Cytologic features of pleural effusion in apocrine sweat gland carcinoma. A case report

BACKGROUND: Carcinoma arising in the apocrine sweat glands is very rare, and there are few reports of the cytologic features. We encountered a case of metastatic apocrine carcinoma in a pleural effusion. CASE: A 46-year-old male had a dark reddish nodule in the right axillary region that was diagnosed as apocrine carcinoma of skin appendage origin. Three years after wide resection and chemotherapy, widespread metastases developed with a massive pleural effusion. Needle aspiration fluid cytology contained clusters of adenocarcinoma. Some tumor cells had abundant cytoplasm or periodic acid-Schiff-positive, coarse granules. Decapitation secretion was occasionally found on the cell surface. Immunohistochemically, the tumor cells were often positive for BRST-2 and BRST-3. CONCLUSION: Cytologic features of metastatic apocrine sweat gland carcinoma show some characteristics of adenocarcinoma. Moreover, its definitive diagnosis in a pleural effusion can be made because of retaining the characteristics of apocrine sweat gland.     

MRP8蛋白在腋臭中的表达及其意义

为了比较腋臭患者与正常人顶泌汗腺中MRP8表达情况,并对其临床应用价值作出评价。随机选取我院2015～2016年就诊患者90例对其进行回顾性研究,其中腋臭病确诊患者30例作为实验组,肺癌患者30例为阳性对照组,正常人腋下皮肤组织30例作为空白对照组,采用免疫组化法检测MRP8蛋白的表达情况并作统计学分析。实验显示:实验组腋臭顶泌汗腺中MRP8的表达阳性率(60%)高于空白对照组(33.3%),差异具统计学意义(p<0.05);阳性对照组中MRP8的表达阳性率(90%)高于实验组,两组间差异具统计学意义(p<0.05)。腋臭患者的汗腺中MRP8蛋白表达较正常人高,提示腋臭的发生、发展与该蛋白表达的变化具有密切关系,能够为腋臭临床诊断提供重要依据。     

Structure and function of human sweat glands studied with histochemistry and cytochemistry

The basic structure and the physiological function of human sweat glands were reviewed. Histochemical and cytochemical techniques greatly contributed the elucidation of the ionic mechanism of sweat secretion. X-ray microanalysis using freeze-dried cryosections clarified the level of Na, K, and Cl in each secretory cell of the human sweat gland. Enzyme cytochemistry, immunohistochemistry and autoradiography elucidated the localization of Na,K-ATPase. These data supported the idea that human eccrine sweat is produced by the model of N-K-2Cl cotransport. Cationic colloidal gold localizes anionic sites on histological sections. Human eccrine and apocrine sweat glands showed completely different localization and enzyme sensitivity of anionic sites studied with cationic gold. Human sweat glands have many immunohistochemical markers. Some of them are specific to apocrine sweat glands, although many of them stain both eccrine and apocrine sweat glands. Histochemical techniques, especially immunohistochemistry using a confocal laser scanning microscope and in situ hybridization, will further clarify the relationship of the structure and function in human sweat glands.     

Immunocytochemical detection of prostate-specific antigen (PSA) in skin adnexal and breast tissues and tumors

Prostate Specific Antigen (PSA) is regarded as a specific marker of prostatic epithelium and has never been detected by immunocytochemistry in extra-prostatic tissues. The casual finding of a strong positivity for polyclonal antisera to PSA in a sweat gland carcinoma prompted a study on a series of skin adnexial and breast specimens (normal and neoplastic). Normal axillary and perineal apocrine sweat glands, some apocrine foci in fibrocystic breast disease and two sweat gland and two breast apocrine carcinomas were stained by several PSA antisera; a recently introduced monoclonal to PSA, however, was unreactive. These observations cast doubt on the specificity of PSA for prostatic epithelium, especially when polyclonal antisera are employed. Immunocytochemical reactions obtained with PSA, in the investigation of skin, lesions must be interpreted with caution and confirmed if necessary with monoclonals to PSA and with PAP.     

