Tiger-Striped PASH: Recognition of a Unique Morphology Allows for a Zippered-Up Diagnosis of Pseudoangiomatous Stromal Hyperplasia of Breast

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is histologically characterized by anastomosing and slit-like spaces invested by collagenous stroma and lined by flattened, spindle cells. These clear spaces that may mimic microscopic vascular channels do not contain red blood cells. Immunohistochemistry (IHC) studies may also help to confirm a diagnosis of PASH, with the spindled cells marking positively with CD34 and PR while demonstrating no reactivity with more specific endothelial antigens such as CD31 and ERG. In the current case, a 39-year-old female was diagnosed with cellular PASH of the right breast with unique histological patterns showing “tiger-striped” and “zippered” histologies. To our knowledge, this is the first report of these unique variant PASH morphologies.

A subset of arachnoid granulations in humans drain to the venous circulation via intradural lymphatic vascular channels

OBJECTIVE The discovery of dural lymphatics has spurred interest in the mechanisms of drainage of interstitial fluid from the CNS, the anatomical components involved in clearance of macromolecules from the brain, mechanisms of entry and exit of immune components, and how these pathways may be involved in neurodegenerative diseases and cancer metastasis. In this study the authors describe connections between a subset of arachnoid granulations (AGs) and the venous circulation via intradural vascular channels (IVCs), which stain positively with established lymphatic markers. The authors postulate that the AGs may serve as a component of the human brain’s lymphatic system. METHODS AGs and IVCs were examined by high-resolution dissection under stereoscope bilaterally in 8 fresh and formalin-fixed human cadaveric heads. The superior sagittal sinus (SSS) and adjacent dura mater were immunostained with antibodies against Lyve-1 (lymphatic marker), podoplanin (lymphatic marker), CD45 (panhematopoietic marker), and DAPI (nuclear marker). RESULTS AGs can be classified as intradural or interdural, depending on their location and site of drainage. Interdural AGs are distinct from the dura, adhere to arachnoid membranes, and occasionally open directly in the inferolateral wall or floor of the SSS, although some cross the infradural folds of the dura’s inner layer to meet with intradural AGs and IVCs. Intradural AGs are located within the leaflets of the dura. The total number of openings from the AGs, lateral lacunae, and cortical veins into the SSS was 45 ± 5.62 per head. On average each cadaveric head contained 6 ± 1.30 intradural AGs. Some intradural AGs do not directly open into the SSS and use IVCs to connect to the venous circulation. Using immunostaining methods, the authors demonstrate that these tubular channels stain positively with vascular and lymphatic markers (Lyve-1, podoplanin). CONCLUSIONS AGs consist of two subtypes with differing modes of drainage into the SSS. A subset of AGs located intradurally use tubular channels, which stain positively with vascular and lymphatic markers to connect to the venous lacunae and ultimately to the SSS. The present study suggests that AGs may function as a component of brain lymphatics. This finding has important clinical implications for cancer metastasis to and from the CNS and may shed light on mechanisms of altered clearance of macromolecules in the setting of neurodegenerative diseases.

Retiform hemangioendothelioma: a rare lesion of the vulva

Retiform hemangioendothelioma (RH) is a rare borderline-malignant vascular tumor with specific histological characteristics, usually occurring in the limbs and trunk. We report the case of a 63-year-old woman who presented with a painless, oval nodule that had been growing slowly on her left vulva for 3 years. Magnetic resonance imaging of the pelvic cavity revealed a 4.4- × 2.7- × 1.8-cm cystic lesion in the subcutaneous fat of the left vulva. Resection beyond the macroscopic border was performed. Pathology revealed vascular structures with elongated and narrow arborizing vascular channels that were arranged in a retiform pattern resembling rete testis tissue. Immunohistochemical endothelial staining was positive for CD31, CD34, and Friend leukemia integration-1 (FLI-1). The above features confirmed a diagnosis of RH. There was no local recurrence or metastasis during the 26-month follow-up. RH of the vulva is rare, and its diagnosis is supported by specific histological characteristics and immunohistochemical staining for CD31, CD34, and FLI-1. Wide surgical resection with tumor-free margins is important for a favorable prognosis.

Lizards and snakes from the earliest Miocene of Saint-Gérand-le-Puy, France: an anatomical and histological approach of some of the oldest Neogene squamates from Europe

Background The earliest Miocene (Aquitanian) represents a crucial time interval in the evolution of European squamates (i.e., lizards and snakes), witnessing a high diversity of taxa, including an array of extinct forms but also representatives of extant genera. We here conduct a taxonomical survey along with a histological/microanatomical approach on new squamate remains from the earliest Miocene of Saint-Gérand-le-Puy, France, an area that has been well known for its fossil discoveries since the nineteenth century. Results We document new occurrences of taxa, among which, the lacertid Janosikia and the anguid Ophisaurus holeci, were previously unknown from France. We provide a detailed description of the anatomical structures of the various cranial and postcranial remains of lizards and snakes from Saint-Gérand-le-Puy. By applying micro-CT scanning in the most complete cranial elements of our sample, we decipher previously unknown microanatomical features. We report in detail the subsurface distribution and 3D connectivity of vascular channels in the anguid parietal. The fine meshwork of channels and cavities or sinuses in the parietal of Ophisaurus could indicate some thermoregulatory function, as it has recently been demonstrated for other vertebrate groups, providing implications for the palaeophysiology of this earliest Miocene anguine lizard. Conclusions A combination of anatomical and micro-anatomical/histological approach, aided by micro-CT scanning, enabled the documentation of these new earliest Miocene squamate remains. A distinct geographic expansion is provided for the extinct anguine Ophisaurus holeci and the lacertid Janosikia (the closest relative of the extant insular Gallotia from the Canary Islands).

