bluuebunny/crossref_metadata_2025 huggingface dataset:
A combined stain for elastin and acid mucopolysaccharides in large blood vessels
Authors: REYNOLDS G. J. , POMERANCE ARIELA , EAMES KATHRYN
Published: April 2007

A reliable, reproducible combined stain for elastin and acid mucopolysaccharides has been developed and is particularly suitable for the study of large blood vessels as muscle and collagen are also stained. The technique is described.
Collagenous colitis
Authors: NIELSEN V.T. , VETNER M. , HARSLØF E.
Published: April 2007

Repeated colonic and rectal biopsies from a 47‐year‐old woman with chronic watery diarrhoea showed an approximately 50 μ thick subepithelial band‐like collagenous deposit. The histopathological and clinical picture was consistent with the recently described condition of ‘collagenous colitis’.
Atypical gastric carcinoids
Authors: SWEENEY E.C. , McDONNELL L.
Published: April 2007

Four examples of infiltrating gastric tumours which had light microscopic features suggestive of carcinoid or oat‐cell carcinoma are documented. Histological and ultrastructural findings indicated that these tumours were atypical carcinoids. A spectrum of endocrine cell neoplasia in the stomach analagous to that observed in the bronchus is postulated. It is felt that increased recognition of poorly differentiated endocrine tumours of the stomach might be of prognostic and therapeutic importance.
Granulomatous lesions in nasal biopsies
Authors: COUP A. J. , HOPPER I. P.
Published: April 2007

A series of 19 cases has been reviewed in which biopsy of an intra‐nasal lesion revealed a granulomatous pathology. These have been classified on an aetiological basis. They include infections, Wegener's granuloma and neoplasms with a granulomatous stroma. One patient with sarcoidosis first presented with lesions in the nasal cavity. Cholesterol granulomata were seen in four lesions removed from the paranasal sinuses. In six cases clinical and histological examination failed to show a cause for the granulomata; in all of these patients the nasal cavity was free from disease at a subsequent examination.
Presence of ganglion cells in Wilm's tumours: a review of the possible neuroepithelial origin of nephroblastoma
Authors: LLOMBART‐BOSCH A. , PEYDRO‐OLAYA A. , CERDA‐NICOLAS M.
Published: April 2007

Twenty‐seven cases of Wilm's tumour were reviewed in order to confirm the presence of nervous tissue which could imply a ‘neuroepithelial’ origin for these neoplasms. For this purpose a double‐silver impregnation technique was used. Groups of ganglion cells with neurofibrils and non‐myelinated axon‐like processes appeared associated with a fine neurofibrillar network with neuromuscular junctions. Nervous tissue in nephroblastoma is mature and should not be confused with primary ganglioneuroblastoma of the kidney in which neuroblasts in rosette‐like groupings are very numerous. A case report of such a lesion is discussed for purposes of comparison.
Retrospective studies of early gastric cancer in a high incidence area of Italy
Authors: GRIGIONI W. F. , ALAMPI G. , BONDI A. , BIASCO G. , SANTINI D. , MIGLIOLI M.
Published: April 2007

Frequency and characteristics of early gastric cancer (egc) were evaluated in a retrospective study of 511 surgical specimens of gastric carcinoma. We observed a total of 46 egc in 40 patients. The predominant macroscopic type was IIc, followed by I and III. On the basis of histological appearance, 25 egc were of intestinal type and 15 of diffuse type. Seventy‐six per cent of egc were localized at the lesser curvature of the stomach and in particular at the pyloric antrum. Twenty‐two egc were limited to the mucosal layer. No relationship was observed between macroscopic type or histological characters, and tumour staging. As Italy can be considered a high‐risk country for gastric carcinoma and because this disease is in many respects similar to that observed in Japan, it seems possible to obtain a reduction of the death rate for gastric cancer by increasing, as in Japan, the number of cancers diagnosed in the early phase.
Histological demonstration and frequency of intrahepatocytic copper in patients suffering from alcoholic liver disease
Authors: BERRESFORD P. ANNE , SUNTER J. P. , HARRISON VALERIE , LESNA MILENA
Published: April 2007

This study was carried out to determine whether stainable copper accumulates in the hepatocytes of patients with alcoholic liver disease. Liver sections from 44 cases of alcoholic cirrhosis and 32 cases of non‐cirrhotic alcoholic liver disease were stained by the rubeanic acid, rhodanine and orcein methods. Intrahepatocytic copper granules were found in 13 cases of cirrhosis (30%), but in none of the non‐cirrhotic livers. The abundance of granules did not appear to be related either to the activity of the cirrhotic process or to the presence of cholestasis. It may well be that alcoholic cirrhosis is the most common disease associated with excess of intrahepatocytic copper.
Atypical juvenile polyposis
Authors: GRIGIONI W. F. , ALAMPI G. , MARTINELLI G. , PICCALUGA A.
Published: April 2007

Two cases of atypical juvenile polyposis are described in males of 9 months and 25 years‐of‐age. The first was associated with congenital megacolon and presented as juvenile polyps with features suggesting mild dysplasia. In the second case six histological lesions are found:1hyperplastic polyps;2juvenile polyps;3hyperplastic polyps with adenomatous areas;4juvenile polyps with areas of dysplastic epithelium;5adenomas; and6adenocarcinomas. On the basis of the morphological features we propose a pathogenetic sequence of focal mucosal hyperplasia to adenoma and carcinoma through stages of non‐neoplastic and non premalignant polyps. Finally, the possibility that hyperplastic epithelium can in some circumstances have a greater dysplastic potential than normal colorectal mucosa is raised.
Monophasic synovial sarcoma, epithelioid sarcoma and chordoid sarcoma: ultrastructural evidence for a common histogenesis, despite light microscopic diversity
Authors: COONEY T. P. , HWANG W. S. , ROBERTSON D. I. , HOOGSTRATEN J.
Published: April 2007