Regulation of steroid and steroid sulfate production and aromatase activity in cultured human granulosa-luteal cells

The regulation of the production of steroids and steroid sulfates and the activity of aromatase in human luteinized granulosa cells were investigated. The cells were cultured for 48 h in the presence or absence of hCG and FSH. Basal production of pregnenolone (Pre, 0.3 +/- 0.03 ng/micrograms protein) and progesterone (P, 19.3 +/- 1.7 ng/micrograms protein) were high compared with that of other steroids beyond P in the steroidogenic pathway. The concentration of 17 alpha-hydroxyprogesterone (17-OHP) was lower 0.17 +/- 0.06 ng/micrograms and that of other steroids in the 4-ene and 5-ene pathways and steroid sulfates less than 0.05 ng/micrograms. Both hCG and FSH (100 ng/ml) stimulated the production of Pre and P 3- to 5-fold, but only minimal stimulation of other steroids and steroid sulfates was observed. Aromatase activity of granulosa-luteal cells was measured from the rate of formation of 3H2O from 1 beta-[3H]androstenedione (1 beta[3H]A) after exposing the cells to hCG, FSH or estradiol (E2) for 48 h. Basal aromatase activity was relatively low, but hCG and FSH stimulated aromatase 8- and 4-fold, respectively. The incubation of granulosa-luteal cells with E2 did not affect basal aromatase activity, but E2 augmented FSH-stimulated aromatase 1.4-fold (P less than 0.025). The results suggest that there is low 17 alpha-hydroxylase and steroid sulfokinase activity in human granulosa-luteal cells. Aromatase activity in these cells is regulated by both hCG and FSH, and intra-ovarian estrogens may regulate granulosa cell aromatase activity.     

腋臭患者大汗腺中ApoD和AR的表达水平与气味强度间的关系

目的:明确大汗腺组织中ApoD和AR的表达水平与腋臭患者散发出气味间的关系,阐明两者在腋臭发病中的作用,为腋臭的临床治疗和干预奠定基础。方法:收集在我院整形外科就诊的腋臭病人腋下皮肤组织标本41例。手术前由3名医生共同判断患者腋下气味强度,按照能在≤1 m、≤3 m、≤5 m距离闻及气味把患者分为轻、中、重三组。随机抽取各组标本组织块进行RT-PCR检测,测定ApoD和AR在大汗腺组织中的含量。结果:根据气味强度判定标准,轻、中和重3组患者人数分别为:7人、11人和23人。按照AB 7500 Real-Time PCR系统分析结果所示ApoD相对表达量的等级与气味强度之间有线性关系(P0.05),ApoD相对表达量的等级随着气味强度的增加而升高;AR相对表达量的等级与气味强度之间有线性关系(P0.05),随着气味强度的增加而升高。结论:ApoD和AR的表达量与腋臭气味强度之间有着密切的联系。进一步证实AR可调节大汗腺组织ApoD的表达,为明确腋臭的发病机制提供了理论依据。     

麝腓腺生长发育与化学通讯机能的探讨

本文对麝的腓腺进行了生长发育与组织化学观察。腓腺由丰富的顶泌汗腺组成,分泌混合性粘多糖成分的信息素。出生８０日龄幼麝的腓腺开始有分泌功能,成体时其分泌功能旺盛。麝以直接和间接方式释放信息素。     

The influence of age on fecal steroid hormone levels in male Budongo Forest chimpanzees (Pan troglodytes schweinfurthii)

Potential interactions between age and endocrinological functioning have been understudied in wild ape populations. Therefore, we examined the relationship between age and the secretion of androgens and glucocorticoids in 15 juvenile, subadult, and adult male chimpanzees (Pan troglodytes schweinfurthii) free ranging in the Budongo Forest of Uganda. One hundred and nine fecal samples were opportunistically collected, between 07:30 and 13:30 hr, during the wet season. Fecal samples were preserved, by oven drying, and steroid content extracted before radioimmunoassay for dehydroepiandrosterone-sulfate (DHEA-S), testosterone (TEST), cortisol (CORT), and corticosterone (CCT). Employing indexes of age as predictive factors, linear mixed-effects modeling and non-parametric statistical comparisons of fecal steroid levels were conducted. Age was observed to significantly influence the production of both glucocorticoids and androgens in male Budongo Forest chimpanzees. Basically, whereas TEST and CORT increased, DHEA-S and CCT levels slightly declined as animals matured.     

