bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet phagocytosis in the spleen of patients with idiopathic thrombocytopenic purpura (ITP)
Authors: LUK S.C. , MUSCLOW E. , SIMON G.T.
Published: April 2007

The ultrastructure of spleen from four patients with idiopathic thrombocytopenic purpura (ITP) is studied. Platelets, with no evidence of degranulation and aggregation, leave the circulation by passing through gaps in the sinus wall in the marginal zones and the red pulp. They are then trapped by pseudopods of macrophages and are phagocytosed as whole elements. The endothelial cells lining the sinuses do not phagocytose platelets or other circulating blood cells. The degradation of these platelets in the phagolysosomes of macrophages is incomplete and results in the formation of myelinic‐like figures which accumulate in large numbers in these cells. This incomplete platelet breakdown may be due to a deficiency of specific lysosomal enzymes. Erythroleucophagocytosis in ITP is normal. The results are consistent with the concept that ‘self’ constituents are normally and readily destroyed by autolytic enzymes. In the case of enzyme deficiency or the presence of ‘foreign’ antigens, including altered ‘self’ antigens, these enzymes become ineffective for rapid and complete degradation of the substrate. Through macrophage‐lymphocyte interaction, antibody‐forming cells are activated against these residual substances. These antibodies, in turn, facilitate the phagocytosis of the specific ‘antigens’ by macrophages. The massive platelet phagocytosis and the presence of large numbers of germinal centres in the white pulp and plasma cells in the marginal zone and red pulp suggest that the spleen is the major site of platelet destruction, as well as the site of antiplatelet antibody synthesis.
Benign and low grade variants of mixed Müllerian tumour of the uterus*
Authors: ÖSTÖR† A. G. , FORTUNE D. W.
Published: April 2007

The clinico‐pathological features of 11 examples of a rare group of uterine neoplasms composed of both epithelial and stromal components are reported. The patients complained of abnormal vaginal bleeding or discharge. Two of the tumours arose in the cervix, seven in the endometrium and two from both, forming large polypoid masses projecting from the cervix and/or filling the uterine cavity. Microscopically, the epithelial elements ranged from benign to adenocarcinoma. A similar range of stromal elements was also seen, varying from entirely bland to low grade to high grade sarcoma. The variable histology of the tumours is reflected in their biologic behaviour. Of the three tumours with the highest histological grade of malignancy, one recurred and killed the patient. One tumour, in which both components were regarded histologically as benign, recurred twice before hysterectomy. Our findings lend support to the concept that these tumours are variants of mixed Müllerian tumour. We advocate the acceptance of the latter term so that all grades of this tumour can be accommodated under one designation.
Argentaffin cells, intestinal metaplasia and antral metaplasia in carcinoma of the gall bladder
Authors: AZADEH B. , PARAI S. K.
Published: April 2007

The occurrence of argentaffin cells, intestinal metaplasia, and antral metaplasia has been studied in 20 gall bladders with carcinomas, in a papilloma, and in 20 specimens of cholelithiasis. Argentaffin cells were present in six carcinomas, but in only one specimen were they present in large numbers. Only one adenocarcinoma contained occasional argyrophil cells and no argentaffin or argyrophil cells were seen in the papilloma. Five of the 20 specimens of cholelithiasis contained occasional argentaffin cells. Intestinal and antral metaplasia were found in four carcinomas, in the papilloma, and in seven of the 20 specimens of cholelithiasis. It is suggested that metaplastic changes may play a role in the pathogenesis of carcinoma of the gall bladder.
Discrimination of hyperplasia and carcinoma of the endometrium by quantitative microscopy–a feasibility study
Authors: BAAK J. P. A. , KURVER P. H. J. , DIEGENBACH P. C. , DELEMARRE J. F. M. , BREKELMANS E. C. M. , NIEUWLAAT J. E.
Published: April 2007

Endometrial hyperplasias and carcinomas have been investigated by quantitative microscopical methods. The aim of this study was to develop an objective method of histopathological diagnosis because of the great subjective variability of these endometrial conditions. A total of 79 cases were studied. Only those were included, which, after re‐examination of the material by different pathologists, were regarded as mild atypical hyperplasia (38 cases), marked atypical (adenomatous) hyperplasia (11 cases), well and moderately differentiated adenocarcinoma (19 and 11 cases, respectively). There are many significant differences between these four groups. Stereological features contained the most important information, whilst nuclear features were less successful discriminators. The volume percentage of the epithelium and of the glands and the inner surface density of the glands showed the most significant differences between adenomatous hyperplasia and well differentiated carcinoma. On the basis of these findings, a quantitative model is suggested which might give more insight into the development of these abnormalities, assuming a gradual transition from one to another. The great advantage of the quantitative analysis of data over subjective impressions, it that is is objective, and provides consistently reproducible results. The present results may be especially useful when histopathological diagnosis is in doubt. It is concluded that application of quantitative microscopy in the discrimination of endometrial hyperplasia and carcinoma in histopathology is feasible.
The Shwartzman reaction: a review including clinical manifestations and proposal for a univisceral or single organ third type
Authors: MORI W.
Published: April 2007

