bluuebunny/crossref_metadata_2025 huggingface dataset:
The histological diagnosis of cutaneous graft versus host disease: relationship of skin changes to marrow purging and other clinical variables
Authors: ELLIOTT C.J. , SLOANE J.P. , SANDERSON K.V. , VINCENT M. , SHEPHERD V. , POWLES R.
Published: April 2007

Punch biopsies of skin were taken from allogeneic marrow recipients routinely before transplantation, at 14–22 and 90–107 d after grafting and in the event of a clinical rash. Three histological appearances were encountered: graft versus host disease (GvHD), epidermal abnormalities, and normal. Graft versus host disease was characterized by epidermal basal vacuolation, spongiosis and individual cell necrosis associated with mononuclear cell infiltration of the upper dermis and lower epidermis, while epidermal abnormalities were identical to GvHD but without the mononuclear cell infiltrate. Graft versus host disease occurred only in patients receiving marrow unpurged of T‐cells while epidermal abnormalities occurred with equal frequency in recipients of purged and unpurged marrow and were also noted in a high proportion of pre‐transplant biopsies. Patients whose skin biopsies exhibited epidermal abnormalities showed no greater incidence of subsequent clinical or histological GvHD than those with normal biopsies. For these reasons, we conclude that epidermal abnormalities cannot be regarded as a minor manifestation of GvHD as has often been previously assumed. We also conclude that they cannot be regarded as the cause of a rash as, unlike GvHD, the incidence was not significantly different in patients with and without rashes. The cause of epidermal abnormalities is not entirely clear; cytotoxic drugs and irradiation appear to play a part but their occurrence in patients with previously normal post‐transplant biopsies suggests that other factors may also be important. Some patients with strong clinical evidence of GvHD had negative biopsies; these should be regarded with caution especially within the first 24 h after the onset of a rash as the diagnostic histological picture may take time to develop. In some cases, GvHD was confined to pilosebaceous units; this seems to represent a minor form of the disease with only a limited capacity for progression. Dysplastic epidermal changes which have previously been attributed to the use of cyclosporin A were found with equal frequency in patients who did not receive this drug and must therefore have some other cause.
Adenosquamous carcinoma of the gallbladder with spindle cell features. A light microscopic and immunocytochemical study of a case
Authors: SUSTER S. , HUSZAR M. , HERCZEG E. , BUBIS J.J.
Published: April 2007

A case of adenosquamous carcinoma of the gallbladder showing extensive spindle transformation is presented. By light microscopy, areas showing interwoven fascicles of fusiform, poorly differentiated cells closely resembling a sarcoma were seen to merge imperceptibly with areas showing more obvious glandular and squamous cell features. Immunocytochemistry utilizing tissue‐specific antibodies against intermediate filaments demonstrated the exclusive presence of prekeratin antibodies in both components of the tumour, thus establishing the epithelial nature of this neoplasm. The importance of immunological phenotyping in the differential diagnosis of epithelial tumours of the gallbladder showing pseudosarcomatous features is underscored.
Malignant lymphomas involving the central nervous system—a morphological and immunohistochemical study of 32 cases
Authors: SIMON J. , JONES E.L. , TRUMPER M.M. , SALMON M.V.
Published: April 2007

The morphological features of 32 cases of malignant lymphomas involving the central nervous system presenting over a 32 year period were reviewed and the lymphomas redefined using current classifications. Twenty‐four cases (75%) of non‐Hodgkin's lymphomas were reclassified using the Kiel classification. There were 18 low grade non‐Hodgkin's lymphomas (comprising 11 lymphoplasmacytoid, five lymphocytic and two centroblastic‐centrocytic) and six high grade tumours (comprising two centroblastic, two immunoblastic, one unclassifiable and one lymphoblastic lymphoma). Cytologically the great majority of non‐Hodgkin's lymphomas were B‐cell lymphomas. The eight cases (25%) of Hodgkin's disease were classified by the Rye subtype and consisted of three mixed cellularity, two lymphocyte depletion, two lymphocyte predominant and one nodular sclerosis. The presence of intracytoplasmic immunoglobulins as well as markers for histiocytic cells were studied by the immunoperoxidase technique using polyclonal antisera. A monoclonal staining pattern, as revealed by light chain restriction, was found in nine cases (38%) of the non‐Hodgkin's lymphomas confirming their B‐cell origin. With the Marshall's metalophil method and the other histiocytic markers, scattered reactive microglial cells and histiocytic reticulum cells were found throughout the tumours in most cases. No histiocytic lymphomas were present in the series.
Primary malignant fibrous histiocytoma of the liver—a case report with immunocytochemical observations
Authors: ARENDS J.W. , WILLEBRAND D. , BLAAUW A.M.M. , BOSMAN F.T.
Published: April 2007

A case of a primary sarcomatous tumour in the liver of an elderly female is reported. The tumour consisted of bundles of spindle cells focally in a storiform pattern, intermingled with bizarre giant cells. Immunocytochemically, carcinoembryonic antigen, alpha‐fetoprotein, keratin, desmin and type IV collagen could not be demonstrated. Most tumour cells, however, expressed vimentin, whereas a granular cytoplasmic immunoreactivity for alpha‐1‐antitrypsin and alpha‐1‐antichymotrypsin was shown in the giant cells. Ultrastructurally the tumour cells did not show any characteristics of epithelial derivation. The morphological and immunocytochemical data justify the conclusion that the tumour should be classified as a malignant fibrous histiocytoma.
Paraplegia due to massive asbestos‐related pleural and mediastinal fibrosis
Authors: O'BRIEN C.J. , FRANKS A.J.
Published: April 2007

