bluuebunny/crossref_metadata_2025 huggingface dataset:
A combination of cytological and architectural morphometry in assessing regenerative hyperplasia and dysplasia in ulcerative colitis
Authors: HAMILTON P.W. , ALLEN D.C. , WATT P.C.H.
Published: April 2007

Morphometry and stereology were used to assess the cytological and architectural characteristics of regenerative and dysplastic colorectal mucosal abnormalities in ulcerative colitis. Reproducibility of measurements was assessed and found to be good, confirming the objective and reproducible nature of morphometric analysis. Discriminant analysis between the morphometric features of regenerative mucosal change and low‐grade dysplasia revealed the significant cytological and architectural variables from which a cytological and architectural score were derived. The architectural score was capable of classifying all of the cases into their correct diagnostic category, although a combination of the two scores provided better separation of cases. Probability density analysis was carried out so that probabilities of group membership could be allocated to cases, given their cytological and architectural scores. Discriminant analysis was also applied to low‐ and high‐grade dysplasia. Important cytological and architectural variables were identified and used separately to derive scoring systems. In combination, the dual scoring of lesions was capable of separating low‐ from high‐grade dysplasia, although overlap was still evident. Again, probability density analysis allowed the allocation of cases into one or other category, although a closer examination showed that such a rule could not successfully classify a new set of low‐ and high‐grade dysplasia cases. Quantitative histological analysis of mucosal abnormalities is shown to be of use in the objective diagnosis of reactive and dysplastic change in patients with ulcerative colitis. The use of simple scoring systems and probability based allocation of cases promotes the future role of morphometric techniques in the diagnostic laboratory.
Dapsone‐induced liver necrosis
Authors: JAYALAKSHMI P. , TING H.C.
Published: April 2007

A patient being treated with dapsone for seborrhoeic dermatitis developed typical features of the ‘sulphone syndrome’ and died due to massive liver necrosis.
Multicentric Castleman's disease in association with a solitary plasmacytoma: a case report
Authors: GOULD S.J. , DISS T. , ISAACSON P.G.
Published: April 2007

Multicentric Castleman's disease with aggressive systemic symptomatology is usually associated with the plasma cell variant. We report a case in which the clinical presentation was typical of multicentric Castleman's disease but which was associated with the hyaline vascular subtype histologically. Plasma cells were absent from all biopsies until, at autopsy, a solitary plasmacytoma was found in the vertebral column. This case supports the view that plasma cells are of primary importance in the clinical and pathological manifestations of multicentric Castleman's disease.
Renal angiomyolipomas: could the histology serve as a marker for tuberous sclerosis?
Authors: BAAL J.G. VAN , BECKER A.E. , FLEURY P. , BRUMMELKAMP W.H.
Published: April 2007

The histological features of 43 renal angiomyolipomas were studied in an attempt to evaluate whether the isolated forms and those that present as part of the tuberous sclerosis complex can be distinguished. In two patients the mass was classified as an angioleiomyoma, because no adipose tissue was present. All renal angiomyolipomas showed the same basic histological picture. The combined forms, however, showed additional features such as extension into pre‐existent renal parenchyma, scattered foci of hamartomatous lesions, calcified spicules and tubular inclusions. The findings suggest that these features, in an otherwise classical angiomyolipoma, should alert the pathologist to the possibility of tuberous sclerosis.
Mucin histochemistry and lectin binding sites in intestinal metaplasia of the urinary bladder
Authors: BARRESI G. , MARAFIOTI T.
Published: April 2007

We report a case of intestinal metaplasia of the bladder urothelium associated with dysplastic foci and a transitional cell carcinoma. A mixture of sialomucins, O‐acetylated sialomucins and sulphomucins was found in the goblet cells. Neuraminidase resistant binding of the lectin peanut agglutinin was demonstrated in the brush border of columnar cells in intestinal metaplasia and diffusely in columnar cells in dysplastic foci. The histochemical findings are compared with those described in normal, dysplastic and neoplastic colonic mucosa.
Gamna–Gandy nodules in a cardiac myxoma
Authors: TROTTER S.E. , SHORE D.F. , OLSEN E.G.J.
Published: April 2007

A 33‐year‐old female was admitted for surgery for removal of a left atrial myxoma. Histological examination of the tumour showed features characteristic of myxoma. Additionally, Gamna–Gandy bodies were present in the tumour. This is a rare finding.
The histological and immunohistochemical evidence of squamous metaplasia from the myoepithelial cells in the breast
Authors: RAJU G.C.
Published: April 2007

Squamous metaplasia in the breast is well documented. However, the putative cell of origin for the squamous epithelium is not clear. This paper describes a case of fibroadenoma of the breast with myoepithelial hyperplasia and squamous metaplasia. The histological finding of transition between myoepithelial cells and squamous cells and the immunohistochemical expressions of actin and S‐100 in the metaplastic squamous cells support the myoepithelial origin of squamous epithelium in the breast.
Comparative phenotypes in rhabdomyosarcomas and developing skeletal muscle
Authors: CARTER R.L. , JAMESON C.F. , PHILP E.R. , PINKERTON C.R.
Published: April 2007