The Shwartzman reaction was first described more than 50 years ago and two types, the generalized and the localized, were established in the early 1930s. Studies were mostly related to experimental pathology or immunology, and its significance in clinical medicine was initially obscure though thought to be obstetrically relevant. It is thought that the generalized type has a relation to human disease and that disseminated intravascular coagulation in man is really the counterpart of the generalized Shwartzman reaction in animals. The localized type on the other hand does not have obvious practical clinical pathological significance and tumour necrosis may be the only real example which is commonly seen. Further studies on the Shwartzman reaction relevant to human pathology have, however, suggested that it could be applied to several diseases, the pathogenesis of which was still obscure. The significance seems, however, different from either the generalized or localized type of reaction and so a proposal of the incidence of a third type—‘univisceral’ or ‘single organ’ Shwartzman reaction is made. Acute liver necrosis, Waterhouse‐Friderichsen's syndrome, haemolytic uraemic anaemia, idiopathic pulmonary haemorrhage, acute pancreatitis, acute pituitary necrosis and pseudomembranous colitis all seem to have features suggesting that they could be clinical manifestations of this type of Shwartzman reaction with focal intravascular coagulation.
Signet ring cell lymphoma: a case report
Authors: PILERI S. , SERRA L. , GOVONI E. , MARTINELLI G.
Published: April 2007

The authors report a case of signet ring cell lymphoma, a rare variety of germinal (follicular) centre cell neoplasm. Its clinical, histological and ultrastructural findings are compared with those of the nine cases previously described. Original immunocytochemical results are presented and discussed.
Medullary carcinoma of the thyroid presenting as tumours of the pharynx and larynx
Authors: SWEENEY E. C. , McDONNELL L. , O'BRIEN C.
Published: April 2007

Two cases of medullary carcinoma of the thyroid presenting as tumours of the pharynx and larynx are described. One patient had a tonsillar mass that resembled a carotid body tumour clinically, radiologically and microscopically. The other had an arytenoid tumour with multiple cervical lymph node metastases but without intrathyroidal carcinoma. The endocrine nature of the neoplasms was indicated by the presence of stromal amyloid, cellular argyrophilia and secretory granules whilst the demonstration of calcitonin and carcinoembryonic antigen provided evidence that they were medullary carcinomas.
Inappropriate mucin production in gall bladder metaplasia and neoplasia–an immunohistological study
Authors: DE BOER W. G. R. M. , MA J. , REES J. W. , NAYMAN J.
Published: April 2007

This study demonstrates the presence of three antigens in glandular metaplasia occurring in patients with cholecystitis and cholelithiasis: specifically carcinoembryonic antigen (CEA), large intestinal mucin antigen (LIMA) and small intestinal mucin antigen (SIMA). These antigens could not be detected in normal gall bladder mucosa or in squamous metaplasia of the gall bladder. The occurrence of the three intestine‐associated antigens in three carcinomas was irregular. In one mucinous carcinoma, only SIMA could be demonstrated. In one adenocarcinoma, SIMA was present in small areas of mucinous change, whilst CEA was present in the nonmucinous malignant tissue. In a mixed mucinous and non‐mucinous adenocarcinoma with widespread dissemination, the three antigens were present both in the primary tumour and the metastases. These observations suggest that all forms of glandular metaplasia of the gall bladder are intestinal in nature and at least a proportion of gall bladder carcinomas are of an intestinal type. Finally they provide further immunological evidence that glandular metaplasia of the gall bladder should be considered a pre‐malignant condition.
Superficial oesophageal carcinoma: an oesophageal counterpart of early gastric cancer
Authors: BARGE J. , MOLAS G. , MAILLARD J. N. , FEKETE F. , BOGOMOLETZ W. V. , POTET F.
Published: April 2007

The clinicopathological features of 10 cases of superficial oesophageal carcinoma without lymph node metastasis are reported. Superficial oesophaoeal carcinoma, an uncommon form of oesophageal cancer, is defined as invasive squamous cell carcinoma confined to the mucosa and submucosa. It includes plaque‐like, erosive, papillary and occult types but is not associated with the usual macroscopic features of advanced oesophageal cancer. The main presenting symptom is dys‐phagia and oesophagitis is a frequently quoted endoscopic diagnosis. Superficial oesophageal carcinoma may be preceded by dysplastic and in situ carcinomatous changes and is a probable oesophageal counterpart to early gastric cancer.
Sclerosing haemangioma of the lung. A histochemical, electron microscopical, tissue culture and time‐lapse cinematographic study
Authors: ALVAREZ‐FERNANDEZ E. , ESCALONA‐ZAPATA J.
Published: April 2007

A case of pulmonary sclerosing haemangioma was studied by electron microscopy, tissue culture, time‐lapse cinematography and enzyme histochemistry. The cells bordering the spaces and forming solid sheets showed abundant surface microvilli, desmosomes and osmiophilic inclusions some of which had a lamellar structure. No Weibel‐Palade bodies were found. The cells showed a negative reaction to ATP‐ase and stained focally for alkaline phosphatase. Normal cells inside the tumour showed positive reactions for both enzymes. In tissue culture, both conventional studies and time‐lapse cinematography showed a rather characteristic behaviour unrelated to that previously described in other neoplasms or in cultures of normal lung. The findings contradict the view that pulmonary sclerosing haemangiomas are proliferations of immature respiratory epithelial cells.
Quantitative, microscopical, computer‐aided diagnosis of endometrial hyperplasia or carcinoma in individual patients
Authors: BAAK J. P. A. , KURVER P. H. J. , OVERDIEP S. H. , DELEMARRE J. F. M. , BOON M. E. , LINDEMAN J. , DIEGENBACH P. C.
Published: April 2007

