bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fibroid polyps of intestinal tract are inflammatory‐reactive proliferations of CD34‐positive perivascular cells
Authors: Wille P. , Borchard F. 
Published: December 2004

AimsOur aim was to determine the histogenesis of fibroid polyps (FP). These polyps are rare inflammatory‐reactive, tumour‐like lesions of unknown aetiology, arising in the submucosa or mucosa of the gastrointestinal tract. They are mainly due to a proliferation of characteristic spindle cells.Methods and resultsNine FP were investigated by light microscopy and immunohistochemistry with endothelial markers (Factor VIII, CD34, CD31), a neuronal marker (S100), muscular markers (desmin, alpha‐smooth muscle actin) and histiocytic markers (PGMI, KP1, MAC387) using the highly sensitive avidin–biotin–peroxidase technique. We demonstrate, for the first time, a consistent positivity of the characteristic spindle cells of FP for CD34. The proposed endothelial, histiocytic or neuronal origin of FP could be completely ruled out.ConclusionsBecause of the consistent positivity of the spindle cells of FP for CD34 we suggest an origin of these lesions from primitive perivascular or vascular cells. This origin and a probable relationship to gastrointestinal stromal tumours (GIST) is discussed.
Ki67 antigen and PCNA proliferation markers predict survival in anorectal malignant melanoma
Authors: Ben‐Izhak O , Bar‐Chana M , Sussman L , Dobiner V , Sandbank J , Cagnano M , Cohen H , Sabo E 
Published: December 2004

Aims:  To find a possible correlation of Ki67 antigen and proliferating cell nuclear antigen (PCNA) with prognosis in anorectal malignant melanoma.Methods and results:  Thirty patients with anorectal malignant melanoma were studied. The percentage of tumour cells stained for Ki67 and PCNA in paraffin sections was assessed. Mode of treatment (local excision or abdominoperineal resection), depth of tumour invasion, attempt at cure as defined by complete tumour excision and absence of distant metastases at presentation, tumour blood vessel invasion, and tumour necrosis, as well as Ki67 and PCNA, were all correlated with survival. By univariate analysis, PCNA, Ki67, attempt at cure, local excision (and not abdominoperineal resection), and depth of invasion were all significantly associated with longer survival. By multivariate analysis, only PCNA was significantly associated with survival, while Ki67 showed a significant positive correlation with PCNA. With a cut‐off point of 40%, patients with lower Ki67 scores showed survival advantage over those with higher Ki67 scores (P=0.0004). With a cut‐off point of 80%, patients with lower PCNA scores showed survival advantage over those with higher PCNA scores (P=0.0001). The staining for proliferation markers was also associated with depth of tumour invasion.Conclusions:  Ki67 and PCNA immunostaining in paraffin sections may be useful for the prediction of survival in patients with anorectal malignant melanoma. Larger studies are needed to confirm our results.
Specificity of tyrosinase and HMB45 PCR in the detection of melanoma metastases in sentinel lymph node biopsies
Authors: Gutzmer R , Kaspari M , Brodersen J P , Mommert S , Völker B , Kapp A , Werfel T , Kiehl P 
Published: December 2004

Aims:  Sentinel lymph node biopsy is an increasingly established procedure in the primary staging of high‐risk melanoma patients. However, the laboratory evaluation of sentinel lymph node biopsies is a matter of controversy. The aim of this study was to determine the specificity of polymerase chain reaction (PCR) techniques for the evaluation of lymph nodes with regard to melanoma metastases in comparison with histology and immunohistology.Methods and results:  Sentinel lymph nodes (n = 41) from 29 melanoma patients and 29 lymph nodes from 27 patients without melanoma were analysed by histology (H&E) and immunohistology (Melan A, HMB45). cDNA of these lymph nodes was subjected to LightCycler PCR amplification using primers specific for tyrosinase and HMB45. Two melanoma sentinel lymph nodes contained naevus cells by histology and immunohistology and were therefore excluded from further evaluation. Eight (20.5%) of the remaining 39 melanoma sentinel lymph nodes were positive by histology and immunohistology and tyrosinase PCR, 15.4% (6/39) were positive only by tyrosinase PCR, 2.6% (1/39) were positive only by histology and immunohistology. HMB45 PCR revealed positive results in 7.7% (3/39) sentinel lymph nodes, which were also positive by tyrosinase PCR and histology and immunohistology. Of non‐melanoma lymph nodes 13.8% (4/29) and 14.8% (4/27) of non‐melanoma patients were positive by tyrosinase PCR but negative by histology and immunohistology and HMB45 PCR. Thus, tyrosinase PCR had a specificity of only 85.2%.Conclusions:  The specificity of tyrosinase PCR and the sensitivity of HMB45 PCR are too low to recommend these PCR examinations for the guidance of therapy, in particular complete regional lymph node dissection.
British Division of the International Academy of Pathology
Authors: Van Den Tweel J , Howat A J , Shepherd N A , Francis N , Harris C 
Published: December 2004