Ultrastructural examination of six rare sarcomas‐four monophasic spindle cell tumours, one epithelioid sarcoma, one chordoid sarcoma‐has revealed marked similarities at the electron microscopic level despite widely divergent light microscopic appearances. These features consisted of: 1 the presence of two cell types, viz. a clear cell and a cell resembling the fibroblast; 2 pseudoglandular spaces with projecting microvilli or filopodia, and with related tight junctions; 3 an amorphous intercellular ground substance with focal condensation into recognizable basement membrane. The findings suggest a common maturation of these diverse tumours to synovial‐like tissue, and support the proposal of Hajdu Shiu & Fortner (1977) that these be considered variants of synovial sarcoma. Published ultrastructural studies of synovial, epithelioid and chordoid sarcoma are reviewed in the light of these findings. The ultrastructural differentiation of synovial sarcoma from extra‐skeletal myxoid chondrosarcoma, chordoma and the spectrum of malignant spindle cell tumours is discussed.
Immunoperoxidase techniques in human renal biopsy
Authors: MacIVER A. G. , MEPHAM B. L.
Published: April 2007

Immunoperoxidase techniques can be easily performed on formalin fixed renal tissue after incubation in trypsin. The sensitivity of the PAP technique on fixed tissue is as good as immunofluorescence methods using frozen sections. The method provides permanent preparations with clear localization of deposited immunoproteins giving accurate classification of renal disease and assessment for treatment. The availability of this technique for retrospective and centralized studies is a major advantage. Infectious agents are rendered harmless and can be specifically identified. The development of the trypsin‐immunoperoxidase technique is an important and exciting advance in renal immunopathology.
Cell coat of podocytes in patients with nephrotic syndrome
Authors: FARAGGIANA T. , GRISHMAN EDITH , CHURG J.
Published: April 2007

Renal biopsies from 23 patients with the nephrotic syndrome and five patients with slight or no proteinuria were examined for the presence of cell coat of podocytes by light and electron microscopy. Of those with nephrotic syndrome, five had minimal change disease, nine focal glomerular sclerosis, six membranous nephropathy and three amyloidosis. Colloidal iron and phosphotungstic acid stains were used for the demonstration of anionic and neutral polysaccharide components of the cell coat. On light microscopy, the colloidal iron reaction showed a reduction in intensity of the stain in glomeruli of patients with massive proteinuria, as compared to those with slight or no proteinuria. On electron microscopy, only the cell coat lining the surface of the foot processes disappeared parallel to the loss of these structures, while the coat covering the surface facing the urinary space remained unchanged with both stains.
The nature of Langerhans cell granules: an ultrastructural study
Authors: EL‐LABBAN N. G.
Published: April 2007

Langerhans cells and macrophages have been studied in both oral lichen planus lesions and histiocytosis X. Many of the macrophages in both lesions contained phagolysosomes in various stages of degradation. Some of these phagolysosomes were found to develop slender processes and very narrow extensions containing little processed phagocytosed material. These latter structures were indistinguishable from Langerhans granules and were termed Langerhans granule‐like structures. There is enough evidence in the present study to suggest that typical Langerhans granules evolve from Langerhans granule‐like structures and to confirm that Langerhans cells are a type of macrophage which at one stage of their development show Langerhans granules.
Primary malignant fibrous histiocytoma of the spleen: an ultrastructural study
Authors: GOVONI E. , BAZZOCCHI F. , PILERI S. , MARTINELLI G.
Published: April 2007

A primary malignant fibrous histiocytoma of the spleen was studied by light and electron microscopy and is believed to be the first reported. The neoplasm was predominantly fibroblastic, with a characteristic storiform pattern, and included histiocyte‐like cells, giant and foam cells confirmed by ultrastructural studies. Additionally, undifferentiated cells, intermediate cells and myofibroblasts were seen. The differential diagnosis from other sarcomas and the histogenesis of this tumour are discussed.
Changes in the mucosa of the stomach and duodenum during immunosuppresive therapy after renal transplantation
Authors: FRANZIN G. , MUSOLA R. , MENCARELLI R.
Published: April 2007

Upper gastrointestinal endoscopic examination of 40 patients on immunosuppressive therapy after successful kidney transplantation revealed a duodenal ulcer in four cases and duodenal erosions in six. Between four and six biopsies were collected from the antral and the fundal mucosa in each case and from the duodenal mucosa in 29. Antral superficial gastritis was found in 13 cases and fundal superficial gastritis in three. In the fundus, heterotopic calcifications were seen in eight cases and cytomcgalovirus inclusion bodies in two. Parietal cells were increased in number and reached the pyloric zone in 34 cases, whilst they spread within the duodenal mucosa in 12. Multinucleate parietal cells were of common occurrence and in some cases showed mitotic figures. Duodenitis was found in 16 cases and in duodenal mucosal cells cytomegalovirus inclusion bodies were seen in nine cases. Biopsy evidence of hyperplasia of Brunner's glands was encountered in 26 cases. Of 20 patients tested for gastric acid secretion, hypersecretion occurred in 14 and normal secretion in six. Endoscopic and histological changes relate to the secretory pattern. Cytomegalovirus inclusion bodies relate to immunosuppressive therapy. An inverse temporal relationship exists between heterotopic calcification and the duration of renal transplant. Steroids seem to be responsible for gastroduodenal changes in transplanted patients.
An improved method of analysis of observer variation between pathologists
Authors: HOLMAN C. D. J. , JAMES I. R. , HEENAN P. J. , MATZ L. R. , BLACKWELL J. B. , KELSALL G. R. H. , SINGH A. , TEN SELDAM R. E. J.
Published: April 2007