There are many significant differences, but also considerable overlap between the quantitative histopathological features of mild and marked atypical endometrial hyperplasias and well and moderately differentiated carcinomas, thus preventing its application to individual patient care. To try to overcome this problem, a classification rule for the diagnosis in individual patients, using discriminant analysis has been developed. Utilizing nine quantitative features, all the above four groups can be adequately separated. None of the carcinomas was misclassified as hyperplasia, and only one case of marked atypical hyperplasia was erroneously classified as well differentiated carcinoma, but with a probability of carcinoma 0.75, hyperplasia 0.25. By contrast, the classification probabilities of all the confirmed carcinomas exceeded 0.90. Therefore, using 0.90 as a classification level (‘threshold’), a reliable rule is obtained. A slightly more simple classification rule distinguishes between all the hyperplasias and all the carcinomas. In this way, all the cases of the test set were correctly classified. The classification rules can be used to select patients with benign disease for hormone therapy(Kistner 1973) as an alternative to hysterectomy, and can be programmed in an inexpensive microcomputer. The quantitative techniques are relatively easy, and are capable of being performed in most histopathological laboratories.
Sinus histiocytosis with massive lymphadenopathy (Rosai–Dorfman disease): report of a case with widespread nodal and extra nodal dissemination
Authors: WRIGHT D. H. , RICHARDS D. B.
Published: April 2007

A fatal case of sinus histiocytosis with massive lymphadenopathy (SHML) is described in a male patient who presented at 11 years‐of‐age with swelling of the malar region and nasal obstruction due to the disease and who died aged 28 in uraemic coma following renal involvement. At autopsy SHML tissue extended into the hilum of both lungs and from the retroperitoneal tissue into the pancreas and kidneys. The appearances suggest that the extension of the disease into these organs may have been due to retrograde lymphatic spread from involved lymph nodes. Replacement of the atypical sinus histiocyte by fibrous tissue was seen in the cervical lymph nodes and this may be the usual mode of resolution of the lesion. The nature of SHML is discussed in relation to a possible infectious aetiology and defects in the host immune system. Finally, it is noted that the term ‘massive lymphadenopathy’ is not applicable to all cases and that sinus histiocytosis is not appropriate for the now frequently recognized extranodal manifestations of the disease. It is proposed that the term ‘lymphophagocytic histiocytosis syndrome’ should be adopted or that the eponymous title ‘Rosai‐Dorfman disease’ should be used.
Morphological identification of alpha‐I‐antitrypsin in the human small intestine
Authors: GEBOES K. , RAY M. B. , RUTGEERTS P. , CALLEA F. , DESMET V. J. , VANTRAPPEN G.
Published: April 2007

Alpha‐I‐antitrypsin immunoreactivity was demonstrated by immunofluorescence in epithelial cells of the normal human small intestine. Its presence was also confirmed in biopsies of patients with Crohn's disease. Specific fluorescence was observed in only four out of 14 adult patients with coeliac disease. These results implicate the human small intestinal epithelium as a possible source of alpha‐I‐antitrypsin. The absence of positive cells may have implications in the aetiology of coeliac disease.
Malignant lymphoma simulating lymph node toxoplasmosis
Authors: MIETTINEN M. , FRANSSILA K.
Published: April 2007

On histological examination of 667 cases originally suspected of lymph node toxoplasmosis, 12 cases were diagnosed as malignant lymphoma and 15 cases as atypical hyperplasia (AH), suspicious of malignant lymphoma. All 12 malignant cases were of Hodgkin's disease: eight of the lymphocyte predominant nodular type, two of lymphocyte predominant diffuse type, and two of the nodular sclerosis type. In all cases, the lymph nodes contained small groups of epithelioid cells which were virtually indistinguishable from those seen in toxoplasmosis. In the differential diagnosis between lymph node toxoplasmosis and malignant lymphoma, the following features were found helpful. In toxoplasmosis the general structure is preserved and germinal centres are frequent, while in malignant lymphoma and in AH the general structure is destroyed. However, in some cases of toxoplasmosis germinal centres may be difficult to identify because their margins are indistinct due to clusters of epithelioid cells. Also, in some types of Hodgkin's disease and in some cases of AH with epithelioid cells, the general structure of the lymph node may be partially preserved. The occurrence of epithelioid cells within germinal centres seems to be a specific feature for toxoplasmosis; it was never seen in malignant lymphoma nor in AH. The occurrence of strands of monocytoid cells (unreife Sinushistiocytose) though a fairly typical feature of toxoplasmosis, was also occasionally seen in Hodgkin's disease or AH.
Benign neural invasion in vasitis nodosa
Authors: GOLDMAN R. L. , AZZOPARDI J. G.
Published: April 2007

Three instances of invasion of nerves of the spermatic cord by benign proliferative ductules of the vas deferens following vasectomy are reported. This phenomenon occurred in association with the histopathological features of vasitis nodosa and was noted in tissue removed during vasovasostomy in two cases and from a painful lower inguinal nodule at the site of vasectomy in a third example. Such neural invasion deserves attention because, especially in association with a proliferative ductular pattern, it may be mistaken for adenocarcinoma. The lesion is also of intrinsic interest in the light of benign neural invasion at other sites.
Gastric cancer: problems in histological diagnosis
Authors: PAGNINI CARLA ARSLAN , RUGGE M.
Published: April 2007

