Clinical, biochemical, and immunohistochemical features of necrobiotic xanthogranulomatosis.
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AIMS: To describe the clinical features of two patients with paraproteinaemia and necrobiotic xanthogranulomatosis together with detailed immunohistochemistry of the lesions in one. METHODS: The clinical history and results of biochemical investigations of the patients were retrieved from the files. Immunohistochemistry was used to investigate the expression of macrophage and mast cell markers, amyloid A and P, S-100 protein, and apolipoprotein AI and B in xanthogranulomatous skin lesions from patient 2. In addition, protein A-sepharose chromatography was used to separate serum from patient 2 and apolipoprotein B and the IgG paraprotein were measured in the fractions eluted. RESULTS: Monocytes/macrophages comprised the major cellular component of the lesion, and unusually for xanthomata, areas of collagen necrosis were also seen. Activated mast cells were present at the margins of macrophage clusters and adjacent to areas of collagen necrosis. Serum paraprotein was bound to low density lipoproteins as judged by protein A-sepharose chromatography, and was also located within macrophagic foam cells of the lesion on immunohistochemistry. CONCLUSIONS: These observations demonstrate many features similar to atherosclerosis including collagen necrosis and mast cell activation. (+info)
Necrobiotic palisading granulomas associated with breast carcinoma.
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AIMS: The presence of granulomas within the stroma of carcinomas and in the lymph nodes draining carcinomas has been well described. To date, however, there have been few studies examining the occurrence and relevance of necrobiotic granulomas occurring in association with breast carcinoma. METHODS/RESULTS: Four cases of breast carcinoma with necrobiotic granulomas were examined using periodic acid Schiff and Ziehl Neelsen stains for fungi and tubercle bacilli and with immunohistochemistry using CAM 5.2, cytokeratin 7, and cytokeratin AE1/3 for tumour cells. In one case the stroma was involved, in the other three cases the lymph nodes contained necrobiotic granulomas. In two of the cases, one with stromal and one with lymph node involvement, the necrobiotic granulomas contained necrotic tumour cells. CONCLUSION: In this study the features of four cases of breast carcinomas with necrobiotic granulomas are examined and their relevance explored. Close scrutiny of such granulomas is necessary to avoid underdiagnosis of metastatic disease. (+info)
Necrobiotic xanthogranuloma.
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A 67-year-old man presented with a 13-year history of slowly enlarging yellow-red plaques on the face and lower extremity. A biopsy specimen was consistent with necrobiotic xanthogranuloma. Necrobiotic xanthogranuloma is a slowly progressive histiocytic disease that is associated with paraproteinemia in most cases; however, its pathogenesis remains unclear. Although there is no first-line therapy, anecdotal reports have shown variable benefit with chemotherapeutic agents. (+info)
Necrobiotic xanthogranuloma of the chest wall.
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Necrobiotic xanthogranuloma is a rare disease that usually presents with indurated yellow red nodules or plaques in the dermis or subdermal tissues. The pathogenesis of this disease is unknown and the limited number of cases has made long-term studies difficult. We report the case of a 61-year-old woman seen in our office for a 5 x 5-cm lesion of her chest wall. Biopsies established a diagnosis of necrobiotic xanthogranuloma. The patient received 4 months of intralesional steroid injections without change in the lesion. The patient was also treated with colchicine for several months without improvement. Therefore, the lesion was surgically excised and the area was reconstructed with local advancement skin flaps. The patient has been followed for 2 years with no evidence of recurrence. (+info)
Pulmonary necrobiotic nodules: a rare extraintestinal manifestation of Crohn's disease.
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The histopathological study of osteoporosis.
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The osteoporosis is characterized by the imbalance between the activity of the osteoblasts, the bone forming cells, and the osteoclasts, the cells that resorb the bone tissue, imbalance that favors the osteoclasts. As a conclusion, in the case of osteoporosis, for the same volume, the bone is less compact and more fragile. The objective of our study is to make a histological evaluation of the different elements of the bone tissue in many 47 bone samples: 27 bone fragments were collected from the head and the femoral head of patients who required hip arthroplasty and 20 bone fragments were collected from the vertebral body of dead patients. The results of our study emphasized the thinned trabeculae of the bone that lost continuity, the preferential resorption of the horizontal trabeculae, the consecutive trabecular anisotropy and the reduction of the trabecular connectivity with enlarged areolae and the adipose degeneration of the marrow. One notices in the osteoporosis a reduction of the trabecular network connectivity directly proportional with the stage of the illness; thus, we determined a strong reduction of the trabecular connectivity in advanced osteoporosis stages. The growth aspects of the medular adiposity, associated with the intratrabecular connectivity concurs to highlight the functional connection between bone and marrow. The diminution of the medullar cellularity together with its enrichment in fat cells has negative outcomes on the bone. (+info)
Necrobiosis and T-lymphocyte infiltration in retrieved aseptically loosened metal-on-polyethylene arthroplasties.
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