bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary neoplasms of the male genital tract with different patterns of involvement in adults and children
Authors: Dutt N , Bates A W , Baithun S I 
Published: March 2003

AimsThe incidence, presentation and macroscopic and histological features of secondary neoplasms of the male genital tract are described with reference to their differential diagnosis.Methods and resultsA retrospective study of cases from the Royal London Hospital yielded a total of 31 secondary neoplasms involving the testis: 14 at postmortem examination and 17 surgical specimens. Nine cases were leukaemias: six acute lymphoblastic and two acute myeloid leukaemias in children, and one chronic lymphocytic leukaemia in an adult. The commonest primary sites of metastases to the testis were prostate (six cases), stomach (five cases) and lung (three cases). There were two malignant melanomas and isolated examples of metastases from the adrenal gland (neuroblastoma), cerebellum (medulloblastoma), soft tissue (alveolar rhabdomyosarcoma), pancreas and rectum. Of the metastases from solid tumours, 12 involved the right testis only, three involved the left and four were bilateral. In seven of these cases there were multiple testicular nodules, in seven there was a single mass, and in the rest there was diffuse involvement. Secondary neoplasms represented 4.6% of all testicular neoplasms at autopsy, and 1.6% in surgical specimens. There were five secondary penile neoplasms: two each from the pancreas and prostate and one from the bladder. Two neoplasms metastatic to the spermatic cord, both from a gastric primary, were included in the series.ConclusionsSecondary neoplasms of the testis occur with a frequency comparable to other sites in the genitourinary tract, and metastases to the spermatic cord, epididymis, and penis, are rare in comparison. Disseminated neoplasms rarely present initially at this site and are histologically distinctive in adults, but in children they must be distinguished from primary small round blue cell tumours.
High sensitivity and specificity of immunohistochemistry for the detection of hormone receptors in breast carcinoma: comparison with biochemical determination in a prospective study of 793 cases
Authors: Zafrani B , Aubriot M‐H , Mouret E , De Crémoux P , De Rycke Y , Nicolas A , Boudou E , Vincent‐Salomon A , Magdelénat H , Sastre‐Garau X 
Published: March 2003

The hormone receptor (HR) status of breast cancer is an important prognostic factor and predictive parameter of the response to hormone therapy. Enzyme immunoassay (EIA) is currently the standard for determination of HR, but immunohistochemistry (IHC) represents a potentially useful alternative. We used IHC to determine HR status in a large prospective study and compared the results to those obtained by EIA. This study was designed to determine which technique should be used in daily practice in our institution which manages a large number of patients.Oestrogen (ER) and progesterone (PgR) receptor status was evaluated in a prospective series of 793 infiltrating breast cancers by IHC in paraffin‐embedded tissue sections, using antibodies 6F11 and 1A6, with a rigorous quality control of the methodology. ER were found to be significantly expressed in 81% of cases after IHC analysis and in 78% of cases by EIA. For PgR, the respective rates of positivity were 65% and 69%. The tumour HR level detected by either technique was significantly correlated with the value of tumour size, histological grade and S‐phase fraction. A significant link was observed between the percentage of labelled cells after IHC analysis and the amount of protein detected by EIA. Critical analysis of discordance found that, in the group of invasive lobular carcinomas, the rate of HR positivity was higher with IHC (84%) than with EIA (45%) and that, in the overall population, IHC was more specific than EIA, since cases with nonrelevant positivity related to intraductal normal or neoplastic cells expressing HR could be discarded. The cost of IHC analysis was found to be about one‐third of that of EIA.IHC is more sensitive, specific and economical than EIA. It should constitute the new standard technique provided that good quality assurance procedures are respected.
Caspase‐3/CPP32 immunoreactivity and its correlation with frequency of apoptotic bodies in human prostatic carcinomas and benign nodular hyperplasias
Authors: Sohn J H , Kim D H , Choi N G , Park Y E , Ro J Y 
Published: March 2003