The reproducibility of the most recent histological classifications for gastric cancer was studied. A comparison of the results obtained independently by both authors using the criteria of Lauren, Ming, Mulligan and WHO, showed that highest reproducibility was achieved with the WHO classification. However, an acceptable accuracy in diagnosis for the other three classifications was obtained. This study confirms the validity of the WHO criterion for initial diagnosis, while the other classifications should be kept for further specific investigations, such as epidemiological or prognostic studies.
Morphological changes of the gastroduodenal mucosa in regular dialysis uraemic patients
Authors: FRANZIN G. , MUSOLA R. , MENCARELLI R.
Published: April 2007

An endoscopic and biopsy study of the upper gastrointestinal tract in 102 patients receiving regular dialysis treatment (RDT) for chronic renal failure, showed prominent hypertrophic folds and a peculiar pale‐grey or pale‐pink colour of the gastric mucosa in most cases. Gastric erosions occurred in 11 cases and gastric ulcer in two. Duodenal erosions were found in 13 cases, eight of which were associated with hyperplasia of Brunner's glands. Duodenal ulcer occurred in one case. The histological findings were compared with those in 100 subjects with an endoscopically normal gastro‐duodenal tract. In most cases of the RDT group the fundal area was enlarged at the expense of the antrum, fundal glands and/or isolated parietal cells often spreading within the duodenal mucosa. In most cases the duodenal bulb showed hyperplasia of Brunner's glands and heterotopic gastric surface epithelium. The frequency of the mucosal changes differs significantly in the two groups of subjects. Gastric hyperplastic changes in RDT are probably due to the trophic action of hypergastrinemia which is of common occurrence in such a condition, and can account for gastric acid hypersecretion. Acid hypersecretion, in turn, can account for the duodenal changes and gastroduodenal lesions.
The ‘transitional’ mucosa adjacent to large bowel carcinoma—electron microscopic features and myofibroblast reaction
Authors: BALÁZS MÁRTA , KOVÁCS AGOTA
Published: April 2007

An electron microscopic study of the ‘transitional’ mucosa adjacent to 10 carcinomas of the colon showed impaired maturation of epithelial cells. The pericryptal fibroblast layer was absent, accounting for an increase in the length and distension of crypts. In the tunica propria a massive accumulation of myofibroblasts was noted and was indicative of an intensive fibre‐producing activity. Review of the literature identifies various theories concerning the functions of myofibroblasts in respect of contraction, embryonal collagen‐fibre formation and non‐specific stromal reaction. Of these, the latter two are considered likely in relationship to transitional colonic mucosa.
A histological comparison of cutaneous malignant melanoma between the Oxford Region and Western Australia
Authors: HEENAN P. J. , HOLMAN C. D. J.
Published: April 2007

Two series of cutaneous malignant melanoma (CMM), one from a low incidence area (the Oxford Region) and one from a high incidence area (Western Australia), were compared by one pathologist using the same histological criteria. The findings included similarities in the distributions of histogenetic type of CMM, predominant cell type, and the degree and pattern of inflammatory reaction. Differences were found in other features including tumour profile, the presence of ulceration, mitotic activity, evidence of regression and level of invasion. The most important, and consistent morphological difference was the greater thickness of tumours from the Oxford Region, which is thought to be consistent with the theory that CMM is diagnosed at an earlier stage in high incidence areas because of greater medical and public awareness of the condition. Some problems in the use of accepted classifications of CMM are discussed.
On the so‐called membrane coating granules in keratinized lichen planus lesions of the buccal mucosa
Authors: EL‐LABBAN N. G. , WOOD R. D.
Published: April 2007

Serial sections of the so‐called membrane‐coating granules have been examined in keratinized oral epithelium of lichen planus lesions. As with ‘granules’ apparent in non‐keratinized epithelium, it is found they do not represent specialized intracytoplasmic organelles, but are the result of sectioning at different areas, levels and planes through the plasma membrane of interdigitating cell processes. Such ‘granules’ appear mostly in the superficial, but not deep, part of the cytoplasm of the upper prickle cells. This is considered to be due to topographic differences between the upper and under surfaces of these cells and the presence of narrower intercellular spaces than those between deeper epithelial cells. Such arrangement often results in cell processes in sections appearing free in the superficial part of the cell below. The appearance of ‘granules’ arises when the plane of section is not at right angles to the two plasma membranes surrounding these processes.
Extraurinary schistosomiasis in Southern Iraq
Authors: AL‐ADNANI M. S. , SALEH K. M.
Published: April 2007

Ninety‐six cases of extraurinary schistosomiasis due to Schistosoma haematobium were encountered in a retrospective histopathological study of cases encountered over a period of 12 years in Southern Iraq. Seventy‐six cases involved three main systems, namely the female genital system (29 cases), male genital system (15 cases) and the lower intestinal tract (32 cases). In the remaining 20 cases unusual sites such as lymph nodes, skin, liver and lungs were affected. In none of these cases did the clinician initially consider schistosomiasis to be the cause of the patient's illness prior to the histological diagnosis.
Sinus histiocytosis with massive lymphadenopathy in Rwanda: report of eight cases with immunohistochemical and ultrastructural studies
Authors: NGENDAHAYO P. , ROELS H. , QUATACKER J. , BODDAERT J. , NTABOMUVRA V. , MBONYINGABO P.
Published: April 2007

The clinico‐pathological, immunohistochemical and ultrastructural features of eight cases of sinus histiocytosis with massive lymphadenopathy (SHML) recorded in Rwanda from 1975 to 1980 are reported.

