bluuebunny/crossref_metadata_2025 huggingface dataset:
The nature of breast dense core granules: uranaffin reactivity
Authors: HOPKINSON H.E. , BATTERSBY S. , ANDERSON T.J.
Published: April 2007

In this study breast tissue that contained ultrastructural dense core granules has been examined from 24 patients. The possible neuroendocrine characteristics of the granules were studied using the uranaffin reaction and an ultrastructural argyrophil stain. The tissue included 15 breast carcinomas and nine benign samples. Two types of breast dense core granules can be distinguished on the basis of intracellular distribution patterns and histochemical reactivity. Type I dense core granules are the most common and they were found subluminally distributed in non‐pathological tissues and benign lesions as well as carcinomas. They were uranaffin‐negative and are unlikely to be of endocrine nature. Type II dense core granules were found only in four carcinomas, where they occurred abundantly throughout the cytoplasm. These granules were uranaffin‐positive and argyrophilic and thus exhibited characteristics consistent with neuroendocrine structure.
Expression of lymphoid‐associated antigens on Hodgkin's and Reed‐Sternberg cells of Hodgkin's disease. An immunocytochemical study on lymph node cytospins using monoclonal antibodies
Authors: FALINI B. , STEIN H. , PILERI S. , CANINO S. , FARABBI R. , MARTELLI M.F. , GRIGNANI F. , FAGIOLI M. , MINELLI O. , CIANI C. , FLENGHI L.
Published: April 2007

The aim of this study was to elucidate the origin of Hodgkin's and Reed‐Sternberg cells. Lymph node cytospins and frozen sections from 20 cases of Hodgkin's disease of different histological subtypes were immunostained by the immunoalkaline phosphatase technique using a panel of monoclonal antibodies. As expected, the Hodgkin's and Reed‐Sternberg cells of all cases were positive for the CD30 (Ki‐1), CD 15 (hapten X) and CD25 (Tac) antigens. In eight cases, a variable percentage of typical Hodgkin's and Reed‐Sternberg cells showed a clear‐cut cytoplasmic and/or surface positivity for the T‐cell‐associated antigens CD3, CD5, CD6 and CD4 (seven cases) or CD8 (one case), but consistently lacked B‐cell and macrophage‐associated markers. The best visualization of T‐cell antigens was obtained in cytocentrifuge preparations and in areas of lymph node frozen sections that had been infiltrated by clusters of Hodgkin's and Reed‐Sternberg cells. In two cases of Hodgkin's disease (nodular sclerosis, mixed cellularity) the neoplastic cells weakly expressed the B‐cell antigens CD19 and CD22, but not T‐cell or macrophage‐associated markers. In 10 cases, Hodgkin's and Reed‐Sternberg cells were negative for all the lymphoid‐ and macrophage‐associated antigens. These results suggest a lymphoid (either T or B) rather than histiocytic origin for the Hodgkin's and Reed‐Sternberg cells in a number of Hodgkin's disease cases.
Adenosis tumour of the breast—a clinicopathological investigation of 27 cases
Authors: NIELSEN B.B.
Published: April 2007

Twenty‐seven cases of palpable and/or tumour‐forming adenosis in the female breast, called adenosis tumour, have been investigated. It is a rare lesion, which most often presents as a breast mass that clinically and histologically is sometimes misinterpreted as carcinoma. The majority of patients were under the age of 45 years. Grossly, most tumours were firm or elastic and showed a grey or greyish‐white cut surface. Furthermore, seven (26%) were granular and nine (34%) were microcystic, whereas none showed chalky streaks. Microscopically, 20 cases were poorly circumscribed and seven cases were well circumscribed. In contradistinction to the often uniform growth pattern of tubular carcinoma, the adenosis tumours characteristically showed adenosis arranged in a mixture of eight different growth patterns. The most frequent and also most extensive growth pattern was classical sclerosing adenosis and the least frequent was tubular adenosis. Another conspicuous feature in adenosis tumours was patchy growth in contrast to the stellate configuration of tubular carcinoma which is the most likely differential diagnosis. Other findings separating adenosis tumours from carcinomas were microcysts (93%), apocrine metaplasia (63%), luminal histiocytes (52%) and pseudopapillomas, called glomeruloid structures (48%). Epithelial changes that could cause anxiety about malignancy were frequently found and comprised epithelial hyperplasia (44%), epithelial atypia (26%) and fat or nerve infiltration (30%). Three patients were subjected to unnecessary mastectomy because of incorrectly diagnosed adenosis tumours. Adenosis tumours and non‐infiltrating carcinoma were found together in five cases, but their association is probably over represented due to selection. None of 18 pure adenosis tumours solely treated by excision had recurred at follow‐up 1–9 years later (mean 3.75 years).
The contribution of immunohistochemical staining in tumour diagnosis
Authors: LEONG A.S‐Y. , WRIGHT J.
Published: April 2007