The morphological and immunohistochemical phenotypes of 51 rhabdomyosarcomas from young people have been described and contrasted with phenotypes in developing skeletal muscle from 20 fetuses and neonates. The tumours express markers in a cumulative and consistent sequence—vimentin, desmin, fast myosin, myoglobin—which evolves pari passu with morphological differentiation and follows the same pattern found in normal myogenesis. Changes in immunohistochemical phenotype are documented in residual and recurrent tumours excised after chemotherapy. The presumptive rhabdomyoblastic nature of some primitive tumours, marking with vimentin alone, is discussed.
Oestrogen receptor in breast cancer: prognostic studies using a new immunohistochemical assay
Authors: COWEN P.N. , TEASDALE J. , JACKSON P. , REID B.J.
Published: April 2007

A recently developed and validated histochemical method—immunogold–streptavidin enhancement—was used to determine oestrogen receptor content in paraffin sections of breast cancers. The selection of the best cut‐off point to define oestrogen receptor status as rich or poor was made on the basis of survival data, using the following indices: survival to term; disease‐free interval; survival at 5 years; and disease‐free interval at 5 years. Oestrogen receptor status was examined in relation to histological grade, lymph node status, menopausal status and tumour size and these four indices were considered as independent prognostic factors. Semi‐quantitative assay of receptor content showed that increasing content was related to better prognosis. Adjuvant therapy alone had no effect on patient outcome. Independently, histological grade and lymph node status, but not menopausal status or tumour size, were prognostic indicators. Oestrogen receptor rich status, as measured by immunogold–streptavidin, in conjunction with certain of these factors indicated a better prognosis. This was comparable with results in reports using other methods of receptor assay. We found the oestrogen receptor status and menopausal status more significant at 5 years than at term. The advantage of immunogold–streptavidin enhancement, which we found as reliable as other methods for oestrogen receptor assay, is that it can be used on archival, routinely paraffin‐processed material.
Osteoclast‐like giant cell tumour of the urinary bladder
Authors: AMIR G. , ROSENMANN E.
Published: April 2007

We report two cases of osteoclast‐like giant cell tumour of urinary bladder associated with papillary transitional cell tumours. Both cases were morphologically identical to giant cell tumour of bone. The giant cells stained strongly for acid phosphatase which was resistant to tartrate digestion, a staining reaction typical of osteoclasts. In view of the ability of urinary bladder to induce metaplastic and neoplastic bone, we believe that these tumours may represent extraosseous giant cell tumours of bone.
Comparison of cell growth in different parts of breast cancers
Authors: VERHOEVEN D. , BOURGEOIS N. , DERDE M.P. , KAUFMAN L. , BUYSSENS N.
Published: April 2007

This study was performed to answer the question: which parts of breast cancers are active in terms of proliferation as measured by the Ki‐67 antibody and in terms of cell division as measured by the mitotic index. Forty‐six breast samples were studied, including 34 breast cancers and 12 benign conditions. The intraductal component of infiltrating breast cancers showed a significantly lower proliferation index than the infiltrating component. The cells at the periphery of infiltrating tumour strands showed a higher proliferation activity than the cells in the core. These findings suggest that infiltration advances through preferential active growth of the cells at the invasion front.
Histopathology of the carotid bodies in neonates and infants
Authors: HEATH D. , KHAN Q. , SMITH P.
Published: April 2007

A histological study was made of the carotid bodies obtained at necropsy in 40 fetuses, neonates, infants and young children, ranging in age from 23 weeks of gestation to 11 years of age. Prominence of the dark variant of chief cells was found in diseases such as bronchiolitis which are associated with sustained hypoxaemia. Such cells have copious cytoplasm known to be rich in peptides such as enkephalins. The same histological features were found in two cases clinically diagnosed as sudden infant death syndrome but in which there was associated bronchiolitis and tracheobronchitis respectively, thought to have given rise to hypoxaemia. In a case of sudden infant death syndrome without infection there was overgrowth of sustentacular cells with predominant progenitor cells in the absence of dark cells. We associate this appearance with inability of the carotid bodies to respond adequately to changes in arterial oxygen tension.
The prevalence and character of the muscularis mucosae of the human urinary bladder
Authors: WEAVER M.G. , ABDUL‐KARIM F.W.
Published: April 2007

We report the results of a histological evaluation of 335 consecutive autopsy specimens of apparently normal urinary bladder for the presence of a complete, partial or minimal muscularis mucosae. There were 164 females (49%) and 171 males (51%), ranging in age from 20 weeks of gestation to 102 years. A muscularis mucosae was present in 117 bladders (35%). The female to male ratio was 2:1, with 45% of female and 25% of male bladders containing a muscularis mucosae. The muscularis mucosae was complete in one case (1%), partial in 23 cases (6%) and minimal in 93 cases (28%). The occurrence of a partial or complete muscularis mucosae was ten times more likely in women than men. The presence of a muscularis mucosae in both women and men was not associated with any known disease process, nor was it related to patient age.
The histopathology of 36 cases of plexogenic pulmonary arteriopathy
Authors: CASLIN A. W. , HEATH D. , MADDEN B. , YACOUB M. , GOSNEY J.R. , SMITH P.
Published: April 2007