Apoptosis is mediated by apoptosis‐specific genes, certain oncogenes and tumour suppressor genes. Caspase‐3, a group of cystein proteases, is involved in the induction of apoptosis and has been considered to correlate with apoptosis. The aim of this study was to determine whether caspase‐3 is expressed in prostatic carcinoma and benign prostatic hyperplasia, and correlated with the apoptosis.We studied the apoptotic index and caspase‐3 immunoreactivity in 40 cases of benign nodular hyperplasia (BPH) and 40 cases of prostate carcinoma (PCA) by in‐situ labelling and immunohistochemistry. The mean number of apoptotic bodies in cases with BPH was not significantly different from cases with PCA I (Gleason score 2–4), but samples from patients with PCA II (Gleason score 5–7) and PCA III (Gleason score 8–10) showed a significantly higher apoptotic number than cases with BPH. Positive staining for caspase‐3 was seen in 42.5% (17/40) of the BPH, and 27.5% (11/40) of the PCA: PCA I was 41.7% (5/12), PCA II 14.3% (2/14) and PCA III was 28.6% (4/14).Based on our results, the number of apoptotic bodies was not correlated with the caspase‐3 expression and there was no relationship between caspase‐3 expression and Gleason score. However, the number of apoptotic bodies was significantly higher in cases with intermediate (Gleason score 5–7) and high‐grade (Gleason score 8–10) PCAs than cases with BPH and low‐grade PCAs (Gleason score 2–4).
S100 expression in cutaneous scars: a potential diagnostic pitfall in the diagnosis of desmoplastic melanoma
Authors: Robson A , Allen P , Hollowood K 
Published: March 2003

Aims:The histological distinction of desmoplastic melanoma from cutaneous scar tissue, particularly in the context of re‐excision specimens or possible recurrence, may be very difficult. Immunostaining for S100 protein is often used to discriminate although there are little data on S100 expression in scar tissue. The aim of this study was to assess whether S100‐positive cells are present in dermal scars and, if so, their extent, distribution and nature.Methods and results:Twenty‐two re‐excision specimens of previously biopsied nonmelanocytic skin lesions were reviewed. Formalin‐fixed paraffin‐embedded sections containing dermal scars were stained by a standard ABC immunoperoxidase technique for S100 protein, CD1a and neurofilaments. The distribution and morphology of positive cells within the dermal scar tissue were documented. Cells expressing S100 protein were identified within the scars of 21 of the 22 cases. The number of S100‐positive cells varied between cases but in four specimens was substantial. They displayed a variety of morphological appearances but the majority were spindle‐shaped. A few showed mild cytological atypia. It is suggested that the majority represent Schwann cells with a minority of Langerhans cells and cells of uncertain lineage.Conclusion:S100‐positive cells, including spindle cells showing mild atypia, are found in cutaneous scars. S100 staining of re‐excision specimens or putative recurrences of desmoplastic melanoma should be interpreted with caution.
Different roles of arteriosclerosis in the rupture of intracranial dissecting aneurysms
Authors: Sakata N , Takebayashi S , Kojima M , Masawa N , Suzuki K , Takatama M , Kusumi Y , Mitsumata M 
Published: March 2003

Aims: Although intracranial dissecting aneurysm (IDA) is a newly described variant of the brain aneurysms that affects mainly the vertebrobasilar arterial system, its pathogenesis remains obscure. We aimed to clarify the role of arteriosclerosis in the pathogenesis of IDA based on histopathological findings in seven autopsy cases of IDA.Methods and results: All cases exhibited systemic hypertension or left ventricular hypertrophy. Macroscopically, all cases exhibited subarachnoid haemorrhage. Two types of dissection were recognized in the vertebral artery. Six of seven IDA cases showed a widespread disruption of the entire thickness of the arterial wall with the formation of a dilated pseudoaneurysm, which consisted of thin adventitia (arterial wall disruption type). Medial disruption of the arterial wall and subadventitial dissecting haemorrhage were also found, resulting in the formation of a false lumen and stenosis of the ‘true’ lumen of the artery. However, these lesions were connected to the site of rupture of the entire arterial wall. Within 1 day after onset of IDA, the autopsy cases showed formation of fibrin thrombus, marked leucocyte infiltration and necrosis of the arterial wall at the site of the lesion. Cases that survived more than 1 week showed smooth muscle cell proliferation, macrophage accumulation and lymphocytic infiltration in the lesions. These cases showed no atherosclerotic plaque, but non‐atherosclerotic fibrocellular intima. The thickness of intima and media was significantly less in the vertebral artery of IDA patients than that of non‐IDA patients with systemic hypertension. On the other hand, the remaining case showed severe atherosclerosis with haemorrhage into the lipid core without connection to the arterial lumen (intra‐atheromatous plaque haemorrhage type). However, unusual arterioles and neovascularization of the intra‐and peri‐arterial walls were observed.Conclusions: Our results suggest that disruption of the entire arterial wall may be a critical event in the development of IDA and result in the medial disruption and subadventitial haemorrhage. Non‐atheromatous intima might function as a protective factor in arterial wall disruption. On the other hand, atherosclerosis may predispose to intra‐atheromatous plaque haemorrhage type of IDA through intramural haemorrhage originating from the newly formed vessels.
Cytoskeletal and kinetic epithelial differences between NSAID gastropathy and Helicobacter pylori gastritis: an immunohistochemical determination
Authors: Lauwers G Y , Furman J , Michael L E , Balis U J , Kubilis P S 
Published: March 2003

