bluuebunny/crossref_metadata_2025 huggingface dataset:
The pathological spectrum of desmoplastic infantile gangliogliomas
Authors: NG T.H.K. , FUNG C.F. , MA L.T.
Published: April 2007

A rare supratentorial neuroepithelial tumour in a 10‐month‐old girl is described. It was characterized by its voluminous size, a predominant leptomeningeal growth pattern with intense desmoplasia and divergent differentiation along astrocytic, neuronal and Schwann cell lines. The differential diagnoses are discussed with special reference to the recently described clinicopathological entity of desmoplastic infantile ganglioglioma.
Immunoglobulin classes in biopsies of autoimmune liver disease
Authors: MILNE D.S. , HORNE C.H.W.
Published: April 2007

The immunological isotypes of plasma cell infiltrates in a series of consecutive liver biopsies from patients with chronic active hepatitis (CAH) and primary biliary cirrhosis (PBC) were determined immunohistochemically. The plasma cell infiltrate was more pronounced in PBC than in CAH. IgA and IgG isotypes predominated in CAH, and IgM and IgG in PBC. The expected predominance of kappa light chains was observed in every biopsy in PBC. However, in 8/14 CAH biopsies the plasma cells were predominantly lambda isotype. Lambda predominance was significantly associated with the presence of serum autoantibodies. These findings would suggest that different mechanisms operate in the pathogenesis of these two autoimmune liver diseases.
Ductal papilloma of the minor salivary gland
Authors: FRANKLIN C.D. , ONG T.K.
Published: April 2007

A case of ductal papilloma occurring in a minor salivary gland is reported. To date, only a few cases of ductal papillomas have been reported; these comprise mainly inverted ductal papilloma, intraductal papilloma and sialoadenoma papilliferum. However, it may be that these neoplasms form a spectrum of neoplastic changes seen in minor salivary gland duct epithelium.
The spectrum of bile duct lesions in end‐stage primary sclerosing cholangitis
Authors: HARRISON R.F. , HUBSCHER S.G.
Published: April 2007

Tissue from 15 livers with primary sclerosing cholangitis, obtained at transplantation, was examined histologically with respect to: small and medium sized bile duct lesions; large bile duct lesions; fibrosis/cirrhosis; and parenchymal changes. Lesions affecting small and medium‐sized bile ducts were quantified by determining the percentage of 20 portal tracts involved. The two characteristic bile duct lesions of primary sclerosing cholangitis, periductal fibrosis and fibro‐obliterative scars, were largely confined to medium‐sized portal areas. Although present in each case, the number of such lesions varied considerably. Loss of bile ducts was the most conspicuous feature in small portal tracts, where the diagnostic duct lesions of primary sclerosing cholangitis were rarely observed. Inflammation, ulceration and cholangiectases of large intrahepatic ducts were common, and appear to be useful additional diagnostic features.
Non‐secretory IgA k myeloma with distended endoplasmic reticulum: a case report
Authors: RAUBENHEIMER E.J. , DAUTH J. , SENEKAL J.C.
Published: April 2007

A case of non‐secretory multiple myeloma is presented. Plasma cells showed abundant cytoplasmic colloid contained in distended rough endoplasmic reticulum. Uniform cytoplasmic positivity for IgA heavy‐ and K light‐chains was demonstrated with the immunoperoxidase staining technique. It is proposed that distension of the endoplasmic reticulum by immunoglobulin‐related proteins is indicative of a block in their excretion or of the presence of active synthesis of the immunoglobulins or their subunits.
Immunophenotypic study of lymphocyte predominance Hodgkin's disease
Authors: BISHOP P. W. , HARRIS M. , SMITH A.P. , ELSAM K.J.
Published: April 2007

An immunophenotypic study of 17 cases of diffuse lymphocyte predominance Hodgkin's disease and 20 cases of nodular lymphocyte predominance Hodgkin's disease, along with eight of mixed cellularity and five of nodular sclerosing Hodgkin's disease, is reported. The atypical cells in nodular lymphocyte predominance Hodgkin's disease showed only minor differences from the published consensus. However, the atypical cells in diffuse lymphocyte predominance Hodgkin's disease showed an immunophenotype which was commonly B‐cell positive (59%), but in a minority of cases (24%) or epithelial membrane antigen (12%) positive; none of the cases was Ber‐H2 positive. These results do not differ greatly from our findings in nodular lymphocyte predominance Hodgkin's disease, but do diverge from the published consensus for diffuse lymphocyte predominance Hodgkin's disease. The question as to whether morphology or immunophenotype should form the primary diagnostic criterion for the definition of lymphocyte predominance Hodgkin's disease is discussed.
Immunoreactivity to desmin in secretory epithelium of eccrine sweat glands
Authors: SEIDAL T.
Published: April 2007

The finding of immunoreactivity to desmin in eccrine sweat glands is reported. Two monoclonal anti‐desmin antibodies of the same clone (33) produced a distinct positivity in the secretory cells of the sweat glands in 15/16 biopsies. No immunoreactivity for desmin was found in control sections from apocrine sweat glands, salivary, mammary, prostate and lacrimal glands.
Neuroglial tissue in partially cystic Wilms' tumour
Authors: JENKINS F. , ALLIBONE E. B. , BERRY P. J.
Published: April 2007