With the increasing use of immunohistochemical stains in the diagnostic laboratory, it becomes relevant to review the contributions of this new technology in the area of tumour diagnosis. During 1986, our laboratory received 21479 biopsy specimens of which 2013 were tumours. Nine hundred and fifty‐eight tumours (47.5%) were subjected to immunohistochemical analysis. The biopsy and immunohistochemistry reports of 200 consecutive tumours, including 41 consultation cases, were retrospectively reviewed and assigned to one of the five categories. Immunohistochemical stains confirmed the preferred H & E diagnosis in 106 cases (53%); made the definitive diagnosis from a list of differential diagnosis in 29 cases (14.5%); provided contributory information in 36 cases (18%); were non‐contributory in 27 cases (13.5%); and rendered an unsuspected diagnosis in two cases (1%). Immunohistochemical stains were particularly useful in distinguishing between malignant lymphoma and anaplastic carcinoma and in the identification of amelanotic melanoma. The application of a panel of antibodies chosen in accordance with the differential diagnoses considered was very useful in the typing of anaplastic round cell and spindle cell tumours. In 27 cases (13.5%), immunohistochemical stains were non‐contributory. About half of these were referred cases and the failure to demonstrate the relevant antigens in normal tissues which served as in‐built controls suggested that part of the problem may be due to differences in methods of fixation which led to sub‐optimal preservation of tissue antigens. We conclude that immunohistochemical stains provide important and sometimes essential information for definitive typing of anaplastic tumours. Often the information derived was of therapeutic and prognostic relevance. We argue that this is a cost‐effective test although we would caution that in all circumstances the interpretation of immunostaining must be made in the context of the histological as well as the clinical and laboratory data.
Synchronous duodenal neuroendocrine tumours in von Recklinghausen's disease—a case report of co‐existing gangliocytic paraganglioma and somatostatin‐rich glandular carcinoid
Authors: STEPHENS M. , WILLIAMS G.T. , JASANI B. , WILLIAMS E.D.
Published: April 2007

The co‐existence of a gangliocytic paraganglioma and a glandular psammomatous carcinoid in the duodenum of a patient with von Recklinghausen's disease and bilateral phaeochromocytomas is reported. The two lesions were considered to be distinctive by light microscopy, electron microscopy and immunocytochemistry. The cells of the glandular carcinoid showed strong cytoplasmic immunoreactivity for somatostatin and contained only scanty intracytoplasmic microfilaments on electron microscopy. In contrast, the endocrine cells of the gangliocytic paraganglioma were positive for pancreatic polypeptide and serotonin, were negative for somatostatin, and contained conspicuous intracytoplasmic aggregates of filaments. The histogenic relationship between the two tumours is discussed. This case strengthens the known association of glandular duodenal somatostatinoma with von Recklinghausen's disease and phaeochromocytoma and, in the light of a previous case report, suggests that von Recklinghausen's disease and gangliocytic paraganglioma may co‐exist more commonly than expected.
Prostatic‐type polyps of the lower urinary tract: three histogenetic types?
Authors: CHAN J.K.C. , CHOW T.C. , TSUI M.S.
Published: April 2007

Seventeen prostatic‐type polyps of the lower urinary tract are reported. All occurred in males, and the mean ages of the patients with ureteric orifice, bladder and urethral polyps were 20.5, 60.2 and 36.6 years, respectively. The commonest presentation for the bladder and ureteric orifice polyps was haematuria, whereas that for the urethral polyps was either dysuria or haematuria. The polyps consisted of acini and papillae lined by prostatic‐type epithelium, as confirmed by immunostaining for prostatic‐specific antigen. Most had interspersed islands or complete covering of transitional epithelium on the surface. We believe that the histogenesis of prostatic‐type polyps may differ in the different sites. For the ureteric orifice polyp, the early age of presentation and the simple occurrence of prostatic acini beneath an intact urothelium suggest a developmental abnormality. For the bladder polyp, the late onset of disease and the commonly observed transition with cystitis cystica‐glandularis suggest that it may be a metaplastic variant of cystitis cystica‐glandularis. On the other hand, the urethral polyp probably represents a hyperplastic lesion, since the prostatic urethra is normally lined partly by prostatic‐type epithelium.
Glycogen‐rich clear cell carcinoma of the breast: a solid variant with mucus. A light microscopic, immunohistochemical and ultrastructural study of a case
Authors: SØRENSEN F.B. , PAULSEN S.M.
Published: April 2007

The light microscopic, immunohistochemical and ultrastructural features of a clear cell carcinoma of the breast have been studied. Both intraductal and invasive components were found. Histochemistry showed large amounts of intracytoplasmic glycogen and sparse neutral mucin in the tumour. The tumour cells were stained by antisera to carcinoembryonic antigen, keratin and epithelial membrane antigen, but not by antisera to alpha‐lactalbumin, desmin or vimentin. Ultrastructurally, the epithelial derivation of the tumour was confirmed. Only a few intracytoplasmic lumina were demonstrated. The tumour was classified as a mucin‐containing variant of glycogen‐rich, clear cell carcinoma of the breast.
‘M’ cells in the follicle‐associated epithelium of the human colon
Authors: JACOB E. , BAKER S.J. , SWAMINATHAN S.P.
Published: April 2007

The morphology of the epithelium overlying human colonic mucosal lymphoid follicles has been studied by electron microscopy. Epithelial crypts stop at the edge of the follicle and the centre is covered by a single layer of enterocytes. Numerous lymphocytes and, occasionally, other mononuclear cells, are associated with these enterocytes. The lymphocytes are situated in the intercellular spaces, invaginate the lateral cell wall and ultimately appear to be completely surrounded by the enterocyte. When the lymphocyte is near the centre of the enterocyte there is usually little change in enterocyte morphology, but when the lymphocyte is near the apical surface of the enterocyte, the latter closely resembles the membranous epithelial cells (‘M’ cells) of human small intestine. It is probable that, as with the ‘M’ cells in the small intestine, these colonic ‘M’ cells have an antigen sampling function. Their presence may explain the localization of the early lesions of some colonic inflammatory diseases, including Crohn's disease. They may also provide a portal of entry for some rectally‐transmitted viral infections.
Angiolymphoid hyperplasia with eosinophilia: report of a case arising from the radial artery
Authors: MORTON K. , ROBERTSON A. J. , HADDEN W.
Published: April 2007

