bluuebunny/crossref_metadata_2025 huggingface dataset:
Benign trichogenic tumours: a report of two cases supporting a simplified nomenclature
Authors: WONG T.‐Y. , REED J.A. , SUSTER S. , FLYNN S.D. , MIHM Jr M.C.
Published: April 2007

We report two cases of a rare benign tumour of hair germ. Clinically, both were solitary, well‐circumscribed, subcutaneous nodules located in the extremities. Histologically, the tumours were characterized by nests and thin cords of basaloid epithelial cells intimately associated with a cellular stroma. The basaloid cells exhibited peripheral palisading, keratinization in the form of keratotic cysts and squamoid transformation, and pilar differentiation. An unusual, but distinctive, cribriform pattern of growth was observed. There was no communication with the overlying epidermis. Abundant primitive hair germinal buds and rare more advanced abortive hair follicles were identified. These histological appearances encompass features of both trichoblastic fibroma and trichogenic trichoblastoma, thus distinguishing these neoplasms from other skin tumours and reinforcing the hypothesis that these tumours are closely related from a histogenetic point of view. The presence of overlapping histological features can be problematic for practising histopathologists who rarely encounter these conditions. With this in mind, the term benign trichogenic tumour may be more appropriate to encompass these two tumours and related neoplasms that appear to lie within the spectrum of hair follicle development.
Differences in clinical behaviour and immunophenotype between primary cutaneous and primary nodal anaplastic large cell lymphoma of T‐cell or null cell phenotype
Authors: BRUIN P.C. DE , BELJAARDS R.C. , HEERDE P. VAN , VALK P. VAN DER , NOORDUYN L.A. , KRIEKEN J.H.J.M. VAN , KLUIN‐NELEMAN J.C. , WILLEMZE R. , MEIJER C.J.L.M.
Published: April 2007

The histological, immunophenotypic and clinical features of 19 primary cutaneous anaplastic large cell lymphomas (cutaneous ALCL) were compared with those of 18 primary nodal anaplastic large cell lymphomas (nodal ALCL) of T‐cell or null cell type. Although cutaneous ALCL and nodal ALCL had identical morphological features, differences in surface marker expression and clinical behaviour were found. Immunophenotypical differences concerned the expression of epithelial membrane antigen (82% of the nodal ALCL were positive v. none of the cutaneous ALCL) and the cutaneous lymphocyte antigen (HECA‐452), a possible skin‐homing receptor on cutaneous T‐lymphocytes (most tumour cells in 44% of cutaneous ALCL cases were positive, whereas nodal ALCL showed expression of HECA‐452 on only few tumour cells (< 25%) in 18% of cases tested). Loss of T‐cell markers was more pronounced for nodal ALCL. Patients with cutaneous ALCL were generally older (median 61 years) than patients with nodal ALCL (median 24 years) and, in contrast to the latter group, did not show bimodal age distribution. Survival after 4 years, using lymphoma‐related death as an end‐point, differed significantly between cutaneous ALCL and nodal ALCL; 92% for cutaneous ALCL and 65% for nodal ALCL (P=0.04). The better survival of cutaneous ALCL patients could not be ascribed to differences in age, stage or initial mode of treatment. These data indicate that differences in ismmunophenotype and clinical behaviour exist between morphologically identical primary cutaneous and primary node‐based ALCL. They indicate that the primary site is an important prognostic factor in predicting the clinical outcome of ALCL.
High incidence of Epstein–Barr virus detection in Hodgkin's disease and absence of detection in anaplastic large‐cell lymphoma in children
Authors: BROGUSSET P. , ROCHAIX P. , CHITTAL S. , RUBIE H. , ROBERT A. , DELSOL G.
Published: April 2007

By in situ hybridization with EBER oligonucleotides and immunohistochemistry with anti‐latent membrane protein 1 (LMP1) antibody, we compared the detection rate of Epstein–Barr virus (EBV) in Hodgkin's disease and anaplastic large‐cell lymphomas in children. Among the 13 cases of Hodgkin's disease tested, 7 (54%) were found to be EBV associated (EBER transcripts +, LMP1 +). None of the 11 cases of ALC lymphomas was found to contain EBV genomes or gene products. This may indicate that EBV is not a pathogenic agent in anaplastic large‐cell lymphomas in children in comparison to Hodgkin's disease.
Verrucous naevoid and keratotic malignant melanoma: a clinico‐pathological study of 20 cases
Authors: BLESSING K. , EVANS A. T. , AL‐NAFUSSI A.
Published: April 2007

Verrucous naevoid malignant melanoma is a recently described variant of malignant melanoma that may be confused both clinically and histologically with benign lesions. This study reports the clinical and pathological features of 20 such cases. These constituted 3.2% of all melanomas diagnosed in the Department of Pathology, Aberdeen University, in the period 1970‐1991. They occurred more often on the back and limbs of male patients with a mean age of 57 years. Clinical diagnosis of benign lesions (warty naevi, papillomas, seborrhoeic keratosis and cysts) were made in over 50% of the cases. Eight patients had metastases, seven of whom died of their disease. Microscopically, these lesions exhibited a spectrum of naevoid features such as symmetry, exophytic and papilliferous growth pattern, hyperkeratosis and pseudo‐epitheliomatous hyperplasia. The majority, however, showed lateral intra‐epidermal spread and were composed of large epithelioid cells exhibiting various degrees of cellular pleomorphism. Histological classification was difficult, as more than 50% of the cases were initially labelled unclassifiable. The marked papilliferous architecture of these lesions made assessment of Breslow depth and Clark levels difficult. Initially, 10% of the cases were histologically diagnosed as benign. It is therefore important for surgical pathologists to recognize this unusual variant of malignant melanoma, as it may be confused both clinically and pathologically with benign lesions.
Oestrogen receptor, progesterone receptor, pS2, ERD5, HSP27 and cathepsin D in invasive ductal breast carcinomas
Authors: HURLIMANN J. , GEBHARD S. , GOMEZ F.
Published: April 2007