A case of massive pleural and mediastinal fibrosis related to occupational exposure to asbestos is presented. The terminal illness was marked by the acute onset of paraplegia. Autopsy revealed occlusive lesions of upper intercostal arteries within sheets of dense fibrous tissue and an ischaemic myelopathy. The presence of vascular lesions suggests a relationship with idiopathic mediastinal fibrosis.
Intramucosal cysts in gastric mucosa adjacent to carcinoma and peptic ulcer: a histochemical study
Authors: ZHU FU‐GANG , DENG XIA‐JIN , CHENG NAN‐JUN
Published: April 2007

Histochemical characteristics and the distribution of gastric intramucosal cysts were studied in 50 cancerous and 51 benign gastrectomy specimens. The frequency of such cysts was significantly higher in stomachs with carcinoma (70%) than in stomachs with peptic ulcer (43%) (P<0.01). Intramucosal cysts were classified into gastric type, small intestinal type, colonic type and non‐mucous type. There were significant differences in the constituent ratios of the four types of cyst between gastric carcinoma and gastric ulcer (P<0.01), as well as between intestinal type and diffuse type cancer (P<0.001). The present results reveal a close relationship between intramucosal cysts and gastric carcinoma. Cysts of small intestinal, colonic and non‐mucous types were associated with intestinal type cancer while cysts of gastric type were related to diffuse type cancer of the stomach.
Nuclear DNA in anaplastic thyroid carcinoma with a differentiated component
Authors: GALERA‐DAVIDSON H. , BIBBO M. , DYTCH H.E. , GONZÁLEZ‐CÁMPORA R. , FERNÁNDEZ A. , WIED G.L.
Published: April 2007

Fifteen cases of anaplastic thyroid carcinoma, including eight cases with a differentiated component, were studied by DNA analysis. All areas of anaplastic carcinoma showed an aneuploid DNA content. The eight cases of anaplastic carcinoma with differentiated component (two follicular carcinomas, two papillary carcinomas, one Hürthle cell carcinoma and three poorly differentiated carcinomas) exhibited aneuploid DNA content in the differentiated area of the tumour. Karyometric parameters allowed a fairly clear separation between giant cell, spindle cell and differentiated components. The results support the hypothesis that patients with aneuploid differentiated carcinoma represent a higher risk group and are probably more prone to developing anaplastic carcinoma.
Cutaneous leucocyte composition after human allogeneic bone marrow transplantation: relationship to marrow purging, histology and clinical rash
Authors: ELLIOTT C.J. , SLOANE J.P. , PALLETT C.D. , SANDERSON K.V.
Published: April 2007

Immunohistological and morphometric techniques were used to study the skin after marrow transplantation with particular reference to the relationship of marrow purging, the presence of a clinical rash and histological changes to leucocyte numbers and phenotype. Recipients of T‐cell‐depleted marrow showed significant reductions in CD2+, CD4+ and CD8+ T‐lymphocytes in the first 22 d after transplantation but not after this time. T‐cell numbers in recipients of unpurged marrow were similar to those of normal donors, indicating a rapid repopulation by cells from the graft. Langerhans cells (CD1+ dendritic cells) and macrophages, on the other hand, were present in similar numbers in both groups of patients within the first 22 d; the former in low and the latter in normal numbers. Biopsies exhibiting graft versus host disease showed increases in CD2+, CD4+ and CD8+ T‐lymphocytes with significant lowering of the CD4: CD8 ratio. A proportion expressed markers of activation and HNK1+ cells and macrophages were also increased. Biopsies exhibiting epidermal basal abnormalities only (changes identical to graft versus host disease but without detectable leucocyte infiltration on conventional microscopy) showed a minor increase in macrophages and HNK1+ cells but no other leucocyte alterations to suggest a pathogenetic link with graft versus host disease. Langerhans cells were reduced in these biopsies, however, when taken more than 22 d post‐transplant, suggesting that the epidermal changes are associated with Langerhans cell damage or repopulation. We were unable to identify any significant alteration in leucocytes in patients with strong clinical evidence of graft versus host disease but with histologically unremarkable biopsies. Although it is possible that perivascular increases in T‐cells and expression of activation markers precede the characteristic histological picture of graft versus host disease the time scale is probably too short to allow diagnostic value.
Basosquamous cell carcinoma of the skin with metastases
Authors: DE FARIA J. LOPES , NUNES P.H.F.
Published: April 2007

Two cases of basosquamous cell carcinoma of the skin with lymph node, lung and bone metastases are reported. Metastases occurred 4 and 7 years after identification of the primary tumour. Both the primary and metastatic lesions had areas of typical basal cell carcinoma and squamous cell carcinoma and also intermediate carcinomatous tissue. In the bone metastasis of one case there were rudimentary hair follicles and areas of matrical differentiation. These cases further support the existence of basosquamous cell carcinoma and emphasize its metastatic potential.
Histological features of value in differentiating small congenital melanocytic naevi from acquired naevi
Authors: WALSH M.Y. , MACKIE R.M.
Published: April 2007