Cytoskeletal and kinetic epithelial differences between NSAID gastropathy and Helicobacter pylori gastritis: an immunohistochemical determination Aims: Distinguishing histological features between non‐steroidal anti‐inflammatory drug (NSAID) gastropathy and Helicobacter pylori gastritis have been accepted. However, the molecular basis explaining these dissimilar histologies has not been elucidated. In an attempt to clarify this question we investigated the differences in the structural cytoskeleton and proliferative activity of these two gastropathies. Methods and results: We assessed the distribution of five cytokeratins (CK) (CK7, 8, 18, 19 and 20) and Ki67 for the ability to distinguish NSAID from H. pylori gastropathies. In H. pylori gastritis, CK7, 8, 18 and 19 were expressed comparably to normal mucosa from the deep foveolae up to the tips of the glands. The detection of CK20, normally expressed in the upper foveolar region and surface, was decreased with only an epithelial surface reaction. In NSAID gastropathy, CK expression was increased in intensity, with normal distribution for CK8, 18 and 19. Modification of localization was noted for CK7 and 20, with labelling extending toward the deep foveolar region. Unlike H. pylori gastritis, no surface epithelial labelling with Ki67 was noted with NSAID gastropathy but downward elongation of the proliferative zone occurred instead. Conclusions: Contrasting cytostructural alterations and distinct proliferative patterns distinguish NSAID gastropathy from H. pylori gastritis, possibly reflecting different injury pathways.
Primary squamous cell carcinoma of the thyroid gland: an entity with aggressive clinical behaviour and distinctive cytokeratin expression profiles
Authors: Lam K‐Y , Lo C‐Y , Liu M‐C 
Published: March 2003

Primary squamous cell carcinoma of the thyroid gland: an entity with aggressive clinical behaviour and distinctive cytokeratin expression profiles Aims: Primary squamous cell carcinoma of the thyroid gland is uncommon. This study aims to identify the clinicopathological features and the pattern of expression of cytokeratins and oncoproteins in this tumour. Methods and results: Histological slides from Chinese patients with thyroid cancer treated in our institution from 1980 to 1999 were reviewed. Patients with primary squamous cell carcinoma of the thyroid were identified and their clinical records were analysed. The expression of cytokeratins (CKs), p53 and p21 in these cases were also studied by an immunohistochemical method. Four women (mean age 71 years) with squamous cell carcinoma of thyroid were found. The main presenting features were signs and symptoms of airway obstruction in three patients and neck swelling in one. The tumours were located at the right lobe (n=2), left lobe (n=1) or in both lobes of the thyroid (n=1). One patient died shortly after admission and the other three died within 4 months after thyroidectomy. The p53 protein was positive in 50% (2/4) of the tumours and p53+ tumours were poorly differentiated. The tumours were negative for p21. CK19 was expressed in all the tumours while CK7 expression was noted in 3/4 of the tumours. One carcinoma showed focal positivity to CK18. The tumours were negative for CKs 1, 4, 6, 10/13 and 20. The pattern of cytokeratin expression in squamous cell carcinoma of the thyroid gland was different from carcinoma showing thymus‐like differentiation (CASTLE) of the thyroid gland and oesophageal squamous cell carcinoma. Conclusions: Squamous cell carcinoma of the thyroid has aggressive clinical behaviour and characteristic CK expression pattern. p53 over‐expression in these tumours was associated with tumour differentiation.
Endothelial nitric oxide synthase is strongly expressed in malignant mesothelioma but does not associate with vascular density or the expression of VEGF, FLK1 or FLT1
Authors: Soini Y , Puhakka A , Kahlos K , Säily M , Pääkkö P , Koistinen P , Kinnula V 
Published: March 2003