Wilms' tumour (nephroblastoma), the commonest malignant renal tumour of childhood, is thought to be derived from metanephric blastema and a majority of cases show the classical triphasic pattern of blastema, stroma and epithelium, There is usually little difficulty in making a correct histological diagnosis, but problems can arise due to the extraordinary potential of metanephric blastema to differentiate into a wide variety of heterologous tissues. Here we probably for the first time, two cases of Wilms' tumour which contained prominent quantities of neuroglial tissue. The classification of these cases as Wilms' tumours rather than renal teratomas is discussed.
The assessment of proliferating cell nuclear antigen (PCNA) immunostaining in primary gastrointestinal lymphomas and its relationship to histological grade, S + G2 + M phase fraction (flow cytometric analysis) and prognosis
Authors: WOODS A.L. , HALL P.A. , SHEPHERD N.A. , HANBY A.M. , WASEEM N.H. , LANE D.P. , LEVISON D.A.
Published: April 2007

PCNA is a nuclear protein that is synthesized in late G1 and S phases of the cell cycle and is, therefore, correlated with the cell proliferative state. A new monoclonal antibody (PC10) to genetically engineered PCNA has been shown to label proliferating cells in formalin‐fixed paraffin‐embedded normal human tissues. Previous studies in lymphomas, using various markers of cell proliferation, have shown a strong correlation between indices of cell proliferation and histological grade. These studies have shown that within each histological subtype there is often a wide range of prolifeative indices and that these may be of some prognostic significance. Thirty‐one gastrointestinal lymphomas were studied. Our results show that there is a good correlation between PC10 index and histological grade of tumour (0.01 > P>0.001) and also a significant relationship between PC10 index and S + G2 + M phase fraction as measured by flow cytometric analysis (r2= 0.62; P≤0.01). Twenty‐three cases were available for survival analysis. In these cases a high PC10 score correlated with poor survival (P=0.04). Based on this series, it appears that there is a significant relationship between PC10 index and histological grade, and between PC10 index and S+G2+M phase as measurred by flow cytometric analysis. In addition, our results suggest that a high PC10 index is an adverse prognostic factor primary gastrointestinal lymphoma.
Demonstration of oestrogen and progesterone receptors in freeze‐dried, paraffin‐embedded sections of breast cancer
Authors: ONETTI‐MUDA A. , CRESCENZI A. , PUJIA N. , FARAGGIANA T. , MARINOZZI V.
Published: April 2007

Immunohistochemical evaluation of oestrogen and progesterone receptors is of importance in evaluating human breast tumours. Staining techniques can be performed on snap‐frozen, cryostat‐cut tissues or, as recently reported, on formalin‐fixed, paraffin‐embedded tissues. These methods are, however, limited by several drawbacks, including difficulties in retrospective studies and in storage of the material, and the relatively high frequency of false negative results for chemically fixed specimens. We therefore investigated the application of freeze‐drying technology to assess the feasibility and reliability of this technique as an alternative method for diagnostic breast pathology. Morphological and immunohistochemical studies were performed on snap‐frozen, freeze‐dried and paraffin‐embedded tissue obtained from 16 cases of benign and malignant breast neoplasms. Our results showed good preservation of tissue morphology, similar to standard formalin fixation, and excellent preservation of antigenic reactivity of nuclear receptors, comparable to that obtained with cryostat sections. We therefore suggest that freeze drying and paraffin embedding of frozen tissue blocks is equivalent or even preferable to formalin fixation for the demonstration of oestrogen and progesterone receptors, at least in the case of small tumours.
The sweat gland in cutaneous vasculitis
Authors: AKOSA A.B. , LAMPERT I.A.
Published: April 2007

Cutaneous vasculitis commonly presents as palpable purpura, and the late stages may become nodular, bullous, infarcted and ulcerated. Involvement of sweat glands in vasculitic lesions has not been previously described. In a detailed study of 48 cases of non‐infarcted cutaneous vasculitis, 18 (36%) revealed morphologically abnormal sweat glands. Basal cell degeneration, necrosis, regeneration and basal cell hyperplasia were found in the excretory ducts. Necrosis of the secretory gland was seen either as apoptosis involving the clear cells or as whole gland necrosis involving both cell types. This unusual feature has only been described in association with coma, commonly due to barbiturate and carbon monoxide poisoning. Its presence in non‐infarcted vasculitis adds support to the hypoxia/ischaemia hypothesis. The functional impact of such lesions in widespread cutaneous vasculitides requires further study.
Intra‐patient variation between breast cancer axillary lymph node metastases using quantifiable features
Authors: DIEST P.J.VAN , FLEEGE J.C. , MATZE‐COK E. , BAAK J.P.A.
Published: April 2007

The intra‐patient variations of some clinically relevant quantifiable features, between axillary lymph node metastases were evaluated in 44 breast cancer patients. In all lymph node metastases detected (range 2‐33 per patient), the mitotic figures were counted, the volume percentage epithelium was assessed and the mean nuclear area was measured. The intra‐patient variation for each quantifiable feature was expressed by the coefficient of variation (CV). Since the measurement techniques used introduce a certain, well known variation themselves because of sampling and measurement errors, the CVs found had to be greater than methodological tolerance limits (established in previous studies) to be interpreted as indicating biological variation.

The CVs exceeded the methodological tolerance limits in 86% of the cases for the mitotic count, in 48% of the cases for the volume percentage epithelium, and in 47% of the cases for the mean nuclear area. This indicated that in these cases, the variation found in the quantifiable features could not be explained by sampling or measurement errors and should be regarded as real biological variation. Furthermore, the variation in the quantifiable features studied showed a significant positive correlation with the number of lymph node metastases.

