bluuebunny/crossref_metadata_2025 huggingface dataset:
Colorectal juvenile polyps: an epidemiological and histopathological study of 144 cases in Jordanians
Authors: DAJANI Y.F. , KAMAL M.F.
Published: April 2007

The minimal incidence rate of colorectal juvenile polyps in Jordanians was 1.4 per 100 000 in the general population and 2.8 per 100 000 in children under 10 years of age. Out of 144 cases, nine had two to seven polyps and one juvenile polyposis coli. There was male preponderance and a mean age of 8 years: 96.5% of the polyps were in the rectum. Characteristically, stromal oedema, inflammation, ulceration with granulation tissue cap formation and gland regeneration were present. Epithelial hyperplasia was not uncommon and focal dysplastic change was occasionally noted, being always accompanied by hyperplastic change. Focal severe dysplasia was seen in one solitary juvenile polyp. It is concluded that varying degrees of focal epithelial atypia can occasionally develop in solitary juvenile polyps, rarely reaching severe dysplastic change. Malignant transformation in the commonly seen form of juvenile polyp (solitary type) is probably a rare phenomenon, but its frequency needs further evaluation.
Immunohistological study of malignant diffuse mesotheliomas of the pleura
Authors: LOOSLI H. , HURLIMANN J.
Published: April 2007

Paraffin sections from fifteen cases of malignant diffuse mesothelioma of the pleura and five cases of bronchial adenocarcinoma infiltrating the pleura were examined with an antiserum specific for factor VIII related antigen and with antisera against various epithelial markers: keratin, carcinoembryonic antigen (CEA), fat globule membrane antigen and secretory component. In all adenocarcinomas all the epithelial markers were present whereas the factor VIII related antigen was absent. The distribution of the fat globule membrane antigens, keratin, secretory component and factor. VIII related antigen varied from one mesothelioma to another. The mesotheliomas were generally negative for CEA. The three mesotheliomas which were positive for CEA were also positive for alcian blue after hyaluronidase treatment. Amongst the markers used, CEA seems the most useful for the differential diagnosis between carcinoma and mesothelioma. However, the simultaneous detection of several markers allows the characterization of various phenotypes. Some of them are close to the phenotypes of true adenocarcinoma. A relation between a given phenotype and the biological behaviour of the tumour has still to be demonstrated.
Proteoglycans in human atherosclerotic lesions‐ a pilot qualitative and quantitative study by ruthenium red
Authors: HUANG WENYING , HAUST M. DARIA
Published: April 2007

A pilot study was carried out to test whether normal human aorta and aortic atherosclerotic lesions obtained at post‐mortem examination were suitable for the demonstration of proteoglycans (PGs) by ruthenium red (RR) staining, and whether by this method qualitative and quantitative differences of PGs might be detectable in various types of lesions and between lesions and the normal aortic intima. The results indicate that the PGs of the above tissues obtained at post mortem were clearly visualized by electron microscopy using the RR‐indicator and were thus suitable for quantitative and qualitative evaluation. Of the RR‐positive granules only those 20 nm and larger were assessed. RR‐granules measuring 20–50 nm were present in normal intima and media, in increased concentration in the innermost part of the mixed fatty‐gelatinous lesion, and in a decreased concentration in the fibrous cap of an atherosclerotic plaque. The same RR‐granules were observed in a fatty streak and in addition 50–100 nm granules were present in this type of lesion; the overall RR‐granule‐concentration was reduced here. Granules of both sizes were interconnected by filamentous network. The differential presence of the large (and hitherto unreported) as well as the smaller granules in the various lesions is briefly discussed in the light of the present‐day knowledge of tissue‐PGs, and the importance of an examination in situ of the compound PGs‐complexes in their native form, is emphasized.
Cardiac myxoma: an immunoperoxidase study of histogenesis
Authors: BOXER M.E.
Published: April 2007

Eleven surgically excised left atrial myxomas have been stained for factor VIII related antigen (VIII‐RA) and actin by the peroxidase‐antiperoxidase technique. Most tumour cells were negative for VIII‐RA. However a population was identified forming cords and vascular channels which possessed a core or lining of tumour cells with an endothelial morphology which were positive. Tumour cells lining vessel‐like invaginations of the surface also showed focal positive staining. The staining pattern for actin precisely mirrored that for VIII‐RA. These findings support the established theory that cardiac myxomas arise from primitive endocardial or subendocardial mesenchymal cells with the potential to differentiate towards endothelial cells. They are incompatible with the theory that these tumours originate from cardiac endothelium.
Endocrine cells in the female genital tract
Authors: FETISSOF F. , BERGER G. , DUBOIS M.P. , ARBEILLE‐BRASSART B. , LANSAC J. , SAM‐GIAO M. , JOBARD P.
Published: April 2007

Endocrine cells are normal inhabitants of the para‐urethral, Bartholin's and endocervical glands and of mesonephric rests. All these cells were characterized as serotonin‐storing cells. In the para‐urethral and Bartholin's glands, serotonin‐containing cells were most often found in the transitional epithelium of excretory ducts. Endocrine cells participated in some pathological conditions. Abundant argentaffin cells were observed among the terminal ductules in chronic bartholinitis and serotonin‐storing cells were identified in a peculiar ectocervical epithelium. Numerous serotonin‐storing cells were detected in a well‐differentiated adenocarcinoma of cervix occurring in a patient with the Peutz‐Jeghers syndrome. Argyrophilic cells were present in cases of endometrial carcinomas; a striking feature was the demonstration of gut peptide hormones in an unusual type of endometrial adenocarcinoma. Finally, serotonin‐storing cells were a constituent of Brenner tumours. It is suggested that a similar endocrine pattern may be shared by tissues originating from both Müllerian ducts and the urogenital sinus.
A study on the relationship between solid cell nests and mucoepidermoid carcinoma of the thyroid
Authors: HARACH H.R.
Published: April 2007

