bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra‐abdominal follicular dendritic cell tumour: a rare tumour in need of recognition
Authors: Shek T W H , Liu C L , Peh W C G , Fan S T , Ng I O L 
Published: March 2003

AimsNeoplasms of follicular dendritic cells are uncommon and the majority of them occur in lymph nodes. Rarely, they may occur inside the abdominal cavity. We describe two examples of intra‐abdominal follicular dendritic cell (FDC) tumour. One involved the liver and the other involved the ampulla of Vater. Our aims are to complement the current understanding on this disease and to alert histopathologists and clinicians to this rare entity.Materials and resultsThe clinical and radiological findings of the two cases of intra‐abdominal follicular dendritic cell tumours were reviewed. The resected specimens were examined macroscopically and microscopically. Immunohistochemical studies, ultrastructural examination and in situ hybridization for Epstein–Barr virus were also performed. Both tumours could not be accurately diagnosed before pathological examination of the resected specimens. The soft to slightly firm consistency of the tumours resembled that of fixed brain tissue, and was distinctly different from hepatocellular carcinoma or pancreatic carcinoma. The fascicular arrangement of syncytial plump to spindle cells in a background of mixed inflammatory cells was the initial clue to the diagnosis, which was confirmed by the immunoreactivity of the tumour cells to follicular dendritic cell markers (CD21 and CD35), and by the demonstration of focal intercellular desmosome‐like junctions between the complex cytoplasmic processes of the tumour cells. The tumour cells in the liver tumour also showed presence of Epstein–Barr virus on in situ hybridization study.ConclusionsAwareness of the entity and the ability to recognize this tumour by histopathologists are emphasized because the tumour closely mimics a wide variety of other tumours and tumour‐like lesions. Similar to the other reported FDC tumours of the liver, our case of hepatic follicular dendritic cell tumour is also positive for Epstein–Barr virus, suggesting that the virus may play a role in its pathogenensis.
Different numerical chromosomal aberrations detected by FISH in oropharyngeal, hypopharyngeal and laryngeal squamous cell carcinoma
Authors: Poetsch  , Kleist  , Lorenz  , Herrmann  
Published: March 2003

AimsLittle information is available about stage‐ or site‐specific chromosomal aberrations in head and neck squamous cell carcinoma (HNSCC). We tried to identify whether different patterns of chromosomal gain or loss in squamous cell carcinomas were associated with different stages or head and neck sites.Methods and resultsWe investigated isolated interphase cells from paraffin sections of 53 squamous cell carcinomas of the head and neck region by fluorescence in situ hybridization techniques. We used centromeric DNA probes for chromosomes 1, 3, 4, 6, 7, 9, 10, 11, 12, 15, 17, 18, X and Y. The majority of tumour samples showed aneuploidy for most chromosomes analysed. We were able to find differences in the chromosomal aberrations between the tumour sites and stages of the HNSCC investigated. The main numerical chromosomal abnormalities were an under‐representation of chromosomes 3 (26%), 6 (17%), 9 (26%), 10 (23%) and 18 (32%). The Y chromosome was lost in 53% of male tumours. A loss of chromosomes 3 and 10 was detected mostly in laryngeal SCC (39% and 30%, respectively); the under‐representation of chromosome 9 was predominantly seen in oropharyngeal SCC (54%) and a copy number decrease of chromosomes 18 was found in 57% of hypopharyngeal tumours.ConclusionAlthough the number of tumour samples investigated is rather low, our results suggest that the different tumour sites of HNSCC may also show different patterns of chromosomal changes.
Myxoid dermatofibroma
Authors: Zelger  , Calonje  , Zelger  
Published: March 2003

