bluuebunny/crossref_metadata_2025 huggingface dataset:
Solitary and synchronous adenomas of the colon and rectum: comparison of malignancy parameters
Authors: GRIFFIOEN G. , BOSMAN F.T. , VERSPAGET H.W. , BRUIN P.A.F. DE , BIEMOND I. , LAMERS C.B.H.W.
Published: April 2007

The histological, mucin histochemical and immunohistochemical features were evaluated of 74 solitary and 73 synchronous colorectal adenomas which were endoscopically removed from 124 patients. Of the patients, 60% had a single adenoma, whereas 40% had at least two adenomas in their colorectum. Comparing the incidence of synchronous adenomas in both sexes revealed a statistically significant higher incidence (P < 0.005) in males. The localization of the solitary and syn hronous adenomas in the large bowel was similar. Moreover, parameters of malignant change within the adenomas (size, predominant type of mucosal growth and degree of dysplasia—with the exception of severe dysplasia) as well as signs of dedifferentiation (relative proportions of goblet and columnar cells) were also similar. Mucin staining intensities (periodic acid‐Schiff, high iron diamine and alcian blue) and the immunoreactivity patterns of secretory component and carcinoembryonic antigen, both cytoplasmic and on the surface of the epithelial cells, were also identical in both groups of adenomas. Thus, neither the routine histological nor the mucin‐and immunohistochemical features differed between the groups, except for severe dysplasia. It is concluded that there is no inherent difference in malignant potential between solitary and synchronous adenomas, with the possible exception of the degree of dysplasia.
Immunohistochemical characterization of inflammatory cells associated with advanced atherosclerosis
Authors: RAMSHAW A.L. , PARUMS D.V.
Published: April 2007

During repair of 12 atherosclerotic abdominal aortic aneurysms, fresh samples of aneurysm wall were obtained. Histology confirmed the presence of advanced atherosclerosis associated with medial thinning and a variable aortic adventitial chronic inflammatory cell infiltrate. Monoclonal antibodies were used to identify the inflammatory cells throughout the aortic wall. The majority of lymphocytes in the aortic adventitia were B‐cells. B‐cells were not present in atheromatous plaques. T‐cells, predominantly T‐helper cells, were found in atheromatous plaques and in aortic adventitia. The majority of lymphocytes and macrophages in aortic adventitia and most vascular endothelial cells were HLA‐DR positive. Ki‐67 staining was found in B‐cells and T‐helper cells, indicating that these cells were proliferating. Occasional lymphocytes were BerH2 positive, indicating that some lymphocytes were activated. These findings suggest that chronic periaortitis is an active, immunoiogically mediated, local complication of advanced human atherosclerosis.
Immunosuppression and thrombosis in renal transplantation: an immunohistological study
Authors: DUNNILL M.S. , GATTER K.C. , MASON D.Y. , MORRIS P.J.
Published: April 2007

Renal biopsies were taken from 42 patients at seven and 21 days after renal transplantation. Paraffin sections from these specimens were examined immunocytochemically for the presence of platelet microthrombi in glomerular capillaries using the monoclonal antibody Y2/51. Patients were treated by one of four different immunosuppressive regimes, three of which included cyclosporin A, either alone or in combination with steroids and azathioprine. Microthrombi were detected in approximately 30% of biopsies and were much commoner in patients receiving multi‐drug therapy. We conclude that, contrary to previous suggestions, glomerular capillary thromboses are not frequent in patients on cyclosporin A alone. They are found mainly in patients on multiple drug therapy, particularly when steroids are included. The detection of microthrombi is unlikely to be of assistance in the earlier detection of cyclosporin toxicity.
Vyelosarcoma without acute leukaemia: immunohistochemical and clinico‐pathologic characterization of eight cases
Authors: FUREBRING‐FREDÉN M. , MARTINSSON U. , SUNDSTRÖM C.
Published: April 2007

Eight cases of myelosarcoma without acute leukaemia at time of diagnosis were reviewed and biopsies were immunostained using antibodies reacting with myeloid/monocytic markers. Initial tumour location included lymph nodes, paranasal sinuses, nasopharyngeal and/or orbital regions and other extranodal locations. Three cases developed acute myeloblastic leukaemia within 1‐9 months. Diagnosis was correct in four of the cases, in the other cases a non‐Hodgkin's lymphoma was initially diagnosed. Morphological examination showed a blastic but variable appearance of the tumours. In a few cases cytoplasmic granulation was present. Chloroacetate esterase was present in all cases. In paraffin sections cathepsin G, elastase or lysozyme were present in all cases except one. In frozen material from four of the cases, the myeloid markers CD 11c and CD 33 were present (all cases) and CD 13 and Ki M8 in 3/4 cases.
Protein gene product (PGP) 9.5 as a reliable marker in primitive neuroectodermal tumours—an immunohistochemical study of 21 childhood cases
Authors: HARRIS M.D. , MOORE I.E. , STEART P.V. , WELLER R.O.
Published: April 2007