A detailed histopathological study was made of the lungs of 36 cases of plexogenic pulmonary arteriopathy coming to combined heart‐lung transplantation. It revealed two dissimilar processes involved in the pathogenesis of this disease. One comprised histological appearances consistent with constriction of muscular pulmonary arteries, a condition that would be likely to be reversed by pulmanry vasodilators. The other was the proliferation of myofibroblasts in the intima and lumen of pulmonary arteries, a disorder of growth unlikely to be influenced by this type of therapy. In previous ultrastructural studies we have shown that the source of these cells of muscular pedigree is muscle cells from the inner half of the media which migrate into the intima through gaps in the inner elastic lamina. In the present study we found a similar proliferation of myofibroblasts in the intima, not only of pulmonary arteries, but also of pulmonary veins, in plexogenic pulmonary arteriopathy. Arterial thrombi found were considered to be a complication rather than a cause of plexogenic pulmonary arteriopathy. Siderophages, cholesterol granulomas and focal fibrosis in the lung were considered to be a consequence of intrapulmonary haemorrhage early in the course of the disease. It is concluded that, while plexogenic pulmonary arteriopathy has an important vasoconstrictive element, it is also based on a disorder of growth of cells of muscular pedigree. This view has clear implications for the therapy of primary plexogenic pulmonary arteriopathy.
Pulmonary endocrine cells in hypertensive pulmonary vascular disease
Authors: HEATH D. , YACOUB M. , GOSNEY J.R. , MADDEN B. , CASLIN A.W. , SMITH P.
Published: April 2007

A study was made of the number of pulmonary endocrine cells, immunoreactive for gastrin‐releasing peptide (bombesin) or calcitonin, in the terminal bronchioles of 39 cases of pulmonary vascular disease. In 25 of these, the form of vascular disease was plexogenic pulmonary arteriopathy, primary in 12 and secondary in 13, while the remaining 14 subjects had a wide range of other varieties of hypertensive pulmonary vascular disease. We found that pulmonary endocrine cells, especially those containing bombesin, were increased in number in both the primary and secondary forms of plexogenic pulmonary arteriopathy but not in other varieties of pulmonary hypertension. The prominent bombesin‐containing cells were found in cases with cellular plexiform lesions but occurred even more prominently at an earlier stage when vascular smooth muscle cells were migrating from the inner media into the intima.
Superficial adenocarcinoma of the oesophagus arising in Barrett's mucosa with dysplasia: a clinico‐pathological study of 12 patients
Authors: BAECQUE C. DE , POTET F. , MOLAS G. , FLEJOU J.F. , BARBIER P. , MARTIGNON C.
Published: April 2007

Superficial adenocarcinoma of the oesophagus is defined as carcinoma limited to the mucosa or submucosa regardless of lymph node status. Columnar epithelium lined lower oesophagus, now generally referred to as Barrett's oesophagus, is probably the main cause of adenocarcinoma in the lower oesophagus. Twelve cases of superficial adenocarcinoma arising in Barrett's oesophagus are presented. They were observed over a 6 year period and taken from a series of 50 cases of patients with Barrett's oesophagus and adenocarcinoma, a prevalence of 24%. Endoscopic diagnosis of malignancy was made in six patients. The initial biopsies showed an adenocarcinoma in six patients and some degrees of dysplasia in the other six patients. Prior to surgery, a histological diagnosis of adenocarcinoma was made in all twelve patients. In four patients the adenocarcinoma was confined to the mucosa. and in eight it extended to the submucosa. One patient had a metastatic lymph node. Ten patients are alive without evidence of tumour spread after a mean follow‐up of 30 months.
Hepatocyte inclusions of δ1‐antichymotrypsin in a patient with partial deficiency of δ1‐antichymotrypsin and chronic liver disease
Authors: LINDMARK B. , MILLWARD‐SADLER H. , CALLEA F. , ERIKSSON S.
Published: April 2007

We present a case of chronic liver disease with selective and exclusive hepatocyte endoplasmic reticulum storage of δ1‐antichymotrypsin in the form of granules, detected by specific immunohistochemistry at the light microscopy level and corresponding to material found in dilated endoplasmic reticulum of hepatocytes by electron microscopy. The patient had intermediate deficiency of δ1‐antichymotrypsin. Thus, the hepatocyte accumulation of δ1‐antichymotrypsin may indicate the presence of an export block resembling that of a closely‐related protein, namely PiZ δ1‐antitrypsin. It is proposed that hepatocyte storage of δ1‐antichymotrypsin may be an expression of an inborn error of metabolism bearing the characteristics of endoplasmic reticulum storage diseases such as PiZ δ1‐antitrypsin deficiency and hereditary hypofibrinogenaemia.
The distribution of renin‐containing cells in kidneys with renal artery stenosis—an immunocytochemical study
Authors: GRAHAM P.C. , STEWART H.V.A. , DOWNIE I. , LINDOP G.B.M.
Published: April 2007

In 10 kidneys removed for hypertension due to renal artery stenosis, the histological appearances varied from negligible ischaemic damage to end‐stage ischaemic atrophy. We stained the renin‐containing cells in tissue sections using an antiserum to pure human renin and an immunoperoxidase technique. In all kidneys there was hyperplasia of the renin‐containing cells both in juxtaglomerular apparatuses (JGAs) and in arteries outside the JGA, where these cells extended proximally as far as the Interlobular arteries. We mapped the distribution of renin‐containing cells and found them in all zones of the renal cortex; in three kidneys they were predominantly in the superficial cortex; in four they were distributed more evenly throughout the width of the cortex; but in three kidneys the normal gradient was reversed, with most of the cells being in the juxtamedullary cortex and, in two of the cases, little or no stainable renin in the superficial cortical JGAs. We suggest that these abnormalities in the distribution of renin‐containing cells could affect both the pattern of intrarenal blood flow and the site in the kidney at which secreted renin enters the blood.
Small cell undifferentiated (‘neuroendocrine’) carcinoma of the colon
Authors: SARSFIELD P. , ANTHONY P.P.
Published: April 2007

