bluuebunny/crossref_metadata_2025 huggingface dataset:
Subacute cutaneous lupus erythematosus—the annular variant. A histological and ultrastructural study of five cases
Authors: MURPHY J.K. , STEPHENS C. , HARTLEY T , DAS A.K. , HUGHES G.R.V. , MCKEE P.H.
Published: April 2007

Subacute cutaneous lupus erythematosus is an uncommon, non‐scarring variant oflupus erythematosus which has received scant attention in the pathology literature. Its recognition as a distinct entity is important, as, although mild systemic features may be associated, there is characteristically a relative absence of life‐threatening renal or central nervous systemic involvement. Subacute cutaneous lupus erythematosus may be clinically sub‐divided into the more common annular and the rarer papulosquamous (psoriasiform) variants.

A clinicopathological study of five cases of the annular variant is presented with a review of the literature. We highlight the histological and ultrastructural appearances. Discriminatory features from the other variants of lupus erythematosus and additional conditions with which it may be confused, including lichen planus and acute graft‐versus most disease, are discussed.
Keratinocyte expression of intercellular adhesion molecule 1 (ICAM‐1) correlated with infiltration of lymphocyte function associated antigen 1 (LFA‐1) positive cells in evolving allergic contact dermatitis reactions
Authors: GARIOCH J.J. , MACKIE R.M. , CAMPBELL I. , FORSYTH A.
Published: April 2007

Adhesion molecules are considered to have an important role in inflammatory reactions. We investigated the kinetics of ICAM‐1 expression on keratinocytes and correlated this with the numbers of lymphocytes expressing LFA‐1 in the dermis and epidermis of evolving allergic contact dermatitis reactions. In nickel‐sensitive individuals, after application of a nickel patch, increased expression of ICAM‐1 on keratinocytes was observed as early as 3 h and reached a maximum at 48 h. The number of lymphocytes expressing LFA‐1 in the dermis and epidermis was greatest at 48 h. The LFA cells were observed to be in close proximity to keratinocytes expressing ICAM‐1, thus supporting the hypothesis that T‐lymphocytes attach to keratinocytes via LFA‐1/ICAM‐1 molecules.
Immunohistochemical demonstration of epidermal growth factor and c‐myc oncogene product in normal, benign and malignant thyroid tissues
Authors: MIZUKAMI Y. , NONOMURA A. , HASHIMOTO T. , MICHIGISHI T. , NOGUCHI M. , MATSUBARA F. , YANAIHARA N.
Published: April 2007

The expression of epidermal growth factor (EGF) and c‐myc oncogene product was studied immunohistochemically in 65 benign and malignant human thyroids. Normal thyroid tissues were usually negative with each antibody. Benign and malignant neoplastic thyroid tissues demonstrated a high percentage of stained cells. However, there was no significant difference in positivity between benign and malignant neoplastic tissues. In Graves' disease 25% of the cases were positive for EGF, and 100% for c‐myc product. The effect of EGF or c‐myc expression on prognosis was also examined in 42 patients with papillary thyroid carcinoma. When the cases were divided into two groups with regard to their EGF staining score (highly‐expressed and poorly‐expressed groups), the frequency of highly‐expressed tumours was significantly higher in the recurrence‐positive group compared with the recurrence‐free group (86%vs 57%), but there was no significant difference between the groups in respect of c‐myc expression.
Intra‐abdominal neuroectodermal tumour of childhood with divergent differentiation
Authors: VARIEND S. , GERRARD M. , NORRIS P.D. , GOEPEL J.R.
Published: April 2007

Two cases are reported of intra‐abdominal small cell tumours expressing concomitant neural and epithelial differentiation. These features were discernible on conventional microscopy and supported immunocytochemically. Immunoreactive vimentin was also revealed in both tumours, and, in addition, one showed focal desmin positivity. Epithelial differentiation in both tumours was confirmed ultrastructurally. The tumours were interpreted to represent avariant of peripheral primitive neuroectodermal tumour, and the report serves to emphasize a potential among such tumours for complex differentiation. The neoplasms are compared with other similar tumours reported recently in children.
Melanocytes in the anal canal epithelium
Authors: CLEMMENSEN O.J. , FENGER C.
Published: April 2007

We studied the presence of melanocytes in the various epithelial zones of the anal canal, using a recently introduced melanocyte‐specific antibody (HMB‐45) together with antibody to S‐100 protein. In normal anal canals and in haemorrhoids, melanocytes, defined as intraepithelial HMB‐45/S‐100 positive cells, were frequently demonstrated in the anal squamous zone, only sporadically in the anal transitional zone, and not at all in the colorectal zone. In the epithelium surrounding, but clearly separated from, resected primary anal malignant melanomas, increased numbers of benign melanocytes were demonstrated in the squamous zone and transitional zone, but also in the colorectal zone. We interpret this finding as a tumour‐induced proliferation of benign melanocytes normally present, but in very small numbers or in some way ‘masked’, in the epithelium of the upper anal canal. The demonstration of melanocytes in all three zones of the anal canal substantially supports the observation that malignant melanoma of the anal canal may originate not only below but also above the dentate line.
patients with thick melanomas surviving at least 10 years: histological, cytometric and HLA analyses
Authors: RIVERS J.K. , McCARTHY S.W. , SHAW H.M. , JONES A.S. , GLASZIOU P. , DORAN T.J. , McCARTHY W.H.
Published: April 2007