Endothelial nitric oxide synthase is strongly expressed in malignant mesothelioma but does not associate with vascular density or the expression of VEGF, FLK1 or FLT1 Aims: To investigate endothelial nitric oxide synthase (eNOS) expression in malignant mesothelioma and its association with expression of vascular endothelial growth factor (VEGF), its receptors FLK1 and FLT1, and vascular density. Methods and results: eNOS, VEGF, FLK1 and FLT1 were studied in 36 histological mesothelioma samples by immunohistochemistry. Two mesothelioma (M14K, M38K) and one non‐neoplastic mesothelial cell line (MET‐5A) were studied for eNOS mRNA expression by reverse transcriptase‐polymerase chain reaction (RT‐PCR). Vascular density was determined by staining the samples with an antibody to factor VIII. RT‐PCR showed that mesothelioma cells synthesize eNOS in vitro. eNOS immunoreactivity was found in 32/36 (89%) tumours. VEGF, FLK1 and FLT1 expression was found in 17 (45%), 24 (69%) and 25 (71%) cases, respectively. FLK1 or FLT1 immunoreactivity was more often seen in epithelioid and biphasic mesotheliomas than in sarcomatoid ones (P=0.007 and P=0.011, respectively). There was a significant association between FLK1 and FLT1 immunoreactivity (P=0.032). No significant association was found between FLK1, FLT1, VEGF and eNOS immunoreactivity and vascular density. Conclusions: eNOS is strongly expressed in malignant mesothelioma. Since eNOS did not associate with VEGF, FLK1 or FLT1, its synthesis seems not to be regulated through VEGF in malignant mesothelioma as has been shown in non‐neoplastic endothelial cells.
Diverse differentiation in malignant peripheral nerve sheath tumours associated with neurofibromatosis‐1: an immunohistochemical and ultrastructural study
Authors: Takeuchi A , Ushigome S 
Published: March 2003

Diverse differentiation in malignant peripheral nerve sheath tumours associated with neurofibromatosis‐1: an immunohistochemical and ultrastructural study Aims: The diverse histological features in malignant peripheral nerve sheath tumours (MPNSTs) associated with NF‐1 were investigated by immunohistochemical and electron microscopic analysis. Our study is focused on the differentiation of the tumour cells in the heterogeneous components. Methods and results: Twenty‐three cases were classified as conventional type, epithelioid type, anaplastic type, and heterogeneous type, and divided into three groups by the presence of S100 protein (S100)‐positive cells in each tumour; Group A was defined as having >50% S100+ cells, Group B as having <50%, and Group C as cases with no positive cells. To investigate the differentiation of the tumour cells, the morphology and immunoreactivity for neural or mesenchymal markers among the three groups were compared. For the identification of Schwannian, perineurial, and endoneurial differentiation, markers for S100, EMA and CD34 were used, respectively. In three tumours of the Group A type, there were no cases showing differentiation towards perineurial or endoneurial cells, or formation of heterogeneous components. In nine tumours of the Group B type, one tumour expressed EMA and CD34, suggesting probable perineurial and/or endoneurial differentiation. One tumour showed rhabdomyoblastic differentiation. Three tumours showed cartilaginous or osteogenic differentiation, and one of the three also showed a focal vascular differentiation. The surrounding areas of the heterogeneous components were composed of mixed S100+ cells and S100– cells. S100– cells in the areas were positive for CD34 in one case. In 11 tumours of Group C type, one tumour expressed EMA and CD34 suggesting perineurial and/or endoneurial cell differentiation. Three tumours showed rhabdomyoblastic differentiation. The tumour cells around the heterogeneous components in the three cases were negative for EMA and CD34. Conclusion: Our results suggest that tumour cells differentiating to Schwann cells are not the only component of MPNSTs. Furthermore, tumour cells other than Schwann cells are largely related to the formation of the heterogeneous components in MPNSTs associated with NF‐1.
Scoring nuclear pleomorphism in breast cancer
Authors: Dunne B , Going J J 
Published: March 2003

