bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of epithelial markers in sarcomatoid carcinoma: an immunohistochemical study
Authors: OGAWA K. , KIM Y‐C. , NAKASHIMA Y. , YAMABE H. , TAKEDA T. , HAMASHIMA Y.
Published: April 2007

Thirty‐four cases of sarcomatoid carcinoma with minimal epithelial components (SC) and six cases of sarcomatous tumour without any epithelial component (ST) in various organs were studied by the immunoperoxidase technique for the expression of epithelial markers, cytokeratins and epithelial membrane antigen (EMA). Employing antibodies against both high and low molecular weight cytokeratins, sarcomatoid components in 30 examples of SC were stained positively. Epithelial membrane antigen was demonstrated in 19 out of 34 SC. The positive cells for epithelial markers within sarcomatoid components in some cases of SC, which were regarded as originating from squamous cell carcinoma, tended to be seen less frequently than in the tumours derived from adenocarcinoma or transitional cell carcinoma. In six cases of ST, stain for EMA was negative and stain for cytokeratins was positive in three examples. The immunohistochemical examination of epithelial markers in the tumours of these types may be of value in differentiating these tumours from true sarcomas.
Pulmonary alveolar microlithiasis. A new analytical approach
Authors: BARNARD N.J. , CROCKER P.R. , BLAINEY A.D. , DAVIES R.J. , ELL S.R. , LEVISON D.A.
Published: April 2007

A case of pulmonary alveolar microlithiasis is presented which has been investigated using X‐ray energy spectroscopy and microscopic infrared spectroscopy. These methods gave precise details of the chemical composition of the microliths seen in this unusual disease. The pathogenesis of this disorder is discussed in the light of these findings.
Modification of caecal lymphoid tissue and relationship to granuloma formation in sporadic ileocaecal tuberculosis
Authors: GAFFNEY E.F. , CONDELL D. , MAJMUDAR B. , NOLAN N. , MCDONALD G.S.A. , GRIFFIN M. , SWEENEY E.C.
Published: April 2007

The histopathology of eight cases of sporadic ileocaecal tuberculosis is described with particular reference to caecal lymphoid tissue. Adjacent to areas of ulceration in all cases there was an increase in lymphoglandular complexes (LGC) and proliferation of paravascular lymphoid aggregates deeper in the gut wall. Early and fully‐developed granulomas were present in locations comparable to LGC and lymphoid aggregates. Immunocytochemical staining of paraffin sections with monoclonal antibodies UCHL1 (T‐lymphocyte membrane antigen) and LN‐1, LN‐2 and LN‐3 (B‐lymphocyte and Ia antigens) showed that central cells in LGC and lymphoid aggregates stained like follicular centre B‐lymphocytes. Both LGC and lymphoid aggregates had a distinct peripheral rim of cells staining as T‐lymphocytes, but LN‐2 and LN‐3 also stained scattered peripheral cells, some of which were recognizable as interdigitating reticulum cells. Most lymphocytes within and around granulomas stained as T‐lymphocytes. In lymph nodes, granulomas appeared to occur first at the periphery of, and later to efface, cortical follicles. Lymph node compartments showed the expected T‐ and B‐zonation, and lymphocytes associated with granulomas stained as in caecal granulomas. Our observations suggest that LGC are sites of mycobacterial antigen sampling, of T‐lymphocyte and macrophage activation, and of (potential) granuloma formation in ileocaecal tuberculosis. Lymphoid aggregates deeper in the gut wall probably subserve a similar function during extension of the lesion. The location of both LGC and lymphoid aggregates beside lymphatics is suited to the transfer of their cellular constituents throughout the gut and to regional lymph nodes.
Stromal cells in cerebellar haemangioblastomas: an immunocytochemical study
Authors: IRONSIDE J.W. , STEPHENSON T.J. , ROYDS J.A. , MILLS P.M. , TAYLOR C.B. , RIDER C.C. , TIMPERLEY W.R.
Published: April 2007

The nature of the stromal cells in formalin‐fixed paraffin‐embedded material from 23 cerebellar haemangioblastomas was investigated using antisera to intermediate filaments (glial fibrillary acidic protein, vimentin and desmin), histiocytic markers (α1‐antitrypsin, α1‐antichymotrypsin and lysozyme), glycolytic enzymes (alpha and gamma enolase and aldolase C4) and the endothelial markers, factor VIII related antigen and Ulex europaeus I lectin. Most stromal cells stained positively for vimentin and the glycolytic enzymes. Occasional process‐bearing cells within the stroma stained strongly for glial fibrillary acidic protein, α1‐antitrypsin and α1‐antichymotrypsin. No stromal cell staining for desmin, lysozyme or the endothelial markers was observed, although the latter stained the vascular endothelium within all neoplasms. The findings do not support previous suggestions of an endothelial or histiocytic origin for the stromal cells. They appear to be a heterogeneous population including entrapped reactive astrocytes and locally‐derived non‐angiogenic cells of neuroectodermal (pial) origin.
Intramuscular and intermuscular lipoma: neglected diagnoses
Authors: FLETCHER C.D.M. , MARTIN‐BATES E.
Published: April 2007

Fifty‐four cases of lipoma arising either within or between skeletal muscles are presented. Of these, 52 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. Intramuscular lipomas account for 1.8% of fatty tumours, arise predominantly in middle to late adult life and, in our series, are commonest on the trunk. They may be divided into infiltrative and well‐circumscribed types, respective local recurrence rates being 19 and 0%. Intermuscular lipomas are comparatively rare, 0.3% of fatty tumours, have a similar age distribution and arise most often in the anterior abdominal wall; none of the seven cases recurred. It is important that both pathologists and surgeons appreciate the significant tendency of infiltrative intramuscular lipomas to recur. Hence, preventative surgical measures may be undertaken and worries that the lesion may be sarcomatous can be avoided. Differential diagnosis, most importantly from well‐differentiated liposarcoma, is discussed.
Pigmented neuroectodermal tumour of infancy: an immunohistochemical study
Authors: STIRLING R. W. , POWELL G. , FLETCHER C. D. M.
Published: April 2007