Hormonal receptors and markers for prognostic evaluation were detected immunohistochemically in 196 infiltrating ductal breast carcinomas. Immunohistochemical detection of progesterone and oestrogen receptor is a method giving results generally concordant with those of the binding assay. However, immunohistochemical detection seems better. It allows the detection of hormonal receptors on small carcinomas, it is not modified by the endogenous hormones, and it has a slightly better correlation with prognosis and with the response to hormone therapy. Immunohistochemical detection of progesterone receptor has a prognostic value, sorting a negative subgroup with a poor prognosis from the oestrogen receptor positive tumours. These results can be obtained without quantitative immunohistological methods. ERD5, pS2, HSP27 and cathepsin D are associated with oestrogen receptor positivity. pS2 and HSP27 are interesting markers. They characterize a subgroup of oestrogen receptor negative tumours with a good prognosis. Moreover, pS2 is a marker of response to hormone therapy. ERD5 and cathepsin D do not appear to be of value as markers of prognosis.
Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients
Authors: FURMANCHUK A.W. , ROUSSAK N. , RUCHTI C.
Published: April 2007

Thyroid glands from 215 patients, aged 19 to 88 years, without known thyroid disease, were serially sectioned at 2–3 mm intervals and microscopically examined for occult disease. Glands were normal in 32.5%, while nodules were observed in 60% and adenomas in 13%. Carcinomas were found in 20 cases (9.3%): occult papillary carcinomas in 19 (8.8%) and one medullary carcinoma. No carcinomas were found in the thyroids of 15 patients less than 40 years of age. There were no significant differences in frequency of occult carcinomas between female and male patients and, for patients over 40 years, with increasing age. Of the 19 papillary tumours more than one focus was found in six cases (a total of 28 foci). The diameter of 27 of these tumours was less than or equal to 5 mm (96.4%), with one exception (diameter 6.3 mm). These findings were compared with those obtained in 86 thyroid glands of children surgically resected for carcinomas between 1986 and 1991. Only 10 of these tumours (11.6%) were less than or equal to 1 cm. These tumours, however, were significantly larger than the occult papillary carcinomas and their morphological features were quite different. Our results are discussed with regard to the possible role of factors other than irradiation due to the nuclear accident at Chernobyl, and the observed sharp numerical increase of thyroid carcinomas in children of the Republic of Belarus after this event.
Gastritis in patients on non‐steroidal anti‐inflammatory drugs
Authors: QUINN C.M. , BJARNASON I. , PRICE A.B.
Published: April 2007

This study investigated the spectrum of gastric mucosal pathology, including the prevalence of reactive gastritis in patients on non‐steroidal anti‐inflammatory drugs (NSAIDs). The histological findings were correlated with upper gastrointestinal symptom status and endoscopic findings and were also compared with the histological appearances of the gastric mucosa in a corresponding age‐matched control group of 75 patients not receiving NSAIDs or any other drug therapy. Reactive gastritis of the gastric antrum was more common in the NSAID group and was observed in 34 patients (45.3%), as an isolated phenomenon in 24 patients (32%) and with evidence of coexistent chronic gastritis in 10 patients (13.3%). In the control group reactive gastritis of the antrum was seen in 10 patients (13.3%), as an isolated finding in eight cases (10.7%) and with accompanying chronic gastritis in two cases. Chronic antral gastritis of usual type was observed in 36 patients on NSAIDs (48%) and Helicobacter‐like organisms were identified histologically in 18 of these (50% carriage rate). These organisms were not seen in any of the patients in whom the picture of reactive gastritis was present. In the control group chronic antral gastritis was seen in 51 patients (68%) with organisms in 34 (66.6% carriage rate). No correlation was found between the presence or absence of upper gastrointestinal symptoms, endoscopic findings and the histological appearances of the gastric mucosa. We conclude that NSAIDs are an independent cause of reactive gastritis in the antrum and do not appear to alter gastric mucosal colonization by Helicobacter‐like organisms. However, the changes of reactive gastritis, of whatever cause, appear to produce a local micro‐environment, hostile to these organisms.
Pulmonary adenofibroma: report of two cases of an unusual type of hamartomatous lesion of the lung
Authors: SUSTER S. , MORAN C.A.
Published: April 2007

We report two cases of a primary lung tumour characterized by complex gland‐like spaces lined by simple cuboidal to columnar epithelium surrounded by a hyalinized spindle‐cell fibroblastic proliferation reminiscent of adenofibromas of the female genital tract. The lesions occurred in a 54‐year‐old woman and a 56‐year‐old man. The tumours presented clinically as 1–2 cm, solitary ‘coin’ lesions and were discovered incidentally on routine chest X‐rays. Both lesions were treated by lobectomy. One patient is alive and well with no evidence of disease after 8 years; the other died of myocardial infarction 5 years following resection of his tumour without evidence of recurrence. We interpret these lesions as benign hamartomatous growths; their main importance lies in distinguishing them histologically from other types of pulmonary hamartomas, pulmonary blastomas, intrapulmonary solitary fibrous tumours, and metastases from soft tissue and visceral sarcomas.
An unusual perilobular pattern of pulmonary interstitial fibrosis associated with Crohn's disease
Authors: DAWSON A. , GIBBS A.R. , ANDERSON G.
Published: April 2007