Three patients are described who presented with a large colonic adenoma in which a solid, undifferentiated carcinomatous component was found on microscopic examination. Despite small size (1.0 and 1.5 cm) and submucosal location in two cases, the tumours had metastasized to regional lymph nodes and the liver and death ensued at 4, 11 and 18 weeks after surgery. Immunocytochemistry was positive for carcino‐embryonic antigen, low molecular weight cytokeratins and neuron specific enolase in all three cases and scanty dense core granules of neurosecretory type were found in one of two examined by electron microscopy. These ‘neuroendocrine’ carcinomas are compared with ‘pure’ adenomas and ‘ordinary’ poorly differentiated adenocar‐cinomas of the colon from which they differ, mainly by lack of glandular differentiation and mucus secretion, although two adenocarcinomas also showed patchy reactivity for neuron specific enolase. The term ‘neuroendocrine’ may be disputed but is now well established to describe a tumour that runs a uniquely aggressive course and for which radical surgery alone cannot provide a cure.
Tissue polypeptide antigen in thyroid tumours of follicular cell origin: an immunohistochemical re‐evaluation for diagnostic purposes
Authors: TUCCARI G. , BARRESI G.
Published: April 2007

Using immunoperoxidase procedures on paraffin sections, we have investigated the distribution pattern of tissue polypeptide antigen (TPA) in follicular adenomas, (20 cases), follicular carcinomas (23 cases), papillary carcinomas (10 cases), anaplastic carcinomas (eight cases) and medullary carcinomas (four cases). Normal thyroid tissue surrounding adenomas was also tested as a control. Our results document positivity for TPA in follicular, papillary and medullary carcinomas, whereas no reactivity was encountered in follicular adenomas and anaplastic carcinomas. These immunohistochemical data were compared with serological levels of TPA and the findings were discordant only for anaplastic carcinomas. We contend that the demonstration of TPA, possible in alcohol‐ or formalin‐fixed tissues, may prove to be of value in the differential diagnosis of thyroid adenomas from carcinomas of follicular cell origin.
Attenuated cells in breast stroma: the missing lymphatic system of the breast
Authors: HARTVEIT F.
Published: April 2007

The breast stroma, in association with normal and neoplastic epithelium, is shown to contain cells of similar ultastructure to the fine lymphatic vessels and sinusoids described in detail in the literature on other organs. As in other organs, the lumen of these structures is in continuity with the tissue spaces, allowing a free flow of lymph and its content, fluid and cells, from the tissues to the drainage system. The lymphatic system is, thus, open‐ended—the endothelial cells of its finest branches having overlapping junctions that open passively on demand. There is, therefore, no need to postulate that cancer cells actively invade the surrounding tissues. In addition, the breast stroma contains endothelial cells in which the luminal side is not apposed to that of the same or another endothelial cell. These, like other endothelial cells, are attached to the connective tissue elements on one side only. It is suggested that they provide a series of potential spaces that can conduct fluid rapidly through the tissues, providing the epithelial cells with a copious supply of nutrients. This irrigation system is termed the lymphatic labyrinth, to distinguish it from the classical sinusoids and collecting vessels of the drainage system.
Polymorphous low‐grade adenocarcinoma of the salivary glands
Authors: SIMPSON R.H.W. , CLARKE T.J. , SARSFIELD P.T.L. , GLUCKMAN P.G.C. , BABAJEWS A.V.
Published: April 2007

Six cases of polymorphous low‐grade adenocarcinoma (terminal duct adenocarcinoma) of the minor salivary glands are presented. In all but one there was a history of a painless intra‐oral mass of fairly long duration. The histopathological appearances were characterized by cytological uniformity in a variety of morphological patterns, including tubular, solid, fascicular and cribriform areas. At a cellular level, the tumours possessed regular, often vesicular nuclei and generally eosinophilic cytoplasm. Five of the patients are still alive, although one had recurrent disease 16 years after her original operation: none died of their tumour. These findings are compared with those of six salivary adenoid cystic carcinomas, a neoplasm with many similar histological features, but with a much worse prognosis. The microscopic differences were mainly cytological and, to a lesser extent, morphological. The immunohistochemical reactions of the two tumours were not sufficiently dissimilar to be of practical value. Polymorphous low‐grade adenocarcinoma has only rarely been reported in Britain, but we believe it deserves wider recognition as a distinct clinicopathological entity and, in particular, separation from adenoid cystic carcinoma.
Hodgkin's disease and sinus histiocytosis with massive lymphadenopathy‐like changes
Authors: FALK S. , STUTTE H.J. , FRIZZERA G.
Published: April 2007

Sinus histiocytosis with massive lymphadenopathy (SHML) is a disorder of unknown origin which is only infrequently associated with lymphoid neoplasms. We report the first two cases of Hodgkin's disease with simultaneous SHML‐like changes in the same lymph node.
A new insight into the histogenesis of ‘mesodermomas’—malignant mesotheliomas
Authors: DONNA A. , BETTA P.G. , BIANCHI V. , RIBOTTA M. , BELLINGERI D. , ROBUTTI F. , MARCHESINI A.
Published: April 2007