An improved method of analysing interobserver variation in histopathological studies is described and illustrated, by use of data from a congruence survey of malignant melanoma. The method provides, between any number of pathologists, an assessment of overall agreement and of agreement on each individual category of a classification system. Adjustment for differences in chance agreement due to varying numbers of categories or an altered composition of cases is included in the analysis. A generalization of the procedure designed to measure the strength of associations between different categories is formulated and explained with the use of an example.
Lectin staining of carbohydrates of haemic cells. III. The cells of Hodgkin's disease and other lymphomas
Authors: COLLINS R. D. , JACOBSON W. , STODDART R. W.
Published: April 2007

When stained for reactive sialyl groups with fluorescein‐labelled Aprotinin (FLA), lymphocytes of three diffuse lymphomas were uniformly faintly fluorescent. The nodules of a nodular lymphocytic lymphoma showed dimly fluorescing lymphocytes surrounded by brightly fluorescing, apparently normal cells. The spleens of eight patients with Hodgkin's disease showed involvement in six cases. With FLA, the two uninvolved spleens contained only brightly fluorescing lymphocytes, whereas the foci of Hodgkin's lesions in the six spleens and in eight involved lymph nodes from a further eight patients contained varying proportions of brightly and dimly fluorescing lymphoid cells. Mononuclear Hodgkin's cells and bi‐ or multinucleated Reed‐Sternberg cells fluoresced faintly. Fluorescein‐labelled Ricinus communis agglutinin (FL‐RCA) for galactose, and Concanavalin A (FL‐Con A) for mannose or glucose, showed eosinophils, reticulin and collagen fibres especially in nodular sclerosing Hodgkin's disease, whereas all lymphocytes, Hodgkin and Reed‐Sternberg cells stained faintly with either lectin. The reduction of reactive sialyl groups in malignant lymphocytes of lymphomas and Hodgkin's lesions is similar to that in lymphocytic leukaemias. It is suggested that in Hodgkin's disease these lymphocytes together with the Hodgkin and Reed‐Sternberg cells represent the malignant component, whereas the brightly fluorescent normal lymphocytes, together with histiocytes, eosinophils (and neutrophils) represent a reactive component in the lesions. Similarly, the reactive lymphocytes in sarcoid lesions and sinus histiocytosis were brightly fluorescing.
Immunoblastic lymphoma at the site of an infected vitallium bone plate
Authors: DODION P. , PUTZ P. , AMIRI‐LAMRASKI M. H. , EFIRA A. , DE MARTELAERE E. , HEIMANN R.
Published: April 2007

The authors report a case of immunoblastic lymphoma occurring at the site of an osteosynthesis complicated by infection. The hypothetical carcinogenic roles of the infection and of the alloy used in the prosthesis are discussed in the light of recent literature. It is suggested that both may have acted synergistically either as inducing or, more likely, as localizing factors of the lymphoma.
A staining procedure for melanin in semithin and ultrathin epoxy section
Authors: VAN DUINEN S.G. , RUITER D.J. , SCHEFFER E.
Published: April 2007

Staining for melanin at the ultrastructural level may act as an important diagnostic aid by helping to identify apparently amelanotic melanomas. A modified Warthin‐Starry (WS) procedure for melanin has therefore been adapted for direct application to epoxy sections. Minute amounts of melanin can thus be demonstrated in individual melanosomes, indicating a high sensitivity. Using the usual types of fixation, specificity for melanin at the ultrastructural level is high. Primary osmium tetroxide (OsO4) fixation probably induces false positive staining of lipofuscin and should not be used prior to the WS procedure, but it does not influence the results of the procedure when employed as a post‐fixative. It is not improbable, however, that the positive staining of lipofuscin and also of mast cell granules is due to the presence of melanin in these structures. The WS procedure yields additional diagnostic information, especially in suboptimally preserved material, as expressed by an increase in the number of convincingly identifiable melanosomes in one completely and four partly amelanotic melanomas.
Oncocytic hepatocellular tumour
Authors: BAITHUN S.I. , POLLOCK D.J.
Published: April 2007

A case of hepatocellular carcinoma in a non‐cirrhotic liver of a 51–year‐old female is described. The macroscopic appearance is of a well circumscribed tumour measuring 20 × 10 cm with a central fibrous scar. Histologically, the tumour is an unusual variant of epithelial liver cell tumour characterized by polygonal cells set in a fibrous stroma and showing oncocytic change. Electron microscopy confirms the oncocytic features. Oncocytic change in liver cell and other tumours is discussed.
Merkel cell carcinoma: a report of three cases with neurone‐specific enolase activity
Authors: KIRKHAM N. , ISAACSON P.
Published: April 2007

Three cases are described of a primary cutaneous neoplasm occurring in elderly patients, histological and immunohistochemical features of which support an origin from Merkel cells. Microscopically sheets of uniform small cells filled the dermis, often with a prominent trabecular pattern. Ultrastructurally the cells showed neurosecretory granules, tangles of microfilaments, scattered mitchondria and occasional intranuclear rodlets. Immunohistochemical staining for neuronespecific enolase was positive and for prekeratin was negative in each case. The definitive diagnosis of Merkel cell tumour can be made with a combination of electron microscopy and immunohistochemistry.
The histopathology of adult T‐cell lymphoma/leukaemia in blacks from the Caribbean
Authors: O'BRIEN C. , LAMPERT I.A. , CATOVSKY D.
Published: April 2007

