bluuebunny/crossref_metadata_2025 huggingface dataset:
The grading of rectal cancer: historical perspectives and a multivariate analysis of 447 cases
Authors: JASS J.R. , ATKIN W.S. , CUZICK J. , BUSSEY H.J.R. , MORSON B.C. , NORTHOVER J.M.A. , TODD I.P.
Published: April 2007

The grade of a tumour is gauged on the subjective assessment of a number of histopathological parameters. The problems associated with this exercise were viewed from a historical perspective and survival analysis of 447 patients receiving surgery for rectal adenocarcinoma was undertaken. Only deaths from rectal adenocarcinoma were included as events in the survival analysis. Seven grade‐related parameters were scored by one observer. A grading system was constructed using the Cox regression model. The variables in the best‐fitting parsimonious model comprised lymphocytic infiltration, tubule configuration and pattern of growth. Scores were derived from the model and a four grade system was created in which the groups were of similar size. Good reproducibility of the selected histopathological parameters was demonstrated. Grade‐related parameters were then allowed to compete with stage‐related parameters in an overall model of pathological prognostic categories. The parameters selected in the best model were number of affected lymph nodes, the presence of lymphocytic infiltration and extent of spread through bowel wall. A set of five prognostic categories was developed from this model.
Demonstration of S‐100 protein in sustentacular cells of phaeochromocytomas and paragangliomas
Authors: SCHRODER H. D. , JOHANNSEN L.
Published: April 2007

Eighteen phaeochromocytomas, including both sporadic and familial cases, four cervical paragangliomas, two jugular paragangliomas, and one abdominal paraganglioma were examined immunohistochemically for the presence of 5–100 protein. Positive staining in cells morphologically similar to the sustentacular cells of normal paraganglia and adrenal medulla were found in all paragangliomas and in the benign and aggressively growing phaeochromocytomas. In the two malignant tumours no positive reaction was demonstrated. In one tumour the sustentacular cells were shown to contain glial fibrillary acidic protein further supporting their Schwann cell relationship. The number of 5–100 positive cells varied considerably. They demonstrated a spindle celled or elongated configuration with long slender processes. The nature of the sustentacular cell proliferation, neoplastic versus reactive, is discussed.
Decidual change in pelvic lymph nodes: a source of possible diagnostic error
Authors: BURNETT R.A. , MILLAN D.
Published: April 2007

The presence of heterotopic decidual tissue in the sinuses of a pelvic lymph node from a pregnant patient with cervical carcinoma is described. The diagnostic implications are discussed.
An ultrastructural study of mucoid carcinoma of the breast: variability of cytoplasmic features
Authors: FERGUSON D.J.P. , ANDERSON T.J. , WELLS C.A. , BATTERSBY S.
Published: April 2007

The ultrastructural characteristics of 14 cases of mucoid carcinoma of the breast, with different histological appearances, have been examined. Thirteen of the tumours were observed to consist of two populations of tumour cells, one showing secretory changes while the other group showed no evidence of activity. In one tumour only synthetically active cells were observed. Ultrastructurally, six different types of cytoplasmic granules, comprising typical mucin plus glycoprotein or proteincontaining granules, were identified within the synthetically active tumour cells. The number of types of granules and the relative proportion of the various granules varied between tumours with only mucin granules present in all tumours. It would appear that synthetic pathways are activated in certain tumours which result in protein/glycoprotein granules associated with the argyrophilia observed histologically. In addition, the tumours varied with respect to luminal differentiation, presence of intracytoplasmic lumina, intracytoplasmic mucin pools, lipid droplets, ciliated cells and areas of calcification. The marked heterogeneity of the ultrastructural features of the mucoid carcinoma of the breast prevents the tumours from being readily divided into distinct subgroups.
The prognostic value of sulphomucin positive intestinal metaplasia in the development of gastric cancer
Authors: ECTORS N. , DIXON M.F.
Published: April 2007

Gastric biopsy specimens from 230 patients with chronic atrophic gastritis were investigated with the use of mucin stains for the presence and type of intestinal metaplasia. Metaplasia was not shown in 59 cases; 92 of the 171 cases with metaplasia were sulphomucin positive and 79 were negative. The patients were followed‐up from 1976 to 1985. Eight patients were registered as having gastric cancer over this period. However, five of them had to be eliminated from the study because on careful review of all the clinical data it was clear that they had gastric cancer at the time of the biopsy. Two of the three remaining patients had sulphomucin negative biopsies. Thus, only one patient out of 90 with chronic atrophic gastritis and sulphomucin positive intestinal metaplasia developed gastric cancer when followed‐up for 8—9 years. None of the patients with unequivocal type IIb metaplasia developed gastric cancer. We conclude that sulphomucin positive intestinal metaplasia does not identify a high risk group and its recognition is thus of no value in surveillance for gastric cancer.
Secretory component in pulmonary adenocarcinoma and mesothelioma
Authors: KONDI‐PAPHITIS A. , ADDIS B.J.
Published: April 2007

The distribution of secretory component was examined by an immunoperoxidase method in 40 pulmonary adenocarcinomas, 11 malignant pleural mesotheliomas and areas of normal lung adjacent to the tumours. Secretory component was demonstrated in tumour cells in 25 (67%) adenocarcinomas. Its presence correlated with the degree of differentiation but was not related to tumour pattern. In the normal lung secretory component can be demonstrated in bronchial ciliated cells, bronchial gland serous cells, bronchiolar epithelium and hyperplastic alveolar epithelium. Although not usually detectable in normal mucous cells it was frequently present in mucin‐producing tumours. None of the mesotheliomas examined contained secretory component and this may be an additional useful feature in the differential diagnosis between mesothelioma and adenocarcinoma.
Epithelial markers in thyroid carcinoma: an immunoperoxidase study
Authors: WILSON N.W. , PAMBAKIAN H. , RICHARDSON T.C. , STOKOE M.R. , MAKIN C.A. , HEYDERMAN E.
Published: April 2007