One hundred and twelve melanocytic naevi measuring less than 5 cm in largest diameter were excised from 85 patients referred because of minor concern about possible growth or malignant potential of these naevi. Sections from all 112 naevi were examined histologically, without access to the clinical history, and the following features noted: type of melanocytic proliferation in the basal layer area, contiguity of epidermal and dermal components, total width and depth of naevus, involvement of subcutaneous fat and of skin appendages, the presence or absence of an ‘Indian file’ type of naevus cell infiltration, cellular atypia and evidence of maturation of these cells. On the basis of these features, naevi were assigned to either a ‘congenital type’ or ‘acquired type’ classification, and their distribution in these two classifications then compared with the clinical history. It was found that in 107 of 112 lesions correct assignation had been made on histological grounds alone, 43 as congenital and 64 as acquired. A histological pattern not previously reported to be associated with congenital naevi was seen in 17 (34%) of the congenital lesions. This study suggests that it is possible to differentiate the majority of small congenital naevi from acquired naevi on histopathological grounds alone. This observation could be of considerable value in the examination of excised primary malignant melanomas for evidence of a pre‐existing naevus of either type.
Large cell lymphoma of bone. A report of three cases of B‐cell origin
Authors: FALINI B. , BINAZZI R. , PILERI S. , MORI A. , BERTONI F. , CANINO S. , FAGIOLI M. , MINELLI O. , CIANI C. , PELLICIOLI P.
Published: April 2007

Clinicopathological and immunohistological features of three cases of large cell lymphoma of bone are reported. On histological grounds, all the cases were diagnosed as histiocytic lymphomas (Rappaport) or primary centroblastic lymphomas, polymorphic subtype (Kiel). On immunophenotyping, malignant cells strongly reacted with the anti‐ieucocyte antibodies PD7/26 and ROS‐220C, thereby indicating their lymphomatous nature, and expressed the B‐cell antigens CD19 and CD22. Further studies are warranted to determine whether the B‐cell phenotype observed in our cases is typical of the majority of primary large cell lymphomas of bone. Immunohistological analysis with monoclonal antibodies is expected to be of great value not only in defining the immunological phenotype of this rare pathological entity, but also in differentiating it from other neoplasms that involve the skeleton, either primarily or secondarily.
The efficacy of histopathological criteria required for diagnosing dysplastic naevi
Authors: STEIJLEN P.M. , BERGMAN W. , HERMANS J. , SCHEFFER E. , VAN VLOTEN W.A. , RUITER D.J.
Published: April 2007

The efficacy of specific histopathological features for diagnosing dysplastic naevi was established by comparing their frequency in 62 dysplastic naevi, from 36 patients with the dysplastic naevus syndrome, with those in 326 ostensibly benign naevocellular naevi derived from a group of 67 autopsy cases. Individual diagnostic features had a low sensitivity, a low specificity or low predictive values. Discriminant analysis showed that the presence of dust‐like melanin, irregular naevoid nests, markedly increased junctional activity and melanocytic nuclei equal or larger in size than overlying keratinocyte nuclei were the most discriminating features. Using two or more of these criteria plus a lymphocytic infiltrate as an obligatory diagnostic criterion, a reasonable efficacy could be reached for dysplastic naevi. Based on these combinations of criteria the prevalence of histologically proven dysplastic naevi in the autopsy group would be 10%. Lesions with all these four discriminating features were found in half of the patients from the dysplastic naevus syndrome group, but were absent in the autopsy group. We suggest that such severely atypical dysplastic naevi may be indicative of patients at high risk for developing malignant melanoma.
Choriocarcinoma arising in transitional cell carcinoma of bladder: a case report
Authors: MORTON K.D. , BURNETT R.A.
Published: April 2007

Trophoblastic metaplasia can occasionally occur in transitional cell carcinomas of the bladder and the resultant choriocarcinoma is likely to behave differently from typical epithelial bladder tumours.
Expression of the cytokeratin marker CAM 5.2 in cervical neoplasia
Authors: RAJU G. C.
Published: April 2007

It has been suggested that cytokeratin CAM 5.2 is a useful marker to indicate malignant transformation and invasive potential in cervical neoplasia. In this study we examined normal ectocervical epithelium, endocervical squamous metaplasia, cervical intra‐epithelial neoplasia (CIN) and invasive carcinoma by the indirect immunoperoxidase method using commercially available CAM 5.2. Positive staining was seen in 12 of 42 (28%) invasive carcinomas and in 2 of 26 specimens of CIN III. No positive staining was observed in any case of CIN II (22 specimens), CIN I(19), squamous metaplasia (21) or normal ectocervical epithelium (16). These results suggest that although CAM 5.2 expression is found in only 28% of cervical squamous carcinoma, it is highly specific for malignant transformation of cervical squamous epithelium. In view of its potential diagnostic value in doubtful cases of CIN III and squamous cell carcinoma, the specificity and sensitivity of CAM 5.2 expression in cervical neoplasia need to be examined in other laboratories under various processing schedules.
Malignant nerve sheath tumour arising in a ganglioneuroma
Authors: FLETCHER C. D. M. , FERNANDO I. N. , BRAIMBRIDGE M. V. , McKEE P. H. , LYALL J. R. W.
Published: April 2007

A malignant nerve sheath tumour arising within a thoracic ganglioneuroma is described. This is only the seventh such case described in the literature and the first at this site. The previously documented cases are reviewed.
Immunomorphological analysis of the role of blood vessel endothelium in the morphogenesis of cutaneous Kaposi's sarcoma: a study of 57 cases
Authors: FACCHETTI F. , LUCINI L. , GAVAZZONI R. , CALLEA F.
Published: April 2007

