bluuebunny/crossref_metadata_2025 huggingface dataset:
Collagenous and basement membrane proteins of chordoma: immunohistochemical analysis
Authors: UEDA Y. , ODA Y. , KAWASHIMA A. , TSUCHIYA H. , TOMITA K. , NAKANISHI I.
Published: April 2007

Tissue localization of collagenous and basement membrane proteins in the extracellular matrix of five sacro‐coccygeal chordomas and human fetal notochords was examined immunohistochemically to assess the implications for the histogenesis and histological diagnosis of chordoma. Human fetal notochords and conventional chordomas both exhibited basement membrane proteins (such as type IV collagen and laminin) and type VI collagen on the surfaces of cellular cords. Type II collagen, a main structural protein of cartilage, was also present in both tissues. In the chordomas, however, type II collagen was not so widespread as it was in the notochords, and the predominant collagenous protein was type I. In contrast, an altered deposition of these proteins was noticed in a recurrent tumour which, histologically, showed considerable atypia and eventually metastasized to the liver. The characteristic cartilage‐type and basement membrane proteins disappeared and unusual collagen types, such as types III and V, appeared in the stroma. The results further support the notochordal origin of chordoma and suggest that the immunohistochemistry of collagenous and basement membrane proteins may be a helpful criterion for the histological diagnosis and prediction of the biological aggressiveness of chordomas.
Detection of immunoglobulin light chain mRNA in nodular sclerosing Hodgkin's disease by in situ hybridization with biotinylated oligonucleotide probes compared with immunohistochemical staining with poly‐ and monoclonal antibodies
Authors: LAURITZEN A.F. , PLUZEK K.‐J. , KRISTENSEN L.E. , NIELSEN H. WINTHER
Published: April 2007

In order to elucidate the origin of the Hodgkin's and Reed–Sternberg cells, the expression of immunoglobulin kappa‐and lambda light chain mRNA in 23 cases of nodular sclerosing and two cases of mixed cellularity Hodgkin's disease was examined by in situ hybridization using biotinylated oligonucleotide probes and compared with immunohistochemical staining with mono‐ and polyclonal antibodies against immunoglobulin kappa‐ and lambda light chains. No hybridization signals were seen in Hodgkin's or Reed–Sternberg cells in any of the cases. Polyclonal staining with polyclonal anti‐immunoglobulin light chain antibodies was seen in Hodgkin's and Reed–Sternberg cells in 12 cases of nodular sclerosis and in two cases of mixed cellularity and with monoclonal antibodies in three cases of nodular sclerosis, but in no cases of mixed cellularity. In all cases, there was polyclonal labelling of plasma cells with both the oligonucleotide probes and the antibodies. In five cases, the Hodgkin's and Reed–Sternberg cells were also stained with one of the B‐cell antibodies L26, MB2 or LN1.

Lack of mRNA signals in Hodgkin's and Reed–Sternberg cells might indicate that these cells in Hodgkin's disease of the nodular sclerosis subtype are either not B‐cell derived or they are early B‐cells (precursor B‐cells) not yet able to produce immunoglobulin light chain mRNA, at least not at a level detectable by in situ hybridization. Immunohistochemical staining of Hodgkin's and Reed–Sternberg cells, however, with antibodies against immunoglobulin kappa and lambda light chains may be explained by cellular uptake of the light chains, but the difference in reactivity between poly‐ and monoclonal antibodies cannot be explained at present.
Clear cell sarcoma of kidney: a clinicopathological study of eight cases from Malaysia
Authors: CHEAH P.L. , LOOI L.M. , LIN H.P.
Published: April 2007

Eight cases of clear cell sarcoma of kidney were seen in the Department of Pathology, University Hospital, Kuala Lumpur, Malaysia over the 16‐year period from 1973 to 1989. Five of the patients were males. Six patients were Malay, one Chinese and one Indian. The patients' ages ranged from 8 months to 3 years. Clear cell sarcoma was the original diagnosis in two patients while six were diagnosed as blastemal‐predominant Wilms' tumours at presentation. Metastases developed in five patients. Metastatic sites included the thoracic vertebra, skull, orbit, humerus, radius, ulna, shoulder, lung and liver. The prolonged survival, of 9 years and 9 months, seen in one patient despite omission of Adriamycin (doxorubicin) from the chemotherapeutic protocol is highlighted. We also emphasise the histological factors which are of help in differentiating clear cell sarcoma from Wilms' tumour.
Cribriform intra‐tubular epididymal change and adenomatous hyperplasia of the rete testis—a consequence of testicular atrophy?
Authors: BUTTERWORTH D.M. , BISSET D.L.
Published: April 2007

We have observed an unusual change in the epididymal tubules, ranging from focal epithelial proliferation forming bridges, to a pronounced intra‐tubular cribriform pattern of the epithelium. This often occurs in association with adenomatous hyperplasia of the rete testis which is an uncommon, usually incidental finding. Both processes appear associated with underlying testicular atrophy and may be related to local hormonal imbalance.
Parathyroid hyperplasia in tertiary hyperparathyroidism: a pathological and immunohistochemical reappraisal
Authors: HARACH H.R. , JASANI B.
Published: April 2007