Ten cases each of papillary, follicular, anaplastic and medullary carcinoma of the thyroid were stained for thyroglobulin, calcitonin, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and cytokeratin (CAM 5.2). Monoclonal or affinity purified polyclonal antibodies, and an indirect immunoperoxidase technique were used. All the papillary and follicular tumours, 5/10 anaplastic and 3/10 medullary carcinomas contained thyroglobulin. Only the 10 medullary carcinomas stained positively for calcitonin. Three out of 10 papillary, 1/10 follicular, 0/10 anaplastic and 10/10 medullary carcinomas were positive for CEA. Nine out of ten papillary, 7/10 follicular, 2/10 anaplastic and 3/10 medullary carcinomas were positive for EMA. Ten out of 10 papillary, 10/10 follicular, 5/10 anaplastic and 10/10 medullary carcinomas were positive for cytokeratin. The presence of calcitonin and CEA is of value in the diagnosis of medullary carcinoma, and enable its distinction from anaplastic thyroid carcinoma. Thyroglobulin is a useful marker in thyroid carcinomas.
Spindle cell lipoma: a clinicopathological study with some original observations
Authors: FLETCHER C.D.M. , MARTIN‐BATES E.
Published: April 2007

Forty‐one cases of spindle cell lipoma, an entity first described in 1975, are presented. Of these, 38 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. This lesion, therefore, accounts for about 1.5% of adipocytic neoplasms and is outnumbered by conventional benign lipomas by approximately 60 to 1. The remaining three were referred cases. Seventy‐five per cent of the lesions arose, as expected, on the back of the neck, upper back or shoulder, almost exclusively in males between 40 and 70 years of age. Ten lesions were identified at unusual sites: six in the limbs, three on the face and one on the trunk. One lesion arose within skeletal muscle, a previously unreported phenomenon, and this case showed both cartilaginous and osseous metaplasia. Only one of the 41 tumours has recurred locally. The range of histological features in spindle cell lipoma is described and the differential diagnosis is discussed.
Neurogenous hyperplasia leading to appendiceal obliteration: an immunohistochemical study of 237 cases
Authors: OLSEN B.S. , HOLCK S.
Published: April 2007

A series of 237 appendices was studied immunohistochemically for neurogenous hyperplasia. This was observed in 195 cases. It was possible to trace a continuum from appendices with intact lumens, featuring intramucosal neurogenous hyperplasia often with co‐existent submucosal and muscular nerve growth, to obliterated specimens whose axial portions were composed of varying proportions of nerve tangles and fibrous tissue. Predominantly fibrotic specimens were considered as end‐stages of this process. Stromal, argyrophilic cells lying amidst the nerve elements were prominent in the early, non‐obliterated cases; their number decreased in the obliterated nerve rich specimens and such cells became inapparent in the late fibrotic stage. Repeated minimal subclinical attacks of inflammation are thought to trigger this lesion.
The distribution of cytokeratin antigens in the kidney and in renal tumours
Authors: FLEMING S. , SYMES C.E.
Published: April 2007

The distribution of cytokeratin antigens during embryogenesis of the kidney and in 57 renal tumours has been studied using immunocytochemical techniques. A polyclonal antiserum to epidermal prekeratins and the monoclonal antibodies CAM 5.2 and PKK1 have been used to identify cytokeratins of different molecular weights. The ureteric bud‐derived structures expressed large molecular weight cytokeratins. The tubular component of the kidney expressed cytokeratins detected by CAM 5.2 and PKK1. During glomerular development there was transient expression of low molecular weight cytokeratins by the visceral glomerular epithelium but in the adult kidney only the parietal epithelium expressed cytokeratins. Tubules in nephroblastomas contained low molecular weight cytokeratins but the blastema did not. Some ureteric bud‐derived structures were identified in six nephroblastomas. Renal carcinomas expressed low molecular weight cytokeratins. Four collecting duct carcinomas were studied; these all expressed the large molecular weight cytokeratins found in collecting duct epithelium. These results indicate that the cytokeratin phenotype of renal tumours is unchanged from that of the normal epithelial cells.
Immunohistochemical differentiation of neuroblastomas from other small round cell neoplasms of childhood using a panel of mono‐and polyclonal antibodies
Authors: OPPEDAL B.R. , BRANDTZAEG P. , KEMSHEAD J.T.
Published: April 2007

A panel of monoclonal antibodies to neuroblastoma cells, leucocyte common antigen, vimentin and MHC class II antigens (HLA‐DR) and a polyclonal antibody to epidermal keratin were used for immunohistochemistry on sections of ethanol fixed and paraffin embedded specimens from 40 undifferentiated small cell tumours and 10 neural crest neoplasms. With the exception of central nervous system neoplasms and two embryonal rhabdomyosarcomas, immunohistochemical examination discriminated between the neural crest neoplasms and the other small cell tumours. Moreover, the staining pattern of neoplastic cells and structures in the neural crest neoplasms obtained with antibodies to neuroblastoma cells seemed, in part, to reflect the degree of tumour differentiation.
Soft tissue sarcomas apparently arising in chronic tropical ulcers
Authors: FLETCHER C.D.M.
Published: April 2007