A myogenic phenotype was induced in cultures of human mesothelial cells treated for 72 h with atrazine, a triazine derivative. Immunoreactivity for both myosin and myoglobin was detected in a large number of these cells, irrespective of their polygonal or spindle morphology, whereas no expression of desmin was observed. These findings support the embryological identity of mesothelium and mesoderm, the former being, in the post‐embryonic stage, potentially capable of differentiation along the same lineages which the latter normally displays during embryogenesis. In the light of this concept it can be assumed that primary malignancies arising from the mesothelium have the competence to express the pluripotent nature of embryonic mesoderm, and hence the term mesodermoma is appropriate for this group of tumours, including mesotheliomas in a classical sense. A postulated mechanism for the phenotypic change of mesothelial cells is also outlined, involving atrazine conversion to 5‐aza‐chloro‐cytidine, a probable DNA hypomethylating and gene activating agent, like its analogue 5‐azacytidine.
Testicular regression syndrome — a pathological study of 77 cases
Authors: SMITH N.M. , BYARD R.W. , BOURNE A.J.
Published: April 2007

Testicular regression syndrome is characterized by a rudimentary epididymis and spermatic cord with absence of testicular tissue. Although it has been well‐described in the surgical literature, few pathological studies have been performed. We report 77 cases of the syndrome, deriving from a 26‐year retrospective review. Typical gross descriptions described several cm of spermatic cord with a small mass of firm, fibrotic tissue at one end; elements of the vas deferens, spermatic artery and venous plexuses were usually present. Histologically, the distal expansion of most of the specimens was composed of dense fibrovascular tissue with no evidence of seminiferous tubules or normal testicular elements. Instead, scattered foci of calcification and brown pigment were present. The finding of dystrophic calcification and haemosiderin deposition, with no evidence of viable testicular tissue, in the presence of relatively normal spermatic cord elements, supports the concept of generally unilateral and occasionally bilateral anorchia secondary to remote infarction. The young age of the patients, coupled with the history of an absent testis from birth, is supportive of in utero damage. These histopathological findings provide support for the concept of in utero torsion of the testis as the basis for the testicular regression syndrome.
Pulmonary granulomatosis and angiitis
Authors: DUNNILL M.S.
Published: April 2007

A wide variety of disease processes, each requiring different therapy, may give rise to granulomatous and vasculitic pulmonary lesions, making accurate aetiological diagnosis essential. For this, adequate sampling of tissue is necessary, and this usually requires open lung biopsy in order to obtain sufficient material for microbiological, immunocytochemical and ultrastructural as well as histopathological investigation. Many cases diagnosed as lymphonatoid granulomatosis are examples of extranodal lymphoma. It is suggested that this is an inappropriate name and that such cases should be referred to as pulmonary lymphomas and the phenotype specified.
Gastrointestinal stromal tumours: an immunohistochemical study of 165 cases
Authors: HURLIMANN J. , GARDIOL D.
Published: April 2007

The phenotype of 165 gastrointestinal stromal tumours was studied by immunohistochemistry. In each case the phenotype was compared to the histological diagnosis. The phenotype was muscle in 49 tumours (30%), neural in 18 (11%), histiocytic in 20 (12%) and mixed in five (3%); 68 tumours (41%) were positive for vimentin only, four tumours had no markers and one tumour was positive for keratin only. Histologically, the tumours were classified as smooth muscle, probably smooth muscle, probably nerve sheath tumours or tumours of undetermined differentiation, In 30 istologically unequivocal muscle tumours, the phenotype was muscle in 28. Half of them, all benign, arose in the oesophagus or gastric cardia. Apart from this group, there was no correlation between phenotype, site of tumour and histological differentiation. Actin was a more sensitive muscle marker than desmin. With the exception of oesophageal tumours, the histological appearances alone could not establish a diagnosis of malignancy and were inadequate in evaluating differentiation. Immunohistochemical examination determined differentiation in 54% of the tumours, but this finding should be interpreted with caution in terms of histogenesis. It allowed us. however, to specify the differential diagnosis in 57 tumours in which the histological diagnosis was uncertain.
Qligodendrogliomas: a clinical, histological, immunocytochemical and lectin‐binding study
Authors: CRUZ‐SANCHEZ F.F. , ROSSI M.L. , BULLER J.R. , CARBONI P. , FINERON P.W. , COAKHAM H.B.
Published: April 2007

We have studied 27 oligodendrogliomas with a panel of antibodies (vimentin, GFAP, S‐100 protein, myelin basic protein, CAM 5.2) and of lectins (WGA, Con A, PNA, RCA, DBA, SBA) to different glycoproteins. There were 16 well‐differentiated tumours, including one gliofibrillary and 11 anaplastic oligodendrogliomas, three of which were gliofibrillary. Four cases showed positivity for vimentin, three of which were anaplastic tumours. Fifteen cases were positive for S‐100 protein (nine well‐differentiated and six anaplastic tumours) and 13 contained GFAP‐positive cells (three well‐differentiated and 10 anaplastic tumours). WGA binding was positive in 75% of well‐differentiated and 63% of anaplastic oligodendrogliomas, the corresponding figures were 50% and 45% for PNA, 37% and 81% for Con‐A and 25% and 54% for RCA. On the basis of the results with lectin binding, we believe that there are changes in the spectrum of tumour cell‐associated lectin‐like proteins during malignant transformation. Our observations also suggest at the pattern of lectin expression can undergo substantial changes in the course of differentiation.
Appendiceal goblet cell carcinoids: a clinicopathological and immunohistochemical study
Authors: ANDERSON N.H. , SOMERVILLE J.E. , JOHNSTON C.F. , HAYES D.M. , BUCHANAN K.D. , SLOAN J.M.
Published: April 2007