The pigmented neuroectodermal tumour of infancy is a rare neoplasm of uncertain histogenesis which, in the majority of cases, arises in the maxilla and pursues a benign course. Currently, it would be classified in the group of peripheral primitive neuroectodermal tumours. Histologically it is composed of two principal cell types: neuro‐blast‐like and melanocyte‐like. Three typical cases are presented herein, which appear to be the first examined with a panel of antibodies. The neuroblast‐like cells labelled positively for neurone‐specific enolase but were negative for S‐100, neurofilaments, glial fibrillary acidic protein, vimentin, cytokeratin, epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA). The melanocyte‐like cells stained positively for neurone‐specific enolase, vimentin and cytokeratin but were negative for S‐100, neurofilaments, glial fibrillary acidic protein, EMA and CEA. The significance of these findings is discussed in the light of previous suggestions about the differentiation that these tumours show.
A simple guide to the terminology and application of leucocyte monoclonal antibodies
Authors: CHAN J. K. C. , NG C. S. , HUI P. K.
Published: April 2007

This review aims to provide a simple guide and quick reference to the terminology and diagnostic applications of leucocyte monoclonal antibodies. The differentiation cluster terminology, where applicable, is used throughout.
Histochemistry and electron microscopy in the diagnosis of small mucous cells in carcinoma of the stomach
Authors: HUANG C. B. , LI W. C. , XU J. , ZHANG Y. C.
Published: April 2007

One hundred and two cases of poorly differentiated adenocarcinoma were obtained from 71 surgical and 31 biopsy specimens of the stomach. These tumours produced both intracellular and extracellular mucins, which were demonstrated to be neutral mucins, N‐acetyl sialomucins, sulphomucins and O‐acetyl sialomucins. The majority of tumours (85.3%) secreted two or more kinds of mucins simultaneously, but only a small proportion (14.7%) produced a single kind of mucin. Ultrastructurally, three types of mucin granules were identified; these differed in shape and density. Tumour cells containing intracellular mucins or mucin granules were designated as mucous cancer cells and further subdivided into small, large and goblet mucous cells; tumour cells having neither mucins nor glandular differentiation were designated as undifferentiated cancer cells. These histochemical distinctions, supported by the electron microscopical observations, may be useful to demonstrate early malignant foci in gastric biopsies.
Dedifferentiated chondrosarcoma with muscle and cytokeratin differentiation in the anaplastic component
Authors: DERVAN P. A. , O'LOUGHLIN J. , HURSON B. J.
Published: April 2007

Dedifferentiated chondrosarcoma is a biphasic tumour, comprising well‐differentiated chondrosarcoma and an anaplastic non‐cartilaginous sarcoma juxtaposed but distinct from each other. Two cases of dedifferentiated chondrosarcoma, one primary and one recurrent, demonstrated muscle differentiation when studied with monoclonal antibodies to muscle specific actin, desmin and myoglobin. One of the tumours was also positive for cytokeratin, identified by AE1/AE3 and CAM 5.2 antibodies. Our findings are consistent with the concept that these tumours are capable of diverse patterns of morphological and immunophenotypic differentiation.
Primary pulmonary lymphoma: a re‐appraisal of its histogenesis and its relationship to pseudolymphoma and lymphoid interstitial pneumonia
Authors: ADDIS B. J. , HYJEK E. , ISAACSON P. G.
Published: April 2007

The clinical, morphological and immunohistochemical features of 15 cases of pulmonary lymphoproliferative disease are described. The diagnosis of primary pulmonary lymphoma was based in 13 cases on the demonstration of light chain restriction and in two cases on morphological characteristics. Many patients had a prolonged clinical course without significant clinical or radiographic deterioration, a feature associated with malignant lymphomas of mucosa‐associated lymphoid tissue in other sites. Lympho‐epithelial lesions were characteristic and malignant cells had the features of centrocyte‐like cells, similar to those described in gastric and salivary gland lymphomas. Germinal centres were present in three cases: some were partially overgrown by centrocyte‐like cells but residual polyclonal follicle centre cells and dendritic reticulum cells were still detectable. It is suggested that primary pulmonary lymphoma arises from centrocyte‐like cells normally present in bronchus‐associated lymphoid tissue. In addition to the malignant population, reactive follicles and polytypic plasma cells are frequently present and may prejudice interpretation of immunohistochemical features. In the light of these findings, cases previously diagnosed as pseudolymphoma or lymphoid interstitial pneumonia require careful assessment and the majority are, in reality, examples of primary pulmonary lymphomas.
Paraffin section immunohistochemistry. I. Non‐Hodgkin's lymphoma
Authors: HALL P. A. , D'ARDENNE A. J. , STANSFELD A. G.
Published: April 2007