Pulmonary pathology associated with inflammatory bowel disease is rare, and seldom biopsied. In this report, we describe a case of pulmonary interstitial fibrosis associated with Crohn's disease. Biopsy showed a unique pattern, with cellular fibroblastic proliferation and fibrosis affecting interlobular septa, spreading into the parenchymal interstitium from the periphery, with associated lymphoid aggregates and thickening of arterial adventitia.
Familial haemophagocytic lymphohistiocytosis. A report of three cases with unusual lung involvement
Authors: POPPER H.H. , ZENZ W. , MACHE C. , ÖHLINGER W.
Published: April 2007

Three cases of familial haemophagocytic lymphohistiocytosis are presented with lung infiltration by haemophagocytic histiocytes. In all patients the diagnosis was based on hepatosplenomegaly, thrombocytopenia and anaemia, abnormal increase in triglycerides, ferritin and LDH, hypofibrinogenaemia and lymphohistiocytosis with haemophagocytosis in bone marrow. Two patients died of respiratory failure due to interstitial pneumonia. In these two patients the pneumonia was obscured and misinterpreted by the pathologists. A careful re‐examination revealed lymphohistiocytosis and haemophagocytic cells within the lung parenchyma. The third patient showed alveolar wall infiltration by haemophagocytic histiocytes and lymphocytes. In early childhood acute or recurrent interstitial pneumonia should prompt a search for haemophagocytic histiocytes, and familial haemophagocytic lymphohistiocytosis should be included in the differential diagnosis.
CD34 immunoexpression in stromal tumours of the gastrointestinal tract and in mesenteric fibromatoses
Authors: MONIHAN J.M. , CARR N.J. , SOBIN L.H.
Published: April 2007

The aim of this study was to explore whether CD34 immunoreactivity can distinguish between different types of gastrointestinal stromal tumour, i.e. smooth muscle and neurogenic. We studied 87 stromal tumours from different sites in the gastrointestinal tract, as well as the omentum and mesentery, using a monoclonal antibody to CD34 (QBEND10). We also determined the immunoexpression of smooth muscle and muscle specific actins, S‐100 protein, cytokeratin, desmin and vimentin. In addition, 15 cases of mesenteric fibromatosis were tested for CD34. Immunoexpression of CD34 was observed in 40 of the 87 stromal tumours and correlated with evidence of differentiation towards a smooth muscle phenotype. Large intestinal stromal tumours were less likely than gastric lesions to be CD34 positive. None of 15 cases of mesenteric fibromatosis was positive for CD34. We conclude that CD34 immunoexpression is seen in a proportion of stromal tumors of the gastrointestinal tract, mesentery and omentum, particularly those of smooth muscle type, and it may be useful as part of an immunohistochemical panel in the differential diagnosis of these neoplasms.
Immunohistochemical localization of chromogranins A and B and secretogranin II in normal, hyperplastic and neoplastic prostate
Authors: SCHMID K.W. , HELPAP B. , TÖTSCH M. , KIRCHMAIR R. , DOCKHORN‐DWORNICZAK B. , BÖCKER W. , FISCHER‐COLBRIE R.
Published: April 2007

Routinely processed normal, hyperplastic and neoplastic prostatic tissue was immunohistochemically investigated with antibodies against chromogranin A and B and secretogranin II. In normal and hyperplastic prostates all three peptides were immunolocalized in scattered neuroendocrine cells situated within the glandular epithelium. In 17 prostatic carcinomas with pronounced neuroendocrine differentiation and in a case of prostatic carcinoid, chromogranin B was the major component whereas chromogranin A and secretogranin II were virtually absent in poorly differentiated (grade III) tumours. Neuroendocrine differentiation in prostatic cancer is most likely to be associated with a poor clinical outcome; thus, chromogranin B appears to be a useful marker in the histopathological diagnosis of these neoplasms.
Emergence of α5β1 fibronectin‐ and αvβ3 vitronectin‐receptor expression in melanocytic tumour progression
Authors: DANEN E.H.J. , BERGE P.J.M. TEN , MUIJEN G.N.P. VAN , VAN'T HOF‐GROOTENBOER A.E. , BRÖCKER E.B. , RUITER D.J.
Published: April 2007

Cell adhesion is crucial in the process of tumour progression. As integrins are important receptor molecules involved in cell adhesion, we studied the distribution of the α1‐6, αv, αIIb, β1, β3, and β4 integrin subunits in tissue sections of common naevocellular naevi (n=22), dysplastic naevi (16), thin (24) and thick primary cutaneous melanomas (28), and melanoma metastases (25). We found correlated expression of α1/α2, of α4/α5/β3, and of α6/β4. Decrease of α6 and β4, and increase of α4 and αv were found to be correlated with melanoma progression. Furthermore, expression of α5 and β3 was detected only in primary melanoma and melanoma metastasis. Our findings indicate that during melanoma progression alterations in integrin expression occur, the most striking being emergence of α5β1 fibronectin and αvβ3 vitonectin receptor.
Dendritic cells in cutaneous lupus erythematosus: a clue to the pathogenesis of lesions
Authors: MORI M. , PIMPINELLI N. , ROMAGNOLI P. , BERNACCHI E. , FABBRI P. , GIANNOTTI B.
Published: April 2007

