bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomy of the renin‐angiotensin system in the normal and pathological kidney
Authors: LINDOP G.B.M. , LEVER A.F.
Published: April 2007

In this review we describe the contributions made by immunocytochemistry to our knowledge of the renin‐angiotensin system in the normal and the pathological kidney. Most of the renin‐secreting cells appear to be on the outer aspect of the vessel wall, supporting the view that renin is secreted mainly into the interstitium of the kidney rather than into the lumen of the vessel. Angiotensin II immunoreactivity is present within renin‐secreting cells. The angiotensin II appears to be present in high concentration in the renin storage granules and is therefore presumably secreted from the cell with renin. The pathways by which renin is secreted from the cell have also been clarified. In pathological kidneys, the reactions of renin‐secreting cells to variation in functional demand have been confirmed. Renin‐containing cells have also been found in most types of renal tumours and occasional cases probably secrete renin or prorenin into the blood. In renal tumours and in the developing kidney (in all species studied) the renin‐containing cells are also intimately associated with blood vessels.
Cellular heterogeneity in lung cancer
Authors: DUNNILL M.S. , GATTER K.C.
Published: April 2007

Sixty‐six lung carcinomas have been examined by light and electron microscopy, as well as by immunocytochemical techniques using a panel of monoclonal antibodies. There was considerable heterogeneity with regard to cell type and in only 18 cases was it possible to classify the tumour as a solely small cell, squamous or adenocarcinoma. In the remaining cases there was evidence of two or three cell types. These findings support the thesis that all lung cancers are derived from a pluripotential basal or reserve cell in the bronchial mucosa which may proliferate along one or more lines of differentiation. This view of the histogenesis of lung cancer would account for the heterogeneous appearance of many tumours and the difficulty experienced in placing them in one of the standard classifications.
Connective tissue stroma in bladder papillary transitional cell carcinoma, carcinoma in situ and benign cystitis
Authors: OOMS E.C.M. , BLOMJOUS C.E.M. , ZWARTENDIJK J. , VELDHUIZEN R.W. , BLOK A.P.R. , HEINHUIS R.J. , BOON M.E.
Published: April 2007

The stromal characteristics in papillary and non‐papillary tumours of the urinary bladder were investigated in an attempt to improve the accuracy of histopathological diagnosis. It appeared to be possible to differentiate true papillary tumours from pseudopapillary structures lined by carcinoma in situ. Stromal differences were not found in cases of carcinoma in situ accompanied by denuding cystitis and cystitis due to other aetiological factors. It is concluded that histopathological examination of the stroma of bladder tumours improves diagnostic accuracy.
A classical osteogenic sarcoma of the breast: histology, immunohistochemistry and ultrastructure
Authors: GOING J.J. , LUMSDEN A.B. , ANDERSON T.J.
Published: April 2007

A classical osteogenic sarcoma of the breast is described and the results of light microscopy, including immunohistochemistry for epithelial and mesenchymal markers, and of electron microscopy are presented. No epithelial features were detected by any of the methods used, the tumour being considered a true osteogenic sarcoma. The tumour appears to have arisen de novo, and not from a pre‐existing fibroadenoma.
Primitive neuroectodermal tumour of the central nervous system associated with malignant rhabdoid tumour of the kidney: report of a case
Authors: HOWAT A.J. , GONZALES M.F. , WATERS K.D. , CAMPBELL P.E.
Published: April 2007

Malignant rhabdoid tumour of the kidney is a recently reported tumour presenting in young children. Irrespective of stage and despite intensive chemotherapy these tumours have a poor prognosis, with death usually occurring within a matter of months. A recent report has shown the association of second embryonal tumours of the central nervous system occurring in patients with the renal tumour; most of these second tumours have occurred in the posterior fossa. We report here an infant who presented with a mass in the right groin, showing features of a poorly differentiated sarcoma, possibly rhabdomyosarcoma. Further investigations revealed a tumour in the lower pole of the right kidney which was subsequently shown to be a malignant rhabdoid tumour. The child was given chemotherapy but re‐presented at 10 months of age with hydrocephalus, irritability and spasms leading to death. At autopsy a large tumour was found filling the right lateral and third ventricles; histology showed a primitive neuroectodermal tumour with focal astrocytic differentiation. Residual rhabdoid tumour was restricted to a few para‐aortic lymph nodes and focal lymphatic micrometastases in lungs. The association of two embryonal neoplasms of possible similar histogenesis is discussed.
An immunohistochemical study of non‐Hodgkin's lymphomas: correlation of morphological appearances and immunophenotype in 148 cases
Authors: NASH J.R.G.
Published: April 2007

An unselected series of 148 cases of non‐Hodgkin's lymphoma has been studied by immunohistological methods. In each case, the morphological features displayed in paraffin sections were correlated with the immunophenotype, determined using a panel of monoclonal antibodies. Of the lymphomas 82% were B‐cell type, 28% of follicle centre cell origin, 17% lymphocytic or immunocytic and 30% of large cell type. All the B‐cell tumours expressed pan‐B antigen, and nearly all HLA‐DR. In most, light chain monoclonality was demonstrable. Nearly all had moderate to large numbers of T‐cells of both subtypes interspersed amongst the B‐lymphocytes. Follicle centre cell tumours expressed surface IgM and IgD and had numerous dendritic reticulum cells. Lymphocytic and immunocytic lymphoma expressed IgM but less IgD, and had fewer or no dendritic reticulum cells. Large cell lymphoma expressed either no immunoglobulin or only IgM, and contained ragged dendritic reticulum cells, giving the appearance of ‘burnt‐out’follicles. T‐cell lymphomas usually showed a clear preponderance of either helper or suppressor subtype. Additionally, they contained residual B‐cells and sometimes germinal centres. Only 3% of this series were ‘non‐B, non‐T', and only one case HLA‐DR negative, so the ‘null’or ‘unclassifiable’group is very small when information from antibody markers is available.
Malignant disease of the pleura: a histopathological study with special emphasis on diagnostic criteria and differentiation from reactive mesothelium
Authors: TUDER R.M.
Published: April 2007