Reagents that recognize antigens on lymphoid cells in fixed and wax‐embedded sections have been applied to a series of cases of non‐Hodgkin's lymphomas. The panel consisted of MB1, 4KB5 (CD45r), LN1, L26 and MB2 which recognize antigens expressed predominantly on B‐lymphocytes; UCHL1 and MT1 which recognize antigens expressed on T‐lymphocytes and myeloid cells; antibodies recognizing the non‐lineage antigens LeuM1 (CD15), BerH2 (CD30), anti‐EMA; anti‐lysozyme and MAC 387 which detect antigens present on some macrophages; and finally TAL1B5 (class II MHC), CAM 5.2 (low molecular weight cytokeratin) and PD7/26+2B11(CD45). Two hundred and four cases of non‐Hodgkin's lymphoma have been studied, of which 158 had been fully characterized on frozen sections. The series was biased towards high‐grade (n=108) and T‐cell (n=44) tumours and these were largely prospectively accrued. It was found that discrimination between B‐cell and T‐cell lymphomas can be reliably achieved using these reagents and that a small panel (CD45, L26, MB2, MT1, UCHL1) is adequate for this purpose. Using the full range of reagents it is not possible to subdivide cases into groups that correspond with morphological subtypes of lymphoma. Although paraffin section immunohistochemistry is of value, the diagnosis of lymphoproliferative disorders must still be based upon the assessment of well fixed, carefully prepared tissue sections using conventional tinctorial methods.
Collagenous colitis: an electron microscopic study including comparison with the chronic fibrotic stage of ulcerative colitis
Authors: BALÁZS M. , EGERSZEGI P. , VADÁSZ G. , KOVÁCS Á.
Published: April 2007

Light and electron microscopic studies of 14 cases of collagenous colitis are reported. Comparative electron microscopic examinations were carried out on 13 cases of ulcerative colitis in the chronic fibrotic stage of the disease. Separation of pericryptal fibro‐blasts which showed enhanced fibre‐forming activity, proliferation of myofibroblasts, accumulation of mast cells and a pericapillary collagen accumulation were noted in both groups. Based on these results, collagenous colitis was considered to result from scar formation secondary to previous superficial inflammation.
Observer variation in the assessment of dysplasia in ulcerative colitis
Authors: DIXON M. F. , BROWN L. J. R. , GILMOUR H. M. , PRICE A. B. , SMEETON N. C. , TALBOT I. C. , WILLIAMS G. T.
Published: April 2007

Six histopathologists allocated 100 sections from patients with long‐standing ulcerative colitis into four diagnostic categories, regular hyperplasia, reactive atypia, low‐grade and high‐grade dysplasia. Their allocations were analysed using kappa statistics, including Fleiss's multiple kappa for groups of observers, and agreement on specific diagnoses was explored by constructing a conditional probability matrix. The nature of their disagreements was investigated using coefficients for systematic and haphazard errors. Over the four diagnostic categories there was a wide range of pairwise agreement from a low of 49% up to 72% and kappa values were only ‘fair’ or ‘moderate’. As expected, agreement over the two categories ‘dysplasia’vs‘no dysplasia’ was better, ranging from 68% to 84%, and for ‘atypia present’ (reactive atypia, low‐ and high‐grade dysplasia) vs‘no atypia’ two pairings achieved over 90% and 11 pairings over 80% agreement. In view of its clinical importance, conditional agreement on high‐grade dysplasia was examined. Given that a first observer allocates a case as high‐grade dysplasia, pairwise agreement on this diagnosis ranged from 100% down to as low as 33%. However, most of these disagreements fell into the low‐grade dysplasia category so that closer follow‐up and further biopsies would still have been indicated. It is a truism that the basis for safe management is careful co‐operation between clinicians and pathologists who have all the relevant facts and who know and trust one another's judgement. Thus, several aspects of the ideal diagnostic process cannot be evaluated in inter‐observer studies and the element of artificiality should be borne in mind when applying the findings to diagnostic practice. Nevertheless, the low level of agreement on the diagnosis of high‐grade dysplasia achieved by certain pairings of specialist pathologists is a disturbing outcome of this study. Inaccuracies should be minimized by a concensus approach and we therefore recommend referral of putative cases of dysplasia to interested pathologists for further opinions. We would also advocate that pathologists faced with appearances which are indefinite between reactive atypia and dysplasia, would do better to describe them in terms of ‘atypia, significance uncertain’, so that closer surveillance is undertaken, rather than force them into more precise diagnostic categories which may be incorrect.
High iron diamine–alcian blue mucin profiles in benign, premalignant and malignant colorectal disease
Authors: ALLEN D. C. , CONNOLLY N. S. , BIGGART J. D.
Published: April 2007

The presence of mucosal hyperplasia and sialomucin goblet cell secretion (transitional mucosa) was assessed in various benign, premalignant and malignant colorectal tissues. Transitional mucosa was seen in diverticular disease, solitary ulcer syndrome of the rectum, ischaemic and irradiation colitis and other diseases including pneumatosis coli, endometriosis, haemorrhoids and a colostomy margin. Adenocarcinomas had a sulphomucin or mixed secretion pattern with transitional features in the adjacent mucosa (18/27). Premalignant adenomatous polyps showed mixed secretion with transitional glands incorporated in the stalk and sometimes in the adjacent mucosa. Epithelium showing dysplasia secreted sulphomucins and in amounts related to its degree of differentiation. Transitional mucosa may not be a primary premalignant phenomemon. The conclusion and unifying concept is that it is a secondary event related to goblet cell immaturity. This can occur, secondary to proliferation in mucosal inflammation, ischaemia and prolapse or as a phenotypic expression of growth derived from underlying dysplastic epithelium.
High‐grade non‐Hodgkin's lymphoma complicating polypoid nodular lymphoid hyperplasia and multiple lymphomatous polyposis of the intestine
Authors: HARRIS M. , BLEWITT R. W. , DAVIES V. J. , STEWARD W. P.
Published: April 2007