Mucoepidermoid carcinoma of the thyroid (MECT) has been recently recognized as a pathological entity. The origin of MECT is unknown but the morphology of this tumour closely resembles features seen in the ultimobranchial body (UB) vestiges. Recent studies in man have shown strong evidence that the so‐called solid cell nests (SCN) of the thyroid may correspond to the human UB vestiges. To investigate whether these vestiges are the site of origin of this tumour a comparative study on SCN and MECT was undertaken. One hundred autopsied thyroids cut at 2–3 mm intervals were studied for the presence of SCN. Histochemical (H & E, Alcian blue‐PAS, Mayer mucicarmine) and immunohistochemical studies (calcitonin, epidermal keratin) were perfonned in SCN and four cases of MECT. Sixty percent of thyroids were found to have SCN. They were mainly composed of epidermoid‐like cells arranged in solid structures or lining cystic cavities, tubular and follicular structures. Solid clusters usually showed lumina containing PAS‐positive and mucin‐positive cell debris. Mucin stains also revealed mucinous cells placed around lumina filled by mucosubstances. Characteristic PAS‐positive rounded bodies were found filling lumina as well as within some apical epidermoid‐like cells, mucinous cells and cell debris. An obvious transition between these cells, cell debris and mucosubstances filling the lumina was noticed; suggesting degenerative changes undergone by the epidertnoid‐like cell. MECT basically presented all histological and histochemical features shown by SCN, furthermore, calcitonin containing cells were observed in 54% of SCN, while a metastatic MECT also showed scattered C cells within solid islands. The presence of epidermal keratin in all SCN and MECT, together with the previous findings, are strong evidence that MECT could originate in the SCN or human UB vestiges.
Verruciform xanthoma of the skin
Authors: AL‐NAFUSSI A.I. , AZZOPARDI J.G. , SALM R.
Published: April 2007

A case of verruciform xanthoma is described, representing the fourth case of an extraoral lesion and the first case of xanthoma of this type to involve the true skin. The differential diagnosis from other types of xanthoma, and from granular cell tumour, verrucous carcinoma and other lesions is discussed. This lesion is well known to oral pathologists but deserves wider recognition by histopathologists in general.
A case of pulmonary vascular occlusive disease: comparison of post‐mortem radiography and histology
Authors: PääKKö P. , SUTINEN S. , REMES M. , PAAVILAINEN T. , WAGENVOORT C.A.
Published: April 2007

A case of rapidly progressing fatal pulmonary hypertension in a nine‐year‐old boy showing histological narrowing and occlusion of pulmonary veins and arteries is described. Post‐mortem radiography of the air‐inflated, excised lung without use of additional contrast media nicely demonstrated the vascular lesions.
Benign localized mesothelioma of the pleura
Authors: JANSSEN J. P. , WAGENAAR SJ. SC. , VAN DEN BOSCH J. M. M. , VANDERSCHUEREN R. G. J. R. A. , PLANTEYDT H. T.
Published: April 2007

Eleven cases of benign localized mesotheliomas of the pleura are described. Ten patients were asymptomatic and discovered by routine X‐rays. In eight cases the tumour was localized in the visceral pleura and all tumours showed only a benign mesenchymal component. Non‐neoplastic epithelial structures can become entrapped within the tumour. A benign clinical behaviour and an excellent prognosis could be expected after surgical resection.
Plastic embedding in routine histology I: Preparation of semi‐thin sections of undecalcified marrow cores
Authors: ISLAM A. , FRISCH BERTHA
Published: April 2007

The preparation of sections of bone marrow cores in a routine histology laboratory requires decalcification and paraffin embedding, which produces shrinkage and considerable loss of cellular detail. This may be avoided by using plastic embedding procedures. This report describes a simplified routine procedure for using methyl‐methacrylate as a plastic embedding medium for the preparation of semi‐thin sections of undecalcified bone marrow cores. A modification of the May‐Grunwald‐Giemsa stain is also given which provides good colour differentiation of various haematopoietic cells in the marrow. The method is simple, reproducible, requires no expensive equipment, and is suitable for routine processing of bone marrow biopsy cores in any histopathology laboratory.
The assessment of cardiac hypertrophy at autopsy
Authors: HANGARTNER J.R.W. , MARLEY N.J. , WHITEHEAD A. , THOMAS A.C. , DAVIES M.J.
Published: April 2007

The total weight of the normal adult human heart as well as that of each ventricle is proportional to body size. Body weight is superior to height as a predictor of total heart and isolated ventricular weights. Ventricular wall thickness is an insensitive means of assessing ventricular hypertrophy. Heart weight is a poor predictor of isolated right ventricular mass but a slightly better predictor of isolated left ventricular mass. The only method of determining the presence or absence of hypertrophy with confidence is to use the Fulton technique for isolated ventricular weights. The use of an arbitrary upper and lower limit, as currently used, for isolated ventricular weights obtained by Fulton's method may, however lead to errors in determining the presence or absence of ventricular hypertrophy.
The organization of cell populations within lymph nodes: their origin, life history and functional relationships
Authors: FOSSUM S. , FORD W. L.
Published: April 2007