A number of antibodies to neural proteins have been used to demonstrate neuronal differentiation in primitive neuroectodermal tumours. One of them is protein gene product (PGP) 9.5, a neuronal protein isolated from brain, whose function is unknown at present. We have studied differentiation in 21 cases of primitive neuroectodermal tumours of the CNS in children. Immunocytochemical staining was performed for such neuronal markers as: PGP 9.5, neuron specific enolase and synaptophysin, a glycosylated protein associated with synaptic vesicles. Positive staining for PGP 9.5 was present in 16 cases (strong staining in 12), for neuron‐specific enolase in 16 cases (strong staining in 10) and for synaptophysin in 10 cases (strong staining in six). Both PGP 9.5 and synaptophysin showed a clear staining pattern with less non‐specific background than with neuron‐specific enolase. Our findings demonstrate the value of using more than one antibody marker in assessing neuronal differentiation in tumours. The high incidence of positive staining with antibody to PGP 9.5 suggests that this is an essential marker in the panel of antibodies used for the identification of primitive neuroectodermal tumours.
Intranodal myofibroblastoma presenting in the submandibular region: evidence of a broader clinical and histological spectrum
Authors: FLETCHER C.D.M. , STIRLING R.W.
Published: April 2007

Intranodal myofibroblastoma is an uncommon benign mesenchymal tumour of lymph nodes which was first described in May 1989. All the cases described to date have presented exclusively in the groin, a feature which has been regarded as distinctive. Two new cases are presented herein, both of which arose in the submandibular region of middle‐aged females. Both lesions showed histological features marginally different from the cases originally described, which may reflect their different anatomical location. Immunohistochemical staining revealed positivity for muscle‐specific actin (HHF 35), as previously described, and ultrastructural examination in one case confirmed the presence of myofibroblasts. The data presented suggest that this distinctive lesion has a broader clinicopathological spectrum than previously realised.
Pulmonary fibrosis
Authors: DUNNILL M.S.
Published: April 2007

Diffuse interstitial pulmonary fibrosis is the end result of alveolar damage which may occur as a sudden acute incident or as a slowly developing process. Potentiating factors include release of enzymes and generation of oxygen radicals by granulocytes. Evidence from studies on broncho‐alveolar lavage fluid and from immunocyto‐chemistry indicate that an autoimmune process has an important but, as yet, not clearly defined role in initiating the disease. The fibrosis is probably due to proliferation of small clones of fast growing fibroblasts of a specific phenotype. Bronchiolitis obliterans, organizing pneumonia, idiopathic pulmonary fibrosis, usual interstitial pneumonia and desquamative interstitial pneumonia represent different aspects of the same condition. Their varied morphological appearances probably reflect the fact that tissue has been taken at different stages in the development of the disease.
The renin‐secreting cell in polyarteritis—an immunocytochemical study
Authors: GRAHAM P.C. , LINDOP G.B.M.
Published: April 2007

We studied kidney sections from 15 cases of polyarteritis using an immunocytochemical technique to demonstrate cells containing immunoreactive renin. Ten cases of classical polyarteritis nodosa showed hyperplasia of renin‐containing cells in areas of renal cortex with histological evidence of ischaemia—appearances indistinguishable from those seen in renal artery stenosis. Histologically normal cortex showed little or no immunostainable renin. In the ischaemic areas there was loss of the normal gradient of renin‐containing cells from superficial to deep cortex. In many cases this gradient was abolished or even reversed; in some cases most renin‐containing cells were in juxtaglomerular apparatuses. This alteration in the distribution of immunoreactive renin has only been described in renal artery stenosis in man. In five cases of microscopic polyarteritis there were fewer than normal numbers of renin‐containing cells.

We suggest that in classical polyarteritis nodosa, focal ischaemia causes activation of the renin‐angiotensin system analogous to the changes caused by renal artery stenosis. This may be important in the pathogenesis of hypertension in this condition. By contrast, in microscopic polyarteritis, the appearances of the juxtaglomerular apparatus and the reduced amounts of immunostainable renin suggest suppression of renin synthesis.
The endocrine‐paracrine cells of von Brunn's nests and glandular metaplasia in the supramontanal prostatic urethra
Authors: KIERNAN M. , GAFFNEY E.F.
Published: April 2007

Endocrine‐paracrine (EP) cells are normal cellular constituents of the human genitourinary tract. We examined the distribution and immunostaining profile of EP cells in von Brunn's nests and glandular metaplasia in the supramontanal (proximal) prostatic urethra of adult males and in prostatic ducts of the male fetal urethra. In 15/17 transurethral prostatic resection specimens there were argyrophilic cells and/or serotonin and neuron‐specific enolase containing cells in von Brunn's nests/glandular metaplasia and in the supramontanal prostatic urethra. All seven fetal specimens examined contained EP cells and five had focal calcitonin immuno‐reactivity in prostatic ducts and ductal buds. One adult resection specimen had focal staining for human chorionic gonadotrophin and no case showed staining for somatostatin. These results further support the contention that von Brunn's nests and glandular metaplasia are probably normal urothelial variants in the adult supramontanal prostatic urethra.
Primary lymphomas of the lung: morphological, immunohistochemical and clinical features
Authors: LI G. , HANSMANN M.‐L. , ZWINGERS T. , LENNERT K.
Published: April 2007

Sixty‐two cases of primary malignant lymphoma of the were investigated. Fifty‐eight lymphomas were of B‐ and two of T‐cell type. Two cases of high‐grade homa could not be further classified. The largest group (43 cases) consisted of low‐grade B‐cell lymphoma of the bronchus‐associated lymphoid tissue. These showed features similar to low‐grade B‐cell lymphomas of the mucosa‐associated lymphoid tissue of the stomach. The low‐grade lymphomas showed a peak occurrence in the sixth decade, the high‐grade lymphomas in venth decade. Males predominated slightly. Three‐quarters of the patients with low‐grade B‐cell lymphoma of the bronchus‐associated lymphoid tissue showed solitary or multiple sharply defined nodules of the lung. The prognosis of the B‐cell‐derived lung lymphomas without constitutional symptoms was relatively favourable, regardless of whether they were of low‐ or high‐grade malignancy, whereas patients with constitutional symptoms and the two patients with T‐cell lymphomas showed a bad prognosis. However, recurrences and metastases in the lung, stomach, lymph nodes and salivary glands were seen in about 46% of the cases of low‐grade B‐cell lymphoma of the bronchus‐associated lymphoid tissue.
Cutaneous ciliated cyst: a case report and immunohistochemical comparison with fallopian tube
Authors: AL‐NAFUSSI A.I. , CARDER P.
Published: April 2007

