bluuebunny/crossref_metadata_2025 huggingface dataset:
The non‐Hodgkin's lymphomas: old and new thinking
Authors: VAN DER VALK P. , MEIJER C. J. L. M.
Published: April 2007

Knowledge of non‐Hodgkin's lymphomas has increased enormously in the last 10–15 years. The various types are considered to reflect the normal immunological processes that take place in the lymphoid tissue after antigenic challenge. This concept, which states that non‐Hodgkin's lymphomas are neoplastic counterparts of normal processes, has implications for morphology, immunology and clinical behaviour. Based on this concept, as well as on immunohistological and functional data, a hypothetical scheme of B‐cell development is proposed. The relation to normal physiology also holds for lymphomas localized outside the lymph nodes. Normal structure and function in two important extranodal lymphoid tissues, the gastrointestinal mucosa and the skin‐associated lymphoid tissues, are related to the lymphomas arising in these sites. This relation and some of its implications are discussed, with special reference to the important processes of homing and recirculation of lymphocytes.
Cytokeratin and vimentin intermediate filament proteins in benign and neoplastic prostatic epithelium
Authors: LEONG A. S‐Y. , GILHAM P. , MILIOS J.
Published: April 2007

Prostatic samples from 30 hyperplastic prostates and 61 prostatic adenocarcinomas were examined for vimentin and cytokeratins. The co‐expression of cytokeratins and vimentin was found in all benign prostatic epithelium and in 83% of adenocarcinomas. Benign prostatic epithelium showed vimentin intermediate filaments distinctively distributed in the basal regions and as paranuclear sheaves along the long axis of the cell. This pattern of vimentin staining was seen in adenocarcinomas with low Gleason scores, whereas high‐grade tumours showed intense diffuse perinuclear staining.
Histopathology of bone marrow reconstitution after allogeneic bone marrow transplantation
Authors: VAN DEN BERG H. , KLUIN Ph. M. , ZWAAN F. E. , VOSSEN J. M.
Published: April 2007

In order to study haematopoietic reconstitution in allogeneic bone marrow transplantation we investigated bone marrow histology in 61 biopsies of 37 patients, treated with HLA‐compatible bone marrow grafts for leukaemia or severe aplastic anaemia. The biopsies were taken from the day of transplantation until 100 d after transplantation. Stromal changes, in particular oedema, fibrosis and granulomas, were found during the whole period of observation. These changes were more prominent in biopsies from leukaemia patients than from patients with aplastic anaemia. The cellularity in the biopsies increased until 28 d after bone marrow transplantation and was stable thereafter. Initially, only clusters of cells belonging to a single cell lineage were seen, suggesting that the first outgrowth of haematopoietic cells is by proliferation of committed precursor cells. Long‐lasting abnormalities in localization of haematopoietic cells in the bone marrow space and of the myeloid: erythroid ratio were seen; dyserythropoiesis was common.
Morphologic and immunophenotypic characterization of primary brain lymphomas using paraffin‐embedded tissue
Authors: MURPHY J. K. , O'BRIEN C. J. , IRONSIDE J.W.
Published: April 2007

Primary lymphomas of the brain constitute about 1% of all primary intracranial neoplasms, but recent studies suggest an increasing incidence. Most cases are associated with an immunosuppressed state. We reviewed 29 cases of primary brain lymphoma from the Yorkshire Health Authority Region between 1970 and 1988 and found a striking increase in incidence over this period. No overt evidence of immunosuppression was found in any case. All were non‐Hodgkin's in type and were classified morphologically using Kiel criteria and immunophenotypically using a panel of antibodies. Cryo‐preserved tissue was available in five cases for parallel immunophenotyping. The majority of tumours were high‐grade lymphomas together with three of lymphoplasmacytoid type. Thirteen tumours showed a striking pleomorphic morphology with plasmacytoid features. A reactive, predominantly perivascular monomorphic T‐cell population was seen in all tumours. Most tumours were of B‐cell lineage. No cases of Hodgkin's disease, T‐cell or histiocytic lymphoma were present. Light chain restriction was present in only 46% of cases. The results of tumour immunophenotyping on cryostat sections were comparable with those from paraffin blocks. Our study emphasizes the value of a panel of antibodies reactive in paraffin‐embedded tissue, allowing simultaneous evaluation of morphology and immunophenotype, and suitable for small biopsies received from stereotactic procedures.
Endoplasmic storage disease of liver: characterization of intracytoplasmic hyaline inclusions
Authors: NG I. O. L. , NG M. , LAI E. C. S. , WU P. C.
Published: April 2007

Two cases of endoplasmic storage disease of liver are described. The liver tissue in each case showed numerous intracytoplasmic hyaline inclusions of varying sizes with formation of ground‐glass hepatocytes. These inclusions were pale eosinophilic in hematoxylin & eosin stained sections, and were periodic acid‐Schiff and HBsAg negative. Immunoperoxidase studies revealed strong positivity for fibrinogen and complement components C3 and C4 in case 1 and exclusive positivity for fibrinogen in case 2. On electron microscopy, the inclusions appeared as granular or fibrillar material within dilated cisternae of rough endoplasmic reticulum.
Immunological marker patterns in granulomatous lymph node lesions
Authors: BRINCKER H. , PEDERSEN N. T.
Published: April 2007

