Applied pathology最新文献

Pulmonary lymphangiomyomatosis is a rare disease characterized by wide-spread proliferation of smooth muscle cells around lymphatic and blood vessels, smaller airways and in the interstitium. Young women in the fertile status are almost exclusively affected. Spontaneous recurrent pneumothorax is the most important symptom. Chylous effusions are reported in 37.5% of cases. Our observation deals with a woman aged 43. Light- and electron-microscopic findings are described. Estrogen receptors have been detected on smooth muscle cells. Bilateral oophorectomy and treatment with progesterone were successful.

A case of malacoplakia with a tumor-like involvement of the pelvis is presented. It was characterized by a urine-trickling fistula from the bladder to the gluteal surface and by acute urinary retention. Examinations both cytologic of urine collected from urethra and from fistula, and histological of tissues from bladder and rectum were performed. Histiocytes with Michaelis Gutmann bodies were found in all specimens. The specimens were also studied from an immunohistochemical and electron-microscopic point of view. The case was found interesting because of the unusual fistulization and for the absence of other important associated diseases usually reported in the literature.

We report the unusual case of two distinct hamartomas in one of the breasts of a 20-year-old woman. Hamartoma (adenolipoma, fibroadenolipoma, lipofibroadenoma) of the breast, a rare benign lesion, occurs in females. It is unilateral and displays an organoid structure. It is composed of lactiferous ducts, mammary glands, and connective and fatty tissue, surrounded by a pseudocapsule. It causes enlargement of the breast, usually without localized lesion on palpation. Mammographic and intraoperative findings, however, are characteristic. As the microscopic features of hamartoma are similar to those of other related benign lesions of the breast, diagnosis may be difficult by histologic examination alone; in addition, knowledge of radiologic, surgical and clinical findings may be required.

Morphological changes in lymph node biopsies of HIV-infected patients can be classified in four stages, based upon the degree of damage to follicular structures: (1) follicular hyperplasia, (2) follicular lysis, (3) follicular atrophy and (4) follicular and lymphocytic depletion. To define the relative usefulness of morphological, clinical and immunological findings for prognostic purposes, we followed the clinical evolution of 86 biopsied HIV+ patients for a period ranging from 1 to 56 months. A relatively good correlation between histological and clinical findings, at the time of biopsy, was observed. Statistical analysis confirmed the prognostic value of the histological features for clinical deterioration, progression to AIDS and survival. Moreover, histological findings gave more reliable prognostic information than clinical values. Our data suggest that lymph node biopsy can be utilized for prognostic purposes in the evaluation of the progression of the disease and effectiveness of antiviral therapeutic trials.

A Leydig cell tumor of testis was discovered during evaluation of infertility in a 36-year-old white man with azoospermia and high plasma estrogen level. Histological examination revealed multiple foci of calcification and massive adipose metaplasia. This is the first time that adipous metaplasia is observed in association with Leydig cell tumor of testis.

Eleven cases of thyroid lymphoma were studied by the immunoperoxidase avidin-biotin technique with calcitonin and somatostatin rabbit antisera. In 6 cases of non-Hodgkin lymphoma, in thyroid tissue residual to the lymphomatous infiltration, the C cell density was markedly increased and clustering was often observed; the C cells often took part in the follicular lining, frequently with polar distribution; these elements displayed a strong positivity for calcitonin, while the number of somatostatin-containing cells was lower and the staining less intense. In the only case of Hodgkin's lymphoma of the thyroid gland the staining was negative; in other 4 cases of non-Hodgkin lymphoma no residual thyroid tissue was found and the staining was also negative. As Hashimoto's thyroiditis is often associated with thyroid lymphoma, 13 cases of Hashimoto's thyroiditis were also studied; no C cells were observed and both stainings were negative. These data show that an increase in the C cell number may be a hallmark of thyroid lymphoma and that hyperplastic C cells show an intensive positivity for calcitonin. On the other hand, C cell hyperplasia is not present in Hashimoto's thyroiditis, in spite of the close association with thyroid lymphoma. Furthermore, we provide evidence that somatostatin-containing cells are present both in normal thyroid glands and in thyroid lymphoma.

The nature of hyaline bodies (HB) in Kaposi's sarcoma (KS) has been investigated by electron microscopy (EM) and immunohistochemical methods. Paraffin sections from 45 cases of KS selected on the basis of their high content of HB were challenged with antisera against factor VIIIR:Ag, carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), alpha 1-antitrypsin (A1AT), fibrinogen, hemoglobin, alpha-actin and lysozyme. HB showed positivity for all the antibodies except for the last two. By EM, HB showed features consistent with red blood cell, fibrin and platelet phagocytosis. Therefore, HB in KS are considered to be the expression of an indiscriminate process of phagocytosis which involves not only erythrocytes and platelets, but also other substances such as fibrinogen, factor VIIIR:Ag, A1AT, CEA and AFP.

Morphometric and morphological parameters have been evaluated in tumours of carotid body paraganglia and of aorticopulmonary and aorticosympathetic paraganglia. Paragangliomas are characterized by a higher cell density and rounder nuclei (roundness factor) than non-neoplastic carotid body paraganglia. The nuclear area has similar mean values in tumours and normal paraganglia; however, the former group shows higher standard deviation values and coefficients of variation, reflecting the fact that paragangliomas have nuclei of variable size; the variation is more pronounced in aorticopulmonary and aortico-sympathetic paragangliomas. However, subgroups on the basis of morphological features (architectural patterns and degree of intensity of argyrophilia), site of origin, and clinical behaviour (metastases and recurrences) show no morphometric differences.

The influence of magnification on light microscopic morphometry was studied. Morphometry was performed on 34 hepatocytes by using a digitizer plate with micrographs of the nuclei, and with digitized image of the nuclei on a separate monitor. Intraobserver variation was smallest at objective magnifications of 40 and 100 X (CV of form factor, maximum diameter and nuclear perimeter under 1%, of nuclear area under 2%, when measured from the monitor). The results show that more reproducible measurements are possible with higher magnifications. The authors recommend objective magnifications of 40 and 100 X for morphometric measurements on nuclei. The results also suggest that morphometric grading should apply an intermediate third grade in dichotomous grading scales.

Platelet factor 4 (PF 4), the low molecular weight polypeptide stored in the alpha granule, has been shown to be released from platelets during the process of activation. To examine the effects of known atherogenic food fats on platelet activation, as manifested in circulating PF 4 concentrations, groups of rhesus monkeys were fed diets enriched with varying quantities of different food fats. Plasma PF 4 levels were measured at set intervals during the experimental period. Platelet counts were performed and PF 4 values assayed using the radioligand binding technique. Animals given coconut-oil-enriched diets showed the greatest increase in PF 4 levels; while those fed corn, peanut and soybean-oil-containing rations showed small insignificant fluctuations of plasma PF 4 values. In this study the coconut oil effect on plasma PF 4 values increased with time; diluting the coconut oil with increasing quantities of corn oil led to progressive decreases in these values. These data indicate an increased incidence of platelet activation in animals fed coconut-oil-enriched diets, and suggest that corn oil counteracts this thromboactive effect of coconut oil.