A case of angiolymphoid hyperplasia with eosinophilia arising from the radial artery is presented. Histologically, there was proliferation of atypical endothelial cells forming vascular spaces and solid cords, with a background infiltrate of inflammatory cells and prominent tissue eosinophilia. Immunohistochemical studies demonstrated vimentin and factor VIII related antigen in the endothelial cells. The lymphoid infiltrate was polyclonal. These lesions, which typically occur in the dermis and subcutaneous tissue of the head and neck, are known by a variety of different names reflecting disagreement regarding their pathogenesis. The probable nature of the process is discussed.
Malignant lymphoma with eosinophilia of the gastrointestinal tract
Authors: SHEPHERD N.A. , BLACKSHAW A.J. , HALL P.A. , BOSTAD L. , COATES P.J. , LOWE D.G. , LEVISON D.A. , MORSON B.C. , STANSFELD A.G.
Published: April 2007

Lesions of the gastrointestinal tract with massive tissue eosinophilia may present a difficult diagnostic problem. In a series of 250 gastrointestinal lymphomas drawn from the files of St Bartholomew's and St Mark's Hospitals there were 28 cases of a lymphoma with distinctive histological features, characterized by a massive tissue eosinophilia. Two of these tumours were present in the stomach and 26 in the small intestine. Eight of the latter were associated with coeliac disease. On low power examination a zoning phenomenon was regularly seen and fissuring ulceration, with perforation and fistula formation, was a common finding. The tumour cells were large and pleomorphic with irregular nuclear morphology and prominent nucleoli. Eosinophils were the predominant inflammatory cell associated with the lymphoma but plasma cells, epithelioid histiocytes and small lymphocytes were also present. Vascular changes were prominent. Involved lymph nodes showed gross expansion of the paracortex by tumour. Immunohistochemical studies showed that this lymphoma was probably of T‐cell origin.
Infantile myofibromatosis: a light microscopic, histochemical and immunohistochemical study suggesting true smooth muscle differentiation
Authors: FLETCHER C.D.M. , ACHU P. , VAN NOORDEN S. , MCKEE P.H.
Published: April 2007

Eight cases of infantile myofibromatosis, a rare, sometimes multicentric neoplasm which shows an inherited tendency, have been studied by light microscopy, conventional histochemistry and immunohistochemistry. This tumour is commonest in early infancy and may arise at a wide variety of sites, most often in subcutaneous tissue. Evidence is presented that this entity shows true smooth muscle differentiation, rather than it being of a myofibroblastic nature and hence its current name may be incorrect. In this context, the presence of desmin positivity in six out of eight cases is of particular importance. The differential diagnosis is discussed.
The value of tumour marker CA 125 in surgical pathology
Authors: KOELMA I.A. , NAP M. , RODENBURG C.J. , FLEUREN G.J.
Published: April 2007

CA 125 is a tumour marker located primarily on non‐mucinous epithelial ovarian tumours and which is recognized by the monoclonal antibody OC 125. In this study the value of CA 125 in surgical pathology was assessed. In fresh frozen material, the expression of CA 125 was demonstrated in 82% of 83 epithelial ovarian neoplasma using the indirect immunoperoxidase technique. In addition, all adenocarcinomas of cervix (n=5) and endometrium (n=5) tested expressed CA 125, and 25 of 111 (22%) non‐gynaecological malignat tumours were positive. The positive cases included 20 breast carcinomas, one carcinoma of the stomach and one of the colon. Using a commerical kit on routinely fixed, apraffin embedded material, CA 125 positivity was demonstrated in 29 of 36 (80%) serous cystadenocarcinomas after pronase pre‐teratment of the sections, in cotrast to 100% (n=25) posivity on frozen tissue sections. CA 125 can. therefore, be demonstrated in routinely fixed paraffin embedded material, although the number of positive results is less than in fresh frozen sections.
Anti‐Leu 7 immunoreactivity with human tumours: its value in the diagnosis of prostatic adenocarcinoma
Authors: MAY E.E. , PERENTES E.
Published: April 2007

The reactivity of the anti‐Leu 7 monoclonal antibody (Leu 7) was tested on 83 human tumours and on non‐neoplastic prostatic, hepatic and pancreatic tissues. A four‐step peroxidase‐anti‐peroxidase method was used on paraffin embedded tissues and we observed strong cytoplasmic positivity in all 19 primary prostatic tumours, in two metastatic, poorly differentiated prostatic adenocarcinomas, and in normal and hypertrophic prostatic epithelium. All the primary prostatic tumours also stained positively for prostate‐specific antigen and for prostatic acid phosphatase using polyclonal antisera. The degree of positivity for these antigens varied from case to case. Adenocarcinomas arising from the gastrointestinal tract, pancreas and gallbladder were anti‐Leu 7 negative. Focal Leu 7 positivity, largely confined to cell membranes, was observed in some ovarian, endometrial, renal, lung and breast adenocarcinomas. These tumours, as well as some of the gastrointestinal, hepatic and pancreatic tumours, also showed focal cytoplasmic positivity for prostate‐specific antigen and prostatic acid phosphatase. Our findings suggest that the anti‐Leu 7 monoclonal antibody is a marker that may facilitate the detection of metastatic prostatic adenocarcinoma, especially when used in conjunction with staining for prostate‐specific antigen.
Malignant osteoclastoma‐like giant cell tumour of the renal pelvis
Authors: BORG‐GRECH A. , MORRIS J.A. , EYDEN B.P.
Published: April 2007

We report the fourth case of an osteoclastoma‐like giant cell tumour of the renal pelvis. A special feature was that although thorough sampling of the tumour showed an osteoclastoma‐like pattern throughout, it was intimately associated with carcinoma in situ change of the adjacent transitional epithelium and this provides further support for the view that these tumours are of epithelial derivation. However, immunohistological and ultrastructural studies failed to reveal epithelial features within the tumour cells and the possible significance of this finding is discussed.
Malignant lymphoma of mucosa‐associated lymphoid tissue
Authors: ISAACSON P.G. , SPENCER J.
Published: April 2007