The distribution of various types of lymphocytes and macrophages was studied in 19 cases with granulomatous lymph node lesions using 14 monoclonal antibodies. Cases of sarcoidosis, tuberculosis and atypical mycobacteriosis all showed well demarcated granulomas devoid of B‐lymphocytes and natural killer cells. In these cases, T‐helper: T‐suppressor cell ratios were >2 and poor preservation of the normal lymphoid tissue outside the granulomas was seen. In contrast, cases of non‐specific lymphadenitis showed less well‐demarcated granulomas always containing B‐lymphocytes and natural killer cells, with a T‐helper: T‐suppressor cell ratio < 1 and good preservation of the normal lymphoid tissue outside the granulomas. Immunological marker studies may be helpful in the differential diagnosis of granulomatous lymph node lesions, as well as in the study of the pathogenesis of such lesions.
An immunohistochemical study of the presence of c‐erbB‐2 protein in Paget's disease of the nipple
Authors: LAMMIE G. A. , BARNES D. M. , MILLIS R. R. , GULLICK W. J.
Published: April 2007

Tumours from 45 patients with Paget's disease of the nipple have been stained with antibody 21N which was raised against a peptide from the C‐terminus of the predicted c‐erbB‐2 protein. Positive staining was observed in 41 cases (91%). In 42 cases the underlying mammary carcinoma was also available for study. In all but two cases staining was similar in the Paget's cells and the underlying carcinoma whether the latter was purely in situ ductal (35%) or in situ associated with infiltrating carcinoma (65%); the malignant cells in both components were large and pleomorphic and the in situ ductal carcinoma was of the comedo type. In the two exceptions the underlying carcinoma showed different histological features. The significance of the high levels of c‐erbB‐2 protein in this pattern of mammary carcinoma is considered.
Mucosal mast cells in reflux gastritis and chronic (type B) gastritis
Authors: MANGHAM D. C. , NEWBOLD K. M.
Published: April 2007

The histological features that characterize alkaline reflux gastritis are typical of the histamine‐mediated response to tissue injury. We have investigated this in nine patients with symptomatic reflux gastritis following partial gastrectomy for duodenal ulcer by determining the gastric mucosal mast cell count before and after Roux‐en‐Y biliary diversion. Following diversion, the histological picture changed from that of reflux gastritis to type B chronic gastritis in all cases. The mean mucosal mast cell count in all patients was 47.57/mm2 before diversion and 123.33/mm2 after diversion (P > 0.05). Analysis of the paired data, in which eight out of nine patients showed a rise in mucosal mast cell numbers following bile diversion, also showed a significant difference before and after surgery (P < 0.01).

The gastric mucosal mast cell count is significantly less in reflux gastritis than in type B chronic gastritis. This is most likely to be due to increased degranulation, which would explain why striking vascular changes occur in the absence of inflammatory cell infiltration in reflux gastritis.
Secretory carcinoma of the breast in adults: emphasis on late recurrence and metastasis
Authors: KRAUSZ T. , JENKINS D. , GRONTOFT O. , POLLOCK D. J. , AZZOPARDI J. G.
Published: April 2007

Secretory (so‐called juvenile) carcinoma of the breast, first described in children, occurs also in adult women, predominantly in the third decade. Less commonly it is seen in older age groups, up to the eighth decade. We report five patients with this tumour; one, a female aged 73, is the oldest age at which the tumour has been recorded, and one is the first report in an adult male in whom the disease recurred after 20 years, only the second recorded death attributable to this tumour type. Secretory carcinoma in adults is potentially more aggressive than in childhood. Nodal metastases are more frequent and sometimes more extensive. Recurrence of tumour after surgery developed in four of our five patients at 3, 8, 15 and 20 years. Slow growth and delayed recurrence are characteristic of many of these tumours. Death from systemic metastases is rare, but may ensue either rapidly or following a long latent period after treatment. Prolonged follow‐up is needed to assess accurately the biological behaviour of this tumour.
Type IV collagen immunostaining and computerized image analysis (SAMBA) in breast and endometrial disorders
Authors: CHARPIN C. , ANDRAC L. , DEVICTOR B. , HABIB M. C. , VACHERET H. , XERRI L. , LAVAUT M. N. , TOGA M.
Published: April 2007

Type IV collagen immunostaining was performed on tissue sections from a large series of non‐malignant and malignant disorders of the breast and endometrium. The results were analysed by means of a computerized system of image analysis referred to as SAMBA. It was shown that this system provided an accurate, reliable, reproducible, automated and multiparametric analysis of collagen IV immunoprecipitates. It was concluded that this standardized method of analysis can be routinely used for the measurement of collagen IV, thus enabling correlations to be sought with histopathological and clinical data.
Bacterial lymphadenitis with the picture of a lymphoepithelioid cell lymphoma—Lennert's lymphoma
Authors: KAISERLING E. , PATSOURIS E. , MÜLLER‐HERMELINK H. K. , WICHTERICH D. , LENNERT K.
Published: April 2007

Three cases with the typical light microscopic picture of lymphoepithelioid cell lymphoma (so‐called Lennert's lymphoma) were investigated by electron microscopy. Surprisingly, Lennert's lymphoma could be excluded in two cases. These two cases exhibited, in addition to pleomorphic lymphocytes and epithelioid cells, macrophages with accumulations of bacteria, indicating that a bacterial infection was the cause of the disease. By comparing the typical case of Lennert's lymphoma with the other cases, we found several criteria for distinguishing between Lennert's lymphoma and bacterial lymphadenitis. In bacterial lymphadenitis: (1) small and medium‐sized lymphocytes exhibited a wide cytological spectrum whereas the lymphocytes in Lennert's lymphoma were relatively uniform; the lymphocytes with prominent lysosome‐like granules found in Lennert's lymphoma were not seen; (2) cytology and distribution of epithelioid cells were similar to those in Lennert's lymphoma; (3) epithelioid venules contained recirculating lymphocytes, which were rarely found in Lennert's lymphoma; (4) numerous interdigitating reticulum cells, fibroblasts and myofibroblasts were seen, but not in Lennert's lymphoma; (5) focal increase in reticulin fibres was the main difference in light microscopy; (6) rod‐shaped bacteria were accumulated in the cytoplasm of a few macrophages. The presence of bacteria could not be demonstrated unequivocally by light microscopy. In both cases the large number of intracytoplasmic bacteria suggests that this unusual and until now unknown lymphadenitis is the result of an infection caused by facultative intracellular parasitic bacteria. The outcome of bacterial lymphadenitis that gives the false impression of Lennert's lymphoma is uncertain. Cure was achieved in one of our cases. The other patient died before therapy was commenced.
Malignant rhabdoid tumour of the bladder with immunohistochemical and ultrastructural evidence suggesting histiocytic origin
Authors: CARTER R. L. , McCARTHY K. P. , AL‐SAM S. Z. , MONAGHAN P. , AGRAWAL M. , McELWAIN T. J.
Published: April 2007