Structures and concentrations of fifteen different steroid sulfates in human breast cyst fluids

By applying capillary gas chromatography (GC) and gas chromatography mass spectrometry (GC-MS), a simultaneous quantitation of all important steroid sulfates present in a number of breast cyst fluids, has been obtained. The fact that prevailing androgen sulfate structures in the cyst fluids are different from those in blood suggests at least intracystic metabolism of blood-born precursors. Particularly greater amounts of 5 alpha-reduced steroids are found in breast cysts. 5 alpha-Androstane-3 alpha,17 beta-diol is a major androgen sulfate of breast cyst fluids, its concentration being some 2000-fold that of blood. After prolonged topical application of progesterone on the breast, an accumulation of the sulfates of several pregnanediol isomers could be observed.     

Stable isotope studies on steroid metabolism and kinetics: sulfates of 3 alpha-hydroxy-5 alpha-pregnane derivatives in human pregnancy

The metabolism and production rates of 3 alpha-hydroxy-5 alpha-pregnan-20-one sulfate and the 3-sulfate and 3,20-disulfate of 5 alpha-pregnane-3 alpha,20 alpha-diol in pregnant women were studied. The steroid sulfates were labeled with deuterium in the 3 beta,11,11- or 3 beta,11,11,20 beta-positions and were injected intravenously. The deuterium content of steroids in the monosulfate and disulfate fraction of plasma collected at different times after the injection was determined by capillary column gas chromatography/mass spectrometry. The injected steroid sulfates underwent oxidoreduction at C-20 and 16 alpha-hydroxylation. In addition, the 3-sulfate of 5 alpha-pregnane-3 alpha,20 alpha-diol became hydroxylated at C-21. The pregnanediol and pregnanetriol monosulfates were also converted to disulfates. No evidence was obtained for a metabolic sequence involving hydrolysis, oxidoreduction, and resulfation at the C-3 position. Production rates and rates of metabolic transformations were determined using different one- and two-pool models. The production rate of the pregnanolone/pregnanediol monosulfate couple was 0.08 to 0.5 mmol/24 h, the variability probably depending both on individual factors and stage of pregnancy. The half-life time for oxidation and reduction at C-20 was 0.1 to 0.4 hours, reduction being the faster process. The half-life time for the turnover of the steroid skeleton was 1.3 to 3.3 hours. The injected steroid monosulfates were 16 alpha-hydroxylated at a rate of 1 to 8 mumol/24 h. A significant fraction of these 16 alpha-hydroxylated steroid sulfates, 0.5 to 25 mumol/24 h, was formed from other, probably unconjugated, precursors. The 16 alpha-hydroxylated steroid monosulfates underwent rapid oxidoreduction at C-20. The 3-sulfate of 5 alpha-pregnane-3 alpha,20 alpha-diol was hydroxylated at C-21. The production rate of 5 alpha-pregnane-3 alpha,20 alpha,21-triol 3-sulfate was 8 to 36 mumol/24 h in four women and 180 mumol/24 h in one woman, and this steroid was not formed from other precursors to a significant extent. 5 alpha-Pregnane-3 alpha,20 alpha-diol disulfate was a metabolic end product accounting for a major part of the elimination of the steroids injected. Its half-life time was 1.4 to 2.8 hours. The results show that the formation of sulfated steroids with a 3 alpha-hydroxy-5 alpha configuration may account for 50% of the metabolism of progesterone in late pregnancy.     