Of 720 soft tissue sarcomas received from Malawi over a 15 year period, eight had apparently arisen in chronic tropical ulcers which are endemic in that part of Africa. These eight tumours were classified as leiomyosarcoma (three), extraskeletal osteosarcoma (two), malignant fibrous histiocytoma (one), myxoid liposarcoma (one) and unclassifiable (one). All had a history suggestive of malignant change in a long‐standing ulcer, in each case clinically thought to be a squamous carcinoma. However, in none was there evidence of an epithelial origin and ail were negative for epithelial membrane antigen and cytokeratin. This association has not previously been reported. The validity of this proposed association is discussed.
Oncocytic liver cell adenoma
Authors: SALISBURY J.R. , PORTMANN B.C.
Published: April 2007

A 46‐year‐old woman underwent right hepatic lobectomy for the removal of a solitary liver tumour from a non‐cirrhotic liver. The macroscopic and light microscopic features were those of a liver cell adenoma but the cells appeared oncocytic. Electron microscopy confirmed the numerous mitochondria characteristic of oncocytes. The difficulty of distinguishing oncocytic liver cell adenoma from fibrolamellar hepatocellular carcinoma is discussed.
Correlation between immunohistochemically determined oestrogen receptor content, using monoclonal antibodies, and qualitative and quantitative tissue features in ductal breast cancer
Authors: TOSI P. , BAAK J.P.A. , LUZI P. , SFORZA V. , SANTOPIETRO R. , LIO R.
Published: April 2007

Previous studies have shown that oestrogen receptor content in breast cancer was correlated with qualitative and also, more strongly, with quantitative nuclear features in tissue sections. However, even with the better reproducible quantitative microscopical assessments, the variance in the correlation with oestrogen receptor was considerable. This might be due to the implicit problems of oestrogen receptor determination with the biochemical assay. Therefore, receptor content was studied using monoclonal antibodies in 50 consecutive invasive ductal breast cancers. Oestrogen receptor status was compared with qualitative features and with the mean and standard deviation of the nuclear area, morphometrically evaluated on immunostained and adjacent haematoxylin and eosin stained sections. In agreement with earlier observations, nearly all tumours with prominent elastosis were oestrogen receptor positive; but a minority of negative cases also showed elastosis. The correlation between the other qualitative features and receptor status was weak. A significant inverse correlation (P<0.001) existed between the receptor status and the mean and standard deviation of the nuclear area. Even with the highly reproducible morphometrical analysis, correlation between nuclear oestrogen receptor content and quantitative nuclear features was relatively weak. This might indicate that receptor status and nuclear morphometric features reflect different biological characteristics of breast cancers.
Ultrastructure of early plexogenic pulmonary arteriopathy
Authors: HEATH D. , SMITH P. , GOSNEY J.
Published: April 2007

A lung biopsy specimen from a young woman with the clinical features of primary pulmonary hypertension showed grade 2 plexogenic pulmonary arteriopathy. Electron microscopy revealed ‘dark’, electron‐dense smooth muscle cells in the inner part of the media of muscular pulmonary arteries. Many of these transformed myocytes had migrated into the lumens of pulmonary arteries and arterioles which they occluded. This migration of smooth muscle cells was associated with a substantial increase in the number of pulmonary endocrine cells in the bronchioles containing bombesin and calcitonin.
The histopathology and staging of carcinoma of the ampulla of Vater
Authors: TALBOT I.C. , NEOPTOLEMOS J.P. , SHAW D.E. , CARR‐LOCKE D.
Published: April 2007

Review of 26 resected ampullary carcinomas revealed intestinal type adenocarcinoma in all but one and overtly papillary carcinoma in only one case. Co‐existing adenoma of the ampulla was present in 11 cases, over half of which were low‐grade carcinomas. Flat duct epithelial dysplasia was present in a further eight cases, the adenocarcinoma in only two of these being well differentiated. The estimated 5 year survival rate, overall, was 52% and, with well differentiated adenocarcinoma, 75%. We recommend a new staging system, based on extent of local and lymph node spread: I=invasion confined to wall of common bile duct; II=infiltration of duodenal or retroperitoneal tissues, excluding pancreas; III=infiltration of pancreas; IV=metastasis to nearby lymph nodes. Long‐term survival correlates inversely with stage, both by univariate analysis and independently of grade, so that a simple scoring system, based on a combination of both grade and stage, is an excellent predictor of the long‐term outcome, defining two groups, with 5 year survival rates of 79% and 0% (P<0.001).
Melanin‐forming Schwann cells in some oral mucosal lesions
Authors: EL‐LABBAN N.G.
Published: April 2007

Normal oral mucosa and some mucosal lesions show melanin pigmentation, and it is usually assumed that melanin‐containing cells in the lamina propria are melanophages. In a study of oral mucosa from two cases of lichen planus and two of sublingual keratosis, many brown, intracellular, Masson‐Fontana‐positive granules were seen. At the ultrastructural level some of the melanin‐containing cells displayed characteristics of Schwann cells rather than melanophages. These cells were surrounded by a basal lamina and contained unmyelinated axons. Although the majority of the melanin granules in these cells were compound melanosomes, single melanosomes and premelanosomes were also seen. These findings show that in sublingual keratosis and oral lichen planus lesions some of the melanin‐containing cells in the connective tissue may be melanin‐forming Schwann cells.
Congenital Leydig cell hyperplasia
Authors: NISTAL M. , GONZÁLEZ‐PERAMATO P. , PANIAGUA R.
Published: April 2007

