skin of new-born and 14 to 25-day-old mice were labeled with bromodeoxyuridine (BrdU) and stained immunohistochemically using anti-BrdU monoclonal antibody. In primary hair germ, lower and outer cells were positively stained. In hair peg, the positive cells were divided into upper and lower portions. In bulbous hair peg, the lower positive cells gathered at the suprapapillary area, whereas the upper positive cells were located in the outer part of the hair apparatus. The latter positive cells were further divided in the middle and upper parts of the epithelial cord. The upper cells were going to form a sebaceous gland. From the suprapapillary group of germinative cells, hair cortex through the innermost cell layer of the outer root sheath were considered to be produced. The positive cells of the outer middle group may be important for elongation of hair apparatus and produce outer root sheath cells. At the end of anagen phase, first the suprapapillary cells became negative and then the outer root sheath cells became negative. BrdU-positive cells reappeared at the bottom of telogen hair apparatus and formed a secondary hair germ. Then, a similar cell kinetics was repeated in the renewed anagen hair apparatus. The germinative cells were separated into a few groups during the generation and cyclic changes of hair apparatus. Each cell group formed the individual part of the hair apparatus in a coordinate fashion, resulting in dynamic changes of the hair apparatus.

Differential analysis of the human anagen hair apparatus using lectin binding histochemistry

SummaryCell differentiation in the human anagen hair apparatus was examined by lectin-binding histochemistry using seven different lectins: Con A, WGA, RCA-I, PNA, SBA, DBA and UEA-I. Con A and WGA positively stained almost all the cells in the hair apparatus. RCA-I and PNA positively stained the outer cells of the outer root sheath (ORS), but they did not stain the innermost cells (IMCs) of the ORS in the suprabulbar region. However, in the isthmus region, the IMCs showed positive staining with RCA-I, and more intense staining with PNA than that of the outer ORS cells. The ORS cells, including the IMCs, were negative with SBA and DBA below the suprabulbar region, whereas the IMCs became more strongly positive with these two lectins than the other ORS cells in the isthmus region. UEA-I strongly stained the IMCs, but not the outer ORS cells in the hair bulb. The latter cells became positive for UEA-I above the suprabulbar region. These findings indicate that the surface glycoconjugate distribution of the IMCs differs from that of the outer ORS cells. It is concluded that the IMCs of the ORS may undergo an independent cell differentiation process.

A case of vascular sarcoma.

An 85-year-old man presented a dome-shaped violaceous tumor of 2 cm in diameter, in the center of a palm-sized erythematous macule on his frontal scalp. This lesion was considered to be a local recurrence of a nodular lesion which had been previously excised marginally 4 months before. The primary lesion was histologically reevaluated and diagnosed as a moderately differentiated type of angiosarcoma. The intravenous and intralesional injections of recombinant interleukin-2 (rIL-2) was started at total daily doses ranging from 70 to 105 JRU, 6 days a week. The recurrent lesion disappeared 5 weeks after the initiation of the therapy and no remnant of malignant tissue was recognized in the specimen of the excisional biopsy taken after the treatment. Seven weeks after the biopsy, sacral bone metastasis was noted by sacral pain and comfirmed by CT scan. Both scalp area and metastatic bone lesion were treated by low dose irradiation combined with systemic intravenous administration of rIL-2. However, the metastatic lesion did not show any response to the therapy. Three months later the patient died of respiratory failure caused by pneumothorax and pleuritis due to the multiple lung metastases. It is suggested that the systemic rIL-2 therapy alone is not so effective to the distant metastatic lesion in spite of the remarkable curative effect of intralesional injection of rIL-2 on the primary skin lesion of angiosarcoma.