Forthcoming meetings 1–4 July 2003 2nd Joint Meeting with the Pathological Society of GB & Ireland. Bristol, UK28‐‐29 November 2003 Symposium on Lymphoreticular Disease. London, UKSpring 2004 Symposium on Dermatopathology. Brussels, Belgium10‐‐15 October 2004 XXVth International Congress. Brisbane, Australia26‐‐27 November 2004 Symposium on Pulmonary Pathology. London, UK
Endometrioid adenocarcinoma of the uterus with a minimal deviation invasive pattern
Authors: Landry D , Mai K T , Senterman M K , Perkins D G , Yazdi H M , Veinot J P , Thomas J 
Published: December 2004

Aims:  Minimal deviation adenocarcinoma of endometrioid type is a rare pathological entity. We describe a variant of typical endometrioid adenocarcinoma associated with minimal deviation adenocarcinoma of endometrioid type.Methods and results:  One ‘pilot’ case of minimal deviation adenocarcinoma of endometrioid type associated with typical endometrioid adenocarcinoma was encountered at our institution in 2001. A second case of same type was received in consultation. We reviewed 168 consecutive hysterectomy specimens diagnosed with ‘endometrioid adenocarcinoma’ specifically to identify areas of minimal deviation adenocarcinoma of endometrioid type. Immunohistochemistry was done with the following antibodies: MIB1, p53, oestrogen receptor (ER), progesterone receptor (PR), cytokeratin 7 (CK7), cytokeratin 20 (CK20), carcinoembryonic antigen (CEA), and vimentin (VIM). Four additional cases of minimal deviation adenocarcinoma of endometrioid type were identified. All six cases of minimal deviation adenocarcinoma of endometrioid type were associated with superficial endometrioid adenocarcinoma. In two cases with a large amount of minimal deviation adenocarcinoma of endometrioid type, the cervix was involved. The immunoprofile of two representative cases was ER+, PR+, CK7+, CK20–, CEA–, VIM+. MIB1 immunostaining of four cases revealed little proliferative activity of the minimal deviation adenocarcinoma of endometrioid type glandular cells (0–1%) compared with the associated ‘typical’ endometrioid adenocarcinoma (20–30%). The same four cases showed no p53 immunostaining in minimal deviation adenocarcinoma of endometrioid type compared with a range of positive staining in the associated endometrioid adenocarcinoma.Conclusions:  Minimal deviation adenocarcinoma of endometrioid type more often develops as a result of differentiation from typical endometrioid adenocarcinoma than de novo. Due to its deceptively benign microscopic appearance, minimal deviation adenocarcinoma of endometrioid type may be overlooked and may lead to incorrect assessment of tumour depth and pathological stage. There was a tendency for tumour with a large amount of minimal deviation adenocarcinoma of endometrioid type to invade the cervix.
Paget's disease of the oesophagus associated with mucous gland carcinoma of the lower oesophagus
Authors: Haleem A , Kfoury H , Al Juboury M , Al Husseini H 
Published: December 2004

Aim:  To report a rare case of oesophageal Paget's disease and its rarer combination with submucosal gland carcinoma of the lower oesophagus.Methods and results:  A 74‐year‐old Saudi female was admitted with the complaint of dysphagia. Endoscopic examination showed an ulcerated tumour at the gastro–oesophageal junction. Initial biopsy showed an undifferentiated carcinoma with pagetoid spread in the oesophageal stratified squamous epithelium. Oesophago‐gastrectomy specimen showed a lobulated, poorly differentiated mucous gland carcinoma at the gastro–oesophageal junction. The tumour showed focal acinar differentiation and obvious cancerization of the submucosal glands, somewhat similar to the breast lobular carcinoma in situ. One of the isolated and cancerized submucosal glands also showed carcinoma in situ of its duct. Oesophageal surface epithelium showed extensive pagetoid spread, both over and away from the main tumour. The pagetoid tumour cells showed selective positivity for cytokeratin 7, cytokeratin Cam 5.2, BerEP4 and to a lesser extent for CEA.Conclusions:  As far as we know, this is the fifth case report of oesophageal Paget's disease and the first report of its association with the underlying mucous gland carcinoma.
Philadelphia chromosome and/or bcr‐abl mRNA‐positive primary thrombocytosis: morphometric evidence for the transition from essential thrombocythaemia to chronic myeloid leukaemia type of myeloproliferation
Authors: Pajor L , Kereskai L , Zsdrál K , Nagy Z , Vass J A , Jáksó P , Radványi G 
Published: December 2004