Three patients with multiple lymphoid polyps of the small intestine—two with nodular lymphoid hyperplasia and one with multiple lymphomatous polyposis—developed high‐grade B‐cell lymphomas. A literature search has revealed only 10 previous cases of nodular lymphoid hyperplasia complicated by lymphoma and none of an association between multiple lymphomatous polyposis and high‐grade lymphoma.
Diagnostic reliability of histological and cytological fine needle biopsies from focal liver lesions
Authors: GLENTHØJ A. , SEHESTED M. , TORP‐PEDERSEN S.
Published: April 2007

In 175 consecutive cases of ultrasonically detected focal liver lesions both cytological and histological fine needle biopsies were performed using two different 0.6 mm needles. The cytological and histological material was evaluated blindly and separately by two examiners, who had no access to clinical data. In 65 cases a reliable final diagnosis as defined by autopsy or surgical biopsy within 6 months could be reached. Eleven cases of benign liver lesions were correctly classified by the two examiners by both cytological and histological fine needle biopsies, resulting in a predictive value of 100% for a malignant diagnosis. The predictive value for a benign diagnosis was 85% for both examiners' evaluation of cytological fine needle biopsies, while it was 73% and 85%, respectively, for histological fine needle biopsies. At reevaluation both sampling error and difficulties in interpretation of biopsies of poor quality were responsible for the false benign diagnosis. The origin of the primary tumour was correctly diagnosed in about 50% of the cases by both techniques. Correct tumour typing could most often be made by both methods in cases of hepatocellular carcinoma, breast carcinoma, colonic carcinoma and small cell carcinoma of the lung.
Immunohistochemical demonstration of leucocyte differentiation antigens on paraffin sections using a modified AMeX (ModAMeX) method
Authors: DELSOL G. , CHITTAL S. , BROUSSET P. , CAVERIVIERE P. , RODA D. , MAZEROLLES C. , BARILLET‐ALARD C. , AL SAATI T. , GORGUET B. , VOIGT J‐J.
Published: April 2007

The AMeX method (cold Acetone fixation with subsequent Methyl benzoate and Xylene treatment and routine paraffin embedding) has been recently revived for simultaneous preservation of morphology of cells and their antigens. We propose a modification of this method (ModAMeX), with the use of proteolytic enzyme inhibitors and low temperature paraffin wax embedding, which results in better preservation of a large number of leucocyte differentiation antigens and diagnostic morphologic detail. T‐cell antigens (CD1, CD2, CD3, CD7 & CD8), B‐cell antigens (CD22), macrophage associated antigens (CD11c, CD14 and others), activation antigens (CD25 and others), as well as some other antigens of diagnostic interest (CD10) were found to be preserved with a staining intensity equal to that of sections of fresh frozen tissue. Although the staining intensity of other T‐cell antigens (CD4 & CD5), B‐cell antigens (CD19, CD21 & CD37), activation antigens (Ki‐1) and nuclear proliferation antigen (Ki‐67) was slightly weaker as compared with frozen sections, this could be corrected by increasing the monoclonal antibody concentration. Staining for heavy and light chains of immunoglobulins was minor, sometimes compromised due to persistence of background staining as a result of extracellular immunoglobulins. The ModAMeX method has the advantages of simplicity, low cost and the possibility of exchange of tissue material between laboratories.
Immunohistochemical study of monoclonal antibody MGD‐1 in gastric carcinoma
Authors: CHAO C. Y. , LIE J. , FAN D. M.
Published: April 2007

This paper reports a pathological and immunohistochemical study of gastric carcinoma for immunoreactivity with a monoclonal antibody, MGD‐1, raised against cells from an adenocarcinoma of stomach. Fifty‐four of 61 gastric carcinomas (89%) were positive for MGD‐1. Metastatic gastric carcinoma in local nodes was positive in all 11 such cases. Out of 40 examples of chronic atrophic gastritis, only three, with mild dysplasia, were positive (7.5%). Forty cases with normal gastric mucosa were negative. The MGD‐1 detection‐rate of well‐ and poorly‐differentiated gastric carcinoma was 85% and 93% respectively. The metastatic cells and cells infiltrating the submucosa and muscular layer were more frequently positive and showed stronger staining with MGD‐1 than those in mucosa. These results show that MGD‐1 possesses a high degree of specificity for gastric carcinoma and could be used diagnostically.
The expression of the CD3 antigen in Hodgkin's disease
Authors: CIBULL M. L. , STEIN H. , GATTER K. C. , MASON D. Y.
Published: April 2007

Tissue from 86 cases of Hodgkin's disease, fixed in formalin and embedded in paraffin, was immunostained for the T‐cell marker CD3. Of these cases, 20 were selected on the basis of previous reactivity of Reed‐Sternberg cells for T‐cell associated antigens in frozen sections whilst the remaining 66 were retrieved from the routine pathology files. Five of the 20 selected cases and 22 of the retrieved cases showed predominantly cytoplasmic positivity in a subpopulation of Hodgkin and Reed‐Sternberg cells. CD3 positive cells were present in all subtypes of Hodgkin's disease including three of nine lymphocyte predominance cases. It therefore appears that some Hodgkin and Reed‐Sternberg cells can express the major T‐cell antigen CD3. Although these findings are open to other interpretations, they are consistent with the hypothesis that at least some cases of Hodgkin's disease arise from activated T‐cells.
Mucinous carcinoma of the breast: further characterization of its three subtypes
Authors: COADY A. T. , SHOUSHA S. , DAWSON P. M. , MOSS M. , JAMES K. R. , BULL T. B.
Published: April 2007

Nineteen cases of mucinous carcinoma of the breast were studied. Twelve tumours were of the pure type, and seven were mixed. All had abundant neutral and acidic mucin, and stained strongly with CAM 5.2. Of the 12 pure mucinous tumours, six were devoid of argyrophilic granules and were S‐100 negative, and only one was CEA positive. All six patients are alive with no evidence of recurrence (mean follow‐up 42 months). The other six pure mucinous tumours were rich in argyrophilic granules. Five of these showed S‐100 positivity and all were CEA positive. One patient developed local recurrence and one died of myocardial infarction with no evidence of tumour recurrence (mean follow‐up 80 months). Of the seven mixed tumours, only one contained an occasional cell with argyrophilic granules and four had variable degrees of CEA positivity. Two patients died and one developed bony metastasis (mean follow‐up 40 months).

