bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant melanoma of the conjunctiva
Authors: JEFFREY IONA J.M. , LUCAS D.R. , McEWAN CARRIE , LEE W. R.
Published: April 2007

The clinicopathological features of 37 patients with invasive melanoma of the conjunctiva have been studied. Prognosis was closely related to the subsite and size of the primary tumour. Twenty of 21 patients with small localized bulbar neoplasms (95%) and four of six patients with diffuse bulbar melanomas (67%) have survived with no evidence of secondary spread. By contrast, only one of six patients with neoplasms involving the fornix (17%) and two of four (50%) with caruncular melanomas have survived. Metastatic spread was very uncommon in patients with melanomas less than 1.5 mm in maximum thickness, but the outcome of the disease in patients with tumours >1.5mm was not always bad. Treatment by local excision biopsy was followed by a high rate of conjuctival recurrence (59%). Exenteration of the affected eye guarded against the development of further orbital disease, but was not infrequently followed by the appearance of metastases. Many (62%) of the tumours appeared to have arisen in a pre‐existing melanotic lesion or pigmented naevus of long‐standing. Histologically, the tumours could be divided into those with an adjacent intra‐epithelial component, manifest as atypical melanocytic hyperplasia in the conjunctival epithelium adjacent to the invasive melanoma, and those without (nodular melanoma). However, clear separation of the former group into the subtypes described for cutaneous melanomas proved impossible. Prognosis was not related to the type of melanoma, mitotic rate, cell type or degree of pigmentation.
Large cell lymphoma of the mediastinum: a B‐cell tumour of probable thymic origin
Authors: ADDIS B.J. , ISAACSON P.G.
Published: April 2007

Fifteen cases of non‐Hodgkin's lymphoma of the anterior mediastinum are reported. In the first group of four, fresh tissue was available and immunohistochemical studies demonstrated their B‐cell origin, with monotypic immunoglobulin production in two. Only fixed tissue was available in the second group of 11 patients. All stained with antibody to leucocyte common antigen (PD7/26) and three showed monotypic immunoglobulin production. If the two groups are combined seven of the 15 tumours were clearly of B‐cell origin. Classification on morphological grounds was difficult, with most tumours showing mixtures of centroblasts and large centrocytes, and the original diagnoses had included Hodgkin's disease (three), thymoma (one) and undifferentiated carcinoma (two). None of the patients had evidence of extra‐thoracic disease at presentation and when this developed the organs involved were liver (one), kidney (two) and thyroid (one). Direct extension within the chest led to infiltration of chest wall, sternum, lung, superior vena cava and other structures. The site of origin, lack of nodal involvement and, in one case, presence of residual thymus around the tumour indicate an origin in thymic B‐cells.
Adenoid cystic carcinoma of the breast: a case with axillary lymph node metastasis
Authors: WELLS C.A. , NICOLL S. , FERGUSON D.J.P.
Published: April 2007

A breast tumour with proven lymph node metastasis is conclusively characterized as an adenoid cystic carcinoma using immunocytochemistry and electron microscopy. The majority of tumour cells showed certain of the characteristic features of myoepithetial cells while the pseudocystic spaces contained large amounts of reduplicated basal lamina. A small proportion of tumour cells, however, showed epithelial differentiation with the formation of true lumina.
Use of a panel of monoclonal antibodies for the diagnosis of hairy cell leukaemia. An immunocytochemical study of 36 cases
Authors: FALINI B. , PULFORD K. , ERBER W. N. , POSNETT D. N. , PALLESEN G. , SCHWARTING R. , ANNINO L. , CAFOLLA A. , CANINO S. , MORI A. , MINELLI O. , CIANI C. , VOXES E. E. , GOLOMB H. M. , DELSOL G. , STEIN H. , MARTELLI M. F. , GRIGNANI F. , MASON D. Y.
Published: April 2007

The phenotype of 36 cases of hairy cell leukaemia has been investigated using a panel of monoclonal antibodies reactive with normal human lymphoid cells and with hairy cells. Staining was performed on frozen sections and/or cell smears by the recently developed APAAP immuno‐alkaline phosphatase procedure. In about 90% of cases, neoplastic cells reacted strongly with antibodies against HLA‐DR, leucocyte common antigen, B‐cells (antibodies B1 and To15), hairy‐associated antigens (antibodies KB‐90, S‐HCL3, HC2) and activated T‐lymphocytes (antibodies anti‐Tac and Tü69). The phenotype of 10% of cases was clearly different in that the neoplastic cells were negative or only weakly positive for one or more of the antigens recognized by HC2, anti‐Tac and Tü69. Antibody HC1 reacted with tumour cells of only 50% of the hairy cell leukaemia cases investigated. Monoclonal antibody Ki‐67 (which selectively detects proliferating cells) stained only a low percentage of cells in all but three of the cases studied. The neoplastic cells in all cases were unreactive with monoclonal antibodies
Correlation of histopathological characteristics with staining patterns in human melanoma assessed by (monoclonal) antibodies reactive on paraffin sections
Authors: HAGEN E. C. , VENNEGOOR C. , SCHLINGEMANN R. O. , VAN DER VELDE E. A. , RUITER D. J.
Published: April 2007