The testes and epididymes collected at autopsy from 21 newborns showed apparent Leydig cell hyperplasia which was studied by light and electron microscopy. Twelve newborns were the sons of diabetic mothers, two had undergone rhesus isoimmunization, two were twins of a non‐diabetic mother, three had Beckwitz‐Widemann's syndrome, and two had leprechaunism. In the first two groups the placentas were also collected and studied. All the testes showed normal seminiferous tubules and diffuse Leydig cell hyperplasia in the testicular interstitium. In addition one son of a diabetic mother and another with Beckwitz‐Widemann's syndrome presented multiple Leydig cell nodules in the mediastinum testis and epididymis. The number of Leydig cells per unit area of the testis was calculated on histological sections stained with the peroxidase‐anti‐peroxidase method for the detection of testosterone. These numbers varied from 1.4 to 3.2 times those found in age‐matched controls, except for the two testes with nodular hyperplasia in which the increase in Leydig cells was even greater. The differential diagnosis between Leydig cell hyperplasia, ectopic adrenal cells and Leydig cell tumour is discussed. It is proposed that the cause of congenital Leydig cell hyperplasia might be related to placental secretion of human chorionic gonadotrophin.
Testicular atrophy after oestrogen therapy
Authors: VENIZELOS I. D. , PARADINAS F. J.
Published: April 2007

Therapeutic use of oestrogens by males with carcinoma of the prostate leads to testicular atrophy with markedly reduced spermatogenesis after only 21 d (Oshima et al. 1974). Treatment for over a year results in paucity of germ cells, vacuolation of Sertoli cells and reduction in Leydig cells (Lu & Steinberger 1978, Smith & Urry 1985). There is, apparently, no information on the histology of the human testis after more than 1 year oestrogen therapy. We here report changes in testes from five transsexuals treated for periods of up to 5.5 years.
Chronic intestinal pseudo‐obstruction in two patients. Overlap of features of systemic sclerosis and visceral myopathy
Authors: VENIZELOS I. D. , SHOUSHA S. , BULL T. B. , PARKINS R. A.
Published: April 2007

Two patients with chronic intestinal pseudo‐obstruction are reported, one of whom had definite systemic sclerosis while the other had certain manifestations of the disease. Biopsies of the small intestine revealed increased collagen and elastic fibres in the muscularis propria and subserosa in each case, while ganglion cells were normal. In addition, one patient had severe atrophy of the inner muscle layer and the other obvious vacuolation of the muscularis propria. Ultrastructural examination confirmed degeneration of the smooth muscle fibres. These latter features have been considered the hallmark of visceral myopathy and their finding in this patient therefore suggests that the different causes of pseudo‐obstruction may not be completely demarcated and cases in which the features overlap may occur.
Cytokeratins in smooth muscle cells and smooth muscle tumours
Authors: RAMAEKERS F. C. S. , PRUSZCZYNSKI M. , SMEDTS F.
Published: April 2007

A keratin positive metastatic leiomyosarcoma in the lung, which resulted in diagnostic error, is reported. The results of additional studies of 17 benign and malignant leiomyogenic tumours with various keratin antibodies are presented and discussed in the light of recent bibliographical data.
The diagnostic significance of periportal hepatic necrosis and inflammation
Authors: BAPTISTA A. , BIANCHI L. , DE GROOTE J. , DESMET V. J. , ISHAK K. G. , KORB G. , MACSWEEN R. N. M. , POPPER H. , POULSEN H. , SCHEUER P. J. , SCHMID M. , THALER H.
Published: April 2007

In this review the several types of cell damage and cell death which may be found in liver biopsy specimens are defined. We describe the different processes which occur at the portal/parenchymal or septal/parenchymal interface, viz. periportal spillover, periportal hepatitis, classic or lymphocytic piecemeal necrosis and biliary piecemeal necrosis. The diagnostic implications of these lesions in relation to the clinicopathological diagnosis and prognosis in various liver diseases are discussed.
Carcinoma of the extrahepatic biliary tract: a clinicopathological and immunohistochemical study
Authors: DAVIS R. I. , SLOAN J. M. , HOOD J. M. , MAXWELL P.
Published: April 2007

The clinical and histological findings in 15 cases of carcinoma arising from the extrahepatic biliary tract are reviewed. The clinical findings are in agreement with previously reported series and the dismal prognosis is confirmed. The prognosis does not appear to be related to tumour size, site, mitotic count or laboratory data on presentation. Only histological grading of the tumour is related to prognosis. Perineural tumour infiltration was a prominent feature and dysplasia within adjacent bile duct epithelium was present in five cases. The value of carcinoembryonic antigen (CEA) as a histological tumour marker was investigated. All tumours from the upper and middle biliary tree expressed this antigen. Although immunocytochemistry is seldom needed to assess malignancy in large surgical resection specimens anti‐CEA helps delineate the extent of tumour infiltration and discriminates between normal and dysplastic or malignant epithelium; anti‐CEA may also be helpful in identifying foci of malignancy in small sclerotic biopsy specimens.
Gastric adenocarcinoleiomyosarcoma: a light, electron microscopic and immunohistological study
Authors: DUNDAS S. A. C. , SLATER D. N. , WAGNER B. E. , MILLS P. A.
Published: April 2007

There have been few reports of gastric carcinosarcoma. We report the first case of gastric adenocarcinoleiomyosarcoma in which glandular and smooth muscle differentiation has been definitively demonstrated using transmission electron microscopy and immunohistology.
Histometry of splenic microvascular architecture in hairy cell leukaemia
Authors: Re G. , Pileri S. , Cau R. , Bucchi M. L. , Casali A. M. , Cavalli G.
Published: April 2007