Thus, there may be considerable intra‐patient variation in quantifiable features between axillary lymph node metastases in breast cancer. This may indicate that these lymph node metastases originate independently from different clones within the primary tumour, that they are independently formed in different stages of tumour development, or that they, as an expression of intrinsic tumour heterogeneity, may develop in different directions from the start.
Ceroid granuloma of the uterine cervix
Authors: AL‐NAFUSSI A.I. , HUGHES D. , REBELLO G.
Published: April 2007

An excision biopsy was taken from a 59‐year‐old woman with a small dark‐brown lesion on the anterior lip of the cervix. The histology revealed an ulcerated surface epithelium with a band‐like infiltrate of pigment containing macrophages in the subepithelial zone. Histochemical examination of the specimen revealed that the pigment was ceroid. This is, to the best of our knowledge, the first case report of ceroid granuloma of the uterine cervix.
Recombinant DNA technology and its diagnostic applications
Authors: ARENDS M.J. , BIRD C.C.
Published: April 2007

As yet recombinant DNA technology does not appear to have widespread diagnostic application in pathology. However, it does have a useful role to play in specific circumstances in at least three main areas: a it can provide precise diagnostic information about genetic diseases, allowing appropriate counselling, and indicating future directions for research on therapeutic intervention, e.g. gene therapy; b micro‐organisms can be identified more sensitively and specifically, in fresh or fixed tissue samples, and their genomes can be analysed in fine detail, providing information relevant to the aetiology, epidemiology and pathogenesis of many diseases; c in tumour pathology the main application so far has been to resolve diagnostic problems associated with leukaemias and lymphomas, when other diagnostic procedures have been inconclusive. Specific chromosomal translocations, involving recognized genes, are particularly amenable to diagnosis by these means. Diagnostic applications to solid tumours are yet to be identified, although significant insights into tumorigenesis have been obtained, and these may ultimately lead to the development of useful markers for prognostic and therapeutic purposes.
The histology and immunohistochemistry of small cell mesothelioma
Authors: MAYALL F.G. , GIBBS A.R.
Published: April 2007

The object of this study was to describe the histology and immunohistochemistry of 13 small cell mesotheliomas, concentrating on reliable distinctions between them and small cell carcinoma. All 13 tumours showed regions of more typical mesothelioma if multiple blocks were examined. No tumours showed the streams, ribbons, rosettes, or haematoxyphilic blood vessels that are typical of small cell carcinoma. Mitotic figures were relatively scarce and the nuclei had a particularly characteristic open appearance with prominent nucleoli and delicate chromatin. Nuclear moulding was not seen. No tumour produced neutral mucin. Immunohistochemical positivity for neuron‐specific enolase (NSE) was found in 11/13, cytokeratin in 9/13 and Leu‐7 in 4/13 but none was positive for chromogranin A, carcino‐embryonic antigen (CEA) or leucocyte common antigen (LCA). We conclude that the accurate diagnosis of small cell mesothelioma is possible, provided that the clinical presentation is known, the tumour is adequately sampled and the microscopy carefully assessed. In small biopsy specimens, where the diagnosis is less straightforward, immunohistochemistry for CEA, and perhaps LCA and chromogranin A may be helpful. NSE and Leu‐7 positivity is common in these tumours and might be misleading if interpreted as reliable evidence of neuroendocrine differentiation.
Intratubular germ cell neoplasia in an infantile testis with immature teratoma
Authors: STAMP I.M. , BARLEBO H. , RIX M. , JACOBSEN G.K.
Published: April 2007

A case of intratubular germ cell neoplasia adjacent to an immature teratoma is described in an 8‐month‐old boy with normally descended testes. The pattern of intratubular germ cell neoplasia in the infantile testis appeared different from that in the adult, but the abnormal germ cells were morphologically and immunohistochemically similar. In the few previous reports, which have investigated infantile testicular tissue for the presence of intratubular germ cell neoplasia adjacent to germ cell tumours, intratubular germ cell neoplasia in conjunction with a yolk sac tumour and mature teratoma have not been found, and cases with immature teratoma have not been reported. The presence of intratubular germ cell neoplasia in conjunction with immature teratoma and its apparent absence in conjunction with the mature form and with yolk sac tumour may indicate difference in tumour development. Whether there is a true difference in the occurrence of intratubular germ cell neoplasia in the infantile testis according to the various types of germ cell tumours remains, however, to be proven by investigations of more cases.
Expression of the Ig‐associated heterodimer (mb‐1 and B29) in Hodgkin's disease
Authors: KUZU I. , DELSOL G. , JONES M. , GATTER K.C. , MASON D.Y.
Published: April 2007

Eighty‐three cases of Hodgkin's disease were studied immunocytochemically for the presence of the Ig associated heterodimer (mb‐1 and B29) which is believed to be a specific pan B‐cell marker. These results were compared with those achieved using other B‐cell markers against CD19, CD20 and CD22. Although a small number of cases of nodular sclerosis and mixed cellularity subtype showed positivity for CD19, CD20 or CD22, no case showed any reactivity with antibodies against mb‐1 or B29. This contrasted markedly with the cases of lymphocyte predominance where all seven cases expressed one or more of the B‐cell antigens, with six cases being positive for mb‐1. These results confirm previous studies that have suggested lymphocyte‐predominance Hodgkin's disease is of B‐cell origin and different from the other subtypes. However, they do not provide support for the thesis that these other subtypes may also have a B‐cell origin, albeit with a different phenotype to lymphocyte predominance.
The tissue distribution of factor XIIIa positive cells
Authors: DERRICK E.K. , BARKER J.N.W.N. , KHAN A. , PRICE M.L. , MACDONALD D.M.
Published: April 2007

Factor XIIIa has previously been used to identify a subgroup of dermal dendritic cells which co‐express class II MHC antigens, intercellular adhesion molecule‐1 (ICAM‐1) and lymphocyte function associated antigen‐1 (LFA‐1), leading to the suggestion that they play a central role in skin immune responses. To examine whether these cells may also be important constituents of other organs we have performed an immunohistochemical survey of normal tissue to identify the distribution of this factor XIIIa positive subgroup of dendritic cells in humans.

