Applied pathology最新文献

Diet-induced atherosclerosis in rhesus monkeys was suppressed in the carotid arteries and thoracic aorta by the calcium antagonist nifedipine given orally for a period of 1 year at a dose of 10 mg b.i.d. The extent of atherosclerosis was determined by quantitative micromorphometric studies. No change in serum blood cholesterol or biochemical composition of the major vessels was detected, but the intimal area and thickness of the atherosclerotic plaques in the carotid arteries of the nifedipine group were markedly less than those found with the control group (p less than 0.05). However, no statistically significant differences were seen in the degree of atherosclerotic involvement of the other major arterial vessels. Although the mechanism is not clear, nifedipine may be useful in the treatment of carotid artery disease.

Thirty-three cases of European Kaposi's sarcoma (KS) were investigated by immunohistochemical methods using a panel of antibodies specific for the markers of the cell types proposed for its histogenesis in the literature: S-100 protein for Schwann cells; lysozyme for histiocytes; alpha-actin, desmin and vimentin for pericytes and other mesenchyme-derived cells; factor VIIIR:Ag and Ulex europaeus agglutinin-I for endothelial cells. Antifibronectin antibodies were also used in order to investigate some functional activities of the proliferating cells. Immunohistochemical results showed that KS cells were diffusely positive for vimentin and alpha-actin and negative for all other cell markers. Furthermore, KS cells were constantly surrounded by fibronectin-positive material. Since the KS cells are diffusely positive for vimentin, they may be considered a monotypic proliferation of mesenchyme-derived cells which lack the markers of full endothelial cell differentiation; however, the occurrence of fibronectin-positive material around them suggests that these cells are actively proliferating endothelial cells and their diffuse positivity for alpha-actin suggests a possible differentiation to pericytic cells. In conclusion KS cells may be considered as mesenchymal cells which are at an intermediate stage of maturity or immaturity in vascular differentiation.

Twenty-one cases of medulloblastoma (MB), 20 corresponding to the classical type and 1 to the desmoplastic variant (DPM), were studied immunohistochemically with glial fibrillary acidic protein (GFAP), S-100 protein (S-100P), neuron-specific enolase (NSE) and 200-kd neurofilaments (NF) in order to assess their differentiation potential. Their respective positivities in neoplastic cells were: 42% for GFAP, 47% for S-100P, 61% for NSE and absence of NF. Isolated neoplastic cells (e.g., cells lacking processes and with scanty cytoplasm), appeared positive for neuroglial markers (GFAP and S-100P). Most cases, however, showed positive reactive neuroglial cells. NF were never found in neoplastic cells, but in trapped neuronal processes. In most cases, large numbers of cells had high positivity to NSE. Cells of lucent islands of DPM were positive for GFAP and S-100P, while Homer-Wright type rosettes showed positive only for NSE. The above results support a neuroglial differentiation in MB. NSE was considered a nonspecific marker for neuroblastic cells.

We have described the case of a 73-year-old female patient affected by multicentric Castleman's disease and complicated by Kaposi's sarcoma. Histologically the specimens of nodal biopsy showed combined patterns, both the hyaline-vascular type and the plasma cellular one. We have discussed the relationship between classic Castleman's disease and the multicentric type and the meaning of its association with Kaposi's sarcoma. Both diseases may present in immunologically depressed patients, but it is unknown whether Kaposi's sarcoma is a consequence of immunologic alterations caused by Castleman's disease or whether both processes are due to a primitive disorder of immunologic regulating factors.

Although membranous glomerulonephritis (MGN) has been long considered as a prototype of glomerulonephritis (GN) due to the deposition of circulating immune complexes (CIC), a growing body of evidence indicates that immune deposits can also be formed in situ and implicate antigens expressed by glomerular epithelial cells (GEC). Some of these antigens have recently been identified. The first one, gp330 - a 330-kd glycoprotein restricted to the coated pits of GEC and renal brush border (BB) - is responsible for Heymann nephritis, a rat model of MGN. However, it is absent in the human glomerulus and is therefore probably not involved in human cases of MGN, at least in those due to in situ formation of CIC. In addition, by raising monoclonal antibodies against rat and rabbit BB, we have isolated two other BB proteins also expressed on GEC. The latter, respectively identified as dipeptidyl peptidase IV (90 kd) and enkephalinase (85 kd), can serve as targets for the formation of short-lived immune deposits. Since they are also detected on human GEC, they might play a role in the pathogenesis of MGN in man.