In order to define the histopathological criteria for the diagnosis of malignant neoplasm involving pleura, we studied 11 pleurectomy specimens containing undoubted malignant cells. The most important feature for a diagnosis of malignancy was the pattern of neoplastic infiltration of the fibrous sub‐pleural tissue. These criteria were subsequently applied in a re‐analysis of 76 pleural needle biopsies with a diagnosis of cancer. The patterns most frequently seen were a multi‐pronged growth of at least four clusters of atypical cells in the fibrous sub‐pleural tissue, a solid pattern with a large collection of atypical cells and a confluent one where large numbers of small clusters of atypical cells appeared almost fused in the stroma. Less frequently, malignant cells covered the surface of fibromuscular tissue, or were found in an intravascular or intramuscular location, but often associated with any of the three main patterns. Five needle biopsies were considered suspicious and 11, considered benign, contained a prominent mesothelial reaction. The benign control cases showed mesothelial cells mainly in a peripheral growth pattern or as clusters of cells interspersed with fibrin, without any mitotic activity; granulation tissue and lympho‐histiocytic infiltrates were more frequently seen in the control group.
Lymphocyte predominance Hodgkin's disease: a reappraisal based upon histological and immunophenotypical findings in relapsing cases
Authors: REGULA D.P. , WEISS L.M. , WARNKE R.A. , DORFMAN R.F.
Published: April 2007

The clinical, morphological and immunological findings in nine cases of relapsing lymphocyte predominance Hodgkin's disease (LPHD) are examined. Six patients had initial biopsies demonstrating nodular lymphocytic and/or histiocytic (L & H) LPHD; Leu‐Mi was not expressed by any of the atypical cells in these cases. All six demonstrated one or more recurrences of nodular L & H LPHD; four are currently free of disease, one died of non‐Hodgkin's lymphoma and another died of leukaemia. Two patients had initial biopsies demonstrating diffuse LPHD, with only rare multilobated atypical cells (L & H variants). Both patients had recurrences interpreted as mixed cellularity Hodgkin's disease, 10 and 15 years after initial therapy and both died with lymphocyte depleted Hodgkin's disease. The atypical cells in the initial biopsies and in subsequent recurrences failed to express Leu‐Ml, but did express leukocyte common antigen. The initial biopsy from the final patient was histologically interpreted as focal involvement by LPHD, but interfollicular Hodgkin's disease was considered after the Leu‐Ml stain revealed additional atypical cells. The disease relapsed and the patient died with typical nodular sclerosing Hodgkin's disease. The pattern of the relapses supports the concept that the histological entity of LPHD may include several distinct clinicopathological subgroups.
Low‐grade lymphoma of immature T‐cell phenotype in a case of lymphocytic interstitial pneumonia and Sjögren's syndrome
Authors: SCHUURMAN H.‐J. , GOOSZEN H.CH. , TAN I.W.N. , KLUIN P.M. , WAGENAAR SJ.SC. , UNNIK J.A.M. VAN
Published: April 2007

A 19–year‐old male patient presented with lymphocytic interstitial pneumonia and Sjögren's syndrome, confirmed by histopathology. He was treated with prednisone; 4 months later, cyclophosphamide was added. A lymph node taken at presentation revealed no histological signs of malignancy. Lymph nodes obtained 1 and 2 years later exhibited an effaced structure and a diffuse infiltration of small‐sized lymphocytic cells compatible with a low‐grade non‐Hodgkin's lymphoma. The immunological phenotype of the lymphoma resembled that of immature T‐cells present in the normal thymus cortex—positivity for CD1, CD2, CD4, CD7, CD38 and terminal deoxynucleotidyl transferase; faint positivity for CD5 and in the second specimen for CD3; negativity for CD6 and MHC class 1 antigen. The occurrence of such a peculiar lymphoma in Sjögren's syndrome has not been reported thus far. Small numbers of putative malignant cells were found on immunohistochemistry in a lymph node and a lung biopsy obtained at presentation. This is suggestive of one underlying pathogenetic event in the development of lymphocytic interstitial pneumonia, Sjögren's syndrome and non‐Hodgkin's lymphoma.
Critical assessment of four monoclonal antibodies reactive with B‐cells in formalin‐fixed paraffin‐embedded tissues
Authors: NG C.S. , CHAN J.K.C. , LO S.T.H. , LO D.S.Y.
Published: April 2007