In this study we report the histopathological features in a series of 88 biopsies from patients with cutaneous Kaposi's sarcoma; immunohistochemical examination for Factor VIII related antigen has been carried out on frozen and paraffin‐embedded sections. The patient groups comprised 50 elderly patients, seven of whom were immuno‐compromised, six patients with AIDS and one patient who had received a renal allograft. The findings were similar in these three groups. Histological staging was carried out with subdivision into stage I–patches characterized by angiomatoid and glomeruloid structures; stage II–plaques characterized by confluence of angiomatoid and glomeruloid structures and with spindle cells; and stage III–nodules in which the spindle cells were proliferative and frankly sarcomatous. Factor VIII related antigen was demonstrated in the central vessels of glomeruloid lesions whilst the surrounding vascular network contained both antigen‐negative and antigen‐positive vessels; in stage II and III lesions the spindle cells were consistently positive only in frozen section material. The findings were similar in the three patient groups. Our results suggest that Kaposi's sarcoma evolves from stage I through to stage III, that both blood vessels and lymphatic vessels are involved in the vascular proliferation and that the spindle cells are derived from vascular endothelium.
ras p21 oncoprotein expression in human colonic neoplasia—an immunohistochemical study with monoclonal antibody RAP‐5
Authors: LANZA G.
Published: April 2007

Expression of the ras oncogene product p21 (ras p21) in benign and malignant human colonic tissues was studied using the monoclonal antibody RAP‐5 and the avidin‐biotin‐peroxidase technique. Histologically normal colonic mucosa and hyperplastic mucosa adjacent to carcinomas (transitional mucosa) were found, in most cases, to be negative for reactivity with the antibody or showed weak staining of a few epithelial cells. Similar findings were observed in hyperplastic and juvenile polyps. Of the 145 adenomas studied, 47 (32.4%) showed detectable levels of ras p21 expression. RAP‐5 immunohistochemical staining was significantly associated with the degree of epithelial dysplasia (P < 0.01) and the size of adenoma (P < 0.05), but not with the histological type. Fiftyfour of 70 primary adenocarcinomas (77.1%) were reactive with RAP‐5 and usually demonstrated a higher percentage of stained cells and more intense cytoplasmic staining than that observed in adenomas. Although metastases often displayed a similar or even higher levels of ras p21 expression compared with the primary carcinomas, in 10 cases one or more metastatic lesions showed lower levels of ras p21. These results suggest that enhanced ras p21 expression may, at times, occur in the early stages of human colon carcinogenesis but are probably not associated with metastatic tumour progression.
Prediction of impending blast cell transformation in chronic granulocytic leukaemia
Authors: ISLAM A.
Published: April 2007

Bone marrow trephine biopsy specimens from 24 patients with chronic granulocytic leukaemia were studied to identify bone marrow changes that suggest incipient or impending blast transformation. In the chronic phase of chronic granulocytic leukaemia, blasts and promyelocytes were seen predominantly in the paratrabecular and perivascular regions, while myelocytes, metamyelocytes and segmented polymorphs were seen predominantly in the central intertrabecular marrow space. The patients were divided into two equal groups according to the degree of perivascular and paratrabecular infiltration: those with minimal (one to three layers of blasts and promyelocytes) and those with marked (four to eight layers of blasts and promyelocytes) infiltration. Ten of the 12 patients in the former group did not develop blast transformation and remained in the chronic phase during a 32‐ to 84‐week follow up period, whereas nine of the 12 patients in the latter group developed blast transformation, with six undergoing transformation within the first 26 weeks. These findings suggest that the histomorphological pattern of bone marrow changes in chronic granulocytic leukaemia may be useful in recognizing a subset of chronic granulocytic leukaemia patients undergoing blast transformation in the ensuing 6 months.
An unusual morphological variant of follicular lymphoma. Report of two cases
Authors: CHAN J. K. C. , NG C. S. , HUI P. K.
Published: April 2007

Most follicular lymphomas can be readily diagnosed on morphological grounds by finding closely packed pale‐staining follicles partitioned by scanty dark‐staining inter‐follicular tissue. We describe two cases of an unusual ‘reverse’ variant of follicular lymphoma in which the nodules have dark‐staining centres and pale‐staining cuffs due to concentration of centroblasts at the periphery of the neoplastic follicles. Recognition of this unusual pattern of follicular lymphoma is important, to avoid confusion with progressive transformation of germinal centres or nodular lymphocyte predominance Hodgkin's disease.
Expression of IgA and secretory component in the normal and in adenocarcinomas of Fallopian tube, endometrium and endocervix
Authors: LEE Y‐S. , RAJU G. C.
Published: April 2007

The occurrence and localization of IgA and secretory component (SC) were examined in the normal and in adenocarcinomas of Fallopian tube, endometrium and endocervix. IgA‐containing immunocytes were identified in the stroma of 90% of normal Fallopian tubes. It is suggested that the Fallopian tube may have an immunological function and may, together with the endocervix, constitute the local secretory immune system of the female genital tract. IgA and SC were frequently demonstrated in the cytoplasm and luminal secretion of adenocarcinomas of the endocervix, endometrium and Fallopian tube. This study has shown a decrease in immunoreactivity of SC among poorly differentiated adenocarcinomas but has failed to demonstrate any correlation between the expression of IgA and the degree of differentiation of the tumours. Secretory component appears, therefore, to be more useful than IgA as an indicator of secretory activity and differentiation of adenocarcinomas of the female genital tract.
Alveolar soft part sarcoma: immunological evidence of rhabdomyoblastic differentiation
Authors: FOSCHINI M. P. , CECCARELLI C. , EUSEBI V. , SKALLI O. , GABBIANI G.
Published: April 2007