The main histopathological features were a massive enlargement of the lymph node sinuses which were filled with large histiocytes, a great number of which phagocytosed blood cells, especially lymphocytes, and an important proliferation of plasma cells in the medullary cords. The pathogenesis of this syndrome is discussed, particularly the role of immunological disorders challenged by a chronic, but non‐specific, infectious state. The ultrastructural study revealed no micro‐organisms and no Langerhans’ granules. Immunohistochemical staining revealed two interesting features: the presence of immunoglobulins in the cytoplasm of the histiocytes indicating the presence of an immune phagocytosis and the absence of lysozyme and α1‐antichymotrypsin (α1‐AC) from the histiocytes. The significance of the latter phenomenon is still unknown.
A scanning and transmission electron microscopic study of human nodular goitre
Authors: SOBRINHO‐SIMÕES M. , JOHANNESSEN J.V.
Published: April 2007

This paper is a concurrent scanning and transmission electron microscopic study of 13 cases of nodular goitre.
Necrotizing pseudolymphomatous lymphadenitis and rapidly fatal lymphoma in Okinawa
Authors: MICHALEK HILMA , HENZAN E.
Published: April 2007

Thirty‐one cases of a peculiar lymphadenitis with pathognomonic necrosis and prominent infiltration with immunoblasts were studied together with 36 cases of a rapidly fatal lymphoma of distinctive morphological pattern and characterized by massive coagulative necrosis. These cases all occurred on the island of Okinawa, and the lesions have not, to our knowledge, been reported previously. This further example of a type of geographically confined lymph nodal disease may, on further study yield insights into pathogenetic mechanisms in lymphomas. Further studies should include cell marker and virological investigations, which were not available to us at the time of the study.
Adenosquamous carcinoma of the stomach: histological, histochemical and ultrastructural observations
Authors: MINGAZZINI P.L. , BARSOTTI P. , ALBEDI F. MALCHIODI
Published: April 2007

The histochemical and ultrastructural features of an adenosquamous carcinoma of the stomach have been studied. Both the adenomatous and the squamous component of the tumour showed malignant characteristics. Elements which were considered as undifferentiated cells on light microscopy showed ultrastructural features of poorly differentiated squamous cells. No intermediate cells, sharing squamous and glandular aspects, were found by electron microscopical examination. The adenomatous component exhibited histochemical and ultrastructural features of the intestinal type of gastric carcinoma and the mucosa surrounding the tumour showed a colonic type of intestinal metaplasia. A possible histogenesis from a totipotential undifferentiated cell is considered.
The immunohistological demonstration of carcinoembryonic antigen in intra‐epithelial and invasive squamous carcinoma of the cervix
Authors: McDICKEN I.W. , RAINEY MARGARET
Published: April 2007

Using the sensitive peroxidase, anti‐peroxidase immunohistological technique, carcinoembryonic antigen (CEA) was studied in formalin‐fixed, paraffin‐embedded cervical specimens from 225 patients. CEA was demonstrated in 33% of moderate dysplasia, 78.5% of severe dysplasia, 79% of in‐situ carcinoma and 78% of invasive carcinoma. CEA was not demonstrated in normal squamous epithelium, squamous metaplasia, reserve cell hyperplasia nor in mild dysplasia.
An appraisal of the value of the bone marrow biopsy in the assessment of proliferative lesions of the bone marrow
Authors: KRAUSE J.R.
Published: April 2007

The diagnostic value of the bone marrow needle biopsy has proved impressive in a variety of disorders. As a complementary procedure to the aspiration smear it adds an invaluable dimension to the examination of haematopoietic tissue. The procedure is easily learned and safe and should be utilized routinely in haematological practice. The usefulness of the bone marrow biopsy is examined in assessing proliferative lesions of the bone marrow.
Exocrine pancreatic tumours and their histological classification. A study based on 167 autopsy and 97 surgical cases
Authors: MOROHOSHI T. , HELD G. , KLÖPPEL G.
Published: April 2007

Based on histopathological examination of 264 exocrine pancreatic tumours (167 autopsy and 97 surgical) from the files of the Institute of Pathology, University of Hamburg, over a 15‐yr period (1966–1980), a histogenetic classification is proposed. In addition to the more common neoplasms this also includes rarer and more recently defined entities. Of the 264 tumours, 250 were of duct origin, 10 acinar and four of uncertain histogenesis. Ductal adenocarcinoma, subdivided into a well‐differentiated and a poorly‐differentiated type, was most frequent (81.1%), followed by its variants: pleomorphic giant cell carcinoma 5·3%, adenosquamous carcinoma 3·8%, and mucinous carcinoma 1.1%. All these had a poor prognosis. Serous cystadenoma (1.1%), mucinous cystic tumour (1.5%) and intraductal papilloma (0.8%), which were rare tumours and mostly apparent in surgical material, proved to be benign or of only latent malignancy. The group of tumours of acinar cell origin consisted of the solid and cystic tumour (2.7%) with favourable prognosis and the acinar cell carcinoma (1.1%). No pancreatoblastoma was observed. The pleomorphic carcinomas of the small cell type (1.5%) were classed as tumours of uncertain histogenesis.
Prognosis in patients with thin malignant melanoma: influence of regression
Authors: McGOVERN V. J. , SHAW H.M. , MILTON G.W.
Published: April 2007