Thirty‐one parathyroid glands from 11 patients with tertiary hyperparathyroidism were examined histologically and immunohistochemically to characterize better the nature of the accompanying parathyroid hyperplasia. The parathyroids showed varying degrees of nodular and diffuse hyperplastic involvement as well as apparently normal background tissue. The nodules were usually multiple within any one gland and, together with diffuse hyperplastic tissue, showed a varied cyto‐architectural pattern. All glands studied showed both cellular argyrophilia and parathyroid hormone immunoreactivity. The staining pattern for parathyroid hormone ranged from negative or weak to strong, and from patchy to diffuse in hyperplastic tissue from different glands and within the same gland, regardless of the cell type. Apparently normal areas usually showed only patchy weak to moderately strong parathyroid hormone positivity. From the data obtained the most striking feature of the parathyroid glands in tertiary hyperparathyroidism is their extreme variability, both morphological and functional, as indicated by parathyroid hormone immunoreactivity. Furthermore, the generally lesser degree of parathyroid hormone immunoreaction observed in apparently normal parathyroid tissue may reflect suppression of hormone synthesis, with accompanying morphological regression to normal of pre‐existent diffuse hyperplasia by autonomous hyperfunctioning nodules associated with tertiary hyperparathyroidism.
The morphological spectrum of monocytoid B‐cell lymphoma and its relationship to lymphomas of mucosa‐associated lymphoid tissue
Authors: ORTIZ‐HIDALGO C. , WRIGHT D.H.
Published: April 2007

We report 10 cases of monocytoid B‐cell lymphoma, five of which had extranodal lymphomas of mucosa‐associated lymphoid tissue (MALT) type. In one patient the MALT lymphoma in the salivary gland was microscopic. In another, the small bowel lymphoma, which preceded the monocytoid B‐cell lymphoma by 11 years, showed different clonal immunoglobulin gene rearrangements. Attention is drawn to the extreme degree of plasmacytic differentiation and epithelioid cell infiltration that may occur in monocytoid B‐cell lymphoma. In addition to the cytological and immunophenotypic likeness of monocytoid B‐cells and centrocyte‐like cells, monocytoid B‐cell and MALT lymphomas share a number of micro‐anatomical and behavioural characteristics. These include the sharp separation of the monocytoid B‐cells and plasma cells, follicular colonization and progression to high‐grade lymphoma. It is suggested that the frequent association of monocytoid B‐cell lymphoma with Sjögren's syndrome may be due to the fact that the salivary glands drain to cervical lymph nodes that are part of the systemic, rather than the mucosal, lymphocyte circulation pathway.
Tissue reactivity of anti‐Leu19
Authors: FISCHLER D.F. , BAUER T.W. , TUBBS R.R.
Published: April 2007

Monoclonal antibody anti‐Leu19, is a marker of natural killer cells. Since reactivity between anti‐Leu7, another natural killer cell marker, and small cell neuroendocrine carcinomas has been described, we evaluated the reactivity of anti‐Leu19 in 92 neuroendocrine tumours. Frozen sections in each case were immunostained using the avidin‐biotin‐peroxidase complex method with monoclonal anti‐Leu19. We found Leu19 expression in 93% of the cases. We also evaluated 149 other tumours, including adenocarcinomas, undifferentiated large cell carcinomas, lymphomas, melanomas and soft tissue tumours. We found Leu19 expression in 36% (by liberal interpretative criteria), or 29% (by conservative interpretative criteria) of these cases. Thus, while anti‐Leu19 appears to be a sensitive marker for neuroendocrine tumours, a lack of specificity limits its practical application in diagnostic histopathology.
Hepatic angiomyolipomas with a deceptive trabecular pattern and HMB‐45 reactivity
Authors: TSUI W.M.S. , YUEN A.K.T. , MA K.F. , TSE C.C.H.
Published: April 2007

We report two cases of giant hepatic angiomyolipoma with a prominent component of epithelioid smooth muscle cells exhibiting a distinctive trabecular arrangement. These cells possessed peripherally vacuolated and centrally condensed hyaline cytoplasm. The nuclei were eccentrically placed in the cytoplasm. Immunohistochemically, they expressed HMB‐45 intensely in the central condensed cytoplasm and actin in a perimembranous fashion. Staining for desmin, myoglobin and vimentin was negative. HMB‐45 may prove to be a sensitive marker for angiomyolipoma with epithelioid cells. Hepatocellular carcinoma and other hepatic tumours with polygonal clear cells can be readily distinguished by these means.
Localized deposition of amyloid in articular cartilage
Authors: ATHANASOU N.A. , SALLIE B.
Published: April 2007

The frequency, nature and tissue distribution of localized amyloid deposits in articular cartilage of young and elderly patients, with and without evidence of arthritic disease, was determined. Localized amyloid deposits in articular cartilage were not found in young patients with osteoarthritis of the hip or chondromalacia/osteoarthritis of the patella. However, in elderly patients with osteoarthritis of the hip, amyloid deposits were commonly found, although at no greater frequency than in elderly patients with no evidence of arthritis. Amyloid deposits were commonly present (in 95% of cases) in osteoarthritis of the knee joint and in the articular cartilage of all joints containing pyrophosphate deposits. Similar deposits of amyloid were also found in the articular cartilage of 40–45% of rheumatoid joints. These findings indicate that localized amyloid deposits in the articular cartilage are largely age‐related and not due to specific pathological alterations affecting articular cartilage.
Peripheral nerve sheath differentiation in malignant soft tissue tumours: an ultrastructural and immunohistochemical study
Authors: FISHER C. , CARTER R.L. , RAMACHANDRA S. , THOMAS D.M.
Published: April 2007