Lymphomas of the gastrointestinal tract, salivary glands, lung and thyroid are grouped together as tumours arising in mucosa‐associated lymphoid tissue. The great majority of them are of B‐cell origin but distinctive T‐cell lymphomas are also recognized in the gastrointestinal tract. These lymphomas tend to remain localized for prolonged periods but, whereas the B‐cell group respond favourably to local therapy, the T‐cell group are associated with severe morbidity and their overall prognosis is extremely poor. Accepted histological classifications of non‐Hodgkin's lymphomas are difficult to apply to these tumours. In this paper their morphological features are reviewed; recent findings based on immunohistochemistry and DNA analysis are presented; and the biological behaviour of these tumours is discussed insofar as they offer insight into mucosal immunological mechanisms.
Atypical fibroxanthoma of the skin: a clinicopathological and immunohistochemical study and a discussion of its histogenesis
Authors: LEONG A. S‐Y. , MILIOS J.
Published: April 2007

The morphological and immunohistochemical characteristics of 37 atypical fibroxan‐thomas of the skin were examined. Twenty‐four tumours were nodular ulcerative lesions on the head and face of patients with a median age of 75 years, whereas 13 tumours occurred on the trunk and limbs of patients with a median age of 48 years. Both pleomorphic polygonal and giant cells as well as the spindle cell component of the tumours stained for the histiocytic markers α1‐antichymotrypsin, aggtitypsin, lysozyme and, less frequently, for ferritin. Leu M1 antigen and peanut agglutinin receptors were not demonstrable in tumour cells. This antigenic profile was contrasted with the findings in six cases of dermatotibroma which were largely not reactive with the antisera used. The immunohistochemical findings in atypical fibroxanthomas suggest that they represent a homogeneous group of tumours which are related to tissue histiocytes. These results are discussed in the context of the published findings in other so‐called fibrohistiocytic tumours including dermatofibrosarcoma protuberans and malignant fibrous histiocytoma. The diagnoses in three cases coded as atypical fibroxanthomas were revised on the basis of their showing a different immunohistochemical profile.
Oncocytic glomus tumour: a new variant
Authors: SLATER D.N. , COTTON D.W.K. , AZZOPARDI J.G.
Published: April 2007

A new variant of glomus tumour characterized by oncocytic change is reported. The light and electron microscopy and immunohistological findings are described. This is the first reported case of an oncocytoma of non‐epithelial origin.
Immunohistology of anaplastic thyroid carcinoma. A study of 43 cases
Authors: HURLIMANN J. , GARDIOL D. , SCAZZIGA B.
Published: April 2007

Forty‐three cases of large cell anaplastic thyroid carcinoma were examined with various antisera. Four histological patterns were identified: spindle cell, giant cell, trabecular and squamous. In 38 cases the epithelial origin was demonstrated with various epithelial markers: 11 cases stained positively for thyroglobulin, 19 for T3 and/or T4, 35 for fat globule membrane antigens, 28 for keratin, 29 for lactoferrin, and one for calcitonin. Five cases were negative for all epithelial markers but could not be characterized further since, except for vimentin, they did not have mesenchymal markers. The immunohistochemical proof of the epithelial nature of anaplastic thyroid tumours is given by staining with anti‐keratin and anti‐fat globule membrane antigen. In addition the detection of lactoferrin seems useful, but not that of thyroglobulin which was present in only 4% of the spindle cell tumours and in 32–56% of the other histological types. Thirty carcinomas were positive for vimentin; the co‐expression of vimentin and epithelial markers seems frequent in thyroid anaplastic carcinomas.
Flow cytometric detection of B‐clonal excess in fine needle aspirates for enhanced diagnostic accuracy in non‐Hodgkin's lymphoma in adults
Authors: JOHNSON A. , ÅKERMAN M. , CAVALLIN‐STÅHL E.
Published: April 2007

Fine needle aspiration (FNA) cytology is a valuable aid to diagnosis and tumour staging in patients with non‐Hodgkin's lymphoma. These tumours are often multicentric and involve sites such as the liver or the spleen which are not easily accessible to surgical biopsy. Particularly with splenic involvement, there is a diagnostic problem of morphologically distinguishing the lymphoma cells in an admixture of normal lymphocytes. Since most lymphomas in adults are of B‐cell origin, we studied the diagnostic value of adding a surface immunoglobulin (sIg) light chain analysis to the cytological evaluation of FNAs. B‐clonal excess was determined by flow cytometric analysis of the sIg light chain distribution and a monoclonal finding was considered diagnostic of lymphoma. In primary diagnostic procedures the light chain analysis established a diagnosis of lymphoma in 5/14 (36%) aspirates from patients with poorly differentiated tumours. Fine needle aspirates performed as part of staging procedures were morphologically normal or inconclusive in 19 cases; in seven of these (37%) lymphoma involvement was diagnosed by the light chain analysis. Diagnostic precision was enhanced by combining morphological and immunological evaluation of fine needle aspirates in patients with established or suspected non‐Hodgkin's lymphoma.
An immunohistochemical study of the tissue distribution of the breast cyst fluid protein, zinc alpha2 glycoprotein
Authors: BUNDRED N.J. , MILLER W.R. , WALKER R.A.
Published: April 2007