Four commercially available monoclonal antibodies, MB1, MB2, LN1 and LN2, were studied to determine their sensitivity and specificity for the diagnosis of B‐cell lymphomas when used on formalin‐fixed paraffin‐embedded tissues. In addition to 125 cases of immunologically characterized non‐Hodgkin's lymphoma, a range of normal tissues, reactive lymphoid proliferations, Hodgkin's disease and granulocytic sarcomas were also studied. MB1 was found to give positive results in 53.6% of B‐cell lymphomas, but the staining was sometimes weak and patchy; there was also cross‐reaction with 1.8% of T‐cell lymphomas. MB2 reacted with 88.4% of B‐cell lymphomas and the reaction was often strong and diffuse, but it showed cross‐reaction with 18.2% of T‐cell lymphomas. LN1 and LN2 gave positive staining of 44.9 and 46.4% of B‐cell lymphomas respectively, and the results appeared to be inferior to that obtained in B5‐fixed tissues; staining was sometimes weak and focal, and they also gave false‐positive results in a few cases of T‐cell lymphoma. This study shows that MB1, LN1 and LN2 are fairly but not entirely specific for B‐cells in the non‐Hodgkin's lymphomas, but are not very sensitive when applied to formalin‐fixed tissues. MB2 shows a high sensitivity but only moderate specificity. Therefore, when these antibodies are used to determine the immunophenotype of malignant lymphomas, the B‐cell nature can be predicted with great confidence only when two, preferably three or more, of the antibodies give positive results. The potential applications of these antibodies are discussed.
Chordomas—ultrastructure and immunohistochemistry: a report based on the examination of six cases
Authors: RUTHERFOORD G.S. , DAVIES A.G.
Published: April 2007

Six chordomas (three classic and three chondroid) were examined ultrastructurally and with a panel of monoclonal antibodies. The three classic tumours showed the presence of desmosomes and intermediate filaments on electron microscopy, findings which gave a direct positive correlation when the tumours were stained with monoclonal antibodies against low molecular weight cytokeratin proteins. These results suggest that chordomas are essentially epithelial neoplasms and underline the fact that monoclonal antibodies to cytokeratins cannot be used in the differential diagnosis of classic chordoma vs carcinoma. Furthermore, the epithelial characteristics are lost as the tumour undergoes chondroid differentiation.
Severely atypical changes in renal epithelium in biopsy and graft nephrectomy specimens in two cases of cadaver renal transplantation
Authors: MITTAL B.V. , COTTON R.E.
Published: April 2007

Severely atypical metaplastic and dysplastic changes were noted in the lining epithelium of collecting tubules and pelvis of the graft kidneys in two cases of cadaver renal transplants on immunosuppressive treatment with azathioprine and prednisolone. These changes were observed in case 1 in a needle biopsy and a nephrectomy specimen, 3 and 3.5 years after transplantation respectively. In a second case, the patient received two cadaver grafts, and both transplants showed similar changes 2 years after transplantation. The risk of malignant disease in kidney transplant recipients is now well recognized. The implications of the severe dysplastic changes noted in these two cases are discussed.
The DNA content in cancer and dysplasia in chronic ulcerative colitis
Authors: CUVELIER C.A. , MORSON B.C. , ROELS H.J.
Published: April 2007

The nuclear DNA content was determined with a cytophotometric technique in colonic mucosa of 15 patients with long‐standing ulcerative colitis. The epithelial lesions were classified into inactive colitis, low grade and high grade dysplasia and adenocarcinoma. The histogram pattern varied between narrow unimodal in quiescent colitis, broad unimodal in low grade dysplasia with some hypertetraploid values in three cases (27%) and aneuploid in 62.5% of the lesions with high grade dysplasia. In well‐differentiated adenocarcinoma the histograms were broad unimodal, whereas the curves of moderately and poorly differentiated carcinomas were wider and aneuploid. The technique can be used for a prognostic purpose: in dysplastic lesions, the detection of aneuploidy is important because it is frequently found in the presence of invasion although it does not allow its prediction. Carcinomas with polyploid DNA distribution have a better outcome than tumours with aneuploid distribution.
Chromolipid‐induced portal lymphadenopathy in primary biliary cirrhosis
Authors: BENBOW E.W. , MCMAHON R.F.T.
Published: April 2007

Yellow or brown granules of chromolipid, often called Hamazaki‐Wesenberg bodies, have previously been described in the sinuses of lymph nodes. They have been seen in normal nodes and nodes showing non‐specific reactive changes; particular interest has been shown in a suggested association with sarcoidosis. We describe two patients, both with primary biliary cirrhosis, in whom the accumulation of large numbers of such bodies in the sinuses of lymph nodes of the porta hepatis led to a prominent lymphadenopathy.
Immunohistology of adenolymphoma (Warthin's tumour): evidence for a role of vascularization in the organization of the lympho‐epithelial structure
Authors: RUCO L.P. , ROSATI S. , REMOTTI D. , MODESTI A. , VITOLO D. , BARONI C.D.
Published: April 2007

The epithelial, vascular and lymphoid components present in two cases of adenolymphoma (Warthin's tumour) were characterized by immunohistochemistry on frozen sections. Epithelial cells were positive for cytokeratin and keratin and were in close contact with numerous factor VIII related antigen‐positive capillary vessels, running parallel to the epithelial basement membrane. The capillary vessels were in communication with high endothelial post‐capillary venules which were often lined by HLA‐DR‐positive endothelial cells. The lymphoid tissue was organized in B‐cell and T‐cell areas. The B‐cell areas consisted of B4+/To15+ B‐lymphocytes admixed with DRC‐1–positive follicular dendritic reticulum cells. The T‐cell areas were mainly populated by T11+/T3+/T4+ lymphocytes admixed with some S‐100+/HLA‐DR+ interdigitating reticulum cells. Plasma cells and T8+ lymphocytes were more numerous in the proximity of the epithelium. Leu‐M3+/PAM‐1+ macrophages were scattered singly in the T‐cell areas or were arranged in sinus‐like structures around the epithelial cysts. The epithelial basement membrane, the vascular membrane and the fibrillar reticular stroma of the lymphoid tissue were immunoreactive for laminin and type IV collagen. The possibility is discussed that the accumulation of lymphoid tissue in Warthin's tumour is modulated by the epithelial cells, perhaps through their ability to organize a peculiar pattern of vascularization.
Characterization of a monoclonal antibody (BG3C8) that reacts with basal cells of stratified epithelia
Authors: PALLESEN G. , NIELSEN S. , CELIS J.E.
Published: April 2007