Two cases of alveolar soft part sarcoma have been studied immunocytochemically using antisera against epithelial membrane antigen, lysozyme, keratins, S‐100 protein, desmin, vimentin, fetal myosin, slow myosin, alpha‐skeletal muscle actin, alpha‐smooth muscle actin and myoglobin. The neoplastic cells were negative with all antisera employed with the exception of the alpha‐skeletal muscle actin antiserum which stained the cytoplasm of numerous neoplastic elements, including the crystalloid rods, typical cytoplasmic inclusions of these tumours. It is suggested that the presence of this protein indicates rhabdomyoblastic differentiation of these tumours.
The spleen in Hodgkin's disease. An immunohistochemical study of lymphocyte subpopulations and macrophages
Authors: FALK S. , MÜLLER H. , STUTTE H. J.
Published: April 2007

Lymphocyte subpopulations and macrophages in 16 spleens from patients with Hodgkin's disease were analysed immunohistochemically using monoclonal antibodies of the Leu and the Ki M series. In non‐involved splenic tissue there is an increase of T‐lymphocytes with an increased T‐helper/T‐suppressor cell ratio, while Ki M‐1, ‐2, ‐3 and ‐5‐positive, i.e. phenotypically different macrophages, are reduced. These results indicate that involvement of the spleen in Hodgkin's disease is accompanied by changes with respect not only to lymphocyte subpopulations but also to cells of the mononuclear phagocyte system. The immunodeficiency associated with Hodgkin's disease is probably not solely due to lymphocyte dysfunction, since the disease may lead, at least in the spleen, to alterations in macrophages and accessory cells and this may contribute to the impairment of cell‐mediated immunity.
Paraffin section immunohistochemistry. II. Hodgkin's disease and large cell anaplastic (Ki1) lymphoma
Authors: HALL P. A. , D'ARDENNE A. J. , STANSFELD A. G.
Published: April 2007

A panel of antibodies that recognize antigens that survive fixation and conventional processing have been applied to 43 cases of Hodgkin's disease and five cases of large cell anaplastic lymphoma. Reed‐Sternberg cells in all five cases of nodular lymphocyte predominance Hodgkin's disease were positive with leucocyte common (CD45) and B‐cell antibodies, and negative with LeuM1 (CD15) and BerH2 (CD30) antibodies. In other types of Hodgkin's disease, Reed‐Sternberg cells were positive with BerH2 in all cases, positive with LeuM1 in 63% of cases (with enzymic predigestion), positive with at least one B‐cell antibody in 29% of cases and positive for CD45 in 8% of cases. In 19% of all cases, Reed‐Sternberg cells were positive for epithelial membrane antigen and in 93% they were positive with TAL1B5 (anti‐class II MHC). No case showed immunoreactivity with anti‐T‐cell antibodies. The patterns of immunoreactivity of large cell anaplastic lymphoma were similar, except that none was positive with B‐cell antibodies and three were positive with T‐cell antibodies. All five were positive with BerH2 (CD30) and TAL1B5. Comparison of the results with those seen in other cases of non‐Hodgkin's lymphoma indicates that, with the currently available reagents, this immunohistological profile cannot be used as the sole diagnostic discriminant of these conditions; this must still be based upon careful morphological assessment.
Epithelial membrane antigen expression by the perineurium of peripheral nerve and in peripheral nerve tumours
Authors: THEAKER J. M. , GATTER K. C. , PUDDLE J.
Published: April 2007

Specimens of normal peripheral nerve and a series of peripheral nerve lesions have been immunostained with three different anti‐epithelial membrane antigen (EMA) monoclonal antibodies. Sites of EMA immunoreactivity have been confirmed within perineurial cells of peripheral nerve, noted within the capsule of Schwannomas and palisaded encapsulated neuromas, and also detected with traumatic neuromas and plexiform neurofibromas. No expression was detected within simple neurofibromas, diffuse neurofibromas or within malignant Schwannomas. These sites of EMA expression concur with the suggested involvement of perineurial cells in the formation of the particular lesions. The relationship between EMA expression by the perineurium and the piaarachnoid membrane is discussed.
Conjunctival biopsy in Sjögren's syndrome: correlations between histological and immunohistochemical features
Authors: RAPHAEL M. , BELLEFQIH S. , PIETTE J. CH. , LE HOANG PH. , DEBRE P. , CHOMETTE G.
Published: April 2007

We have examined conjunctival biopsies from nine primary and two secondary cases of Sjögren's syndrome. In all cases histopathological examination revealed metaplasia of the conjunctival epithelium associated with a reduced number of goblet cells and a polymorphic inflammatory cell infiltrate of the stroma. Using monoclonal antibodies with texture analysis of stained preparations we have shown that in all cases me lymphocytic infiltrate was predominantly T‐cell but with substantial numbers of IgA and IgG secretory B‐cells in three cases. The number of Langerhans cells present was reduced in biopsies showing the most marked degree of epithelial metaplasia.
Genesis and decay of the foregut: development and repair
Authors: VILANOVA J. R. , SIMON‐MARIN R. , ANGULO J. C. , RIVERA‐POMAR J. M.
Published: April 2007

The microscopic anatomy of the oesophago‐gastric territory is interpreted as the result of the interaction of three main phenotypes: squamous, oxyntic and intestinal. This synthesis allows the comparison between phenotype development, atrophy and metaplasia. The concomitances in the processes of development and repair lead to the proposal of an intestinalization gradient inherent to the oesophago‐gastric field. This hypothesis permits an integration of the epithelial changes associated with gastritis and oesophagitis together with ontogenesis. The global tendencies in epithelial development and repair are discussed; a link between the two appears evident. The shifting potential of the progenitor gland zones in development and repair is in consonance with Wolpert's theory of positional information.
Penicillium marneffei infection: an underdiagnosed disease?
Authors: TSANG D. N. C. , CHAN J. K. C. , LAU Y. T. , LIM W. , TSE C. H. , CHAN N. K.
Published: April 2007

