Applied pathology最新文献

Local tissue eosinophilia in different carcinomas is a well-described phenomenon which could have prognostic significance. The etiology and pathogenesis of this tissue reaction are controversial and not understood. We found in sequential biopsies of transitional cell carcinomas of the urinary bladder that the most obvious relation was between eosinophilia and granulation tissue. This finding may indicate a nonspecific, nontumor-related tissue eosinophilia.

50 carcinoid tumors of different locations in the gastrointestinal and respiratory tracts were examined histochemically for mucin production. Isolated discrete aggregates of mucosubstances were identified in a large number of cases (46% of all carcinoid tumors, ranging from 53 to 36% in different organ locations). Acidity and composition of mucosubstances (sulfomucin vs. sialomucin contents) in carcinoids were not different from those described in their corresponding locations. These data support numerous other observations that point to a common stem cell precursor for both enterochromaffin and mucus-secreting epithelial cells in gastrointestinal and respiratory tract mucosal membranes. A shared endodermal derivation is favored over a separate neuroectodermal origin for the chromaffin cell system.

We report a new case of histiocytic proliferation, which histologically resembles histiocytosis X, in a lymph node affected by non-Hodgkin's malignant lymphoma. This brings the total number of such reported cases to 12. Histiocytosis X cells, with folded nuclei, expressed S100 protein and an antigen recognized by anti-CD1 monoclonal antibodies. Ultrastructural study did not show any Birbeck granules and demonstrated a morphology similar to that of interdigitating cells. In the absence of Birbeck granules, the term 'Langerhans' cell granulomatosis' is not correct and should be replaced by either 'interdigitating cell granuloma' according to immunohistochemistry and ultrastructure or 'histiocytosis X-like granuloma' according to optical morphology. The fact that some cells with folded nuclei were positive for lysozyme argues in favor of the existence of transitional cells between histiocytes hnd interdigitating cells. The 11 other reported cases were reviewed. In 6 cases, this type of granuloma was associated with B cell lymphoma. In 3 cases the lymphoma was also probably of B cell type. In 2 cases, no information could be found. We could speculate that these histiocytosis X-like lesions are reactive, resulting from immune disturbances due to the lymphoma and/or the treatment.

DNA measurement represents a type of quantitative analysis which allows us to gain prognostic information on malignant tumors and to study the natural history of the epithelial neoplasia. However, there are sources of variation in evaluating the DNA content. These include variation due to field selection, variation between observers (interobserver variation), and variation between laboratories (interlaboratory variation). The influence of various variation sources was studied in 4 experiments. When DNA measurements were made from the same microscopic fields, the results did not differ remarkably. However, observer training proved to be important. Intra- and interobserver variation was lower among experienced morphometrists than among inexpert observers. Different laboratories and image analyzers may give different results when the same case is measured. To overcome at least part of the potential variation sources, undergraduates and postgraduates at the Departments of Pathology of Ancona and Kuopio Universities are specially trained in the use and application of morphometry. Special sampling rules should be applied and observers encouraged to follow the rules as uniformly as possible.

In the light of recent findings concerning the importance of intermediate alpha 1-antitrypsin deficiency in the development of chronic liver disease and of hepatocellular carcinoma, we report the case of a 56-year-old woman affected by cirrhosis with significant features of liver cell dysplasia associated with intermediate alpha 1-antitrypsin deficiency (protease inhibitor SZ phenotype). In our paper we emphasize the importance of a precocious diagnosis and identification of individuals carrying the Z allele, also heterozygous.

A rare case of endomandibular acinic cell carcinoma (ACC) in a white woman aged 79 is reported. Radiologic examination revealed an osteolytic area within the jaw, extending from the left molar region to the ascending branch. The tumor was located within a cavity of the mandible and did not seem to infiltrate the bone. Histologically, it was composed of large epithelial cells with granular cytoplasm, arranged in solid nests, sometimes displaying microcystic spaces. ACC generally occurs in salivary glands. In the reported case, the tumor was considered to arise from ectopic salivary tissue enclosed in the jaw, as no lesion was found in minor salivary glands.

An acute terminal phase of a Bence Jones kappa plasma cell myeloma developed 22 months after chemotherapy is presented. The patient's symptoms were fever, cytopenias, adenomegalies and hepatomegaly. A lymph node biopsy showed an immunoblastic polymorphic kappa B cell lymphoma, expressing CD30 antigen. After new polychemotherapy the patient died because of bleeding and infection. Autopsy revealed a decrease in the tumour with defective immunophenotype. The few reported cases have been reviewed with emphasis on clinical aspects, prognosis and morphology, The significance of CD30 positivity (activation marker) in a high-grade lymphoma is discussed.

34 adenomas of the colon and adjacent flat mucosa were reexamined by morphological, histochemical and immunohistochemical means. Adenomas were grouped according to the degree of epithelial cell atypia: group 1 (dysplastic adenomas) showing mild and moderate dysplasia and group 2 (cancerous adenoma) with severe dysplasia and carcinoma. Morphological and secretive changes (hyperplasia with hypersialomucin secretion), considered typical of 'transitional mucosa', were constantly found in the adjacent and stalk mucosa. A panel of six lectins were tested using PAP and ABC system methods to compare amount and cytoplasmic localization of labelling sites with the morphological changes such as hyperplasia, dysplasia and carcinoma. All the tested lectins were reactive in up to 90% of adenomas as well as in adjacent mucosa. Positivity was unrelated to the severity of dysplasia and no preferential localization of labelled sites was shown in the adenoma groups. However, cytoplasmic distribution of reactivity was quite different in hyperplastic epithelium compared to dysplastic ones.