Routine tissue sections from a range of organs were assayed for factor XIIIa expression using a standard peroxidase‐antiperoxidase (PAP) immunolabelling technique. Dendritic, factor XIIIa positive cells were observed in all tissues studied, but were most numerous in skin and mucosal tissues (gastrointestinal tract, bladder). They were also observed associated with epithelial structures in lung and kidney, but were only rarely observed in liver, thyroid, testis and spleen. The distinctive distribution of these cells is consistent with an important role for them in immune responses at those sites.
Acquired aganglionosis following surgery for Hirschsprung's disease: a report of five cases during a 33‐year experience with pull‐through procedures
Authors: COHEN M.C. , MOORE S.W. , NEVELING U. , KASCHULA R.O.C.
Published: April 2007

Acquired Hirschsprung's disease is a rare and controversial form of colonic aganglionosis. Little is known about its aetiology and pathogenesis. We report five cases encountered amongst 173 long‐term follow‐up patients treated for classical Hirschsprung's disease between 1957 and 1990 at the Red Cross Children's Hospital, Cape Town, and review the current literature. The clinical and pathological findings of the cases have been studied to explore possible aetiological mechanisms. Our cases, like most of those previously reported, developed obstructive symptoms and acquired aganglionosis in pulled‐through bowel which had been previously confirmed as ganglionated. Two patients had histological evidence of hyaline fibrosis of blood vessels in the segment of bowel with acquired aganglionosis. Such fibrosis and other features attributable to regional hypoxia were not found in the other three cases. It is suggested that ischaemia with fibrosis may have a pathogenetic role in some, but not all, cases of acquired Hirschsprung's disease. A ple is made for patients developing recurrent symptoms of Hirschsprung's disease, after adequate surgical correction, to be fully studied with repeated sequential biopsies in order to gain a better understanding of the entity.
Prostatic adenocarcinoma with a bizarre stromal cell reaction
Authors: CHETTY R. , GALL J.A.M.
Published: April 2007

A case of prostatic adenocarcinoma is described that was accompanied by a bizarre stromal cell reaction. These stromal cells were immunoreactive with vimentin but not with either prostatic specific antigen or prostatic acid phosphatase, supporting their mesenchymal origin. It is important to distinguish these cells from true sarcomas and sarcomatoid carcinomas.
The pathology of bone marrow transplantation
Authors: SLOANE J.P. , NORTON J.
Published: April 2007

The pathological complications of bone marrow transplantation are complex and may affect any organ in the body. The causes are often multifactorial and include the effects of chemotherapy, the conditioning regimen, drugs used in the post‐transplant period such as immunosuppressants and antibiotics, graft‐versus‐host disease (GvHD) and the effects of the primary disease itself. Infections are common and result from the immunosuppressive effects of cytotoxic drugs and irradiation, GvHD and marrow failure. Haemorrhage is not infrequent. Graft‐versws‐host disease remains a significant problem and can be difficult to diagnose. Some of its histological features simulate the effects of chemo‐radhtion and the diagnostic lesions may not be present early in the disease, when treatment is most effective. Evidence has accumulated that inflammatory cytokines have a key role in the pathogenesis of GvHD. It can be prevented by eliminating T‐cells from the donor marrow but this procedure adversely affects marrow engraftment, increases the chances of rejection and results in a higher incidence of leukaemic relapse. Immunohistochemical staining for various cytokine‐inducible molecules has led to some improvement in early diagnosis.
Expression of c‐erbB‐2 protein, neuron‐specific enolase and DNA flow cytometry in locally advanced transitional cell carcinoma of the urinary bladder
Authors: BERNER A. , JACOBSEN A.‐B. , FOSSÅ S. D. , NESLAND J. M.
Published: April 2007

Expression of c‐erbB‐2 protein, neuron‐specific enolase (NSE) and DNA ploidy was studied by immunohistochemistry and flow cytometry in formalin‐fixed and paraffin‐embedded specimens from 104 patients with locally advanced transitional cell carcinoma of the bladder. Positive membrane bound c‐erbB‐2 staining was found in 15% of the tumours, and 38% of the tumours were positive for NSE. Only one tumour stained positively for both NSE and c‐erbB‐2. Expression of c‐erbB‐2 protein and NSE was neither correlated to tumour stage nor to histopathological grade. The frequency of non‐diploid tumours was 78% in 49 c‐erbB‐2/NSE negative tumours, 98% in 40 NSE positive tumours, and 100% in 16 c‐erbB‐2 positive tumours (P=0.004). Whether the c‐erbB‐2 expression is a useful prognostic marker in addition to other conventional parameters, remains to be shown.
The bone marrow trephine biopsy: a review of normal histology
Authors: BROWN D.C. , GATTER K.C.
Published: April 2007