Zinc alpha2 glycoprotein is one of the proteins present in breast cyst fluids, being found at levels 30–50 times its plasma concentration. Using an immunoperoxidase technique the distribution of this glycoprotein has been studied in a range of non‐mammary tissues and carcinomas, as well as in normal, benign and malignant breast specimens. The breast cyst fluid protein was detected in all apocrine cells of skin and in the apocrine metaplastic epithelium lining of breast cysts. A progression was apparent from normal to hyperplastic breast in the number of cells reacting, particularly of cystically dilated acini, to a final consistent staining of apocrine‐lined cysts. Zinc alpha2 glycoprotein was demonstrated in 16 of 33 invasive carcinomas, 15 of which were eosinophilic on haematoxylin and eosin staining, and in one of three non‐invasive carcinomas. No staining was apparent in other non‐mammary tissues and carcinomas apart from weak reactivity of serous cells of the parotid gland. Zinc alpha2 glycoprotein is, therefore, a reliable immunohistochemical marker of apocrine cell differentiation.
Apocrine carcinoma of the breast containing foam cells. An electron microscopic and immunohistological study
Authors: SHOUSHA S. , BULL T.B. , SOUTHALL P.J. , MAZOUJIAN G.
Published: April 2007

The detailed light and electron microscopic and immunohistological features of an invasive apocrine carcinoma of the breast developing in a 78‐year‐old woman are presented. The stroma of the tumour contained non‐neoplastic lipid‐filled (foam) cells. To our knowledge, these cells have not been described before in invasive breast carcinoma. Their electron microscopic and immunohistological features confirm their histiocytic nature.
Acute cholangitis and pancreatitis associated with sulindac (clinoril)
Authors: LERCHE A. , VYBERG M. , KIRKEGAARD E.
Published: April 2007

A 68–year‐old man without previous hepatobiliary or pancreatic disease was admitted after five attacks of nausea, vomiting, abdominal pain and high fever. Laboratory investigations indicated cholestatic liver disease and pancreatitis. For 1.5 years the patient had occasionally been taking a non‐steroidal anti‐inflammatory drug, sulindac (clinoril, MSD, New York), for osteoarthritis. On suspicion of a drug‐associated disease, a rechallenge experiment was performed with sulindac. Five hours after drug administration symptoms recurred. There was a pronounced increase in serum alkaline phosphatase and amylase. A liver biopsy 3 d later showed portal tract inflammatory infiltration and abnormal interlobular bile ducts with degeneration and necrosis of the epithelium and neutrophilic infiltration of the ducts. Sulindac‐induced cholangitis has not been described previously. The pathogenetic mechanism is considered to be an immunoallergic idiosyncratic reaction to the active metabolite of sulindac absorbed by the bile duct epithelium. The lesion is apparently reversible.
Soft tissue gliomatosis—heterotopic glial tissue in the subcutis: a case report
Authors: SHEPHERD N.A. , COATES P.J. , BROWN A.A.
Published: April 2007

A subcutaneous nodule composed of heterotopic glial tissue is reported. The lesion was present in the subcutaneous tissue of the chest wall in a 2‐year‐old female. Histologically it was composed of loosely textured fibrillary neuroglial tissue in a densely hyalinized collagenous stroma. Immunohistochemical staining for glial fibrillary acidic protein was positive. The possible origin of this soft tissue glial heterotopia is discussed and the subject of heterotopic glial tissue is reviewed.
Pathology of the lung in the fetus and neonate, with particular reference to problems of growth and maturation
Authors: WIGGLESWORTH J.S.
Published: April 2007

The major forms of lung pathology in the perinatal period are reviewed with emphasis on disturbances of growth and maturation. Lung hypoplasia results from impairment in the physiological control of lung growth during the fetal period. It is more common than organogenetic defects which are discussed only briefly. Hyaline membrane disease is now seldom seen in a pure form due to improvements in perinatal care. However, its complications and sequelae such as interstitial emphysema, pneumothorax and bronchopulmonary dysplasia are encountered more frequently. In addition, a wide variety of pathological processes may localize to, or be expressed in, the lung of the newborn, notably asphyxial changes, persistent pulmonary hypertension, haemorrhage and infection
Immunohistochemical demonstration of ceruloplasmin in follicular adenomas and thyroid carcinomas
Authors: TUCCARI G. , BARRESI G.
Published: April 2007

The presence of ceruloplasmin in follicular adenomas (15 cases) and thyroid carcinomas (39) and two Hürthle cell tumours was investigated by immunohistochemical methods. Follicular adenomas were all negative whereas Hürthle cell tumours, follicular and papillary carcinomas exhibited various degrees of cytoplasmic positivity for ceruloplasmin. Highly atypical multinucleated cells and incorporated follicular structures observed in anaplastic carcinomas were positively stained; the spindle cell variety of these cancers was always negative for ceruloplasmin. Medullary carcinomas and normal thyroid tissue were constantly unstained. The distribution pattern of ceruloplasmin is the same as that of lactoferrin, a marker recently proposed for the differential diagnosis between follicular adenomas and thyroid carcinomas; these two glycoproteins are structurally related.
Genotypic analysis of large cell lymphomas which express the Ki‐1 antigen
Authors: O'CONNOR N.T.J. , STEIN H. , GATTER K.C. , WAINSCOAT J.S. , CRICK J. , AL SAATI T. , FALINI B. , DELSOL G. , MASON D.Y.
Published: April 2007

The monoclonal antibody Ki‐1 reacts with Reed‐Sternberg cells in Hodgkin's disease and with the tumour cells in a minority of large cell non‐Hodgkin's lymphomas. This study describes the results of immunophenotypic and DNA analysis in 30 cases of non‐Hodgkin's lymphoma, all of which expressed the Ki‐1 antigen. The genotypic analysis has been undertaken using both immunoglobulin and T‐cell receptor gene probes. Sixteen cases were shown by this method to be of monoclonal T‐cell origin, six of B‐cell origin, while in eight cases there was no evidence of either T‐ or B‐cell lineage. This confirms previous immunohistological data indicating that non‐Hodgkin's lymphomas which express the Ki‐1 antigen may be of either T‐cell or B‐cell origin.
Evaluation of nucleolar organizer region‐associated proteins in breast malignancy
Authors: SMITH R. , CROCKER J.
Published: April 2007