In order to investigate their possible role as prognostic markers, staining with the antibodies NKI/C‐3 and anti‐S100, that are applicable on paraffin sections, was examined using a group of primary cutaneous melanomas and autologous metastases using the immunoperoxidase procedure. All melanoma lesions stained with anti‐S100, and the large majority with NKI/C‐3. In primary melanomas showing a moderate or dense associated lymphocytic infiltrate, significantly more tumour cells stained with anti‐S100 than in primary melanomas with a slight or absent infiltrate. In markedly pigmented metastases, significantly more tumour cells stained with NKI/C‐3 than in less pigmented lesions; in primary melanomas this phenomenon just failed to be significant. In metastases with a high mitotic index a significantly lower proportion of tumour cells stained with NKI/C‐3 than in lesions with a low mitotic index. No significant differences in staining were found between a group of primary melanomas with metastases and a group without metastases within a follow‐up period of 5 years. Therefore, although staining with NKI/C‐3 and anti‐S100 appears to be associated with certain histopathological characteristics, it has no direct contribution to the assessment of prognosis in primary melanoma.
Plasmacytoma and follicular lymphoma in a case of Hashimoto's thyroiditis
Authors: AOZASA K. , INOUE A. , KATAGIRI S. , MATSUZUKA F. , KATAYAMA S. , YONEZAWA T.
Published: April 2007

Monoclonal gammopathy (IgG, lambda) in a 37‐year‐old man with Hashimoto's thyroiditis, was markedly decreased after thyroidectomy. Histological examination of the thyroid showed large lymphoid follicles surrounded by a massive proliferation of plasma cells. Immunological studies revealed that interfollicular plasma cells stained monotypically for lambda chain, findings in keeping with a diagnosis of plasmacytoma of the thyroid. In addition, there was kappa monotypic staining of the lymphoid follicles and absence of tingible body macrophages, indicating the presence of a follicular lymphoma derived from a separate cell line from the plasmacytoma.
A comparison of cytoplasmic immunoglobulins in retroperitoneal fibrosis and abdominal aortic aneurysms
Authors: MUNRO J.M. , VAN DER WALT J.D. , COX E.L.
Published: April 2007

Retroperitoneal fibrosis is associated with Riedel's thyroiditis, in which an unexpectedly high proportion of the plasma cells have been reported to contain IgA and lambda light chains. It has been suggested that retroperitoneal fibrosis and the inflammation and fibrosis in thick‐walled abdominal aortic aneurysms are caused by a hypersensitivity reaction to antigens leaked from aortic atheroma. We examined cases of retroperitoneal fibrosis and aortic aneurysms in order to quantify the types of heavy and light chains in the plasma cells. A mean of 44% of the plasma cells contained IgA and 52% contained lambda light chain. These results provide further evidence of the pathological relationship between retroperitoneal fibrosis and Riedel's thyroiditis. It is suggested that a cross‐reaction between antigens in mucosal surfaces and in the thyroid or retroperitoneum may be implicated, possibly involving vessel walls. Of the total plasma cells in the wall of the aortic aneurysms 24% contained IgA and 40% lambda, although there was a significant trend towards a higher proportion of IgA with increasing thickness of the wall. No definite support for a relationship between atheroma and retroperitoneal fibrosis is provided by this study.
Glandular lesions of the uterine cervix: the present state of our knowledge
Authors: WELLS M. , BROWN L.J.R.
Published: April 2007

The assessment of squamous lesions of the uterine cervix is a major preoccupation of diagnostic histopathologists and this can overshadow the recognition of significant abnormalities affecting the adjacent endocervical glands. This review gives an account of recent advances in our knowledge of the histology and histochemistry of endocervical glands. The review of benign lesions concentrates on those that continue to cause diagnostic difficulty. Adenocarcinoma in situ, lesser degrees of possibly pre‐malignant cervical glandular atypia and histological subtypes of adenocarcinoma are outlined. The increasing awareness that glandular and squamous lesions often co‐exist is emphasized. Finally, adenocarcinoma metastatic to the cervix is discussed.
Distribution of basement membrane laminin and type IV collagen in human reactive lymph nodes
Authors: KARTTUNEN T. , ALAVAIKKO M. , APAJA‐SARKKINEN M. , AUTIO‐HARMAINEN H.
Published: April 2007

The location of two basement membrane components, laminin and the 7‐S domain of type IV collagen, was studied in human lymph nodes using the peroxidase‐antiperoxidase method. Basement membrane antigens were present on the walls of blood vessels and of marginal, trabecular and medullary sinuses. Thin, fragmented fibre‐like staining was present also in parenchyma outside the germinal centres, in a pattern overlapping with reticular fibres as seen on conventional reticulin stains. This finding suggests that basement membrane components are a part of the reticular fibres of lymph nodes, or are closely associated with them.
Solitary (localized) fibrous mesothelioma: evidence against mesothelial cell origin
Authors: DERVAN P.A. , TOBIN B. , O'CONNOR M.
Published: April 2007

Five cases of solitary (localized) fibrous mesothelioma were studied immunohistochemically, utilizing monoclonal antibodies against high and low molecular weight cytokeratin, vimentin, carcinoembryonic antigen, epithelial membrane antigen and factor VIII related antigen. In contrast to normal mesothelium and contrary to previous reports from malignant mesotheliomas all the tumours were negative for keratin. They were strongly positive for vimentin. Two cases were studied electron microscopically; no ultrastructural evidence of mesothelial cell differentiation was identified. Our immunohistochemical and ultrastructural findings argue against a mesothelial cell origin, whereas the presence of vimentin suggests a mesenchymal histogenesis. It is postulated that these tumours arise from sub‐mesothelial mesenchymal connective tissue.
Papillary adenocarcinoma of lung with psammoma bodies: report of a case derived from type II pneumocytes
Authors: SALISBURY J.R. , DARBY A.J. , WHIMSTER W.F.
Published: April 2007