The normal lymph node comprises a superficial cortex, a deep cortex or paracortex and a medulla. In each of these regions there are three kinds of spaces: an intralymphatic space, an intravascular space and an extravascular space or interstitium. Both the vascular endothelium and the lymphatic endothelium are specialized in these different regions. The cell types in lymph nodes comprise lymphoid cells, accessory or non‐lymphoid cells and stromal cells, and within these cell types a number of different sub‐types can now be identified by means of enzyme‐ and immunocytochemistry. Based predominantly on experimental studies, the origin, migratory patterns, localization, inter‐relationships and interactions between these various cells are reviewed.
Melanocytic dysplasia and melanoma
Authors: COOK M.G. , ROBERTSON I.
Published: April 2007

A review of a series of 226 melanomas, representing 95% of the melanomas presenting in one year, has shown that 34% are associated with atypical melanocytic proliferation or melanocytic dysplasia in the adjacent skin. The dysplasia may be lentiginous, predominantly spindle‐celled or non‐lentiginous in pattern. These variants appear to correspond to the previously reported lesions, lentiginous and epithelioid melanocytic dysplasia and atypical melanocytic hyperplasia respectively. Some of these are referred to as dysplastic naevi. All these variants were seen in a review of 325 cases of melanocytic dysplasia. The variations are commonly seen within the same lesion and it is argued that they are variants of a single premalignant process which might best be termed melanocytic dysplasia. Melanocytic dysplasia is seen in white races, on non‐exposed and exposed skin. They may be solitary as well as multiple and the majority are non‐familial. Although melanocytic dysplasia may be a precursor of a large proportion of malignant melanomas it is suggested that most lesions mature into a benign intradermal melanonaevus. The behaviour of the lesions in any single patient appears to be proportional to the number and cellularity of the lesions and the strength of the family history. A diffuse mottled pattern of melanocytic dysplasia appears to have a particularly unfavourable prognosis.
The granular peripolar cell of the human glomerulus: a new component of the juxtaglomerular apparatus?
Authors: GARDINER D. S. , LINDOP G. B. M.
Published: April 2007

Using serial sections of resin‐embedded tissue we found granular peripolar cells in six human kidneys. They were present in 3% to 28% of the glomeruli. Using an immunoperoxidase staining technique and an antibody to pure human renin we showed that the human peripolar cell contains no immunostainable renin. The number of peripolar cells correlated with the number of juxtaglomerular apparatus (JGAs) with renin‐containing cells; their distribution within the renal cortex was similar, both being found predominantly in glomeruli in the superficial cortex. There was a close anatomical relationship between the peripolar cells and the renin containing cells in individual JGAs. These findings suggest the possibility of a functional relationship between the peripolar cell and the other components of the juxtaglomerular apparatus.
Leucocyte antigens in human post mortem tissues: their preservation and loss as demonstrated by monoclonal antibody immunohistological staining
Authors: PALLESEN G. , KNUDSEN L.M.
Published: April 2007

The development of monoclonal antibodies and of techniques for demonstrating antigens in situ in frozen tissue sections has been responsible for remarkable progress in diagnostic histopathology. We explored the potential of these techniques when applied to post mortem tissues that were frozen at various intervals after death and stained by monoclonal antibodies using immunoperoxidase technique. The monoclonal antibodies were selected according to their reactivity with essential markers of the lymphatic system and also to their availability. Lymph nodes and splenic tissue from 30 autopsy cases were stained in addition to thymic tissue from eight deceased infants. The antigens proved to be surprisingly well preserved. Staining could be precisely evaluated with UCHT1, OKT6 and anti‐Leu‐7 antibodies at least 72 h after death; staining with DAKO‐pan‐B, DAKO‐LC and anti‐Leu‐3a was also very reliable. Antigens expressed by T‐suppressor lymphocytes and dendritic reticulum cells were less well preserved. The T8‐antigen of suppressor lymphocytes was usually demonstrable in the lymph nodes but less frequently in the splenic tissues. It is concluded that most leucocyte antigens are very resistant to post mortem disintegration, and that they can be reliably interpreted by immunohistological staining using monoclonal antibodies. We therefore recommend this in autopsy specimens in cases where in‐vivo examination was not feasible.
Concomitant angiosarcoma and carcinoma of the breast: a case report
Authors: RYAN J.F. , KEALY W.F.
Published: April 2007

A case of concomitant angiosarcoma and carcinoma of the left breast in a forty‐three year old woman is described. Following a diagnosis of angiosarcoma she was treated by simple mastectomy. Five months later, left axillary lymph node biopsy showed metastatic adenocarcinoma. Retrospective examination of the mastectomy specimen disclosed a concomitant but separate adenocarcinoma. The patient remains well after 3 years. The implications of this rare association are discussed and the long survival gives an opportunity to review the prognosis in breast angiosarcomas.
Mediastinal and retroperitoneal fibrosis with fibrotic pulmonary nodules: a case report
Authors: MAGEE J. F. , WRIGHT J. L. , DODEK A. , TUTASSAURA H.
Published: April 2007

We report a patient with a long history of pan‐hypopituitarism treated with pituitary snuff who developed superior mediastinal fibrosis involving the visceral pericardium, retroperitoneal fibrosis, and a peculiar widespread nodular fibrosis of the lungs.
Immunohistochemical demonstration of p24 HTLV III major core protein in different cell types within lymph nodes from patients with lymphadenopathy syndrome (LAS)
Authors: BARONI C. D. , PEZZELLA F. , MIROLO M. , RUCO L. P. , ROSSI G. B.
Published: April 2007