Our findings emphasise the microscopic and prognostic differences between the three subtypes of mucinous carcinoma of the breast, and support the concept of dividing pure mucinous tumours into two distinct subtypes. We suggest that the latter subtyping can be qualitatively made on the basis of the presence or absence of argyrophilic granules in the tumour cells.
A case of ovarian fibromatosis with disseminated intra‐abdominal fibromatosis
Authors: ROCHE W. R. , DU BOULAY C. E. H.
Published: April 2007

A case of bilateral ovarian fibromatosis and massive oedema with subsequent intra‐abdominal fibromatosis which underwent an aggressive and fatal course is described. This is the first report of co‐existence of these two conditions and the possible relationship between them is discussed.
Histomorphological variations in systemic AA amyloidosis: clues of AA protein polymorphism
Authors: LOOI L. M.
Published: April 2007

The histological location of amyloid within various organs in 25 cases of systemic AA amyloidosis was studied with a view to determine whether different morphological patterns exist in this category of amyloidosis. Although morphological variations due to progressive severity of disease were observed, there were appreciable variations in the patterns of amyloid deposition in the kidney and spleen that could not be simply explained on those grounds. Eleven (61%) of 18 kidneys examined showed severe glomerular involvement with mild degrees of vascular deposition while the remaining seven showed predominantly vascular involvement. The glomerular pattern appeared to be more ominous, being significantly associated with severe proteinuria or chronic renal failure. In nine (69%) of 13 spleens examined, amyloid was confined to the walls of small and medium‐sized arteries while in the remaining four, vascular involvement was less severe and amyloid was deposited mainly along the reticulin of the white pulp. Possible explanations for these different patterns included resorption and redistribution of amyloid within the body during the course of the disease, and variation in tissue deposition as a manifestation of polymorphism of amyloid proteins. The latter appeared more feasible in view of the recent demonstration of SAA polymorphism and AA heterogeneity in man.
Cytokeratin expression in cervical epithelium: an immunohistological study of normal, wart virus‐infected and neoplastic tissue
Authors: WHITTAKER J. R. , SAMY A. M. J. , SUNTER J. P. , SINHA D. P. , MONAGHAN J. M.
Published: April 2007

In this study using a panel of anticytokeratin antibodies and an indirect immunoper‐oxidase method, we examined cervical squamous epithelia including mature stratified epithelium, immature squamous metaplasia, CIN 1, 2 and 3, wart virus infection and squamous carcinoma. Changes from the normal patterns of staining were inconsistently seen in CIN 1 and 2, but in CIN 3 the changes were more marked, and consisted of a loss of stratification of the staining pattern and a patchy reduction in staining. Invasive carcinomas showed a similar staining pattern to CIN 3 lesions.
Malignant transformation in endometriosis of the urinary bladder
Authors: AL‐IZZI M. S. , HORTON L. W. L. , KELLEHER J. , FAWCETT D.
Published: April 2007

A case of primary intravesical endometrioid carcinoma is described, together with a review of the literature. This represents the fourth reported case of malignant transformation in vesical endometriosis.
Hepatic sinusoidal endothelium: Ulex lectin binding
Authors: PETROVIC L. M. , BURROUGHS A. , SCHEUER P. J.
Published: April 2007

The sinusoidal endothelial cells of human liver can be identified by light and electron microscopy, but there appear to be no specific immunocytochemical markers of these cells. Among specific markers available for vascular endothelial cells in general, Ulex europaeus I lectin (UEA I) is the most sensitive. In the present study, 37 liver biopsies were examined for UEA I binding and for Factor VIII related antigen (F VIII RAg) to determine if sinusoidal endothelial cells were positive. The material included normal liver, biopsies from patients with cirrhosis and biopsies in a variety of other liver diseases. Three embryonal human livers were also included in the immunocytochemical analysis. Eleven oesophageal rings obtained at mechanical transection for variceal bleeding in cirrhotic patients were used as control tissue. Sinusoidal endothelial cells of normal liver did not stain with UEA I, but six of seven with alcoholic cirrhosis and only one of 25 non‐cirrhotic liver specimens (a case of acute hepatitis with bridging necrosis) were positive. In two of the six cirrhoses the sinusoidal endothelial cells were stained for F VIII RAg as well. Embryonal sinusoidal endothelial cells were stained with UEA I but were negative for F VIII RAg. The results of the study confirm that sinusoidal endothelial cells of normal adult human liver are phenotypically different from those lining blood vessels in other sites. In cirrhosis, positive staining may be related to the transformation of hepatic sinusoids into true capillaries and thus be a marker of the severity of physiological disturbance in the liver.
The value of nucleolar organizer region staining in the differential diagnosis of borderline melanocytic lesions
Authors: FALLOWFIELD M. E. , COOK M. G.
Published: April 2007

