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International Journal of Women's... Jun 2021Pacinian corpuscle hyperplasia typically presents as a tender nodule on the volar aspect of the palm or digit, often after trauma. Histologically, it presents as one to... (Review)
Review
OBJECTIVE
Pacinian corpuscle hyperplasia typically presents as a tender nodule on the volar aspect of the palm or digit, often after trauma. Histologically, it presents as one to multiple normal-sized to enlarged Pacinian corpuscles in the deep dermis or subcutaneous adipose tissue. Given its rarity, its pathogenesis is debated and nomenclature is poorly defined. Herein, we present a case of Pacinian corpuscle hyperplasia and review the current literature.
METHODS
A literature review was conducted using PubMed with the following search terms: Pacinian corpuscle hyperplasia, Pacinian corpuscle neuroma, Pacinioma, Pacinian corpuscle hypertrophy, and heterotopic Pacinian corpuscles. All case reports and case series were reviewed for histopathologic evidence of true Pacinian corpuscle hyperplasia. Cadaveric studies, cases without true Pacinian corpuscles, and noncutaneous cases were excluded from our analysis.
RESULTS
Sixty patients with Pacinian corpuscle hyperplasia of the hands and feet (65 cases, some with >1 location) were reviewed. The mean age of presentation was 49.5 years, and women accounted for 60% of cases. Pain was the most commonly reported symptom (55 of 65 cases; 84.6%). Forty-five cases (69.2%) were localized to a digit, most commonly the second digit (17 of 65 cases; 26.2%), and 18 of 65 cases (27.6%) affected the palm, primarily the distal palm. Surgical excision was curative in 50 of 65 cases (76.9%).
CONCLUSION
Although relatively uncommon, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of a tender nodule on the digit or distal palm, particularly after trauma.
PubMed: 34222593
DOI: 10.1016/j.ijwd.2020.10.005 -
Radiology Case Reports Sep 2023Pacinian corpuscles are mechanoreceptors frequently found between the dermis and subcutaneous tissues of the hands and feet. They are responsible for sensitivity to...
Pacinian corpuscles are mechanoreceptors frequently found between the dermis and subcutaneous tissues of the hands and feet. They are responsible for sensitivity to vibration and pressure. Pacinian corpuscle hyperplasia is a rare cause of induration in the palms of the hands or the soles of the feet, often of unknown origin or occasionally related to neurofibromatosis. It can be characterized by magnetic resonance imaging and is included in the differential diagnosis of anechoic lesions on high-resolution soft tissue ultrasound. The definitive diagnosis is made through histopathologic examination. In this case report, we present the findings of a 29-year-old patient who presented with painful nodules on the palms of both hands, with typical findings on ultrasound and magnetic resonance imaging indicative of Pacinian corpuscle hyperplasia. We also discuss the imaging findings and the differential diagnosis through a non-systematic review. Pacinian corpuscle hyperplasia is a rare condition that can be readily identified by high-resolution ultrasound and magnetic resonance imaging, and it should be considered in the differential diagnosis of hand nodules.
PubMed: 37483376
DOI: 10.1016/j.radcr.2023.06.046 -
Journal of Pediatric Urology Apr 2021Circumcision is a common procedure. Recently, tissue-sparing approaches have become a matter of interest, and a nerve-sparing approach is described in adults. Although...
BACKGROUND
Circumcision is a common procedure. Recently, tissue-sparing approaches have become a matter of interest, and a nerve-sparing approach is described in adults. Although circumcision is common in the practice, the nerve-sparing approach has not been evaluated in the pediatric age group.
OBJECTIVE
To give a contemporary evaluation of the preputium histology, challenge the phenomenon of a genuine nerve-sparing approach, and report the results of a prospective cohort contrasting the tissue-sparing fine dissection technique to the regular sleeve circumcision in the pediatric age group.