In view of the critical role of dendritic cells in immune mediated skin diseases, we have investigated the membrane antigen patterns and ultrastructure of cutaneous dendritic cells in eight patients with chronic discoid lupus erythematosus and five with subacute cutaneous lupus erythematosus. In the lesional epidermis, the expression of HLA‐DR antigens by epidermal dendritic cells was reduced, as compared with perilesional, clinically normal skin. In addition, only few CD1a+ dendritic cells (Langerhans' cells), along with some CD11c+ and CD14+ cells (presumable precursors of Langerhans' cells), were found in atrophic areas of lesional epidermis. In contrast, the number of Langerhans' cells in non‐atrophic areas of lesional epidermis was similar to that in perilesional skin. On electronmicroscopy, epidermal Langerhans' cells appeared depleted of organelles and dendrites and contained tubuloreticular inclusions. In the lesional dermis, both CD1a+ and CD36+ dendritic cells were found, associated with CD4+ and CD8+ T‐cells, respectively. Moreover, CD11c+ and CD14+ cells were found around capillaries in the papillary dermis on electronmicroscopy. Indeterminate cells (dendritic cells with features of Langerhans' cell lineage, but apparently without Birbeck granules) and dendritic macrophages were found, associated with lymphocytes and mast cells. No cells with intermediate/transitional features between these two dendritic cell types were found. Conversely, peculiar dendritic cells—with short and blunt dendrites and cytoplasm containing many flat, rough cisternae, moderately well developed Golgi apparatus and no lysosomes—were found in the same location as the CD11c+ and CD14+ cells identified by light microscopy. These findings might be interpreted as follows: 1 the alterations in cytological differentiation and expression of functionally meaningful molecules by epidermal Langerhans' cells in cutaneous lupus erythematosus lesions suggest an impairment of their immunological efficiency; 2 in the lesional dermis of cutaneous lupus erythematosus, a CD4+ T‐cell/CD1a+ dendritic cell‐based, delayed‐type immune response is possibly modulated by a suppressor T‐cell circuit in which CD36+ dendritic cells may act as accessory cells; 3 CD11c+ and CD14+ cells with peculiar ultrastructure are possible precursors of both CD1a+ indeterminate cells and CD36+ dermal dendrocytes in the dermis.
The regressing keratoacanthoma
Authors: BLESSING K. , NAFUSSI A.AL , GORDON P.M.
Published: April 2007

The clinical and pathological features of 11 cases of regressing keratoacanthoma are presented. These lesions were from sun‐exposed skin of individuals between the ages of 58 and 92 years and were of short clinical duration (2–12 months). Histologically, these lesions showed similar features and consisted of symmetrical shallow cup‐shaped invaginations of thin atrophic epidermis with overhanging edges. The underlying papillary dermis demonstrated variable degrees of inflammatory infiltrate and scarring. It is important to recognize these features as representing regressed keratoacanthoma as they may be confused with other unrelated skin conditions.
Cutaneous malignant melanoma in teenagers
Authors: McCARTHY S.W. , CROTTY K.A. , PALMER A.A. , NG A.B.P. , McCARTHY W.H. , SHAW H.M.
Published: April 2007

Of 57 reviewed cases of malignant melanoma in teenagers, 51 had a minimum follow‐up of 5 years. The histological and some clinical features of the 51 cases were compared for diagnostic and prognostic significance with those of 19 Spitz naevi and 10 other benign naevi using the SPSS‐X computer program. The overall crude survival was 71% (males 64%, females 81%). Five patients with regional metastases survived more than 5 years, three of these more than 10 years. The main statistically significant features associated with a poor prognosis were Breslow thickness, diameter of ulcer, abnormal mitoses, pushing dermal borders and marginal (deep) mitoses. In comparison with Spitz naevi, features favouring malignancy were Breslow thickness, fine dusty cytoplasmic melanin pigment, marginal or abnormal mitoses, epithelioid intra‐epidermal melanocytes below parakeratosis, dermal nests larger than junctional nests and the mitotic rate in the papillary dermis. Features favouring a benign lesion were diffuse maturation, spindle cells, spindle nuclei and Kamino bodies, especially if numerous or clustered. In comparison with the atypical benign naevi, significant features favouring malignancy were marginal or abnormal mitoses, single cell epidermal invasion below parakeratosis, large nuclei and irregular nuclei.
Neural cyst of the ovary with central nervous system microvasculature
Authors: FOGT F. , VORTMEYER A.O. , AHN G. , GIROLAMI U.DE , HUNT R.B. , DALY T. , LODA M.
Published: April 2007

A case of a monodermal teratoma of the ovary composed solely of mature neuroglial elements is described. The cyst lining comprised ependymal cells surrounded by white matter which itself was resting on mesothelial cells. Astrocytes, oligodendrocytes, microglia and neurofilament‐positive fibres were seen, but no neuron cell bodies were present. Immunohistochemical stains showed positivity for glial fibrillary acidic protein in ependymal, subependymal and the white matter regions while S‐100 protein positivity was restricted to the white matter. Vessels within neuroectodermal tissue, but not those within the mesodermal tissue, stained positively for anti‐glucose transporter protein, a marker shown to be present in vessels with barrier functions. We conclude that this is a rare case of monodermal teratoma consisting of purely mature brain tissue with a microvasculature exhibiting blood–brain barrier characteristics.
Obstructive jaundice caused by the deposition of amyloid‐like substances in the extrahepatic and large intrahepatic bile ducts in a patient with multiple myeloma
Authors: TERADA T. , HIRATA K. , HISADA Y. , HOSHII Y. , NAKANUMA Y.
Published: April 2007