Nucleolar organizer regions (NORs) have been identified by means of an argyrophilic technique (Ag‐NOR) in routinely processed, formalin‐fixed paraffin sections of breast lesions. This method, which is novel in histopathology, reveals NORs as black dots in the nuclei of cells, by virtue of the argyrophilia of NOR‐associated proteins. The number of Ag‐NORs has been thought to be related to cellular activation and has recently been applied to non‐Hodgkin's lymphomas and melanocytic skin lesions. It was found in the present study that the total number of Ag‐NORs in malignant breast lesions significantly exceeded those of normal breast and benign lesions. The number of clumps of Ag‐NORs, however, were not useful discriminators. Neither numbers of total Ag‐NORs nor of clumps of Ag‐NORs correlate with mitotic counts and it may be that their numbers relate to ploidy. It is suggested that the Ag‐NOR technique will find increasing application as an adjunct to diagnostic histopathology.
Synovial sarcoma of the heart arising from a so‐called mesothelioma of the atrio‐ventricular node
Authors: SHEFFIELD E.A. , CORRIN B. , ADDIS B.J. , GELDER C.
Published: April 2007

A primary tumour of the right atrium with morphological, ultrastructural and immunohistochemical features of a synovial sarcoma is described. This appeared to have arisen from a benign so‐called mesothelioma of the atrio‐ventricular node and had metastasized to the lungs. The histogenesis and relationship of these two tumours are discussed.
Primary malignant lymphoma of the colon and rectum. A histopathological and immunohistochemical analysis of 45 cases with clinicopathological correlations
Authors: SHEPHERD N.A. , HALL P.A. , COATES P.J. , LEVISON D.A.
Published: April 2007

Primary colorectal lymphoma accounts for only about 0.2% of large intestinal malignancies. Management difficulties are compounded by a lack of consistent pathological reporting and by the use of numerous different classifications. Forty‐five cases of primary colorectal lymphoma are included in this study. The presenting features are indistinguishable from those of colorectal cancer. Seven patients had a history of chronic ulcerative colitis but no other predisposing factors were identified. Immunohistochemical studies showed that all tumours were of B‐cell phenotype. Most tumours were difficult to characterize using standard pathological classifications such as Kiel, except for the 11 cases of malignant (multiple) lymphomatous polyposis, which were morphologically diffuse centrocytic lymphomas. Twenty‐nine lymphomas showed the morphological and immunohistochemical features associated with tumours arising in mucosaassociated lymphoid tissue. These tumours showed variable but often marked polymorphism and we have used the term polymorphic B‐cell lymphoma to describe them. Consistency was achieved between three observers as to whether these tumours were low or high grade, and grade was found to be prognostically important. A modified Dukes staging system was adopted and there was a trend for early stage to give prognostic advantage. This study supports the view that surgery should be the primary treatment for localized lymphoma of the gastrointestinal tract with radiotherapy and/or chemotherapy for advanced cases and for malignant lymphomatous polyposis.
Lymphadenitis mimicking Hodgkin's disease
Authors: FELLBAUM CH. , HANSMANN M.‐L. , LENNERT K.
Published: April 2007

A variant of lymphadenitis mimicking interfollicular Hodgkin's disease is described. The morphology, immunohistochemistry and clinical course of 25 cases are reported. The morphology is characterized by changes in the interfollicular region within a well‐preserved lymph node architecture. These changes include variegated hyperplasia of the pulp with epithelioid cells, mature eosinophilic granulocytes and immunoblasts occasionally resembling Hodgkin cells. In contrast to Hodgkin's disease no typical Sternberg‐Reed cells could be found. Immunohistochemically, neither positive reactions with Hodgkin cell markers (anti‐CD15: LeuM1; 3C4; C3D‐1) nor B‐cell monoclonality could be detected. Transition to malignancy, in particular Hodgkin's disease, did not occur in our cases.
Granular cell tumours revisited. An immunohistological and ultrastructural study
Authors: BULEY I.D. , GATTER K.C. , KELLY P.M.A. , HERYET A. , MILLARD P.R.
Published: April 2007

Twenty‐five granular cell tumours were stained with a panel of antibodies to histiocytic, muscle, neural, neural crest, epithelial and endothelial markers. Electron microscopy was also performed in six cases. Twenty‐four of the cases were similar morphologically and immunocytochemically. One case with features of an endothelial origin is described. The present study strongly supports the viewpoint that granular cell tumours are a distinct entity rather than being the common appearance of a group of lesions of differing histogenesis. Origin from a neural crest‐derived peripheral nerve‐related cell is favoured.
Squamous carcinoma arising in a giant peri‐anal condyloma associated with human papillomavirus types 6 and 11
Authors: WELLS M. , ROBERTSON S. , LEWIS F. , DIXON M.F.
Published: April 2007

A case is reported of squamous carcinoma of the peri‐anal region arising in a giant condyloma. In situ DNA hybridization showed human papillomavirus (HPV) types 6 and 11. These HPV types are commonly demonstrated in ano‐genital condylomas but have not previously been reported in association with malignant change at this site.
Monocytoid B‐cell lymphoma, a tumour related to the marginal zone
Authors: PIRIS M. A. , RIVAS C. , MORENTE M. , CRUZ M. A. , RUBIO C. , OLIVA H.
Published: April 2007