A 52‐year‐old woman underwent thoracotomy for the removal of a mass in the middle lobe of the right lung. Light microscopy showed a tumour with the morphology of a papillary adenocarcinoma with numerous psammoma bodies. Electron microscopy revealed the tumour cells to possess the lamellated intracytoplasmic inclusions characteristic of normal and neoplastic type II pneumocytes. Psammoma bodies have not previously been reported in type II cell carcinoma of the lung. Alveolar cell carcinoma should be considered in the differential diagnosis of a papillary adenocarcinoma with psammoma bodies occurring in the lung.
Liver findings in infantile cytomegalovirus infection: similarity to extrahepatic biliary obstruction
Authors: LURIE M. , ELMALACH I. , SCHUGER L. , WEINTRAUB Z.
Published: April 2007

The histological findings in the liver in four fatal cases of infantile cytomegalovirus (CMV) infection are presented, three occurred in premature infants, and all died at the ages of 2–4 months. Most previously reported cases showed various degrees of hepatitis with giant cell transformation. In three of our four cases, however, the main feature was cholestasis, portal fibrosis and bile duct proliferation, not unlike the findings seen in extrahepatic biliary obstruction. In one case, massive hepatic necrosis was found, a finding not previously reported in this disease. The diversity of liver findings in infantile CMV infection is stressed.
S‐100 protein: a prognostic indicator in cutaneous malignant melanoma?
Authors: KERNOHAN N.M. , RANKIN R.
Published: April 2007

A series of 215 cases of cutaneous malignant melanoma referred to a single department of clinical oncology between 1940 and 1969 was studied to assess the accuracy of the Breslow thickness and the role of S‐100 protein in predicting the clinical prognosis. Histological examination of these tumours showed that although the Breslow thickness correlated well with prognosis, in a significant number of cases it did not reliably forecast clinical outcome. From this series, tissue from those patients who survived disease‐free for more than 10 years and those who died within a year of diagnosis was stained immunohistochemically for S‐100 protein. Contrary to the findings of earlier studies, strong staining for S‐100 protein was associated with improved survival (P<0.001). A marked increase in the incidence of cutaneous malignant melanoma was noted during the period of the study.
Adenocarcinoma of the endocervix—a histochemical study
Authors: COOPER P. , RUSSELL G. , WILSON B.
Published: April 2007

The histological distinction between endometrial and endocervical adenocarcinoma may present diagnostic difficulties. Several reports have suggested that differences in the histochemical staining of the tumours may indicate their histogenesis. In this paper we have compared the staining properties of 20 endocervical adenocarcinomas (14 invasive and six in situ) with 12 cases of endometrial adenocarcinoma. Unequivocal examples were used where the site of origin was not in doubt. Sections were stained using a monoclonal antibody to carcinoembryonic antigen (CEA), alcian blue at pH 1.0 and pH2.5, PAS‐diastase and toluidine blue. The results were graded by two pathologists and results compared. Three poorly differentiated invasive endocervical tumours were completely negative for CEA. Seventeen out of the remaining 20 endocervical tumours and 7/12 endometrial adenocarcinomas showed a non‐specific apical staining pattern. This also occurred in normal and dysplastic endocervical glands. Intense intracytoplasmic staining for CEA was found in 7/14 invasive and 3/6 in situ endocervical adenocarcinomas. Normal endocervix never showed this staining reaction. However, 4/12 endometrial tumours showed a similar pattern. Mucin stains showed no specific staining pattern for either tumour. In an individual case where the site of origin is in doubt, histochemical methods are of little value in confidently resolving the problem.
Immunohistological characterization of malignant lymphomas of the Waldeyer's ring other than the nasopharynx
Authors: CHAN J.K.C. , NG C.S. , LO S.T.H.
Published: April 2007

Among extranodal lymphomas, the Waldeyer's ring is the second most frequently involved site after the gastrointestinal tract. Fresh tissue from 23 consecutive cases of malignant lymphoma of the faucial tonsil, palate and base of tongue were studied histologically and with a panel of 25 monoclonal antibodies. Twenty cases were primary Waldeyer's ring lymphoma, and all were found to express B‐cell phenotype. Most cases were classified as diffuse centroblastic lymphoma, polymorphic subtype, in which there were immunoblast‐like, centrocyte‐like and/or multilobated centroblasts. All except one case expressed all three B‐cell lineage antigens CD 19, CD20 and CD22, but they showed inconsistent expression of the B‐cell antigens CD9 and CD24. Four cases lacked surface immunoglobulin. Six cases expressed interleukin‐2 receptor, suggesting that they were composed of highly activated B‐cells. Three cases represented relapse in the tonsil or tongue in patients with known malignant lymphoma in other sites; one case expressed T‐cell and two cases B‐cell phenotype (both of which also expressed interleukin‐2 receptor). The clinical features and immunohistological findings suggest that Waldeyer's ring lymphomas, other than those of the nasopharynx, share some of the characteristics of ‘mucosa‐associated lymphoid tissue’ lymphomas. In contrast, nasopharyngeal lymphomas are more related to nasal lymphomas, and are almost exclusively peripheral T‐cell neoplasms.
Morphometrical analysis in ulcerative colitis with dysplasia and carcinoma
Authors: ALLEN D.C. , HAMILTON P.W. , WATT P.C.H. , BIGGART J.D.
Published: April 2007