An example of a cutaneous ciliated cyst in the buttock of a 42 year old woman is reported. The histological and immunohistochemical features of the cyst are presented; comparisons with fallopian tube are made and this rare lesion is discussed.
KP1 (CD 68) staining of malignant melanomas
Authors: FACCHETTI F. , BERTALOT G. , GRIGOLATO P.G.
Published: April 2007

The monoclonal antibody KP1, which recognizes the CD 68 antigen on macrophages and myeloid precursors, was tested on 28 malignant (primary and metastatic) melanomas. 28 naevi, and 17 skin biopsies showing either normal (10) or hyperplastic melanocytes (7). Sixteen of 20 primary melanomas and six of eight metastatic melanomas showed variable numbers of KP1 positive tumour cells. All but five benign melanocytic proliferations (two Spitz naevi and three intradermal naevi), as well as normal and hyperplastic melanocytes were negative. These results indicate that difficulties may occur with the use of KP1 in the differential diagnosis between melanomas and neoplasms derived from histiocytes‐macrophages, and that the expression of CD 68 antigen might be related to tumour progression in melanocytic cells.
Large B‐cell lymphoma rich in T‐cells and simulating Hodgkin's disease
Authors: CHITTAL S.M. , BROUSSET P. , VOIGT J.‐J. , DELSOL G.
Published: April 2007

Unusual clinicopathological features drew our attention to nine of 208 cases diagnosed as Hodgkin's disease. Lymph node biopsy specimens in these cases were immunostained with monoclonal antibodies against B‐cell, T‐cell and Reed‐Sternberg cell associated antigens and epithelial membrane antigen (EMA). Reed–Sternberg‐like and other atypical large cells were dispersed in a diffuse, small lymphocyte‐rich background, consistent more often with the initial diagnosis of diffuse, lymphocyte predominance Hodgkin's disease. The clinical stage in these cases was unusually advanced (stages III and IV). Splenomegaly was a common feature (six of nine cases), the male to female ratio was 7:2 and the median age was 55 years (range 25–77). Response to recognized regimes for Hodgkin's disease treatment was poor in most cases, and three patients died early of their disease. Large cells were B‐lymphocytes expressing EMA—an immunophenotype similar to nodular, lymphocyte predominance Hodgkin's disease. Reed–Sternberg cell and T‐cell associated antigens were absent on large cells. Mature T‐cells, with nuclear irregularities in some instances, predominated in the background. A more appropriate diagnostic category is, therefore, T‐cell‐rich B‐cell lymphoma. The cases represent a 4–5% erroneous diagnosis of Hodgkin's disease and further suggest that there is a need for revision of criteria for the diagnosis of the diffuse, lymphocyte predominance variant.
Mac387: its non‐specificity as a tumour marker or marker of histiocytes
Authors: LOFTUS B. , LOH L.C. , CURRAN B. , HENRY K. , LEADER M.
Published: April 2007

A commercially available monoclonal antibody which detects histiocytes in paraffin sections, Mac387, was reacted with 148 soft tissue sarcomas, 29 carcinomas and 10 malignant melanomas. The soft tissue sarcomas had been previously immunophenotyped. All categories of sarcomas, with the exception of angiosarcomas, were positive. Most showed staining in less than 50% of the tumour cells. Six of 10 adenocarcinomas and three of nine basal cell carcinomas were positive, while squamous carcinomas and malignant melanomas were negative. Normal squamous mucosa and epidermis were also positive. The results of this study suggest that Mac387 is of little value in the differential diagnosis of soft tissue tumours, nor is it a specific histiocytic marker.
Primary leiomyosarcoma of bone
Authors: YOUNG M.P.A. , FREEMONT A.J.
Published: April 2007

Four cases of primary leiomyosarcoma of bone are presented. The histology of this rare tumour has been studied with a panel of monoclonal antibodies to the intermediate filaments desmin and vimentin, and to other markers including smooth muscle actin, myosin, α1‐antitrypsin, α1‐antichymotrypsin, lysozyme, S‐100 protein and cytokeratin. The tumour cells were uniformly positive for desmin, vimentin, and in one case for smooth muscle actin; all the other markers were negative. The findings have been compared with other spindle cell lesions of bone and with electron‐microscopy of the tumours. Immunohistochemistry allows the histological diagnosis to be made without the need to resort ultrastructural studies.
Sweat gland abnormalities in lichenoid dermatosis
Authors: AKOSA A.B. , LAMPERT I.A.
Published: April 2007