The histopathological features of seven cases of adult T‐cell lymphoma/leukaemia (ATLL), all occurring in black patients from the Caribbean, are described. Lymph node infiltrates are initially restricted to the paracortical zone, with preservation of the nodal shape and subcapsular sinus, and accompanied by a proliferation of post‐capillary venules. Cytologically, a range of cell types is present, from smaller cells with irregularly shaped nuclei and clumped nuclear chromatin to larger cells with dispersed chromatin and more prominent nucleoli, apparently corresponding to the stages of peripheral T‐lymphocyte transformation. The proportion of each cell type present varies from case to case, as do the numbers of admixed eosinophils, plasma cells and interdigitating reticulum cells. These histological appearances are very similar to those of the pleomorphic T‐cell lymphoma described in Japan, which also shows many clinical similarities, including a high incidence of complicating hypercalcaemia. There is a strong association in both Japanese and Caribbean patients with a recently described human retrovirus, HTLV, which occurs endemically in those areas where the disease clusters. Morphological similarities exist between ATLL and other peripheral T‐cell lymphomata and leukaemias. These are illustrated by one notable ‘linking’ case. However, while related to other disorders of mature T‐lymphocytes, ATLL nevertheless represents an identifiably separate clinicopathological entity.
Angiosarcoma and hepatocellular carcinoma in vinyl chloride workers
Authors: EVANS D.M.D. , WILLIAMS W. JONES , KUNG I.T.M.
Published: April 2007

The livers from five vinyl chloride workers are described. They show angioformative and hepatocellular growth disturbance in varying proportions: angiosarcoma in four cases, liver cell hyperplasia in all, hyperplastic nodules in three cases and hepatocellular carcinoma in two cases. In one case the transition between hyperplastic nodule and hepatocellular carcinoma is demonstrated. The relationship between these changes and vinyl chloride exposure is discussed, with evidence that they are causally related.
The immunocytochemical demonstration of renin in a juxtaglomerular cell tumour by light and electron microscopy
Authors: LINDOP G.B.M. , STEWART J.A. , DOWNIE T.T.
Published: April 2007

This is a study of a juxtaglomerular cell tumour using an antibody to pure human renin and the peroxidase‐antiperoxidase technique. We report the distribution of immunoreactive renin in the tumour visualized by light microscopy of both paraffin and resin embedded tissue sections. We found that the cells which contained most renin granules were endocrine‐like cells in the parenchyma of the tumour. Ultrastructural immunocytochemistry showed that immunoreactive renin was present not only in crystalline protogranules and in round membrane bound granules, but also in intermediate forms.
Early apocrine change in hyperplastic cystic disease
Authors: VILANOVA J.R. , SIMON R. , ALVAREZ J. , RIVERA‐POMAR J.M.
Published: April 2007

Biopsy material from 42 cases of florid hyperplastic cystic disease of the breast were reviewed and were found to have foci of apocrine metaplasia. This appearance was limited to the ductular epithelium of hyperplastic lobules. It is believed that this scattered change is an initial feature in relation to the genesis of apocrine‐lined and fully developed cysts.
Cystic ‘hamartomatous’ gastric polyps: a disorder of oxyntic glands
Authors: SIPPONEN P. , LAXÉN F. , SEPPÄLÄ K.
Published: April 2007

In 1977, Elster et al. described gastric polyps of a new type. These polyps were formed of fundic glandular cysts in otherwise normal gastric mucosa. In this paper a series of 52 cases of this type of polyp are presented. In addition to cysts, polyps contained deformed oxyntic glands and areas where the formation of secondary irregular glands occurred from cysts and from the existing glands. However, all glands and cysts in polyps were composed of normal, but intermixed cells of oxyntic type, suggesting that deranged differentiation of otherwise normal oxyntic glands is the basic mechanism in the pathogenesis of these polyps. Based on these observations, the polyps were considered most likely to be epithelial hamartomas. In agreement with the findings of Elster et al., the present cases showed typical clinical characteristics: three‐quarters of patients were females with a peak prevalence in the fifth and sixth decades. Polyps were most often multiple and occurred only in the oxyntic mucosa of the stomach.
Chronic duodenitis with gastric metaplasia: electron microscopic study including comparison with normal
Authors: SHOUSHA S. , PARKINS R.A. , BULL T.B.
Published: April 2007

Dudoenal biopsies from 11 patients with non‐ulcer dyspepsia were examined by electron microscopy. Chronic duodenitis with gastric metaplasia was seen in samples from four patients, and areas of normal‐looking duodenal mucosa were present in nine. The metaplastic cells were similar to those previously described in association with duodenal ulcers. They usually showed marked morphological differences from the normal duodenal absorptive cells. The microvilli were distorted and reduced in number, the glycocalyx was ill‐defined, the cytoplasm filled with mucous globules and the intercellular spaces, in some areas, were widened and contained acute and chronic inflammatory cells.
Angiosarcoma in irradiated post‐mastectomy chest wall
Authors: DAVIES J.D. , REES G.J.G. , MERA S.L.
Published: April 2007

A 61‐year‐old woman developed an angiosarcoma in the irradiated chest wall 2½ and 4 years after mastectomy for a carcinoma of breast. The two sets of tumours were morphologically distinct and differed immunohistochemically. The short interval between post‐operative irradiation and presentation of the angiosarcoma is unusual. The case is discussed in relation to others of allied type.
An immunohistological study of the cellular constituents of Hodgkin's disease using a monoclonal antibody panel
Authors: ABDULAZI Z. , MASON D.Y. , STEIN H. , GATTER K.C. , NASH J.R.G.
Published: April 2007