Monoclonal antibodies were produced against a suspension of formaldehyde fixed human epidermal cells. The supernatant fluid of one clone (BG3C8) yielded a bright immunofluorescent staining of basal cells both in cryostat sections of human split skin and in preparations of purified basal cells. As determined by one‐ and two‐dimensional gel immunoblotting of epidermal basal cell proteins the antibody recognized a minor basic poiypeptide of 55000 apparent molecular weight that was not present in extracts of cultured cell lines of epithelial, fibroblast and lymphoid origin. The distribution of the 55000 molecular weight protein in normal human tissue was determined by immunohistological staining of cryostat tissue sections that included: central nervous, endocrine, female and male reproductive, alimentary, lymphatic‐haemopoietic, respiratory and urinary systems, skin and its appendages, mesenchymal tissue (bone, cartilage, muscle, connective tissue, blood vessels, nerves and synovia) as well as placenta and umbilical cord. The results showed a restricted distribution of this antigen which was found only in basal cells of most stratified or pseudostratified epithelia and in myoepithelial cells. This antibody may be useful in the study of normal and pathological differentiation in various epithelial disorders.
Pulmonary blastoma. Immunohistochemical and ultrastructural studies of a case
Authors: KORBI S. , M'BOYO A. , DUSMET M. , SPILIOPOULOS A.
Published: April 2007

The immunohistochemical and ultrastructural features of a case of pulmonary blastoma in a 39‐year‐old woman are documented. Three types of cells were observed: epithelial, mesenchymal and ‘blastomatous'. The latter stained with intermediate filament antibodies similar to those of mesenchymal and epithelial elements, thus supporting the hypothesis that this tumour is derived from a pluripotent undifferentiated element.
Transferrin receptor expression in human hepatocellular carcinoma: an immunohistochemical study of 34 cases
Authors: SCIOT R. , PATERSON A.C. , VAN EYKEN P. , CALLEA F. , KEW M.C. , DESMET V.J.
Published: April 2007

Using a panel of five monoclonal anti‐transferrin receptor antibodies, we investigated the transferrin receptor expression in 34 human hepatocellular carcinomas of Belgian (n=6), Italian (n=7) and South African (n=21) origin. For comparison the tumours were also stained with the monoclonal antibody BK 19.9, recognizing an antigen biochemically similar to the transferrin receptor, and with a monoclonal antibody against the epidermal growth factor receptor. Hepatocellular carcinomas express large amounts of transferrin receptors as demonstrated by the intense transferrin receptor immunostaining in 33/34 cases. Differences in staining pattern between and within the tumours were not related to the degree of tumour differentiation, nor to the origin or race of the patient. In 15 cases which included non‐tumoural tissue, the tumour was more intensely stained than the surrounding liver parenchyma. The BK 19.9 immunoreactivity was generally weaker and mainly involved stromal cells, except in three cases where an intense staining of the tumour cells was seen. The epidermal growth factor receptor staining was also weaker and only in four cases was the immunoreactivity of the tumour stronger than the surrounding parenchyma. Demonstration of the transferrin receptor may be useful for the detection of malignant foci in liver biopsies. This may be of particular interest in the histological investigation of minute hepatocellular carcinomas.
Enteric tumours of the lower female genital tract: a report of three cases
Authors: FOX H. , WELLS M. , HARRIS M. , McWILLIAM L.J. , ANDERSON G.S.
Published: April 2007

Three enteric‐type neoplasms of the lower female genital tract are described; an enteric adenocarcinoma of the cervix, an enteric adenocarcinoma of the vagina and a tubulo‐villous adenoma of the vagina. The two adenocarcinomas were characterized by the presence of columnar cells with a prominent brush border and an abundance of goblet cells. The tubulovillous adenoma was identical to similar lesions found in the large intestine. The criteria for diagnosis of an enteric adenocarcinoma of the female genital tract are discussed and it is concluded that the histochemical demonstration of o‐acetylated sialomucin is the most specific marker of intestinal differentiation. It is suggested that enteric tumours of the cervix arise from foci of gastrointestinal metaplasia. Enteric tumours of the vagina are more likely to develop from cloacal remnants.
Intracranial olfactory neuroblastoma mimicking carcinoma: report of two cases
Authors: NG H. K. , POON W. S. , POON C. Y. F. , SOUTH J. R.
Published: April 2007

Two cases of olfactory neuroblastoma which presented clinically as intracranial lesions are described. Prominent features of epithelial differentiation were present, which led to initial diagnoses of poorly differentiated carcinoma. The true nature of the lesions was only established subsequently by careful histological examination, immunohistochemistry and electron microscopy. The potential towards epithelial differentiation in such tumours was emphasized and certain new histological features were described, including a biphasic epithelial and stromal pattern, papillae formation and positive staining for cytokeratin. These two cases underline the importance of exhaustive examination of poorly differentiated epithelial‐like lesions of the frontal lobes by conventional histology, immunohistochemistry and electron microscopy.
Malignant glandular schwannoma: a case with favourable prognosis
Authors: ALLEGRANZA A. , FERRARESI S. , LUCCARELLI G.
Published: April 2007