Penicillium marneffei is a rare human pathogen that often causes problems in clinical and histological diagnosis. A patient who presented with autoimmune haemolytic anaemia and hepatosplenomegaly, and was subsequently found to be suffering from disseminated Penicillium marneffei infection, is reported. The liver biopsy showed epithelioid cell granulomas only, and tuberculosis was initially considered the most likely diagnosis. The correct diagnosis became evident in a subsequent colonic biopsy, which showed extensive infiltration by penicillium‐laden macrophages.
The expression of the neu oncogene product in breast lesions and in normal fetal and adult human tissues
Authors: De POTTER C. R. , Van DAELE S. , Van De VIJVER M. J. , PAUWELS C. , MAERTENS G. , De BOEVER J. , VANDEKERCKHOVE D. , ROELS H.
Published: April 2007

The expression of the neu oncogene product was investigated in invasive and non‐invasive ductal carcinomas of the breast, non‐neoplastic lesions of the breast, fragments of normal adult and fetal breasts and in several other normal and fetal tissues at different weeks of pregnancy by means of an immunohistochemical study with monoclonal antibodies. The staining pattern along the cytoplasmic membrane was specific for malignancy and occurred in 29% of the breast carcinomas. It was observed in invasive carcinomas as well as in ductal carcinoma in situ and it showed a significantly higher expression in premenopausal women than in postmenopausal women. This higher expression was also present in oestrogen receptor‐negative tumours. The tubules of the fetal and adult kidney, the absorption cells of the fetal and adult small and large intestine, the sebaceous glands of the fetal and adult small and large intestine, the sebaceous glands of the fetal and adult skin, the adult endocervix, the endometrium, the C‐cells of the thyroid, hepatocytes and all ductal cells of the fetal breast showed a constant diffuse intracytoplasmic granular staining. staining. The same granular intracytoplasmic staining pattern was focally observed in rare cases of normal breast tissue in adults and in some cases of epitheliosis, aprocrine metaplasia and some breast carcinoma cells, which did not express neu oncogene product on their membrane. Western blot experiments showed that the cytoplasmic protein had a molecular weight of 155 kD (kilodaltons); the membrane protein is the known 185 kD neu protein.
Subinvolution of the uteroplacental arteries in the human placental bed
Authors: ANDREW A. C. , BULMER J. N. , WELLS M. , MORRISON L. , BUCKLEY C. H.
Published: April 2007

Subinvolution of the uteroplacental arteries of the placental bed is a recognized cause of post partum haemorrhage causing significant morbidity. Whilst the physiological changes in these arteries during pregnancy and the part played by endovascular trophoblast migration are well documented, the sequence of events during involution and the pathophysiology of subinvolution are unknown. Using immunohistochemical techniques we have studied uteroplacental arteries in the placental bed in 25 cases of post partum haemorrhage and compared the subinvoluted vessels with normally involuted vessels. Non‐involuted vessels were present in 22 test cases; these abnormal vessels were filled with thrombus and no endothelial lining was detected. Extravillous perivascular trophoblast was usually present in the walls of these abnormal vessels and in some cases was seen in an endovascular position. Subinvolution of placental site vessels may represent an abnormal interaction between maternal uterine cells and fetal trophoblast.
Oestrogen receptors in benign epithelial lesions and intraduct carcinomas of the breast: an immunohistological study
Authors: GIRI D. D. , C.DUNDAS S. A. , NOTTINGHAM J. F. , E.UNDERWOOD J. C.
Published: April 2007

We examined 198 breast lesions, representing commonly encountered benign epithelial proliferative disorders, lobular carinoma in situ and intraduct carcinoma, immunohistologically for oestrogen receptors (ER). A mixture of three ER monoclonal antibodies—H222, D75 and D547—was used on sections of routinely processed and paraffin‐embedded tissue blocks. Over 65% of the benign and malignant lesions showed some evidence of ER expression and significant staining was recorded by two observers in 28–31% of fibroadenomas, 18–28% of ductal epithelial hyperplasias, 30–40% of sclerosing adenosis cases, 38–45% of papillomas, 60% of in situ lobular carcinomas and 42–45% of intraduct carcinomas. Apocrine metaplastic cells and myoepithelial cells showed absent or only weak staining. Amongst intraduct carcinomas, less than 20% of comedo carcinomas and over 50% of cribriform, papillary and solid variants showed significant ER staining.
Sinus histiocytosis with massive lymphadenopathy (Rosai‐Dorfman disease)
Authors: NAWROZ I. M. , WILSON‐STOREY D.
Published: April 2007

A child of 11 years with a solitary involvement of the right radius by sinus histiocytosis with massive lymphadenopathy (Rosai‐Dorfman disease) is presented. The literature of bone involvement in this condition is reviewed.
Multicystic peritoneal mesothelioma: a case report
Authors: ALVAREZ‐FERNANDEZ E. , RABANO A. , BARROS‐MALVAR J. L. , SANABIA‐VALDEZ J.
Published: April 2007