Lichenoid dermatosis is a pattern description of a variety of cutaneous lesions which primarily affect the dermoepidermal junction. Involvement of skin appendages has been restricted to hair follicles in lichen planopilaris and discoid lupus erythematosus. Sweat gland involvement has not been described in the four common members of this group, namely, lichen planus, discoid lupus erythematosus, fixed drug eruptions and erythema multiforme, although structural abnormalities have been reported in graft‐versus‐host disease. In a detailed morphological study of 59 cases, including lichen planus (12), discoid lupus erythematosus (18), fixed drug eruption (14) and erythema multiforme (15 78% (47/59) showed sweat, gland abnormalities. The abnormalities included vacuolation of cell cytoplasm, with and without lymphocytic infiltration, apoptosis of basal cells and basal cell hyperplasia of the excretory ducts which predominantly affected the portion of the duct adjoining the acrosyringium. The portion of the duct close to the secretory gland was only involved in continuity and the secretory glands were unaffected. These abnormalities of the sweat gland mostly constitute primary involvement by the disease process in contrast to structural abnormalities secondary to fibrosis.
Silver staining of nucleolar organizer regions in prostatic lesions
Authors: GHAZIZADEH M. , SASAKI Y. , OGURO T. , AIHARA K.
Published: April 2007

Variations in the number of silver‐stained nucleolar organizer region‐associated proteins (AgNORs) were studied in paraffin sections of 42 benign prostatic lesions, comprising four cases of granulomatous prostatitis, five of squamous or transitional metaplasia, eight of atypical and 25 of regular hyperplasia, and 37 of prostatic adenocarcinoma, with their metastases. There was a significant difference between the mean AgNOR counts of the benign and malignant prostatic lesions (1.58±0.26 v. 4.34±1.53; P<0.01). The mean AgNOR counts significantly increased with increasing Gleason's grade (P<0.01) and clinical stage (P<0.05) of the tumours. AgNOR counting may contribute to the conventional diagnostic and prognostic indices of cancer of the prostate.
Immunolocalization of tumour necrosis factor α in lung tissue from patients dying with adult respiratory distress syndrome
Authors: NASH J.R.G. , McLAUGHLIN P.J. , HOYLE C. , ROBERTS D.
Published: April 2007

Using a mouse monoclonal antibody raised against recombinant human tumour necrosis factor α. (TNFα), we have studied immunostained paraffin‐embedded autopsy lung tissues from 13 patients dying with adult respiratory distress syndrome and 10 control patients dying of unrelated conditions. Material from 12 of the 13 cases showed positive staining, strong in six, less strong in the remaining six. TNF was located principally within epithelial cells resembling type II pneumocytes in both early and late stages of adult respiratory distress syndrome. In the early stages the TNFα positive cells were scattered and appeared disorganized, but in later cases they formed an epithelium. The cells were confirmed as epithelial by their staining pattern with monoclonal antibodies reactive with epithelial, cytokeratin and macrophage antigens, and by double staining for epithelial membrane antigen and TNFα. In the control group, Staining for TNF was confined to very occasional plump type II pneumocytes, and a weak reaction in bronchial lining cells. Macrophages were only weakly stained in either group. It is suggested that TNFα is synthesized (or possibly absorbed) by type II pneumocytes and may be involved in the production of, or recovery from, adult respiratory distress syndrome.
Ultrastructural localization of blood group antigen A in normal and neoplastic urothelium
Authors: LIMAS C. , CUTLER B. , LANGE P.
Published: April 2007

The subcellular distribution of the blood group antigen A in the transitional epithelium of the urinary tract and its neoplastic growths was studied using transmission immuno‐electronmicroscopy. Sixty‐five tissue specimens from 50 blood group A1 patients were processed according to an immunogold procedure which was optimized for preservation of both antigen and ultrastructure. The reactions were stronger in the glycocalyx of the luminal surfaces and at the interdigitating cytoplasmic processes of the cells. In the intracellular compartment the reactions were associated with tubulovesicular membrane‐bound structures and with the Golgi complexes. Secretory products, intra‐ or extra‐cellular, were also positive. The greatest variability was noted in the cell surface reactions, which were positive in 88% of normal but only 41% of neoplastic urothelial specimens. An inverse correlation was found between malignant behaviour and cell surface, but not intracellular, reactions.

We conclude that, in transitional cell carcinomas, there is a quantitative defect in the processing of substance A which affects predominantly the cell surface component and may involve either the transport–insertion steps, the plasma membrane‐associated glycosyltransferases or internalization of blood group antigen A.
CD 30 expression in follicular lymphoma
Authors: PIRIS M. , GATTER K.C. , MASON D.Y.
Published: April 2007

The CD30 antigen is a characteristic phenotypic feature of Sternberg‐Reed and Hodgkin cells and is also found in a subset of large cell non‐Hodgkin's lymphomas. The finding of CD30 positive cells in some centroblastic/centrocytic (cb/cc) follicular lymphomas prompted us to characterize the presence and distribution of CD30 positive cells in this type of lymphoma, using the monoclonal antibody BerH2. CD30 positive cells were present in 17/19 of the cases studied, located mainly at the edge of the neoplastic follicles, but also in some cases in perinodular or T‐cell areas. This distribution resembles that found in reactive tonsils and lymph nodes. The majority of these CD30 positive cells in cb/cc lymphoma seem to be B‐cells, as suggested by their reactivity with B‐cell markers demonstrated by double immunostaining. The nature of these CD30 positive cells is unclear, but they should be taken into consideration in the differential diagnosis of cb/cc lymphoma with lymphocyte predominance Hodgkin's disease.
Intramuscular angioma: a clinicopathological analysis of 74 cases
Authors: BEHAM A. , FLETCHER C.D.M.
Published: April 2007