A malignant rhabdoid tumour of the bladder is reported from a girl aged 6. Detailed immunohistochemical and ultrastructural investigations provide evidence which suggests a histiocytic origin for this controversial neoplasm
‘Krukenberg’ tumour of the testis
Authors: ZUK R. J. , TROTTER S. E. , BAITHUN S. I.
Published: April 2007

Metastatic tumours are only rarely seen within the testis. We report a signet‐ring cell carcinoma of stomach metastasizing to a maldescended testis in a young male. The routes of spread are discussed and support is given to the theory of transperitoneal (transcoelemic) spread. The similarities with Krukenberg tumour of ovary are discussed.
‘Pseudoadenomatoid’ tumour of prostate
Authors: HULMAN G.
Published: April 2007

A prostatic nodule with the histological appearance of an adenomatoid tumour is described. Mucin and immunohistochemical stains, however, revealed striking differences from five classical adenomatoid tumours and from mesothelium but similarities with prostatic glandular epithelium. It is concluded that the prostatic nodule was a localized area of florid epithelial hyperplasia and not a true adenomatoid tumour despite its appearance.
Assessment of oesophagitis by histology and morphometry
Authors: COLLINS J. S. A. , WATT P. C. H. , HAMILTON P. W. , COLLINS B. J. , SLOAN J. M. , ELLIOTT H. , LOVE A. H. G.
Published: April 2007

Morphometric measurements of nuclear area, nuclear concentration and nucleolar dimensions in defined tissue zones of orientated oesophageal biopsy sections were compared between three patient groups–asymptomatic/normal endoscopy (n= 8): symptomatic reflux/normal endoscopy (n= 17); and symptomatic/endoscopic oesophagitis (n= 15). No significant differences could be shown for any mean parameter between clinical groups. In a further group of 16 patients, identical morphometric measurements were made in non‐orientated grasp biopsies and correlated with prolonged ambulatory pH data. No significant correlations could be shown between nuclear parameters and acid reflux measurements. These results suggest that morphometric measurement cannot be recommended as a diagnostic tool in the diagnosis of oesophagitis, although it may be useful in the assessment of individual therapeutic response in clinical trials.
The histogenesis of mammary and extramammary Paget's disease
Authors: JONES R. RUSSELL , SPAULL J. , GUSTERSON B.
Published: April 2007

The histogenesis of mammary and extramammary Paget's disease has been studied by immunohistochemical staining of paraffin‐embedded tissue using a panel of epithelial cell markers, which react with secretory or ductal epithelium, but not stratified epithelium. These markers included a monoclonal antibody E29 to epithelial membrane antigen EMA, the cytokeratin marker CAM 5.2 and three new monoclonal antibodies raised to human milk fat globule membrane (LICR‐LON‐TW19 and H.10.A) and a human bladder cell cancer line (3.77). The findings demonstrate that both mammary and extramammary Paget's disease are of epithelial cell origin and share antigens expressed by simple epithelia. Some antigens, such as EMA and low molecular weight cytokeratins are consistently present in both diseases, whereas other antigens, identified by H.10.A and TW19 are found more frequently in cases of extramammary Paget's disease. This panel of monoclonal antibodies also proved useful in distinguishing Paget's disease from pagetoid melanoma and clear cell Bowen's disease.
Pneumatosis cystoides‐like appearances in a mature cystic teratoma of the ovary
Authors: MAUDSLEY G. , ZAKHOUR H. D.
Published: April 2007

A case of mature ovarian teratoma is described showing appearances not unlike those seen in pneumatosis cystoides intestinalis, posing intriguing problems in its explanation.
Lymphoma phenotyping in formalin‐fixed and paraffin wax‐embedded tissues. I. Range of antibodies and staining patterns*
Authors: NORTON A. J. , ISAACSON P. G.
Published: April 2007

Recently, monoclonal antibodies capable of phenotyping malignant lymphomas in routinely fixed and processed tissue have become available. Some of these reagents identify lineage‐restricted variants of the leucocyte common molecule, whereas others identify unique fixation‐resistant epitopes on lymphoid cells, some of which are shared by non‐lymphoid tissues. A new generation of antibodies recognizing ‘classical’ leucocyte antigens such as CD3 are also emerging. Refinements in antigen detection systems, especially for immunoglobulin recognition, combined with these new reagents promise to improve the accuracy of lymphoma diagnosis in routine histopathology. These new antibodies are reviewed, and their limitations, cross reactivities and profiles of staining in lymphoreticular disease are discussed. A strategy for their optimal use is proposed.
The significance of alpha‐fetoprotein and other tumour markers in differential immunocytochemistry of primary liver tumours
Authors: BRUMM C. , SCHULZE C. , CHARELS K. , MOROHOSHI T. , KLÖPPEL G.
Published: April 2007