Semi‐automatic image analysis was used to assess the epithelium in ulcerative colitis with dysplasia and carcinoma. There were three main sources of variation within the dataset: (1) nuclear size, nuclear cytoplasmic ratio and nuclear stratification; (2) the variation of nuclear size; and (3) nuclear shape and polarity. Discriminant analysis chose the mean nuclear cytoplasmic ratio % and the coefficient of variation of nucleus to cell apex distance to derive a scoring system which completely separated normal mucosa (n=20) and carcinoma (n=30). The classification rule allocated all high grade dysplasia to the tumour category. Scores for regeneration and low grade dysplasia overlapped with each other and the normal and tumour groups. Scatter plots of the two discriminating variables showed good separation of regeneration and high grade dysplasia, and a degree of overlap with low grade dysplasia. The scatter plots allowed identification of overlapping and misallocated cases, requiring review of their histology and redesignation of the diagnosis in five cases. This study confirms quantitatively the visual criteria used in grading mucosal changes and their trend from regeneration through dysplasia to carcinoma. It underlines the necessity of assessing not only cytological but also architectural and inflammatory components when diagnosing regeneration and low grade dysplasia. Mucosal morphometry may be of use in confirming high grade dysplasia which is an indication for colectomy.
Diffuse sclerosing variant of papillary carcinoma of the thyroid: a histological and immunohistochemical study of three cases
Authors: CHAN J.K.C. , TSUI M.S. , TSE C.H.
Published: April 2007

Three cases of an unusual diffuse sclerosing variant of papillary carcinoma of the thyroid occurring in young adults are reported. The tumour is characterized by diffuse involvement of one or both lobes of the thyroid, marked squamous metaplasia, numerous psammoma bodies, extensive interstitial fibrosis and heavy lymphocytic infiltration with formation of germinal centres. Lymphatic and vascular permeation was found in all three cases. An interesting finding was the presence of irregularly disposed thin bundles of smooth muscle within the fibrous stroma, presumably a result of splaying of the smooth muscle of vessel walls by the sclerotic process. The papillary areas of the tumour stained for thyroglobulin and cytokeratin, while the squamous areas stained strongly for cytokeratin but not for thyroglobulin. The tumours were negative for calcitonin and carcinosmbryonic antigen, but showed weak staining for S‐100 protein. Numerous S‐100 positive Langerhans/interdigitating reticulum cells were scattered within the tumour islands and the lymphoid infiltrate, suggesting an immunological reaction mediated by these antigen‐presenting cells.
Sarcomatous Wilms’tumour with clear cells and hyalinization. A study of 38 tumours in children from the SIOP nephroblastoma file
Authors: SANDSTEDT B.E. , DELEMARRE J.F.M. , HARMS D. , TOURNADE M.F.
Published: April 2007

The International Society of Paediatric Oncology (SIOP) nephroblastoma trial and studies 1, 2 and 5 include 33 sarcomatous Wilms’tumours with a clear cell pattern and five with a hyalinizing pattern among 909 renal tumours. Bone metastases developed in 22 (67%) and one patient (20%) respectively compared with 14 patients (1.6%) in the rest of the series. Both subgroups had clear cells and hyalinization. A constant and characteristic feature of the clear cell tumours was an alveolar vascular pattern which aids in the recognition of this tumour even in fibrous and sclerotic forms. Sarcomatous Wilms’tumour with a hyalinizing pattern had homogeneous areas of sclerosis with clustering of tumour cells but lacked the vascular pattern. Two tumours showed atypia similar to that in malignant rhabdoid tumour of the kidney but had no cytoplasmic inclusions. Five year recurrence‐free survival for the entire series was 68%, for sarcomatous clear cell tumours, 42% and for sarcomatous tumours with hyalinizing pattern, 20%.
Signet ring cell ‘mucinous’thyroid adenoma: a follicle cell tumour with abnormal accumulation of thyroglobulin and a peculiar histochemical profile
Authors: GHERARDI G.
Published: April 2007

This study describes two cases of signet ring cell thyroid adenoma. Signet ring cells contain immunoreactive thyroglobulin and stain positively for mucin by histochemical methods: previous interpretations of these peculiar findings suggested that signet ring celled thyrocytes may show dual endocrine and non‐endocrine differentiation. In the present material the histochemical profile of mucinous collections was consistent with a glycoprotein containing 1:2‐glycol groups and sialic acid residues. These biochemical features are the same as those of the thyroglobulin molecule although in normal thyroid tissue they can be only partially demonstrated by histochemical methods. It is suggested that the signet ring configuration may be solely due to the intracytoplasmic accumulation of thyroglobulin and that histochemically reactive protein‐polysaccharide complexes derived from partial degradation of this glycoprotein may account for the positive mucin staining.
Immunohistochemical performance testing of monoclonal antibodies to neuroblastoma cells on normal adrenals, spinal and sympathetic ganglia, and neural crest tumours
Authors: OPPEDAL B.R. , BRANDTZAEG P. , KEMSHEAD J.T.
Published: April 2007

Tissue specimens of neural crest‐derived structures like normal spinal and sympathetic ganglia and adrenals of adults, infants and fetuses were used as immunohistochemical test substrates for a panel of 10 monoclonal antibodies to neuroblastoma cells raised by immunization with a variety of immunogens (fetal brain, neuroblastoma cell lineages, chick retinal cells or purified Thy‐1 antigen). Antigen expression varied among normal structures such as ganglion cells, satellite cells, various nerve fibres, and different cells in the adrenal cortex. This variability in immunoreactivity shown by different cell types and structures was comparable to that seen when the same panel of moncclonal antibodies was applied to neuroblastomas and to ganglioneuroblastomas of different degrees of maturation and differentiation. The neoplasms thus seemed to reflect the normal maturation in the neuroectodermally‐derived structures. Also, the studies give indications as to the cell of origin of the undifferentiated neuroblastomas.
An immunohistochemical study of differentiation in malignant fibrous histiocytoma
Authors: LAWSON C.W. , FISHER C. , GATTER K.C.
Published: April 2007