The p24 protein is the major core protein of LAV/HTLV III which is the putative agent of the lymphadenopathy syndrome. By the use of an anti‐p24 monoclonal antibody we have studied the presence of LAV/HTLV III infected cells in 20 lymph nodes obtained from lymphadenopathy syndrome patients: 14 lymph nodes were characterized by prominent follicular hyperplasia consistent with the early phase of the syndrome and six lymph nodes presented marked regressive changes. Cells positive for p24 were detected in 8/14 lymph nodes with hyperplastic changes and in 1/6 lymph nodes with regressive changes. Positive cells were most often located in germinal centres and were mainly characterized by a lymphoid morphology. However, immunoreactivity for p24 protein was also occasionally observed in some histiocytic‐like cells and in high endothelial cells of post‐capillary venules, suggesting that these ‘accessory cells’ also play a role in the early phases of the lymphadenopathy syndrome.
Dendritic reticulum cells in reactive lymph nodes and tonsils: an immunohistological study
Authors: GUETTIER C. , GATTER K. C. , HERYET A. , MASON D. Y.
Published: April 2007

There has recently been much interest in the patterns of follicular dendritic reticulum cells (DRC) in pathological lymph nodes, particularly in relation to the phenomenon of DRC break‐up (thought to be pathognomonic of AIDS‐related lymphadenopathies) and to progressive transformation of germinal centres (as a possible precursor of lymphocyte predominant Hodgkin's disease). In the present study we have immunostained twenty‐nine reactive lymph nodes and five tonsils with monoclonal antibody R4/23 (DAKO‐DRC) in order to evaluate the frequency of such changes in lymphoid tissue unaffected by AIDS or Hodgkin's disease. Most of the specimens contained typical secondary follicles with clearly defined germinal centres and mantle zones. There were two variants in lymph nodes showing follicular hyperplasia characterized by (i) progressive transformation of germinal centres and (ii) inclusions of nests of small lymphocytes within germinal centres. In each of these types of follicles the compact evenly‐distributed meshwork of DRCs, as previously described, was seen. However there were considerable variations in DRC meshwork in each category (the pattern could not be predicted from the morphology) with examples in all three of the DRC break‐up previously considered specific for the AIDS related lymphadenopathy. Since none of the lymph nodes and tonsils studied had any known relationship to either Hodgkin's disease or AIDS it is argued that none of the changes in the DRC meshwork observed are specific for these conditions.
Papillary carcinoma of the thyroid gland with lipomatous stroma: report of a peculiar histological type of thyroid tumour
Authors: VESTFRID M. A.
Published: April 2007

The author reports a case of a 53‐year‐old woman with a slowly growing thyroid papillary carcinoma. Microscopically the presence of adult adipose tissue was detected in numerous papillae. The recognition of this histological type as a new variety of papillary carcinoma is proposed.
Prevalence and morphological features of adenomas of the large intestine in individuals with and without colorectal carcinoma
Authors: EIDE T.J.
Published: April 2007

The presence of adenomas in 164 surgical specimens of the large intestine from 81 males and 83 females with colorectal carcinomas was compared with the presence of adenomas in a general necropsy population in northern Norway. In the group of patients with colorectal carcinomas the observed prevalence of single or multiple adenomas was 5.9 times higher than expected from the prevalence in the general necropsy population. The observed‐to‐expected ratios of all adenomas (4.7), adenomas with villous elements (4.6), adenomas with moderate or severe grades of dysplasia (4.9) and adenomas 10 mm or larger (5.5) were also higher in the surgical series. The study indicates that factors which initiate the growth of adenomas and; to a minor degree, factors which promote the growth of adenomas to a large size are more prevalent in individuals with colorectal carcinoma than in the necropsy population. Factors determining the presence of villous elements and the grades of dysplasia of adenomas seem to operate similarly in adenoma‐bearing patients with and without colorectal carcinoma.
Operation‐associated neutrophils in a percutaneous liver biopsy: effect of prior transjugular procedure
Authors: McDONALD G.S.A. , COURTNEY M.G.
Published: April 2007

A young man with chronic active hepatitis was heavily sedated during an attempted transjugular liver biopsy. The procedure was abandoned after 3 h and an immediate percutaneous liver biopsy was performed. This showed features of chronic active hepatitis but, in addition, groups of polymorphonuclear leukocytes in the parenchyma. These were similar to the operation associated neutrophils encountered in liver biopsies taken during the course of abdominal surgery. In a review of 78 liver biopsies from patients with chronic active hepatitis, this type of infiltrate was seen in four of eight surgically resected specimens but not in 70 percutaneous biopsies. The neutrophilic infiltrate in the present case appears to be an unique occurrence in a percutaneous liver biopsy. It was probably related to hypoperfusion during the preceding prolonged sedation and illustrates the ease with which an already diseased liver can be further damaged.
Lymphoglandular complexes of the colon: structure and distribution
Authors: O'LEARY A.D. , SWEENEY E.C.
Published: April 2007

The structure and distribution of lymphoglandular complexes of the colon are described. The cellular composition of these complexes, as detailed by immuno‐histochemistry and electron microscopy, suggests that they are sites of antigen processing. Variations in structure and in the number of complexes that are found in certain colonic diseases are documented.
Ultrastructural and immunocytochemical definition of component neoplasms in an unusual gastrooesophageal collision tumour
Authors: PURDY S. , GAFFNEY E.F.
Published: April 2007