Thirteen soft tissue sarcomas with ultrastructural evidence of nerve sheath differentiation were investigated by immunohistochemistry. Three arose in a major nerve or nerve trunk and four patients had von Recklinghausen's neurofibromatosis. Ultrastructurally, 10 cases showed variable differentiation towards Schwann cells, two resembled perineurial cells and one tumour had features suggestive of both cell types. Immunostaining for S‐100 protein was positive in eight Schwann cell tumours, negative in the other two Schwann cell tumours and negative in those with perineurial‐like cells. No cases demonstrated epithelial membrane antigen, so that the existence of perineurial cells in malignant nerve sheath tumours remains immunohistochemically unsubstantiated; it may be that the perineurial‐like cells are merely incompletely differentiated Schwann cells, with nerve sheath differentiation manifesting a continuous spectrum. Leu 7 was detected in four Schwann cell tumours, three of which were ultrastructurally well differentiated. Cytokeratin and desmin were demonstrated only in an undifferentiated pleomorphic area of one Schwann cell tumour. Electronmicroscopy can aid diagnosis by revealing nerve sheath differentiation in malignant soft tissue tumours without demonstrable S‐100 protein.
The distribution of type IV collagen in invasive carcinoma of the uterine cervix
Authors: PITT M.A. , HALE R.J. , BUCKLEY C.H.
Published: April 2007

The presence of type IV collagen at the tumour/stromal interface of invasive carcinoma of the cervix was evaluated in 60 cases. It was assessed semi‐quantitatively according to its staining characteristics, and expressed as: thick, with or without minimal discontinuity; thin, with or without moderate discontinuity; fragmentary or absent. In each case the tumour type was identified, the differentiation, growth pattern and peritumoural inflammatory infiltrate was graded and lymph node status established. There was, overall, a significant correlation between a paucity of type IV collagen and a poorer prognosis and an infiltrating growth pattern. There was a highly significant correlation for adenocarcinomas in relation to poor outcome, infiltrating growth pattern and lymph node metastases. By contrast, no statistically significant correlation was found between paucity of type IV collagen and the other parameters for either squamous or adenosquamous carcinomas. The presence or absence of type IV collagen may be a useful prognostic marker, particularly for adenocarcinomas, and may play a part in the invasive and metastatic process.
Tendon sheath tumours: a pathological study of the relationship between giant cell tumour and fibroma of tendon sheath
Authors: SATTI M.B.
Published: April 2007

Thirty‐nine soft tissue lesions occurring on the distal aspect of the limbs have been selected because of histological features consistent with those recognized for giant cell tumour of tendon sheath or fibroma of tendon sheath. In spite of the frequent occurrence of such lesions at the stated sites, they were rarely correctly diagnosed pre‐operatively. Using a scoring system to grade specified histological features, a blind evaluation to re‐classify these 39 lesions was undertaken. This resulted in 29 cases of giant cell tumour of tendon sheath, six fibromas of tendon sheath and four ‘transitional stage’ lesions. Despite the heterogeneous morphology of these categories, there were no significant differences in the clinical features of affected patients. The existence of a ‘transitional stage’ lesion, combined with the homogeneous clinical picture of all categories, supports the concept that fibroma of tendon sheath is the end and sclerosing stage of giant cell tumour of tendon sheath, probably consequent on progressive vascular impairment. There is a need for pathologists to recognize the transitional stage lesions so as to avoid their inclusion with other diagnostic entities. For this group the name ‘giant cell tumour of tendon sheath—transitional stage lesion’ is suggested.
Microscopic thymoma: histological evidence of multifocal cortical and medullary origin
Authors: PESCARMONA E. , ROSATI S. , PISACANE A. , RENDINA E.A. , VENUTA F. , BARONI C.D.
Published: April 2007

Twenty cases of macroscopically non‐neoplastic thymuses obtained from patients with myasthenia gravis have been studied histologically. Seven cases were characterized by lymphoid follicular hyperplasia and 13 by involutional changes of variable degree. In three cases (15%), one with lymphoid follicular hyperplasia and two with involutional changes, multiple microscopic epithelial lesions, 0.2–0.4 mm in diameter and consistent with foci of microscopic thymoma, were observed. Most of them were related to the thymic cortex and one, displaying a different histological pattern, was located in a medullary area. These observations provide morphological evidence of a possible multifocal origin of thymoma from distinct epithelial clones present in the different topographic areas of the human thymus.
Histological regression in primary cutaneous melanoma: recognition, prevalence and significance
Authors: BLESSING K. , McLAREN K.M.
Published: April 2007

Five hundred and sixty‐three primary cutaneous melanomas were assessed for the presence of histological regression in relation to the thickness of the lesion and features such as sex, anatomical location and clinical outcome. Regression was more common in thin lesions, being seen in 46% of thin (< 1.5 mm) lesions, 32% of intermediate (1.5–3.0 mm) lesions and 9% of thick (> 3.0 mm) lesions. However, severe regression was only identified in 6.5% of thin lesions, 5.2% of intermediate lesions and 1.5% of thick melanomas. Regression was more common in superficial spreading melanomas and in lesions from the trunk and lower limb. Moderate and severe regression were seen slightly more often in men. Clinical follow‐up, although not of statistical significance, suggests that regression in thin lesions is a sinister histological feature.
Co‐expression of markers for hepatitis delta and hepatitis B viruses in human liver
Authors: RYLEY N.G. , HERYET A.R. , GOLDIN R. , MONJARDINO J. , SALDANHA J. , FLEMING K.A.
Published: April 2007