Obstructive jaundice has rarely been reported in liver amyloidosis. We report here an autopsy of a 55‐year‐old woman with multiple myeloma and obstructive jaundice due to the deposition of amyloid‐like substances in the walls and lumina of the extrahepatic bile duct and intrahepatic large bile ducts, resulting in obstruction and narrowing of the bile ducts. The amyloid‐like deposits were negative with Congo red stain, and were negative immunohistochemically for IgG, IgA, IgM, kappa chain, beta‐2‐microglobulin, and amyloid A and P components. However, they were positive for lambda chain, and ultrastructurally composed of non‐branching filaments with a diameter of 7–10 nm. This is the first case of obstructive jaundice due to histologically confirmed amyloid‐like deposits in the biliary system.
The arteritides
Authors: PARUMS D.V.
Published: April 2007

This article reviews the histopathological, clinical and immunological features of the arteritides. Based on these criteria, a classification scheme is proposed that includes infectious and non‐infectious causes. Included in the non‐infectious arteritides are: hypersensitivity vasculitis including serum sickness, Henoch–Schönlein purpura, mixed cryoglobulinaemia, hypocomplementaemia, drug and malignancy‐associated vasculitis; arteritides of small and medium‐sized arteries including polyarteritis nodosa, Kawasaki's disease, Wegener's granulomatosis, Churg–Strauss syndrome, necrotizing sarcoid granulomatosis, thromboangiitis obliterans (Buerger's disease) and localized forms of arteritis; arteritides involving large, medium and small‐sized arteries which includes giant cell (temporal) arteritis, Takayasu's disease and arteritis of collagen‐vascular disease (rheumatoid arthritis, rheumatic fever, Behçet's disease, Sjögren's syndrome, systemic lupus erythematosis and systemic sclerosis).
Granulomatous slack skin
Authors: TSANG W.Y.W. , CHAN J.K.C. , LOO K.T. , WONG K.F. , LEE A.W.M.
Published: April 2007

Granulomatous slack skin

Granulomatous slack skin is an extremely uncommon form of cutaneous T‐cell lymphoma. We report a case occurring in a 29‐year‐old man, who had generalized, progressive skin lesions evolving to nodular swellings and folds in the flexural regions, and peripheral blood and marrow involvement. The biopsies were initially misinterpreted as xanthogranuloma or granulomatous inflammation. Histologically, the entire dermis and subcutis was infiltrated by non‐necrotizing granulomas comprising mononuclear histiocytes, multinucleated giant cells and small lymphoid cells with irregularly folded nuclei, associated with loss of elastic fibres. The small lymphoid cells showed focal epidermotropism. Immunohistochemical studies showed that they were of T‐lineage (CD3 +, CD43 +, CD45RO +). The multinucleated giant cells, which showed reactivity with the histiocytic markers CD68 and Mac387, were highlighted by intense, thick membrane staining with CD45, CD43 and CD45RO. Ultrastructurally, they exhibited features of macrophages with numerous surface villous processes and lysosomes. Greater awareness of this entity may facilitate more prompt and accurate diagnosis, obviating a futile search for a non‐existent infective aetiology.
Quantitative analysis of macrophages and perisinusoidal cells in primary biliary cirrhosis
Authors: MATHEW J. , HINES J.E. , TOOLE K. , JOHNSON S.J. , JAMES O.F.W. , BURT A.D.
Published: April 2007

Immunohistochemistry and image analysis were used to quantify alterations in the Kupffer cell and ‘activated’ perisinusoidal cell populations in the different stages of primary biliary cirrhosis. Anti‐CD68 macrophage antibodies were used to detect Kupffer cells, and anti‐α‐smooth muscle actin (α‐SMA), PR 2D3 and anti‐desmin antibodies to detect perisinusoidal cells. Liver biopsy material was available from 26 patients with primary biliary cirrhosis and 23 patients with histologically normal liver. Increased Kupffer cell numbers were observed in periportal/periseptal zones of stage 3 primary biliary cirrhosis (n= 9), and in random parenchymal areas of stage 3 and stage 4 cases. Significantly increased ‘activated’ perisinusoidal cell numbers were seen only in periportal/periseptal zones of stage 3 and stage 4 primary biliary cirrhosis. Neither Kupffer cell nor perisinusoidal cell numbers altered significantly in stage 1 and 2 primary biliary cirrhosis (n= 6). PR 2D3 positivity and increased α‐SMA immunoreactivity by perisinusoidal cells in primary biliary cirrhosis support myofibroblastic differentiation of these cells. Human perisinusoidal cells, unlike their rodent counterparts, did not express desmin in primary biliary cirrhosis or control liver. Kupffer cell and ‘activated’ perisinusoidal cell accumulation in periportal/periseptal zones of the precirrhotic and cirrhotic primary biliary cirrhosis liver support the concept of Kupffer cell‐mediated stimulation of perisinusoidal cells. Furthermore, these findings indicate that Kupffer cell–perisinusoidal interactions play an important role in the development of liver fibrosis and cirrhosis in primary biliary cirrhosis.
Low‐grade B‐cell lymphoma of mucosa‐associated lymphoid tissue type in Waldeyer's ring
Authors: PAULSEN J. , LENNERT K.
Published: April 2007