Survival for melanoma patients with thick primary tumours is notoriously short. A small number of patients with tumours > 5.5 mm thick do, however, have protracted survival intervals. Attempts were made to account for this phenomenon by means of histological, cytometric and HLA serotyping analyses. Patients with thick lesions surviving more than 10 years were matched–by sex, age, anatomical site of primary lesion, stage of disease and, whenever possible, by initial surgical therapy–to patients dying of their disease within 5 years. This case‐control study on 13 long‐term survivors and 13 short‐term survivors did not show that any of the following attributes of the primary lesion were useful in predicting survival: Clark's level of invasion, ulceration, mitotic rate, host inflammatory response, tumour regression, tumour necrosis, vascular invasion, satellitosis, radial or vertical growth phase, predominant cell type, histogenetic type, borders, DNA quantification and cytomorphometry. HLA serotyping of long‐term survivors showed an excess of antigen DQwl compared with the general population, although this excess was not statistically significant.
A blue naevus of the prostate: a light microscopic study including an investigation of S‐100 protein positive cells in the normal and in the diseased gland
Authors: LEW S. , RICHTER S. , JELIN N. , SIEGAL A.
Published: April 2007

A blue naevus of the prostate in an 80‐year‐old patient is presented, including electronmicroscopical examination and the demonstration of S‐100 protein positivity. Cells expressing S‐100 protein were sought in prostates of infants, young adults and elderly patients with hyperplasia and carcinoma. Positive staining was found in stromal cells, but the number diminished with age and disease. These findings could explain the rarity of blue naevus and the virtual absence of primary malignant melanoma in the prostate.
Immunocytochemistry of paragangliomas—value of staining for S‐100 protein and glial fibrillary acid protein in diagnosis and prognosis
Authors: ACHILLES E. , PADBERG B.‐C. , HOLL K. , KLÖPPEL G. , SCHRÖDER S.
Published: April 2007

Surgical specimens of 65 adrenal and 27 extra‐adrenal paragangliomas, the latter comprising 11 carotid body, five jugulotympanic, one aorticopulmonary, eight aorticosympathetic and two visceral autonomic tumours, were examined immunocytochemically for the presence of glial fibrillary acid protein (GFAP) and S‐100 protein. Six adrenal and four extra‐adrenal (one parasympathetic and three sympathetic) neoplasms pursued a malignant clinical course. S‐100 staining of sustentacular (type 2) cells was seen in both adrenal (48/65) and extra‐adrenal (23/27) lesions, the 10 malignant tumours being entirely devoid of S‐100 protein positive cells. GFAP positivity of type 2 cells was seen in only 16 of the extra‐adrenal tumours, all of these lesions belonging to the group of benign parasympathetic paragangliomas. The presence of S‐100 positive type 2 cells may thus help to exclude malignancy in individual paraganglioma cases, while GFAP positivity of such cells renders possible the correct typing of benign parasympathetic paragangliomas.
Surgical pathology of the liver in HIV infection
Authors: WILKINS M.J. , LINDLEY R. , DOURAKIS S.P. , GOLDIN R.D.
Published: April 2007

In the 6‐year period 1984‐1989, 101 liver biopsies or ‘needle necropsies’ from human immunodefeciency virus positive patients were examined histologically. Of these, only nine showed no abnormality whatsoever. The commonest histological findings were either fatty change or changes related to co‐existent chronic viral hepatitis. Granulomas were seen in 15 cases, four of which were positive for acid‐fast bacilli. A range of organisms were recorded: cytomegalovirus (4); Histoplasma capsulatum (1); Pneumocystis carinii (2); Cryptococcus neoformans (1); and Leishmania donovani (1). There were two cases of non‐Hodgkin's lymphoma, but no cases of Kaposi's sarcoma. Marked iron deposition, which correlated with multiple blood transfusions was seen in nine biopsies. We were unable to identify any histological feature in the liver as being specific for HIV infection. The high incidence of liver abnormalities reflects: (i) the coincident exposure to hepatotropic viruses; (ii) the presence of opportunistic infections and neoplasms, usually part of a disseminated multi‐organ process arising in the setting of profound immune depression; (iii) iatrogenic causes, in particular iron overload related to multiple blood transfusions received for treatment of zidovudine‐induced anaemia; and (iv) non‐specific changes associated with chronic debilitating disease.
Basaloid‐squamous carcinoma of the upper aerodigestive tract and so‐called adenoid cystic carcinoma of the oesophagus: the same tumour type?
Authors: TSANG W.Y.W. , CHAN J.K.C. , LEE K.C. , LEUNG A.K.F. , FU Y.T.
Published: April 2007

Basaloid‐squamous carcinoma of the larynx, pharynx and base of tongue and the so‐called adenoid cystic carcinoma of the oesophagus are rare but distinctive tumours associated with a grave prognosis. They occur most commonly in elderly males and present at an advanced stage. Our study of four such laryngeal tumours and five such oesophageal tumours shows that they are histologically and immunohistochemically identical, providing support for the idea that they are the same tumour type. They show a biphasic pattern in which basaloid tumour is intimately associated with a neoplastic squamous component which can be invasive or in situ. The basaloid component is in the form of invasive lobules with frequent comedo‐necrosis and hyalinization. The constituent cells possess pale pleomorphic nuclei with frequent mitoses. Immunoreactivity for cytokeratin in the basaloid component is remarkable for its absence or weak and focal nature. Review of the literature shows that only a few cases of ‘adenoid cystic carcinoma’ of the oesophagus are bona fide examples of adenoid cystic carcinoma as it occurs in the salivary glands, while the others are identical to basaloid‐squamous carcinoma of the upper aerodigestive tract. Their distinction is important because genuine adenoid cystic carcinoma is much less aggressive than basaloid‐squamous carcinoma.
Hairy leukoplakia–a histological study
Authors: SOUTHAM J.C. , FELIX D.H. , WRAY D. , CUBIE H.A.
Published: April 2007