An unusual collision tumour (concrescence of two neighbouring independent neoplasms) is reported. One tumour was a small cell undifferentiated (oat cell) carcinoma of the lower oesophagus and the other was a gastro‐oesophageal adenocarcinoma. There was little intermingling of the two patterns. The adenocarcinoma stained strongly positive for mucin and carcinoembryonic antigen (CEA), but the small cell carcinoma was negative for both and also argyrophil‐negative; both were negative for neurone‐specific enolase and common leukocyte antigen. Ultrastructural study showed extracellular glandular lumina lined by cells with apical microvilli and junctional complexes in the adenocarcinoma; primitive cells without tonofilaments or dense‐core granules, and joined by rudimentary desmosomes were seen in the small cell carcinoma. Collision carcinomas may result from a carcinogenic stimulus affecting two neighbouring regions of mucosa or may simply be the chance apposition of two unrelated tumours.
Multilobated B‐cell lymphoma, a variant of centroblastic lymphoma. Report of four cases
Authors: CHAN J.K.C. , NG C.S. , TUNG S.
Published: April 2007

Four cases of multilobated B‐cell lymphoma, one follicular and three diffuse, are described. Many of the lymphoma cells show marked lobulation of the nuclei, and possess multiple prominent nucleoli. There are admixed classical centrocytes, classical centroblasts, and cells with morphology intermediate between classical centroblasts and multilobated cells. Multilobated cells are also observed in small numbers in germinal centres of lymph nodes showing reactive follicular hyperplasia. We believe that the multilobated B‐cell may represent one form of centroblast during transition between the centroblastic and centrocytic stages. Multilobated B‐cell lymphoma may be its neoplastic counterpart in which the nuclear lobulation is further exaggerated.
O‐acetylated sialic acid variants in intestinal glandular metaplasia of the urinary tract
Authors: LAPERTOSA G. , BARACCHINI P. , FULCHERI E. , TANZI R.
Published: April 2007

Two cases of chronic cystitis, two of chronic ureteritis, one of chronic pyelitis and two transitional cell carcinomas of the urinary tract showed glandular metaplasia or focal mucin production. Positive staining for O‐acetylated sialic acid variants (sites 7 and 8) detected by the PB‐KOH‐PAS method was found in the two cases of cystitis, in one of chronic ureteritis and in one of chronic pyelitis. Positive staining was observed only in areas showing an intestinal type of metaplasia and in which goblet cells and argyrophil cells were also identified. These findings taken together with earlier studies on ovarian cystadenomas lead the authors to believe that O‐acetylated variants are markers of an intestinal type of epithelium. Evaluation of O‐acetylated sialomucins may be useful in further studies on the histogenesis of primary adenocarcinomas of the bladder.
Malignant carcinoid of oesophagus
Authors: SIEGAL A. , SWARTZ A.
Published: April 2007

This paper presents a unique apudoma variant—a malignant carcinoid of mid and lower oesophagus in an elderly man. It was remarkable in the short duration of the clinical symptoms, its rather easy resectability despite its large size and the local perigastric lymph node metastases. On light microscopy, the neoplasm was composed entirely of atypical but uniform round cells lacking argentaffin and argyrophilic staining, arranged in a carcinoid pattern. On electron microscopy, they exhibited dense‐core neurosecretory granules.
Use of silver staining (Dieterle's stain) in the diagnosis of cat scratch disease
Authors: KORBI S. , TOCCANIER M‐F. , LEYVRAZ G. , STALDER J. , KAPANCI Y.
Published: April 2007

Lymph node involvement in cat scratch disease is characterized by a granulomatous lymphadenitis with micro‐abscesses. Recently, it has been shown that the possible aetiological agent is a micro‐organism which stains with some silver stains. In this study 60 lymph nodes were studied from 60 patients, using a modified Dieterlé's stain. In 40 cases (66%) rod‐shaped bacilli with rounded extremities were observed. They were negative both with the Gram and Ziehl‐Neelsen stains. Since such micro‐organisms were demonstrated in the majority of the nodes examined, it can be concluded that silver stains are appropriate for the diagnosis of this condition.
Simultaneous AL‐type amyloid and light chain deposit disease in a liver biopsy: a case report
Authors: SMITH N.M. , MALCOLM A.J.
Published: April 2007

A 57‐year‐old male caucasian presented with a peripheral neuropathy which had an autonomic component. Clinical examination revealed hepatomegaly and laboratory tests showed derangement of liver function tests and IgG lambda myeloma. Biopsy of the liver was performed. Histological examination revealed AL‐type amyloid in the hepatic arteries and a perisinusoidal deposit of diastase resistant, periodic acid‐Schiff positive material which did not react in the same way as the arterial deposit, giving no apple green birefringence when stained with Congo red. Immunohistochemistry showed the material to consist of lambda light chains. Electron microscopy confirmed that the material did not have the ultrastractural characteristics of amyloid. A diagnosis of light chain deposit disease concurrent with vascular AL‐type amyloid was made.
The value of lymph node biopsy in patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS‐related complex (ARC): a morphological and immunohistochemical study of 90 cases
Authors: PILERI S. , RIVANO M.T. , RAISE E. , GUALANDI G. , GOBBI M. , MARTUZZI M. , GRITTI F.M. , GERDES J. , STEIN H.
Published: April 2007