Immunohistochemistry was used to examine 10 cases of malignant fibrous histiocytoma. Malignant cells in all cases expressed vimentin and in eight there was co‐expression of either desmin or neurofilament, both of these being present in four cases. In addition, cytokeratin was found in one case. In each tumour, a population of small cells was identified which had the staining characteristics of benign macrophages, and this was distinct from the tumour cells. This study supports the concept that malignant fibrous histiocytoma is a tumour of mesenchymal cells rather than of histiocytes and emphasizes the diversity of its cytostructure.
Multiple melanomas associated with diffuse melanocytic dysplasia
Authors: ROBERTSON I. , COOK M.G.
Published: April 2007

An uncommon form of presentation of melanocytic dysplasia is described in 15 patients with primary cutaneous melanoma and a high incidence of multiple melanomas. This variation in melanocytic dysplasia appears macroscopically to the pathologist and to the clinician as a diffuse mottling or ‘freckling’of the widely excised skin around the melanomas. Most patients also were described clinically as having multiple moles in other sites as well as round the melanoma. Histologically, the abnormally pigmented skin of the wider excisions has the features of melanocytic dysplasia, usually of lentiginous type, and this is seen both in continuity with the melanoma and distant from it including the margins of the wider excisions. These patients seem particularly prone to developing additional primary melanomas and therefore recognition of this form of presentation of melanocytic dysplasia may be important in patient management and prophylactic care of their families.
Pedunculated hepatocellular carcinoma. Is it an entity?
Authors: ANTHONY P.P. , JAMES K.
Published: April 2007

Two cases of pedunculated hepatocellular carcinoma are reported. One of these was known to have been present for 5 years. Both patients are alive 1 and 2 years after surgery though the former has developed a solitary bone metastasis. The literature on 30 previously published cases is reviewed and it is concluded that, minor differences apart, this tumour is not substantially different from hepatocellular carcinomas in general. The slow growth and good prognosis relate to its extrahepatic location which may be explained by an origin from accessory lobes of the liver.
Cytokeratin expression in smooth muscle and smooth muscle tumours
Authors: BROWN D.C. , THEAKER J.M. , BANKS P.M. , GATTER K.C. , MASON D.Y.
Published: April 2007

The expression of cytokeratin intermediate filaments by a tumour has been accepted as evidence of an epithelial origin. Although there have been anecdotal reports of Cytokeratin expression within tissues and neoplasms of non‐epithelial origin, particularly muscle, there have been no comprehensive studies of its frequency and distribution. In order to investigate this we have studied 51 cases of normal smooth muscle and benign and malignant smooth muscle tumours using a panel of monoclonal antibodies against a range of intermediate filaments (cytokeratins, desmin and vimentin). Cytokeratin expression was noted overall in 50% of normal, benign and malignant smooth muscle tissues. Such expression tended to have a focal or patchy distribution. No case expressed cytokeratins in the absence of both desmin and vimentin. The implication of these findings for diagnostic immunocytochemistry is that intermediate filaments alone are not completely reliable markers of tumour histogenesis and should be used as part of a larger panel of monoclonal antibodies.
Does nodular lymphocyte predominant Hodgkin's disease arise from progressively transformed germinal centres? A case report with an unusually prolonged history
Authors: CROSSLEY B. , HERYET A. , GATTER K.C.
Published: April 2007

A case is reported of nodular lymphocyte predominant Hodgkin's disease arising 13 years after the removal of a lymph node from the same site which showed marked progressive transformation of germinal centres. The morphological evidence for a histogenetic relationship between the two conditions is presented and discussed.
Human lung tumours: does intermediate filament co‐expression correlate with other morphological or immunocytochemical features?
Authors: GATTER K.C. , DUNNILL M.S. , HERYET A. , MASON D.Y.
Published: April 2007

Co‐expression of intermediate filaments is being increasingly reported for many human tumours including carcinoma of the lung. However, it is unclear whether such findings are unusual or restricted to a group of highly atypical tumours. In the present study the pattern of co‐expression of intermediate filaments in 94 human lung tumours has been correlated with light and electron microscopical features which are thought to be atypical for particular tumour types. These same aberrant patterns of intermediate filament co‐expression have also been compared with the proliferative rate of these tumours as determined by labelling with the monoclonal antibody Ki67. The results of this study have shown that the aberrant expression of intermediate filaments is not a feature unique to a group of highly unusual tumours but is found throughout the spectrum of lung cancer. The implications of these findings for the use of anti‐intermediate filament antibodies in pulmonary pathology are discussed with suggestions for future directions which might be taken in this field.
Ependymoblastoma: a histological, immunohistological and ultrastructural study of five cases
Authors: CRUZ‐SANCHEZ F.F. , HAUSTEIN J. , ROSSI M.L. , CERVOS‐NAVARRO J. , HUGHES J.T.
Published: April 2007