Aims:  The incidence, bone marrow morphology and genetic features of bcr+ essential thrombocythaemia were investigated.Methods and results:  Sixty‐four consecutive patients meeting the criteria of essential thrombocythaemia have been investigated for bcr‐abl rearrangement and chimera mRNA expression. Reverse transcriptase‐polymerase chain reaction indicated bcr‐abl expression in six patients, in two of whom large fraction of the blood and bone marrow cells proved to be positive for Philadelphia chromosome (Ph) by fluorescent in‐situ hybridization (FISH) and conventional cytogenetic analysis. In the remaining four patients FISH analysis could not detect Ph+ cells among the blood cells, but in one of these four patients conventional cytogenetic analysis indicated a very small fraction (2%) of Ph+ mitoses in the bone marrow (bcr+ essential thrombocythaemia patients). In three of these four patients, X‐chromosome‐linked clonality assay showed that the disease is of uncommitted stem cell origin. During an average of 57 month long follow‐up no transformation to chronic myeloid leukaemia type of disease or acceleration/blastic crisis could be observed in the four bcr+ essential thrombocythaemia patients. They did not differ significantly from typical essential thrombocythaemia patients in quantitative indices of bone marrow cellularity or the size of megakaryocytes. In these two parameters as well as in the total nucleolus organizer region area per nucleus, however, significant differences could be detected between these four as well as typical chronic myeloid leukaemia patients. Statistical analysis of the morphometric data obtained from all six Ph+ and bcr+ essential thrombocythaemia patients combined indicated a shift of the bone marrow morphology towards the chronic myeloid leukaemia type of myeloproliferation.Conclusions:  These investigations indicate that bcr+ essential thrombocythaemia is infrequent among essential thrombocythaemia patients, and this condition resembles essential thrombocythaemia more than chronic myeloid leukaemia. Various expansions of the Ph+ clone appear to lead to either essential thrombocythaemia or, rather, chronic myeloid leukaemia type of myeloproliferation; however, data in the present study do not indicate that bcr+ essential thrombocythaemia would be a form fruste variant of chronic myeloid leukaemia.
Cyclin E immunoexpression in gastric cancer does not correlate with clinicopathological parameters
Authors: Chetty R , Sitti C W 
Published: December 2004

Aims:  To ascertain whether cyclin E immunoexpression relates to clinicopathological characteristics of gastric cancer and is of possible routine use.Methods and results:  One hundred and twenty‐four gastrectomy specimens were assessed for age, gender, histological subtype, lymph node status and Helicobacter pylori infection. Immunohistochemistry using a commercially available antibody to cyclin E was then applied to the cases. The immunohistochemical staining was correlated with clinicopathological features. Fifty‐three of 124 cases were cyclin E‐positive, with 28 of these cases showing >50% of the tumour cells staining. However, no statistical significance was obtained between cyclin E immunostaining and any clinicopathological parameter, especially lymph node spread.Conclusions:  We have not demonstrated any significant relationship between cyclin E immunopositivity and any of the usual clinicopathological parameters (especially lymph node involvement) and therefore cyclin E immunohistochemistry alone does not appear to have a role in the assessment of gastric cancer currently.
H‐caldesmon expression in myofibroblastoma of the breast: evidence supporting the distinction from leiomyoma
Authors: Magro G , Gurrera A , Bisceglia M 
Published: December 2004