Cryostat sections of lymphoid tissue from 44 cases of Hodgkin's disease were analysed by immunoperoxidase staining using a panel of monoclonal antibodies which included reagents reactive with T cells and their subsets, B cells, HLA‐DR, Ig, dendritic reticulum cells and C3b receptor. A wide spectrum of immunohistological patterns was observed ranging from cases in which T cells were numerous (B cells being absent or present in only small numbers) to cases in which very prominent B cell follicles were present. These follicles contained a meshwork of dendritic reticulum cells and were composed of polyclonal B cells (as assessed by light chain expression). T cells were present in small numbers within these B cell follicles, often clustered in a thin rim around individual Reed‐Sternberg and Hodgkin's cells. All B cell‐rich cases were examples of lymphocyte predominant Hodgkin's disease. Assessment of the T cell helper/suppressor ratios was hindered by the fact that both anti‐helper antibodies (OKT4 and anti‐Leu 3a) reacted with macrophages. However the majority of cases appeared to contain a normal excess of T helper cells. HLA‐DR was strongly expressed in T cell rich areas, on Reed‐Sternberg and Hodgkin's cells, on vascular endothelium and on numerous infiltrating cells in the fibrous tissue areas in cases of nodular sclerosing disease. Reed‐Sternberg and Hodgkin's cells were not labelled by either anti‐fibronectin or by antibodies reactive with dendritic reticulum cells (anti‐C3b receptor and antibody R4/23).
A new precursor lesion of Wilms’ tumour (nephroblastoma): intralobar multifocal nephroblastomatosis
Authors: MACHIN G.A. , McCAUGHEY W.T.E.
Published: April 2007

Almost half of the kidneys containing Wilms’ tumours also contain persistent renal blastema in one or more of its forms. Persistent renal blastema is present in almost all cases of bilateral nephroblastoma. Multifocal superficial nephroblastemomatosis is the best known form of persistent renal blastema, and there is good evidence that it is a precursor of nephroblastoma. This paper reports four cases of a second, deep cortical type of nephroblastomatosis. This type of persistent renal blastema appears to be a precursor of a distinct histologic subtype of nephroblastoma, and differs from multifocal superficial nephroblastomatosis also in its teratological background.
A histochemical and immunohistological study of a testicular malignant teratoma containing embryonic and extraembryonic elements in various stages of development
Authors: SHOUSHA S. , MILLER GILLIAN C.
Published: April 2007

A testicular malignant teratoma containing embryoid bodies and other embryonic and extra‐embryonic structures in various stages of development has been examined by several histochemical and immunohistological techniques to study the distribution of various substances in the teratomatous elements. The substances demonstrated included various types of mucins; argyrophil, argentaffin, Paneth cells and haemosiderin granules; alpha‐fetoprotein, alpha‐1‐anti‐trypsin, lysozyme, β‐HCG and CEA. The significance of the findings is discussed in relation to early embryonic development
ACTH‐producing pituitary adenoma in an infant with cysts of the kidneys and lungs
Authors: PULLINS D.I. , CHALLA V.R. , MARSHALL R.B. , DAVIS C.H.
Published: April 2007

The light microscopical, electron microscopical and immunohistological features of a rare ACTH‐producing chromophobe adenoma of the pituitary gland in an 11‐month‐old infant are presented. An unusual histological feature was the presence of numerous follicles. These follicles may develop secondary to necrosis of individual tumour cells. There is only one previous report in the literature of a pituitary adenoma occurring in infancy and that tumour also produced ACTH and showed a follicular histological pattern. It is of interest that our patient also had a combination of medullary cysts of the kidneys and congenital peripheral cysts of the lungs. The association of cysts in lungs with cysts in kidneys also has been reported only once previously. We conclude that the occurrence of cysts in kidneys and lungs and a pituitary tumour in infancy represents a bizarre coincidence although an unknown common embryonic insult to these organs cannot be ruled out.
Histopathology of gastric carcinoids: a survey of 42 cases
Authors: WILANDER E. , EL‐SALHY M. , PITKÄNEN P.
Published: April 2007

An unselected series of 42 gastric carcinoids has been reviewed. Clinically the tumours simulated common gastric lesions including ulcer, polyp and carcinoma. No endocrine symptoms were identified. The tumours were most frequent in the body of the stomach and in 25% in that site were multiple. Morphologically most tumours when classified according to Soga (1974) demonstrated a mixed growth pattern. Six tumours displayed an atypical morphology (type D): they were larger and metastasized more frequently than the rest of the tumours. Six tumours contained a few scattered argentaffinic cells but the others were negative indicating negligible serotonin secretion in only a few cases. The Grimelius argyrophilic reaction was positive in most cells in all tested tumours except in three, two of which showed atypical morphology (type D). It is suggested that gastric carcinoids with a type D morphology or a minority cell population of argyrophil cells are dedifferentiated carcinoids which are biologically nearer to gastric carcinomas. The most frequent clinicopathological correlation was achlorhydria linking pernicious anaemia and gastric carcinoids. This indicates pathogenetic similarities between gastric carcinoids and gastric carcinomas.
Identification of large cell undifferentiated tumours in lymph nodes using leucocyte common and keratin antibodies
Authors: LAUDER I. , HOLLAND D. , MASON D.Y. , GOWLAND G. , CUNLIFFE W.J.
Published: April 2007