Goblet cell carcinoids are uncommon but distinctive tumours of the appendix. We have reviewed 11 cases diagnosed within the period 1976‐1990. The mean age at presentation was 58 years (range 24–76), with a female: male ratio of 8:3. At presentation, in seven patients tumour was confined to the appendix or mesoappendix (mean age 51) and in four there was extension beyond the appendix (mean age 69). Of the seven patients with localized tumour, six are alive and without clinical disease after a mean follow‐up period of 32 months and one died with recurrent tumour after 10 years. Of the four with more extensive disease, two died during follow‐up (at 23 months with probable liver metastases and at 16 months with intestinal obstruction) and two are alive, one with disease and one clinically disease‐free. Immunohistochemistry showed that all of the tumours stained positively for either neuron‐specific enolase, chromogranin A or protein gene product 9.5. No tumour stained with antiserum to serotonin or substance P and none showed glucagon‐like immunoreactivity, but four cases stained positively for pancreatic polypeptide, an unusual feature in midgut carcinoids.
Pseudosarcomatous lesions of the urinary bladder
Authors: HUGHES D.F. , BIGGART J.D. , HAYES D.
Published: April 2007

The clinical, microscopical, immunocytochemical and ultrastructural features of five cases of benign mesenchymal proliferative lesions of the urinary bladder, mimicking sarcoma, are presented. Four of the five patients are alive and disease‐free following diagnosis, an interval ranging from 9 months to 9 years, mean 4 years. A fifth patient, who had a pseudosarcomatous stromal response adjacent to a urinary transitional cell carcinoma, now has invasive transitional cell carcinoma. The lesions revealed a striking microscopical, immunocytochemical and ultrastructural similarity to nodular fasciitis, suggesting the lesions represented a bizarre mesenchymal proliferative response to inflammation.
Cutaneous gangrene, metastatic calcification and secondary hyperparathyroidism
Authors: YOONG A.K.H. , SMALLMAN L.A.
Published: April 2007

A case of cutaneous gangrene in association with secondary hyperparathyroidism is described. Histology of a skin ulcer showed medial calcification of small blood vessels with superimposed thrombosis. The patient's skin lesions have not recurred after medical therapy and parathyroidectomy.
Vimentin expression of renal cell carcinoma in relation to DNA content and histological grading: a combined light microscopic, immunocytochemical and cytophotometrical analysis
Authors: DIERICK A.‐M. , PRAET M. , ROELS H. , VERBEECK P. , ROBYNS C. , OOSTERLINCK W.
Published: April 2007

An immunocytochemical and cytophotometrical analysis of 30 renal cell carcinomas was carried out in order to investigate the expression of cytokeratin and vimentin in relation to the ploidy and mitotic index. Thirty renal cell carcinomas were studied using monoclonal antibodies CAM 5.2 and anti‐vimentin in a biotin‐streptavidin staining procedure. The renal cell carcinomas were classified according to the criteria of Furhman with a nuclear grading from I to IV. All carcinomas expressed cytokeratin, whereas co‐expression with vimentin was present only in 53%. Expression for both intermediate filaments was present in aneuploid tumours with a marked nuclear pleomorphism and was more frequently related to a tubulo‐papillary and pseudosarcomatous growth pattern. It is suggested that vimentin expression in renal cell carcinomas may be useful as a prognostic index in addition to nuclear grade, DNA content, mitotic rate and tumour stage.
Hepatocellular ballooning after liver transplantation: a light and electronmicroscopic study with clinicopathological correlation
Authors: NG I.O.L. , BURROUGHS A.K. , ROLLES K. , BELLI L.S. , SCHEUER P.J.
Published: April 2007

The histopathological features of orthotopic liver grafts were studied in 107 serial specimens from 25 patients, to assess the prevalence, possible pathogenesis and prognostic implications of hepatocellular ballooning. Ballooned hepatocytes were found in 46 (54%) of 8 5 biopsies taken five or more days after transplantation from 16 patients. They were not found in any of the protocol biopsies taken at the time of the operation. Ballooning usually appeared in the second week after transplantation, and in most patients persisted to the time of the latest biopsy studied. The affected cells were always found in acinar zone 3, and sometimes also in other zones. Forty‐four of the 46 biopsies with ballooning were taken during a period of clinical and biochemical cholestasis. In 13 of the 16 patients the degree of ballooning paralleled the severity of the cholestasis. Electronmicroscopy of affected hepatocytes showed conspicuous dilatation of the cisternae of the rough endoplasmic reticulum rather than the classical features of cholestasis. It was therefore concluded that ballooning was associated with but not directly caused by bile retention. There was no obvious association between ballooning and cellular rejection, sepsis, immunosuppressive therapy or parenteral nutrition. The most severe early ballooning was associated with serum transaminase levels over 1000 IU/l within 48 h of transplantation, suggesting that ischaemia was one of the pathogenetic factors. Hepatocellular ballooning did not in itself appear to have sinister short‐term prognostic implications
Nodular regenerative hyperplasia of the liver in a non‐treated patient with mesangiocapillary glomerulonephritis
Authors: HABOUBI N.Y. , SMITH V.J. , COYNE J.D. , ACKRILL P.
Published: April 2007

The recognition of nodular regenerative hyperplasia of the liver in patients with renal transplant is well‐known. This report, we believe, is the first well‐documented case of nodular regenerative hyperplasia in a patient with chronic renal disease and who had not been transplanted.
14;18 translocation in primary intestinal lymphoma: detection by polymerase chain reaction in routinely processed tissue
Authors: SHEPHERD N.A. , McCARTHY K.P. , HALL P.A.
Published: April 2007