The technique of silver (Ag) staining of nucleolar organizer region‐associated proteins (AgNORs) has been shown to be of value in differentiating between benign and malignant cells. We have studied 33 borderline melanocytic lesions, in which a diagnosis of melanoma had been seriously considered, in order to assess the value of this technique in a commonly encountered diagnostic situation. We found that benign naevus cells possessed single compact or granular AgNORs, whereas some malignant melanocytes possessed large, often loosely arranged groups of AgNORs. However, the pattern of AgNORs observed in melanocytes of some atypical but benign lesions was also seen in some melanomas. The differential diagnosis of borderline melanocytic lesions is not clarified by use of the AgNOR technique.
Expression of the epithelial L1 antigen as an immunohistochemical marker of squamous cell carcinoma of the lung
Authors: DALE I. , BRANDTZAEG P.
Published: April 2007

The distribution of epithelial L1 antigen was evaluated in 139 bronchogenic carcinomas which had been classified by a panel of pathologists according to the WHO recommendation of 1981. L1 was not found in three large cell and 13 small cell carcinomas, but it was expressed by tumour cells in 67 of 69 squamous cell carcinomas (97%), in three of four adenosquamous carcinomas (75%), and in three of 49 adenocarcinomas (6%). The staining for L1 antigen was more diffusely distributed in the positive adenocarcinomas than in the squamous cell carcinomas. Its expression in squamous cell carcinomas was typically confined to relatively small tumour cell groups and never included a complete specimen. Semi‐quantitative estimation of the immunostaining showed no clear relationship to the degree of differentiation and scores for proliferation, but L1 expression was negatively related to nuclear aberration (P <0.025) and malignancy scores (P <0.002). The good agreement between morphological classification and expression of L1 makes this a valuable marker in the diagnosis of lung carcinomas.
‘Atypical adenomatous hyperplasia’ in liver cirrhosis: low‐grade hepatocellular carcinoma or borderline lesion?
Authors: NAKANUMA Y. , TERADA T. , TERASAKI S. , UEDA K. , NONOMURA A. , KAWAHARA E. , MATSUI O.
Published: April 2007

Adenomatous hyperplasia, defined as a sizable parenchymal nodule in cirrhosis, was examined morphologically, Ninety‐seven nodules of adenomatous hyperplasia were ained from 47 cirrhotic livers and were divided into ‘ordinary’ (44 nodules) and ‘atypical’ (53 nodules) types. The former consisted of hepatocytes similar to those of the surrounding liver, and showed regularly distributed portal tracts. The latter type was composed of hepatocytes showing nuclear atypia, relative to the surrounding liver, and showed irregular or sparse portal tracts. Atypical nodules were histologically heterogen, possessing areas of normo‐trabecular, compact, pseudoglandular and/or scirrhous patterns. Several cytological changes, such as clear cell change, small or large cell change and fatty change, were intermingled variably within a given nodule. Atypical nodules showed expansive and/or replacing growth into the surrounding liver. Atypical hepatocytes also infiltrated into the fibrous septa and portal tracts. Foci of overt hepatocellular carcinoma were found in 11 of the 53 atypical nodules. These findings suggest that ordinary adenomatous hyperplasia may be a large‐sized regenerative nodule, while atypical adenomatous hyperplasia may be a hepatocellular neoplasm, a peculiar form of low‐grade hepatocellular carcinoma or borderline lesion, in which overt hepatocellular carcinoma is likely to evolve through multiple steps.
Combined immunohistochemical study of tissue polypeptide antigen and cancer antigen 125 in human ovarian tumours
Authors: GHAZIZADEH M. , SASAKI Y. , OGURO T. , AIHARA K. , TENJIN H. , ARAKI T.
Published: April 2007

An indirect immunoperoxidase method was used to study the expression of tissue polypeptide antigen (TPA) and cancer antigen 125 (CA 125) in 47 benign and malignant ovarian tumours. Tissue polypeptide antigen and CA 125 antigen were expressed respectively in 22 (73%) and 16 (53%) of the 30 adenocarcinomas and in five (29%) and four (23%) of the 17 benign tumours. Co‐expression of TPA and CA 125 antigen occurred in 12 (40%) malignant and four (23%) benign tumours. Ultrastructurally, TPA and CA 125 antigens were located at the cell surface and microvillous surfaces.

Evaluation of combined TPA and CA 125 antigen results revealed a remarkable improvement in the positivity rate and a significant decrease (P<0.05) in the negativity rate of ovarian carcinomas as compared with the result of each one separately. These findings provide complementary evidence for the previous results on the plasma levels of TPA and CA 125 antigen and suggest that specific combinations of tumour markers may be more effective for the diagnosis and monitoring of ovarian carcinomas, than the use of any single marker.
Bilateral virilizing sclerosing stromal tumours of the ovary in a pregnant woman with Gorlin's syndrome: implications for pathogenesis of ovarian stromal neoplasms
Authors: ISMAIL S.M. , WALKER S.M.
Published: April 2007

A woman with Gorlin's syndrome who had become pregnant following clomiphene therapy presented in early pregnancy with bilateral ovarian sclerosing stromal tumours which were associated with profound virilization. Pre‐ and post‐operative hormone profiles indicated androgen production by the tumours. Ovarian sclerosing stromal tumours have not previously been reported as occurring bilaterally or in association with Gorlin's syndrome. We discuss the questions raised by this unusual case regarding the pathogenesis of ovarian stromal neoplasms.
Signet‐ring cell carcinoid of the gallbladder
Authors: PAPOTTI M. , GALLIANO D. , MONGA G.
Published: April 2007