One hundred benign and malignant primary liver tumours were screened immunocytochemically for alpha‐fetoprotein (AFP), α1‐antitrypsin, alpha‐human chorionic gonadotropin, carcinoembryonic antigen (CEA), keratin and vimentin. Alphafetoprotein was found in 16/63 (24%) hepatocellular carcinomas and in two hepatoblastomas. When comparing tissue positivity for AFP with tumour differentiation, grade 1 hepatocellular carcinomas were found to be negative, while 21% of grade 2, 36% of grade 3 and 16% of grade 4, respectively, stained positively. Alphafetoprotein positive cells were present in 9/10 hepatocellular carcinomas with serum levels exceeding 5000 ng/ml, but were absent in 17 tumours with serum AFP levels below 5000 ng/ml. All tumours other than hepatocellular carcinomas and hepatoblastomas were AFP negative. Carcinoembryonic antigen was present in 72% of cholangiocarcinomas, but was demonstrated in only one hepatocellular carcinoma. This exception was a combined hepatocellular‐cholangiocarcinoma in which CEA expression was restricted to the cholangiocellular part. α1‐antitrypsin was found in 4/63 hepatocellular carcinomas, in 2/2 fibrolamellar carcinomas and in 2/18 cholangiocarcinomas. Alpha‐human chorionic gonadotropin was detected in one hepatocellular carcinoma and was strongly expressed in both fibrolamellar carcinomas. Weak staining for keratin was seen in most tumours with hepatocellular differentiation. All cholangiocarcinomas, in contrast, were strongly labelled with the keratin antibody. Co‐expression of keratin and vimentin was observed in seven poorly differentiated hepatocellular carcinomas and three cholangiocarcinomas as well as in the two hepatoblastomas. The findings suggest that AFP is a diagnostic but rather insensitive immunocytochemical marker for hepatocellular differentiation in malignant liver tumours; CEA and keratin may help in discriminating cholangiocarcinomas from hepatocellular carcinomas.
Hamartomas of the spleen: a study of 20 biopsy cases
Authors: FALK S. , STUTTE H. J.
Published: April 2007

Twenty hamartomas of the spleen were studied by histological, immuno‐ and enzyme‐histochemical methods. In all cases nodules of varying size resembling proliferation of splenic red pulp structures were present that exhibited considerable morphological variation with regard to plasmacytosis, extramedullary haematopoiesis and phagocytic activity of macrophages. Splenic red pulp structures could be identified by immuno‐ and enzyme‐histochemical markers reacting with sinus endothelium, including Factor VIII related antigen, proteinase inhibitors and nonspecific esterases. In conjunction with the absence of organized lymphoid tissue and of dendritic reticulum cells these studies allow the differentiation of splenic hamartomas from haemangiomas that may possess a deceptively similar morphological appearance.
Prognostic factors in colonic cancer
Authors: SHEPHERD N. A. , SARAGA E‐P. , LOVE S. B. , JASS J. R.
Published: April 2007

Prognostic variables in 251 ‘curative’ specimens of colonic cancer were studied. Subjective variables—tumour type, grade of differentiation, character of invasive margin and lymphocytic infiltration—were associated with fair to excellent levels of inter‐observer agreement. Variables found to be of prognostic significance by univariate analysis were subjected to Cox regression analysis. This was undertaken for all three observers and for a consensus grading. No case in which direct spread in continuity was limited to the bowel wall was associated with a cancer‐related death; 63 such specimens were removed as a group with an excellent prognosis and did not require further stratification. In the remaining 188 cases, all showing extramural spread, only lymph node invasion, character of invasive margin and tumour type were independent prognostic variables. The model differs from that developed previously for rectal cancer and is superior to the Dukes classification.
Current problems in the pathology of intra‐epithelial lesions of the uterine cervix
Authors: FOX H. , BUCKLEY C.H.
Published: April 2007

Problems in the interpretation and diagnosis of intra‐epithelial lesions of the uterine cervix include inter‐observer differences in respect of grading, uncertainty as to the significance of human papillomavirus infection and debate about the current terminology. The role of human papillomaviruses in cervical intra‐epithelial neo‐plasia (CIN) remains unclear and the specific type of virus present does not correlate closely with the behaviour of these lesions. There are defects in the current terminology and in proposed new terminology for CIN; it is suggested that the term ‘borderline CIN’ should be introduced in cases where there is uncertainty as to whether or not CIN 1 is superimposed on a flat condyloma.
Florid reactive lymphoid hyperplasia of the terminal ileum in adults: a condition bearing a close resemblance to low‐grade malignant lymphoma
Authors: RUBIN A. , ISAACSON P.G.
Published: April 2007

Five cases of florid lymphoid hyperplasia of the ileocaecal region are described. This condition is characterized by large reactive germinal centres and a diffuse infiltrate of lymphoid cells and eosinophils which extends through the muscularis propria. There is a close resemblance to low‐grade malignant lymphoma from which it can be distinguished only by the use of immunocytochemistry for light‐chains. Using this technique it should be possible to classify all such lymphoid proliferations as either reactive or neoplastic and to eliminate ambiguous labels like pseudolymphoma.
An immunohistological study of condylomata acuminata
Authors: McMILLAN A. , BISHOP P.E. , FLETCHER S.
Published: April 2007