Chromosomal translocations involving the heavy chain immunoglobulin locus on chromosome 14 and a region on chromosome 18 encoding the bcl‐2 gene [t(14;18)] are a characteristic and prevalent chromosomal abnormality in nodal malignant lymphoma, particularly follicular lymphoma. Using the polymerase chain reaction on routinely processed tissue, t(14;18) has been demonstrated in 22% of primary intestinal lymphomas, i.e. in two of nine cases of malignant lymphomatous polyposis, in four of 19 cases of polymorphic B‐cell lymphoma and in one of four high‐grade unclassified tumours. The findings in this study contradict those of other studies which have shown no such translocation in primary gastric and small intestinal lymphoma. The presence oft(14; 18) indicates heterogeneity of molecular abnormalities within histopathologically homogeneous tumours and suggests that caution should be employed in using molecular cytogenetic data to support theories of tumour histogenesis. The low prevalence of this translocation in intestinal lymphoma makes the use of such a methodology as a primary diagnostic aid doubtful, although the technique may help to distinguish primary and secondary lymphoma and could also be used to demonstrate secondary spread.
Diffuse sclerosing papillary carcinoma of the thyroid gland: immunohistochemical analysis of the local host immune response
Authors: GÓMEZ‐MORALES M. , ALVARO T. , MUÑOZ M. , MORAL R. GARCIA DEL , AGUILAR D. , CABALLERO T. , ANEIROS J.
Published: April 2007

Surgical specimens from four patients with diffuse sclerosing papillary carcinoma of thyroid were examined by electronmicroscopy. In addition, immunohistochemical examination using a panel of monoclonal and polyclonal antibodies was carried out in order to investigate the expression of HLA‐DR antigen, the presence of Langerhans' cells and the phenotypic characteristics of the inflammatory infiltrate. The ultrastructural study showed that the intraglandular dissemination, typical of this tumour, was due to massive lymphatic invasion. Many Langerhans' cells were observed among tumour cells and in the lymphoid infiltrates in proximity to tumour foci. HLA‐DR expression was seen on macrophages, Langerhans' cells, endothelial cells, lymphoid cells, many tumour cells and in some nonneoplastic follicles close to tumour clusters and lymphoid infiltrates. The immunohistochemical analysis of the inflammatory infiltrates showed a high proportion of B‐ and T‐cells, and moderate numbers of plasma cells. Our results suggest that the tumour‐specific immune response can give rise to an autoimmune reaction involving non‐neoplastic follicles. It is suggested that this could be one of the mechanisms responsible for immunofacilitation of tumour growth.
An immunohistological study of granulomatous prostatitis
Authors: DHUNDEE J. , MACIVER A.G.
Published: April 2007

Granulomatous prostatitis may result from tuberculosis and fungal infection and has been described following prostatic surgery. In most cases, however, the aetiology is unknown, although it may be due to a reaction to extravasated or altered prostatic secretions. We have investigated cells (macrophages, lymphocytes), serum proteins (fibrinogen, α1‐antitrypsin) and prostatic epithelial products (prostatic‐specific antigen and prostatic acid phosphatase) in diffuse granulomatous prostatitis (3 cases), focal periacinar prostatic granulomas (9) and focal prostatic infarcts (5). using an immunohistological technique. T‐lymphocytes and macrophages are present in diffuse and focal granulomatous prostatitis, but few B‐lymphocytes occur'. Fibrinogen‐related antigen is absent from granulomas, but a small amount is present within infarcts, whereas plentiful α1‐antitrypsin was detected both in granulomas and infarcts. Significant reduction in prostatic‐specific antigen and acid phosphatase reactivity occurs in granulomatous prostatitis. This suggests that cytokines derived from activated macrophages and T‐lymphocytes may be exerting a cell regulatory effect and altering cell secretions, as well as causing destruction of the prostatic epithelium.
Failure of elastin development in hypoplastic lungs associated with oligohydramnios: an electronmicroscopic study
Authors: HAIDAR A. , RYDER T.A. , WIGGLESWORTH J.S.
Published: April 2007

Pulmonary hypoplasia associated with oligohydramnios results in delayed maturation of fetal lung as assessed at light microscope level. Using an elastin‐specific electron‐microscopic staining technique, we report absent elastic tissue development in the septal crests of these lungs even at term.
Gastrointestinal manifestations of type 1 neurofibromatosis (von Recklinghausen's disease)
Authors: FLULLER C.E. , WILLIAMS G.T.
Published: April 2007

Gastrointestinal involvement in von Recklinghausen's disease occurs in three principal forms: hyperplasia of the submucosal and myenteric nerve plexuses and mucosal ganglioneuromatosis which leads to disordered gut motility; gastrointestinal stromal tumours showing varying degrees of neural or smooth muscle differentiation; and a distinctive glandular, somatostatin‐rich carcinoid of the periampullary region of the duodenum that contains psammoma bodies and which may be associated with phaeochromocytoma. This review describes the histopathological leatures of these lesions and discusses potential pitfalls in their differential diagnosis. Their accurate identification has significant implications for clinical management and may even provide the first pointer to the diagnosis of neurofibromatosis.
Haemangiopericytomas: the prognostic value of immunohistochemical staining with a monoclonal antibody to proliferating cell nuclear antigen (PCNA)
Authors: YU C.C.‐W. , HALL P.A. , FLETCHER C.D.M. , CAMPLEJOHN R.S. , WASEEM N.H. , LANE D.P. , LEVISON D.A.
Published: April 2007