In this study we investigated the splenic microvascular architecture in hairy cell leukaemia, in order to provide a morphological basis for the haemodynamic modifications occurring in the disease. When compared with controls, the four leukaemic spleens examined showed a set of changes involving both the arterial and the venous system. A real increase in the absolute volume, surface and length of pulp arterial vessels was present. This increase was not so great as the enlargement of the spleen, thus resulting in a reduced density of distribution of arterial vessels in the infiltrated pulp. Enlargement of pulp cords and sinuses was also present: the pulp cord enlargement was apparent in the unit volume, which resulted in a disproportionately higher increase of the absolute volume, compared with that of sinuses. The sinus–cordal rearrangement and, particularly, the increase in the volume of pulp cords may cause a slowing down of blood cell circulation with resultant increased phagocytosis and hypersplenism. Moreover, it is suggested that the changes observed in the arterial bed of the spleen in hairy cell leukaemia involve both a reduced blood supply per unit volume of splenic pulp and a more marked conditioning of blood cells prior to their screening by cordal macrophages.
Neuroendocrine (Merkel cell) carcinoma of the skin: a clinico‐morphological study of 13 cases
Authors: SZADOWSKA A. , WOZNIAK L. , LASOTA J. , GIRYN I. , MIRECKA B. , WOLSKA H.
Published: April 2007

The clinico‐morphological features in 13 patients (nine female) with neuroendocrine carcinoma of the skin are presented. The mean age was 64.9 years. The limbs were the most common site of primary tumour, followed by the face. The clinical course was characterized by a high incidence of regional lymph node metastases (69%) and recurrences (46%). Seven of the patients died of tumour, with a mean survival time of 13 months. Histologically, a solid pattern of tumour growth was most common. The cells were usually small and uniform. Squamous cell differentiation was found in one tumour. The cell of all tumours reacted positively for cytokeratins and neuron‐specific enolase. The positive reaction frequently had a ball‐like globular pattern, corresponding to inclusion‐like bodies seen on light microscopy and to paranuclear whorls of intermediate filaments observed on electron microscopy. Neurosecretory granules were seen on electron microscopy in the 11 cases examined and in one case a ‘Luse body’ was found in the intercellular space.
The pathology of cholesterol embolism arising as a complication of intra‐aortic catheterization
Authors: KENNEDY A. , CUMBERLAND D. , GAINES P.
Published: April 2007

Cholesterol embolism is an unusual but serious complication of intra‐arterial procedures such as arteriography and angioplasty. The pathological findings in four cases confirm that this syndrome is due to disseminated micro‐emboli composed mainly of cholesterol crystals and that these originate from atheromatous plaques in the aorta which may be traumatized by the catheter used in the intra‐arterial procedure. However, angiography is not the sole precipitating cause of this syndrome but is an exacerbating event in a pre‐existing process.
Epithelioid haemangioma (angiolymphoid hyperplasia with eosinophilia) and Kimura's disease in Chinese
Authors: CHAN J. K.C. , HUI P. K. , NG C. S. , YUEN N. W.F. , KUNG I. T. M. , GWI E.
Published: April 2007

Although Kimura's disease has often been considered to be identical to angiolymphoid hyperplasia with eosinophilia (epithelioid haemangioma), recent studies suggest that they are different clinicopathological entities. In this study, we have made a detailed morphological comparison of 10 cases of epithelioid haemangioma and 40 cases of Kimura's disease occurring in the Chinese population. The epithelioid haemangiomas occurred in the subcutaneous tissue, skin and maxillary antrum, whereas Kimura's disease affected the subcutaneous tissue, major salivary glands and lymph nodes. Distinctive features of epithelioid haemangiomas were exuberant proliferation of vessels lined by cuboidal to hobnail endothelial cells with irregular nuclei and cytoplasmic vacuoles, fibromyxoid matrix, involvement of muscular coat of blood vessels and zonation of inflammatory infiltrate towards the peripheral portion of the lesion. Distinctive features of Kimura's disease were florid lymphoid infiltrate with prominent lymphoid follicles, vascularization of germinal centres, germinal centre necrosis, marked eosinophilia with or without eosinophil abscess formation, proliferation of high endothelial venules, and sclerosis. The histological features suggest that epithelioid haemangioma is a proliferation of atypical endothelial cells, possibly neoplastic, that is associated with a variable inflammatory infiltrate, whereas Kimura's disease is primarily an inflammatory condition in which high endothelial venules are usually found.
Expression of desmin and myoglobin in rhabdomyosarcomas and in developing skeletal muscle
Authors: CARTER R. L. , MCCARTHY K. P. , MACHIN L. G. , JAMESON C. F. , PHILP E. R. , PINKERTON C. R.
Published: April 2007

Immunohistochemical staining for desmin and myoglobin was investigated in 35 rhabdomyosarcomas from young people and in skeletal muscle from 16 human fetuses of known gestational age. Twenty‐nine of the rhabdomyosarcomas expressed desmin but six undifferentiated or poorly‐differentiated tumours were desmin negative. Of the desmin positive cases, most undifferentiated or poorly‐differentiated sarcomas expressed desmin alone (12/35). Tumours with increasing rhabdomyoblastomic differentiation co‐expressed myoglobin (9/35) and well‐differentiated examples also contained cross‐striations (7/35). Skeletal muscle from fetuses aged 8 weeks or less consisted mainly of primitive desmin negative round cells. As the cells began to differentiate they quickly expressed desmin and, at approximately 10 weeks, myoglobin was expressed and cross‐striations were seen. The combined results strengthen the view that desmin (within a strictly defined context of round cell tumours in young people) is a reliable marker for rhabdomyoblastic differentiation. Support is also given to the notion that very primitive rhabdomyosarcomas may be desmin‐negative, although the difficulties of establishing firm diagnoses for some of these tumours is emphasized.
Histopathology of skin lesions in renal allograft recipients—an assessment of viral features and dysplasia
Authors: BLESSING K. , McLAREN K. M. , BENTON E. C. , BARR B. B. , BUNNEY M. H. , SMITH I. W. , BEVERIDGE G. W.
Published: April 2007