Amongst a total of 329 cases of low‐grade B‐cell lymphoma of Waldeyer's ring, we identified 12 cases that corresponded histomorphologically to low‐grade B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT) type. These lymphomas are characterized by an extrafollicular growth pattern, often with a marginal zone‐like arrangement, and by the centrocyte‐like morphology of the tumour cells. They have not been described previously in this location. They predominantly affected the palatine tonsil. Ten cases were primary lymphomas of Waldeyer's ring. In two cases there was a simultaneous high‐grade component. Two cases showed regional spread to cervical lymph nodes, but there was no widespread nodal involvement at the time of diagnosis. Immunohistochemically, all cases displayed B‐cell markers and light chain restriction. Tropism of tumour cells for the epithelium was a consistent finding. In two cases involvement of Waldeyer's ring was secondary; in one of them the primary tumour was a gastric low‐grade B‐cell lymphoma of MALT type and in the other a high‐grade B‐cell non‐Hodgkin's lymphoma of the stomach. These findings indicate that low‐grade B‐cell lymphomas of MALT type occurring in Waldeyer's ring should be included amongst the tumours of the MALT system. We surmise that in Waldeyer's ring such tumours are derived from the marginal zone, as has already been postulated for similar gastric tumours.
Immunocytochemical localization of oestrogen and progesterone receptors in primary adenocarcinoma of the cervix
Authors: GHANDOUR F.A. , ATTANOOS R. , NAHAR K. , GEE J.W. , BIGRIGG A. , ISMAIL S.M.
Published: April 2007

Archival material from 47 primary invasive adenocarcinomas of the uterine cervix was examined using an immunocytochemical technique for detection of oestrogen receptor and progesterone receptor in paraffin‐wax embedded tissues. Immunostaining for oestrogen receptor was noted within tumour cells in 12 cervical adenocarcinomas while 13 tumours contained progesterone receptor. Eleven cervical adenocarcinomas expressed both oestrogen and progesterone receptor simultaneously. There was no association between steroid receptor status and major histological subtype, grade of tumour, clinical stage or age of patient at presentation. However, oestrogen receptor immunoreactivity was associated with disease‐free survival. This preliminary study raises the possibility that, as in breast carcinoma, steroid receptor status may be a useful prognostic factor in adenocarcinoma of the cervix.
Immunocytochemical and serological expression of CA 125: a clinicopathological study of 40 malignant ovarian epithelial tumours
Authors: LEAKE J. , WOOLAS R.P. , DANIEL J. , ORAM D.H. , BROWN C.L.
Published: April 2007

Elevated serum levels of the tumour‐associated antigen CA 125 occur in more than 80% of cases of ovarian carcinoma. The antigen can be demonstrated in formalin‐fixed tissue using the monoclonal antibody OC 125, which localizes it to the surface membrane or cytoplasm. This study was performed to determine the relationship between pre‐operative serum levels of CA 125 and the subsequent immunocytochemical findings in the surgical specimen. Paraffin‐wax embedded sections from 40 consecutive borderline and frankly malignant ovarian epithelial tumours were stained with OC 125. The pattern and distribution of immunostaining were investigated in relation to histological appearances. Serous tumours showed a 100% correlation between immunocytochemical findings and elevated serum levels of CA 125. Amongst the other histological types, correlation was less good; mucinous tumours and undifferentiated carcinomas showed a poor correlation. Immunostaining within tumours was heterogeneous and only loosely related to morphological appearances. Our finding suggests that, with the exception of serous tumours, immunolocalization of CA 125 is insufficiently sensitive to provide reliable clinical guidance to the likely value of serum CA 125 monitoring on follow‐up.
Immunohistochemical detection of the receptor for urokinase plasminogen activator in human colon cancer
Authors: PYKE C. , RALFKIÆR E. , RØNNE E. , HØYER‐HANSEN G. , KIRKEBY L. , DANØ K.
Published: April 2007

Paraffin‐wax embedded specimens from 30 cases of colonic adenocarcinoma were investigated for immunoreactivity for the receptor of urokinase‐type plasminogen activator (uPAR). In all cases there was a strong signal, predominantly at the invasive foci. The positive cells were mainly tumour‐infiltrating macrophages but neutrophils and eosinophils were also strongly stained. The neoplastic cells were positive in 19 of the samples with staining of occasional or a moderate number of cells. In uninvolved, normal‐appearing mucosa adjacent to the malignant infiltrates, immunostaining of both macrophages and neutrophils was seen, but the labelling was less intense than that seen in the malignant lesions. Weak to moderate staining of normal intestinal epithelium was also seen at the luminal surface. Comparison between immunoreactivity and in situ hybridization showed a similar distribution of protein and mRNA with two exceptions: first, neutrophils (strongly immunoreactive for uPAR) were negative or only weakly positive for uPAR mRNA; and second, many cancer cells at invasive foci showed prominent hybridization signals but no detectable uPAR immunoreactivity. Together with previous findings of urokinase plasminogen activator (uPA) protein and mRNA being expressed in tumour‐infiltrating fibroblast‐Iike cells at the invasive foci, these results support the view that the uPA pathway of plasminogen activation is involved in tissue degradation in colon cancer. The results also extend and consolidate an emerging picture of non‐neoplastic tumour stromal cells producing molecules involved in the generation and regulation of extracellular proteolysis in cancer.
Orange‐red birefringence of gold particles in paraffin wax embedded sections
Authors: AL‐TALIB R.K. , WRIGHT D.H. , THEAKER J.M.
Published: April 2007

Chrysiasis, the systemic deposition of gold pigment in patients on long term chrysotherapy, is identified histologically as small black granules within macrophages. Histological sections from 12 confirmed cases of chrysiasis were examined under crossed polarized light. This revealed a striking orange–red birefringence of the pigment not detected in other histologically similar deposits. This technique provides a valuable adjunct to the histological identification of gold without the need to resort to ultrastructural and analytical procedures.
Perineurioma (storiform perineurial fibroma)
Authors: MENTZEL T. , TOS A.P. DEI , FLETCHER C.D.M.
Published: April 2007