5α‐Androst‐16‐en‐3α‐ol β‐D‐Glucuronide,Precursor of 5α‐Androst‐16‐en‐3α‐ol in Human Sweat

5α‐Androst‐16‐en‐3α‐ol (α‐androstenol) is an important contributor to human axilla sweat odor. It is assumed that α‐andostenol is excreted from the apocrine glands via a H₂O‐soluble conjugate, and this precursor was formally characterized in this study for the first time in human sweat. The possible H₂O‐soluble precursors, sulfate and glucuronide derivatives, were synthesized as analytical standards, i.e., α‐androstenol, β‐androstenol sulfates, 5α‐androsta‐5,16‐dien‐3β‐ol (β‐androstadienol) sulfate, α‐androstenol β‐glucuronide, α‐androstenol α‐glucuronide, β‐androstadienol β‐glucuronide, and α‐androstenol β‐glucuronide furanose. The occurrence of α‐androstenol β‐glucuronide was established by ultra performance liquid chromatography (UPLC)/MS (heated electrospray ionization (HESI)) in negative‐ion mode in pooled human sweat, containing eccrine and apocrine secretions and collected from 25 female and 24 male underarms. Its concentration was of 79 ng/ml in female secretions and 241 ng/ml in male secretions. The release of α‐androstenol was observed after incubation of the sterile human sweat or α‐androstenol β‐glucuronide with a commercial glucuronidase enzyme, the urine‐isolated bacteria Streptococcus agalactiae, and the skin bacteria Staphylococcus warneri DSM 20316, Staphylococcus haemolyticus DSM 20263, and Propionibacterium acnes ATCC 6919, reported to have β‐glucuronidase activities. We demonstrated that if α‐ and β‐androstenols and androstadienol sulfates were present in human sweat, their concentrations would be too low to be considered as potential precursors of malodors; therefore, the H₂O‐soluble precursor of α‐androstenol in apocrine secretion should be a β‐glucuronide.     

Formation of neutral steroids from endogenous precursors in minced human fetal adrenals in vitro

The role of endogenous precursors in steroid biosynthesis in the human fetal adrenals was studied in $\text{in vitro}$ incubations with no added exogenous substrate. The identification and quantitative determination of the steroids was carried out by gas-liquid chromatography and gas chromatography - mass spectrometry. During the incubation a 10–60-fold increase in the concentration of dehydroepiandrosterone sulfate was observed. An increase was also seen in the concentrations of the other two steroid sulfates detected, pregnenolone and 17-hydroxypregnenolone sulfate. The concentrations of the corresponding free steroids were seen to decrease during the incubations. Only traces of free dehydroepiandrosterone and progesterone were detected endogenously or at any stage during the incubations. No corticoids could be found. Endogenous cholesterol was found in high concentrations (1.5 – 3.0 mg/g wet tissue) in the tissue samples studied. A small proportion of it was present as a sulfate conjugate.It is concluded that fetal adrenals can form neutral steroid sulfates of the 3β-hydroxy-5-ene series from endogenous precursors $\text{in vitro.}$ Cholesterol which was detected in high concentrations in the adrenal tissue is a possible precursor of these metabolites. The results obtained would suggest that this endogenous metabolism involves sulfated intermediates principally.     

Multipotent Nestin-Positive Stem Cells Reside in the Stroma of Human Eccrine and Apocrine Sweat Glands and Can Be Propagated Robustly In Vitro

Human skin harbours multiple different stem cell populations. In contrast to the relatively well-characterized niches of epidermal and hair follicle stem cells, the localization and niches of stem cells in other human skin compartments are as yet insufficiently investigated. Previously, we had shown in a pilot study that human sweat gland stroma contains Nestin-positive stem cells. Isolated sweat gland stroma-derived stem cells (SGSCs) proliferated in vitro and expressed Nestin in 80% of the cells. In this study, we were able to determine the precise localization of Nestin-positive cells in both eccrine and apocrine sweat glands of human axillary skin. We established a reproducible isolation procedure and characterized the spontaneous, long-lasting multipotent differentiation capacity of SGSCs. Thereby, a pronounced ectodermal differentiation was observed. Moreover, the secretion of prominent cytokines demonstrated the immunological potential of SGSCs. The comparison to human adult epidermal stem cells (EpiSCs) and bone marrow stem cells (BMSCs) revealed differences in protein expression and differentiation capacity. Furthermore, we found a coexpression of the stem cell markers Nestin and Iα6 within SGSCs and human sweat gland stroma. In conclusion the initial results of the pilot study were confirmed, indicating that human sweat glands are a new source of unique stem cells with multilineage differentiation potential, high proliferation capacity and remarkable self renewal. With regard to the easy accessibility of skin tissue biopsies, an autologous application of SGSCs in clinical therapies appears promising.     