Delta hepatitis (HDV) infection can only occur in the presence of hepatitis B (HBV) infection, as HDV requires a coat of HBV surface antigen (HBsAg) for assembly of complete virus. A number of studies have examined the variation of HBV markers in serum and liver during establishment of HDV infection, but none has systematically examined the relationship between the two viruses in individual hepatocytes. Liver biopsies from five patients with HDV/HBV infection were stained for HBsAg, HBV core antigen (HBcAg) and hepatitis D (delta) antigen (HDAg). Double immunostaining was performed with a combination of indirect immunoperoxidase and alkaline phosphatase/anti‐alkaline phosphatase techniques. HDV and HBV antigens were expressed in all five liver biopsies. Co‐localization of HBsAg was seen in up to 39% of HDAg positive cells, and HBcAg in up to 8% of HDAg positive cells. HBcAg was detectable in approximately 9% of HBsAg positive cells, and HBsAg in approximately 12% of HBcAg positive cells. HDV can replicate without HBV but ultimately requires HBV to produce complete virus and subsequently infect other cells. In this study the majority of HDV positive cells did not appear to contain HBV markers. This might suggest delta virus replication without assembly, or possibly sequential production/assembly of the virus.
Minimal deviation endometrioid adenocarcinoma of cervix: a clinicopathological and immunohistochemical study of two cases
Authors: RAHILLY M.A. , WILLIAMS A.R.W. , AL‐NAFUSSI A.
Published: April 2007

We describe the clinicopathological features of two cases of minimal deviation endometrioid adenocarcinoma of cervix. This is a rare tumour whose predominant pattern is one of bland endometrial‐type glands infiltrating the cervical wall without a stromal response. Thus, it may be confused with benign conditions such as cervical endometriosis. The two cases demonstrate that this tumour may behave aggressively despite its bland appearances. An immunohistochemical study was performed and showed only focal reactivity of neoplastic glands for carcinoembryonic antigen, which would limit its diagnostic use in small biopsy specimens.
Is poor prognosis really related to HLA‐DR expression by malignant melanoma cells?
Authors: COLLOBY P.S. , WEST K.P. , FLETCHER A.
Published: April 2007

HLA‐DR expression was examined in 50 consecutive primary cutaneous malignant melanomas with a Breslow depth > 2 mm using two well‐characterized monoclonal antibodies which detect fixation‐resistant epitopes. In 31 of these cases (62%) a subpopulation of tumour cells was reactive, although there was considerable heterogeneity. Positive labelling did not correlate with depth but was associated with a reduced likelihood of developing early metastatic disease and a tendency for better overall survival, particularly in male patients. These findings contrast with earlier studies using cryostat sections and one study on paraffin‐embedded tissue in which HLA‐DR expression was shown to be a poor prognostic factor, but are consistent with the findings in other malignant tumours studied. The significance of HLA‐DR expression as a marker of prognosis may depend on the type of tissue preparation, the sensitivity of the immunocytochemical techniques used and the method of assessment.
Molecular differential pathology of renal cell tumours
Authors: KOVACS G.
Published: April 2007

Recent application of molecular cytogenetic techniques to the evaluation of renal cell tumours revealed four subtypes, each with a characteristic combination of genetic alterations within the chromosomal and mitochondrial DNA. The most common, nonpapillary renal cell carcinomas are characterized by the loss of chromosome 3p sequences, rearrangement of the chromosome 5q region and loss of the chromosome 14q sequences. Papillary renal cell tumours can be divided into two groups. Tumours with a combined trisomy of chromosomes 7 and 17 as well as loss of the Y chromosome are papillary renal cell adenomas. Tumours with additional trisomies such as trisomy 16, 20 or 12 are pipillary renal cell carcinomas. Chromophobe renal cell carcinomas show a combination of allelic losses, which do not occur in other types of renal tumours. In addition, they have a rearrangement in the mitochondrial DNA. Renal oncocytomas are benign tumours marked by normal or abnormal karyotypes with balanced or unbalanced translocations and an altered restriction pattern of the mitochondrial DNA. Although the major cytological characteristics of renal cell tumours, such as clear, granular, chromophobe and oncocytic cell phenotypes correspond to nonpapillary, papillary and chromophobe renal cell carcinomas and renal oncocytomas, there are many cases with overlapping phenotype. Therefore, a classification of renal cell tumours based on specific genetic alterations is proposed.
Pathology of the gastric antrum and body associated with Helicobacter pylori infection in non‐ulcerous patients: is the bacterium a promoter of intestinal metaplasia?
Authors: RUGGE M , MARIO F.DI , CASSARO M. , BAFFA R. , FARINATI F. , RUBIO J. , NINFO V.
Published: April 2007

A series of 115 consecutive, non‐ulcerous, dyspeptic patients were examined for Helicobacter pylori (H. pylori) colonization in the gastric antral and/or body mucosa using Giemsa staining. Findings were correlated with the presence and degree of activity of superficial gastritis, deep gastritis, atrophic gastritis and with the presence of intestinal metaplasia. The prevalence of H. pylori positivity was 61.7%. In 59 of the 71 positive patients (83%), H. pylori was detected in the antrum or in both the antral and oxyntic mucosa. In the remaining 12 positive patients, H. pylori was detected only in the oxyntic mucosa and in all these cases, the antrum showed intestinal metaplasia associated with atrophic gastritis (25%). In both antral and oxyntic mucosa, the activity of the gastritis was significantly correlated with H. pylori colonization. Linear logistic regression analysis showed that in patients with intestinal metaplasia the presence of H. pylori infection was significant in predicting the presence of more extensive intestinal metaplasia after adjusting for age. The prevalence of intestinal metaplasia types II and III was 65.5% in the H. pylori positive and 25% in the H. pylori negative patients. The antral mucosa is thought to be the elective site for H. pylori related histological lesions. At a later stage, H. pylori can be detected only in the oxyntic area while the antral mucosa shows extensive metaplastic or atrophic lesions. We would suggest that H. pylori plays a promotional role in the morphogenesis of intestinal metaplasia.
p53 protein expression in non‐neoplastic lesions and benign and malignant neoplasms of soft tissue
Authors: TOS A.P. DEI , DOGLIONI C. , LAURINO L. , BARBARESCHI M. , FLETCHER C.D.M.
Published: April 2007