Hairy leukoplakia is a recently described oral mucosal condition seen in immunosuppressed individuals, usually in association with HIV infection, when it is thought to be a sign of decreasing immunocompetence. It probably results from reactivation of infection by Epstein‐Barr virus (EBV) and usually presents as bilateral white patches on the lateral borders of the tongue. From a histological study of 20 cases we have found that the typical appearance of hairy leukoplakia is of acanthotic, hyperparakeratinized epithelium with Candida hyphae sometimes present in the parakeratin. A band of EBV infected, koilocyte‐like cells is present in the upper part of the prickle cell layers, these cells being swollen and pale staining, with prominent cell borders and perinuclear vacuoles. There is a paucity of inflammation in both the epithelium and lamina propria. An atypical appearance shows the koilocyte‐like cells lying isolated or in small groups, irregularly arranged in the prickle cell layer and without a hyperparakeratinized surface. Diagnosis of hairy leukoplakia should normally be confirmed by demonstrating EBV in the koilocyte‐like cells by immunocytochemistry or DNA in situ hybridization.
Autoimmune oophoritis associated with polycystic ovaries
Authors: LONSDALE R.N. , ROBERTS P.F. , TROWELL J.E.
Published: April 2007

Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous histological descriptions are sparse, with even fewer reports of cystic ovaries associated with this condition. Two cases of autoimmune oophoritis presenting as cystic ovaries with menstrual abnormalities are described, with immunocytochemical analysis of the inflammatory cell infiltrate. Serum autoantibodies to ovary and adrenal were present in both cases. Although rare, recognition of the condition by histopathologists is important because of the strong association with other ‘organspecific’ autoimmune diseases, especially idiopathic Addison's disease. A review of the 17 reported cases indicates five where cystic changes were present in the ovary.
Bellini duct carcinoma: further evidence for this rare variant of renal cell carcinoma
Authors: RUMPELT H.J. , STÖRKEL S. , MOLL R. , SCHÄRFE T. , THOENES W.
Published: April 2007

Bellini duct carcinomas have recently been identified as a new entity in the spectrum of renal cell carcinomas and 10 cases have now been reported. The present paper adds detailed clinical and morphological data on six new cases. In addition, immunohistological and electronmicroscopical results support the origin of these tumours from the renal collecting ducts, especially the papillary ducts (Bellini ducts). A set of immunohistological reactions, including reactions to cytokeratins 13 and 19, vimentin and UEA‐1 was found to facilitate the differential diagnosis of Bellini duct carcinomas from other renal cell carcinomas and infiltrating urothelial carcinomas of renal pelvis.
Ceroid‐containing histiocytic granuloma of the endometrium
Authors: SHINTAKU M. , SASAKI M. , BABA Y.
Published: April 2007

In an endometrial curettage specimen, taken from a 67‐year‐old woman with post‐menopausal bleeding, the endometrium was replaced by aggregates of swollen histiocytes filled with yellowish‐brown pigment. Histochemical and ultrastructural examination of the specimen revealed that the pigment was of ceroid nature. Previously reported cases with similar findings are reviewed, and the distinction of this type of endometrial lesion from ‘foam cell reaction’ is briefly discussed.
Uterus‐like mass of the ovary associated with endometrioid carcinoma
Authors: RAHILLY M.A. , AL‐NAFUSSI A.
Published: April 2007

We describe a solid and cystic right ovarian mass removed from a 38‐year‐old woman. The solid component, which had a central cavity lined by endometriotic tissue and surrounded by a thick muscle wall, strongly resembled a miniature uterus. The contiguous cystic mass was an endometrioid carcinoma. We review the literature and discuss the theories of histogenesis of uterus‐like ovarian masses.
Immunolocalization of prealbumin (transthyretin) in renal cell carcinoma
Authors: ANG L.C. , DEBOWSKI T. , MICHALSKI R.
Published: April 2007

Fourteen primary and nine metastatic renal cell carcinomas were examined with a commercially available antibody against prealbumin (transthyretin) using the avidin‐biotin‐peroxidase complex (ABC) technique. Twenty‐two of the 23 tumours expressed prealbumin, and in 16 of them more than 50% of the tumour cells showed immunoreactivety. The same tumours were subjected to immunostaining with antibodies against low molecular weight keratin, carcino‐embryonic antigen, S‐100 protein and epithelial membrane antigen for comparison. We conclude that prealbumin, which was absent in 14 adenocarcinomas from other organs, should be included in the panel of markers for differentiating metastatic adenocarcinoma of renal origin from those of other primary tumours.
Extracellular matrix in hepatoblastoma: an immunohistochemical investigation
Authors: RUCK P. , KAISERLING E.
Published: April 2007