Individual comparisons of the levels of (E)-3-methyl-2-hexenoic acid, an axillary odor-related compound, in Japanese

The (E)-3-methyl-2-hexenoic acid (E3M2H), an axillary odor-related compound, is known to occur in Caucasians. The aims of this study were to clarify whether E3M2H contributes to axillary odor in Asians and to quantify and compare individual levels of E3M2H. Quantitative determination of E3M2H was performed by means of gas chromatography-mass spectrometry of sweat extracted from the axillary areas of T-shirts worn for 24 h by Japanese subjects. The amount of E3M2H was 15.9-34.6 nmol/ml in six of 30 subjects. Our method succeeded in quantitative analysis of E3M2H from axillary sweat collected individually; we also showed that E3M2H could be detected in Asians. This is the first report in which the amount of E3M2H in axillary sweat was quantified on an individual basis and compared to reveal individual differences. The results of this study indicate that E3M2H might contribute to axillary malodor in Asians as well as Caucasians.     

Immunoelectron microscopic localization of epidermal growth factor in the eccrine and apocrine sweat glands.

We studied the localization of the epidermal growth factor (EGF) in eccrine and apocrine sweat glands with light microscopic and electron microscopic immunohistochemistry. Anti-human EGF (anti-hEGF) polyclonal antiserum and anti-hEGF monoclonal antibody (MAb) were used for the study. Light microscopic immunohistochemistry with monoclonal and polyclonal antibodies showed that hEGF-like immunoreactivity was strongly positive in the myoepithelial cells and weakly positive in the secretory cells of eccrine sweat glands. In apocrine sweat glands, it was strongly positive in the secretory cells as well as in the myoepithelial cells. Immunoelectron microscopy with polyclonal antibody showed that hEGF-like immunoreactivity was present in secretory granules of apocrine secretory cells. These granules had mitochondrion-like internal structure. No reactivity was observed on the eccrine secretory cells by immunoelectron microscopy. Neither dark cell granules nor mitochondria in eccrine secretory cells were labeled with anti-hEGF antibody. In both eccrine and apocrine sweat glands, hEGF-like immunoreactivity was diffusely present in the cytoplasm of myoepithelial cells. However, nuclei and mitochondria of myoepithelial cells were devoid of immunoreactivity for hEGF. Our observations indicate that apocrine sweat glands may secrete more hEGF in the sweat than eccrine sweat glands.     

A convenient, unified scheme for the differential extraction of conjugated and unconjugated serum C19 steroids on Sep-Pak C18-cartridges

In order to conveniently and rapidly isolate by group both conjugated and unconjugated serum androgens, a scheme has been devised for their differential extraction from commercially available, disposable octadecylsilane cartridges (Sep-Pak C18). Using added radioactive steroid standards and detection of endogenous serum steroids by group-specific enzymatic assays, the quantitative recovery of steroid glucuronides and sulfates in the 47% methanol fraction and of unconjugated steroids in the 100% methanol fraction was observed. Maximum recovery of serum protein-bound steroids (e.g. testosterone) was achieved with serum denatured by urea and heat. In order to separate glucuronides from sulfates, sequential hydrolysis of the conjugated fraction (47% methanol) by enzymatic hydrolysis and then organic solvolysis as well as an additional Sep-Pak cartridge extraction step was required. Groups of extracted steroids may be further separated and assayed by any appropriate method(s). An application is given which employs HPLC and an enzymatic assay for 17 beta-hydroxy- and 17-oxo-steroids to provide separate profiles of unconjugated, glucuronidated, and sulfated androgens in human, male serum.     