Five ependymoblastomas were studied by means of routine histological techniques, immunohistology and electron microscopy. The tumours were characterized histologically by medium sized, poorly differentiated cells with round or oval nuclei frequently in mitosis and by ependymoblastic rosettes. Reactions for cytokeratin and neurofilament were negative and tubular material positive for glial fibrillary acidic protein was scanty. All five tumours demonstrated positivity for vimentin and S‐100 protein. Electron microscopy showed poorly differentiated cells with high nucleo‐cytoplasmic ratio and scanty cytoplasmic organelles. Sparse rosettes were present and the cells were united by junctional complexes. Frequent rudimentary or incomplete cilia, a few basal bodies and a few short intercellular glial‐like filaments were seen. Features differentiating ependymomas and anaplastic ependymomas from ependymoblastomas are discussed and the need for a definite category separating ependymoblastomas from the former tumours is emphasized.
Fibrous hamartoma of infancy: a histochemical and immunohistochemical study
Authors: FLETCHER C.D.M. , POWELL G. , VAN NOORDEN S. , McKEE P.H.
Published: April 2007

Fibrous hamartoma of infancy is an uncommon lesion, the histogenesis and biological nature of which are uncertain. Ten cases have been studied by light microscopy, mucin histochemistry and immunohistochemistry. The typical histological features are presented. The presence of hyaluronic acid and of chondroitin‐4‐ and ‐6‐sulphate and keratan sulphate has been demonstrated in different components of the tumour. Vimentin positivity was noted in the undifferentiated and fibroblastic components. The implications of these findings are discussed. Whether the lesion merits the designation of hamartoma or is, in fact, a benign neoplasm remains obscure.
High‐grade non‐Hodgkin's lymphoma of B‐cell type. I. Histopathology
Authors: HUI P.K. , FELLER A.C. , LENNERT K.
Published: April 2007

One hundred and twenty‐eight cases of high‐grade malignant B‐cell lymphoma were studied with a plastic re‐embedding technique and classified according to the Kiel classification. The cytological details could be better recognized than in the original paraffin sections, thus permitting a more precise definition of the various lymphoma types. The entities centroblastic and immunoblastic lymphoma are more precisely defined and supplemented by the addition of several new variants. In contrast to the present Kiel classification we separate Burkitt's from lymphoblastic lymphoma. In all cases investigated, the B‐cell nature of the tumour cells was proven by immunohis‐tochemistry using monoclonal antibodies. The four entities of high‐grade malignant B‐cell lymphoma described in this paper are: (1) centroblastic lymphoma with four morphological variants (monomorphic, polymorphic, multilobated and centrocytoid); (2) immunoblastic lymphoma with three morphological variants (with or without plasmacytic differentiation, with many lymphocytes); (3) Burkitt's lymphoma and the closely related Burkitt's lymphoma‐like lymphoma with plasmablastic differentiation; and (4) lymphoblastic lymphoma. Only the centroblastic lymphomas (in 17%) showed occasional follicular growth pattern, which further confirms the view that they are derived from germinal centre cells.
Elastosis in the male breast
Authors: RAJU G.C. , LEE Y‐S.
Published: April 2007

Elastosis, a common finding in infiltrating ductal and lobular carcinomas of the female breast, has also been described in a variety of other benign and malignant lesions. However, elastosis has not been previously documented in male breast lesions. Ten cases of gynaecomastia and five neoplastic lesions of the male breast were evaluated for elastosis. In gynaecomastia, elastosis is a feature of the ducts surrounded by collagenized fibrous tissue but not of ducts with loose connective tissue stroma. This association is also evident to some extent in neoplastic lesions. These findings suggest that elastosis is an expression of periductal fibrosis irrespective of the nature of the lesion.
Renal vascular disease in diabetes mellitus
Authors: MORLEY A. R.
Published: April 2007

Nephropathy remains a major cause of morbidity and mortality in diabetes mellitus and increasing numbers of patients require dialysis maintenance therapy. Diagnostic criteria of diabetic nephropathy are well established, but the relationship between the morphological changes of glomerular basement membrane thickening and increased mesangial volume and functional abnormalities, such as proteinuria and impaired renal function, are still not clearly understood. Tissue studies in patients with micro‐albuminuria, as well as increased knowledge of the structure of the glomerular basement membrane, should lead to an understanding of how the diabetic process affects blood vessels throughout the body.
Expression of intermediate filament proteins in adrenal cortex and related tumours
Authors: HENZEN‐LOGMANS S. C. , STEL H. V. , van MUIJEN G. N. P. , MULLINK H. , MEIJER C. J. L. M.
Published: April 2007

The intermediate filament profile of adrenal cortex and its related tumours has been evaluated. Most adrenocortical cells contained cytokeratin 8 and 18 as demonstrated by monoclonal antibodies CAM 5.2, M20, M9 and RGE53. Cytokeratin immunoreactivity was not confined to a functional zone of the adrenal cortex. Only a small number of the adrenocortical cells showed vimentin immunoreactivity. From normal adrenal cortex through adenomas, to carcinomas, there is a progressive decrease or even loss of cytokeratin immunoreactivity and an increase in vimentin immunoreactivity. Aberrant cytokeratin expression was not found in adrenocortical adenomas and carcinomas with the antibodies used. Awareness of the possible absence of cytokeratin immunoreactivity in adrenocortical carcinomas is important whenever antibodies to cytokeratins and vimentin are used for diagnostic purposes in poorly differentiated neoplasms.
A comparison of nucleolar organizer region staining and Ki‐67 immunostaining in non‐Hodgkin's lymphoma
Authors: HALL P. A. , CROCKER J. , WATTS A. , STANSFELD A. G.
Published: April 2007