Alterations of the p53 tumour suppressor gene, with consequent nuclear p53 protein accumulation, are among the most common genetic lesions in human neoplasms. In the present paper we show p53 immunoreactivity in 65% of malignant and 21% of intermediate malignancy soft tissue tumours, and in 48% of benign/reactive soft tissue lesions. p53 immunoreactivity of sarcomas can be interpreted as an indirect indication of a mutation of the corresponding p53 gene, suggesting that its alteration may have a role in their pathogenesis. Our data on p53 immunoreactivity in benign lesions of the soft tissues are among the first demonstrations of p53 over‐expression in benign/reactive conditions. We cannot exclude mutations of the p53 gene in these cases, but it is difficult to sustain this hypothesis in reactive/pseudoneoplastic lesions. Alternatively p53 immunoreactivity in benign processes could be due to an increase in wild‐type p53 as a result of different physiological mechanisms (cell type‐specific p53 regulation, cell maturation, DNA repair). Our results do not indicate that immunohistochemical demonstration of p53 expression is a marker of malignancy in soft tissue tumours and therefore is of limited use in differential diagnosis. However, they suggest the need for further molecular genetic studies in order to elucidate the biological significance of the abnormal expression of p53 in benign soft tissue lesions.
Mycobacterial cervical lymphadenitis in children: can histological assessment help differentiate infections caused by non‐tuberculous mycobacteria from Mycobacterium tuberculosis?
Authors: PINDER S.E. , COLVILLE A.
Published: April 2007

Most mycobacterial lymphadenitis in children in developed countries is caused by non‐tuberculous (the so‐called ‘atypical’) mycobacteria. In view of the widely different treatment regimes and the requirement for contact tracing in Mycobacterium tuberculosis infections but not in non‐tuberculous mycobacterial infections, it is very important to attempt to define histologically which is the aetiological agent. We have reviewed the histological appearances of mycobacterial cervical lymphadenitis in children and have found that, if any one of several ‘atypical’ features were seen, the appearances were much more likely to be due to a non‐tuberculous mycobacterium. These features include ill‐defined (non‐palisading) granulomas, irregular or serpiginous granulomas, a predominantly non‐specific granulomatous response, predominantly sarcoid‐like granulomas or lack of significant caseation. In addition, the non‐tuberculous mycobacterial infections showed a different distribution of neutrophil polymorphs, which tended to be seen in the centre of areas of necrosis rather than in Mycobacterium tuberculosis infections where a polymorph infiltrate, if present, was more diffusely scattered. Although no one definitive feature is diagnostic of non‐tuberculous mycobacterial infection, some features are helpful in differentiating the two groups of organisms histologically.
Ossifying fibromyxoid tumour of soft parts: immunohistochemical and ultrastructural analysis
Authors: SCHOFIELD J.B. , KRAUSZ T. , STAMP G.W.H. , FLETCHER C.D.M. , FISHER† C. , AZZOPARDI J.G.
Published: April 2007

Ossifying fibromyxoid tumour of soft parts is a recently described benign neoplasm which usually presents in soft tissue. The histogenesis or pattern of differentiation is a source of controversy. Thirteen cases are reported herein. All arose in adults, principally on the upper trunk or head and neck region. None recurred. All but one tumour showed a shell of lamellar bone, laid down by reactive osteoblasts, at the tumour‐host interface. The characteristic laciform, glomoid and fascicular patterns, usually in combination, necessitate differential diagnosis from chondroid, smooth muscle and neural tumours especially. Immunohistochemistry revealed positivity for S‐100 protein in 10/12, desmin in 7/10 and smooth muscle actin in 4/8. Ultrastructural examination of four cases revealed prominent intermediate filaments, without myofilamentous organization, and a discontinuous external lamina. Immunoelectronmicroscopy localized desmin positivity to the filamentous meshwork. Differentiation therefore appears to take the form of an incomplete neural and smooth muscle phenotype, without evidence of complete maturation.
Expression of epithelial and extracellular matrix protein markers in meningiomas
Authors: NG H.K. , WONG A.T.C.
Published: April 2007