A case of signet‐ring cell carcinoid of the gallbladder is reported. The tumour diffusely infiltrated the gallbladder wall and extensively ulcerated the mucosa. Neoplastic nests were composed of numerous signet‐ring cells mixed with clear endocrine cells. The latter expressed chromogranin A, gastrin and somatostatin and contained neurosecretory granules. The diagnostic problem of differentiating between signet‐ring cell carcinomas and composite adenocarcinoma‐carcinoid tumours is discussed.
A histopathological study of the appendix at autopsy and after surgical resection
Authors: ANDREOU P. , BLAIN S. , BOULAY C.E.H.DU
Published: April 2007

In a study of 101 autopsy appendices and over 3000 surgically resected appendices, the range of histopathological features seen in each group is described. Fibrosis and faecoliths were more common in the older autopsy group than in the younger surgically resected group. The high incidence of fibrosis in the autopsy group suggests that this is an age‐related change, although some may be due to previous inflammation. The low incidence of faecoliths in the surgically resected group does not support the hypothesis that they are a major cause of appendicitis.
Abnormalities of intrahepatic bile ducts in extrahepatic biliary atresia
Authors: RAWEILY E.A. , GIBSON A.A.M. , BURT A.D.
Published: April 2007

The infantile cholangiopathies are a group of conditions associated with neonatal jaundice, which include extrahepatic biliary atresia, paucity of intra‐hepatic bile ducts and disorders associated with persistence of fetal biliary structures, the so‐called ductal plate malformations. Although previously regarded as distinct entities, it has recently been suggested that they may represent parts of a disease spectrum in which the principal process is one of bile duct destruction, the morphological manifestations in individual cases being influenced by the stage of intra‐uterine development at which such injury occurs and by the site within the biliary system at which there is maximum damage. To further examine this concept, we have studied liver biopsy specimens from 37 neonates with extrahepatic biliary atresia, with particular reference to abnormalities of the intrahepatic bile ducts. Paucity of intrahepatic ducts, defined as a bile duct: portal tract ratio of less than 0.9, was identified in six cases (16.2%). In eight cases (21.6%) we found concentric tubular ductal structures similar to those observed in ductal plate malformations. In one case, both abnormalities could be demonstrated. Our findings support the concept that there is overlap between the various types of infantile cholangiopathy.
Demonstration of clonality in T‐cell lymphoma using an anti‐T‐cell receptor variable region antibody panel
Authors: GRADY J.O' , KRAJEWSKI A.S. , RAMAGE E.F.
Published: April 2007

Frozen sections from 35 T‐cell lymphomas were stained with the Diversi‐T αβ T‐Cell Receptor panel which includes seven antibodies to T‐cell receptor variable region gene products. In five cases a monoclonal population of T‐cells could be demonstrated (one case Vβ5 +, three cases Vβ8 + and one case Vβ6 +) and in a further case a biclonal population (Vβ5 + and Vβ8+). We conclude that this antibody panel is of limited usefulness for the demonstration of clonality in T‐cell lymphoma.
Elastosis in granular cell tumours: prevalence and distribution
Authors: McMAHON J.N. , RIGBY H.S. , DAVIES J.D.
Published: April 2007

Elastosis, a previously unreported feature, was found to be common in granular cell tumours. Twenty‐four of 28 consecutive granular cell tumours were shown to display elastosis. The elastosis was found in three main sites: adventitial, interstitial and septal. Elastosis is statistically associated with the fibrosis present within this tumour. It appears that elastic fibres are synthesized by connective tissue cells, possibly induced by the tumour cells.
Transferrin receptor expression in benign tumours and in hepatoblastoma of the liver
Authors: SCIOT R. , EYKEN P. VAN , DESMET V.J.
Published: April 2007

To further investigate the possible usefulness of antitransferrin receptor staining in the differential diagnosis between benign and malignant primary liver tumours, we examined the transferrin receptor expression in ten cases of focal nodular hyperplasia, six of nodular regenerative hyperplasia, two adenomas and six hepatoblastomas. In focal nodular hyperplasia, the ductular structures were always positive and the parenchymal cells displayed three staining patterns of moderate intensity. In nodular regenerative hyperplasia there was scattered, relatively weak transferrin receptor staining. The tumour cells in the adenomas were only weakly positive. Three hepatoblastomas showed an intense staining of tumour cells; one was weakly positive and two were negative. A high intensity of transferrin receptor staining, as previously described in hepatocellular carcinomas, was only observed in the hepatoblastomas. This gives further credence to the usefulness of strong transferrin receptor expression in evaluating the malignant nature of tumour foci in liver biopsies.
Alveolar soft part sarcoma of the uterus
Authors: NOLAN N.P.M. , GAFFNEY E.F.
Published: April 2007

A 14‐year‐old girl presented with menorrhagia. The curettage specimen was extensively necrotic but examination of the subsequent hysterotomy specimen established the diagnosis of alveolar soft part sarcoma of the uterus, a very rare site for this uncommon malignant tumour.
Melanin production in black medullary thyroid carcinoma (MTC)
Authors: BEERMAN H. , RIGAUD C. , BOGOMOLETZ W.V. , HOLLANDER H. , VELDHUIZEN R.W.
Published: April 2007

Melanin production by two medullary carcinomas of the thyroid is reported and discussed. In both tumours, melanin and calcitonin could be detected in the same cells.
Nucleolar organizer regions in gastric carcinoma and its precursor stages
Authors: ROSA J. , MEHTA A. , FILIPE M.I.
Published: April 2007