Aims:  The ultrastructural detection of leiomyomatous rather than myofibroblastic features in some cases of myofibroblastoma of the breast led some electron microscopically orientated pathologists to doubt the commonly accepted myofibroblastic nature of such a tumour, so the alternative terms ‘myogenic stromal tumour’ or ‘variant of leiomyoma’ have been proposed. The aim of this study was to analyse the immunohistochemical expression of h‐caldesmon, a reliable marker in distinguishing smooth muscle versus myofibroblastic cellular differentiation, in a large series of myofibroblastomas of the breast to clarify whether these tumours are basically leiomyomatous. Moreover, cases from primary myofibroblastic lesions of the breast, such as fibromatosis and inflammatory myofibroblastic tumour, were analysed to assess whether h‐caldesmon expression parallels that observed in their soft tissue counterparts.Methods and results:  Paraffin‐embedded sections from 12 cases of myofibroblastoma, seven cases of fibromatosis, and one case of inflammatory myofibroblastic tumour were evaluated immunocytochemically for the expression of h‐caldesmon. As expected, all myofibroblastic lesions failed to express h‐caldesmon. Conversely, focal staining, ranging from 2% to 10% of neoplastic cells, was detected in myofibroblastomas, even though it was restricted to 50% of analysed cases.Conclusions:  Our results, indicating that smooth muscle differentiation occurs in a minority of the myofibroblastoma cells exclusively in half of the analysed cases, support the separation of myofibroblastoma from leiomyoma. The detection of smooth muscle cells in breast myofibroblastoma is easily explained if we postulate its histogenesis from the CD34+ fibroblasts of mammary stroma capable of multidirectional mesenchymal differentiation, including smooth muscle. We recommend retention of the term myofibroblastoma for all the desmin‐positive and/or α‐smooth muscle actin‐positive spindle cell tumours of the breast consistent with the previously well‐established morphological criteria for such neoplasms, unless one is dealing with a typical leiomyoma easily recognizable at light microscopy.
Fibrinogen storage disease without hypofibrinogenaemia associated with acute infection
Authors: Marucci G , Morandi L , Macchia S , Betts C M , Tardio M L , Dal Monte P R , Pession A , Foschini M P 
Published: December 2004

Aims:  The presence of ground glass hepatocytes in a liver biopsy may be related to different conditions, including fibrinogen storage disease. Three types of fibrinogen storage disease have been described, namely types I, II and III. Type I is an hereditary hypofibrinogenaemia genetically characterized by a mutant variant of the fibrinogen molecule designated as fibrinogen Brescia, consistent with a γ284 Gly→Arg mutation. Only rare cases of types II and III fibrinogen storage disease have been described. The purpose of the present paper is to describe two cases of fibrinogen storage disease without associated hypofibrinogenaemia, which appeared during acute infectious diseases.Methods and results:  Both patients were female, aged 77 and 73 years, who developed high transaminases during an infectious disease. In each case blood coagulation tests were within the normal range, and despite clinical and laboratory investigations no possible cause for liver disease could be found. Liver biopsies were performed; in both cases weakly eosinophilic cytoplasmic inclusions were observed. Using immunohistochemistry the inclusions were found to be due to fibrinogen accumulation. At ultrastructural level features corresponding to type II inclusions were observed. Molecular studies, performed in case 2, excluded the mutation typical of type I fibrinogen storage disease. Both patients also presented features of chronic hepatitis. In case 1, giant cell granulomas were additionally present. No close relatives of the patients presented any clinical or laboratory features of liver disease. In both patients altered liver function test values gradually, spontaneously, returned to within normal ranges after infectious disease was resolved.Conclusions:  These cases suggest that, on rare occasions, hepatocytes may accumulate fibrinogen during an infectious disease.
Biopsy of a biopsy: validation of immunoprofiling in gastric cancer biopsy tissue microarrays
Authors: Gulmann C , Butler D , Kay E , Grace A , Leader M 
Published: December 2004

Aims:  Tissue microarrays offer an efficient way of examining a large number of tumour cases on a single glass slide. A major concern, however, is tumour heterogeneity. Also, the use of tissue microarrays in biopsy material is unexplored. The purpose of the present study was to assess the possibility and validity of arraying three 0.6‐mm cores per case in endoscopic gastric cancer biopsies for immunophenotyping.Methods and results:  Thirty‐eight cases were studied with immunohistochemical staining for p53, CD44v6 and vascular endothelial growth factor. Full tissue sections were compared with triple core‐tissue microarrays. Thirty‐six cases contained three cores with tumour, one case contained two cores with tumour and one case contained only a single core with viable tumour and was excluded. Three further cores had been lost from three separate cases on the sections for immunohistochemistry. κ values for whole‐sections versus tissue microarrays ranged between 0.77 and 0.94. p53 immunohistochemical staining (interpretation as + or –) yielded the best result with only 1/37 mismatches, whereas CD44v6 (graded both for intensity and extent) showed 3/37 mismatches. The small depth of tissue in cores from biopsies necessitates all cores being arrayed flush with the face of the recipient wax block for maximizing the number of sections available. Compared with the first section over 30 additional 4‐µm sections were available before the first case (with one core left) had to be excluded and 80 sections before half the tissue cores were lost.Conclusions:  It is impracticable to array more than 120–150 cores per block. Tissue microarray with three cores per case is feasible and valid for studying biopsy material.
Association of histochemical expression of Maackia amurensis leukoagglutinin‐positive glycoconjugates with behaviour of human gastric cancer
Authors: Tang W , Mafune K , Nakata M , Konishi T , Kojima N , Mizuochi T , Makuuchi M 
Published: December 2004