In an attempt to characterize the dual mesenchymal and epithelial differentiating potential of meningiomas, cryostat sections from 50 meningiomas of diverse histological subtypes were examined immunohistochemically with a panel of markers for epithelial and mesenchymal differentiation. The overall positivities were: keratins 50%, epithelial membrane antigen 94%, human milk fat globules 38%, carcinoembryonic antigen 4% (secretory meningiomas only), desmoplakins 64%, collagen I 82%, procollagen I 96%, collagen III 74%, collagen IV 60%, laminin 54%, fibronectin 98% and vimentin 98%. Such production of keratins was not found in many previous immunohistochemical analyses of meningiomas with paraffin sections. The extracellular matrix proteins were present in a pericellular distribution suggestive of their being produced by the tumour cells. The potential of dual epithelial and mesenchymal differentiation in meningiomas was further examined in seven cases established on short‐term cultures. Morphologically, subcultured tumour cells resembled fibroblasts and in five cases revealed similar epithelial and mesenchymal immunohistochemical profiles as for direct tumour immunostaining. In two cases, cells from the primary cultures revealed a fine skeleton of intercellular matrix proteins stainable by immunohistochemical methods, providing further proof that meningioma cells possess the capability to elaborate extracellular matrix proteins, a major mesenchymal function akin to that of fibroblasts.
Detection by in situ hybridization of HIV and c‐myc RNA in tumour cells of AIDS‐related B‐cell lymphomas
Authors: PREVOT S. , RAPHAEL M. , FOURNIER J.G. , DIEBOLD J.
Published: April 2007

The incidence of acquired immune deficiency syndrome (AIDS)‐related malignant lymphoma has increased since the disease was first described, but its pathogenesis is still not understood. There have been numerous molecular studies addressing the clonality of these proliferations, the presence of Epstein‐Barr virus genome in the tumour cells, and rearrangements of the c‐myc oncogene. However, very few in situ hybridization studies have been carried out. We analysed 24 cases of high‐grade B‐cell malignant lymphomas and two cases of polymorphic B‐cell proliferation associated with human immunodeficiency virus (HIV) infection. Human immunodeficiency virus ribonucleic acids were detected in some of the tumour cells in 19 of the 24 cases of malignant lymphomas and in both cases of polymorphic B‐cell proliferation, with the in situ hybridization technique and using a specific tritiated copy deoxyribonucleic acid probe. With the same technique, c‐myc ribonucleic acid was detected in most of the tumour cells from all the 21 cases of malignant lymphomas tested but not in the polymorphic B‐cell proliferation.
A histological and electronmicroscopic study of intracorneal melanin in benign and malignant melanocytic lesions
Authors: JONES H. , ALLIBONE R.O. , CLARKE T.
Published: April 2007

Intracorneal melanin is a feature quite frequently encountered in a range of melanocytic lesions, yet has rarely been described in the literature. We examined a variety of melanocytic lesions with increasing degrees of melanocytic atypia for this feature. The distribution and amount of intracorneal melanin is described and it was shown to be entirely within keratinocytes. In general, the amount of intracorneal melanin was related to increasing melanocytic atypia and was typically distributed in a disorderly fashion in malignant lesions.
Placental malaria. II. A semi‐quantitative investigation of the pathological features
Authors: BULMER J.N. , RASHEED F.N. , MORRISON L. , FRANCIS N. , GREENWOOD B.M.
Published: April 2007

Malaria in pregnancy is associated with reduced birth weight. Most pathological studies of placental malaria infection have focused on severe Plasmodium falciparum infection. In the present study of 121 placentas delivered in a rural area of The Gambia, malaria infection was diagnosed in tissue sections using a simple classification system and severity of pathology was ranked semiquantitively. Deposition of malaria pigment in circulating cells was associated with active infections whereas pigment in fibrin was a feature of active‐chronic infections. Primigravidae had higher levels of pigment at all sites, although these observations were not always significant. Thickening of the trophoblast basement membrane occurred in all infection categories but fibrinoid necrosis of chorionic villi was a feature of active and active‐chronic infection. Both birth weight and placental weight were increased in infected placentas but widespread trophoblast basement membrane thickening was associated with decreased birth weight. Both birth weight and placental weight decreased with increased fibrinoid necrosis and cytotrophoblast prominence but the results were not sigaificant. By this approach it has been possible to correlate placental pathology with different infection categories and to analyse the pathological features associated with decreased birth weight.
Necrotizing squamous metaplasia in herpetic tracheitis following prolonged intubation: a lesion similar to necrotizing sialometaplasia
Authors: BEN‐IZHAK O. , BEN‐ARIEH Y.
Published: April 2007

In the last year we have encountered three cases of clinically inapparent herpes simplex virus (HSV) tracheitis in biopsies from patients undergoing tracheostomy following prolonged intubation. The diagnosis was based on finding characteristic inclusion‐bodies on haematoxylin and eosin stained sections and was confirmed by immunohistochemical staining of infected cells with antibodies to HSV. A prominent mononuclear infiltrate, originally described in HSV oesophagitis, was recognized in two cases. Diffuse squamous metaplasia of both surface and glandular epithelium adjacent to necrotic ulcerated areas was evident in all three cases. Where extensive, the necrotizing squamous metaplasia of the glandular/ductal component was similar to necrotizing sialometaplasia of salivary glands, and likewise simulated squamous or mucoepidermoid carcinoma.
Peripheral T‐cell lymphoma: a clinicopathological study of 41 cases and evaluation of the prognostic significance of the updated Kiel classification
Authors: MONTALBÁN C. , OBESO G. , GALLEGO A. , CASTRILLO J. M. , BELLAS C. , RIVAS C.
Published: April 2007