We report the pathology of benign and malignant skin lesions from 13 renal allograft recipients. The 59 lesions included 18 squamous carcinomas, 16 verrucous keratoses, 19 warts with varying dysplasia, three plaque lesions resembling those found in epidermodysplasia verruciformis, two non‐specific keratoses and one basal cell carcinoma. We delineate criteria for histological assessment of the presence of human papilloma virus (HPV) and use the term verrucous keratosis for lesions in which there is a putative viral contribution. Our findings emphasize the lack of correlation between clinical and histological assessment of the lesions. We note the variable and significant dysplasia within otherwise typical viral warts and the architectural features suggestive of HPV presence in the dysplastic lesions and in in situ and invasive squamous carcinomas. Parallel virological studies have revealed the presence of HPV 5/8 in over 60% of the invasive and in situ carcinomas probed. These HPV types have previously been isolated from squamous carcinomas of epidermodysplasia verruciformis, a condition whose defective cell‐mediated immunity may be compared with that of the immunosuppression in our patients.
A case of metastatic malignant melanoma masquerading as disseminated mammary carcinoma
Authors: BARKER J. N. W. N. , GIRLING A. C.
Published: April 2007

A 42‐year‐old woman presented with widespread secondaries and a mammary mass. A provisional diagnosis of metastatic breast carcinoma was made. Histological evaluation of the mammary tumour including immunohistochemical studies suggested the diagnosis of metastatic malignant melanoma, which was later confirmed.
Portal tract macrophages are increased in alcoholic liver disease
Authors: KARAKUCUK I. , DILLY S. A. , MAXWELL J. D.
Published: April 2007

Previous studies indicated decreased numbers and depressed clearance function of hepatic macrophages in alcoholic liver disease (ALD). We examined hepatic macrophages by immunohistochemical techniques in 45 liver biopsies from patients with a spectrum of ALD and compared them with 20 histologically normal biopsies from non‐alcoholic patients. Antisera against lysozyme, α1‐antitrypsin (α1AT) and a cytoplasmic molecule on macrophages (MAC‐387) were used and the number of positively staining hepatic sinusoidal macrophages and portal tract macrophages assessed separately. Portal tract macrophage numbers were increased with all three markers in biopsies exhibiting only fatty change (P < 0.05) and with MAC‐387 in all ALD groups. In agreement with previous studies, lysozyme positive hepatic sinusoidal macrophages were decreased in all ALD groups. However, the other markers did not show any significant decrease and MAC‐387 positive macrophages were incieased in livers with cirrhosis plus hepatitis (P<0.01). The use of three markers revealed phenotypic heterogeneity of hepatic macrophages with antibodies to lysozyme and α1AT staining more hepatic sinusoidal macrophages than MAC‐387, but MAC‐387 and anti‐lysozyme staining more portal tract macrophages than anti‐α1AT. Since hepatic macrophages appear to be heterogeneous and capable of diverse functions including the release of cytotoxic mediators, the finding of increased numbers, even in early ALD, suggests they may contribute to the tissue damage.
Biopsy pathology of HIV infection: experience at St Stephen's Hospital, London
Authors: SCHOFIELD J. B. , LINDLEY R. P. , HARCOURT‐WEBSTER J. N.
Published: April 2007

In a 3 year period from the beginning of January 1985 to the end of December 1987, 474 biopsies obtained from 266 patients with serological evidence of human immunodeficiency virus infection were examined. Most frequent were skin biopsies of which 52% showed Kaposi's sarcoma, and transbronchial lung biopsies of which 40% showed Pneumocystis carinii pneumonia. Other opportunistic infections were much less common; Mycobacterium avium intracellulare was found in six biopsies and Cytomegalovirus in three. Non‐Hodgkin's lymphoma was diagnosed in six patients.
Morphometric assessment of ovarian stromal proliferation–a clinicopathological study
Authors: SNOWDEN J. A. , HARKIN P. J. R. , THORNTON J. G. , WELLS M.
Published: April 2007

Ovarian stromal hyperplasia is commonly observed in peri‐ and post‐menopausal ovaries. Assessment has, hitherto, been largely subjective or dependent on arbitrary criteria, which has made comparison of studies difficult. In this study, the stroma of a large number of ovaries was assessed morphometrically. Data were related to clinicopathological and cytomorphological information. A significant association was noted between the degree of stromal proliferation and post‐menopausal endometrial adenocarcinoma (P=0.004). There were no significant correlations between the degree of stromal proliferation and average cytomorphological dimensions.
Malignant granular cell tumour with intraperitoneal dissemination
Authors: O'DONOVAN D. G. , KELL P.
Published: April 2007

An unusual case of a malignant granular cell tumour involving the peritoneal cavity and probably arising in the pelvis is reported. The light microscopic diagnosis was confirmed by electron microscopy and immunohisto‐chemistry.
Histiocytoid breast carcinoma: an apocrine variant of lobular carcinoma
Authors: WALFORD N. , TEN VELDEN J.
Published: April 2007