A solitary malignant schwannoma with glandular differentiation occurred in the forearm of a 54‐year‐old man. The patient displayed no stigmata of von Recklinghausen's neurofibromatosis. He did well after conservative surgery and there are no signs of recurrence 5 years after operation. The rarity of the tumour and the unusually long survival are points of interest. The histogenesis of the glandular component is discussed.
Mucosubstances in medullary carcinoma of the thyroid
Authors: MARTIN‐LACAVE I. , GONZALEZ‐CAMPORA R. , FERNANDEZ A. MORENO , GALLEGO F. SANCHEZ , MONTERO C. , GALERA‐DAVIDSON H.
Published: April 2007

We have studied mucosubstances in 12 cases of medullary carcinoma of the thyroid using histochemical techniques and a number of different lectins. Immunohistochemical staining for calcitonin and carcinoembryonic antigen was also performed. We have found that the presence of mucosubstances is a constant finding in medullary carcinomas; they were present extracellularly in 100% of cases and intracellularly in 53.3%. In both these compartments there was a predominance of neutral over acid mucosubstances. Receptors for UEA‐I, Con A, RCA‐I, Succ‐WGA and SBA were found in many cells in the majority of cases, but there were differences in the affinity from one case to another. Because of this lack of specificity lectin histochemistry is not of diagnostic value in medullary carcinomas of the thyroid. The possible relationships of the lectin‐binding results to glycosylated hormone precursors and carcinoembryonic antigen are discussed.
Nucleolar organizer regions in melanocytic dysplasia and melanoma
Authors: FALLOWFIELD M. E. , DODSON A. R. , COOK M. G.
Published: April 2007

Using silver (Ag) staining to demonstrate nucleolar organizer region‐associated proteins (AgNORs), pigmented naevi exhibiting features of melanocytic dysplasia have been examined and compared with benign intradermal and compound naevi and with malignant melanomas. A highly significant difference was found between the numbers of AgNORs demonstrated in benign naevus cells and atypical melanocytes and in malignant melanocytes, suggesting that this technique may have a role in differentiating between difficult melanocytic lesions.
Dermal adnexal differentiation in a squamous cell carcinoma of the uterine cervix
Authors: GROVE A.
Published: April 2007

The first case of a keratinizing squamous cell carcinoma of the uterine cervix with differentiation toward dermal adnexal structures is reported. A review of skin‐associated structures in the non‐neoplastic uterine cervix is given and the histogenesis discussed. Recent literature dealing with extracutaneous neoplasms with sebaceous differentiation is cited.
Cavernous haemangioma of breast in a man with contralateral gynaecomastia and a family history of breast carcinoma
Authors: SHOUSHA S. , THEODOROU N. A. , BULL T. B.
Published: April 2007

A 73‐year‐old man with a cavernous haemangioma of the right breast is presented. The patient had had gynaecomastia of the left breast 8 years earlier. Prior to that he had been on cimetidine for 2 years. The patient's mother and sister had breast carcinomas, while two other sisters and a brother had carcinomas of kidney, uterus and lung respectively.
What naevus is dysplastic, a syndrome and the commonest precursor of malignant melanoma? A riddle and an answer
Authors: ACKERMAN A. B.
Published: April 2007

This essay examines critically the concept of ‘dysplasia’ as it applies to melanocytic neoplasia and concludes that the concept is flawed. Doubt is cast also upon the validity of the concepts of a dysplastic naevus and a dysplastic naevus syndrome. The author is of the view that most malignant melanomas arise de novo and not in pre‐existing dysplastic naevi. Because so‐called dysplastic naevi are considered by the author to be the commonest melanocytic naevi in man and devoid of nuclear atypia, he proposes that they be re‐named ‘common naevi’ in the interest of symplicity, accuracy, and care of patients. Lastly, it is suggested that resolution of problems in the sphere of melanocytic neoplasia might be accomplished more readily were terms like dysplasia, dysplastic cells, dysplastic naevi, and the dysplastic naevus syndrome eschewed.
Non‐small cell lung carcinomas with neuroendocrine features. A light microscopic, immunohistochemical and ultrastructural study of 11 cases
Authors: MOOI W. J. , DEWAR A. , SPRINGALL D. , POLAK J. M. , ADDIS B. J.
Published: April 2007

Eleven resected primary lung carcinomas classified as large cell carcinomas or squamous cell carcinomas, but showing some microscopic resemblances to bronchial carcinoid and small cell carcinoma, were studied. All cases were neurone‐specific enolase and protein gene product 9.5 positive, indicating neuroendocrine differentiation. Staining for bombesin, C‐terminal peptide of human pro‐bombesin and chromogranin was positive in some cases. Electron microscopy showed dense‐core granules in six of seven cases investigated, the remaining case showing small granules of uncertain nature. All but one patient died within 15 months after operation. These data indicate that neuroendocrine differentiation in non‐small cell carcinomas of the lung may in some cases be suspected on routine histology. The follow‐up data suggest that the identification of these cases might have implications for prognosis and therapy, and consequently for diagnostic lung tumour classification.
Extensive necrosis in malignant lymphoma with granulomatous reaction mimicking tuberculosis
Authors: HALL P. A. , KINGSTON J. , STANSFELD A. G.
Published: April 2007

Epithelioid cell granulomas occur in association with a wide range of neoplasms but necrotizing granulomas mimicking tuberculosis are less well recognized. Two cases of high‐grade malignant lymphoma of Burkitt type are presented which were associated with such a response. In both cases this caused difficulty in interpretation and in one led to delayed diagnosis. Regional lymph nodes were not involved by lymphoma but contained epithelioid cell granulomas in both cases. Features that suggested that the granulomatous reaction was related to the tumour included a close spatial relation, the reticulin pattern in the areas of necrosis and the immunohistochemical demonstration of lymphoid antigens in the necrotic debris. A diligent search for mycobacteria and other micro‐organisms failed to reveal any infective cause. We suggest that the local granulomatous response is a reaction to the presence of necrotic and poorly viable tumour and the granulomas in nearby lymph nodes may be a response to tumour derived debris.
Mucin profiles in ulcerative colitis with dysplasia and carcinoma
Authors: ALLEN D. C. , CONNOLLY N. S. , BIGGART J. D.
Published: April 2007