We have studied 74 benign intramuscular angiomas in order to try and correlate clinical behaviour with histological appearances. The purpose was to find means of predicting those which would recur. Mean age at presentation was 17.6 years and 85% of the cases presented before age 30. The male: female ratio was 1.4:1. Anatomical distribution was 32% lower limb. 27% head/neck, 24% upper limb and 17% trunk. Reliable histological subclassification proved impossible since almost all lesions were of mixed type, albeit often with a single predominant vessel type—of which venous (42%) was the most common. Over 90% of the lesions contained a variably prominent adipocytic component. More than 50% of patients suffered local recurrence. Neither predominant vessel type nor anatomical localization correlated with recurrence, which was always due to incomplete excision.
Histological features in liver biopsy specimens of patients with acute reactivation of chronic type B hepatitis
Authors: VILLARI D. , RAIMONDO G. , BRANCATELLI S. , LONGO G. , RODINÒ G. , SMEDILE V.
Published: April 2007

The histological features in liver biopsy specimens from seven patients with acute exacerbation of chronic type B hepatitis were analysed. In all the cases typical changes of acute hepatitis were superimposed on signs of chronicity, namely peripheral piecemeal necrosis, plasma cell infiltration and porto‐portal bridges, which in three cases contained elastic fibres. Reactivation of silent hepatitis B virus chronic infection should be considered as a possible diagnosis in any patient with histological findings of acute and chronic hepatitis.
Laryngeal paragangliomas and neuroendocrine carcinomas
Authors: MILROY C.M. , RODE J. , MOSS E.
Published: April 2007

Forty‐eight neuroendocrine tumours of the larynx were studied, of which 41 were classified as large cell neuroendocrine carcinoma. Most of these tumours occurred in the supraglottic larynx and the patients were predominantly male. Exquisite pain was a presenting feature in one third. These carcinomas metastasized, frequently to skin, giving rise to painful secondary lesions, but long‐time survival occurred. Histologically, large cell neuroendocrine carcinoma had a number of features seen in neuroendocrine tumours at other sites, including grouping into ‘Zellballen’ which mimics paraganglioma. Four tumours were definite paragangliomas. These tumours have behaved benignly. There were three cases of small cell neuroendocrine carcinoma, a tumour which is histologically identical to its counterpart in the bronchus and has a very aggressive course. All three types of tumour expressed general neuroendocrine markers, but only large cell neuroendocrine carcinoma marked for both cytokeratin and calcitonin. In the paraganglioma cases sustentacular cells were identified and marked for S‐100 protein and glial fibrillary acidic protein. Histological examination, supplemented with immunohistochemistry, helped distinguish these tumours into those requiring different treatment regimens.
Determination of proliferating fractions in malignant melanomas by anti‐PCNA/cyclin monoclonal antibody
Authors: TAKAHASHI H. , STRUTTON G.M. , PARSONS P.G.
Published: April 2007

An immunohistochemical study of melanocytic tumours using 19A2, a monoclonal antibody against proliferating cell nuclear antigen (PCNA/cyclin), was performed on tissues routinely processed with formalin fixation and paraffin embedding. In normal skin, keratinocytes of the suprabasal region in epidermis, the papillae and outer root sheath of hair follicles and the basal cells lining the lobules of sebaceous glands were stained in the nucleus. Other skin components, including basal and follicular melanocytes, did not demonstrate nuclear labelling. In addition, expression of PCNA/cyclin in keratinocytes was higher in sun‐exposed skin compared with unexposed skin. In melanocytic lesions, PCNA/cyclin positive tumour cells increased in number and staining intensity according to the following progression: common melanocytic naevi; dysplastic naevi; primary melanomas; and metastatic melanomas. Expression of PCNA/cyclin, therefore, provides a useful marker for proliferation and tumour progression in skin.
Heterotopic glial nodules: a light microscopic and immunohistochemical study
Authors: THEAKER J.M. , FLETCHER C.D.M.
Published: April 2007

The clinical, light microscopic and immunohistochemical features of 14 heterotopic glial nodules are described. In keeping with previous experience, most cases were located around the nose and had been present since birth. However, several lesions presented as cutaneous nodules elsewhere and, in some, presentation was delayed into childhood or even adulthood. The histological diagnosis is usually uncomplicated, but we draw attention to a variant with a markedly sclerosed stroma in which the glial cells are relatively inconspicuous. Such lesions tend to be found in older subjects and can cause problems in diagnosis. We emphasize the value of immunohistochemical demonstration of glial fibrillary acidic protein in the diagnosis of these lesions, especially the sclerotic variant. Other immunohistochemical features include the presence of axons in most cases and cell bodies in some, emphasizing the mixed nature of these lesions. A meningeal component could not be demonstrated immunohistochemically, even at the edge of the lesions.
The temporal bone: an organ in search of a Histopathology
Authors: MICHAELS L.
Published: April 2007

The pathology of the temporal bone and the inner ear in particular has been a neglected area for histopathologists. This review sets out to answer a number of questions on the topic: why is it neglected: how do you learn its anatomy: how do you process it: why do it: and who should do it? The histopathological features of cholesteatoma, otosclerosis and presbyacusis are discussed in detail and future areas of research are identified.
Expression of the intestinal T‐lymphocyte associated molecule HML‐1: analysis of 75 non‐Hodgkin's lymphomas and description of the first HML‐1 positive T‐lymphoblastic tumour
Authors: FALINI B. , FLENGHI L. , FAGIOLI M. , PELICCI P.‐G. , STEIN H. , BIGERNA B. , PILERI S. , MARTELLI M.F.
Published: April 2007