Monocytoid B‐lymphocytes are a B‐cell subset present in subcapsular sinuses in some cases of lymphadenitis. We describe a case of lymphoma of this cell type. The tumour shows a distinctive morphology characterized by concentric strands of tumour cells around lymphoid follicles with hyperplastic germinal centres and conserved mantle zones. Electron microscopy of these cells shows short cellular processes as well as moderate development of endoplasmic reticulum. The phenotype of the tumour was monoclonal IgM‐kappa, distinct from other node‐based B‐cell subpopulations and suggesting a possible relationship to the lymphocytes of the marginal zone present peripheral to lymphoid follicles of the spleen. Morphological features that suggest a relationship with hairy cell leukaemia are contrasted by phenotypic differences and the ultrastructural absence of ribosomic lamellar complexes.
Malignant haemangiopericytomas and haemangioendotheliosarcomas: an immunohistochemical study
Authors: HULTBERG B. M. , DAUGAARD S. , JOHANSEN H. F. , MOURIDSEN H. T. , HOU‐JENSEN K.
Published: April 2007

Formalin‐fixed, paraffin‐embedded material from 15 haemangioendotheliosarcomas and eight malignant haemangiopericytomas was stained with an immunohistochemical technique for the presence of factor VIII‐related antigen (F VIII‐RAg), actin, laminin and for reactivity with the lectin Ulex europaeus I (UEA‐I). Haemangioendotheliosarcomas stained with both F VIII‐RAg and UEA‐1; however, UEA‐I was found to be the more sensitive of the two, reacting also with the poorly differentiated tumours. Haemangiopericytomas reacted negatively with UEA‐I; surprisingly, some of these tumours exhibited a weak positivity in staining for F VIII‐RAg, possibly supporting the theory about intermediate forms between haemangioendotheliosarcomas and haemangiopericytomas. Laminin was found in most of the haemangioendotheliosarcomas and was useful in illustrating their vascular growth pattern. Haemangiopericytomas also reacted positively for laminin, but the intensity of staining was less pronounced. Positive staining for actin was demonstrated in both tumour types.
Infantile digital fibromatosis‐like tumour (inclusion body fibromatosis) of adulthood: report of two cases with ultrastructural and immunocytochemical findings
Authors: VIALE G. , DOGLIONI C. , IUZZOLINO P. , BONTEMPINI L. , COLOMBI R. , COGGI G. , DELL'ORTO P.
Published: April 2007

Two adult cases of a cutaneous lesion indistinguishable from typical infantile digital fibromatosis are added to the unique similar case so far reported in adulthood. The immunocytochemical localization of vimentin and muscle actin in the proliferating cells confirms their myofibroblastic nature and establishes closer relationships between the adult and the infantile variants of this entity. These two variants, however, appear to be clinically different, since all the adult cases were extradigital and did not recur after surgical excision. The term inclusion body fibromatosis underlines the histological hallmark of the lesion and should be used to identify this entity in place of recurrent infantile digital fibromatosis which does not seem any longer appropriate.
The pancreas in idiopathic Addison's disease—a search for a prediabetic pancreas
Authors: FOULIS A. K. , JACKSON R. , FARQUHARSON M. A.
Published: April 2007

Autopsy pancreases were studied from 14 patients who had idiopathic Addison's disease. One patient had been diabetic for 12 years and three patients were found to be diabetic during their terminal admission. While there was no evidence of diabetes or destruction of insulin‐secreting beta cells in the remaining 10 patients, islets in one pancreas exhibited many of the histological and immunohistochemical features seen in the patients with recent onset diabetes. These included the presence of alpha‐interferon in endocrine cells, hyper‐expression of class I major histocompatibility complex molecules by endocrine cells in islets where alpha‐interferon was also present, aberrant expression of class II major histocompatibility complex molecules by endocrine cells and the presence of insulitis. Since the combination of these changes has only been described in type 1 diabetes it is thought that the appearances seen in this pancreas were those of prediabetes.
Value of long‐core biopsy in the detection of discrete bone marrow lesions
Authors: ISLAM A. , HENDERSON E. S.
Published: April 2007

A series of 256 bone marrow biopsy specimens was obtained at different times from a group of patients with acute myeloid leukaemia, chronic granulocytic leukaemia and acute lymphoblastic leukaemia, and was analysed in parallel with peripheral blood smears and bone marrow aspirate samples. In five of these biopsy specimens the bone marrow lesion was discrete, deeply seated within the marrow cavity and detected only in long‐core biopsies. Neither peripheral blood nor bone marrow aspirates obtained at the same time established the correct diagnosis. This suggests that when peripheral blood and bone marrow aspirate samples fail to indicate the diagnosis a long‐core biopsy may yield positive results.
T‐cell lymphoma: morphology, immunophenotype and clinical features
Authors: KRAJEWSKI A. S. , MYSKOW M. W. , CACHIA P. G. , SALTER D. M. , SHEEHAN T. , DEWAR A. E.
Published: April 2007