Mucin secretion was assessed in Crohn's colitis, in ulcerative colitis with regeneration, dysplasia and carcinoma and in non‐colitic adenocarcinoma. The high iron diaminealcian blue (HID–AB) and periodate borohydride–saponification periodic acid Schiff (PB–KOH–PAS) techniques were used to demonstrate sulphomucins and sialomucins, and O‐acylated sialomucins respectively. There was mucosal hyperplasia and increased sialomucin secretion in Crohn's disease, quiescent and active ulcerative colitis. In colitis with carcinoma inflamed mucosa away from the tumour had increased sialomucins as had colitis with dysplasia. They did not differ statistically from each other or from colitic controls without cancer. Dysplastic crypts frequently secreted sulphomucins and the increased sialomucins were in transitional‐like glands in the surface fronds or adjacent to the dysplasia. A comparative study of the HID–AB technique gave total correct qualitative allocation of individual quantitatively assessed crypts. Routine HID–AB staining did not aid the recognition of dysplasia in ulcerative colitis. With the PB–KOH–PAS technique colorectal adenocarcinoma showed a significant diminution in O‐acylated sialomucins compared with its adjacent mucosa. Mucosal dysplasia in ulcerative colitis displayed a similar trend in O‐acylated sialic acid variants, differing with respect to age‐ and sex‐matched colitic controls. The PB–KOH–PAS technique may be of help in assessing mucin secretion in ulcerative colitis as a guide to the evolution of malignancy.
Liver cell carcinoma with orcein‐positive granules and no identifiable copper
Authors: SHOUSHA S. , BULL T. B.
Published: April 2007

A liver cell carcinoma removed surgically by partial hepatectomy from a 79‐year‐old woman contained abundant orcein‐positive granules in many tumour cells. The granules were similar to those usually identified as representing copper‐associated protein, yet they lacked copper, as demonstrated by negative rhodanine and rubeanic acid stains and energy dispersive X‐ray microanalysis.
Primary malignant lymphoma of the large intestine complicating chronic inflammatory bowel disease
Authors: SHEPHERD N. A. , HALL P. A. , WILLIAMS G. T. , CODLING B. W. , JONES E. L. , LEVISON D. A. , MORSON B. C.
Published: April 2007

Ten cases of malignant lymphoma of the colon and rectum complicating chronic inflammatory bowel disease are presented. Seven patients had chronic ulcerative colitis with a history varying from 6 to 20 years. There was extensive colitis in six of these patients and left‐sided colitis in one. All seven lymphomas showed the pathological and immunohistological features of primary B‐cell tumours of the gastrointestinal tract with a predominance of high‐grade tumours. Three patients had Crohn's disease of the large intestine complicated by malignant lymphoma of the sigmoid colon or rectum. The history of Crohn's disease varied from 30 months to 20 years and in each case there was fissuring and fistulae. There was extensive anal involvement in two cases. Histologically the three lymphomas were heterogeneous: one was of ‘granulomatous’ T‐cell type and the other two were markedly polymorphic and of equivocal phenotype. They were also characterized by numerous multinucleate tumour giant cells. Primary colorectal malignant lymphoma should be regarded as a rare, but significant, complication of ulcerative colitis. Immunosup‐pression may be an additional factor in the genesis of intestinal lymphoma in Crohn's disease. The prognosis appears to be dependent on factors already known to be of prognostic significance in primary gut lymphomas: a predominance of high‐grade tumours suggests that the outlook is generally worse than that for idiopathic primary large intestinal lymphoma.
Mucin‐negative biopsy in extra‐mammary Paget's disease. A diagnostic problem
Authors: ALGUACIL‐GARCIA A. , O'CONNOR R.
Published: April 2007

A case of extra‐mammary Paget's disease with a mucin‐negative small biopsy is reported. Study of a small series of vulvar Paget's disease demonstrated that areas devoid of much in the mm range are frequently found, creating the conditions for diagnostic problems in small biopsies. In this situation, positive immunoreactions for carcinoembryonic antigen and low molecular weight cytokeratins and a negative reaction for S‐100 protein serves to differentiate Paget's disease from other pagetoid lesions.
The pancreas in acute graft versus host disease in man
Authors: FOULIS A. K. , FARQUHARSON M. A. , SALE G. E.
Published: April 2007

Twenty‐six bone marrow transplant recipients, 14 of whom had evidence of acute graft versus host disease at autopsy, were studied. The pancreas in four of these patients exhibited changes thought to be due to acute graft versus host disease. Pathognomonic findings were in exocrine ducts which showed marked epithelial cellular atypia associated with a mild lymphocytic infiltrate. This was accompanied by ulceration and intraluminal haemorrhage in severe cases. In three of these four cases ductal epithelium showed marked hyperexpression of class I and class II major histocompatibility complex molecules. By contrast islets were not inflamed, showed no evidence of endocrine cell damage and no abnormalities of major histocompatibility complex expression were seen.
Paraganglioma presenting with an aortic aneurysm
Authors: AKOSA A. B. , ALI M. H.
Published: April 2007