Bone marrow trephine biopsies are becoming increasingly common in routine surgical pathology. Familiarity with normal marrow histology plays an important part in understanding and interpreting marrow pathology. The aim of this article is to describe the histological features of normal human bone marrow, in particular those features which are relevant to the diagnostic pathologist. The advantages and disadvantages of different technical aspects, such as choice of embedding material and type of stain, are discussed. The use of immunochemistry in identifying different cell types within the marrow is illustrated.
Carcinosarcoma of the oesophagus with rhabdomyoblastic differentiation
Authors: GUARINO M. , REALE D. , MICOLI G. , FORLONI B.
Published: April 2007

We report a case of oesophageal carcinosarcoma with prominent rhabdomyoblastic differentiation. Immunohistochemically, the rhabdomyblasts were mainly reactive to vimentin, cytokeratin, desmin, muscle‐specific actin, myosin, and myoglobin, and were surrounded by laminin and type IV collagen‐positive basement membranes. The tumour had dual differentiation, carcinomatous and sarcomatous, but also showed evident features of transition between the two components, suggesting a common origin. An epithelial‐mesenchymal conversion could be the pathogenetic mechanism involved in the histogenesis of this lesion. The word carcinosarcoma, from a descriptive point of view, seems the most suitable to describe a tumour composed of both carcinomatous and true sarcomatous elements.
Expression of Lewis X‐related antigens in adenocarcinomas of lung
Authors: SHIMIZU T. , YONEZAWA S. , TANAKA S. , SATO E.
Published: April 2007

Fifty primary lung adenocarcinomas were examined immunohistochemically using monoclonal antibodies to determine changes in the expression of N‐acetyl‐lactosamine (blood group type‐2 chain), Lex, LeY and sialyl Lex‐i. These antigens were expressed in 60%, 70%, 90% and 94% of carcinomas, respectively; in 8%, 12%, 56% and 86% of normal broncho‐bronchiolar epithelium; and in 32%, 0%, 100% and 0% of normal alveolar epithelium. The greater the complexity of the antigenic structure, the greater the incidence of positive staining in the adenocarcinomas. Although the more complex antigens such as sialyl Lex‐i and LeY have also been demonstrated in the sera of lung cancer patients, they were not always cancer‐selective in our immunohistochemical study. In contrast, the less complex antigens such as N‐acetyl‐lactosamine (type‐2 chain) and Lex seem to be cancer‐selective, as they showed low positivity in normal lung tissue.
Plasma cell populations in labial salivary glands from patients with and without Sjögren's syndrome
Authors: MATTHEWS J. B. , DEACON E. M. , WILSON C. , POTTS A. J. C. , HAMBURGER J.
Published: April 2007

Plasma cells expressing IgG, IgA and IgM were quantified in labial salivary glands from patients with Sjögren's syndrome (n = 25) and compared with glands from patients with a variety of systemic diseases (n = 32) and normal individuals (n = 15). Based on qualitative and quantitative analysis, glands from the systemic disease group were divided into normal histology (n = 24) and non‐specific inflammation (n = 8) groups. There were no significant differences in cell densities or Ig class proportions between histologically normal glands from patients and those from normal volunteers. Total immunocyte densities were significantly increased in sialadenitis (P≤0.025) and Sjögren's syndrome (P≤0.001) compared with normal histology glands. In both the sialadenitis and Sjögren's syndrome groups there were significant increases in IgG and IgM cell densities (IgG, P≤0.006; IgM, P≤0.001) and proportions (IgG, P≤0.05; IgM, P≤0.001). There were no significant differences in immunocyte densities or proportions between the sialadenitis and Sjögren's syndrome groups except for a lower percentage proportion of IgA cells in the latter (P≤0.038). In all groups the total and individual Ig‐class cell densities showed significant positive correlations with extent of leucocyte infiltration (P≤0.01) and negative correlations between IgA and IgG and/or IgM cell proportions. Analysis of the plasma cell data alone and in combination with quantifiable histological parameters failed to yield specific or sensitive diagnostic information. The results suggest that changes in glandular plasma cell populations in Sjögren's syndrome are non‐specific.
Usefulness of follicular dendritic cell pattern in classification of peripheral T‐cell lymphomas
Authors: LEUNG C. Y. , HO F. C. S. , SRIVASTAVA G. , LOKE S. L. , LIU Y. T. , CHAN A. C. L.
Published: April 2007

Classification of peripheral T‐cell lymphomas based on morphological criteria can present problems due to overlap in histological features amongst the subtypes. An immunohistochemical study was designed to study the follicular dendritic cell patterns in 21 cases of peripheral T‐cell lymphoma which had been classified using the updated Kiel classification. Three patterns of distribution were observed: 1 follicular dendritic cells not detected (3 cases); 2 follicular dendritic cells restricted to remnant follicle centres (7); 3 follicular dendritic cells present as an expanded network of cells exceeding the confines of germinal centres (11). Ten out of 11 angioimmunoblastic lymphomas showed an expanded network of follicular dendritic cells. The only negative case showed features which, on review, were in keeping with a pleomorphic, medium and large cell lymphoma showing an unusual proliferation of small venules. Other than angioimmunoblastic lymphomas, only one other case showed follicular dendritic cell hyperplasia. This was an unclassified peripheral T‐cell lymphoma. We conclude that follicular dendritic cell hyperplasia may be used an an aid to diagnosis of the angioimmunoblastic type of peripheral T‐cell lymphoma, and we recommend the routine staining of these cells in typing of T‐cell lymphomas to facilitate comparison between centres.
Atypical and malignant meningiomas: importance of micronecrosis as a prognostic indicator
Authors: McLEAN C.A. , JOLLEY D. , CUKIER E. , GILES G. , GONZALES M.F.
Published: April 2007