AimsThis report presents seven cases of a rare variant of dermatofibroma, characterized by marked mucinous stromal changes.Methods and resultsIn this retrospective clinicopathological study, lesions preferentially occurred on the lower extremities of young to middle‐aged females. Clinical (differential) diagnoses included: dermatofibroma (two cases), cyst, tophus, ganglion and neurofibroma. Histology revealed well circumscribed, faintly stained dermal to subcutaneous lesions which contained abundant stromal mucin. A variable amount of spindle‐shaped cells, occasional lymphocytes and fine collagen fibres were also seen. Epidermal hyperplasia above as well as storiform arrangement of spindle cells and some sclerotic collagen at the periphery of the lesion indicated the fibrohistiocytic origin. Individual histopathological features included: bizarre giant cells, perifollicular arrangement and seas of mucin with pseudovascular clefts in one case each. Immunohistochemically, all lesions were positive for KiM1p (> 50% of the cells). Moreover, two lesions showed moderate reactivity for factor XIIIa (10–25%), one each with NK1C3 (> 90%) and smooth muscle actin (50%), but were otherwise negative with a broad panel of markers. Electron microscopy in one case revealed large pools of mucin interspersed by a moderate number of fibrocytes with fine fibrillary collagen.ConclusionThis series confirms myxoid dermatofibroma as a rare variant of fibrohistiocytic tissue response; our series also indicates that many of these lesions might be misinterpreted as cutaneous myxoma.
p53 immunoreactivity in endometrial metaplasia with dysfunctional uterine bleeding
Authors: Quddus M R , Sung C J , Zheng W , Lauchlan S C 
Published: March 2003

AimOverexpression of p53 has been reported in endometrial carcinomas, especially in uterine papillary serous carcinoma (UPSC), to correlate with worse prognosis. Endometrial metaplasia is commonly encountered in patients with dysfunctional uterine bleeding (DUB) and may on occasion be difficult to distinguish from atypical endometrial hyperplasia or carcinoma on biopsies. The present study was initiated in the belief that metaplastic tissue might not show overexpression of p53 and would thus help to distinguish it from carcinomas of non‐endometrioid histology.Methods    and resultsParaffin‐embedded tissue of endometrial biopsies with papillary metaplasia (22 cases), tubal metaplasia (five cases) and eosinophilic meta‐plasia (seven cases) from patients with DUB were immunostained for p53 immunoreactivity. No evidence of hyperplasia was noted in any of the cases selected for the study. Twenty‐eight cases of UPSC were included for comparison. Our study showed p53 overexpression in 25 of 28 (89%) UPSC. Weak and heterogeneous p53 immunoreactivity was present in 10 of 22 (45%) papillary metaplasias, four of five (80%) tubal metaplasias and four of seven (57%) eosinophilic metaplasias. Follow‐up of 16–45 (median 32) months was unremarkable except for one patient with eosinophilic metaplasia who had simple endometrial hyperplasia in subsequent biopsy.ConclusionsThe presence of weak and heterogeneous p53 immunoreactivity in metaplastic endometrium is unexpected and might be a consequence of DNA damage. Intense, diffuse and homogeneous p53 staining favours carcinoma.
Diabetic microangiopathy in the small bowel
Authors: De Las Casas  , Finley  
Published: March 2003

AimsMicroangiopathic changes in the gastrointestinal tract of patients with diabetes mellitus are frequently mentioned in the clinical literature. To our knowledge, pathological studies documenting these changes in bowel biopsies have not been previously reported. In this report, we describe striking duodenal biopsy findings of diabetic microangiopathy in a patient with long‐standing insulin‐dependent diabetes mellitus and chronic diarrhoea.Methods and resultsThe diagnosis was based on the histopathological and immunohistochemical findings in the appropriate clinical setting. Blood vessels within the duodenum displayed prominent mural thickening and luminal narrowing secondary to accumulation of hyaline material, which was periodic acid–Schiff positive and intensely stained with monoclonal antibodies against type IV collagen.ConclusionsThis is the first report of diabetic microangiopathy in a bowel biopsy. The pathogenesis, specificity and significance of these angiopathic changes, controversies about diabetic microangiopathy in the gastrointestial tract, and the association with hypertension are discussed.
Protein expression and genetic alterations of p53 and ras in intrahepatic cholangiocarcinoma
Authors: Furubo  , Harada  , Shimonishi  , Katayanagi  , Tsui  , Nakanuma  
Published: March 2003