Two cases of in situ and invasive histiocytoid breast carcinoma are described. The invasive components of both tumours showed architectural and cytological similarities to lobular carcinoma. The in situ components showed areas of classical lobular carcinoma in situ, areas of lobular carcinoma with apocrine features and areas with transitional features. It is concluded that histiocytoid carcinoma represents an apocrine variant of lobular carcinoma. Differentiation of this tumour from chronic sclerosing inflammation may be difficult in both primary and secondary lesions.
Malignant nerve sheath tumour arising in a benign ancient schwannoma
Authors: RASBRIDGE S. A. , BROWSE N. L. , TIGHE J. R. , FLETCHER C. D. M.
Published: April 2007

A malignant nerve sheath tumour arising in a longstanding benign schwannoma in a 75‐year‐old woman is described. Malignant change of this kind is extremely rare; there appear to be only four convincing previously reported cases.
The prognostic significance of immunophenotype in high‐grade non‐Hodgkin's lymphoma
Authors: BROWN D. C. , HERYET A. , GATTER K. C. , MASON D. Y.
Published: April 2007

The prognostic value of immunophenotyping lymphomas was assessed by studying 51 cases of high‐grade non‐Hodgkin's lymphoma for which long term clinical follow‐up (14–28 years) was available. Using antibodies which identify T‐ and B‐cell‐related antigens in formalin‐fixed, paraffin‐embedded material, 43 were shown to be of B‐cell and eight of T‐cell phenotype. In terms of survival, cases of high‐grade T‐cell lymphoma fared significantly worse (P < 0.05) than cases of high‐grade B‐cell subtype. These findings support the belief that T‐cell lymphomas have a more aggressive clinical course than their B‐cell counterparts.
Diagnosis of acute myeloid leukaemia with the use of monoclonal anti‐neutrophil elastase (NP57) reactive with routinely processed biopsy samples
Authors: RALFKIAER E. , PULFORD K. A. F. , LAURITZEN A. F. , AVNSTRØM S. , GULDHAMMER B. , MASON D. Y.
Published: April 2007

The reactivity of a monoclonal anti‐neutrophil elastase antibody (NP57) with routinely processed biopsy samples from various acute leukaemias has been examined and compared with that of chloroacetate esterase and CD15 (hapten X), two other myeloid cell‐associated markers detectable in paraffin sections. No staining was seen with these markers in 14 cases of acute lymphoblastic leukaemia. In contrast the neoplastic cells in 27 of 37 acute myeloid leukaemias were NP57 positive. Twenty of these were also positive for chloroacetate esterase, whereas CD15 was expressed in only six cases. These results indicate that detection of elastase with monoclonal NP57 forms a useful supplement to traditional methods for the histopathological diagnosis of acute myeloid leukaemias.
Megakaryocytes in myelodysplasia: an immunohistochemical study on bone marrow trephines
Authors: FOX S.B. , LORENZEN J. , HERYET A. , JONES M. , GATTER K.C. , MASON D.Y.
Published: April 2007

Megakaryocytes in 63 bone marrow trephine biopsies were examined for their staining characteristics, location and size distribution using the monoclonal antibody Y2/51 directed against platelet glycoprotein IIIa (CD61). Megakaryocytes in normal bone marrow were evenly distributed and demonstrated homogeneous staining with Y2/51. In addition, there was little variation in their size or shape. In contrast, myelodysplastic and myeloproliferative bone marrow trephines showed considerable dysmegakaryopoiesis demonstrated by heterogeneity of staining, an altered architectural distribution with a predominantly paratrabecular location and considerable variation in size and shape. Furthermore, in myelodysplasia 25% of the CD61 positive cells were micromegakaryocytes as opposed to less than 10% in normal or reactive marrows. Such dysmegakaryopoiesis is believed to be a clinically important feature of myelodysplasia, although until now it has only been possible to assess it subjectively. The availability of the monoclonal antibody Y2/51 provides a rapid and reproducible means of studying megakaryocyte size, shape and distribution in routine trephine specimens and may help to overcome some of the diagnostic problems currently associated with myelodysplasia and other intrinsic bone marrow neoplasias.
Congenital juvenile granulosa cell tumour of the testis: report of a case showing extensive degenerative changes
Authors: CHAN J.K.C. , CHAN V.S.M. , MAK K.L.
Published: April 2007

Juvenile granulosa cell tumour is a rare neoplasm of the testis which occurs predominantly in infancy and which may be associated with sex chromosomal abnormalities. We report an unusual case with deceptive histological features resulting from extensive degenerative changes. In the particulated intra‐abdominal mass resected from a 1‐month‐old male baby with 45,X/46,X,iso(Yq) mosaicism, there were multiple large cystic spaces devoid of cellular lining or lined by flat nondescript cells, mimicking various cystic lesions such as multicystic mesothelioma, cystic lymphangioma and cystic dysplasia. The cysts were separated by a highly vascularized fibrous stroma. Only in very rare cysts and the smaller cysts in the region of the pedicle were granulosa cells identified, permitting a diagnosis of juvenile granulosa cell tumour to be made.
Intramammary tuberculous lymphadenitis
Authors: ARNAOUT A.H. , SHOUSHA S. , METAXAS N. , HUSAIN O.A.N.
Published: April 2007