Twenty‐eight patients with a diagnosis of either atypical or malignant meningioma, according to the World Health Organisation (WHO) classification, were followed up to relate histopathological features with times to recurrence and death. Five year disease‐free survival was 41% with a median disease free survival of 27 months. Micronecrosis was the only histopathological feature associated with increased risk of recurrence (rate ratio, 3.73; 95% confidence interval 1.03–13.6). At 36 months, 32% of patients with micronecrosis were alive compared with 71% of patients without micronecrosis. Brain invasion was not associated with disease‐free survival. After recurrence, median survival was 7 months and was not correlated with any histopathological feature. The prevalence of micronecrosis was estimated from random samples of benign, atypical and malignant meningiomas to be 8%, 42% and 71% respectively. The relevance of these findings and the current WHO classification is discussed.
Effects of chemotherapy on ultrastructure of oesophageal squamous cell carcinoma
Authors: ANTONAKOPOULOS G.N. , DARNTON S.J. , NEWMAN J. , DUFFY J.P. , MATTHEWS H.R.
Published: April 2007

Seven oesophageal squamous carcinomas, treated with pre‐operative chemotherapy (mitomycin‐C, ifosfamide and cisplatin‐MIC), with a course finishing 21 days prior to resection, were examined by electronmicroscopy. In one treated case detailed light microscopy failed to reveal any tumour. Five of the remaining six tumours showed cytotoxic damage in that apoptosis and unusual necrotic changes were observed in almost all the neoplastic cells. These features were not seen in untreated cases. In four additional cases, who received one pulse of MIC followed by biopsy or resection within 3–6 days, apoptotic changes were very pronounced and extensive and most neoplastic cells presented unusual degeneration with characteristic derangement of the cytoskeleton, destruction of organelles and accumulation of glycogen. The ultrastructural appearance of 18 untreated resected oesophageal squamous carcinomas was studied for comparison with the treated tumours. The study has demonstrated ultrastructural changes resulting from chemotherapy. Results suggest that the regimen is more effective against squamous carcinomas than against adenocarcinomas of the oesophagus, as judged by comparison with the results of a previous study.
Mesothelial cell inclusions within mediastinal lymph nodes
Authors: RUTTY G.N. , LAUDER I.
Published: April 2007

The presence of mesothelial cell inclusions within mediastinal lymph nodes is an extremely rare occurrence with apparently only two previously reported cases. We report a single case with immunohistochemistry and transmission electron microscopy. A study of 318 mediastinal nodes from 80 patients using haematoxylin and eosin and immunohistochemistry is reported with the observation of no further positive cases. A review of the literature concerning nodal inclusions found at other anatomical sites aids discussion on the aetiology of this type of nodal inclusion.
Autopsy findings in two cases of neonatal herpes simplex virus infection: detection of virus by immunohistochemistry, in situ hybridization and the polymerase chain reaction
Authors: NICOLL J.A.R. , LOVE S. , BURTON P.A. , BERRY P.J.
Published: April 2007

We describe the pathological findings in two fatal cases of neonatal infection with herpes simplex virus. One had an encephalitis caused by herpes simplex virus type 2 (HSV‐2); the other had a disseminated infection with herpes simplex virus type 1 (HSV‐1). Confirmation of the diagnosis was obtained by use of the polymerase chain reaction to amplify viral DNA from paraffin sections of autopsy tissues. By using primers which amplify fragments of the HSV‐1 thymidine kinase gene and HSV‐2 glycoprotein gene respectively it was possible to discriminate between infection with HSV‐1 and HSV‐2. In contrast, immunohistochemistry and in situ hybridization using commercially available reagents did not distinguish between HSV‐1 and HSV‐2 infection. However, immunohistochemistry and in situ hybridization are probably more reliable than the polymerase chain reaction for assessment of the distribution of virus in different tissues.
A comparative analysis of grading systems in renal adenocarcinoma
Authors: LANIGAN D. , CONROY R. , BARRY‐WALSH C. , LOFTUS B. , ROYSTON D. , LEADER M.
Published: April 2007

While the histological grade of a renal cell carcinoma is of prognostic significance there is poor concordance amongst pathologists in the use of these grading systems. Many grading systems have been described, but none has achieved widespread acceptance. The objective of this study was to assess the degree of interobserver variation amongst four experienced pathologists in their use of four commonly applied grading systems. The pathologists reviewed a series of 88 cases of renal cell carcinoma. Grades were detailed on a proforma which consisted of a breakdown of each grading system. Cohen's kappa was calculated for each pair of observers for each system. The mean kappa scores for each system were compared using the Tukey honestly significant differences method. Mean kappa was highest for the grading system of Syrjanen and Hjelt and this grading system also had a higher mean kappa than two of the other systems tested. The most striking feature of the results was the degree to which the pathologists differed in their assessments. The grading system of Syrjanen and Hjelt was shown to be subject to less interobserver variability than other commonly used classifications and we are of the opinion that it should become the standard method.
Basaloid carcinomas of salivary glands
Authors: GALLIMORE A.P. , SPRAGGS P.D.R. , ALLEN J.P. , HOBSLEY M.
Published: April 2007