It has been suggested that patients with thin malignant melanoma displaying evidence of histological regression may have a poor prognosis. In the present study, the case histories of 353 patients with clinical stage I cutaneous malignant melanoma up to 0.7 mm thick were reviewed to determine if either active or past regression in these lesions was a poor prognostic sign. Lesions were reported as displaying evidence of partial regression if either (a) a portion of the melanoma had a heavy lymphocytic infiltrate associated with loss of tumour cells or the presence of degenerating tumour cells, or (b) a portion of the melanoma was replaced by vascular fibrous tissue with or without pigment‐containing phagocytes. The incidence of regression in this study (58%) was similar to that reported in another recent large study on thin lesions (53%). Only slightly more regressed than unregressed lesions metastasized (8% versus 5% respectively). A high proportion of first recurrences from these thin lesions developed at sites remote from the primary lesion (lung, bone or in subcutaneous tissues or lymph nodes wide of the line of spread). However, the presence or absence of regression in thin lesions did not appear to influence the site of first recurrence. Cumulative 10‐year survival rates for patients whose lesions displayed or did not display evidence of either active or past regression were nearly identical. We concluded that in patients with long‐term follow‐up, prognosis was not less favourable if there was presence of regression in their thin lesions.
Juvenile and inflammatory polyps of the colon—a histological and histochemical study
Authors: FRANZIN G. , ZAMBONI G. , DINA R. , SCARPA A. , FRATTON A.
Published: April 2007

A light microscopy and histochemical study of 24 juvenile and 27 inflammatory polyps showed that both may derive from inflammatory processes. Granulation tissue, secondary to spontaneous local inflammation or due to surgical procedures may subsequently be covered by regenerating epithelium which lines haemorrhagic cavities and mucus lakes to form irregular, elongated and cystic glands, which are characteristic of juvenile polyps. Both juvenile and inflammatory polyps showed cystic, metaplastic and ‘transitional‐type’ glands. The mucin distribution was identical in both types of polyps. All these findings suggest a common origin of the polyps. The presence of ‘transitional‐type’ glands seems to confirm these as a secondary regenerative phenomenon rather than pre‐neoplastic, although dysplastic changes in juvenile polyps have been described. It is suggested that both the juvenile and inflammatory polyps may undergo dysplasia only in genetically predisposed subjects. However, this event seems to be very rare.
Sinus catarrh and histological grade in breast cancer
Authors: THORESEN S. , HARTVEIT F. , TANGEN M. , HALVORSEN J.F.
Published: April 2007

Histological grading of 52 primary breast carcinomas and analysis of the findings in the corresponding axillary nodes showed that primaries of high grade tend to have more nodes showing sinus catarrh than those of low grade. This is in keeping with previous reports linking sinus cararrh to aggressive tumour growth.
The amount of white pulp in the spleen; a morphometrical study done in methacrylate‐embedded splenectomy specimens
Authors: VAN KRIEKEN J.H.J.M. , TE VELDE J. , HERMANS J. , CORNELISSE C.J. , WEL VAART C. , FERRARI M.
Published: April 2007

This report deals with a morphometrical study on 92 surgically removed human spleens, to investigate the composition of spleens which are considered to be normal, i.e. spleens which had ruptured in traffic accidents or which had been incidentally removed during abdominal operations. A comparison was made with 16 spleens with hypersequestration of platelets and to 11 with hyper‐sequestration of erythrocytes. Methyl‐methacrylate embedding was used because of the superiority of this technique over conventional paraffin embedding. Significant differences were found between both ‘normal’ groups as to the absolute and relative amount of white pulp as well as the perifollicular red pulp zone. Based also on the few morphometrical reported studies in the literature, spleens removed during abdominal surgery form the best control group. Traumatic rupture of the spleen in traffic accidents might specifically occur in spleens which already contained a stimulated lymphatic compartment. A probably non‐specific increase of white pulp was found in splenomegaly of varied aetiology. An expected influence of age on weight and composition of the spleen was not found in our study. The spleen changes in weight and composition only up to 5 years of age. Significant involution at older age was not found in ours nor in other reported larger series.
Immunohistology and aetiology of histiocytic necrotizing lymphadenitis. Report of three instructive cases
Authors: FELLER A.C. , LENNERT K. , STEIN H. , BRUHN H.‐D. , WUTHE H.‐H.
Published: April 2007

Three cases of histiocytic necrotizing lymphadenitis are reported. Two patients came from Vietnam and the third from Greece. In all cases there was infection with Yersinia enterocolitica of serogroup 9 or 3. Cervical lymph nodes were examined. Histologically, the characteristic necrosis developed in large foci of so‐called T‐associated plasma cells. Immunological analysis showed that these cells have characteristic markers of helper/inducer T cells, but do not express sheep erythrocyte receptors. The T‐associated plasma cells perished by pyknosis and were then phagocytosed and digested by macrophages, which were present in large numbers. The necrotic areas were exclusively located in hyperplastic T regions. The B‐cell system did not play a role in the reaction. T‐associated plasma cells have been renamed ‘plasmacytoid T cells’ because they contain abundant rough endo‐plasmic reticulum (‘plasmacytoid’) and show immunological features of T cells. It appears likely that plasmacytoid T cells are the counterparts of plasma cells of the B‐cell system that secrete lymphokines instead of immunoglobulin.
Evidence for differentiation in medulloblastomas appearing primitive on light microscopy: an ultrastructural study
Authors: MOSS T.H.
Published: April 2007