A silver technique for nucleolar organizer regions (AgNOR) was applied to sections from 156 gastric biopsies and gastrectomy specimens. These included normal controls, normal gastric mucosa from carcinoma‐bearing stomachs, intestinal metaplasia types I and III, dysplasia and carcinoma. AgNOR counts gradually increased from normal, through intestinal metaplasia, to carcinoma. This finding supports the chronic atrophic gastritis–intestinal metaplasia–dysplasia–carcinoma sequence concept for gastric carcinogenesis. Normal gastric mucosa was different from all lesions, including normal mucosa from carcinoma‐bearing stomachs. Significantly higher AgNOR counts were observed in tumours compared to all other lesions except dysplasia. Dysplasia differed from intestinal metaplasia type I but not from type III. Eighty‐five per cent of metaplasia cases overlapped with carcinoma and 19% with normal controls. The spread of AgNOR values in intestinal metaplasia reinforces the concept that this lesion is a heterogeneous entity reflecting a dynamic and continuous process. The AgNOR technique may contribute to the assessment of the stage of evolution of ‘borderline’ lesions.
Malignant sex cord–stromal tumour in a patient with the androgen insensitivity syndrome
Authors: O'DOWD J. , GAFFNEY E.F. , YOUNG R.H.
Published: April 2007

A malignant sex cord–stromal tumour that occurred in a 56‐year‐old patient with the androgen insensitivity syndrome is reported. Although hamartomas composed of sex cord cells are common in the testes of patients with this syndrome, unequivocal neoplasms of sex cord type are rare. The tumour described herein most closely resembled, but lacked the overall morphology of, a juvenile granulosa cell tumour, and Charcot‐Böttcher filaments, indicative of Sertoli cell differentiation, were seen on electron microscopy. The features of the androgen insensitivity syndrome and the various tumours that have been reported in patients with this syndrome are briefly reviewed.
Thin basement membrane nephropathy as a cause of recurrent haematuria in childhood
Authors: LANG S. , STEVENSON B. , RISDON R.A.
Published: April 2007

A survey of 69 children presenting with recurrent or persistent haematuria and submitted to percutaneous renal biopsy at this hospital over a 17‐year period, was performed to establish the incidence of thin basement membrane nephropathy (TBMN). A diagnosis of primary glomerular disease was established in 44 (IgA nephropathy in 16, Alport's syndrome in 13 and other varieties of glomerulonephritis in 15). Of the remaining 25 patients in whom light microscopical and immunochemical examination revealed no abnormalities, material for electron microscopy was available in 11. In eight of these (five of whom had a family history), TBMN was diagnosed on the basis of ultrastructural morphometric evaluation of glomerular basement membrane thickness. Assuming a similar proportion of the remaining 14 patients with renal biopsy specimens normal by light microscopy had TBMN, the probable frequency of this abnormality in the whole series would be 26%, very similar to that of IgA nephropathy. In the eight TBMN patients the mean glomerular basement membrane thickness ranged between 181 and 236 nm, whilst in ‘control’ biopsies from children with ‘minimal change’ nephrotic syndrome or IgA nephropathy, the mean thickness ranged between 242 and 333 nm.
Lymphohistiocytic T‐cell lymphoma (anaplastic large cell lymphoma CD30+/Ki‐1 + with a high content of reactive histiocytes)
Authors: PILERI S. , FALINI B. , DELSOL G. , STEIN H. , BAGLIONI P. , POGGI S. , MARTELLI M.F. , RIVANO M.T. , MASON D.Y. , STANSFELD A.G.
Published: April 2007

We describe 13 cases of a peculiar lymphoid tumour containing very large numbers of reactive histiocytes. The tumours occurred in young patients (mean age 14.8 y) who presented with systemic symptoms and superficial lymphadenopathy. Microscopic examination revealed a diffuse effacement of lymph node structure due to the presence of histiocytes intermingled with a variable number of anaplastic large lymphoid cells. The latter, in some cases, were isolated, while in others they were arranged in clusters or were diffusely present in residual sinuses. The large anaplastic cells expressed the activation markers CD30 (Ki‐1), CD25 (interleukin‐2 receptor), CD70 (Ki‐24) and Ki‐27, as well as varying combinations of T‐associated molecules. The histiocytes expressed lysozyme and the CD11b (C3bi‐R), CD11c (p150, 95) CD14, CD68 (KPI) and Ber‐Mac3 antigens. Double staining with the antibody Ki‐67 demonstrated that the proliferating components were the CD30‐positive cells and not the histiocytes. T‐cell receptor beta gene rearrangements were shown in three cases tested. The patients responded well to aggressive chemotherapy and nine are still alive, eight in complete remission. It is suggested that the tumour represents a well‐defined clinico‐pathological entity originating from activated Tlymphocytes.
The microscopic features of inflammatory abdominal aortic aneurysms: discriminant analysis
Authors: McMAHON J.N. , DAVIES J.D. , SCOTT D.J.A. , TENNANT W.G. , POWELL J.E. , HUGHES A.O. , HORROCKS M. , BRADFIELD J.W.B.
Published: April 2007

Up to 15% of abdominal aortic aneurysms are designated as inflammatory. They are characterized by marked fibrous thickening of the aneurysmal wall, with the fibrosis extending into the adjacent retroperitoneum. Thirty‐five abdominal aortic aneurysms were studied, 15 inflammatory and 20 atherosclerotic. Of the inflammatory group, 10 were symptomatic and five asymptomatic. For each resection specimen, 59 microscopic features (variables) were scored semi‐quantitatively. Discriminant function analysis showed that endarteritis obliterans, fibrosis around nerves or ganglia at the outer margin of mural fibrosis, and the thickness of the combined fibrotic media and adventitia gave a satisfactory high discrimination between atherosclerotic and inflammatory aneurysms. When these three variables are used together, a histological diagnosis of inflammatory aneurysm can be made with an expected accuracy in excess of 80%.