Scoring nuclear pleomorphism in breast cancer Aims: Nuclear grade has equal weight with mitotic index and acinus formation in grading breast cancer, but criteria for its assessment are less well defined. This study examines consistency of nuclear grading in breast cancer and whether improved nuclear grading criteria are required. Methods and results: Photographic prints of haematoxylin–eosin sections of 100 unselected symptomatic breast cancers were circulated to histopathologists who assigned each carcinoma a nuclear pleomorphism score on a linear analogue scale 0–100 (0–33 equating to nuclear pleomorphism grade 1, 34–66 to grade 2, and 67–100 to grade 3). Seventeen histopathologists completed the exercise, including 11 breast specialists. While κ scores for the implied nuclear grades indicated ‘moderate’ or ‘good’ agreement between individuals and the group as a whole, seven pathologists allocated analogue scores significantly lower than the median score allocated by the group to each case, while five allocated significantly higher scores. The range was from analogue scores 11.3 units lower on average than the median (assigning 27% of carcinomas nuclear grade 1, 60% grade 2, and 13% grade 3) to scores 7.5 units higher on average than the median (assigning only 2% carcinomas nuclear grade 1, 46% grade 2, and 52% grade 3). Five of six non‐specialists allocated scores significantly lower than the group medians but only two of 11 specialists did so (P=0.018). Conclusions: Systematic differences between pathologists in scoring nuclear pleomorphism in breast cancer potentially contribute to differences in allocating overall grade and confirm the need for improved nuclear grading criteria. Specialists tend to allocate higher pleomorphism scores than non‐specialists.
Psammomatous malignant melanoma arising in an intradermal naevus
Authors: Monteagudo C , Ferrández A , González‐Devesa M , Llombart‐Bosch A 
Published: March 2003

Psammomatous malignant melanoma arising in an intradermal naevus Aims: A wide variety of differentiation patterns may be found in malignant melanoma. Schwannian features are unusual, and mostly present in the desmoplastic variant. We report the first description of psammoma bodies in malignant melanoma. Methods and results: A malignant melanoma arose in an intradermal naevus of the scalp in a 51‐year‐old woman, displaying focal neural‐like features in the form of rosette‐like pseudo‐meissnerian alveolar nests, as well as numerous psammoma bodies grouped in a few areas. Tumour cell immunostaining for S100, HMB45, NKI‐C3, and vimentin was detected. In addition, both malignant and benign melanocytic cells showed widespread MART‐1 immunoreactivity. Differential diagnosis with psammomatous melanotic schwannoma, a feature of Carney’s complex, is particularly emphasized, since dermal variants of this nerve sheath neoplasm have been described. In addition, its potential relationship with cutaneous malignant melanotic neurocristic tumour is discussed. Conclusions: This is, to our knowledge, the first reported case of cutaneous malignant melanoma with psammoma bodies.
Immunohistochemical markers in the differentiation of thymic and pulmonary neoplasms
Authors: Pomplun S , Wotherspoon A C , Shah G , Goldstraw P , Ladas G , Nicholson A G 
Published: March 2003

Immunohistochemical markers in the differentiation of thymic and pulmonary neoplasms Aims: The histopathological features of some thymic neoplasms overlap with those of pulmonary squamous and large‐cell undifferentiated carcinomas, and identification of the primary site may be difficult on routine staining. We have assessed a panel of antibodies that may help to distinguish between neoplasms from these two sites. Methods and results: Antibodies identifying cytokeratin 7 (CK7), CD5, CD10, CD1a and thyroid transcription factor‐1 (TTF‐1) were applied to a series of 20 thymic neoplasms (thymic carcinomas, atypical thymomas and thymomas), 10 primary squamous cell carcinomas of the lung and 10 large‐cell undifferentiated carcinomas of the lung. Staining for TTF‐1 was positive in 3/10 large‐cell undifferentiated carcinomas, but negative in all other tumours. CD5 showed strong membranous staining in 3/6 thymic carcinomas and 1/14 thymomas, but only focal staining in 1/20 pulmonary carcinomas. CD1a was consistently positive in thymic lymphocytes in both typical and atypical thymomas, but only focally in 1/6 thymic carcinomas. CD1a stained dendritic cells in 7/20 pulmonary carcinomas, but did not stain lymphocytes. Staining for CK7 and CD10 did not aid in differentiating between a pulmonary or thymic origin of the tumour. Conclusion: Staining for TTF‐1, CD5 and CD1a have potential use in distinguishing between pulmonary and thymic neoplasms.