AimsThe significance of molecular and genetic alterations of p53 and ras in the development and progression as well as the histological differentiation of intrahepatic cholangiocarcinoma (ICC) was evaluated.Methods and resultsWe examined immunohistochemically ras p21 protein and p53‐related products (p53 protein, WAF‐1 and mdm‐2) in 43 cases of ICC. In addition, point mutations of ras and p53 were examined genetically in selected ICC cases by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) and direct sequence analysis. Point mutation of K‐ras gene codon 12 was detected in three of 14 cases and one of 15 cases by PCR‐RFLP and direct sequence analysis, respectively. Immunoreactivity of ras p21 protein was not detected. Point mutation of p53 was detected in three of 15 cases. p53 protein was immunohistochemically detectable in 33 of 43 cases. Immunoreactivity of p53 was more frequent in well‐differentiated and less frequent in poorly differentiated cases. Immunoreactivity of WAF‐1 and mdm‐2 was seen in 16 and eight of 43 cases, respectively. Both proteins were frequently detected in the cases positive for p53 protein.ConclusionThese results suggest that dysregulation of ras is involved in at least 20% of ICC and expression of p53 protein is more significantly involved in ICC, particularly in the well and moderately differentiated cases. While some cases of p53 expression may be explainable by point mutation of p53, there may be some epigenetic phenomena that stabilize p53 protein in ICC. That is, wild type p53 may be stabilized and then detectable by forming complexes with other molecules of p53 downstream effector genes, such as WAF‐1 and mdm‐2.
Ultrastructural localization of E‐cadherin and α‐/β‐catenin in adenoid cystic carcinoma
Authors: Shibuya  , Ri  , Umeda  , Yoshikawa  , Masago  , Komori  
Published: March 2003

AimsTo investigate the disturbance of intercellular adhesion in adenoid cystic carcinoma (ACC), we examined the ultrastructural localization of E‐cadherin (E‐cad), α‐catenin (α‐cat) and β‐catenin (β‐cat) in ACC, and compared it with that in the normal labial gland.Methods and resultsUsing immuno‐electron microscopy, in the normal labial gland, E‐cad was found to be uniformly distributed along the plasmalemma, where cells were in close contact with each other, with junctional complexes, desmosomes and interdigitations; expression of α‐cat and β‐cat was also detected. In ACC, which was classified into tubular, cribriform and trabecular types, E‐cad expression seemed not to be uniform, but was observed to be along the plasmalemma where cell‐to‐cell contact was made. On the other hand, expression of α‐cat or β‐cat was uneven in the trabecular‐type cells which were very slender and grew in an infiltrative scattered pattern into the extracellular matrix; that was absent in the cribriform‐type cells which made contact with each other mostly at the tip of the cytoplasmic processes.ConclusionThese findings suggest that the neoplastic cells of ACC express E‐cad for use in intercellular adhesion, but the cadherin–catenin complex might not operate properly, which is the cause of neoplastic cell dissociation, followed by invasion and metastasis.
Primary choriocarcinoma and human chorionic gonadotrophin‐producing giant cell carcinoma of the lung: are they independent entities?
Authors: Ikura  , Inoue  , Tsukuda  , Yamamoto  , Ueda  , Kobayashi  
Published: March 2003

AimsHuman chorionic gonadotrophin (hCG) is a useful marker for chorionic proliferative disorders, such as choriocarcinoma. Although hCG synthesis in lung cancers is frequent, primary pulmonary choriocarcinoma (PCC) is rare. To clarify the differences between primary choriocarcinoma and hCG‐producing giant cell carcinoma (GCC) of the lung, we compared the clinicopathological and immunohistochemical findings of these tumours.Methods and resultsThree patients, one with PCC and two with hCG‐producing GCC, were included in this study. They were all middle‐aged men and habitual smokers. The growth of these tumours and the progression of the clinical courses were extremely rapid, and the patients all died within 8 months after the pulmonary tumours were found. Haemorrhagic appearance was a common macroscopic feature of the specimens obtained. Microscopically, both types of tumours mainly consisted of atypical polygonal cells. While PCC contained many syncytial trophoblast‐like multinucleated cells that had strong immunoreactivity for anti‐hCG, such cells were relatively few in hCG‐producing GCC. These histological and immunohistochemical findings reflected the serum test result for hCG, which was higher in the case of PCC.ConclusionsThere are a few differences between PCC and hCG‐producing GCC, as described above. Reliable distinction between them seems to be difficult for pathologists and worthless for clinicians.
Relationship between fascicle size and perineurial collagen IV content in diabetic and control human peripheral nerve
Authors: Williams P E , Lowry A , Hill R , Masson E 
Published: March 2003

