Dysplastic lesions

Ponticello, A., Barra, E., Giani, U., Bocchino, M., and Sanduzzi, A. (2000). p53 immunohis-tochemistry can identify bronchial dysplastic lesions proceeding to lung cancer A prospective study. Eur. Respir. J. 15,547-552. 

A preliminary study using imaging cytometry of nasal smears obtained from nickel workers indicates that this method may be useful to detect precancerous and cancerous lesions (Reith et al. 1994). With this method in which the cells were obtained by brushing the inside of the nose, the investigators were able to distinguish between nickel-exposed workers with non-dysplastic normal and suspicious mucosa smears and those with dysplastic lesions. 

Groups of BD IX rats sex not specified] received a single subcutaneous injection of 40 mg/kg bw 1,2-dimethylhydrazine at the age of one day (11 rats), 10 days (7 rats) or 30 days (13 rats). The rats lived until their natural death. Among 11 rats treated at one day of age, one developed a colon carcinoma, with no dysplasia or hyperplasia in other rats. Among rats treated at the age of 10 days, 3/7 developed 4 colon carcinomas. One rat had a dysplasia and another had a hyperplasia. Four of 13 rats treated at the age of 30 days developed 13 carcinomas and three rats developed carcinomas of the small bowel. Six rats had dysplastic and four rats hyperplastic colon lesions. One rat had a dysplastic lesion and one a hyperplastic lesion of the small bowel (Martin et al., 1974). 

Dysplastic lesions Due to changes in the cytoplasm or the nucleus, dysplastic lesions exhibit histological characteristics such as irregular structure or growth. Genetic factors are considered to be involved (even though appropriate criteria do not as yet exist for all forms). (53) The lesions are classified as follows (s. tab. 21.4) ... 

Oliver RJ, MacDonald DG, Pelix DH. Aspects of cell proliferation in oral epithelial dysplastic lesions. J Oral Pathol Med. 2000 29(2) 49-55. 

If used cautiously, immunohistochemistry can be employed as an adjunct in the differential diagnosis of reactive versus dysplastic lesions. Nuclear p53 expression is present in more than 30% of all dysplasia in the EHBT (Fig. 15.21) and the incidence and the degree of expression is significantly higher in high-grade lesions," whereas p53 is relatively uncommon in non-neoplastic epithelium. On the other hand, it can be present in areas... 

Increased microvascularity or angiogenic squamous dysplasia [68,74]. The presence of capillary sized blood vessels juxtaposed to and projecting into dysplastic epithelium has been shown in dysplastic lesions compatible with the pattern of tortuous capillaries shown with high magnification broncho-videoscope indicating increased angiogenesis [75]. 

Dysplastic lesions are known to contain higher concentrations of chromophores, such as Flavins and NADH, contributing to the differences in autofluorescence signals between normal and potentially malignant cells [59]. 

AFB-LIFE biopsies show minute pre-cancerous lesions <1.5 mm in size, 50% of which are smaller than the biopsy forceps [69]. This may explain the spontaneous regression rate, especially regarding low-grade dysplastic lesions [76-78]. 

We have calculated the cost of AFB-LIFE bronchoscopy for early detection in the target population consisting of individuals with previously resected stage I-II lung and head and neck cancers, and those with positive sputum cytology. Twenty-one lesions have progressed to cancer so far (171 dysplastic lesions and 429 bronchoscopies). The tariff of one bronchoscopy examination in the Netherlands is 81. The endoscopic cost for early detection per cancer lesion was 1653. Treatment with electrocautery was 380 [10]. The costs for early bronchoscopic intervention per ESSCC was 2033. 

Figure 2. A) H E stained section of a high grade dysplastic lesion. B) " Blow up ofpotential micro-metastacy. C) UHCA map generatedfrom spectra recorded over the area shown in A. D) UHCA map generatedfrom spectra recorded over area shown in B. E) Mean extracted spectra from UHCA map D. (Reproducedfrom reference 22)...

The process, once initiated, is self-sustaining and may become more accelerated with time because the atrophy and intestinal metaplasia are progressive lesions and lead to further loss of parietal cells and incrased bacterial colonization of the mucosa. The initial mutations transform gastric cells into mature intestinal-type cells. Further superimposed mutations transform metaplastic cells into progressively dysplastic cells and eventually into neoplastic cells. This is a process of loss of differentiation which implies a multihit phenomenon which could be explained on the basis of continued formation of minute amounts of nitroso compounds over many years. 

Ellis DL, Wheeland RG, Solomon H. Estrogen and progesterone receptors in melanocytic lesions. Occurrence in patients with dysplastic nevus syndrome. Arch Dermatol 1985 121(10) 1282—5. 

Radovic S, Selak I, Babic M, Pasic F, Carcinoembryonic antigen (CEA) in colonic inflammatory-regenerative and dysplastic epithelial lesions, Croat. Med. J., 39 15-18, 1998. 

L5. Leav, I., McNeal, J. E., Ziar, J., and Alroy, J., The localization of transforming growth factor alpha and epidermal growth factor receptor in stromal and epithelial compartments of developing human prostate and hyperplastic, dysplastic, and carcinomatous lesions. Human Pathol. 29, 668-675 (1998). 

In renal transplant recipients, premalignant dysplastic keratotic lesions increased in frequency by 6.8% per year after the first 3.5 years after transplantation, and were ultimately observed in all 167 patients within 16 years of transplantation (66). No relation with sun exposure or skin type was found. The great majority of these patients were taking prednisolone and azathioprine, but azathioprine was considered as the main causative factor, possibly due to a carcinogenic effect rather than to immunosuppression itself. 

In the first study, the patients had radiography of the left hand for bone age determination, and 12 had deferoxamine-induced long bone dysplasia (107). There was irregularity at the physeal-metaphyseal junction of the distal ulna (the site most frequently affected) and radius metaphyseal sclerosis was also common, especially of the ulna, but also of the radius, metacarpals, and phalanges. Radiolucent lesions occasionally accompanied metaphyseal sclerosis. In six patients with relatively mild lesions, the dysplastic changes had been missed or not mentioned. 

Shiratori, Y., Soma, Y., Mamyama, H., Sato, S., Takano, A., and Sato, K., Immunohistochem-ical detection of the placental form of glutathione S-transferase in dysplastic and neoplastic human uterine cervix lesions. Cancer Res. 47, 6806 (1987). 

Early papillomas (10 wks) during promotion are well differentiated hyperplastic lesions with either mild or no cellular atypia, whereas late ones (40 wks) are dysplastic, show atypia and are aneuploid. 

Relative thickening of dysplastic mucosa and CIS, causing reduction of green light reflectance leading to a red-brownish appearance of the lesion [56,58]. 

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