Four cases of perineurioma (storiform perineurial fibroma) arising in the dermis, subcutis, or deep soft tissue have been studied. Two patients were female and two were male with ages ranging from 19 to 45 years. One lesion each arose on the chest wall, shoulder, neck, and elbow. Follow‐up information in three patients revealed no recurrence. Histologically, the neoplasms were circumscribed but non‐encapsulated lesions and were composed of spindle cells with elongated bipolar cytoplasmic processes, inconspicuous fusiform nuclei and well‐defined palely eosinophilic cytoplasm. These cells were arranged in whorls or lamellar‐like structures and often demonstrated a storiform growth pattern. In areas, the tumour cells appeared larger with more rounded nuclei. Immunohistochemically, most of the tumour cells stained positive for epithelial membrane antigen and vimentin, but failed to stain for S‐100 protein, neurofilament, desmoplakin, and CD34. Ultrastructurally, two cases showed fusiform tumour cells with long, thin cell processes separated by abundant collagen bundles. Tumour cells were covered by discontinuous external lamina, showed many pinocytic vesicles and occasionally desmosome‐like structures. The morphology and EMA immunopositivity of perineurioma are similar to meningioma, especially to cutaneous meningioma type II. We believe that perineurioma and meningioma are closely related, but morphologically distinguishable, neoplasms.
Lymphocytic infiltration and destruction of parathyroid adenomas: a possible tumour‐specific autoimmune reaction in two cases of primary hyperparathyroidism
Authors: VERESS B. , NORDENSTRÖM J.
Published: April 2007

Two cases of primary hyperparathyroidism with underlying parathyroid adenomas were found to be associated with lymphocytic infiltration and destruction of the neoplastic tissue. There was no inflammatory infiltrate in the adjacent rim of the remnant of parathyroid gland or in the other tumour‐free glands. The lymphoid cell population within the tumours was composed of both infiltrating T‐cells and compact nodule‐forming B‐cells. In one of the tumours there was considerable fibrosis and atrophy of the adenomatous tissue. The histological picture was consistent with an autoimmune process directed against the adenomas, indicating that this reaction had, in part, been successful in reducing the abnormal cell population.
Enlargement of the carotid bodies in cirrhosis of the liver
Authors: HEATH D. , SMITH P.
Published: April 2007

The carotid bodies were dissected out at necropsy and weighed in seven subjects with cirrhosis of the liver and in seven control subjects of comparable age free of liver disease. The mean combined carotid body weight of the control group was 17mg but in the cirrhotic patients it was 35 mg, a statistically significant difference (P < 0.005). Differential counts of the various types of glomic cell (progenitor, dark and light variants of chief cells and sustentacular cells) were carried out. The enlargement of the carotid bodies in the subjects with cirrhosis was associated with increased numbers of the dark variant of chief cell. The mean number of dark cells per unit area in the control group was 361 cells/mm2 but in the cirrhosis group it was 1024 cells/mm2, a statistically significant difference (P < 0.005). It is postulated that the prominence of dark cells may be associated with secretion of a natriuretic peptide in response to the hyperaldosteronism and sodium retention of cirrhosis of the liver. Alternatively, it may be a response to hypoxaemia resulting from porta‐pulmonary shunts.
A morphological and immunohistochemical study of 25 cases of so‐called sclerosing haemangioma of the lung
Authors: LEONG A.S‐Y. , CHAN K.‐W. , SENEVIRATNE H.S.K.
Published: April 2007

The so‐called sclerosing haemangioma of the lung is an uncommon tumour with predilection for Chinese women. Twenty‐five cases showed a predominantly solid/cellular pattern in three, a haemorrhagic/angiomatoid pattern in three, a papillary pattern in one, a sclerotic pattern in one, and in seventeen, a mixed pattern was observed. Immunostaining revealed the expression of epithelial membrane antigen, vimentin (V9), and CD68 (KP1) in all tumours, cytokeratin in 23 (Cam 5.2 and MNF116), S‐100 protein in 22 and alpha‐smooth muscle actin in 23 tumours. All tumours were negative for surfactant, factor VIII‐related antigen, CD34 and MAC387. There was strong labelling for progesterone receptor protein in 20 tumours, and oestrogen receptor protein was weakly stainable in 13 tumours. The histogenesis of sclerosing haemangioma of the lung is controversial and origin from pneumocyte, histiocyte, mesothelial, endothelial and Clara cell has been suggested. Our immunohistochemical findings, in the largest series studied to date, indicated a cytokeratin+, vimentin+, epithelial membrane antigen+, alpha‐smooth muscle actin+, CD68+, oestrogen+, progesterone+, phenotype, confirming an epithelial lineage but which does not clearly correspond to any recognized cell in the respiratory system. The distinct expression of progesterone and oestrogen receptor proteins correlates with the predilection of this tumour for women.
Pathology of the liver in leukaemia and lymphoma. A study of 110 autopsies
Authors: SCHEIMBERG I.B. , POLLOCK D.J. , COLLINS P.W. , DORAN H.M. , NEWLAND A.C. , WALT J.D. VAN DER
Published: April 2007

