Extracellular matrix (ECM) composition has an important role in determining airway structure. We postulated that ECM lung composition of chronic obstructive pulmonary disease (COPD) patients differs from that observed in smoking and nonsmoking subjects without airflow obstruction.We determined the fractional areas of elastic fibres, type-I, -III and -IV collagen, versican, decorin, biglycan, lumican, fibronectin and tenascin in different compartments of the large and small airways and lung parenchyma in 26 COPD patients, 26 smokers without COPD and 16 nonsmoking control subjects.The fractional area of elastic fibres was higher in non-obstructed smokers than in COPD and nonsmoking controls, in all lung compartments. Type-I collagen fractional area was lower in the large and small airways of COPD patients and in the small airways of non-obstructed smokers than in nonsmokers. Compared with nonsmokers, COPD patients had lower versican fractional area in the parenchyma, higher fibronectin fractional area in small airways and higher tenascin fractional area in large and small airways compartments. In COPD patients, significant correlations were found between elastic fibres and fibronectin and lung function parameters.Alterations of the major ECM components are widespread in all lung compartments of patients with COPD and may contribute to persistent airflow obstruction.

Microbial diversity has been pointed out as a major factor in the development and progression of colorectal cancer (CRC). We sought to explore the richness and abundance of the microbial community of a series of colorectal tumor samples treated at Barretos Cancer Hospital, Brazil, through 16S rRNA sequencing. The presence and the impact of Fusobacterium nucleatum ( Fn ) DNA in CRC prognosis was further evaluated by qPCR in a series of 152 CRC cases. An enrichment for potentially oncogenic bacteria in CRC was observed, with Fusobacterium being the most abundant genus in the tumor tissue. In the validation dataset, Fn was detected in 35/152 (23.0%) of fresh-frozen tumor samples and in 6/57 (10.5%) of paired normal adjacent tissue, with higher levels in the tumor ( p = 0.0033). Fn DNA in the tumor tissue was significantly associated with proximal tumors ( p = 0.001), higher depth of invasion ( p = 0.014), higher clinical stages ( p = 0.033), poor differentiation ( p = 0.011), MSI-positive status ( p < 0.0001), BRAF mutated tumors ( p < 0.0001), and the loss of expression of mismatch-repair proteins MLH1 ( p < 0.0001), MSH2 ( p = 0.003), and PMS2 ( p < 0.0001). Moreover, the presence of Fn DNA in CRC tissue was also associated with a worse patient cancer-specific survival (69.9 vs. 82.2% in 5 years; p = 0.028) and overall survival (63.5 vs. 76.5%; p = 0.037). Here we report, for the first time, the association of F. nucleatum presence with important clinical and molecular features in a Brazilian cohort of CRC patients. Tumor detection and classification based on the gut microbiome might provide a promising approach to improve the prediction of patient outcome.

Although extremely rare, the presence of ectopic thyroid tissue in the submandibular region should be considered in the differential diagnosis of tissue masses in the cervical region. Diagnosis is confirmed by fineneedle aspiration biopsy and exclusion of malignancy should be confirmed by histopathologic analysis of the lesion. In general, surgery is the treatment of choice. A rare case of ectopic thyroid in the right submandibular region is reported; it was diagnosed after total thyroidectomy and successfully treated through surgery.