479 cases of tumors of salivary glands were examined at the Institute of Surgical Pathology of the University of Padua during the years 1973-1986; all these were reviewed. The diagnosis of individual tumors was based on the World Health Organization classification. Tumors were analyzed considering the histological type, sex, age and site. Primary tumors of epithelial origin were 91.8%. The principal site was the parotid (78.1%) while the submandibular gland forms the second largest group (14.57%). The malignant forms increase with age and were more common in submandibular and sublingual glands than the parotid. Connective tissue tumors were rare; 50% were hemangiomas that occur in children and young people; the only malignant neoplasias of soft tissue were 2 cases of rhabdomyosarcoma.

The aim of our study was to evaluate the validity of the quantitative analysis of nuclear features on aspiration smears in the distinction between follicular adenoma and follicular carcinoma. Karyometric and DNA features, including the nucleolar count, were evaluated on the cytologic material of 28 cases; the values were in general slightly higher in the carcinomas than in the adenomas, with overlap between the two diagnostic groups. By plotting the two most discriminant and least correlated parameters against each other and by drawing two straight lines (one perpendicular to the axis representing the mean of the major nuclear diameter at the 9-microns point, the other perpendicular to the axis of the percentage of nucleolated cells at the 75% point), we obtained two regions: a rectangle delimited by the two axes and the two lines containing 86% of adenomas, and the remaining part of the plane containing 79% of carcinomas. The validity of this approach was tested in 32 new cases not included in the original bivariate classification: accuracy 87%; sensitivity 86%; specificity 88%; predictive value of adenoma 88%; predictive value of carcinoma 85%. In conclusion, a simple cytometric method, i.e., the combined evaluation of the mean of the major nuclear diameter with the percentage of nucleolated nuclei, allows a substantial distinction to be made between follicular adenoma and carcinoma.

The authors report the occurrence of proliferative glomerulonephritis with mesangial IgA deposits in a 47-year-old man, heavy smoker, affected with renal cell carcinoma at stage I. The relationship between neoplastic diseases and IgA glomerulonephritis is unresolved. It is possible that IgA mesangial nephropathy may occur as a paraneoplastic disease, but in this patient its association with renal cell carcinoma may be merely fortuitous.

The clinicopathologic features of 2 cases of sarcoglioma are described. This rare type of mixed brain tumor is composed of a central core of sarcoma with peripheral distribution of gliomatous elements with gradual transition from reactive to neoplastic astrocytes. The immunohistochemical features showed a strict positivity to glial fibrillary acidic protein only in glial cells, a positivity to vimentin prevalently in sarcomatous cells, whereas the factor VIII-related antigen was negative in astrocytes as well as in sarcomatous cells. The different origin of two neoplastic components is demonstrated well by an ultrastructural study. The morphological observations together with an adequate clinical setting contribute to separate this specific entity from other mixed brain tumors.

The utility of fine needle aspiration biopsy (FNAB) was checked in the diagnosis of 187 neoformations which arose in the same number of patients during follow-up after treatment for malignant neoplasia. FNAB diagnosis was 138 malignant lesions (9 primary and 129 secondary) and 49 benign lesions (8 neoplastic and 41 nonneoplastic). 157 of the 187 diagnoses (83.95%) were controlled: 124 histologically (78.98%) and 33 clinically (21.01%). Specificity was 100%, sensitivity 98.36%, predictive negative value 94.59% and total diagnostic efficiency 98.72%. The reliability of the method and the usefulness of the findings from the therapeutic point of view suggest the advisability of performing FNAB during the post-diagnostic phase of neoplastic disease.