STUDY DESIGN
A total of 20 healthy children between 7 and 12 years of age were enrolled in the study. All circumcisions were carried out for religious purposes, and children with any anatomical anomaly, skin lesions, or Balanitis Xerotica Obliterans were not included in the study. The first 10 children underwent regular sleeve circumcision, while the latter 10 children underwent tissue-sparing fine dissection modification of the sleeve technique. All materials obtained from the circumcision were examined by a single pathologist, and relevant tissue structures were counted and compared between the groups.
RESULTS
Both techniques were satisfactory in terms of final cosmetic results, without significant complications, such as bleeding, massive edema, iatrogenic chordee, or unacceptable cosmetics. None of the children required readmission or medical intervention other than analgesics and topical moisturizing creams. Preservation of all nervous system structures, including the receptors, appeared to be not possible with macroscopic dissection techniques due to micrometer scale depth of the touch receptors. Nerve trunks were also located in less than 1-mm depth. The tissue-sparing technique could preserve significantly more vascular structures, nerve trunks, and Pacinian Corpuscles, which can be a matter of further long-term research.
CONCLUSION
We propose the term "tissue-sparing" instead of "nerve-sparing" for the available techniques. The tissue-sparing technique did not affect the clinical outcomes and the postoperative course in our study. However, it showed to be superior in terms of preserving the vascular structures, nerve trunks, and Pacinian Corpuscles.
Topics: Adult; Balanitis Xerotica Obliterans; Child; Circumcision, Male; Foreskin; Humans; Lichen Sclerosus et Atrophicus; Male; Prospective Studies
PubMed: 33339734
DOI: 10.1016/j.jpurol.2020.11.040 -
Journal of Clinical Medicine Jan 2021Sensory corpuscles of human skin are terminals of primary mechanoreceptive neurons associated with non-neuronal cells that function as low-threshold mechanoreceptors.... (Review)
Review
Sensory corpuscles of human skin are terminals of primary mechanoreceptive neurons associated with non-neuronal cells that function as low-threshold mechanoreceptors. Structurally, they consist of an extreme tip of a mechanosensory axon and nonmyelinating peripheral glial cells variably arranged according to the morphotype of the sensory corpuscle, all covered for connective cells of endoneurial and/or perineurial origin. Although the pathologies of sensitive corpuscles are scarce and almost never severe, adequate knowledge of the structure and immunohistochemical profile of these formations is essential for dermatologists and pathologists. In fact, since sensory corpuscles and nerves share a basic structure and protein composition, a cutaneous biopsy may be a complementary method for the analysis of nerve involvement in peripheral neuropathies, systemic diseases, and several pathologies of the central nervous system. Thus, a biopsy of cutaneous sensory corpuscles can provide information for the diagnosis, evolution, and effectiveness of treatments of some pathologies in which they are involved. Here, we updated and summarized the current knowledge about the immunohistochemistry of human sensory corpuscles with the aim to provide information to dermatologists and skin pathologists.
PubMed: 33435193
DOI: 10.3390/jcm10020227 -
Current Opinion in Neurobiology Jun 2022The sense of touch is ubiquitous in vertebrates and relies upon the detection of mechanical forces in the skin by the tactile end-organs of low-threshold... (Review)
Review
The sense of touch is ubiquitous in vertebrates and relies upon the detection of mechanical forces in the skin by the tactile end-organs of low-threshold mechanoreceptors. Significant progress has been made in understanding the mechanism of tactile end-organ function using mammalian models, but the detailed mechanics of touch sensation in Meissner and Pacinian corpuscles, the principal detectors of transient touch and vibration, remain obscure. The avian homologs of these corpuscles present an opportunity for functional study of mechanosensation in these structures, due to their relative accessibility and high abundance in the bill skin of tactile-foraging waterfowl. Here, we review the current knowledge of mechanosensory end-organs in birds and highlight the utility of the avian model to understand general principles of touch detection in the glabrous skin of vertebrates.