Histopathological findings in the liver in a series of autopsies on 110 patients suffering from leukaemia or lymphoma were reviewed. No treatment had been given to 23 patients, 50 had received chemotherapy alone, 23 chemo‐ and radiotherapy and 14 underwent bone marrow transplantation. The 23 untreated patients showed neoplastic infiltration in 10 (44%) and fibrosis in 16 cases (70%). The 14 bone marrow recipients showed mainly acute necrosis, zonal in six (43%) and focal in one (7%), and cholestasis in five (36%), together with marked siderosis in 11 (79%). Patients receiving chemotherapy or chemo‐/radiotherapy showed similar changes consisting of neoplastic infiltration in 14 (28%) and in five (22%) cases respectively, and fibrosis in 31 (62%) and 17 (74%) cases respectively. Steatosis was seen in 70% of cases in the chemo‐/radiotherapy group and in 50% of cases in the other groups. Infections were seen in all groups, particularly in the chemotherapy group (four fungal and two bacterial including one tuberculosis) and in the chemoradiotherapy group (one fungal and one bacterial). Cytomegalovirus infection was seen only in the bone marrow transplant group.
The use of the polymerase chain reaction in the diagnosis of B‐cell lymphomas from formalin‐fixed paraffin‐embedded tissue
Authors: ILYAS M. , JALAL H. , LINTON C. , ROONEY N.
Published: April 2007

In this study the use of the polymerase chain reaction (PCR) to detect monoclonality in B‐cell lymphoid proliferations in archival formalin‐fixed paraffin‐embedded tissue was assessed. Using consensus primers against the framework 3 (FR 3) region of the immunoglobulin heavy chain gene (IgH), PCR analysis was performed on 29 low grade B‐cell non‐Hodgkin's lymphomas. Cases of benign lymphoid hyperplasia served as polyclonal controls. Sequenced cases of acute lymphoblastic leukaemia served as positive controls. In the lymphomas, monoclonality could be demonstrated in 18 of 29 (62%) cases. Only five of 11 (45%) follicle centre cell lymphomas were positive by this method whilst the success rate for the remainder was 13 of 18 (72%). None of the polyclonal controls gave false positive results although occasional non‐specific dominant bands were present which disappeared on repeating the experiments. These results show that this method will identify monoclonality in 62% of low grade B‐cell non‐Hodgkin's lymphomas in archival material. The success rate is increased to 72% if follicle centre cell lymphomas are excluded. Thus, this method is a useful adjunctive test to aid diagnosis in lymphoid infiltrates when standard morphology and immunohistochemistry are equivocal.
Synovial chondromatosis presenting as painless soft tissue mass—a report of 19 cases
Authors: SVILAND L. , MALCOLM A.J.
Published: April 2007

Primary synovial chondromatosis is a disorder of joints, tendon sheaths and bursae characterized by the formation and growth of cartilaginous nodules. It usually presents clinically with joint symptoms and is frequently associated with intra‐articular loose bodies. A large soft tissue mass is an unusual presentation which, both clinically and radiologically, raises the suspicion of malignancy. Nineteen cases of synovial chondromatosis presenting as soft tissue tumours were reviewed. They were all adjacent to joints but with no joint symptoms. Histology showed the typical features of benign synovial chondromatosis, including foci of cartilage cells showing cytological atypia. This is well recognized and does not indicate malignancy. Clinical follow up confirmed this with local recurrence only in three patients. It is important to be aware of this unusual presentation as the alternative diagnosis of a chondrosarcoma, as initially diagnosed in some of these cases, has major implications regarding the treatment of these patients.
Lymphoepithelioma‐like carcinoma of the vulvar region
Authors: AXELSEN S.M. , STAMP I.M.
Published: April 2007

A case of lymphoepithelioma‐like carcinoma of the vulvar region is described. Histologically, the tumour was similar to lymphoepithelioma of the nasopharynx but was Epstein‐Barr virus negative. Infiltrating lymphocytes were predominantly T‐cells, but also included some B‐cells. Immunohistochemical stains showed positivity in tumour cells for cytokeratins but negativity for neuroendocrine markers, the melanoma‐associated antigen, HMB45 and leucocyte common antigen. We conclude that the tumour histologically resembles lymphoepithelioma of the nasopharynx and lymphoepithelioma‐like carcinomas of the skin, and has no relation to prior infection with the Epstein‐Barr virus.
Basophilic degeneration of the myocardium: histological, immunohistochemical and immuno‐electronmicroscopic studies
Authors: TAMURA S. , TAKAHASHI M. , KAWAMURA S. , ISHIHARA T.
Published: April 2007

We studied basophilic degeneration of heart muscle cells in 100 consecutive autopsies (74 males, 26 females). Except for two infants, the age of individuals whose tissue was studied ranged from 10 to 90 years (mean age, 68.3). Using histochemical and immunohistochemical methods, we found the frequency and extent of basophilic degeneration and the materials in type IV glycogenosis (Andersen's‐disease) were reactive to monoclonal antibodies raised against polyglucosan extracted from the myocardium of a patient with Lafora's disease. Basophilic degeneration was found in 98% of the entire study population and in 100% of those aged over 60. The reactivity for polyglucosan became more intense after diastase digestion. Immuno‐electronmicroscopy using an immunogold method showed that the fibril‐like structures of basophilic degeneration were specifically labelled by the monoclonal antibodies to polyglucosan.
Thymoma—a study of 60 cases in Singapore
Authors: TAN P.H. , SNG I.T.Y.
Published: April 2007

Of 60 cases of thymomas studied in Singapore between 1988 and 1992, the histogenetic classification proposed by Müller‐Hermelink was successfully applied to subtype 58 cases. There were 20 (33%) cortical, six (10%) predominantly cortical, three (5%) medullary and 12 (20%) mixed thymomas. Twelve (20%) cases were well differentiated thymic carcinomas and five (8%) were classified as other thymic carcinomas. The pathological and clinical features are presented in detail. These subtypes showed significant correlation with invasive behaviour (stage) and myasthenia gravis. We conclude that the Müller‐Hermelink classification has predictive utility and represents a major step towards the understanding of the biology of thymic epithelial tumours.