Surgical biopsy specimens from five children with cerebellar medulloblastoma were examined for ultrastructural evidence of differentiating activity. At light microscope level, all the tumour samples appeared primitive and featureless, and could not be classified as showing either neuroblastic or spongioblastic differentiation. Using electron microscopy, the major part of each specimen examined likewise showed largely primitive and undifferentiated appearances typical of medulloblastoma. In all the cases however, scattered groups of cells and related cytoplasmic processes were found with more specific, differentiated features. Moreover, in each tumour sample, these cells and processes were found to show two morphologically distinct appearances. One cell type had ultrastructural features reminiscent of primitive neuronal morphology, and a similar appearance was found in cell perikarya forming rosettes. The other cell type showed evidence of spongioblastic differentiation, with bundles of glial‐like filaments in the cytoplasm. Cilia were also found in one case. Whilst in keeping with current views on the neuroectodermal origin of the tumour, these observations suggest that all medulloblastoma cells may have bipotential differentiating capacity, and that at least some evidence of this is likely to be found ultrastructurally, even when there is only a primitive and completely undifferentiated appearance on light microscopy.
The fine structure of choroid plexus carcinoma
Authors: ANGUILAR D. , MARTÍN J.M. , ANEIROS J. , ARJONA V. , LARA J.L. , NOGALES F.
Published: April 2007

The ultrastructural findings of two cases of choroid plexus carcinoma occurring in infants 11 and 24 months old are discussed. Both had a similar ultrastructural pattern which demonstrated a clear polygonal cytoplasm, cell polarity towards the lumina, junctional complexes and evidence of a basement membrane, all of which point to an epithelial origin for the proliferating cells. Abundant immature cellular characters such as polyribosomes, glycogen granules and hypertrophied rough endoplasmic reticulum were found. The importance of the differential dignosis from ependymoblastoma and benign choroid plexus papilloma is emphasized. In the former, the major differentiating features are the existence of abundant glial neuropil and cellular characters of glial differentiation, whilst in the latter, cytoplasmic features demonstrate cellular maturity.
Localized amyloidosis in nasopharyngeal carcinoma
Authors: PRATHAP K. , LOOI L.M. , PRASAD U.
Published: April 2007

A study of biopsies from 434 consecutive primary nasopharyngeal carcinomas revealed amyloid deposits in 54 (12%) of the tumours. Amyloid was present in all three histological types of nasopharyngeal carcinoma, but was more frequently observed in nonkeratinising carcinomas. The amyloid deposits were patchy in distribution and occurred both within tumour cells and extracellularly. A neoplastic origin for this form of amyloid is suggested.
Lung calcification in long‐term dialysed patients: a light and electronmicroscopic study
Authors: BESTETTI‐BOSISIO M. , COTELLI F. , SCHIAFFINO E. , SORGATO G. , SCHMID C.
Published: April 2007

Lung calcification was detected in four out of 29 long‐term dialysed patients on whom postmortem examinations were performed between 1967 and 1980. On light microscopy, calcification showed either a finely granular and linear localization along the alveolar septa, or a coarse and widespread parenchymal distribution. Histochemical studies revealed evidence of calcium, magnesium and phosphate ions in the deposits. Ultrastructural examination of the less severely involved alveolar septa showed selective deposition of calcium salts within an increased amount of elastin. The deposits consisted of electron dense roundish granules with a concentric laminar structure. They appeared either single or conglomerated in polycyclic formations, supposedly representing the progressive steps of the mineralization process, at first localized within elastin and progressively spreading outside it. The high magnesium content of the deposits suggests that the serum concentration of this ion may play an important role in visceral calcification of longterm dialysed patients.
Histiocytic sarcoma (true histiocytic lymphoma): a clinicopathological study of 20 cases
Authors: VAN DER VALK P. , MEIJER C.J. L.M. , WILLEMZE R. , VAN OOSTEROM A.T. , SPAANDER P.J. , TE VELDE J.
Published: April 2007

Large‐cell non‐Hodgkin's lymphomas (T‐ and B‐immunoblastic, centroblastic and true histiocytic lymphomas) have a heterogeneous clinical course. In the present study the clinical and morphological data of 20 cases of histiocytic sarcoma (true histiocytic lymphoma) are presented. Diagnosis was supported by immunohisto‐chemistry, cytochemistry, rosette assays and/or electron microscopy. Although the follow‐up was relatively short (up to 144 months, mean 26 months), the clinical data differed clearly from the series of large‐cell non‐Hodgkin lymphomas, recorded in the literature. Differences were found in age distribution with a peak in the third decade, in organ involvement showing a preference for skin, gastrointestinal tract and bone, and in response to therapy. In general, histiocytic sarcoma appears to have a more favourable response to therapy and clinical course than the other large‐cell lymphomas (T‐ and B‐immunoblastic and centro‐blastic lymphomas). Moreover, preliminary observations in the group of histiocytic sarcomas suggested that the presence of lysozyme and/or 5‐nucleotidase and the absence of α1‐antitrypsin in the cytoplasm is associated with a better response to therapy and favourable clinical course.
Langerhans' cells and T cells in human skin tumours: an immunohistological study
Authors: GATTER K.C. , MORRIS H.B. , ROACH B. , MORTIMER P. , FLEMING K.A. , MASON D.Y.
Published: April 2007