The expression of the gut intra‐epithelial T‐cell associated molecule HML‐1, a trimeric protein of 150, 125, 105 kD, was studied in 75 T‐cell lymphomas of different subtypes: 20 T‐lymphoblastic lymphomas/leukaemias; 50 nodal peripheral T‐cell lymphomas; and five intestinal T‐cell lymphomas. Our results confirm: (i) the usefulness of the HML‐1 monoclonal antibody as an immunohistochemical marker for intestinal T‐cell lymphomas; and (ii) the lack of reactivity of HML‐1 with nodal peripheral T‐cell lymphomas. Moreover, expression of the HML‐1 molecule was found for the first time in a case of T‐lymphoblastic lymphoma/leukaemia. The patient presented with a mediastinal mass which consisted of HML‐1 + neoplastic cells displaying a phenotypic profile consistent with early thymocytes. Genes coding for the α, β, γ, and δ chains of the T‐cell receptor were in a germline configuration. The neoplastic cells could have been derived from the small subset of HML‐1 + thymocytes detectable in the cortex of normal human thymus.
Immunohistochemical staining for ferritin in neuroblastomas
Authors: CARTER R.L. , HALL J.M. , CORBETT R.P.
Published: April 2007

Immunohistochemical staining for ferritin was examined in 35 neuroblastomas from 27 children and compared with serum ferritin levels. All but two of the patients presented with advanced (stages III and IV) disease, and the adrenal was the most common primary site (20/27, 74%). Immunostaining was positive in only one of 14 tumour biopsies taken at the time of diagnosis (7%), but eight of 21 neuroblastomas (38%) marked for ferritin after chemotherapy. No consistent association was established between tumour‐ and serum‐associated ferritins in the untreated or treated groups. Ferritin staining in treated neuroblastomas was usually more marked in partly differentiated tumour cells. The increased frequency of ferritin positive neuroblastomas after chemotherapy appeared to be associated with large local accumulations of ferritin and haemosiderin within the treated tumours, and (probably) with the blood transfusions which these children received.
Lymphoid follicular hyperplasia–a distinctive feature of diversion colitis
Authors: YEONG M.L. , BETHWAITE P.B. , PRASAD J. , ISBISTER W.H.
Published: April 2007

Diversion colitis refers to the inflammatory changes that occur in the defunctioned segment of the large intesting following diversion of the faecal stream. We report the histological features in the defunctioned rectums from seven patients: one each with severe constipation and Behcet's disease, two with Crohn's disease with rectal sparing and three with ulcerative colitis. The appearances of diversion colitis in a previously normal rectum are compared with diversion colitis with superimposed inflammatory bowel disease. Lymphoid follicular hyperplasia was found in all cases. This was marked in patients with inflammatory bowel disease. with or without initial rectal involvement. Other changes comprised surface epithelial degeneration and ulceration, mucosal inflammation including crypt abscesses, and crypt branching. Inflammatory and crypt changes were mild, except in ulcerative colitis where changes were marked and resembled those of the proximal colon. Lymphoid hyperplasia is a distinctive feature in diversion colitis. The term follicular proctitis, previously used to indicate chronic ulcerative colitis exclusively, should be re‐examined.
Wilms' tumour associated with deep cystic nephroma‐like changes: three cases of a putative Wilms' tumour precursor
Authors: WALFORD N. , DELEMARRE J.F.M.
Published: April 2007

We describe three cases of Wilms' tumour accompanied by central pericalyceal multicystic lesions closely resembling those seen in cystic nephroma. In continuity with these lesions or elsewhere in the kidney were areas of dydysplastic renal tissue of the type sometimes referred to as intralobar nephroblastomatosis. A close homology of tissue differentiation was observed between the dysplastic lesions and the interstitial components of the cystic lesion. These findings support the hypothesis that, in some cases at least, cystic nephroma has more in common with the group of dysplastic lesions referred to as the nephroblastomatosis complex than with the true renal tumours of childhood.
Bone marrow diagnosis in lymphoproliferative disorders: comparison of results obtained from conventional histomorphology and immunohistology
Authors: THALER J. , DIETZE O. , DENZ H. , DEMUTH R. , NACHBAUR D. , STAUDER R. , HUBER H.
Published: April 2007

In this study we have investigated 313 bone marrow biopsies from 280 patients with lymphoproliferative disorders. Trephines were sectioned transversely to obtain one cylinder for cryostat sectioning and immunostaining and a second for histomorphological evaluation using a plastic‐embedding technique. The results obtained by histomorphological and immunohistological evaluation were compared for their contribution to staging and classification.

Using both techniques, bone marrow involvement was seen in 3/43 (7.0%) biopsies from patients with Hodgkin's disease and in 193/270 (71.5%) cases with non‐Hodgkin's lymphoma, including multiple myeloma and acute lymphocytic leukaemia. Immunohistology proved superior in detecting minimal mainly interstitial bone marrow infiltration in 15 leukaemia/lymphoma cases.

Biopsies showing infiltration with both methods (n= 157) were re‐examined for classification of lymphomatous infiltrates. Whereas immunohistology did not provide additional information in cases with Hodgkin's disease and myeloma, this method was crucial for establishing the definitive diagnosis in a number of cases with acute lymphocytic leukaemia and non‐Hodgkin's lymphoma. In all of six leukaemia cases, in which no or inadequate material was available for immunophenotyping of cell suspensions, immunohistology clearly defined the subtype. In the 140 cases of non‐Hodgkin's lymphoma the majority of cases (76.4%) were identically classified. In some cases, with important prognostic and therapeutic implications, immunohistology alone provided the definitive diagnosis: T‐cell lymphoma (n= 2), hairy cell leukaemia (n= 2) and centrocytic non‐Hodgkin's lymphoma (n= 3).