Topics: Animals; Birds; Mammals; Mechanoreceptors; Skin; Touch; Touch Perception; Vertebrates
PubMed: 35489134
DOI: 10.1016/j.conb.2022.102548 -
The Journal of Hand Surgery, European... Nov 2019Tumours involving Pacinian corpuscles are rare. The literature identifies two main pathological disorders: the Pacinian corpuscle neuroma or hyperplasia and the Pacinian...
Tumours involving Pacinian corpuscles are rare. The literature identifies two main pathological disorders: the Pacinian corpuscle neuroma or hyperplasia and the Pacinian corpuscle neurofibroma. Published data are confusing and at times conflicting. This systematic review summarizes the available data in order to support clinicians in the differential diagnosis with other tumours responsible for unclear symptoms in the hands and fingers. We identified 67 pertinent articles. Although some similarities have been described, the two tumours have relevant differences, specifically when comparing age of the patient, location, symptoms, characteristic of a mass, and aetiology. All these factors should be taken into account in order to improve diagnostic accuracy. Despite the low incidence of unsuccessful surgeries, extraordinary measures are occasionally necessary to achieve complete resolution of symptoms.
Topics: Diagnosis, Differential; Hand; Humans; Hyperplasia; Neurofibroma; Neuroma; Pacinian Corpuscles
PubMed: 31156019
DOI: 10.1177/1753193419852118 -
Ultrasound in Medicine & Biology Dec 2018The aim of this study was to evaluate the possibility of visualizing Pacinian corpuscles in the palm of the hand with high-resolution ultrasound (HRUS). In this...
The aim of this study was to evaluate the possibility of visualizing Pacinian corpuscles in the palm of the hand with high-resolution ultrasound (HRUS). In this prospective study, HRUS with a high-frequency probe (22 MHz) was used. The palms of two fresh cadaveric hands were screened for potential Pacinian corpuscles. Still ultrasound images and dynamic video sequences were obtained. In five regions with large amounts of suspected Pacinian corpuscles, tissue blocks were excised and histologically processed, and corresponding slices were compared with ultrasound images. Further, the transverse diameters of five Pacinian corpuscles, at the level of the metacarpal heads in the palm, were assessed on both sides (in total 100) in healthy volunteers. On ultrasound, Pacinian corpuscles presented as echolucent dots in the subcutis, adjacent to digital nerves and vessels and located 2-3 mm beneath the surface. On histologic sections, these echolucent dots corresponded to Pacinian corpuscles with respect to their position and topographic relationships. The mean transverse diameter for all volunteers was 1.40 ± 0.23 mm (range: 0.8-2.2 mm). This study confirms the ability to reliably visualize Pacinian corpuscles with HRUS, which contributes to our basic understanding of ultrasonographically visible subcutaneous structures and may enhance the diagnosis of pathologies related to Pacinian corpuscles.
Topics: Adult; Aged; Female; Hand; Humans; Male; Pacinian Corpuscles; Prospective Studies; Ultrasonography; Young Adult
PubMed: 30220423
DOI: 10.1016/j.ultrasmedbio.2018.08.001 -
International Journal of Molecular... Jun 2020We studied telocytes/CD34+ stromal cells in the normal and pathological peripheral nervous system (PNS), for which we reviewed the literature and contributed our... (Review)
Review
We studied telocytes/CD34+ stromal cells in the normal and pathological peripheral nervous system (PNS), for which we reviewed the literature and contributed our observations under light and electron microscopy in this field. We consider the following aspects: (A) general characteristics of telocytes and the terminology used for these cells (e.g., endoneurial stromal cells) in PNS; (B) the presence, characteristics and arrangement of telocytes in the normal PNS, including (i) nerve epi-perineurium and endoneurium (e.g., telopodes extending into the endoneurial space); (ii) sensory nerve endings (e.g., Meissner and Pacinian corpuscles, and neuromuscular spindles); (iii) ganglia; and (iv) the intestinal autonomic nervous system; (C) the telocytes in the pathologic PNS, encompassing (i) hyperplastic neurogenic processes (neurogenic hyperplasia of the appendix and gallbladder), highly demonstrative of telocyte characteristics and relations, (ii) PNS tumours, such as neurofibroma, schwannoma, granular cell tumour and nerve sheath myxoma, and interstitial cell of Cajal-related gastrointestinal stromal tumour (GIST), (iii) tumour-invaded nerves and (iv) traumatic, metabolic, degenerative or genetic neuropathies, in which there are fewer studies on telocytes, e.g., neuroinflammation and nerves in undescended testicles (cryptorchidism), Klinefelter syndrome, crush injury, mucopolysaccharidosis II (Hunter's syndrome) and Charcot-Marie-Tooth disease.