What’s in the Offing?

This chapter attempts to peer into the possible future of bioprinting to consider two conceivable directions that bioprinting might take while also contemplating what we may be able to learn about bioprinting’s trajectory by reflecting on another biomedical quest—the twentieth-century’s attempt to conquer polio. In one study that might offer a route for bioprinting, a team created bioconstructs with cell densities approaching that of native tissue (about 108 cells/gram). The group used embedded 3D printing to create a branched, hierarchical network of vascular channels within a large, high cell density bioconstruct and perfused media through the channels that they created using fugitive ink. This was to provide nutrient support for the cells. They also built a high-density cardiac construct in which the cells beat synchronously and showed functional contractility. They quantitatively measured the deformation of the cardiac tissue during contraction.

Intracranial collateral circulation and its role in neurovascular pathology

Background Collateral circulation is a vascular network which maintains the blood flow after the partial blockage of primary vascular pathways. This acts as potential vascular supplementary system and plays important role in the cerebral ischemia. Main body Collateral circulation has implications in the management especially related to cerebral endovascular treatment and thrombolytic therapy. It is considered as subsidiary network of vascular channels, which is highly variable. Insufficient arterial supply is due to the hemodynamic compromise because of thromboembolism. Apart from the collaterals, there is additional existence of a group of vessels known as venous collaterals. Their function is variable and they contribute to the augmentation of venous drainage in venous ischemias. Various pharmacological interventions are used to modulate the collaterals, these can prove to be a complementary alternative to the invasive intracerebral interventions. Conclusions The aim of this review article is to highlight the importance of cerebral collateral circulation and to discuss the various available pharmacological alternatives available and their current relevance in the management of various neurovascular pathologies.

Fabrication of Nanopores Polylactic Acid Microtubes by Core-Sheath Electrospinning for Capillary Vascularization

There has been substantial progress in tissue engineering of biological substitutes for medical applications. One of the major challenges in development of complex tissues is the difficulty of creating vascular networks for engineered constructs. The diameter of current artificial vascular channels is usually at millimeter or submillimeter level, while human capillaries are about 5 to 10 µm in diameter. In this paper, a novel core-sheath electrospinning process was adopted to fabricate nanoporous microtubes to mimic the structure of fenestrated capillary vessels. A mixture of polylactic acid (PLA) and polyethylene glycol (PEO) was used as the sheath solution and PEO was used as the core solution. The microtubes were observed under a scanning electron microscope and the images were analyzed by ImageJ. The diameter of the microtubes ranged from 1–8 microns. The diameter of the nanopores ranged from 100 to 800 nm. The statistical analysis showed that the microtube diameter was significantly influenced by the PEO ratio in the sheath solution, pump rate, and the viscosity gradient between the sheath and the core solution. The electrospun microtubes with nanoscale pores highly resemble human fenestrated capillaries. Therefore, the nanoporous microtubes have great potential to support vascularization in engineered tissues.

CD133 Expression in Placenta Chorioangioma Presenting as a Giant Asymptomatic Mass

Background: Placental chorioangioma is the most common benign non-trophoblastic neoplasm of the placenta. Its clinical relevance lies in the size of the tumor since larger masses cause pregnancy complications, including an unfavorable neonatal outcome. Case presentation: We report the case of a 34-year-old second gravida and nullipara at the 35th week of gestation, admitted to the gynecological department for antibiotic-resistant fever. The cardiotocography performed during hospitalization showed an abnormal fetal pattern. A 2250 g newborn was delivered by cesarean section. No complications were observed during childbirth and postpartum was insignificant. On gross inspection a white fleshy intraparenchymal mass blooming on the maternal surface was noted; routinely stained sections revealed features consistent with chorioangioma with vascular channels lined by inconspicuous endothelial cells immunoreactive for CD31 and CD133. Focal expression of CD133 was also observed in placental villi. Discussion: CD133 expression indicated the presence of stem cells in chorioangioma, suggesting their possible role in the development of mesenchymal lesions including chorioangioma.

Folliculosebaceous Cystic Hamartoma: A Rare Entity

Folliculosebaceous Cystic Hamartoma (FSCH) is an uncommon cutaneous hamartomatous lesion. It is basically a tumour like malformations exhibiting abnormal overgrowth of biphasic elements i.e., epithelial and mesenchymal components that are normally found in the skin. Few other hamartomas of pilosebaceous origin are trichofolliculoma, trichodiscoma, fibrofolliculoma and pilar sheath acanthoma. Though distinct, this entity shares similar histological features to Sebaceous Trichofolliculoma (STF). Hence, a proper histological examination is must in differentiating it from STF and other clinical and histological entities. Authors hereby, describes a case of FSCH in a 37-year-old male who presented with a slow growing cystic mass on his left earlobe, an uncommon location for such lesion. The mass was excised, and a detailed histological evaluation showed a characteristic multinodular growth pattern with lobules of pilosebaceous glands forming nodules around cystically dilated follicular infundibular structures. No hair shafts were seen in the cystic cavity ruling out differential diagnosis of sebaceous hyperplasia which could have been a close mimic. The intervening stroma revealed dense collagen, sheets and lobules of adipocytes, many vascular channels filled with fibrinous deposits. Perivascular adipocytes were also noted along with few nerve tissues (perineurium). A detailed clinicopathological work-up helped in arriving at a final diagnosis of FSCH with neural component. The patient was doing well till last six months of follow-up. No recurrence of similar lesion was noted in the patient.