It has been suggested that airway remodelling is responsible for the persistent airway obstruction and decline in lung function observed in some asthmatic patients. The small airways are thought to contribute significantly to this functional impairment. Proteoglycans (PGs) are important components of the extracellular matrix (ECM) in the lungs. Besides controlling biophysical properties of the ECM, they play important roles in the regulation of some cytokines. Increased subepithelial PG deposition in the airways of mild asthmatics has been reported. However, there are no data on the PG content in small airways in asthma. This study has compared the content and distribution of PGs in large and small airways of patients who died of asthma with those in control lungs. Immunohistochemistry and image analysis were used to determine the content of lumican, decorin, biglycan, and versican in large (internal perimeter >6 mm) and small (internal perimeter < or =6 mm) airways of 18 patients who had died of asthma (A) and ten controls (C). The results were expressed as PG area (microm2)/epithelial basement membrane length (microm). The main differences between asthmatics and controls were observed in the small airways. There was a significant decrease in decorin and lumican contents in the external area of small airways in asthmatics (decorin: A = 1.05 +/- 0.27 microm, C = 3.97 +/- 1.17 microm, p = 0.042; lumican: A = 1.97 +/- 0.37 microm, C = 5.66 +/- 0.99 microm, p = 0.002). A significant increase in versican content in the internal area of small and large airways in asthmatics was also observed (small: A = 7.48 +/- 0.84 microm, C = 5.16 +/- 0.61 microm, p = 0.045; large: A = 18.38 +/- 1.94 microm, C = 11.90 +/- 2.86 microm, p = 0.028). The results show that PGs are differentially expressed in the airways of fatal asthma and may contribute to airway remodelling. These data reinforce the importance of the small airways in airway remodelling in asthma.

Background: Pilomatrixoma (OMIM ID #132600) is a benign cutaneous tumor originating from the pilosebaceous follicle and characterized by the presence of subcutaneous nodules of up to 3.0 cm in diameter, usually on the head, neck and upper extremities. It is most common in the first two decades of life and after the age of 60.Main observations: An adult female patient was evaluated, presenting a solid tumoral lesion with erythematous surface and purplish tone, with approximately 7.5 x 5.0 cm in size, in the interscapulovertebral region. It was thought to be an epidermoid cyst, sarcoma, calcified hemangioma, giant dermatofibroma, or nodular basal cell carcinoma. The resection of the lesion was carried out and, at the histological examination, specific details were observed that led to the diagnosis of pilomatrixoma. Conclusion:Pilomatrixoma should be suspected in the differential diagnosis of giant adnexal tumors. (J Dermatol Case Rep. 2013; 7(2): 56-59) An unusual presentation of giant pilomatrixoma in an adult patient IntroductionPilomatrixoma (PM; OMIM ID #132600) was first described in 1880 by Malherbe and Chenatais as a "calcified epithelioma of Malherbe" originated from sebaceous glands. In 1961, Forbis and Helwig demonstrated that the tumor originated from the hair matrix; therefore, the name pilomatrixoma. 1-3 PM is the most common hair-follicle tumor and it accounts for one of every 500 specimens submitted by dermatologists. 4 Clinically, the lesion is a benign cutaneous tumor usually characterized by a solitary asymptomatic, firm, and skin-colored faint blue/red nodule in the deep dermis and subcutaneous tissue, with an average size of 0.5 to 3.0 cm. The lesions larger than 5.0 cm are defined as giant pilomatrixomas. Pain and tenderness may be associated symptoms. 3,5 The tumor is generally observed on the head, neck and upper extremities. 6 It is a common skin neoplasm in the pediatric population, but it may be found in all age groups with bimodal peaks under the age of 30 and in the sixth/seventh decades of life. 5,6 Uncommon clinical-pathological variants of PM have been reported, such as bullous like, anetodermic, exophytic, perforating/ulcerated and lymphagiectatic. Multiple and familial cases have been described in association with myotonic dystrophy, Turner's syndrome, Gardner's syndrome, xeroderma pigmentosum, basal cell nevus syndrome and Sotos syndrome. 6,7 The present paper reports an unusual and uncommon case of pilomatrixoma on the back of an adult female patient. Case ReportA 54-year-old female patient sought the medical specialties outpatient service at School of Medical Sciences at Universidade de Marília (UNIMAR) complaining about a back injury three years ago, with progressive growth and sporadic local pain. The patient had undergone a surgery for the removal of the lesion in another hospital two and a half years before, but there was local recurrence 3 months after surgery. Krausen et al. 9 described the first case of giant PM (GPM), few similar lesions were described 5 a...