Topics: Animals; Biomarkers; Disease Susceptibility; Humans; Immunohistochemistry; Nerve Endings; Peripheral Nervous System; Peripheral Nervous System Diseases; Telocytes
PubMed: 32560571
DOI: 10.3390/ijms21124320 -
Anatomical Record (Hoboken, N.J. : 2007) Mar 2024The objective of this study was to analyze the proprioceptive innervation of human lips, especially of the orbicularis oris muscle, since it is classically accepted that...
The objective of this study was to analyze the proprioceptive innervation of human lips, especially of the orbicularis oris muscle, since it is classically accepted that facial muscles lack typical proprioceptors, that is, muscle spindles, but recently this has been doubted. Upper and lower human lips (n = 5) from non-embalmed frozen cadavers were immunostained for detection of S100 protein (to identify nerves and sensory nerve formations), myosin heavy chain (to label muscle fibers within muscle spindles), and the mechano-gated ion channel PIEZO2. No muscle spindles were found, but there was a high density of sensory nerve formations, which were morphologically heterogeneous, and in some cases resemble Ruffini-like and Pacinian sensory corpuscles. The axons of these sensory formations displayed immunoreactivity for PIEZO2. Human lip muscles lack typical proprioceptors but possess a dense sensory innervation which can serve the lip proprioception.
Topics: Humans; Lip; Proprioception; Sensory Receptor Cells; Facial Muscles; Pacinian Corpuscles
PubMed: 37712912
DOI: 10.1002/ar.25324 -
Journal of Anatomy Feb 2021The clitoris is a leading player in female sexual arousal, if not the main protagonist. Despite this role, studies performed on this structure with specific...
The clitoris is a leading player in female sexual arousal, if not the main protagonist. Despite this role, studies performed on this structure with specific neuroanatomical techniques are few. This study focuses on glans clitoris innervation, with special emphasis on sensory corpuscles and the presence of the mechanotransducer protein PIEZO2 in these structures. Six glans clitoris samples were obtained at autopsy covering an age spectrum between 52 and 83 years old. Several types of nerve terminations including free nerve endings, genital endbulbs as well as Meissner-like corpuscles and Pacinian corpuscles, but not Ruffini corpuscles, were found. Although corpuscular morphology in the glans clitoris was subtly different from the cutaneous digital counterparts, their basic composition was comparable for both Pacinian and Meissner-like corpuscles. Genital endbulbs showed heterogeneous morphology, and the axons usually exhibited a typical "wool ball" or "yarn ball" aspect. Some of them were lobulated and variably encapsulated by endoneurial elements (65%); from the capsule originate septa that divides the genital endbulbs, suggesting that they are found in clusters rather than as single corpuscles. In addition, most corpuscles in the glans clitoris showed axonal PIEZO2 immunoreactivity, thus, suggesting a mechanical role and molecular mechanisms of mechanosensibility similar to those of digital Meissner's corpuscles. Our results demonstrate that sensory corpuscles of the glans clitoris are similar to those of other glabrous skin zones, as most genital organs are characterized by clusters of corpuscles and the occurrence of the mechanoprotein PIEZO2 in the axons. These findings strongly suggest that PIEZO2 participates in erotic and sexual mechanical sensing.
Topics: Aged; Aged, 80 and over; Clitoris; Female; Humans; Ion Channels; Mechanoreceptors; Mechanotransduction, Cellular; Middle Aged
PubMed: 32996126
DOI: 10.1111/joa.13317