A case of recurrent cystic peritoneal mesothelioma is reported. Ultrastructurally the tumour cells showed abundant surface microvilli, desmosomes, intracytoplasmic filaments and well‐developed basal lamina. The cells demonstrated positive staining for keratin peptides, vimentin and epithelial membrane antigen and, some of them, for carcinoembryonic antigen. No staining was demonstrable for a number of endothelial markers. The findings are in accord with the proposed mesothelial origin of the neoplasm and can be of help in the differential diagnosis of other multicystic neoplasms arising in the peritoneal cavity.
An immunohistological and genotypic study of the plasma cell form of Castleman's disease
Authors: HALL P. A. , DONAGHY M. , COTTER F. E. , STANSFELD A. G. , LEVISON D. A.
Published: April 2007

The plasma cell variant of Castleman's disease (angiofollicular hyperplasia) is an uncommon and poorly understood lymphoproliferative disorder which may be associated with a wide variety of systemic features. The clinical, pathological, immunophenotypic and genotypic features of a series of five cases are presented. The clinical manifestations were variable but systemic features were present in four cases. Histologically, all five cases were similar. The characteristic follicle‐like structures are composed of concentric rings of B‐lymphocytes with a mantle zone phenotype, surrounding an inner core of dendritic reticulum cells. The central regions are composed of plump cells that express Factor VIII related antigen, stain with Ulex europaeus I and are associated with laminin immunoreactivity. Many of these cells stain with Ki67 indicating cellular proliferation. Between these ‘follicles’, plasma cells are present interspersed between high endothelial venules. Using immunohistochemical techniques two cases were polyclonal, whilst in two others unequivocal lambda/IgA restriction was present; in the other case an intermediate picture of lambda/IgA predominance was apparent. Genotypic studies in three cases indicated immunoglobulin gene rearrangements but germ line T‐cell receptor genes. The significance of the apparent clonal proliferation of plasma cells is discussed and a unifying model of Castleman's disease is proposed.
Phenotypic characterization of non‐haemopoietic small cell tumours of childhood with monoclonal antibodies to leucocytes, epithelial cells and cytoskeletal proteins
Authors: PILKINGTON G. R. , PALLESEN G.
Published: April 2007

Recently, great interest has been shown in the histological identification of small cell tumours of childhood–nephroblastoma (Wilms tumour), neuroblastoma, rhabdomyosarcoma and Ewing's sarcoma–using immunohistochemical methods. However, several antigens operationally specific for leucocyte typing in blood and marrow are also expressed on cells of epithelial and neural origin. We undertook phenotypic characterization of 17 non‐haemopoietic small cell tumours of childhood using a panel of 30 monoclonal antibodies to leucocyte, epithelial and cytoskeletal antigens using a sensitive alkaline phosphatase–anti‐alkaline phosphatase technique on cryostat sections of fresh tumour. Our results demonstrated frequent expression of the leucocyte‐associated antigens CD 10 (CALLA). CD9 (p24) and CDw32 (FcRII) in these small cell tumours and occasional expression of MHC class II (HLA‐DR) and HNK‐1 antigens. However, the leucocyte‐associated antigens CD45 (leucocyte common), CD22 (pan B‐cell), CD11b (C3bi receptor), CD15 (Lewisx) or CDw42 (platelet gp Ib) were not detected on any tumour. Aberrant expression of desmin, neurofilament and UJ13A antigen was found in nephroblastoma and of epithelial‐associated markers (CIBr17 and 43–9F) in neuroblastoma. Our results also demonstrated broad reactivity in frozen section with two monoclonal antibodies specific for melanoma (NKI/C‐3) or epithelial cells (OM‐1) in paraffin sections. Hence, it is necessary to include monoclonal antibodies to CD45 and pan‐epithelial antigens, e.g. LP34 (cytokeratin) or HEA125 for the precise immunohistochemical identification of small round cell malignancies of childhood.
Cytokeratin immunoreactivity in gliomas
Authors: NG H‐K. , LO S. T. H.
Published: April 2007

Monoclonal antibodies (AE1/3, CAM 5.2 and PKK‐1) and polyclonal antisera against the cytokeratin proteins were reacted with a range of astrocytic tumours, oligodendrogliomas and ependymomas. Seven of 12 cases (58%) of glioblastoma multiforme, five of eight (63%) anaplastic astrocytomas and two of five (40%) well‐differentiated astrocytomas were immunoreactive with AE1/3 but not with the other anti‐cytokeratin antibodies. In oligodendrogliomas, AEl/3 stained isolated astrocyte‐like cells as well as scattered neoplastic oligodendrocytes in four of eight cases (50%) cases. Four ependymomas were negative for all cytokeratin markers examined. The immunostaining of astrocytomas and oligodendrogliomas with AE1/3 might represent co‐expression of cytokeratin with glial fibrillary acidic protein by gliomas and calls for caution in the use of these antibodies in the differential diagnosis between gliomas and carcinomas.
Chronic carotid glomitis
Authors: KHAN Q. , HEATH D. , NASH J. , SMITH P.
Published: April 2007

Both carotid bodies were obtained at necropsy from each of 75 subjects, 38 male and 37 female, ranging in age from 14 to 90 years. In each case the histological features were classified as one of four age‐related patterns. The presence and distribution of lymphocytes were noted. They presented either as a diffuse scattering throughout the stroma or as large focal aggregates. In subjects over the age of 50 years the diffuse infiltrates occurred in 56% of cases and were virtually all T‐cells. In the same age group the aggregates of lymphocytes were found in 21% of cases. These findings indicate that there is a disease of human carotid bodies characterized by focal aggregates of lymphocytes that begins in middle age and becomes increasingly common with advancing years, affecting 29% of subjects aged 70 years or over. It is not related to any co‐existing disease but seems to be a response to the degenerative changes in the glomic tissues that occur with age. By analogy with comparable changes in the thyroid and salivary glands, the disease may have a basis in autoimmunity.
Unilateral cystic disease of the neonatal kidney: a rare presentation of tuberous sclerosis
Authors: MILLER I. D. , GRAY E. S. , LLOYD D. L.
Published: April 2007