Eleven hepatoblastomas of various subtypes and normal liver tissue were investigated with antibodies against collagen types I‐VI, laminin, fibronectin and endothelial and macrophage‐associated antigens. Epithelial hepatoblastoma cells, unlike non‐neoplastic hepatocytes, exhibited intracellular immunoreactivity for various extracellular matrix proteins (depending on the subtype: laminin, fibronectin and collagen types III, IV and V). The intracellular expression of extracellular matrix proteins by the tumour cells increased from the fetal subtype, through the embryonal subtype, to the small cell subtype. The epithelial tumours exhibited sinusoid‐like blood vessels in numbers that varied according to the subtype. These contained Kupffer cells and exhibited greater amounts of the basement membrane components collagen type IV and laminin in the perisinusoidal space than those in the normal liver. The small cell hepatoblastoma exhibited smaller numbers of sinusoids, pronounced intracellular expression of extracellular matrix proteins and large numbers of fibres immunoreactive for collagen type III. In the mixed hepatoblastomas, the extracellular matrix of the osteoid was most strongly immunoreactive for collagen type I and that of the spindle cell areas for collagen type III.
Immunochemical investigation of insulinomas for islet amyloid polypeptide and insulin: evidence for differential synthesis and storage
Authors: WILLIAMS A.J.K. , COATES P.J. , LOWE D.G. , McLEAN C. , GALE E.A.M.
Published: April 2007

An affinity purified antibody to fragment 14‐29 of islet amyloid polypeptide (IAPP) has been prepared. This antibody, which does not cross‐react with the related molecule calcitonin gene‐related peptide, was used to investigate immunochemically the presence of IAPP in normal and neoplastic human pancreatic endocrine tissue. The pattern of IAPP staining in normal pancreas mirrors that of insulin, although slight differences were observed. In neoplastic tissue, IAPP was found in 16 out of 19 tumours that were positive for insulin, and was absent from one tumour negative for insulin. In some cases there were differences in the staining patterns of IAPP and insulin. These results suggest that the synthesis and secretion of IAPP and insulin are not inter‐dependent and support the concept that IAPP has a discrete biological function. Islet amyloid polypeptide was found in six out of six insulinoma amyloid deposits, suggesting that the peptide is an invariable component of these deposits. Over‐expression of IAPP, with aberrant processing and/or secretion, may be the causative factor for amyloid deposition in insulinomas and in the islets of type 2 (non‐insulin dependent) diabetic patients. Investigation of patients with insulinomas and of insulin cells in culture and tissue sections may help to clarify the biological function of IAPP.
Histological features and interphase nucleolar organizer regions in hyperplastic, dysplastic and neoplastic epithelium of intrahepatic bile ducts in hepatolithiasis
Authors: TERADA T. , NAKANUMA Y. , OHTA T. , NAGAKAWA T.
Published: April 2007

Neoplastic transformation occurs in the intrahepatic biliary tree in hepatolithiasis. The present study aimed to clarify the neoplastic processes by correlating the histological features of the bile duct lesions with counts of interphase argyrophilic nucleolar organizer regions (AgNORs), which reflect cell proliferative activity. We studied 55 cases of hepatolithiasis and 25 normal autopsy livers. The biliary epithelial lesions in hepatolithiasis were divisible into hyperplasia, dysplasia and neoplasia. These lesions were found in bile ducts containing calculi. All cases of hepatolithiasis showed a varied degree of hyperplasia. Additionally, eight cases showed dysplasia, five non‐invasive intraductal adenocarcinoma and 10 invasive adenocarcinoma. Cases of non‐invasive and invasive carcinoma frequently harboured areas of dysplasia, and areas of dysplasia and non‐invasive carcinoma, respectively. The mean and standard deviation of the number of interphase AgNORs in the normal and abnormal biliary epithelium showed a step‐wise increase in the following order: normal (1.32±0.36), hyperplasia (1.52±0.37), dysplasia (2.28±0.56), non‐invasive carcinoma (3.23±1.00), and invasive carcinoma (3.72±0.77). These histological and cell kinetic observations suggest that, in hepatolithiasis, carcinogenesis in bile duct epithelial cells progresses in a multi‐step manner, through hyperplasia, dysplasia, non‐invasive adenocarcinoma and invasive adenocarcinoma.
Design of an expert system and its application to dermatopathology
Authors: RUBIN A.
Published: April 2007

Expert systems are computer programs which use inference and knowledge to solve problems which usually require the expertise of a human specialist. This paper examines the application of expert systems to histopathology and explains their construction by describing the design of an expert system ‘dermdx’, intended to aid in the interpretation and diagnosis of biopsies of inflammatory diseases of the skin. The system consists of an expert shell, which performs the inference, and a rule‐base, which contains the knowledge with which the system operates. The system can be easily updated or adapted to other tasks.
Necrotizing sialometaplasia (adenometaplasia) of the trachea
Authors: ROMAGOSA V. , BELLA M.R. , TRUCHERO C. , MOYA J.
Published: April 2007

Necrotizing sialometaplasia is a benign condition first described in minor salivary glands of the soft palate with morphological changes which can be misinterpreted as squamous‐cell carcinoma. Similar lesions have been subsequently reported in other locations including major salivary glands, lip, breast and skin (the term syringometaplasia has been applied for the latter). We report three cases of such a process involving submucosal glands in the trachea following prolonged translaryngeal intubation.
Small cell (neuroendocrine) carcinoma of the vagina
Authors: MILIAUSKAS J.R. , LEONG A.S‐Y.
Published: April 2007

We report a case of vaginal small cell (neuroendocrine) carcinoma. Immunostaining for neuron‐specific enolase, PGP 9.5, chromogranin, synaptophysin, Leu 7 and cytokeratin was positive. Neurosecretory granules were found by electronmicroscopy. There was local recurrence and regional lymph node metastases. The patient survived for 10 months following local surgical therapy only.
The peritubular myoid cells in the testes from men with varicocele: an ultrastructural, immunohistochemical and quantitative study
Authors: SANTAMARÍA L. , MARTÍN R. , NISTAL M. , PANIAGUA R.
Published: April 2007