The concurrence of a paraganglioma of the organ of Zuckerkandl and an abdominal aortic aneurysm is reported in a 72‐year‐old caucasian male. Computerized tomography scan confirmed the aneurysm and noted a well‐circumscribed tumour of the aneurysmal wall. At operation, the tumour was identified and excised with part of the aneurysmal wall. The tumour exhibited all the features of a paraganglioma while the vessel wall showed atherosclerosis and secondary degenerative changes. The features of the aortico‐sympathetic group of paragangliomas are discussed.
Clear cell rhabdomyosarcoma of the nasal cavity and paranasal sinuses
Authors: CHAN J. K. C. , NG H‐K. , WAN K. Y. , TSAO S. Y. , LEUNG T. W. T. , TSE K. C.
Published: April 2007

This report describes two cases of alveolar rhabdomyosarcoma of the nasal cavity with unusual histological appearances mimicking clear cell carcinoma. The closely packed tumour cells were polygonal and arranged in sheets and packets. They had an appreciable amount of clear cytoplasm due to accumulation of glycogen. The diagnosis of rhabdomyosarcoma was confirmed by positive staining for desmin and myoglobin. Rhabdomyosarcoma should be included in the differential diagnosis of nasal clear cell tumours, particularly in young adults. A correct diagnosis is important, because chemotherapy is indicated even for apparently localized disease.
Ultrastructure of parathyroid autografts in chronic renal failure including the occurrence of concentric membranous bodies and intermediate filaments
Authors: ELLIS H. A. , COAKER T.
Published: April 2007

The ultrastructure of long‐term parathyroid autografts and their donor glands has been studied in nine patients with chronic renal failure. Autografts showed ultrastructural features of functional activity. Unusual findings included the presence of ‘spironolactone‐like’ concentric membranous bodies derived from the endoplasmic reticulum in one hyperplastic autograft and prominent intracellular intermediate filaments (tonofilaments) in the donor parathyroid gland and recurrent autograft growths in another patient.
Panlobar nephroblastomatosis: a distinctive form of renal dysplasia associated with Wilms' tumour
Authors: WALFORD N.
Published: April 2007

An increasing variety of dysplastic lesions of metanephric origin (‘the nephroblastomatosis complex’) have been recognized as precursors of Wilms' tumour. We describe here four cases of a hitherto unrecognized renal dysplasia associated with Wilms' tumour and having a panlobar distribution. It has many features in common with the intralobar form of nephroblastomatosis, but differs in extending through the full thickness of the renal substance from calyx to capsule. These cases are also characterized by an increased proportion of well‐differentiated tissue elements and by the presence, in some cases, of anomalous metanephric differentiation in the pericalyceal tissues or renal capsule.
Stereological estimates of nuclear volume in normal germ cells and carcinoma in situ of the human testis
Authors: SØRENSEN F.B. , MÜLLER J.
Published: April 2007

Carcinoma in situ of the testis may appear many years prior to the development of an invasive tumour. Using point‐sampled intercepts, base‐line data concerning unbiased stereological estimates of the volume‐weighted mean nuclear volume (nuclear 𝒱vv) were obtained in 50 retrospective serial testicular biopsies from 10 patients with carcinoma in situ. All but two patients eventually developed an invasive growth. Testicular biopsies from 10 normal adult individuals and five prepubertal boys were included as controls. Nuclear 𝒱vv in testicular carcinoma in situ was significantly larger than that of morphologically normal spermatogonia (2P= 1.0 times 10‐19), with only minor overlap. Normal spermatogonia from controls had, on average, smaller nuclear 𝒱vv than morphologically normal spermatogonia in biopsies with ipsi‐ or contra‐lateral carcinoma in situ (2P= 5.2 times 10‐3). No difference in nuclear 𝒱vv was found in carcinoma in situ with or without co‐existing invasion, and no characteristic pattern of nuclear 𝒱vv was disclosed by following the lesion in serial biopsies over time from individual patients. Estimation of nuclear 𝒱vv may represent an adjuvant tool in morphologically puzzling cases of testicular carcinoma in situ, but the prognostic value requires further evaluation in larger series of patients.
Congenital testicular lymphangiectasis in children with otherwise normal testes
Authors: NISTAL M. , GARCIA‐ROJO M. , PANIAGUA R.
Published: April 2007

Two cases of testicular lymphangiectasis are reported, occurring in stillborns. The disease is a congenital malformation consisting of an abnormal expansive development of lymphatic vessels in both testes. Autopsy study revealed the absence of pulmonary, intestinal or systemic lymphangiectasis. The testes showed normal tubular development with normal germ cell numbers and also normal Leydig cell numbers. The epididymis and spermatic cord appeared normal. In contrast with the two previously reported cases of testicular lymphangiectasis, the present cases were not associated with cryptorchidism or other malformations.
Neonatal haemochromatosis
Authors: MOERMAN P. , PAUWELS P. , VANDENBERGHE K. , DEVLIEGER H. , FRYNS J.P. , VERRESEN H. , JAEKEN J. , LAUWERYNS J. , EGGERMONT E.
Published: April 2007