The histology, immunophenotype and clinical presentation of 43 cases of T‐cell lymphoma are described. Cases were classified into nine types; T‐lymphocytic lymphoma (three), mycosis fungoides (six), Sézary syndrome (two), T‐zone lymphoma (13), angio‐immunoblastic lymphadenopathy (AIL)‐like T‐cell lymphoma (five), pleomorphic medium cell (one), large cell immunoblastic (four), large cell polylobated (five) and lymphoblastic (four). The patients comprised 26 males and 17 females aged between 15 and 86 years. The majority showed disseminated disease at the time of diagnosis (18 stage IV, nine stage III, five stage II, eight stage I and three cases not staged). Thirty‐one patients showed lymph node involvement. Cutaneous involvement was a common finding (18 cases, 10 cases excluding mycosis fungoides and Sézary syndrome). Details of therapy and clinical follow‐up were obtained in 37 cases. With simple chemotherapy only one complete response (7%, 1/16) was obtained. With aggressive therapy 48% (13/27) of patients showed complete responses. Twenty patients died during the follow‐up period. Life table analysis showed a 58% probability of surviving 1 year and 36% probability of surviving 3 years. There was a significant difference in survival probability between low/intermediate‐grade (lymphocytic, Sézary syndrome, mycosis fungoides and T‐zone lymphoma including AIL‐type) lymphomas and high‐grade (large cell immunoblastic and polylobated and lymphoblastic) lymphomas (P<0.025). However, when survival of T‐zone and AIL‐like T‐cell lymphoma was compared with survival of large cell immunoblastic and polylobated lymphomas no significant difference was detected. Age (< 50 years) and stage I or II disease were associated with significantly better survival (P<0.005 and P<0.05).
Immunostaining for α1‐antichymotrypsin and α1‐antitrypsin in gliomas
Authors: NG H‐K. , LO S. T. H.
Published: April 2007

Antisera to α1‐antichymotrypsin, α1‐antitrypsin and lysozyme were reacted with 20 cases of glioblastoma multiforme, seven anaplastic astrocytomas, eight astrocytomas, six oligodendrogliomas, four ependymomas and the cerebral cortex from six normal autopsy brains. In addition, two pleomorphic xantho‐astrocytomas and two heavily lipidized malignant gliomas were similarly examined. All astrocytic lesions were confirmed with anti‐GFAP antisera. Thirty astrocytic tumours (77%), four oligodendrogliomas (67%) and three ependymomas (75%) reacted positively with anti‐α1‐antichymotrypsin; 25 astrocytic tumours (64%), three oligodendrogliomas (50%) and three ependymomas (75%) showed positive staining for α1‐antitrypsin. The pattern of staining with either of these two markers did not correlate with tumour grading. None of the gliomas examined stained positively with anti‐lysozyme. Non‐neoplastic glial elements did not react with any of the three antisera. The results of this study suggest that staining for α1‐antichymotrypsin and α1‐antitrypsin is of little value in the differential diagnosis of neuroepithelial or mesenchymal lesions in the brain.
Alzheimer's disease and Down's syndrome
Authors: MANN D. M. A.
Published: April 2007

The neuropathology of Down's syndrome at middle age is compared with that of Alzheimer's disease at that age, through a review of the published literature and from the author's personal observations. The pathological changes of Down's syndrome at middle age, i.e. the form and distribution of senile plaques and neurofibrillary tangles, and the pattern of involvement (atrophy) of neuronal systems are qualitatively the same as those of Alzheimer's disease at that age. Quantitative differences do occur and these may relate to biological or sociological variations inherent to the two parent populations. It is concluded that, in pathological terms, patients with Down's syndrome at middle age do indeed have Alzheimer's disease. Some ways in which a study of patients with Down's syndrome can give insight into the nature and development of the pathological changes of Alzheimer's disease are put forward and discussed.
Observations on the number, size and localization of nucleoli in hyperplastic and neoplastic prostatic disease
Authors: HELPAP B.
Published: April 2007

Specimens of prostate obtained for histopathological and cytological examination by urethral resection and ‘punch’ biopsies showing carcinoma, atypical and typical hyper‐plasia were re‐examined with regard to the number, size and localization of nucleoli. With increasing degrees of malignancy the number and size of the nucleoli increased and the position of the nucleolus shifted to the periphery of the nucleus. In the cells in typical and slightly atypical prostatic hyperplasia there were few nucleoli which were localized to the centre of the nucleus. In moderately atypical hyperplasia there were intermediate locations, while in severe atypical hyperplasia and ‘borderline’ malignant cases there was a distinct shift towards the periphery of the nucleus as well as an increase in the number of nucleoli in each nucleus. It is suggested that careful analysis of the number and localization of nucleoli can be helpful in the analysis of the differential diagnosis between carcinoma and atypical hyperplasia of the prostate, which can be difficult in histopathological and cytopathological material.
Mitotic phase distribution in oral epithelial hyperplasia and neoplasia
Authors: OJO M. A. , MACDCNALD D. G.
Published: April 2007

Assessment of mitotic phase distribution in oral epithelial lesions has shown closely similar features in two categories of hyperplastic condition. By contrast, squamous cell carcinomas showed a significantly different mitotic phase distribution with an increased proportion of metaphases suggesting delay or blockage at this phase. Squamous cell papillomas showed an increased proportion of prometaphase mitoses.
Chrysiasis: transmission electron microscopy, laser microprobe mass spectrometry and epipolarized light as adjuncts to diagnosis
Authors: MILLARD P. R. , CHAPLIN A. J. , VENNING V. A. , WILSON C. , WALLACH R.
Published: April 2007

Two patients receiving gold therapy for rheumatoid arthritis developed skin pigmentation, chrysiasis, which in one appeared 4 months after cessation of the therapy. The diagnosis was confirmed by transmission electron microscopy and mass spectrometry laser microprobe analysis of paraffin sections and its extent demonstrated by epipolarized light. The condition is poorly reported and clinically may be confused with silver and mercury impregnation. Tissue diagnosis requires ancillary methods and of these, transmission electron microscopy and laser microprobe mass spectrometry are excellent examples. The transmission electron microscopy findings differ from previous reports and raise doubts on the hypothesis on the role of the skin in gold excretion. Because of the renewed interest in crysotherapy and the latent period that can separate this from chrysiasis, an increase in chrysiasis and the need for its diagnosis can be anticipated.