Ultrastructural and some immunophenotypic features of the peritubular myoid cells of testes from normal men and from men with varicocele were studied. The seminiferous tubules were classified into five types (a–e), related to the progressive degree of sclerosis measured as thickening of the lamina propria. In normal testes only type a and b tubules were found, whereas the testes from men with varicocele showed type b–e tubules. Myoid cells in tubule types a and b showed slender cytoplasmic projections with abundant, parallel arranged microfilament bundles and electron‐dense bodies. In c tubules, the myoid cells showed the same ultrastructure. The myoid cells of tubules with advanced (type d) or complete (type e) sclerosis showed irregularly outlined nuclei, scant microfilament bundles and absence of electron‐dense bodies. Immunostaining of myoid cells with anti‐actin antibodies was intense in types a–c tubules and scant in types d and e. Immunostaining with anti‐desmin antibodies was intense in tubules types a–d, but the immunoreactive cells in types c and d tubules were irregularly shaped and distributed and were scanty in tubule type e. Immunostaining with anti‐vimentin antibodies was weak in types a–c tubules and intense in types d and e tubules. Quantitative studies revealed that, with the progression of sclerosis, the numbers of both actin‐ and desminimmunoreactive cells per cross‐sectioned tubule, and the surface area occupied by the immunostained portion of these cells, decreases while the number of vimentin‐immunoreactive cells and their immunostained surface area increases.
Paragangliomas of the cauda equina have a distinctive cytokeratin immunophenotype
Authors: ORRELL J.M. , HALES S.A.
Published: April 2007

We have examined immunohistochemically three cases of paraganglioma of the cauda equina and five cases of paraganglioma from other sites using a panel of antibodies to neuroendocrine markers and cytokeratins. All eight tumours stained with at least two neuroendocrine markers. All five paragangliomas from sites other than the cauda equina showed no cytokeratin staining. The three paragangliomas of the cauda equina showed staining of some cells using anticytokeratin AE 1/3. Paragangliomas of the cauda equina appear to have a distinctive cytokeratin immunophenotype.
Oestrogen and progesterone receptors in screen‐detected breast carcinoma: an immunohistological study using paraffin sections
Authors: SOOMRO S. , SHOUSHA S. , SINNETT H.D.
Published: April 2007

The presence of oestrogen and progesterone receptors was studied in paraffin sections of 81 screen‐detected breast carcinomas using the monoclonal antibodies ER‐ICA and PgR‐ICA (Abbott) and the immunoperoxidase technique. The immunohistological results were compared with the results of the standard dextran‐coated charcoal biochemical assay in 28 tumours which were big enough to provide tumour tissue for this assay. Sixty‐three cases (78%) were oestrogen receptor positive and 62 (77%) were progesterone receptor positive. There was no statistical difference between receptor positivity in palpable or impalpable, in situ or invasive tumours. In the 28 cases where the biochemical assay was carried out, the two methods gave similar results in 23 (82%) and 21 (75%) tumours for oestrogen and progesterone receptors respectively. The majority of the remaining tumours, with one exception, were positive with immunohistology and negative with biochemistry. A good correlation was also present between the mean numerical biochemical values and the semiquantitative histological scores for both receptors. It is concluded that assessment of receptor status of small screen‐detected carcinomas is feasible using routinely processed paraffin sections. There is reasonably good correlation with the results obtained by the standard dextran‐coated charcoal biochemical assay, but more genuine receptor positive cases are detected by immunohistology.
The histological features of splenosis
Authors: CARR N.J. , TURK E.P.
Published: April 2007

This study presents a detailed histological analysis of two cases of splenosis, including one of the largest nodules to be reported. Splenosis may exhibit red and white pulp that appears histologically and immunohistochemically normal by routine methods, and a well‐developed capsule and trabeculae may form. The capsule may be thicker than in the normal spleen but is otherwise indistinguishable and may contain fibrous, elastic and smooth muscle elements. These findings are in contrast to previously published works which have described poorly‐developed white pulp, capsule and trabeculae in splenosis. The histological pattern may depend on the blood supply to the autotransplanted splenic tissue in the early days after implantation. The close resemblance that splenosis may show to an accessory spleen suggests that histological examination may have a limited role in the distinction between these two conditions.
Relevance of Ki‐67 expression in the classification of non‐Hodgkin's lymphomas: a morphometric and double‐immunostaining study
Authors: HOUMAND A. , ABRAHAMSEN B. , PEDERSEN N. TINGGAARD
Published: April 2007

The proliferation of reactive and neoplastic cells was retrospectively assessed in 92 cases of non‐Hodgkin's lymphoma by morphometry using a double‐immunoenzymatic technique including surface markers and the monoclonal antibody Ki‐67. The findings were compared with the histological diagnosis. The overall Ki‐67 positivity is not always a good measure of the corresponding corrected values and therefore we recommend that a correction should be made for the total number of complementary lymphocytes in the tumour. Taking the macrophages and the Ki‐67 positivity of the reactive cells into account does not generally add any information. There was no difference in reactive cell content between follicular (counted within follicles) and diffuse lymphomas within the tumour areas. The value of the group mean for low‐grade follicular (nodular) lymphomas was significantly higher than that of diffuse low‐grade lymphomas, but not significantly different from that of intermediate‐grade lymphomas. High‐grade lymphomas exhibited significantly greater Ki‐67 positivity than those of intermediate grade. In 76% of the cases there was significant agreement between malignancy grade (low/intermediate malignant versus high malignant) at 45% corrected Ki‐67 counts.
Primary cutaneous plasmacytoma: the use of in situ hybridization to detect monoclonal immunoglobulin light‐chain mRNA
Authors: WALKER E. , ROBERTSON A.G. , BOORMAN J.G. , MCNICOL A.M.
Published: April 2007