In this study normal skin and a range of skin tumours, both benign and malignant, have been examined using monoclonal antibodies to identify the distribution and morphology of Langerhans' cells. In addition, in view of the putative functional association between Langerhans' cells and T cells, the distribution of T lymphocytes and their subsets have been analysed using monoclonal anti‐T cell antibodies. The results indicated that Langerhans' cells can be reliably identified in both normal and malignant skin biopsies using monoclonal antibodies. A striking finding to emerge was that in benign skin lesions Langerhans' cells were increased, whereas in malignant tumours they were not only markedly depleted or absent but also grossly stunted and deformed in outline. The majority of lymphocytes surrounding these skin tumours were shown to be T cells with helper cells outnumbering suppressor cells by a ratio from 2 to 5:1. This study shows the usefulness of immunohistological techniques using monoclonal antibodies for examining the morphology and distribution of Langerhans' cells in skin pathology. In addition they are particularly appropriate for identifying their topographical relationships with other immunologically important cells such as T cells.
Bronchial carcinoid with fibrillary inclusions related to cytokeratins: an immunohistochemical and ultrastructural study with subsequent investigation of 12 foregut APUDomas
Authors: BERGER G. , BERGER F. , BEJUI F. , BOUVIER R. , ROCHET M. , FEROLDI J.
Published: April 2007

A bronchial P cell carcinoid, which was negative for all hormones immunocytochemically tested, showed a globular intracytoplasmic inclusion in almost every cell. The inclusions were not clearly distinguishable using the haematoxylin‐eosinsafran procedure; they were best demonstrated with the Masson trichrome stain and the Grimelius technique and were easily detected in 1 μm thick Epon sections as target‐like structures. On electron microscopy, they were found to be composed of filamentous aggregates entrapping a few endosecretory granules, which showed degenerative changes. The filaments, 8–10 nm in diameter, lacked any periodicity; they were randomly dispersed in the central area and arranged in broken concentric swirls at the periphery of the inclusions. The globules lacked the tinctorial properties of amyloid, but showed a strong immunostaining for keratin‐like proteins. A systematic investigation of 12 APUDomas of bronchial or duodenopancreatic origin, using both light and electron microscopy, identified a few filamentous bodies in one case, a somatostatin cell tumour of ampulla of Vater. In both cases, the structures appeared similar to those previously reported in growth hormone cell pituitary adenomas as well as in a few bronchial or gut carcinoids. Whatever their nature, morphological data suggest that they are related to abnormalities in the secretory function, involving the Golgi apparatus, the endosecretory granules and the microtubular microfilamentous system.
Mucinous adenocarcinoma in anorectal fistulae
Authors: JONES E.A. , MORSON B.C.
Published: April 2007

Mucinous adenocarcinoma arising in an anorectal fistula is an uncommon condition which gives rise to difficult problems of diagnosis and pathogenesis. The clinical history and pathology of seven patients are described and compared with six patients in whom anal fistulae were lined by normal rectal mucosa or ‘misplaced glands’. In five of the cases granulomas were present which were a further cause of diagnostic difficulty. The evidence from this study suggests that the fistulous tracks are congenital duplications of the lower end of the hind gut lined by rectal mucosa which is prone to malignant change to mucinous adenocarcinoma. The prognosis after excision of the rectum is good.
Quantitation of pulmonary megakaryocytes and fibrin thrombi in patients dying from burns
Authors: WELLS S. , SISSONS M. , HASLETON P. S.
Published: April 2007

Pulmonary megakaryocytes and fibrin microthrombi were counted in lung sections from 22 patients dying from extensive burns. There was a significant correlation between numbers of megakaryocytes and fibrin microthrombi, supporting a relationship between disseminated intravascular coagulation (DIC) and numbers of pulmonary megakaryocytes. No correlation was found between antemortem platelet counts and either fibrin microthrombi or megakaryocytes. Possible explanations for this are forwarded and the nature of pulmonary megakaryocytes discussed.
Metaplasias and neoplasias of Müllerian epithelium
Authors: LAUCHLAN S.C.
Published: April 2007

The three primary epithelia of the Müllerian system are correlated with the three anatomic divisions of that system. Exceptions to normally expected associations and complicating factors including squamous epithelia and clear cells are discussed. A rationale for anticipating these anomalies is offered, and a plea is made for a diagnostic system which will accommodate both the cell type of Müllerian tumours and their anatomic location.
Scanning electron microscopy in early human bladder neoplasia
Authors: HERD M.E. , WILLIAMS G.
Published: April 2007

Biopsies of healthy looking urothelium from 61 patients with transitional cell carcinoma (TCC) of bladder were examined by scanning electron microscopy (SEM) and light microscopy. A proportion (40 %) showed abnormal features on SEM, in particular pleomorphic microvilli (PMV) in at least one area. SEM appearances were graded into four categories depending upon divergence from normal. Patients were followed up at cystoscopy and one year later a strong correlation was noted between original abnormal SEM appearances and subsequent tumour recurrence. These early results suggest that SEM could be helpful in the diagnosis, assessment, and clinical management of the unstable urothelium.
Coeliac disease: alpha‐1‐antitrypsin contents in jejunal mucosa before and after gluten‐free diet
Authors: NIELSEN KARSTEN
Published: April 2007

Biopsies of the jejunum from 10 patients suffering from coeliac disease were investigated by an immunohistochemical technique for α‐1‐antitrypsin. The biopsies obtained before treatment did not contain α‐1‐antitrypsin, but after a gluten‐free diet α‐1‐antitrypsin was present in Paneth cells in the mucosal crypts. This finding suggests that the absence of α‐1‐antitrypsin in the jejunal mucosa might be a pathogenetic factor in coeliac disease.