A total of 43 cases undifferentiated large cell tumours presenting in lymph nodes were stained by immunoperoxidase techniques using antibodies against keratin and a leucocyte‐associated glycoprotein. In 26 cases diagnosed histologically as metastatic carcinoma, staining with the keratin antibody suggested a squamous cell origin in 11 cases. This was supported by microscopic observation of intra‐cellular filaments in seven cases. In 15 patients in whom the original diagnosis was uncertain, a definite diagnosis was possible in all cases following immunoperoxidase staining with the two antibodies and most of these proved to be large cell lympho‐mas. In two cases a potentially major diagnostic error was detected. It is suggested that the staining of undifferentiated human neoplasms using combinations of antibodies reactive with epithelial and lymphoid cells should result in much greater diagnostic accuracy in the field of large cell tumours presenting in lymph nodes.
The site of renin in the human uterus
Authors: JOHNSON JANE , JOHNSON I.R. , RONAN J.E. , CRAVEN D.J.
Published: April 2007

Renin has been known to be present in the human uterus for many years. The study reported in this paper deals with the identification of the site of renin in the human uterus by the peroxidase‐antiperoxidase technique, using anti‐human renin. Cells containing renin granules have been demonstrated only in patients complaining of menorrhagia. The cells occur singly and in clusters in the inter‐arteriolar connective tissue within myometrium adjacent to the endometrium. The cells bear a striking resemblance to those of the juxta‐glomerular apparatus of the kidney.
Polystyrene sulphonates and aspiration pneumonia: a histochemical study
Authors: CHAPLIN A.J. , KEMP P.
Published: April 2007

The histochemical characteristics of a sulphonated polystyrene resin were investigated and compared with those of sulphonic acid residues derived from intrinsic tissue components. The major features of the resin particles were their direct Schiff positivity and basophilia. Unlike the tissue sulphonic acids, the resin particles failed to stain with alcian blue. Because of their acid nature, the particles may be responsible for the onset of an aspiration pneumonia if they are accidentally inhaled by debilitated patients.
Significance of the ‘maturation’ of metastases from germ cell tumours after intensive chemotherapy
Authors: McCARTNEY ALISONC. E. , PARADINAS F. J. , NEWLANDS E. S.
Published: April 2007

A comparison between primary and metastatic germ cell tumours from 38 male patients showed that 19 of 24 metastases with residual differentiated teratoma after adequate therapy came from tumours with teratoma as a component of the primary. The correlation between the presence of teratoma in the primary and the metastases is statistically significant (P < 0.01) and supports the view that the so called ‘maturation’ of germ cell tumours is due to selective destruction of anaplastic components in tumours which have already shown an inherent capacity for differentiation. Elevation of the serum concentrations of HCG and AFP on presentation with disseminated disease was significantly related to the presence of morphologically identifiable trophoblast and yolk sac elements respectively in the primary tumours (P < 0.001). Histological identification and specific mention of teratomatous, trophoblastic and yolk sac elements in reporting germ cell tumours is therefore useful since their presence in the primary correlates with the morphology in the metastases.
Squamous cell carcinoma with sarcoma‐like stroma of the nose and paranasal sinuses: report of two cases
Authors: PISCIOLI F. , ALDOVINI D. , BONDI A. , EUSEBI V.
Published: April 2007

Two cases of squamous cell carcinoma with sarcoma‐like stroma of the nose and paranasal sinuses are described. To the best of our knowledge, this is the first report of such a localization for this tumour type. Keratin was localized by immunocytochemistry in the epithelial cells, as well as in occasional stromal‐like elements. The importance of distinguishing these tumours from morphologically similar neoplasms is emphasized in view of their different therapeutic approach.
Secretory component, α1‐antitrypsin and lysozyme in IgA deficient children. An immunohistochemical evaluation of intestinal mucosa
Authors: DURA W.T. , BERNATOWSKA E.
Published: April 2007

Nine children with IgA deficiency were studied in order to evaluate by the immunoperoxidase technique the behaviour of secretory component (SC), α1‐antitrypsin (α1‐AT), lysozyme and esterase in biopsies of intestinal mucosa. In none of the studied patients was SC found to be lacking, suggesting that the epithelial transport mechanism of IgA across enterocytes was relatively normal. The distribution of SC activity in immunodeficient children differed however from that seen in control intestinal mucosa in its non‐uniform distribution on the villus, abnormal retention in the Golgi region of enterocytes or exclusive activity confined to the proliferating compartment of the villus. The staining of α1‐AT in enterocytes was clearly obvious in all studied cases with no alteration in zonal distribution when compared with normal human mucosa. The lysozyme staining pattern was seen exclusively in Paneth cells. The non‐specific esterase positive enterocytes observed in control mucosa failed to stain in biopsies from IgA deficient children. The results of this study of SC, α1‐AT, lysozyme and esterase may indicate that IgA deficiency is not related to a defect in enterocyte transport of immunoglobulins and confirms previously reported findings indicating the lymphoid B‐cell compartment to be altered.
Primary malignant lymphomas of the central nervous system: a histological and immunohistological study of 12 cases
Authors: ALLEGRANZA A. , MARIANI C. , GIARDINI R. , BRAMBILLA M.C. , BOERI R.
Published: April 2007