Three cases of carcinoma of major salivary glands with basaloid morphology are presented. One case was a clear example of a basal cell adenocarcinoma, an uncommon and infrequently recognized, low‐grade tumour of major salivary glands. The remaining two cases showed a higher cytological grade of malignancy but shared some features of basal cell adenocarcinoma. Common features included the architectural pattern and myoepithelial cell differentiation, as demonstrated by smooth muscle‐specific actin positivity, in cells associated with the deposition of extracellular basal lamina‐like material. The relationship between these cases and adenoid cystic carcinoma is discussed.
Epithelioid leiomyoma of the larynx
Authors: HELLQUIST H.B. , HELLQVIST H. , VEJLENS L. , LINDHOLM C.E.
Published: April 2007

We describe the pathological features of a case of laryngeal epithelioid leiomyoma (leiomyoblastoma) which, to our knowledge, is the second case to be reported in the world literature. A review of the literature confirmed that leiomyoma as such is a very rare neoplasm in the larynx, and only 33 cases have been previously reported. The neoplasm was located in the left vocal cord and consisted of mainly epithelioid, round or spindle‐shaped cells, often with clear cytoplasm, which were arranged predominantly in solid nests and sheets. The tumour cells showed positive immunoreactivity for smooth muscle actin and desmin. The tumour showed low mitotic activity and immunostaining with MIB 1 (Ki‐67) accordingly revealed the occasional cell only to be positive, confirming a low proliferative activity in agreement with a benign neoplasm. Epithelioid leiomyomas located in other sites have been shown to act occasionally in a malignant fashion, and the necessity for careful long‐term follow‐up of the patient is therefore emphasized.
Frequent presence of latent Epstein‐Barr virus infection in lymphoepithelioid cell lymphoma (Lennert's lymphoma)
Authors: ANAGNOSTOPOULOS I. , HUMMEL M. , TIEMANN M. , KORBJUHN P. , PARWARESCH M.R. , STEIN H.
Published: April 2007

This study deals with the investigation of the biological significance of an Epstein–Barr virus (EBV) infection in lymphoepithelioid cell lymphoma. A selection of EBV‐detection techniques was applied to 15 cases, including polymerase chain reaction (PCR) for the detection of EBV‐DNA, in situ hybridization (ISH) for the cellular localization of EBV‐encoded small nuclear (EBER 1 and EBER 2) and immediate‐early (BHLF) RNAs, and immunohistology for the detection of EBV‐encoded latent membrane protein (LMP) expression. PCR and EBER‐ISH produced congruent results in those cases with amplifiable DNA, leading to an EBV presence in 11/15 lymphoepithelioid cell lymphoma cases (73%). EBER‐ISH combined with immunohistology localized the virus predominantly in several B immunoblasts and small B lymphocytes in eight of the EBV‐positive cases, five of which also contained single infected lymphocytes expressing T‐cell characteristic antigens. LMP was detected using immunohistology in only a proportion of immunoblasts in four of these cases. The remaining three EBV‐positive lymphoepithelioid cell lymphoma cases contained only single EBER‐positive small B lymphocytes without LMP expression. No case contained BHLF‐RNA expressing cells. These data imply that, although latently EBV‐infected cells are frequently present in lymphoepithelioid cell lymphoma cases, the virus is probably not directly involved in the pathogenesis of this entity.
Information and observer disagreement in histopathology
Authors: MORRIS J.A.
Published: April 2007

Concepts from information theory are used to assess the process of ordinal classification of histopathological continua such as degree of dysplasia or degree of differentiation. A working model is used to show that reducing the number of categories leads to an increase in inter‐observer agreement, as measured by kappa statistics, but a decrease in information transmitted. It is argued that the prime role of histopathologists is to pass information, obtained from visual patterns, to the clinician and therefore more categories, rather than fewer, should be used. It is suggested that judgements of continua should be made on 100 point scales and quoted together with 95% confidence limits; and that the judgements of different observers should be averaged to form a reference range.
Bone marrow trephines. Findings in patients with hairy cell leukaemia before and after treatment
Authors: PITTALUGA S. , VERHOEF G. , MAES A. , BOOGAERTS M.A. , WOLF‐PEETERS C. DE
Published: April 2007

Bone marrow trephine biopsies from 20 patients with hairy cell leukaemia were reviewed at diagnosis and during therapy with alpha‐interferon (IFN) and with 2‐chlorodeoxyadenosine (2‐CdA). At time of diagnosis the trephines revealed classical features of hairy cell leukaemia and profound alterations of haematopoiesis. All three lines showed dysplastic features with architectural, qualitative and quantitative changes. Review of consecutive trephine biopsies in patients that received IFN showed that a complete remission with disappearance of the tumour was never achieved and that the dysplastic features persisted. An improvement of haematopoiesis was noted, but recovery, especially of the myelopoiesis, was never completely achieved. By contrast, patients treated with 2‐CdA de novo and previously treated with IFN achieved a complete remission in all but three cases. The trephine biopsies showed an improvement of haematopoiesis with progressive disappearance of the dysplastic features and a good recovery of myelopoiesis. A residual lymphocytosis was present, but as it was also present in age‐matched control cases it could not be considered as a residual tumour. The disappearance of the leukaemic infiltrate probably constitutes a prerequisite for the recovery and normalization of haematopoiesis, while the dysplastic changes present at diagnosis could be the result of cytokine production by the leukaemic cells.
Plexiform fibrohistiocytic tumour with novel phenotypic features
Authors: THOMÁZY V. , NAGY A. , GAL I. , NEMES Z.
Published: April 2007