The morphological and immunohistochemical findings in lymph nodes of nine patients with the acquired immunodeficiency syndrome (AIDS) and 81 patients with the AIDS‐related complex (ARC) are presented. Three basic histological patterns were observed: follicular hyperplasia (29 cases), mixed hyperplasia (49 cases) and lymphocyte depletion (12 cases). While the first two variants were detected in typical ARC patients, lymphocyte depletion was always associated with AIDS. Immunohistochemistry on frozen sections showed that the number of B‐cells varied throughout the series, being higher in the follicular type and significantly lower in the lymphocyte depletion nodes. The content of T‐lymphocytes of the helper/inducer (T4) phenotype was reduced in all instances; this reduction was more pronounced in the germinal centres in follicular hyperplasia, while it involved all compartments of the node in the mixed and lymphocyte depletion types. In contrast the cytotoxic/suppressor (T8) subset was increased in the follicular and mixed hyperplasias only. Partial disintegration of the dendritic network in at least some of the follicles could be demonstrated in all lymph nodes. In the follicular and mixed hyperplasias there was a high number of proliferating B‐cells in the germinal centres. Our data indicate the usefulness of grading the changes occurring in lymph nodes of patients with ARC and AIDS, and allow speculation as to the pathophysiology of these conditions.
Staining for factor VIII related antigen and Ulex europaeus agglutinin I (UEA‐I) in 230 tumours. An assessment of their specificity for angiosarcoma and Kaposi's sarcoma
Authors: LEADER M. , COLLINS M. , PATEL J. , HENRY K.
Published: April 2007

In this study we examined the staining reactivity of commercially available antisera to factor VIII related antigen (F VIII RAg) and Ulex europaeus agglutinin I (UEA‐I) on sections from 230 formalin fixed paraffin embedded tumours. These included 196 sarcomas, 20 carcinomas and 14 angiomas. All angiomas showed positive staining for F VIII RAg; all carcinomas showed negative staining; the vasoformative areas of all angiosarcomas stained positively but only four of six angiosarcomas showed positive staining of their solid areas; of seven Kaposi's sarcomas, all showed positive staining of vessels and six showed positive staining of the spindle cell component. In the remaining 181 non‐vascular sarcomas there was a false positive result in four tumours (2.2%), three of which had a history of irradiation. Pre‐radiotherapy biopsies of these three tumours stained negatively with anti‐F VIII RAg. UEA‐I was demonstrated in all the angiomas studied, in all angiosarcomas (including the solid components) and in well‐formed vessels of all Kaposi's sarcomas, but only in the spindle cell component of 3/6. However, there was an unacceptably high rate of false positive staining amongst the carcinomas and non‐vascular sarcomas. In conclusion, F VIII RAg is a specific but not a sensitive marker of angiosarcomas; UEA‐I is a sensitive but not a specific marker of angiosarcomas.
Cytokeratin and laminin immunostaining in the diagnosis of cutaneous neuro‐endocrine (Merkel cell) tumours
Authors: HALL P.A. , D'ARDENNE A.J. , BUTLER M.G. , STEARN P.M. , SUBBUSWAMY S.G. , BLACKSHAW A.J. , LEVISON D.A.
Published: April 2007

Nine cutaneous neuro‐endocrine tumours have been immunostained with monoclonal antibodies to low molecular weight cytokeratin (CAM 5.2) and neurofilament. Polyclonal antisera to neurone‐specific enolase, calcitonin and laminin were also used. All nine cases showed paranuclear, dot‐like positive staining with CAM 5.2 and diffuse cytoplasmic staining for neurone‐specific enolase. Neurofilament and calcitonin immunoreactivity could not be demonstrated. All tumours were negative for laminin immunoreactivity. The limitations of staining for neurone‐specific enolase are discussed and the value of CAM 5.2 in the differential diagnosis of cutaneous neuro‐endocrine tumours is emphasized. The histogenetic implications of the absence of laminin staining are considered.
Neoplastic angioendotheliosis—further evidence supporting a lymphoid origin
Authors: THEAKER J.M. , GATTER K.C. , ESIRI M.M. , EASTERBROOK P.
Published: April 2007

Neoplastic angioendotheliosis is a rare condition, most commonly presenting with a bizarre neurological illness associated with multifocal cerebral infarction due to the occlusion of small blood vessels by neoplastic cells. The histogenesis of the malignant cells is controversial with previous suggestions of an endothelial, epithelial or lymphoid origin. We have studied a case immunohistologically using a panel of monoclonal and polyclonal antibodies recognizing a range of lymphoid, endothelial and epithelial antigens. The results indicate that the malignant cells were of B‐lymphoid origin. We also report a second case in which a patient with a high grade B‐cell non‐Hodgkin's lymphoma developed multiple painful skin nodules which showed the histological features of neoplastic angioendotheliosis. These findings support the view that neoplastic angioendotheliosis is a lymphoma with a propensity to localize and proliferate in small blood vessels throughout the body.
Spitz naevi and malignant melanomas of childhood and adolescence
Authors: PETERS M.S. , GOELLNER J.R.
Published: April 2007

We reviewed 33 cases of Spitz naevus and 19 of malignant melanoma in patients aged 20 years or less who were evaluated at our institution from 1950 to 1975 and followed‐up for up to 32 years. The histological findings were studied prior to review of clinical data. There were no malignant melanomas in patients less than 9 years old; almost half (15/33) of the Spitz naevi were in this age group. Among the 25 histological criteria evaluated in the 52 lesions, the most striking differences between malignant melanomas and Spitz naevi were a higher degree of pagetoid spread, cellular pleomorphism, nuclear hyperchromasia and mitotic activity in the malignant melanomas, and a more prominent spindle cell component in Spitz naevi. We stress the importance of cytological as well as architectural criteria in distinguishing between Spitz naevi and malignant melanomas and emphasize the pitfalls that may be encountered because of overlap in histological features between the two groups.
Proteinase inhibitors in the kidney and its tumours
Authors: FLEMING S. , GIBSON A.A.M.
Published: April 2007