Bone marrow immunohistology is, therefore, an important supplement for classical lymphoma/leukaemia diagnosis. The differences observed between histomorphology and immunohistology emphasize the importance of lymph node biopsy in lymphoma classification.
Smooth muscle tumours of the external genitalia: clinicopathological analysis of a series
Authors: NEWMAN P.L. , FLETCHER C.D.M.
Published: April 2007

Smooth muscle tumours of the external genitalia (vulva, scrotum and nipple) are uncommon and have received little attention in the literature. Given their purported close relationship to cutaneous (pilar) leiomyomatous lesions, we have studied 32 cases (18 vulva, 10 scrotum, four nipple) from 31 patients in order to compare clinicopathological features at the different sites. Only those in the nipple were comparable in size and histology to pilar leiomyomas. Vulval and scrotal tumours tended to be much larger and better circumscribed. Purely epithelioid lesions were only identified in the vulva (two cases) and at this site myxoid change and hyalinization were substantially more common. Almost all cases showed immunohistochemical evidence of muscle differentiation. On histological grounds, nine cases were classified as leiomyosarcoma (six scrotum, three vulva) but only one of the five with follow‐up has led to the patient's death. With the exception of nipple lesions, which are particularly uncommon, we would not support the traditional inclusion of genital smooth muscle tumours under the general heading of cutaneous leiomyoma/sarcoma, as vulval and scrotal lesions are clinicopathologically quite different.
Recently characterized vascular tumours of skin and soft tissues
Authors: TSANG W.Y.W. , CHAN J.K.C. , FLETCHER C.D.M.
Published: April 2007

This review summarizes the clinicopathological features of a number of vascular tumours that have been characterized only in recent years. These include: glomeruloid haemangioma. a multifocal vascular lesion associated with POEMS syndrome; Kaposi‐like infantile haemangioendothelioma, a borderline malignant tumour occurring in the retroperitoneum of infants, mimicking Kaposi's sarcoma histologically; giant cell angioblastoma, characterized by proliferated vessels with a granuloma‐like appearance; benign lymphangioendothelioma (progressive lymphan‐gioma), a slowly‐growing macule or plaque over the trunk or limb, mimicking low‐grade angiosarcoma histologically; largetoid haemosiderotic haemangioma. a benign lesion with a distinctive annular appearance and histologically overlapping with benign lymphangioendothelioma; spindle cell haemangioendothelioma, a lesion located mostly in the distal extremities, characterized by cavernous vascular spaces, spindle cells with interspersed narrow vascular channels and scattered plump vacuolated endothelial cells; acquired tufted angioma. characterized by ‘cannon‐ball’; involve aent of the dermis by lobules of pericyte‐rich capillaries: sinusoidal haemangioma, a distinctive variant of cavernous haemangioma which may be confused with angiosarcoma; and epithelioid angiosarcoma, a highly aggressive tumour of deep soft tissue mimicking metastatic carcinoma and co‐expressing endothelial and epithelial markers.
Plexiform fibrohistiocytic tumour: clinicopathological, immunohistochemical and ultrastructural analysis in favour of a myofibroblastic lesion
Authors: HOLLOWOOD K. , HOLLEY M.P. , FLETCHER C.D.M.
Published: April 2007

Plexiform fibrohistiocytic tumour is a recently described, seemingly benign neoplasm of superficial soft tissue which is poorly recognized and the differentiation pattern of which remains obscure. Fourteen new cases are presented here. These presented predominantly in the upper limb of infants and children, although the age‐range was wide. A morphological spectrum depending on the relative proportions of the spindle cellular and nodular histiocyte‐like components was evident. Immunohistochemical analysis revealed positivity of tumour cells in both components for smooth muscle actin. suggestive of myofibroblastic differentiation, as was borne out ultrastructurally in two cases. In addition, a minority of the histiocyte‐like cells were also CD68 positive but negative for leucocyte common antigen. HLA‐DR, Mac387 and lysozyme. In view of the ultrastructural and other immunohistochemical results, this is regarded as further evidence that the CD68 epitope recognized by KP‐1 is not confined to cells of monocyte/ macrophage or myeloid lineage. Plexiform fibrohistiocytic tumour appears to be a clinicopathologically distinctive myofibroblastic neoplasm which may warrant reclassification in due course.
Urinary bladder carcinoma with a neoplastic squamous component: a mapping study of 31 cases
Authors: SAKAMOTO N. , TSUNEYOSHI M. , ENJOJI M.
Published: April 2007

A mapping study of cystectomy specimens in three cases of pure squamous cell carcinoma and 28 cases with transitional cell carcinoma with squamous differentiation is described, with an emphasis on the histogenesis of pure squamous cell carcinoma. Two of the three cases of pure squamous cell carcinoma had extensive benign keratinizing mucosa and an atypical squamous metaplastic mucosa contiguous with the tumour. These pure squamous cell carcinomas seemed to be derived from the squamous metaplasia. On the other hand, in all except one of the cases of transitional cell carcinoma with squamous differentiation, there was neither benign keratinizing nor atypical squamous metaplastic mucosa in the bladder.