Eighty cases of non‐Hodgkin's lymphomas were examined independently using the monoclonal antibody Ki‐67 and an argyrophilic method for the demonstration of nucleolar organizer regions. The evidence that Ki‐67 immunoreactivity may be used as a marker of cell proliferation is described and the nature of nucleolar organizer regions reviewed. The proportion of tumour cells with nuclear Ki‐67 immunoreactivity and the mean number of nuclear organizer regions are shown to be linearly related (r=0.86, P<0.001) although some scatter was observed. These data suggest that the mean number of nucleolar organizer regions may reflect the cellular kinetics of a tumour. This study also provides further evidence supporting the thesis that the mean nucleolar organizer region score is related to the histological grade of non‐Hodgkin's lymphoma. Ki‐67 immunostaining and nucleolar organizer region staining would seem to provide comparable data, at least in non‐Hodgkin's lymphoma, but the latter method has the advantage of being applicable to conventionally fixed and processed paraffin sections.
Immature teratomas in children
Authors: KOOIJMAN C. D.
Published: April 2007

In a retrospective study comprising 216 germ‐cell tumours occurring in children from birth to the age of 18 years, 27 immature teratomas were found at a variety of sites. Seventeen of these were curatively treated by means of one operation. Only two patients died as a direct result of tumour growth. Recurrences and metastases often proved to be treatable. In ovarian tumours grading was of considerable prognostic importance. The term malignant teratoma, which is sometimes used to describe these tumours, is confusing and should be avoided.
Cystic mucinous tumours of the mesentery and retroperitoneum: report of three cases
Authors: BANERJEE R. , GOUGH J.
Published: April 2007

A mucinous cystadenoma of the mesentery and two borderline mucinous cystadenocarcinomas of the mesentery and retroperitoneum are reported. The patients were females, aged 38, 47 and 58 years. The cysts showed identical features to those commonly seen in the appendix and ovary. One of our cases, with ‘borderline’ histology, developed metastases to mediastinal lymph nodes, 4 years after diagnosis. We suggest that these tumours develop through mucinous metaplasia in pre‐existing mesothelium‐lined cysts, the latter being the commonest cysts in this location.
Congenital absence of insulin‐secreting cells
Authors: WONG K. C. , TSE K. , CHAN J. K. C.
Published: April 2007

A male infant was diagnosed as having diabetes mellitus 1d after birth and died on the third day. Histological examination of the pancreas showed small and inconspicuous islets of Langerhans that were completely devoid of insulin‐secreting cells. There was no evidence of insulitis.
Architectural morphometry in ulcerative colitis with dysplasia
Authors: ALLEN D. C. , HAMILTON P. W. , WATT P. C. H. , BIGGART J. D.
Published: April 2007

Semi‐automatic image analysis was used to assess the architectural features of normal colorectal mucosa and ulcerative colitis with and without dysplasia. Eight measured and derived morphometric variables were compared with the histological grading. The main data‐set variation was due to: (1) the area of mucosa and epithelium per unit length of muscularis mucosae; (2) mean mucosal and epithelial height; and (3) the percentage epithelium and number of crypts per unit length of muscularis mucosae. Discriminant analysis using the variables mean epithelial height and mean lamina propria area per unit length of muscularis mucosae separated normals (n=10) from high‐grade dysplasia (8). The classification rule allocated low‐grade dysplasia (8) to the high‐grade category and 60% of regeneration cases (10) to the normal mucosa group. Scatter plots of the two discriminating variables separated normal and regenerative mucosa from dysplasia. Histological review of overlapping cases allowed redesignation of a high‐grade dysplasia lesion as low grade. Architectural morphometry may be of use in assessing premalignant mucosal changes in ulcerative colitis as a guide to patient surveillance and therapy.
Paget's disease, melanocytic neoplasia and hidradenoma papilliferum of the vulva
Authors: SIMPSON W. A. , BURKE M. , FRAPPELL J. , COOK M. G.
Published: April 2007

We present a case of invasive melanoma of the vulva with contiguous changes including melanocytic atypia showing, in part, the features of melanocytic dysplasia and, in part, an in situ malignant component and extramammary Paget's disease. A benign hidradenoma papilliferum was also present. We can find no other reported cases of this combination of lesions. The possible histogenesis is discussed and an origin from a common local stem cell is suggested.
Thyroglobulin immunostaining in follicular thyroid carcinoma: relationship to the degree of differentiation and cell type
Authors: HARACH H. R. , FRANSSILA K. O.
Published: April 2007

A series of 47 primary and seven metastatic thyroid follicular carcinomas, including well, moderately and poorly differentiated, were tested for thyroglobulin (Tg) using immunohistology. In addition, three combined follicular undifferentiated carcinomas, 17 undifferentiated carcinomas and five renal cell carcinomas metastatic to the thyroid were examined. Only two follicular carcinomas did not stain for thyroglobulin. Some inter‐tumour differences in Tg staining were found but there was no absolute correlation between this and the degree of tumour differentiation. The two tumours that failed to stain for Tg were poorly differentiated; thyroglobulin positive poorly differentiated tumours demonstrated a clearly weaker staining pattern for Tg. All but one of 15 oxyphilic follicular carcinomas stained positively for Tg but the staining intensity was often weak. Five of six clear cell follicular carcinomas were positive for Tg but the staining reaction was generally faint and there were often large areas devoid of positive cells. Positive staining was demonstrated in the differentiated areas of combined follicular undifferentiated carcinomas. Undifferentiated carcinomas and metastatic renal cell carcinomas gave negative results. Thyroglobulin is a reliable marker for thyroid follicular carcinoma but the patchy staining pattern, particularly in the less well‐differentiated tumours, may produce less reliable results in small biopsies.
Distinctive epidermal atypia in immunosuppression‐associated cutaneous malignancy
Authors: PRICE M. L. , TIDMAN M. J. , FAGG N. L. K. , PALMER T. J. , MACDONALD D. M.
Published: April 2007

