Chromophobe renal cell carcinoma was described by Thoenes et al. in 1986, and associations with carcinoma of collecting ducts, conventional renal cell carcinoma and sarcomatoid renal cell carcinoma have been described. We report a case of chromophobe renal cell carcinoma which showed neuroendocrine differentiation. This is the first known case to be clearly identified as such. The patient was a 56-year-old man with constant right flank pain and hematuria; CT scan revealed an 8.5 cm nonhomogeneous mass involving the right kidney. Right radical nephrectomy was performed. The tumor showed a mixture of classical and eosinophilic patterns of chromophobe cell carcinoma. Additionally, it showed insular, glandular and rosetoid-like formations embedded in a dense eosinophilic hyaline stroma. The cells were cuboid or cylindrical with well-defined boundaries, finely stippled chromatin and a small nucleolus. The appearance of the cytoplasm varied from faintly eosinophilic to coarsely granular eosinophilic. Immunohistochemically, the neuroendocrine areas were reactive for C-kit, epithelial membrane antigen, cytokeratin, cytokeratin 7, chromogranin A, neuron-specific enolase, CD56 and S-100 protein. Our case represents a typical chromophobe carcinoma with neuroendocrine differentiation. Additionally, the immunohistochemical profile in both types of lesion suggests a common origin from renal tubular cells.

Malignant melanoma (MM) and blue nevi of the uterine cervix are an extremely rare neoplasm, probably derived from embryologic migration of melanocytes from the neural crest. MM displays aggressive behavior with a poor prognosis. We report the case of a 76-year-old postmenopausal woman abnormal vaginal bleeding. She underwent a hysterectomy and bilateral salpingo-oophorectomy with paraaortic-iliac lymphadenectomy. Histopathological and immunohistochemical studies were consistent with the diagnosis of MM and blue nevi in the uterine cervix. Although it is extremely rare, this case suggests that MM of the uterine cervix should be considered in the differential diagnosis of undifferentiated neoplasm. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.

Members of the family of large chondroitin sulfate proteoglycans (CSPGs), such as versican and aggrecan, are involved in early heart development, and in the development and progression of atherosclerosis and restenosis. Given the important roles played by versican and aggrecan in such processes, we sought to determine whether these molecules are present in the aortic wall during the advanced stages of chicken embryo development and the endothelial-mesenchymal transformation (EMT). Immunolabeling of serial cryosections revealed versican immunoreactivity around the cells within the intimal thickening, and the cells organized in lamellar and interlamellar cell layers. In contrast, a weak aggrecan immunoreactivity was limited to the cells arranged into lamellar and interlamellar cell layers. Immunolabeling also demonstrated that V2 is the main versican isoform present at the intimal thickening. According to immunoblotting analysis, the aggrecan content was very low in all stages examined, and two versican isoforms (V0 and V2) were present at day 14 of development. We also investigated whether versican isoforms were present during EMT in vitro. Versican immunoreactivity was detected in patches of endothelial cells; in the detaching and migrating cells, and the extracellular matrix (ECM) deposited by them; and in cells that had acquired mesenchymal characteristics. These data indicate that versican and aggrecan have different spatial and temporal patterns of expression, and they have different functions during remodeling of the aortic wall. Also, the different immunoreactivity and immunolocalization patterns observed for versican both in vivo and in vitro, in addition to being associated with the presence of different versican isoforms, may be related to the predominance of the V2 isoform during intimal thickening formation and EMT. © 2004 Wiley-Liss, Inc. Key words: aorta; remodeling; endothelial-mesenchymal transformationEndothelial-mesenchymal transformation (EMT) is believed to play a crucial role in embryonic and adult vascular development, and the development of intimal lesions