The quantitative amounts of both the transitional cell and squamous components differed from case to case in 28 cases with transitional cell carcinoma with squamous differentiation. Five of the 28 had a tumour composed predominantly of a squamous component with minute transitional cell components at the margin. In another two cases, transitional carcinoma in situ or satellite tumours of transitional cells were present adjacent to the main tumour which was composed of squamous cell carcinoma alone. We think these seven tumours originated as a result of extensive squamous differentiation in the transitional cell carcinomas. These features may indicate two forms of histogenesis of pure squamous cell carcinoma. The first is malignant transformation on the basis of squamous metaplasia of the bladder mucosa and the second is extensive squamous differentiation in a pre‐existing transitional cell carcinoma.
Metastatic prostatic carcinoma presenting as left‐sided cervical lymphadenopathy: a series of 11 cases
Authors: JONES H. , ANTHONY P.P.
Published: April 2007

Eleven cases of metastatic prostatic carcinoma in cervical lymph nodes as a primary presenting sign were identified in a survey of 250 cervical lymph node biopsies from men. The diagnosis was clinically unsuspected in all cases. All occurred on the left side of the neck. These 11 cases represented 11% of all metastatic carcinomas in the neck and 20% of those with left‐sided involvement. The diagnosis was readily confirmed by immunostaining for prostate specific antigen and prostate specific acid phosphatase. Six patients are alive and well at an average of 25·8 months and five others survived for an average of 34·4 months, the combined survival being 29·7 months. This contrasts with the dismal fate of patients with metastatic adenocarcinoma from other sites who all died at an average of 2 months from diagnosis. Prostatic carcinoma should always be considered in the differential diagnosis of metastatic carcinoma in cervical lymph nodes in elderly men, as appropriate treatment results in worthwhile prolongation of life.
Collecting duct carcinoma: cytogenetic characterization
Authors: FÜZESI L. , COBER M. , MITTERMAYER CH.
Published: April 2007

Most renal cell carcinomas are assigned to either the papillary or clear cell, non‐papillary type by morphological and cytogenetic criteria. In rare cases, papillary carcinomas of the kidney have been classified as collecting duct carcinoma because of their medullary localization and the associated hyperplastic and dysplastic epithelial lesions of collecting ducts in the vicinity of the tumour. In this first report on the cytogenetics of collecting duct carcinoma, we describe unique and consistent chromosomal aberrations in three cases. Each of the three tumours showed monosomies for chromosomes 1, 6, 14, 15, and 22. This suggests that collecting duct carcinoma is the third type of kidney tumour whose definition is based on morphological as well as on cytogenetic criteria. It appears to be cytogenetically different from the cortical papillary kidney tumour which exhibits trisomy 17 and tri‐ or tetrasomy 7, and from the non‐papillary renal cell carcinoma which characteristically presents deletion of the short arm of chromosome 3.
Diagnostic difficulties in ‘non‐mycotic’ cutaneous lymphoproliferative diseases
Authors: SLATER D.N.
Published: April 2007

The diagnosis of cutaneous lymphoproliferative diseases is an area of bewildering complexity to many histopathologists. This article concentrates on ‘non‐mycotic’ cutaneous diseases. The ‘current state of the diagnostic art’ is critically assessed. Cutaneous ‘pseudolymphoma’ is relegated to the position of an aid‐memoire and is not a diagnosis. Inadequacies in the classification of cutaneous lymphoma are discussed and the non‐specificity of many histopathological features is highlighted. The status of specific entities is analysed and the contribution of modern investigative techniques in diagnosis is evaluated. This includes cutaneous T‐cell lymphomas with a detailed consideration of large cell lymphoma heterogeneity. Cutaneous B‐cell diseases are shown to be an unresolved diagnostic maze and the necessity for new clearly defined diagnostic criteria is emphasized. Evidence is presented to show that many cutaneous lymphoproliferative diseases lie on continuous spectra that, initially, are probably antigenically driven, and that a diagnosis is best achieved by a multifaceted approach. This is exemplified by cutaneous diseases that have origins from both B‐ (cutaneous lymphoid hyperplasia/lymphoma) and T‐cells (lymphomatoid papulosis, lymphomatoid granulomatosis and mycosis fungoides). The future diagnostic role of the polymerase chain reaction and cytogenetic analysis is discussed. Intriguingly, recent molecular evidence has shown that lymphomatoid papulosis, cutaneous T‐cell lymphoma, CD30 positive large cell lymphoma and Hodgkin's disease can originate from a single T‐cell clone and display an identical chromosomal translocation and T‐cell receptor rearrangement. Careful clinico‐pathological correlation combined with prolonged patient follow‐up remains the gold standard for diagnosis.
A major solid undifferentiated carcinoma pattern correlates with tumour progression in locally advanced prostatic carcinoma
Authors: GAFFNEY E.F. , O'SULLIVAN S.N. , O'BRIEN A.
Published: April 2007

Solid undifferentiated carcinoma was the major microscopic pattern in 24 prostatic carcinomas, 12 of which were clinically recurrent. Tumour cells were uniform, with moderately hyperchromatic nuclei and indistinct cytoplasm, and were arranged in solid or focally irregular aggregates. In areas, the tumour cells were large with vesicular nuclei, nucleoli and more abundant cytoplasm. In previous specimens, solid undifferentiated carcinoma was absent or was a minor pattern. Twenty of 23 cases showed prostate specific antigen and prostatic acid phosphatase immunoreactivity, and nine of 17 cases contained scattered argyrophilic or chromogranin‐immunoreactive cells. On proliferating cell nuclear antigen immunostaining of 12 specimens, the mean tumour proliferative fraction in solid undifferentiated carcinoma (range: 10.5‐18%) was greater than in areas of grade 3 prostatic carcinoma (range: 3‐6%). In all 22 stage C and D cases, there was a close correlation with clinical evidence of tumour progression, and the overall 2‐year survival rate was only 16.7%. It is concluded that a major solid undifferentiated pattern correlates with increased biological aggressiveness and a poor prognosis in locally advanced prostatic carcinoma.