Aim: The relationship between perineurial collagen IV content and fascicle size was determined in diabetic and control human peripheral nerve.Methods and resultsAge‐matched diabetic and control sural nerve samples were immunostained using antibodies to collagen IV. The number of cell layers and the perimeter of the fascicle were measured and the collagen IV content of the perineurium determined. Using this method, a comparison could be made of collagen IV content in the perineuria of fascicles of different size. A positive linear relationship was found between fascicle size and the amount of collagen IV per unit of perineurium. The number of perineurial cell layers and the collagen IV content of the diabetic nerve did not differ from control values.ConclusionsThe linear relationship between fascicle size and perineurial collagen IV content per unit of perineurium underlines the importance of taking fascicle size into account when determining changes in basement membrane components associated with neuropathy. The results indicate that increased deposition of collagen IV is not involved in the early changes in the perineurial cell basement membrane and is thus not the primary factor involved in altered nerve function associated with diabetic neuropathy.
‘Mucin‐positive’ epithelial mesothelioma of the peritoneum: an unusual diagnostic pitfall
Authors: Cook D S , Attanoos R L , Jalloh S S , Gibbs A R 
Published: March 2003

AimsThe histopathological, immunohistochemical and ultrastructural features of a primary ‘mucin‐positive’ epithelial mesothelioma of the peritoneum are reported to draw attention to a potential cause of diagnostic error.Methods and resultsLight microscopy showed an infiltrative neoplasm within the gastric wall and omentum which was composed of sheets of ‘signet‐ ring’ tumour cells and contained abundant diastase‐resistant periodic acid–Schiff‐positive material. Immunohistochemistry supported a mesothelial phenotype (cytokeratin AE1/3, thick membranous HBME‐1, focal thrombomodulin and calretinin expression and no reactivity for carcinoembryonic antigen, Leu‐M1 and Ber‐EP4). Ultrastructural features showed large cells with prominent intercellular desmosomes and numerous delicate, elongated microvilli. Within intracytoplasmic neolumina, crystalloidal ‘fern‐like’ bodies were identified with features similar to the ultrastructural appearances of hyaluronic acid crystals. Repeat histochemical analysis following hyaluronidase pretreatment revealed a significantly diminished diastase‐resistant periodic acid–Schiff reaction.ConclusionsThis case of primary peritoneal ‘mucin‐positive’ epithelial mesothelioma demonstrates morphological and histochemical mimicry with diffuse gastric adenocarcinoma. A similar case has not been previously reported in the peritoneum and an awareness of the tumour (with application of suitable ancillary studies) prevents misdiagnosis and assists in potentially difficult medicolegal cases.
Intravascular large B‐cell lymphoma with bone marrow involvement at presentation and haemophagocytic syndrome: two Western cases in favour of a specific variant
Authors: Dufau J P , Le Tourneau A , Molina T , Le Houcq M , Claessens Y E , Rio B , Delmer A , Diebold J 
Published: March 2003

To report two cases of an unusual form of intravascular lymphoma, characterized by bone marrow involvement at presentation with haemophagocytic syndrome.We describe the clinicopathological features of two patients with intravascular lymphoma primarily involving bone marrow. Both patients complained only of fever with pancytopenia and reactive haemophagocytic syndrome. Diagnosis was made on bone marrow examination, which showed large tumour cells of B‐cell lineage confined within the lumen of sinuses.These two cases and five previous reports could represent a variant of intravascular lymphoma, characterized by early involvement of bone marrow without dissemination to other organs. This form of intravascular lymphoma, called IVL‐HS, seems to be an ‘Asian’ variant with a high prevalence in Asian people and a very low prevalence in Western countries. At a practical level, bone marrow biopsy may be useful in the diagnosis of intravascular lymphoma when the clinical presentation is restricted to fever of unknown origin with a reactive haemophagocytic syndrome.
Ultrastructural examination is essential for diagnosis of papillary meningioma
Authors: Al‐Sarraj S , King A , Martin A J , Jarosz J , Lantos P L 
Published: March 2003