Four cases of neonatal haemochromatosis presenting as fulminant hepatic failure in the newborn were diagnosed by autopsy. In all four cases the diagnosis was made by histochemical demonstration of excessive iron deposition in hepatocytes and extrahepatic parenchymal cells, particularly pancreatic acinar epithelium, thyroid follicular epithelium and distal renal tubules. No haemosiderin was detectable in the extrahepatic mononuclear‐phagocytic cells of the spleen, lymph nodes and bone marrow. The liver was the most severely affected organ. The hepatic haemosiderosis was associated with massive hepatocellular necrosis of prenatal onset in three patients, one of whom showed formation of regenerative nodules, establishing true congenital cirrhosis. Other inconstant findings included giant cell transformation, diffuse sinusoidal fibrosis with segregation of small groups of hepatocytes and cholestasis with pseudoacinar change of liver cell plates. The fetal liver disease had its onset in the late second trimester of pregnancy and was reflected clinically by severe panhypoproteinaemia with non‐immune hydrops; hyperbilirubinaemia and haemorrhagic diatheses were apparent in the newborn. Neonatal haemochromatosis is a metabolic disorder, probably of autosomal recessive inheritance. The site and nature of the basic defect remain uncertain. Pathologists should be aware of this condition and its potential recurrence in subsequent pregnancies.
Pulmonary blastoma with neuroendocrine differentiation in cell morules resembling neuroepithelial bodies
Authors: CHEJFEC G. , COSNOW I. , GOULD N.S. , HUSAIN A.N. , GOULD V.E.
Published: April 2007

Pulmonary blastoma is an infrequent malignant neoplasm, so called because of its resemblance to fetal lung. The original description outlined the components as variable mixtures of epithelial and stromal elements. More recently, a variant displaying almost exclusively epithelial differentiation has been described. We report our findings in a case of pulmonary blastoma with predominance of epithelial cells, forming tubular structures and large morules. The architectural arrangement of the morules was remarkably similar to normal bronchial neuroepithelial bodies. Moreover, their immunohistochemical profiles were also very similar, including the expression of cytokeratins, chromogranin, neuron‐specific enolase, synaptophysin, gastrin, calcitonin, bombesin, somatostatin and serotonin.
Thin malignant melanomas (< 1.5 mm) with metastasis: a histological study and survival analysis
Authors: BLESSING K. , McLAREN K.M. , McLEAN A. , DAVIDSON P.
Published: April 2007

It is known that not all thin malignant melanomas have an excellent prognosis and that the specific features identifying the patients at risk of metastasis have not been fully elucidated. We have looked at thin malignant melanomas (< 1.5 mm) in the East of Scotland that had proven metastasis and death, and compared the clinical and histological features with a similar group (< 1.5 mm) that have had no further recurrence after a minimum of 6‐year follow‐up. We identified 26 patients with thin melanomas who had developed histologically proven metastasis and/or died following adequate surgical treatment of their primary lesion. When compared with the control group, factors found to be significantly different between the two groups and present in the group that did badly were (a) histological regression, (b) lesion size, (c) Clark level IV and (d) depth of the uninvolved dermis.
Epidermal melanocytes adjacent to melanoma and the field change effect
Authors: FALLOWFIELD M.E. , COOK M.G.
Published: April 2007

The presence of a field change, affecting epidermal melanocytes in the skin surrounding melanomas, has been cited as a justification for performing radical excision of these lesions. Twenty‐five consecutive reexcisions of melanoma specimens were examined and melanocytes per 100 keratinocytes counted continuously across the width of each, in order to ascertain whether melanocyte counts decreased from the centre to the periphery, as would be expected if there were a field change effect associated with the tumour. Melanocyte counts did not appear to diminish with increasing distance from the tumour site and were within the range seen in a previous study in which we demonstrated increased numbers of basal melanocytes and melanocyte atypia in sun‐exposed skin from a control population. Melanocyte atypia of a mild degree was present in five of the 25 cases studied, but in no case was this greater than that observed in sun‐exposed forearm skin. We therefore suggest that the ‘field change effect’ in epidermal melanocytes adjacent to melanoma could be a result of chronic sun exposure alone.
Tamm Horsfall protein expression by a small renal cell carcinoma presenting with metastases
Authors: GAULIER A. , LUCAS G. , RONCO P.
Published: April 2007

The clinical presentation of cervical metastases in a young woman presenting with cervical lymphadenopathy is described. The clinical, histological, ultrastructural and immunological findings establishing the diagnosis of a renal primary tumour are seen. The significance of mixed tumour cell expression of antigens specific for the proximal tubule (CD10, DPP4 and aminopeptidase N) and of Tamm Horsfall protein, normally expressed on the thick ascending limb of loop of Henle and distal tubule, is discussed.
Fibrillary cytoplasmic inclusions in neoplastic Paneth cells
Authors: WATSON P.H.
Published: April 2007

Paneth cell differentiation was investigated in two colorectal carcinomas. Ultrastructural study showed a range of granules and, in one case, fibrillary cytoplasmic inclusions. Similar inclusions in normal Paneth cells have been associated with zinc deficiency. However, there was no clinical evidence of abnormal zinc metabolism in this patient, nor were inclusions seen in adjacent non‐neoplastic Paneth cells. It is speculated that these fibrillary inclusions might reflect an intrinsic zinc‐related metabolic defect in the tumour cells.
Epithelioid angiomatosis in the acquired immunodeficiency syndrome: morphology and differential diagnosis
Authors: WALFORD S. , WOUW P.A. VAN DER , DAS P.K. , VELDEN J.J.A.M. TEN , HULSEBOSCH H.J.
Published: April 2007

A rare vascular proliferation found as a skin lesion in patients suffering from the acquired immunodeficiency syndrome and sometimes referred to as epithelioid angiomatsis is believed to be a manifestation of infection by the cat scratch bacillus or a related organism. We describe the histological findings from eight lesions seen in two cases. In all cases the diagnosis could be confirmed by demonstration within the lesions of groups of gram‐negative rod‐shaped organisms staining positively with the Warthin‐Starry stain. This condition needs to be distinguished from a variety of reactive and neoplastic vascular proliferations.