Neuroendocrine (NE) differentiation is infrequent in testicular tumors and its histogenesis is not well understood. The present study is aimed at elucidating the pathway of neuroendocrine differentiation in germ cell tumors (GCTs) of the testis. In the analysis of 46 germ cell tumor components from 23 testicular tumors, we focused on GCTs with neuroendocrine differentiation, 7 teratoma, 1 embryonal carcinoma and 1 neuroendocrine carcinoma by immunohistochemical study and confocal laser scanning microscopy (CLSM) analysis. NE marker positive cells were noted in the tumor with collision of teratoma and embryonal carcinoma (E&T tumor), in the immature columnar cells of transitional form of embryonal carcinoma to teratoma (E-T cells) and neuroendocrine carcinoma cells, in addition to the well known mature intestinal mucosa in teratoma. Double staining for a NE marker (CGA) and a germ cell marker (PLAP) demonstrated the localization of both proteins in the same E-T cells confirmed by CLSM. Another finding, indicating the intimate relation between embryonal carcinoma and neuroendcrine differentiation, is that neuroendocrine carcinoma expressed a marker of embryonal carcinoma, CD30. The present results indicated that the NE cells might be differentiated from embryonal carcinoma, a view that has not been proposed before, but that is made in the present study using CLSM.

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To determine the involvement of the non-receptor tyrosine kinase cSrc in plaque destabilization in carotid atherosclerosis (CAS), which is responsible for cerebral infarction, we performed quantitative and morphological detection of phosphorylated active cSrc (p-cSrc) and histopathological examination in CAS lesions. We examined carotid endarterectomy specimens obtained from 32 CAS patients. Each specimen was used for immunoblot and immunohistochemical analyses of p-cSrc, histopathological analysis, and image analysis of macrophage content. There was a strong positive correlation between cSrc activation on blots and macrophage content on sections. When we defined the macrophage-rich plaque (MRP) and the macrophage-poor plaque (MPP) as having macrophage content more and less than 5%, respectively, the p-cSrc density and the occurrence of plaque hemorrhage and thrombus formation were significantly increased in the MRP group (n=18) compared to the MPP group (n=14). p-cSrc immunoreactivity was localized in lesional endothelial cells, macrophages, and smooth muscle cells, which contained proinflammatory substances: the upstream oxidized low density lipoprotein, tissue factor and osteopontin, and the downstream active forms of extracellular signal-activated kinase and p38 and nuclear factor-κB. Our results suggest that cSrc activation in lesional cells contributes to plaque destabilization in CAS via persistent inflammation.

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