Aims: Papillary meningioma is a rare meningeal tumour. To date only a few cases have been reported and their immunohistochemical features have not been fully documented.Methods and results: A 49‐year‐old woman presented with a 2‐month history of headaches and memory disturbance. CT and MRI imaging showed an enhancing pineal mass with extension into the occipital lobes and invasion of the splenium. At surgery, the tumour was found to be tough and vascular with a well‐defined capsule. No recurrence was noted 19 months after the operation. In another case a 44‐year‐old woman was admitted with 1‐month history of headaches, poor memory, imbalance and diplopia. CT scan showed a large hyperdense, uniformly, enhancing mass within the middle cranial fossa at the petrous ridge. The tumour recurred 19 and 25 months after first resection. The histology of both tumours was similar. The neoplasms contained polygonal cells with a moderate amount of cytoplasm, rounded regular nuclei and distinct cell borders. The cells were arranged radially around the blood vessels (perivascular pattern) and a papillary pattern was seen only focally. Mitotic figures were moderately frequent. Immunohistochemistry showed that both tumours were immunoreactive to vimentin and NSE, whereas GFAP, CAM5.2, EMA, S100 protein and synaptophysin were negative. Electron microscopy revealed interdigitating cell processes, desmosomes and intermediate filaments.Conclusions: The histological and immunohistochemical features of these two tumours are complex and difficult to interpret. Although papillary meningiomas were considered in our initial differential diagnosis, the final conclusion was possible only when the ultrastructural features were revealed.
Mitotic counting in surgical pathology: sampling bias, heterogeneity and statistical uncertainty
Authors: Thunnissen F B J M , Ambergen A W , Koss M , Travis W D , O'Leary T J , Ellis I O 
Published: March 2003

Mitotic counting in surgical pathology: sampling bias, heterogeneity and statistical uncertainty Although several articles on the methodological aspects of mitotic counting have been published, the effects of macroscopic sampling and tumour heterogeneity have not been discussed in any detail. In this review the essential elements for a standardized mitotic counting protocol are described, including microscopic calibration, specific morphological criteria, macroscopic selection, counting procedure, effect of biological variation, threshold, and the setting of an area of uncertainty (‘grey area’). We propose that the use of a standard area for mitotic quantification and of a grey area in mitotic counting protocols will facilitate the application of mitotic counting in diagnostic and prognostic pathology.
Merkel cell carcinoma of the parotid gland associated with Warthin tumour: report of two cases
Authors: Fornelli A , Eusebi V , Pasquinelli G , Quattrone P , Rosai J 
Published: March 2003

Merkel cell carcinoma of the parotid gland associated with Warthin tumour: report of two cases Aims: Two cases of Merkel cell carcinoma occurring simultaneously and in close association with a Warthin tumour of the parotid gland are reported Methods and results: The patients were a 65‐year‐old man and a 70‐year‐old man, respectively. The Merkel cell carcinoma component was immunoreactive for chromogranin and keratin 20 and contained neuroendocrine‐type granules at the ultrastructural level. Conclusions: The histogenesis of this heretofore undescribed combination is discussed.
Malignant deciduoid mesothelioma of the pleura: report of two cases with long survival
Authors: Serio G , Scattone A , Pennella A , Giardina C , Musti M , Valente T , Pollice L 
Published: March 2003

Malignant deciduoid mesothelioma of the pleura: report of two cases with long survival Aims: To present two rare cases of malignant mesotheliomas with deciduoid features arising in the pleura, both with long survival. Methods and results: These two cases of deciduoid mesotheliomas were observed in adult patients (one 73‐year‐old male and one 23‐year‐old female). Only the male had a history of occupational asbestos exposure, whereas the woman had a history of familial mesothelioma. A deciduoid morphology was predominant and focal areas with tubular‐papillary features were noted. The tumour cells were positive for cytokeratins, HMBE‐1, calretinin, EMA and mitochondrion antibodies. The follow‐up data did not suggest a particularly poor prognosis; the mean survival observed was 23 months (17 and 39 months, respectively). Conclusions: This deciduoid mesothelioma histological subtype does not appear to represent an unfavourable prognostic category.