A 50‐year‐old North African woman presented with a painful lump in the left breast. Fine needle aspiration cytology suggested an inflamed lymph node and histology established the diagnosis of intramammary tuberculous lymphadenitis. The case raises the possibility that the nodular type of tuberculous mastitis arises in intramammary lymph nodes.
Abundant expression of cytokeratin 7 in fibrolamellar carcinoma of the liver
Authors: EYKEN P. VAN , SCIOT R. , BROCK P. , DAELE M. CASTEELS‐VAN , RAMAEKERS F.C.S. , DESMET V.J.
Published: April 2007

Two cases of fibrolamellar carcinoma of the liver, one with lymph node metastasis are reported. Using immunohistochemistry as well as one‐ and two‐dimensional gel electrophoresis and Western blotting, tumour cells of both primary lesions and of the metastasis were found to express cytokeratin polypeptides 8 and 18 and, surprisingly, cytokeratin 7. A small number of cells also expressed cytokeratin 19. This is the first detailed analysis of the cytokeratin expression of fibrolamellar carcinoma, and is also the first to present biochemical evidence that, contrary to what has been suggested, hepatocellular carcinomas do not always preserve the pattern of cytokeratin expression of normal hepatocytes.
Cystadenocarcinoma of the appendix testis
Authors: KERNOHAN N.M. , COUTTS A.G. , BEST P.V.
Published: April 2007

We report an example of what we believe to be an adenocarcinoma of the appendix testis. This very rare neoplasm arose in a patient on long term treatment with oestrogens which may be implicated as an aetiological factor.
Congenital tumours of the salivary gland: a case report and review
Authors: HARRIS M.D. , McKEEVER P. , ROBERTSON J.M.
Published: April 2007

A congenital epithelial tumour of the submandibular salivary gland, occurring in a child of 10 months, is described. The lesion appeared benign and consisted of basal type cells, showing ductal and acinar differentiation with myoepithelial cells. The associated fibrous stroma contained blood vessels and small nerve bundles.

A few similar lesions have been reported in the past, some of which showed features of malignancy. Although various names have been proposed, we suggest that these lesions represent a single group derived from a primitive cell line and advocate the use of the term sialoblastoma.
Atypical ‘pseudosarcomatous’ variant of cutaneous benign fibrous histiocytoma: report of eight cases
Authors: BEHAM A. , FLETCHER C.D.M.
Published: April 2007

Eight cases of benign cutaneous fibrous histiocytoma containing scattered, bizarre, pleomorphic cells of multinucleate or histiocyte‐like type are described. All arose in adults and four had originally been diagnosed as sarcomas. Lesions of this type are not well‐known and merit wider recognition in order to avoid inappropriate treatment. Differential diagnosis principally includes atypical fibroxanthoma and pleomorphic malignant fibrous histiocytoma.
Viral myocarditis
Authors: BURKE M.
Published: April 2007

Evidence suggests that in susceptible individuals lymphocytic myocarditis is a virus‐induced autoimmune disease which may progress to dilated cardiomyopathy. Its biopsy pathology, the application of the ‘Dallas’ criteria for diagnosis and the role of immunohistochemistry are discussed. The potential role for in situ hybridization in the detection of viral genomes is referred to. Pathogenesis may be related to persistence of viral RNA in tissues and may involve both cellular and humoral immune mechanisms. The effect may manifest itself at cellular level with myocytolysis or at sub‐cellular level with interference in energy production, giving rise to considerable functional deficit with few morphological changes.
Extraskeletal mesenchymal chondrosarcoma of the mediastinum
Authors: CHETTY R.
Published: April 2007

Extraskeletal mesenchymal chondrosarcoma is a rare tumour with a predilection for the meninges and lower limb, especially the thigh region. This paper reports an extraskeletal mesenchymal chondrosarcoma occurring in the posterior mediastinum, a previously undocumented site.
Multicystic structures appearing in mature cystic teratomas of the ovary: an immunohistochemical and ultrastructural study
Authors: RUBIN A. , PAPADAKI L.
Published: April 2007

Multicystic or sieve‐like areas are frequently present in the walls of mature cystic ovarian teratomas. This histological, immunohistochemical and ultrastructural study supports the contention that such cysts arise from oleous material which has been extravasated through the cyst wall and become lodged within fibrous tissue and small blood vessels. Some cysts may also arise from degenerate sebaceous glands.
A comparative morphological and immunohistochemical study of testicular seminomas and intracranial germinomas
Authors: BENTLEY A.J. , PARKINSON M.C. , HARDING B.N. , BAINS R.M. , LANTOS P.L.
Published: April 2007

A series of 10 classical testicular seminomas and 10 intracranial germinomas were reviewed and examined using immunohistochemical techniques. In particular, the staining profiles of the tumour cells and the nature of the mononuclear cell infiltrate at the two sites were studied and compared. The tumour cells in eight of the 10 intracranial germinomas and nine of the 10 seminomas exhibited positive staining with placental alkaline phosphatase. Only one intracranial germinoma showed evidence of human chorionic gonadotrophin expression. Tumour cells in all cases at both sites were negative for cytokeratin and vimentin. The lymphocytic infiltrate in both the testicular and intracranial tumours was similar, comprising T‐cells and B‐cells, the former predominantly. The presence of macrophages and granulomas in tumours at both sites was noted. These findings confirm the high degree of similarity of germinomas of intracranial and testicular origin, and support the hypothesis of a common derivation. We could find no evidence of differentiation of tumour cells at either site.
Juvenile granulosa cell tumour of the ovary containing a nodule of Wilms' tumour
Authors: O'DOWD J. , ISMAIL S.M.
Published: April 2007

We describe a very unusual case of an ovarian juvenile granulosa cell tumour containing a discrete nodule of Wilms' tumour. The tumour occurred in a 20‐year‐old woman and was associated with androgen secretion.