Using an indirect immunoperoxidase method and a panel of monoclonal antibodies, anogenital warts removed from 86 individuals (28 heterosexual men, 47 homosexual men and 11 women) were studied. A constant feature was the presence of a stromal infiltrate of lymphocytes, in which CD4+ and CD8+ cells appear in a ratio of about 5:1. Cells expressing interleukin‐2 receptors were found in the stroma, amounting to 10% of the CD3+ cells. Leu 6+ epidermal dendritic cells (Langerhans' cells) were present in each wart; their density and morphology were similar to that in adjacent, apparently normal, skin. The mean number of Langerhans' cells that expressed HLA‐DQ was lower than that of HLA‐DR+ cells. In 40 warts. HLA‐DR was expressed on the surface of keratinocytes. Leu 7+ and Leu 11b+ cells were found in the epidermis of 17 and five warts, respectively. B‐cells were noted in only five warts. These results are discussed in relation to persistence of wart virus infection.
Ground‐glass hepatocytes with Lafora body like inclusions—histochemical, immunohistochemical and electronmicroscopic characterization
Authors: NG I.O.L. , STURGESS R.P. , WILLIAMS R. , PORTMANN B.
Published: April 2007

We report two adult patients whose liver biopsy specimens revealed numerous ground‐glass hepatocytes due to inclusions resembling Lafora bodies. The inclusions were large, intracytoplasmic, pale, eosinophilic and kidney‐shaped and were periodic acid‐Schiff positive and HBsAg negative. Immunoperoxidase studies showed that the inclusions were positive for cytokeratins and α1‐antitrypsin. In case 1, the inclusions were not membrane‐bound and consisted of secondary lysosomes and degenerate organelles including rough and smooth endoplasmic reticulum. In case 2, electronmicroscopy showed the inclusions were not membrane‐bound, but consisted of dense granules, fibrils and vacuoles, with appearances very similar to Lafora bodies. Neither patient had myoclonus or epilepsy. Electronmicroscopy is important in differentiating the type of Lafora body like inclusions found in liver biopsies.
The innervation and neuroendocrine cell population of the appendix in total colonic aganglionosis
Authors: SHAW P.A.V.
Published: April 2007

There is little published information on changes in the appendix in Hirschsprung's disease despite the presence within the mucosa of nerves and neuroendocrine cells together forming a ‘neuroendocrine ganglion’. The innervation and neuroendocrine cell population of 11 appendices (two from patients with total colonic aganglionosis, six from patients with short segment Hirschsprung's disease and three normal controls) were examined using H & E, a standard Grimelius silver stain and immunocytochemistry for S‐100 protein, neuronspecific enolase, neurofilament and synaptophysin. Compared with both normal and short segment Hirschsprang's disease controls, the total colonic aganglionosis appendices showed decreased numbers of nerve bundles around the muscle layers and within the submucosa, markedly decreased numbers of smaller fibres within the circular muscle and absence of the finer fibres within the lamina propria. There was no change in the overall number of epithelial neuroendocrine cells but subepithelial neuroendocrine cells, normally found in association with mucosal nerve fibres, were totally absent. The concomitant loss of nerve fibres and neuroendocrine cells from the lamina propria in total colonic aganglionosis suggests a different embryological origin for epithelial and sub‐epithelial neuroendocrine cells.
Diamond‐shaped' crypts and mucosal elastin: elpful diagnostic features in biopsies of rectal prolapse
Authors: WARREN B.F. , DANKWA E.K. , DAVIES J.D.
Published: April 2007

The biopsy diagnosis of prolapsing rectal mucosa syndrome can be difficult. We present two newly described features —‘diamond‐shaped’ crypts and mucosal elastin—which appear to be helpful in histological diagnosis. Of 32 biopsies of prolapsing rectal mucosa syndrome, all showed diamond‐shaped crypts or mucosal elastin. and 28 contained both. Control biopsies comprised cases of normal or irritable bowel syndrome (46), irradiation colitis and ischaemic colitis (16), inflammatory bowel disease (26), and adenomas (30). Mucosal elastin and ‘diamond‐shaped’ crypts with distinctive scalloped edges, which were never seen in prolapse, were observed in half the cases of irradiation and ischaemic colitis. Diamond‐shaped crypts were seen in one case of inflammatory bowel disease. Diamond‐shaped crypts and elastin were seen in the base of adenomas large enough to cause localized prolapse, and in four biopsies from patients with irritable bowel syndrome, all of whom had given a history of straining at stool.
A study of vesical adenocarcinoma, intestinal metaplasia and related lesions using mucin histochemistry
Authors: NEWBOULD M. , McWILLIAM L.J.
Published: April 2007

Biopsy and autopsy material from the urinary bladder was studied using PAS and PAS‐D techniques to identify glycogen and neutral mucins, the alcian blue/high iron diamine method to distinguish sialo‐ and sulphamucins and the PB/KOH/PAS technique to localize O‐acylated sialomucins. All of 10 examples of normal urothelium and both of two cases of transitional carcinoma in situ contained glycogen, but no mucin. Other lesions displayed one of two patterns of mucin production: the extracellular mucin seen focally in 17 cases of cystitis cystica consisted of sialo‐ and/or neutral mucins only, a pattern also displayed by mucins produced in 10 of 13 examples of transitional cell carcinomas and by three of nine tumours purely or in part adenocarcinomas. The intracellular mucins expressed in five of the 17 cases of cystitis glandularis and in all of eight cases of frank intestinal metaplasia with goblet cells displayed a colonic phenotype, with production of O‐acylated sialomucins. A similar profile was expressed by six adenocarcinomas and this included tumours likely to be of vesical and also of urachal origin. It is concluded that identification of O‐acylated mucins cannot distinguish between primary bladder tumours and metastases from a colonic primary, or between carcinomas of vesical and urachal origin.
QBEND/10, a new monoclonal antibody to endothelium: assessment of its diagnostic utility in paraffin sections
Authors: RAMANI P. , BRADLEY N.J. , FLETCHER C.D.M.
Published: April 2007