The proteinase inhibitors alpha‐1‐antitrypsin and alpha‐1‐antichymotrypsin are found in a variety of tissues including the kidney. We have used the immunoperoxidase technique to study the distribution of these glycoproteins in 10 fetal and five adult kidneys and in 44 renal tumours. Proteinase inhibitors were found in fetal kidneys in the cells of the metanephric blastema, primitive mesenchyme and in proximal tubules. They were found in proximal tubules of adult kidneys. These substances were also found in the mesenchyme of nephroblastomas and in the tumour cells of clear cell, oncocytic and sarcomatoid variants of renal cell carcinoma. These observations are significant in the understanding of the patterns of differentiation of which renal cell carcinoma is capable.
The carotid bodies in a case of ventricular septal defect
Authors: SMITH P. , HURST G. , HEATH D. , DREWE R.
Published: April 2007

A woman of 62 years with Turner's syndrome died in congestive cardiac failure secondary to a large ventricular septal defect with biventricular hypertrophy. During her last few months the lifelong left‐to‐right shunt underwent reversal exposing her carotid bodies to hypoxaemia. The carotid bodies were not enlarged, thus demonstrating that hyperplasia of glomic tissue is not brought about by increased myocardial mass per se. They were, however, abnormally cellular with more dark cells (a variant of chief cells), many of which were abnormally large and showed ultrastructural features of metabolic activity. These changes may represent the earliest histological response of the carotid body to hypoxaemia and later, the dark cells may mature into the more familiar and common light variant. It seems likely that this dark cell activity precedes, probably by a long period, the sustentacular cell hyperplasia and proliferation of nerve axons which we have reported elsewhere as the chronic reaction of the carotid bodies to hypoxaemia.
A histological and immunocytochemical study of lymphoid tissue in rectal biopsies from homosexual men
Authors: BISHOP P.E. , McMILLAN A. , GILMOUR H.M.
Published: April 2007

A histological study of the lymphoid tissue of the rectums of 323 homosexual and 30 heterosexual men (including five intravenous drug users seropositive for human immunodeficiency virus, HIV) was undertaken. Marked lymphoid hyperplasia (germinal centre >680μm in diameter) was found in 13 men, nine of whom had a sexually transmitted infection of the rectum. Immunocytochemical studies showed that the germinal centres contained B‐cells and follicular dendritic cells, surrounded by CD4+ and CD8+ T‐cells in a ratio of between 5:1 and 10:1. In HIV‐infected men there were decreased numbers of CD4+ cells and increased numbers of CD8+ cells, resulting in a ratio of between 0.8:1 and 2:1. In biopsies from four of seven HIV‐infected men the follicular dendritic cell processes appeared shorter and fragmented. The pathogenesis of HIV infection is discussed in the light of these findings.
Carcinoma of the nasopharynx. Histopathological examination with supplementary immunohistochemistry
Authors: OPPEDAL B.R. , BÖHLER P.J. , MARTON P.F. , BRANDTZAEG P.
Published: April 2007

One hundred and one nasopharyngeal malignancies, clinically accepted and treated as carcinomas, were histologically reviewed. Originally, all of them had been given the histopathological diagnosis of carcinoma or possible carcinoma. A wide variety of diagnostic formulations had been used, some of them inconclusive. The review was based on strict morphological WHO criteria, and a definite diagnosis was attained in most cases. Three of the neoplasms, however, did not fulfil the criteria of carcinoma, and were given the diagnosis of malignant tumour, probable lymphoma. Immunohistochemistry with routinely processed tissue was performed on 69 of the poorly differentiated non‐keratinizing neoplasms, including the three possible non‐Hodgkin's malignant lymphomas. The neoplasms were positive for cytokeratin PKKl with four exceptions: the three possible lymphomas and a large cell tumour with epithelial growth and prominent nucleoli which was found to be positive only for neurone‐specific enolase. Two of three possible lymphomas were verified as such by being positive for leucocyte common antigen. This study showed that the WHO classification is quite useful when strictly applied. The histopathological diagnosis of this category of neoplasms can easily be confirmed by immunohistochemistry on routinely processed material and this adjunct can usually resolve questionable cases.
Langerhans cell histiocytosis: an unusual case illustrating the value of immunohistochemistry in diagnosis
Authors: HALL P.A. , O'DOHERTY C.J. , LEVISON D.A.
Published: April 2007

The morphological features of Langerhans cell histiocytosis (histiocytosis X) are characteristic but the diagnosis can on occasion be difficult. A case is presented that illustrates the diagnostic value of immunohistochemistry in the differential diagnosis of this condition. The cells of Langerhans cell histiocytosis were found to express CD1, CD4, CD11b and CD11c. They also reacted with EBM11, UCHM1, KB61 and HLA‐DR. Occasional cells showed nuclear staining with Ki67, but no other lymphoid antigens were detected. Immunoreactivity of the cells of Langerhans cell histiocytosis with antibodies that recognize antigens present on macrophages provides further evidence for immunological similarities between these cell types.
Histological aspects of sexually transmitted genital lesions
Authors: FREINKEL A.L.
Published: April 2007