Forty‐tow cases of haemangiopericytoma were studied retrospectively using immunohistochemical staining with PC10, a monoclonal antibody to PCNA. The percentage of tumour cells with positive staining for PCNA was found to correlated well with histological grading. Clinical follow‐up data were available in 25 adults and showed no known deaths in 11 cases with a low proportion (<14%) of positive cells. Out of 14 cases with a high number (≥14%) of positive cells, seven patients are known to have died, two had metastases, and in a further two there have been multiple recurrences of tumour. DNA flow cytometry was performed on 26 cases but this showed no correlation with PC10 staining or clinical outcome. Staining with PC10 may be of particular value in the identification of patients at greatest risk of rapid tumour metastasis and early death.
Epithelial damage by Helicobacter pylori in gastric ulcers
Authors: CHAN W.Y. , HUI P.K. , CHAN J.K.C. , CHEUNG P.S.Y. , NG C.S. , SHAM C.H. , GWI E.
Published: April 2007

On review of 136 consecutive biopsies of benign gastric ulcer, Helicobacter pylori was detected in 78 cases (57.3%). The gastric epithelium colonized by Helicobacter pylori showed a characteristic constellation of changes, including loss of apical mucous portion of individual cells, drop‐out of epithelial cells, epithelial pits, erosions and cellular tufts, indicative of cellular injury and regeneration. Among the 58 Helicobacter‐negative cases, similar changes were not observed in the ulcer edges, except for two cases which exhibited some cellular tufts. Thus, the topographic association of Helicobacter pylori with epithelial damage in the gastric ulcer edges in more than half of the cases suggests that this organism probably plays an aetiological role in ulcerogenesis, at least in these cases. Furthermore, the epithelial changes are so distinctive that they can serve as a helpful histological indicator for the presence of Helicobacter pylori in gastric biopsies.
Peripheral T‐cell lymphomas: an evaluation of reproducibility of the updated Kiel classification
Authors: HASTRUP N. , HAMILTON‐DUTOIT S. , RALFKIAER E. , PALLESEN G.
Published: April 2007

Haematoxylin and eosin, and Giemsa stained sections from 100 peripheral T‐cell lymphomas were examined blind on two occasions by four experienced haematopathologists in order to evaluate the inter‐ and intra‐observer reproducibility of the updated Kiel classification for these malignancies. In all cases, the T‐cell phenotype had been established previously in frozen section using a panel of monoclonal antibodies. Analysis by kappa statistics showed poor reproducibility, both overall and for most subtypes, with the exception of large cell anaplastic lymphoma. The distinction between low‐ and high‐grade lymphomas was also unsatisfactory. These results indicate the need for improved precision in the definition of histological categories of peripheral T‐cell lymphoma. The reproducibility of the updated Kiel classification for peripheral T‐cell lymphomas in its present form is inadequate.
Non‐epithelial cellular components in eccrine spiradenoma: a histological and immunohistochemical study of 20 cases
Authors: AL‐NAFUSSI A. , BLESSING K. , RAHILLY M.
Published: April 2007

In this study, 20 cases of eccrine spiradenoma have been examined using monoclonal antibodies to identify the nature of the epithelial, as well as the non‐epithelial, cellular components of this tumour. The results indicate that there is striking similarity between the epithelial cells of eccrine spiradenoma and the normal cells lining eccrine apparatus. An interesting finding was the presence of abundant T‐lymphocytes and Langerhans' cells within the tumour lobules. Additionally, endothelial‐lined vascular channels and neurofibrils were prominent in larger lesions.
‘Organoid’ thymoma: a well‐differentiated variant with distinctive clinicopathological features
Authors: PESCARMONA E. , PISACANE A. , RENDINA E.A. , RICCI C. , RUCO L.P. , BARONI C.D.
Published: April 2007

The present paper describes the clinical, histological and immunohistochemical features of five cases of ‘organoid’ thymoma. The histological hallmark of this lesion is the prominent and diffuse ‘organoid’ pattern, defined by the presence of several areas of medullary differentiation. These areas, which are strictly reminiscent of the medullary area of the normal thymus, are scattered within a neoplastic tissue resembling the thymus cortex, the overall appearance mimicking that of normal thymus. All cases shared common clinical features: they were non‐invasive or minimally invasive tumours arising in young or middle‐aged female patients. Although the incidence of ‘organoid’ thymoma is low (5.2% in our series), our morphological, immunohistochemical and clinical data suggest that this peculiar tumour may represent a well‐differentiated variant of thymoma, with low‐grade aggressiveness and a distinct clinicopathological profile.
Bone marrow trephine interpretation: diagnostic utility and potential pitfalls
Authors: WOLF‐PEETERS C. DE
Published: April 2007

Good quality paraffin‐embedded sections can be obtained from bone marrow trephines, allowing the routine use of these biopsies in diagnostic histopathology. Trephines are superior to aspirates, especially for the assessment of marrow cellularity, the extent and pattern of tumour infiltration and the cell type. Bone marrow biopsies are useful in several areas, e.g. non‐haematological disorders, myelodysplasia, the myeloproliferative group, lymphomas and leukaemias, which are briefly discussed below. Further advances in interpretation are likely with more frequent use of bone marrow trephines.