The immunoreactivity of a new monoclonal antibody to endothelium, QBEND/10, in formalin‐fixed, paraffin‐embedded sections from a variety of vascular and lympotic tumours is described and compared to that of two other endothelial markers, von Willebrand factor and Ulex europaeus agglutinin, type 1. All the benign tumours of blood vascular origin showed immunoreactivity whereas only five out of eight lymphangiomas demonstrated a weak focal reaction with QBEND/10. Primitive lumina in epithelioid and spindle cell haemangioendotheliomas were highlighted in all the cases. Tumour cells in angiosarcoma forming vasoformative areas and solid areas showed immunopositivity to QBEND/10 in 17/23 and 13/24 cases respectively, and complementary immunoreactivity for von Willebrand factor was observed. Proliferating vessels and the majority of spindle cells in Kaposi's sarcoma were positive in all 40 cases. Only one of 54 cases of carcinoma showed luminal reaction to QBEND/10. However, 17 of 45 spindle cell tumours displayed a positive reaction. QBEND/10 is an additional marker for demonstrating endothelial differentiation and has some advantages over currently available antibodies.
c‐erbB‐2 oncoprotein expression in mammary and extramammary Paget's disease: an immunohistochemical study
Authors: KEATINGS L. , SINCLAIR J. , WRIGHT C. , CORBETT I.P. , WATCHORN C. , HENNESSY C. , ANGUS B. , LENNARD T. , HORNE C.H.W.
Published: April 2007

Over‐expression of the c‐erbB‐2 oncogene occurs in a proportion of human adenocarcinomas and in breast carcinoma is associated with poorer prognosis. Sections of formalin‐fixed, paraffin‐embedded tumour tissue from 22 patients with mammary and extramammary Paget's disease have been stained immunohistochemically using a monoclonal antibody (NCL‐CB11) raised against a synthetic peptide from the C‐terminal end of the predicted equence of the c‐erbB‐2 protein product. All 12 cases of mammary Paget's disease showed membrane staining of intra‐epidermal cells, indicating c‐erbB‐2 over‐expression. Sections of underlying ductal breast carcinoma were available in nine cases; all nine tumours were c‐erbB‐2 positive and in eight the in situ component was of comedo or solid type. There was membrane staining of tumour cells in four of the 10 cases of extramammary Paget's disease; staining intensity was generally weaker than that observed in the cases of mammary disease. The possible implications of these findings for the histogenesis of both mammary and extramammary Paget's disease are discussed.
Granulomatous inflammation of the spleen in infectious mononucleosis
Authors: THOMAS D.M. , AKOSA A.B. , LAMPERT I.A.
Published: April 2007

Granulomatous inflammation of the spleen has not previously been recorded in infectious mononucleosis. We report two cases and describe further morphological features more often associated with malignant lymphoid conditions.
Macrophages and interdigitating reticulum cells in normal human thymus and thymomas: immunoreactivity for interleukin‐1 alpha, interleukin‐1 beta and tumour necrosis factor alpha
Authors: RUCO L.P. , PISACANE A. , POMPONI D. , STOPPACCIARO A. , PESCARMONA E. , RENDINA E.A. , SANTONI A. , BORASCHI D. , TAGLIABUE A. , UCCINI S. , BARONI C.D.
Published: April 2007

Pairs of monoclonal/polyclonal antibodies directed against interleukin‐1 (IL‐1) alpha, IL‐1 beta and tumour necrosis factor (TNF) alpha were used for immunocytochemical identification of cytokine‐containing cells in cryost sections of human fetal thymuses and thymomas. In the fetal thymus immunoreactivity for IL‐1 alpha was mainly confined to the medulla and was detected in S‐100 positive interdigitating reticulum cells. The pattern of immunoreactivity for IL‐1 beta was similar to that for IL‐1 alpha, but the number of positive cells was much lower. Cells positive for TNF alpha were extremely rare in the fetal thymus. In 11 thymomas macrophages were constantly present and were regularly distributed throughout the tumour, whereas S‐100 positive interdigitating reticulum cells were fewer and were characterized by a zonal distribution. Thymoma‐associated macrophages were negative for IL‐1 beta and were poorly reactive for IL‐1 alpha, only a few positive cells being detected in five of the cases. Some macrophages with immunoreactivity for TNF alpha were detected in seven cases; they formed rosettes with surrounding lymphocytes or were located in a perivascular position. A marked immunoreactivity for TNF alpha was constantly detected in mast cell granules, which were observed in nine thymomas but not in fetal thymus. Positive immunoreactivity of interdigitating reticulum cells for IL‐1 alpha was confirmed in five reactive lymph nodes and was also observed in Langerhans' cells in dermatopathic lymphadenitis. Our findings suggest that IL‐1 alpha is a crucial molecule for interdigitating reticulum cell and Langerhans' cell function. Furthermore, they indicate that most thymic cortical macrophages and thymoma‐associated macrophages are poorly active in the production of IL‐1 and TNF alpha.
Chondroid syringoma: a histological and immunohistochemical study of 15 cases
Authors: IGLESIAS F. DOMINGUEZ , FORCELLEDO F. FRESNO , SANCHEZ T. SOLER , GARCÍA L. FERNANDEZ , ZAPATERO A. HERRERO
Published: April 2007

Fifteen cases of chondroid syringoma have been studied histologically and by immunohistochemical methods in an attempt to establish their phenotypic profile and to elucidate their histogenesis. The epithelial elements were classified as tubuloglandular, solid nests and stromal cells. The inner cell layers of tubuloglandular components had distinct epithelial features, expressing cytokeratin, carcino‐embryonic antigen and epithelial membrane antigen. The outer cell layers expressed vimentin, S‐100 protein, neuron‐specific enolase and muscle‐specific actin and were negative for epithelial markers. The immunophenotypes of stromal cells and solid nests were similar to those of the outer cell layers. These data suggest that the stromal components may derive from the outer cell of tubuloglandular elements and that myo‐epithelial cells have an important role in the histogenesis of these lesions and in their mesenchymal matrix production.
Hürthle cell neoplasms of the thyroid gland: an immunohistochemical study
Authors: CHETTY R.
Published: April 2007