A case of primary cutaneous plasmacytoma in a 16‐year‐old male is described. The neoplastic nature of the plasma cell infiltrate has been clearly established by the demonstration of monoclonal κ immunoglobulin light‐chain mRNA using in situ hybridization with biotin‐labelled oligonucleotide probes applied to routine tissue sections.
Basaloid carcinoma of the prostate gland: histogenesis and review of the literature
Authors: DENHOLM S.W. , WEBB J.N. , HOWARD G.C.W. , CHISHOLM G.D.
Published: April 2007

The clinicopathological features of a basaloid carcinoma of the prostate gland are described in a 28‐year‐old man, and the management and prognosis discussed. Basaloid tumours of the prostate are very rare and only a few cases have been described in detail. Those cases which have been reported as adenoid cystic carcinoma, adenoid cystic‐like carcinoma and adenoid basal cell tumour are reviewed.
Renal interstitial foam cells are macrophages
Authors: FRANCO M. , SCHMITT F. , REJAILI W.A. , VIERO R.M. , BACCHI C.E.
Published: April 2007

Immunohistochemical studies on renal biopsies from eight patients with various types of glomerulonephritis showed that the interstitial foam cells belonged to the monocyte‐macrophage lineage. There was a strong association between hypercholesterolaemia and the presence of renal interstitial foam cells.
Desmoplastic melanoma
Authors: BRUIJN J.A. , MIHM M.C. , BARNHILL R.L.
Published: April 2007

Desmoplastic melanoma is a rare tumour of which a limited number of cases have been described. The clinical and histopathological features of desmoplastic melanoma and its variants may give rise to perplexing diagnostic and therapeutic dilemmas. In the past decades, some insight has been gained into the histogenesis of these lesions and discriminating clinical and morphological features are now recognized. Review of the literature reveals an extensive list of differential diagnoses. Adequate surgical excision and close follow‐up of these radioresistant, frequently‐recurring tumours is strongly advocated.
Laminin and type VII collagen distribution in different types of human lung carcinoma: correlation with expression of keratins 14, 16, 17 and 18
Authors: WETZELS R.H.W. , SCHAAFSMA H.E. , LEIGH I.M. , LANE E.B. , TROYANOVSKY S.M. , WAGENAAR S.S.C. , VOOIJS G.P. , RAMAEKERS F.C.S.
Published: April 2007

The expression patterns of basement membrane components and keratin intermediate filament proteins were studied in normal human bronchial epithelium and 56 lung carcinomas using monoclonal antibodies to laminin, type VII collagen and the individual keratins 14, 16, 17 and 18. In normal lung, laminin and type VII collagen were present between the epithelium and the lamina propria of bronchi and bronchioles. Keratin 14 was expressed in the basal cells, keratin 17 in the basal and some suprabasal cells and keratin 18 in the columnar cells of the bronchi and bronchioles. Keratin 16 was not present in normal bronchial epithelium. Laminin was found in all subtypes of lung carcinoma, but type VII collagen was present only in squamous cell carcinomas, where it showed a reduction in expression with decreasing differentiation. Type VII collagen was not identified in adenocarcinomas, small cell carcinomas or carcinoids. Antibodies to basal cell keratins 14 and 17 also displayed positivity only in squamous cell carcinomas, although no correlation with the degree of differentiation could be observed. Keratin 16 appeared to be a marker of the squamous phenotype, rather than of hyperproliferation. The keratin 18 marker for columnar epithelial cells showed a reaction pattern opposite to that of the basal cell keratins, being extensively present in adenocarcinomas, small cell carcinomas and carcinoids, with less expression in squamous cell carcinomas. This study shows a correlation between the presence of type VII collagen and the basal cell keratins 14 and 17, and a negative correlation between these components and keratin 18. These findings are likely to be useful in identifying lung cancer subtypes.
Parathyroid hyperplasia in multiple endocrine neoplasia type 1: a pathological and immunohistochemical reappraisal
Authors: HARACH H.R. , JASANI B.
Published: April 2007

Twenty‐nine parathyroid glands from nine patients with multiple endocrine neoplasia type 1 (MEN 1) syndrome were examined histopathologically and immunocytochemically to characterize better the nature of the accompanying parathyroid hyperplasia. The parathyroids showed varying degrees of nodular and diffuse (partial and total) hyperplastic involvement as well as apparently normal tissue. The nodules were usually multiple within any one gland and showed a varied cytoarchitectural pattern. All glands studied showed both cellular argyrophilia and parathyroid hormone immunoreactivity. The staining pattern for parathyroid hormone ranged from negative or weak to strong and from patchy to diffuse in hyperplastic tissue from different glands and within the same gland. Apparently normal areas usually showed the strongest positive reaction. Amyloid material was observed within glandular lumens from hyperplastic areas in over half of the studied cases and stained positively for parathyroid hormone. This suggests that the hormone could be the precursor molecule of parathyroid amyloid as occurs with hormone‐derived amyloid from other endocrine tumours. The overall findings indicate that the most striking feature of the parathyroid glands in MEN 1 is their variability, both morphological and functional, as indicated by their parathyroid hormone immunoreactivity.
The histogenesis of appendiceal carcinoid tumours
Authors: GODDARD M.J. , LONSDALE R.N.
Published: April 2007