A total of 41 non‐cutaneous peripheral T‐cell lymphomas were classified following the updated Kiel classification. Of these, 20 cases belonged to the low‐grade group (T‐cell chronic lymphocytic leukaemia, 3; lymphoepithelioid, 5; angioimmunoblastic, 4; pleomorphic small cell, 8) and 21 to the high grade group (pleomorphic medium and large cell, 11; immunoblastic, 3; large‐cell anaplastic Ki‐1 positive, 7). Seventy per cent showed a CD4+/CD8‐phenotype, 39% a defective phenotype and 88% an activation phenotype. Eighty per cent had B‐symptoms, 63% hepatomegaly, 48% splenomegaly and 26% had involvement of more than three lymphoid areas. Bone marrow was infiltrated in 34% central nervous system in 4%, lung in 12% and skin in 14.6%. Seventeen per cent presented with extranodal disease and 82.8% had stage III/IV disease. Hypergammaglobulinaemia was found in 29%, hypercalcaemia in 7%, raised LDH serum levels in 58% and HTLV‐I antibodies in only one case. Of the 37 treated patients 18 (48%) achieved a complete remission, but 33% relapsed. Mortality was 59% and actuarial overall survival at 38 months was 0.32. In the comparison of the clinical, analytical and immunophenotypic variables and outcome between low and high grade groups, only the average of bone marrow infiltration in the low grade and stage I–II, presence of defective phenotypes and higher Ki‐67 positivity in the high grade group were significantly different. In the statistical studies, extranodal prentation and the failure to achieve a complete remission were the only variables that influenced mortality; there weere no significant differences in the general features of the low and high grade groups and only minor differences were found in the immunoblastic and angioimmunoblastic subgroups. There were no differences in the actuarial survival between the low and high grade groups, among the subgroups of the Kiel classification, among stages I to IV, between patients with or without B‐symptoms, with or without defective phenotypes, Ki‐67 positivity over or under 60%, or among different CD4/CD8 phenotypes. The updated Kiel classification did not separate groups with a prognostic significance.
Solitary myofibroma in adults: clinicopathological analysis of a series
Authors: BEHAM A. , BADVE S. , SUSTER S. , FLETCHER C. D. M.
Published: April 2007

Solitary myofibroma is a recently described, benign neoplasm of superficial soft tissue, which represents the adult counterpart of infantile myofibromatosis and is poorly recognized. Eleven new cases are presented herein. The patients were mostly adults with ages ranging from 13–64 years. They presented with a solitary, usually painless nodule of variable duration in the skin or oral cavity. Histologically, each lesion had a biphasic pattern with spindle cells forming fascicular or whorled areas and rounded, more primitive cells arranged around small vessels, forming haemangioperi‐cytoma‐like areas. The characteristic zonation of infantile myofibromatosis was often less marked in adult lesions and there was a haphazard arrangement of the fascicular and pericytic areas in some cases. Hyalinization, especially of the peripheral spindle‐celled areas, was frequent. Immunohistochemically, the spindle cells were desmin negative but muscle actin (HHF‐35 and IA4) positive. The rounded cells were both desmin and actin negative. Electronmicroscopy confirmed the myofibroblastic/fibroblastic nature of tumour cells in two cases. Although vascular invasion was seen in two cases, solitary adult‐type myofibroma pursues a benign clinical course.
Assessment of proliferating cell nuclear antigen expression in precursor stages of gastric carcinoma using the PC10 antibody to PCNA
Authors: FILIPE M. I. , MENDES R. , LANE D. P. , MORRIS R. W.
Published: April 2007

Immunohistochemistry using the PC10 antibody to proliferating cell nuclear antigen (PCNA) was applied to archival material from mucosa adjacent to gastric carcinoma (‘normal’, hyperplasia, complete and incomplete intestinal metaplasia and dysplasia) and non‐cancer controls (normal and complete intestinal metaplasia). Overall, increased PCNA indices, with expansion and altered location of the proliferative zones, were observed in carcinoma fields and compared with controls (P≤0.001). These differences were particularly significant in ‘normal’ mucosa far from carcinoma as compared with normal in controls (P≤0.001). In carcinoma ‘fields’ distinct patterns of PCNA expression were noted in complete and incomplete intestinal metaplasia. Similarly, in dysplastic lesions high PCNA indices were present either throughout the gland or found predominantly in the upper compartment. We conclude that these differences in PCNA index and staining patterns might prove useful in monitoring the evolution of the disease in the follow‐up of patients at risk of developing gastric cancer.
Chromogranin A, secretogranin II and vasoactive intestinal peptide in phaeochromocytomas and ganglioneuromas
Authors: SCHMID K.W. , DOCKHORN‐DWORNICZAK B. , FAHRENKAMP A. , KIRCHMAIR R. , TÖTSCH M. , FISCHER‐COLBRIE R. , BÖCKER W. , WINKLER H.
Published: April 2007

By means of immunohistochemistry we analysed the distribution of chromogranin A, secretogranin II and vasoactive intestinal peptide (VIP) in 16 phaeochromocytomas, twotases of combined phaeochromocytoma‐ganglioneuroma and sour adrenal ganglioneuromas. Chromogranin A was found in the majority of phaeochromocytes and in mixed phaeochromocytomas‐ganglioneuromas. Secretogranin II was present to a lesser degree in phaeochromocytes, but strong immunostaining was found in most ganglion cells of phaeochromocytomas, in the ganglioneuroma component of combined tumours and in adrenal ganglioneuromas. Vasoactive intestinal peptide was present in some ganglion cells of phaeochromocytomas, in the ganglioneuroma component of mixed tumours and in three of four adrenal ganglioneuromas. On semi‐adjacent sections a co‐localization of VIP and secretogranin II was demonstrated. These results indicate that neuronal differentiation is accompanied by an increased immunohistochemical expression of secretogranin II. Therefore, secretogranin II may be a useful marker for ganglion cell differentiation.
The significance of proliferating cell nuclear antigen in human trophobiastic disease: an immunohistochemical study
Authors: CHEUNG A.N.Y. , NGAN H.Y.S. , CHEN W.Z. , LOKE S.L. , COLLINS R.J.
Published: April 2007