Paraffin sections of surgical and autopsy material from 12 cases of primary non‐Hodgkin's lymphomas of the central nervous system were examined for histopathological diagnosis and for the demonstration of cytoplasmic immunoglobulins. According to the Kiel classification, there were five cases of lymphoplasmacytoid polymorphous lymphoma, five of immunoblastic lymphoma, one of lymphoblastic lymphoma of convoluted cell type. There was also one of the recently described multilobated lymphoma. An immunohistological study of light and heavy chains by peroxidase‐antiperoxidase (PAP) technique and avidin‐biotin complex (ABQ)technique was performed. Intracellular immunoglobulins were demonstrated in seven cases: four cases were classified as immunoblastic lymphomas and three cases as lymphoplasmacytoid lymphomas. Negative immunoglobulin staining was observed in five cases: two lymphoplasmacytoid lymphomas, one immunoblastic, one lymphoblastic of convoluted cell type and one multilobated. A ‘monoclonal’ pattern of immunoglobulin staining was detected in six cases. One case, classified as immunoblastic lymphoma, showed ‘bitypic’ staining for k and λ chains. It was concluded that primary CNS non‐Hodgkin's lymphomas of the present series showed morphological and immunohistological features similar to those of malignant lymphomas arising in extraneural sites. In particular, the presence in our series of a multilobated lymphoma, as a primary CNS tumour, is emphasized.
Sialomucins in the assessment of dysplasia and cancer‐risk patients with ulcerative colitis treated with colectomy and ileo‐rectal anastomosis
Authors: EHSANULLAH M. , MORGAN M. NAUNTON , FILIPE M.I. , GAZZARD B.
Published: April 2007

The clinical notes and histology of 374 patients treated by colectomy and ileo‐rectal anastomosis for ulcerative colitis were reviewed. Only those with definite diagnosis of ulcerative colitis and follow‐up rectal biopsies were included (171 cases). Morphology and patterns of mucin secretion were investigated to assess whether abnormal mucin with predominance of sialomucins is a useful indicator of malignancy‐risk. Carcinoma has developed in six patients and ‘precancer’ in seven. The results show coexistence of dysplasia and sialomudn even in the absence of inflammation in all but three biopsies; in contrast the presence of both dysplasia and normal mucin profile was found in less than 1%. A significant correlation was noted between an inflamed mucosa and the development of cancer or precancer, the presence of sialomucins and the appearance of dysplasia. Sialomucins showed a greater sensitivity in detecting cancer than dysplasia (75% versus 30%). However, dysplasia was notably more specific (94% compared with 50%), hence its greater predictive value as indicator of malignancy (50% as against 15% for a positive sialomucin result). Mucin stains on routine fixed paraffin‐embedded tissue provide a simple screening method to sharpen the assessment of dysplasia and cancer‐risk in patients with ulcerative colitis despite the limitations referred to above. The lack of definite evidence of dysplasia in four patients who developed malignancy without premalignant changes in the rectal biopsies emphasises the need for frequent multiple biopsies in patients with an ileo‐rectal anastomosis for ulcerative colitis.
Diabetic hepatitis preceding the onset of glucose intolerance
Authors: BATMAN P.A. , SCHEUER P.J.
Published: April 2007

A patient who abstained from alcohol consumption but who had asymptomatic chronic progressive hepatomegaly, mild disturbance of liver function tests and hepatitis resembling alcoholic hepatitis (nonalcoholic steatohepatitis) developed glucose intolerance several years after the hepatitis was diagnosed. The patient had a family history of both diabetes and chronic liver disease. A lesion resembling alcoholic hepatitis in a patient who denies alcohol consumption, may be diabetic or pre‐diabetic in aetiology and such a patient should be followed up with glucose tolerance tests.
Frozen sections of bone biopsies in metabolic and other bone diseases
Authors: STEVENS A. , PALMER JANET
Published: April 2007

Frozen sections of bone trephine and needle biopsies can be satisfactorily cut in a standard cryostat and, when stained with haematoxylin and eosin, they enable a rapid diagnosis to be made in a wide range of metabolic bone disorders including Paget's disease, osteoporosis, osteomalacia, hyperparathyroidism and renal osteodytrophy. Neoplastic disease of bone may also be diagnosed using the same technique. A tissue diagnosis can be established within an hour of the biopsy being taken, instead of the 1–3 weeks required for resin section diagnosis, with a consequent potential saving in further costly biochemical and radiological investigations, a possible shortening of the patient's stay in hospital and earlier initiation of correct treatment. The method is quick, reliable and highly cost‐effective; it is of particular value in laboratories with insufficient workload to justify the expenditure on specialized microtomes and reagents for resin embedding.
Fibrolamellár hepatocellular carcinoma. An immunohistochemical and ultrastructural study
Authors: CABALLERO T. , ANEIROS J. , LOPEZ‐CABALLERO J. , GOMEZ‐MORALES M. , NOGALES F.
Published: April 2007

Two cases of fibrolamellar carcinoma of the liver are reported in young female patients of 12 and 21 years of age. Small amounts of perinuclear alpha‐fetoprotein were found, unrelated to hyaline globules, as well as alpha1‐antitrypsin in a periglobular fashion in isolated cells. Ferritin was present in a large number of cells. Ultrastructurally, the well differentiated nature of the neoplasm was substantiated by previously unreported findings such as intercellular lumina analogous to bile canaliculi and peroxisome‐like bodies containing a central crystalloid. Filamentous material resembling Mallory's type of hyaline was also found. We conclude that both immunohistochemical and ultrastructural features reflect a high degree of differentiation.
The reproducibility of a quantitative grading system of bladder tumours
Authors: OOMS E. C. M. , BLOK A. P. R. , VELDHUIZEN R. W.
Published: April 2007