Plexiform fibrohistiocytic tumour is a recently described type of fibrohistiocytic tumour, the differentiation pattern of which is poorly understood. A case representing the predominantly fibrohistiocytic type of the tumour is reported. Immunohistochemical analysis supports the histiocytic origin of this entity. The expression of EBM/11 and tissue transglutaminase both in fibroblast‐like and histiocyte‐like cells indicate that a single cell line produces the dual morphological features. It is proposed that a non‐phagocytic epithelioid pattern of histiocytic differentiation characterizes this tumour.
Mixed pulmonary blastoma and carcinosarcoma
Authors: OLENICK S.J. , FAN C.C. , RYOO J.W.
Published: April 2007

Pulmonary blastemas and carcinosarcomas are uncommon tumours, accounting for less than 1% of all lung neoplasms. Three previously described mixed epithelial and mesenchymal tumours having both adult and embryonal elements were termed ‘transitional’. We report a similar case and evaluate the application of the term ‘transitional tumour’.
Nodular transformation of splenic red pulp due to carcinomatous infiltration. A diagnostic pitfall
Authors: FAKAN F. , MICHAL M.
Published: April 2007

Autopsy of three women dying of disseminated carcinoma of stomach, colon, and breast, respectively, revealed a grossly unremarkable spleen. Microscopic examination demonstrated a nodular transformation of the red pulp, simulating a follicular lymphoma. Immunostaining revealed dissociated carcinomatous cells between the nodules, and this was thought to be the cause of the nodular transformation.
Immunohistochemical detection of bcl‐2 protein in thymoma
Authors: BROCHERIOU I. , CARNOT F. , BRIERE J.
Published: April 2007

The protooncogene bcl‐2 encodes a protein that inhibits apoptosis. The protein is expressed in most epithelial cells of the fetal thymic medulla but, to the best of our knowledge, no data are available on bcl‐2 expression in thymoma. Expression of bcl‐2 protein was analysed in 30 cases of thymoma by immunohistological staining of paraffin‐embedded tissue. All cases were examined and classified according to the Salyer and Eggleston and the Müller‐Hermelink classification. In four cases, the protooncogene bcl‐2 was abnormally expressed in spindle cells of pure medullary thymoma, whereas the non‐spindle cells in mixed and in cortical thymoma were negative. All the lymphocytes were also strongly positive in medullary thymoma while a few lymphocytes showed light staining in other thymomas.
Benign myoepithelioma of the salivary glands: a true entity?
Authors: SIMPSON R.H.W. , JONES H. , BEASLEY P.
Published: April 2007

Myoepithelioma is a rare neoplasm of the salivary glands which is now recognized as an individual entity in the revised WHO classification. In this study, eleven benign tumours are presented. Most patients gave a history of a slowly enlarging mass, which was cured by surgical excision. However, one case recurred several times over 50 years, and another still has residual tumour and removal is not possible. The histological appearances included solid, myxoid and reticular growth patterns, composed predominantly of spindle shaped or plasmacytoid (hyaline) cells. Many of the tumours also contained occasional small ducts. All 11 tumours were positive for S‐100 protein, variable reactions being seen for various other antigens—keratins, human milk fat globulin, carcinoembryonic antigen, alpha smooth muscle actin and vimentin. It is probable that myoepithelioma constitutes one end of a biological spectrum which also includes pleomorphic adenoma and some (non‐membranous) basal cell adenomas. In practice, however, we still advocate retention of myoepithelioma as a separate diagnostic category, on the grounds that it has a range of distinctive microscopic appearances and poses its own unique problems in correct identification.
Vesical clear cell adenocarcinoma V. Nephrogenic adenoma: a diagnostic problem
Authors: ALSANJARI N. , LYNCH M.J. , FISHER C. , PARKINSON M.C.
Published: April 2007

Following the diagnosis of nephrogenic adenoma in a bladder lesion, which was later interpreted as early clear cell adenocarcinoma, the morphological and immunocytochemical features of these two lesions were reviewed to see if differences could be established for future diagnostic application. The architecture, extent, cell type, nuclear pleomorphism, presence of mitotic figures and glycogen content were recorded in 28 nephrogenic adenomas and the clear cell carcinoma. Similarly, the immunoreactivity for CAM 5.2, LP34, EMA and CEA of 10 nephrogenic adenomas and the clear cell carcinoma were compared. Proliferation rate in five nephrogenic adenomas and the carcinoma was assessed by antibody M1B1. Many of the features showed differences in degree or extent (clear cell change, nuclear pleomorphism, CAM 5.2 and CEA positivity). The only features distinct to clear cell carcinoma were the presence of solid islands, mitoses greater than 1/10 HPF (HPF area = 0.4 mm2) and M1B1 counts in excess of 29/200 in clear cell carcinoma (range 30/200‐83/200). Only the high M1B1 count was present in the first biopsy of the clear cell carcinoma.
Giant cell rich parosteal osteosarcoma
Authors: SCIOT R. , SAMSON I. , CIN P. DAL , LATEUR L. , DAMME B. VAN , BERGHE H. VAN DEN , DESMET V.
Published: April 2007

A parosteal osteosarcoma of the distal femur with a typical radiographic and macroscopic appearance is reported. On histology the tumour was dominated by large numbers of osteoclast‐like giant cells in a fibro‐osseous background and islands of immature bone. Most of the neoplastic bone lacked osteoblastic rimming. There was no spatial relationship between the giant cells and areas of haemorrhage. Signs of ‘dedifferentiation’ were lacking. Cytogenetic a analysis revealed telomeric associations which are frequently found in giant cell tumours of bone. Parosteal osteosarcoma may, on histological appearances, hardly be recognizable as malignant. In addition, unusual changes such as abundant giant cells may be misleading in the absence of clinico‐pathological correlation.