Two renal lesions have been described in tuberous sclerosis, angiomyolipomas and cysts. We report a newborn male infant in whom massive cystic enlargement of one kidney was the first manifestation of the disease.
Lymphoma phenotyping in formalin‐fixed and paraffin wax‐embedded tissues: II. Profiles of reactivity in the various tumour types*
Authors: NORTON A. J. , ISAACSON P. G.
Published: April 2007

Recently, monoclonal antibodies capable of phenotyping malignant lymphomas in routinely fixed and processed tissue have become available. Some of these reagents identify lineage‐restricted variants of the leucocyte common molecule, whereas others identify unique fixation‐resistant epitopes on lymphoid cells, some of which are shared by non‐lymphoid tissues. A new generation of antibodies recognizing ‘classical’ leucocyte antigens such as CD3 are also emerging. Refinements in antigen detection systems, especially for immunoglobulin recognition, combined with these new reagents promise to improve the accuracy of lymphoma diagnosis in routine histopathology. These new antibodies are reviewed, and their limitations, cross reactivities and profiles of staining in lymphoreticular disease are discussed. A strategy for their optimal use is proposed.
Epithelial membrane antigen expression by the perineurial cell: further studies of peripheral nerve lesions
Authors: THEAKER J. M. , FLETCHER C. D. M.
Published: April 2007

We have previously shown that a range of anti‐epithelial membrane antigen monoclonal antibodies show immunoreactivity with the perineurial fibroblast, both in normal nerves and within a range of common peripheral nerve tumours. We have extended these observations by studying a further collection of peripheral nerve lesions, including some which have previously been thought to have an origin from the perineurial cell. The results provide further evidence that these antibodies reliably stain perineurial cells and that in conjunction with antisera to S‐100 protein and neurofilaments, the relative contributions of the perineurial fibroblast, Schwann cell and neurone can be assessed within a nerve‐related tumour/lesion. The perineurial fibroblast is an important component of some peripheral nerve lesions.
Endomyocardial biopsy pathology in insulin‐dependent diabetic patients with abnormal ventricular function
Authors: SUTHERLAND C. G. G. , FISHER B. M. , FRIER B. M. , DARGIE H. J. , MORE I. A. R. , LINDOP G. B. M.
Published: April 2007

We have previously shown impaired ventricular function in asymptomatic middle‐aged type 1 (insulin‐dependent) diabetic patients who had no evidence of coronary artery disease. The diabetic patients had normal coronary angiograms but reduced ventricular ejection fraction on exercise. To examine the possible contribution of small vessel disease to this functional abnormality, we compared endomyocardial biopsies from seven symptom‐free type 1 diabetic patients with biopsies from seven age‐ and sex‐matched non‐diabetic subjects. Interstitial fibrosis was present in three diabetic patients, arteriolar hyalinization in three patients and arteriolar thickening was observed in five patients. Morphometry performed on electron micrographs showed no significant difference in the thickness of the capillary basal lamina between diabetics and controls. While the functional significance of the abnormalities on light microscopy is unclear, our findings indicate that the abnormality of cardiac function described in diabetes is not associated with thickening of the myocardial capillary basal lamina.
A retrospective study of follicular lymphomas
Authors: WEST K. P. , POTTER L. J. , HENDERSON S. D. , LAUDER I.
Published: April 2007

Sixty‐four cases of follicular lymphoma followed‐up for 10 years have been studied. The influence of age, sex, histological appearance, immunophenotype and T‐cell content on prognosis has been examined. Initial evaluation indicated that increasing age, relatively low numbers of intrafollicular T‐cells and absence of mantle zones around the neoplastic follicles were associated significantly with mortality. Multiple regression analysis with adjustment for age and sex was performed and the only significant variable was then found to be the histological grade.
Immunoproliferative small intestinal disease: A study of 13 cases with alpha heavy‐chain disease
Authors: PRICE S.K.
Published: April 2007

The pathology of 13 cases of immunoproliferative small intestinal disease (IPSID) associated with α‐heavy‐chain disease—one an apparent non‐secretor and another with localized infiltration—is described. Four cases exhibited immunohistological light‐chain monotypia. In one of these, evolution of a light‐chain negative cell population was observed over a 7‐year period. In the Intestine, centrocyte‐like cells produced lympho‐epithelial lesions in 11 cases and enlarged lymphoid follicles in three. In lymph nodes, perifollicular infiltration was observed in 11 cases and abnormal follicles in six. Of three patients with high‐grade lymphoma at presentation one died untreated at 2 months, and two are alive at 34 and 91 months. Of 10 patients with low‐grade disease at presentation, two died—one at 76 months, the other after transforming to high‐grade lymphoma at 73 months. Eight patients with low‐grade disease are alive, an average of 67 months after presentation. Four of five conservatively treated low‐grade cases (including three in remission) showed evidence of monoclonality at presentation (light‐chain monotypia in two and gene rearrangement in two), while two of the five exhibited DNA aneuploidy. It is concluded that IPSID with α‐heavy‐chain disease is neoplastic in all its stages and is a variant of mucosa‐associated lymphoma. The role of centrocyte‐like cells and the response to conservative therapy are discussed.