Twenty‐two appendiceal carcinoid tumours, comprising 10 classical carcinoids, six tubular carcinoids and six goblet cell carcinoids were examined by histochemistry and immunohistochemistry. All of the tumours showed evidence of neuroendocrine differentiation. Classical carcinoids were invariably intimately associated with S‐100 protein positive cells, supporting an origin from sub‐epithelial neuroendocrine cells. Both tubular and goblet cell carcinoids expressed cytoplasmic mucin and immunoglobulin A, and neither were associated with S‐100 protein positive cells. These observations suggest that tubular and goblet cell carcinoids are derived from epithelial crypt stem cells.
Fatty change in the endometrium
Authors: NOGALES F.F. , PAVCOVICH M. , MEDINA M.T. , PALOMINO M.
Published: April 2007

Fatty change of the endometrial stroma is reported for the first time in the literature. This incidental finding further exemplifies the capacity of the endometrial stroma to undergo benign mesenchymal metaplasia.
Cellular ‘neurothekeoma’: an epithelioid variant of pilar eiomyoma? Morphological and immunohistochemical analysis of a series
Authors: CALONJE E. , WILSON‐JONES E. , SMITH N.P. , FLETCHER C.D.M.
Published: April 2007

Cellular neurothekeoma is a recently recognized benign cutaneous neoplasm, which is currently regarded as being of nerve sheath origin and is thought to represent a variant of conventional neurothekeoma (dermal nerve sheath myxoma). Nine new cases presenting predominantly in adolescents or young adults are described. Morphologically they were characterized by short fascicles or small nests of palely eosinophilic epithelioid or spindle‐shaped cells which ramified in an ill‐defined manner between dermal collagen bundles. Myxoid matrix was absent or sparse. Scattered normal mitoses and multinucleate giant cells were often present. Immunohistochemically all nine cases were strongly NK1/C3 positive, seven were weakly NSE positive and three were smooth muscle actin positive. Staining for S‐100 protein, PGP 9.5, epithelial membrane antigen and desmin was negative in all cases. In view of its distinctive architecture and immunophenotype, both of which are totally different from conventional neurothekeoma, it is proposed that cellular ‘neurothekeoma’ is a separate discrete entity which may represent an epithelioid variant of pilar leiomyoma.
The palisaded, encapsulated neuroma (solitary circumscribed neuroma)
Authors: DAKIN M.C. , LEPPARD B. , THEAKER J.M.
Published: April 2007

We describe the clinical and pathological features of 41 palisaded encapsulated neuromas. They present as small, solitary, asymptomatic papules, predominantly on the face in middle age. No case had co‐existent neurofibromatosis or multiple mucosal neuromas. Histologically, they have distinctive features, consisting of a proliferation of Schwann cells and large numbers of axons within a perineurial derived capsule, permitting simple and reliable distinction from schwannomas and neurofibromas. Overall, the palisaded encapsulated neuroma accounts for approximately 25% of all nerve sheath tumours of the dermis. True schwannomas rarely occur in the dermis. Despite their original name, many cases are incompletely encapsulated and we support the recent proposal to rename these lesions solitary circumscribed neuroma.
OV‐TL 12/30 (keratin 7 antibody) is a marker of glandular differentiation in lung cancer
Authors: MOLENGRAFT F.J.J.M.VAN DE , NIEKERK C.C.VAN , JAP P.H.K. , POELS L.G.
Published: April 2007

The immunoreactivity of OV‐TL 12/30, a monoclonal antibody to keratin 7 was investigated on paraffin‐embedded human lung cancer tissues of 61 patients. A modified AEC‐immunoperoxidase method with pepsin pre‐digestion was used. In normal lung tissue keratin 7 was found in bronchial and bronchiolar epithelium, pneumocytes and compound glands. Squamous metaplasia of the bronchial tree was negative. All 24 squamous cell carcinomas were negative irrespective of grade of differentiation. All differentiation grades of 20 adenocarcinomas including bronchioalveolar carcinomas were positive. Since six large cell anaplastic carcinomas did not react with keratin 7 antibody these tumours are considered to be of squamous cell rather than adenocarcinomatous origin. Small cell anaplastic carcinomas were negative in 10 of 11 cases. Our study demonstrates that this keratin 7 antibody is useful in differentiating between squamous cell carcinoma and adenocarcinoma of the lung and it may be particularly useful in making the correct diagnosis in small lung biopsy specimens.
Glomerular perfusion in renal allograft biopsies
Authors: FURNESS P.N. , MORGAN J. , HORSBURGH T.
Published: April 2007

In the commonest causes of impaired renal transplant function there is reduced renal and glomerular perfusion. We investigated the possibility of identifying this phenomenon in renal transplant biopsies, by the crude but simple method of counting the mean numbers of glomerular capillary loops which contained erythrocytes. In cyclosporin toxicity, acute tubular necrosis and in acute cellular rejection there was a considerable reduction in the numbers of erythrocyte‐containing glomerular capillaries. The separation of the acute tubular necrosis group from normal was almost complete. This feature is therefore not specific but appears to correlate well with states of impaired glomerular perfusion. We suggest that a simple assessment of glomerular erythrocyte ‘load’ forms a useful part of the histological examination of renal transplant biopsies.
High incidence of papillary renal cell tumours in patients on chronic haemodialysis
Authors: ISHIKAWA I. , KOVACS G.
Published: April 2007