Comparative purity of commercially available sodium dodecyl sulfates: A simple criterion

The purity of various commercially available sodium dodecyl sulfates was checked by gas chromatographic analysis of the fatty alcohols obtained from the acid hydrolysis of the alkyl sulfates. The content of tetradecyl sulfate in these samples was found to vary from 0 to 31% as impurity, while the content of the decyl sulfate homolog was ～2% in all the samples. Accurate critical micelle concentration measurements are a sensitive means of detecting impurities, especially those of higher chain-lengths. These measurements have indicated the presence of large amounts of tetradecyl sulfate impurity in one of the “pure” samples.In the course of work on the determination of the binding of large amounts of various detergents to proteins (1), we have discovered that some of the commercially available “pure” sodium dodecyl sulfates fall far short of any conceivable standards of purity. Although one might expect rather small amounts of inorganic salts and organic compounds such as unsulfated alcohols, the major impurities found are the homologous sodium decyl sulfate and sodium tetradecyl sulfate.In this communication, we will report only the degree of impurity arising from decyl and tetradecyl sulfates in some of the commercially available samples of “ 99 1/2% pure” sodium dodecyl sulfates. Such large contents of tetradecyl sulfates have been found that even methods simpler than the more sensitive ones (i.e., gas chromatography of the fatty alcohols after acid hydrolysis) reveal their presence.     

Quantitative analysis of steroid profiles from urine by capillary gas chromatography : I. Accuracy and reproducibility of the sample preparation

A method is described for the determination of steroid profiles from urine by means of gas chromatography using high-efficiency glass capillary columns. The accuracy and reproducibility of essential steps in the sample preparation (extraction of steroids and steroid conjugates by means of XAD-2, enzymatic hydrolysis with Helix pomatia juice, solvolysis in acidified ethyl acetate and alkali wash) are established using different endogenously labelled urine samples, obtained from normal subjects to whom labelled steroids had been administered. Preliminary results are given on the reproducibility of the derivatization procedure (formation of methoxime-trimethylsilyl (MO-TMS) ethers), the gas chromatographic analysis and the whole method. Two procedures for the purification of MO-TMS steroid derivatives are compared. Application of the method to urine samples of patients with various endocrine disorders is included.     

¿Carcinoma de mama o carcinoma de glándula sudorípara? Presentación de dos casos y análisis de la literatura

Primary apocrine carcinoma of the sweat gland is a neoplasm with a very low incidence that may represent a clinical and histological diagnostic challenge, as well as for adequate local, adjuvant, and advanced disease management. The average age of patients is around 67 years with no gender preference. This cancer develops primarily at the axillary and scalp levels and is clinically characterized by slow growth, but can progress aggressively with local, nodal, and metastatic involvement (primarily lung, liver, and bone). The recommended management, once the histology is established, consists of a wide local resection with a clear margin of 1 to 2 cm and regional lymphadenectomy if clinically positive nodes are detected. The adjuvant treatment (radiotherapy or chemotherapy) and for the advanced disease is not established.We report here the cases of two female patients initially diagnosed with breast cancer who were finally diagnosed with apocrine carcinoma of the sweat gland.     

The metabolism of estrone and estradiol-17β and their 3-sulfates by female guinea pig liver microsomes

The metabolism, by female guinea pig liver microsomes of estrogen 3-sulfates (estrone-3-sulfate and 17β-estradiol-3-sulfate) was compared to that of the unconjugated estrogens, estrone and estradiol-17β. Metabolites identified indicated that 16β-hydroxylated products (16β hydroxyestrone and 16 epiestriol) arose mainly from the free estrogens while 16α-hydroxy steroid sulfates (16α hydroxyestrone-3-sulfate and estriol-3-sulfate) were predominantly formed from the sulfated estrogens. These results show that the sulfate moiety at position 3 of the steroids directs 16-hydroxylation from the β to the α configuration.