The expression of proliferating cell nuclear antigen (PCNA) in human trophobiastic disease was assessed immunohistochemically in tissue from 29 spontaneous abortions, 33 partial moles, 40 complete moles and 23 chorio carcinomas using the monoclonal antibody PC ID. PCNA immunoreactivity occurred predominantly in the cytotrophoblasts in each of the four types of tissues. Quantitative analysis showed that the choriocarcinoma group gave a statistically significant higher PCNA index than the other three. There was no significant difference between the groups of spontaneous abortion, partial or complete mole. Sixteen of the 73 patients with partial and complete moles developed persistent gestational trophobiastic disease and there was no significant difference between the patients requiring chemotherapy and those who did not. We conclude that choriocarcinoma has a significantly higher PCNA proliferative index whilst hydatidiform moles cannot be distinguished from abortions by such analysis. The PCNA index does not appear to be useful in predicting the progression of molar pregnancies to persistent trophobiastic diseases.
Primary neoplasia of the female peritoneum
Authors: FOX H.
Published: April 2007

Primary neoplasms of the female peritoneum may be mesothelial or Müllerian in nature. Primary mesotheliomas may be cystic, benign papillary or diffuse malignant. Primary Müllerian tumours of the peritoneum are thought to arise within the secondary Müllerian system: the overwhelming majority are serous in nature and probably develop from pre‐existing endosalpingiosis. Primary peritoneal serous tumours of borderline malignancy are identical histologically to the peritoneal ‘implants’ found in association with ovarian serous tumours of borderline malignancy, whereas primary peritoneal serous adenocarcinomas are histologically identical to ovarian serous adenocarcinomas. The recognition of a primary peritoneal serous neoplasm of borderline malignancy rests on the presence of either normal ovaries, ovaries containing only a fully benign neoplasm or ovaries showing only minimal surface involvement. The diagnosis of a primary peritoneal serous adenocarcinoma is made if the ovaries are of normal size with either no tumour or only minimal surface involvement: in some cases normal ovaries will have previously been prophylactically removed because of a family history of ovarian cancer. The differential diagnosis between a primary serous adenocarcinoma and a diffuse malignant mesothelioma can be difficult and is often not resolved by either electronmicroscopy or immunocytochemistry.
Cutaneous immunocytomas: a clinicopathologic study of 26 cases
Authors: RIJLAARSDAM J.U. , PUTTE S.C.J. VAN DER , BERTI E. , KERL H. , RIEGER E. , TOONSTRA J. , GEERTS M.L. , MEIJER C.J.L.M. , WILLEMZE R.
Published: April 2007

The clinical and histological features of 16 patients with a primary cutaneous immunocytoma and 10 patients with a secondary cutaneous immunocytoma are reported. In all cases the diagnosis was based on the presence of monotypic plasma cells or lymphoplasmacytoid cells. Our data show that primary cutaneous immunocytomas are a distinct type of cutaneous lymphoma, characterized by (a) the presence of solitary or localized skin lesions (13 of 16 cases); (b) preferential localization on arms and legs (15 of 16 cases); (c) excellent response to local treatment (15 of 16 cases) and (d) a favourable prognosis. Histologically, these primary cutaneous immunocytomas are characterized by the presence of nodular or diffuse infiltrates with monotypic lymphoplasmacytoid/plasma cells located at the periphery of the infiltrates. Important clinical and histological differences were noted between primary and secondary immunocytomas. In the latter group more widespread skin disease was seen, often in the presence of paraproteins and/or autoimmune diseases. In contrast with the peripheral localization of the monotypic cells in primary cutaneous immunocytomas the monotypic lymphoplasmacytoid/plasma cells in secondary immunocytomas formed diffuse infiltrates or these cells were found dispersed throughout the infiltrate. There were no differences in clinical presentation or course between the different subtypes of cutaneous immunocytomas (lymphoplasmacytic, lymphoplasmacytoid and polymorphic immunocytomas). The differential diagnosis between primary cutaneous immunocytomas and cutaneous plasmacytomas, primary follicular centre cell lymphomas and cutaneous ‘pseudolymphomas’ is discussed.
Lymphomas of mucosa‐associated lymphoid tissue arising in the urinary bladder
Authors: PAWADE J. , BANERJEE S.S. , HARRIS M. , ISAACSON P. , WRIGHT D.
Published: April 2007

The clinical, histological and immunohistochemical findings in five primary lymphomas of the urinary bladder are reported. One patient had both lymphoma and transitional cell carcinoma of the bladder. All of the lymphomas showed histological features of mucosa‐associated lymphoid tissue (MALT) lymphomas with centrocyte‐like cells in all cases. One patient with pre‐existing cystitis glandularis showed lymphoepithelial lesions. Biopsies from four patients contained reactive germinal centres and, in two of these, there was follicular colonization by tumour cells. In three patients, repeat biopsies, over several years, showing the changes of MALT lymphoma, were diagnosed as cystitis. We suggest that a large proportion of primary lymphomas of the bladder are lymphomas of MALT and that the characteristic morphological and immunohistochemical features of these tumours should be sought in biopsies containing large numbers of lymphoid cells.