Twenty‐five Hürthle cell follicular neoplasms (19 adenomas and six carcinomas) were tested against the following markers using the peroxidase–anti‐peroxidase technique; thyroglobulin, calcitonin, carcino‐embryonic antigen (CEA), cytokeratin (CAM 5.2), neuron‐specific enolase (NSE), chromogranin and vimentin. Thyroglobulin positivity was predominantly found in colloid within follicular structures. Very patchy cytoplasmic staining was noted. Immunoreaction for CEA was apical in location. Staining for vimentin showed diffuse cytoplasmic positivity in up to 50% of cells. All other markers were negative. There were no staining differences between adenomas and carcinomas.
Depressed tubular adenoma of the stomach: pathological and immunohistochemical features
Authors: ITO H. , YASUI W. , YOSHIDA K. , NAKAYAMA H. , TAHARA E.
Published: April 2007

We examined 12 depressed tubular adenomas of the stomach pathologically and immunohistochemically in order to clarify the difference between the depressed type and the elevated type. Depressed tubular adenomas showed shallow mucosal depression and, of the 12, nine were endoscopically diagnosed as early gastric cancer. Histologically, the adenoma cells showed dysplasia in varying degree and focal adenocarcinoma occurred in two adenomas measuring over 2 cm. The mean height of the adenoma glands was 0.63 ± 0.31 mm in the 12 depressed adenomas and 1.32 ± 0.43 mm in 44 elevated adenomas, while the mean heights of the subjacent mucosa were 0.18 ± 0.19 mm and 1.07 ± 0.71 mm, respectively. Thus, depressed adenomas resulted from paucity of the mucosa subjacent to the adenoma glands and the height of the adenomatous glands was half that found in the elevated type. Goblet cells, a variety of endocrine cells and lysozyme‐containing cells were found in nine, nine and eight depressed adenomas, respectively, in variable numbers. Hyperplasia of these cells was also detected in depressed adenomas showing mild or moderate dysplasia. Immunohistochemical examination revealed no difference in the phenotypic expression of adenoma cells as between the depressed and the elevated type.
Cerebral ganglioglioma with anaplastic oligodendroglial component
Authors: ALLEGRANZA A. , PILERI S. , FRANK G. , FERRACINI R.
Published: April 2007

We report an unusual and possibly unique example of cerebral ganglioglioma with an anaplastic oligodendroglial component. The latter was documented on both morphological and immunohistochemical grounds. Immunohistochemically, the anaplastic cells were strongly positive with the monoclonal antibody anti‐Leu‐7, while they lacked glial fibrillary acid protein, vimentin and neurofilaments.
Monoclonal antibody Ki‐67: its use in histopathology
Authors: BROWN D.C. , GATTER K.C.
Published: April 2007

Monoclonal antibody Ki‐67 is a reliable and easy means of accurately assessing the growth fraction of human neoplasms. Although the number of long‐term follow‐up studies is limited, it does appear to provide valuable progrostic information particularly in lymphoproliferative disease. Since the estimation of growth fraction is only one factor influencing tumour behaviour it would be naive to believe that measurement of this parameter alone, no matter how accurately, would provide the clinician with definitive prognostic information for all tumours. The antibody is also of use in research, providing a means of measuring proliferative activity in a variety of conditions besides malignancy, and may prove of value in monitoring tumour response to established and trial therapies.
Helicobacter pylori and gastric carcinoma
Authors: LOFFIELD R.J.L.F. , WILLEMS I. , FLENDRIG J.A. , ARENDS J.W.
Published: April 2007

A etrospective study was performed on gastric carcinomas to establish the prevalence of Helicobacter pylori infection in gastric epithelium adjacent to the tumour. A total of 105 carcinomas were studied. The overall prevalence of Helicobacter pylori infection was 59%. The prevalence in different age cohorts from patients with gastric carcinoma was compared with that in patients suffering from non‐ulcer dyspepsia and, based on serological testing, with that in healthy blood donors. The presence of Helicobacter pylori in cancer patients aged 41–50 and 51–60 was significantly higher than in blood donors. No difference was seen in comparison with non‐ulcer dyspepsia patients. The presence of Helicobacter pylori showed an inverse correlation with the extent of intestinal metaplasia. The intestinal type of carcinoma was associated with a higher bacterial load than the diffuse type. These data suggest that the presence of Helicobacter pylori in gastric mucosa could play a role in the pathogenesis of gastric carcinoma, especially in the younger age group.
Basement membrane continuity in benign, premalignant and malignant epithelial conditions of the uterine cervix
Authors: RICHARDS C.J. , FURNESS P.N.
Published: April 2007

The pattern of basement membrane deposition in the uterine ectocervix was assessed in benign, premalignant and malignant conditions, using an indirect immunoperoxidase technique to detect laminin, an intrinsic basement membrane component. A semi‐quantitative approach was used to assess the frequency of small break in the basement membrane. The cervical squamous epithelium in benign epithelial conditions has an almost completely continuous basement membrane, but the development of viral atypia or cervical intraepithelial neoplasia (CIN) is associated with the appearance of small basement membrane breaks. There is a correlation between increasingly severe CIN and increasing numbers of breaks, and there is a concurrent increase in the numbers of subepithelial inflammatory cells. The development of invasive neoplasm is associated with a sudden change to a fragmented pattern of basement membrane deposition, a finding which is of potential diagnostic use.
Ultrastructural localization of extracellular matrix proteins in liver biopsies using ultracryomicrotomy and immuno‐gold labelling
Authors: BURT A.D. , GRIFFITHS M.R. , SCHUPPAN D. , VOSS B. , MACSWEEN R.N.M.
Published: April 2007