Aims:  To investigate the relationship between sialylation of glycoconjugates and clinicopathological characteristics of gastric cancer.Methods and results:  Sialylation of glycoconjugates was examined histochemically in 71 gastric cancers using Maackia amurensis leukoagglutinin (MAL), a lectin that recognizes the trisaccharide sequence NeuAcα2,3Galβ1,4GlcNAc/Glc. Positive staining with MAL was observed in the tumour region of all of the samples, but the populations of MAL‐positive tumour cells in the tumour region varied among the samples. In the corresponding non‐cancerous regions, however, no positive staining was observed. Calculating the percentage of MAL‐positive tumour cells as part of the total tumour cells with respect to the MAL‐staining index (MI) allowed the gastric cancer to be classified into two distinct groups: high and low levels of MI, with a cut‐off level of 40% of MI. Furthermore, statistical analyses using the MI level and clinicopathological characteristics of the tumour indicated that a high MI level in gastric tumour tissues is related to a poorer prognosis.Conclusions:  The appearance of MAL‐positive glycoconjugates in gastric tumour cells is associated with the behaviour of gastric cancer.
How accurate are subjective judgements of a continuum?
Authors: Deolekar M , Morris J A 
Published: December 2004

Aims:  To assess the accuracy of subjective judgements of a uni‐dimensional continuum.Methods and results:  Twenty‐four observers were asked to estimate the position of a dot placed between two lines using a 100‐point scale. Each observer judged 20 different positions. Ninety‐five percent of observations were between −7 and +9 of the true value. The median and the mean value of the estimates for each position were within one or two points of the true value in most cases with a maximum deviation of five. There was perfect correlation between the ranks of the median and the mean and the true value (correlation coefficient +1, P < 0.00001). The κ values for interobserver agreement varied from 0.98 for two categories to 0.55 for 10 categories and 0.39 for 20 categories. Information transmitted increased from 0.98 bits with two categories to 2.83 bits with 20 categories.Conclusions:  The experiment indicates that subjective judgements can be accurate but it is necessary to use a large number of categories. One hundred‐point scales allow confidence intervals to be calculated and the intervals are reduced if the results from several observers are pooled. The mean and the median of the judgements of a large number of observers are close to objective reality and this approach could be used to define a gold standard of rankings of pathological continua such as cervical dyskaryosis or tumour differentiation. There is a reciprocal relationship between κ values and information transmitted which demonstrates the fallacy of using κ statistics in studies of continua.
Association of maspin expression with the high histological grade and lymphocyte‐rich stroma in early‐stage breast cancer
Authors: Kim D H , Yoon D S , Dooley W C , Nam E S , Ryu J W , Jung K C , Park H R , Sohn J H , Shin H S , Park Y E 
Published: December 2004

Aims:  Maspin is a recently described member of the serpin family or protease inhibitors that is known to be a tumour suppressor gene product. Loss of maspin expression has been found in most breast cancer cases and is correlated with cell motility and tumour invasiveness. However, its precise role in human breast cancer remains to be discovered. We aimed to evaluate the role of maspin in early‐stage breast cancer.Methods and results:  We analysed the expression of maspin in 192 stage I and II primary breast cancers by immunohistochemistry. Of these cases, 34.4% showed maspin expression. Maspin expression was more frequently found in invasive ductal carcinoma (36.4%) than in invasive lobular carcinoma (7.1%). High maspin expression was demonstrated in breast cancers showing high histological grade or lymphocyte‐rich stroma (P < 0.05). Maspin expression was not associated with overall and disease‐free survival rate of breast cancer.Conclusions:  The results indicate that different biological mechanisms may be responsible for maspin expression in histologically distinct types of breast cancer. Our survey suggests that maspin expression in breast cancer might have a compensatory role rather than prognostic one.