Occasional biopsies of genital lesions due to chancroid, secondary syphilis (the condyloma latum) and granuloma inguinale are encountered in routine histopathological practice. These lesions have specific microscopical appearances enabling a confident, or at least a presumptive, diagnosis to be made in most cases, yet the value of biopsy in the diagnosis of these diseases is not generally appreciated. The ulcer of chancroid shows three zones—a narrow superficial zone of degenerate leucocytes and fibrin, a broader middle zone with characteristic vascular changes, and a deep zone in which there is a plasma cell and lymphocyte infiltrate. The condyloma latum shows hyperplasia of the epidermis which is infiltrated with polymorphonuclear leucocytes in addition to the mononuclear infiltration of the dermis. Large numbers of spirochaetes are found in the area of the polymorph exocytosis of the epidermis. The inflammatory infiltrate of granuloma inguinale consists of a neutrophil and plasma cell infiltrate with moderate numbers of large mononuclear cells in which there are one or more vacuoles containing Donovan bodies.
Spindle cell squamous carcinoma of the lung. Immunocytochemical and ultrastructural study of a case
Authors: SUSTER S. , HUSZAR M. , HERCZEG E.
Published: April 2007

A case of squamous cell carcinoma of the lung showing extensive spindle transformation is presented. On light microscopy, the tumour showed sheets and fascicles of elongated fusiform cells resulting in a growth pattern which closely resembled a sarcoma. Immunocytochemistry using tissue‐specific antibodies against intermediate filaments demonstrated exclusive labelling of the tumour cells with prekeratin antibodies. Electron microscopy showed well‐formed intercellular junctions and thick bundles of tonofilaments within the cytoplasm of the cells further confirming the squamous epithelial nature of the neoplasm. The findings in the present case point to the existence of a non‐metaplastic spindle cell variant of squamous carcinoma of the lung. The possible mechanisms which may account for the spindle shape of the cells are reviewed.
Classification of normal colorectal mucosa and adenocarcinoma by morphometry
Authors: HAMILTON P.W. , ALLEN D.C. , WATT P.C.H. , PATTERSON C.C. , BIGGART J.D.
Published: April 2007

Semi‐automatic image analysis was used to make a morphometrical assessment of 15 nuclear and cellular variables in normal (n=20) and malignant (n=30) colorectal epithelium. Principal components analysis on the matrix of correlations between variables identified four main sources of variation within the dataset. These were, in decreasing order of importance: (1) nuclear size, nuclear cytoplasmic ratio and nuclear position within the cell; (2) the variability of nuclear size; (3) nuclear elongation and polarity; (4) nuclear shape and its variation. Discriminant analysis was conducted between histologi‐cally normal mucosa (n=10) and adenocarcinoma in ulcerative colitis (n=20). Using stepwise variable selection, the mean nuclear cytoplasmic ratio (normal, mean 20.4 (s.d. ± 2.0); tumour, mean 39.7 (s.d. ± 7.0)) and the coefficient of variation of nucleus to cell apex distance (normal, mean 19.2 (s.d ± 7.5); tumour, mean 47.8 (s.d. ± 9.1)) were chosen as discriminating features. They were used to derive a discriminant function which gave perfect discriminating between the two groups. Scatter plots of these two variables confirmed complete separation of normal mucosa from adenocarcinoma and provided a simple method of applying the discriminant function. Discriminatory performance did not deteriorate when the function was applied to further normals (n=10) and adenocarcinoma (n=10). This study highlights the descriptive differences between normal and malignant colorectal epithelium and shows that case allocation may be made to these two lesion categories using a morphometrically‐derived classification rule.
Polycystic disease of the parotid glands: case report of a rare entity and review of the literature
Authors: DOBSON C.M. , ELLIS H.A.
Published: April 2007

We report a case of polycystic disease of the parotid glands. This is a rare disorder and we know of only two previous documented cases in the literature. The disease presents with painless enlargement of one or both parotid glands and is not associated with any clinical abnormality of salivation or with any apparent anomaly of the other salivary glands. Histologically, the overall glandular architecture is preserved but the lobules are all markedly distended by epithelial‐lined cysts, which appear to be derived from the intercalated ducts. Characteristic congophilic laminated spheroliths are present within the cystic spaces. The condition must be differentiated from cystic neoplasms, particularly papillary cystic adenocarcinoma, and from various non‐neoplastic disorders including sialectasia, retention cysts and lymphoepithelial cysts.
Granulomatous sialadenitis of the major salivary glands. A clinicopathological study of 57 cases
Authors: VAN DER WALT J.D. , LEAKE J.
Published: April 2007

Fifty‐seven of 469 major salivary glands excised for various reasons were found to contain granulomas. The aetiologies were tuberculosis (eight parotid, one sublingual), sarcoidosis (two parotid), calculous duct obstruction (34 submandibular), carcinomatous duct obstruction (four submandibular, one sublingual) and undetermined (four submandibular, three parotid). The tuberculous glands showed caseation in the majority of cases but two cases consisted predominantly of discrete granulomas with minimal necrosis. The sarcoid granulomas were typically non‐caseating but a few were centrally necrotic. The cases of calculous and carcinomatous duct obstruction contained single to multiple small granulomas which contained mucin and were related to ruptured ducts. It is suggested that the frequency of calculi and the mixture of serous and mucous acini in the submandibular gland account for the distribution of obstructive granulomas. This study establishes calculous sialadenopathy as a major cause of granulcmatous sialadenitis.