Papillary and nonpapillary renal cell tumours can be differentiated according to their genetic constitution. In this study, their incidence in end stage kidney disease has been investigated histologically. Nonpapillary renal cell carcinoma was observed in 22 cases (51.2%) whereas papillary renal cell tumours were diagnosed in 21 (48.8%) of the 43 patients with end stage kidney disease. The incidence of papillary renal cell tumours in end stage kidney disease is significantly higher (χ2= 31.9; P<0.001) than in the general population (4.8%). Haemodialysis patients with nonpapillary and papillary renal cell tumours did not show significant differences in age, sex or size of tumour. However, patients with papillary renal cell tumours had received longer duration of haemodialysis than patients with nonpapillary renal cell carcinomas. These data suggest that not only different genetic events but also different aetiological factors are involved in the development of the two types of tumour in end stage kidney disease.
Spindle‐cell non‐pleomorphic atypical fibroxanthoma: analysis of a series and delineation of a distinctive variant
Authors: CALONJE E. , WADDEN C. , WILSON‐JONES E. , FLETCHER C.D.M.
Published: April 2007

Atypical fibroxanthoma is a bizarre, cytologically malignant but usually clinically benign, lesion which typically arises in sun‐damaged skin of the head and neck region in the elderly. Classically, its morphology is said to represent the dermal counterpart of pleomorphic malignant fibrous histiocytoma. We have identified 10 cases of a more monomorphic spindle‐celled, fascicular variant which, paradoxically, was often mistaken for a clinically malignant lesion because it lacked the pleomorphism of conventional atypical fibroxanthoma. These tumours all arose in the head and neck region as polypoid lesions in the elderly. The tumours were confined to the dermis, often had an epidermal collarette, showed an eosinophilic fascicular morphology and were highly mitotic. All 10 were vimentin positive and five showed very focal actin positivity. Desmin, keratin and S‐100 protein were negative in all cases. The clinical course was benign in all cases, justifying their accurate recognition. The principal differential diagnoses are spindle cell squamous carcinoma, spindle cell melanoma and leiomyosarcoma. Immunohistochemistry plays a key role in this distinction.
Clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts) in the duodenum: the first visceral case
Authors: EKFORS T.O. , KUJARI H. , ISOMÄKI M.
Published: April 2007

An ulcerated tumour was removed by a Whipple's operation from the descending part of the duodenum of a 38‐year‐old male. The tumour cells were mainly spindle‐shaped, arranged in nests and had very prominent nucleoli. A few cells contained melanin and melanosomes. Immunoreactivity for S‐100 protein and focally for HMB‐45 was observed. These features are diagnostic for clear cell sarcoma of tendons and aponeuroses. Because no other primary tumour could be found and the search for similar cases from the literature was unsuccessful, we believe that this tumour is the first reported clear cell sarcoma in a visceral location.
Mucins in prostatic intra‐epithelial neoplasia and prostatic carcinoma
Authors: SENTINELLI S.
Published: April 2007

A histochemical study of 27 well‐differentiated prostatic carcinoma cases associated with prostatic intra‐epithelial neoplasia (PIN) was carried out. In the histological areas examined a decreasing production of neutral mucin was found as follows: normal prostatic tissue (70%), prostatic carcinoma (55%), PIN 1 (50%), PIN 2 (30%) and PIN 3 (15%). A progressively increasing content of acidic mucin (AB 2.5) was observed in the areas of PIN 3 (25%), PIN 2 (35%) and prostatic carcinoma (70%), while it was absent in the areas of PIN 1 and normal prostatic tissue. Acidic mucin sulphated type (AB 1) was secreted only in PIN 3 (5%) and prostatic carcinoma (10%) areas. These data were correlated with the proliferative activity of PIN. It is postulated that the lower neutral mucin production by PIN 3 can be linked to the higher proliferative activity of this lesion. Moreover, the acidic mucin secretion by PIN and prostatic carcinoma is considered to be a further feature of these lesions.
Immunohistochemical markers of carcinoma in situ of the testis also expressed in normal infantile germ cells
Authors: JφRGENSEN N. , GIWERCMAN A. , MÜLLER J. , SKAKKEBÆK N. E.
Published: April 2007

Carcinoma in situ of the testis is an intratubular, pre‐invasive lesion preceding germ cell tumour. In adult men, carcinoma in situ cells differ in several aspects from normal germ cells. For example, placental‐like alkaline phosphatase and/or the epitopes for the monoclonal antibodies M2A, 43‐9F and TRA‐1–60 are not seen in normal germ cells, whereas their presence is considered a specific sign of carcinoma in situ. As it is known that placental‐like alkaline phosphatase and the epitope for TRA‐1–60 are expressed in normal fetal germ cells it is possible that the markers could appear in normal infantile germ cells in a period after birth before they lose their expression. In children, carcinoma in situ cells may be difficult to identify morphologically and the use of the markers could be of great value. However, little information is available on the expression of the markers of adult carcinoma in situ in normal infantile germ cells. We investigated gonads from 66 boys less than 15 years old who died suddenly. Their deaths were unrelated to testicular disease. Immunohistochemical staining with anti‐placental‐like alkaline phosphatase antibody and monoclonal antibodies TRA‐1–60 and 43–9F were performed. We found that these markers were expressed in some normal infantile germ cells until the age of 1 year. Therefore, these markers are not suitable for diagnosis of carcinoma in situ during the early postnatal period of life. Furthermore, our findings of placental‐like alkaline phosphatase and the epitope for TRA‐1–60 in normal germ cells before birth indicate that the markers of adult carcinoma in situ cells are of embryonic origin. This is in accordance with the hypothesis that carcinoma in situ cells are fetal germ cells malignantly transformed during fetal life, although re‐expression of the antigens could provide an alternative explanation.