We describe a technique for the localization of extracellular matrix proteins in wedge and needle biopsy specimens of human liver. Using ultra‐thin (50–70 nm) sections of puncture perfusion fixed tissue, extracellular matrix proteins were localized using a protein A‐gold labelling procedure. We obtained good preservation of ultrastructural detail and specific labelling for collagen types I, III and IV and fibronectin. The method represents a sensitive means of identifying the extracellular distribution and the cellular origin of these proteins in normal and diseased human liver.
Small cell neuroendocrine carcinoma of the rectum associated with chronic ulcerative colitis
Authors: RUBIN A. , PANDYA P.P.
Published: April 2007

A case of small cell carcinoma of the rectum in a patient with chronic ulcerative colitis is described. There was no evidence of enteroendocrine cell hyperplasia.
Cytokeratin expression in chondroblastomas
Authors: SEMMELINK H.J.F. , PRUSZCZYNSKI M. , TILBURG A. WIERSMA‐V. , SMEDTS F. , RAMAEKERS F.C.S.
Published: April 2007

The present study is based on the histopathological and immunohistochemical examination of seven chondroblastomas, including one lung metastasis occurring 9 years after treatment. Chondroblastomas were shown to co‐express vimentin, S‐100 protein, neuron‐specific enolase, and the epithelial markers recognized by CAM 5.2, EMA and a polyclonal cytokeratin antibody. The cytokeratins present in the tumour cells of the lung metastasis were characterized as cytokeratins 8, 18, 19 and, to a lesser extent, cytokeratin 7. The results suggest aberrant cytokeratin expression in chrondroblastomas.
Co‐existence of hepatocyte ground‐glass inclusions from several causes
Authors: ALONSO‐MARTI C. , MORENO A. , BARAT A. , SOLERA J.C. , OLIVA H.
Published: April 2007

Two patients with two and three types respectively of ground‐glass hepatocyte inclusions are described. Both were hepatitis B surface antigen (HBsAG) positive and received cyanamide for alcohol aversion therapy. In addition, one of them had taken benzodiazepines and barbiturates. In one patient, cyanamide and HBsAg inclusions co‐existed in the same hepatocytes.
HIV encephalitis‐like multinucleated giant cells in a nodal lymphoma in AIDS
Authors: GRAY F. , GAULARD P. , BEZU M. LE , SINCLAIR E. , GHERARDI R. , SCARAVILLI F. , POIRIER J.
Published: April 2007

A case of acquired immune deficiency syndrome (AIDS), in which multinucleated giant cells, characteristic of the human immunodeficiency virus (HIV)‐encephalitis, were found in a mediastinal nodal deposit of lymphoma, is reported. Immunocytochemical studies confirmed the macrophage/histiocytic origin of these cells and the presence of HIV antigen in their cytoplasm. The occurrence of such multinucleated giant cells, representing the hallmark of HIV infection, has not been previously reported outside the central nervous system.
Prognostic factors in anal squamous carcinoma: a multivariate analysis of clinical, pathological and flow cytometric parameters in 235 cases
Authors: SHEPHERD N.A. , SCHOLEFIELD J.H. , LOVE S.B. , ENGLAND J. , NORTHOVER J.M.A.
Published: April 2007

Clinical, pathological and flow cytometric parameters have been analysed by univariate and multivariate analysis to define those parameters of important prognostic influence in 235 cases of surgically treated squamous carcinoma of the anus and perianal skin. Patients had been treated by anorectal excision (166 patients) or by local excision (69). Analyses were carried out on five data sets—the two surgical subgroups, two groups distinguished by site of tumour and on all 235 patients. Univariate analysis showed many parameters to be of prognostic influence, although histological typing of tumours into the more common histological subtypes was of no prognostic value. Parameters of independent prognostic significance in multivariate analysis were those indicating depth of spread, inguinal lymph node involvement and DNA‐ploidy. In this study the subdivision of the rarer types of anal canal tumour, such as mucoepidermoid carcinoma, microcystic squamous carcinoma and small cell anaplastic carcinoma, was relevant confirming that these tumours have a poor prognosis. It is now felt that surgery should not be employed as primary treatment in most cases of anal cancer and the results of this study have to be interpreted with caution when applied to patients treated with radiotherapy with or without chemotherapy. Nevertheless, our findings suggest that the most useful prognostic information can be gleaned from accurate clinical staging and an assessment of DNA‐ploidy status.
Small pulmonary arterial vessels of Aymara Indians from the Bolivian Andes
Authors: HEATH D. , WILLIAMS D. , RIOS‐DALENZ J. , CALDERON M. , GOSNEY J.
Published: April 2007

A study was made of the qualitative histological features of the small pulmonary arterial vessels of 25 adult citizens of La Paz, Bolivia (altitude 3600 m) coming to necropsy. Abnormalities found included muscularization of pulmonary arterioles, the development of longitudinal muscle in the intima of pulmonary arteries and arterioles, and the formation of muscular tubes lining the longitudinal muscle which extended through arterioles into the precapillaries of the lung. Arteriolar muscularization was found in three of the 13 Aymaras and in two of the 12 Mestizos studied. Intimal longitudinal muscle was present in four Aymaras and five Mestizos. Muscular tubes were found in only one case, a young Aymara. The features were very similar to those found in chronic obstructive airways disease. The appearances are consistent with a growth of new vascular smooth muscle in response to alveolar hypoxia as opposed to hypoxic vasoconstriction.