The histopathological appearance of proliferative squamous lesions removed from the skin of iatrogenically immunosuppressed patients differs subtly from that of classical malignant and premalignant epidermal lesions. The majority of cases show ‘Bowenoid’ changes with a marked degree of cellular atypia including characteristic multinucleate cells.
Giant pigmented tumour of the scalp—a diffuse neurofibroma or a congenital naevus showing neurofibromatous changes? Immunohistochemical and electron microscopic studies
Authors: ITO H. , AKAGI O. , NOMURA N. , TAHARA E.
Published: April 2007

A case of giant pigmented tumour of the scalp which developed in a 47–year‐old woman is reported. Macroscopically, the tumour showed a peculiar two‐layered structure, consisting of an upper non‐pigmented and a lower pigmented portion. Histologically, it was composed of elongated neurofibromatous tumour cells with abundant collagen fibres in the non‐pigmented portion and round naevus‐like cells with abundant melanin pigment in the pigmented portion. S‐100 protein and neurone‐specific enolase were demonstrated in most of the tumour cells, but neurofilament and myelin basic protein were not detected. Electron microscopy revealed melanosomes in the tumour cells of the pigmented portion. These findings might support a melanocytic origin for the tumour, but the lack of superficial pigmentation and the associated hair loss were against this. The tumour may represent an example of duality of neural crest differentiation.
Benign axillary epithelial lymph node inclusions—a histological pitfal
Authors: HOLDSWORTH P. J. , HOPKINSON J. M. , LEVESON S. H.
Published: April 2007

We present two cases of axillary epithelial lymph node inclusions in the presence of benign and malignant breast disease. Although the presence of lymph node inclusions is well recognized at other sites in the body, their presence in the axillary nodes of women with breast disease necessitates close attention. This is particularly true in women with malignant breast disease as misinterpretation may lead to inappropriate treatment.
The immunohistological detection of platelets, megakaryocytes and thrombi in routinely processed specimens
Authors: GATTER K. C. , CORDELL J. L. , TURLEY H. , HERYET A. , KIEFFER N. , ANSTEE D. J. , MASON D. Y.
Published: April 2007

The production and characterization of a new monoclonal antibody, Y2/51, against platelet glycoprotein IIIa is described. A useful feature of this antibody is its ability to recognize platelets and megakaryocytes in formalin‐fixed routinely processed material. It could also be used to reveal platelets both in thrombi in large vessels and in microthrombi too small to be readily apparent on conventional microscopic examination. For this purpose it was helpful to use the antibody in conjunction with a new monoclonal reagent (Ret40f) against red cell sialoglycoprotein β‐which detects red cells and their precursors in routinely processed tissue. The use of these antibodies should be valuable for the detection of thrombi in a variety of situations such as renal transplant rejection, coronary artery disease and vasculitis.
Fate of long‐term parathyroid autografts in patients with chronic renal failure treated by parathyroidectomy: a histopathological study of autografts, parathyroid glands and bone
Authors: ELLIS H. A.
Published: April 2007

The aims of the study were to (1) determine the histopathology of parathyroid autografts in patients with renal failure treated by parathyroidectomy, (2) relate this to any evidence of hyperfunction, such as histological osteitis fibrosa and (3) determine whether there were any features in the donor parathyroid glands which correlated with autograft behaviour. Fourteen patients were studied; 106 implanted parathyroid fragments were identified in nine at necropsy and in the remaining five patients multiple fragments were obtained at the time of autograft surgical reduction. Of the patients studied at necropsy, in two the autografts were small and hypofunctional and in one of these the implants appeared partially involuted. In neither was there osteitis fibrosa. In the others there were varying degrees of hyperplasia and osteitis fibrosa. Four of the surgically excised autografts were markedly hyperplastic but there was no unequivocal evidence of malignancy. In one case, requiring repeated reduction of rapidly growing autograft tissue, there were frequent mitoses in the donor parathyroid gland and in the autograft. The presence of atypical cellular features and frequent mitoses in intra‐operative frozen sections of a parathyroid gland militate against its use for implantation.
An immunohistological study of 66 ependymomas
Authors: CRUZ‐SANCHEZ F. F. , ROSSI M. L. , HUGHES J. T. , CERVOS‐NAVARRO J.
Published: April 2007

Sixty‐six ependymomas were examined immunohistologically to determine their distribution of glial fibrillary acidic proteins, S‐100 protein and vimentin. The neoplasms were subdivided into four groups: (1) ependymomas from the cauda equina, predominantly of the myxopapillary type; (2) benign ependymomas; (3) malignant ependymomas; and (4) ependymoblastomas. Marked differences in antigen reactivity were observed between each group. The intensity of the reaction with the three antibodies was strongest in malignant ependymomas. Ependymomas from the cauda equina showed a patchy distribution of positivity for the three antigens in cells surrounding blood vessels but there was no staining of collagenous septa or the myxoid areas. In ependymoblastomas, the cells of the rosettes were negative for glial fibrillary acidic protein, but there was focal positivity for vimentin and S‐100. Other areas showed tumour cells containing moderate amounts of vimentin and small amounts of S‐100, and a few bands of filaments positive for glial fibrillary acidic protein. The cytogenetic and biological implications of these findings are discussed.