In order to test the reproducibility of a histomorphometrical grading system of bladder tumours, 15 tumours were twice measured independently by three pathologists. The data obtained were then analysed and compared with that of histological grading only. The way in which these morphometrical results are presented to the clinician in a computerized report is described. The need for a satisfactory reliable reproducibility test of every histomorphometrical grading system before introduction in diagnostic pathology is discussed.
Nuclear morphometry of epitheliosis and intraduct carcinoma of the breast
Authors: BHATTACHARJEE D. K. , HARRIS M. , FARAGHER E. B.
Published: April 2007

Nuclear morphometry has been studied by a simple visual method in order to obtain an objective criterion for distinguishing epitheliosis from intraduct carcinoma in tissue sections. Nuclear area was found to be superior to the measurement of major or minor axes. Estimated area (major x minor axes), although less accurate than measured area, gave equally good discrimination. The best discrimination was obtained using the differences between the mean estimated nuclear area of the diseased duct and a normal duct in the same section. Using a difference of 20μm2 as the dividing line, epitheliosis and intraduct carcinoma could be correctly classified by this criterion alone in 86% of the lesions studied.
Pathology of seven mucous cell adenomas of the bronchial glands with particular reference to ultrastructure
Authors: HEARD B. E. , CORRIN B. , DEWAR A.
Published: April 2007

The pathology, including ultrastructure, of seven mucous cell adenomas of the bronchial glands is described. They occurred as polypoid intraluminal lesions in both male and female patients between the ages of 7 and 55 years (mean 26 years). Histologically they were all benign and consisted of predominantly mucus‐secreting cells arranged in acini or ducts or in solid groups. A little squamous differentiation was evident in four cases, insufficient in our opinion, to justify the term mucoepidermoid tumour. By electron microscopy, many tumour cells resembled mucous cells of the bronchial glands, containing typical large mucous granules of finely granular, reticular or fibrillated material, and sometimes small electron‐dense bodies. In four cases some cells showed both secretory granules and features of squamous differentiation such as numerous tonofilaments and desmosomes. Oncocytic differentiation was seen occasionally.
Non‐conventional chondrosarcomas and chondrogenesis
Authors: VILANOVA J. R. , SIMON‐MARIN R. , BURGOS‐BRETONES J. , RAMIREZ M. M. , RIVERA‐POMAR J. M.
Published: April 2007

Pattern formation in chondroid development is compared with growth models exhibited by mesenchymal and myxoid chondrosarcomas. The results reveal strong similarities between mesenchymal chondrosarcoma and normal chondrogenesis. The fine vascularization of the tumor lobules of myxoid chondrosarcoma is discussed in relation to chondroid differentiation. A common histogenetic approach to the interpretation and classification of these neoplasias is proposed.
Malignant histiocytosis (true histiocytic lymphoma) clinicopathological study of 25 cases
Authors: PILERI S. , MAZZA P. , RIVANO M. T. , MARTINELLI G. , CAVAZZINI G. , GOBBI M. , TARUSCIO D. , LAURIA F. , TURA S.
Published: April 2007

Twenty‐five cases originally diagnosed as malignant histiocytosis/true histiocytic lymphoma were reviewed according to both pathological and clinical criteria. Microscopically, they were characterized by large, pleomorphic tumour cells showing variable degrees of atypia and phagocytic activity. The growth more often appeared as diffuse, being limited to the sinuses in only two cases. Cytochemistry on touch imprints showed tumour cells strongly positive for acid phosphatase and α‐naphthyl‐acetate esterase in all the samples tested. Immunohistochemistry on paraffin embedded sections using specific antisera showed tumour cell positivity for lysozyme in 12 of 25 cases, for α1‐antitrypsin in 24 of 25 cases and for α1‐antichymotrypsin in all 25 cases. Immunophenotyping on frozen‐sections in three cases displayed a clear‐cut reactivity of the neoplastic cells with the monoclonal antibody OKM1. Clinically, the disease more often presented with B‐symptoms, lymphadenopathy and mediastinal involvement. In the majority of the patients (18/25) it had a fatal and rapid course, despite therapy (median survival: 9 months; mean survival: 12 months). The presence of B‐symptoms and bulky disease appeared as the only factors influencing the prognosis, both suggesting a more aggressive course of the tumour.
Misplaced epithelium in ulcerative colitis and Crohns disease of the colon and its relationship to malignant mucosal changes
Authors: ALLEN D.C. , BIGGART J.D.
Published: April 2007

The presence of misplaced mucosal epithelium was studied in the colectomy specimens from 30 patients with Crohn's disease, 30 patients with ulcerative colitis, 15 patients with ulcerative colitis complicated by carcinoma and 30 patients with non‐colitic colorectal carcinoma. Misplaced epithelium was present in 21 (70%) of the resection specimens with Crohns disease, 20 (66.7%) with ulcerative colitis and 12 (80%) with ulcerative colitis complicated by carcinoma. None of the specimens with non‐colitic colorectal adenocarcinoma showed misplaced foci of epithelium. Two pathogenetic mechanisms for epithelial misplacement are proposed: (1) the effects of mucosal inflammation and repair; and (2) muscular abnormalities in inflammatory bowel disease. The proposed mechanisms and patterns of epithelial misplacement are discussed and illustrated. The importance of its recognition is emphasized because, when associated with mucosal dysplasia, difficulties in interpretation arise in distinguishing it from ‘early’ invasive adenocarcinoma. Epithelial misplacement is common in patients with longstanding ulcerative colitis and may be a factor in increasing the significance of pre‐existing mucosal dysplasia and promoting the development of adenocarcinoma. This may explain the unusual growth pattern encountered id ulcerative colitis, of submucosal cancer underlying a flat, non‐dysplastic mucosa.