Applied pathology最新文献

A further case of xanthomatous endometritis, characterized by the presence of histiocytic cells in the endometrium, in the absence of carcinoma is described. This lesion seems to be a rare complication of hematometra with cervical occlusion. The foam cells would appear to be macrophages, components of a nonspecific inflammatory reaction, which have phagocytosed breakdown elements of retained endometrial hemorrhage.

Out of a total of 200 patients with solitary thyroid nodules, 41 diagnosed by fine-needle aspiration biopsy (FNAB) (group A) and 159 by clinical and/or scintiscanning data (group B), 22 were found to have malignant neoplasias, 31 adenomas, 145 simple goiters and 2 thyroiditis. The use of the FNAB technique led to a percentage increase in the operations for malignant neoplasias, while it markedly reduced the number of surgical interventions for simple goiter. Statistical calculation of the sensitivity, specificity, negative predictive value and overall diagnostic accuracy of FNAB indexes demonstrated that FNAB is a simple, reliable, useful and cost-effective procedure.

We discuss the morphological, immunohistochemical and electron-microscopical features of a malignant myxoid liposarcoma which appeared in the left thigh of a 52-year-old woman. The cytogenetic analysis following short-term tissue culture confirmed the existence of a nonrandom translocation t(12;16)(q13;p11). Furthermore, immunohistochemistry showed positivity for S-100 antigen and vimentin, both of which are considered to be markers for liposarcoma. The electron-microscopical study revealed a close contiguity between the tumoral cells and atypical pericytes.

'Normal' dome biopsies from 20 cystectomies for infiltrating bladder carcinomas were studied with scanning electron microscopy (SEM). All cases showed alterations ranging from minimal changes to numerous pleomorphic microvilli, and were classified according to Herd and Jacobs. The SEM findings and grades were correlated with dome histology and the results were quite good. However, in our opinion, the Herd and Jacobs classification and subclassifications are poorly reproducible without morphometric analysis. Nevertheless the SEM study is useful to strengthen the diagnosis of dysplasia/carcinoma in situ in 'healthy'-looking urothelium.

Biopsy of the minor salivary glands is an accepted method in the diagnosis of Sjögren's syndrome, the most characteristic feature being the prominent inflammatory cell infiltration. However, difficulties exist in the early diagnosis of Sjögren's syndrome. The present study was conducted to analyse by subjective and quantitative methods the morphological changes of the salivary glands in patients with rheumatoid arthritis (RA) frequently complicated by Sjögren's syndrome. The subjects of this study were 71 RA patients (mean age 54 +/- 15 years) and their 45 healthy age-matched controls (mean age 60 +/- 14 years). The histologic parameters evaluated were: inflammatory cell infiltration; acinar atrophy; fibrosis, and fatty infiltration. Statistically significant differences between the RA and the control groups were found in all parameters (p less than 0.001) except the fatty infiltration. This indicates that destruction of the salivary glands including fibrosis and acinar atrophy is associated with RA. Only the fatty infiltration seems to be an age-dependent change. All salivary gland biopsies of the RA patients were photographed and evaluated planimetrically, for the same parameters as in the subjective evaluation. An excellent reproducibility between the two methods was found, thus indicating the applicability of the subjective evaluation in the assessment of early salivary gland changes in RA patients.

Twelve anaplastic thyroid carcinomas were investigated with a panel of antibodies. The squamoid and giant cell anaplastic carcinomas showed coexpression of cytokeratin and vimentin in 66% of the cases. Reactivity for A-1-AT and A-1-ACT antiserum appeared when the spindle cell component became prevalent. The antidesmoplakin antibody can be employed on cryostat sections in differential diagnosis between sarcoma and carcinoma of the thyroid.

An immunocytochemical study using a panel of commercially available antisera, has been performed to distinguish on the basis of their immunoreactivity a series of spindle cell sarcomas diagnosed solely on the histologic features: 11 malignant schwannomas (MS), 8 leiomyosarcomas (LMS) and 3 malignant fibrous histiocytomas (MFH). The results have been compared with those obtained in 12 benign and 8 malignant peripheral nerve sheath tumors (MPNST) in which the microscopic diagnosis was supported by their origin in a nerve trunk and/or in von Recklinghausen's (vR) disease. The following antisera were used: anti-S-100 protein, anti-Leu-7, anti-neuron specific enolase (NSE), anti-myelin basic protein (MBP), anti-glial fibrillary acidic protein (GFAP) and anti-actin. S-100 protein was present in 100% of benign and malignant peripheral nerve tumors and in 7/11 (63%) of MS diagnosed on histological basis only and in 3/8 (37%) LMS. MFH were negative. Leu-7 positivity was observed in 8/12 (66%) and 6/8 (75%), respectively, in benign and malignant PNS neoplasms, in 5/11 (45%) MS, 4/8 (50%) LMS and 2/3 (66%) MFH. NSE was present in 7/12 (58%) and 6/8 (75%), respectively, in benign and malignant PNS tumors, in 6/11 (54%) MS and in 1/8 (12%) LMS. MFH were negative. MBP resulted negative in peripheral nerve neoplasms and spindle cell sarcomas. GFAP positivity was observed in 2/12 (16%) and 1/8 (12%), respectively, in benign and malignant PNS neoplasms. All spindle cell sarcomas were negative. All cases of MPNST and spindle cell sarcomas showed actin immunoreactivity. These results indicate that: (1) MBP, Leu-7 and NSE do not represent markers of schwannian differentiation; (2) GFAP, although rarely expressed, may indicate schwannian differentiation, and (3) malignant peripheral nerve neoplasms and LMS share immunoreactivity for S-100, Leu-7, NSE and actin, therefore they cannot be differentiated on immunocytochemical basis using commercially available antisera.

We report a unique case of primary myxoid chondrosarcoma in the posterior mediastinum. This lesion clinically mimicked a neurogenic tumor due to its location and dumbbell appearance. The histogenesis of this tumor is discussed and a skeletal origin from the thoracic vertebrae is suggested. It is concluded that myxoid chondrosarcoma has to be distinguished for the differential diagnosis among the long list of myxoid tumors arising in the posterior mediastinum.

Nuclei of melanocytes in 10 common acquired melanocytic nevi, 10 malignant melanomas and 10 dysplastic melanocytic nevi (melanocytic dysplasia) (MD) were morphometrically analyzed. MD group consisted of 6 lesions with (MD 1) and 4 without (MD 2) the clinical features of dysplastic nevi. The considered parameters were area, perimeter and form Ar. In the MD group, the results showed that median values of each considered parameter of MD 1 were close to those of MD 2. For each evaluated parameter, median values of MD turned out to be intermediate between those of common acquired melanocytic nevi and of malignant melanomas. Confirming the histologic evidence of a double - nonatypical and atypical - melanocytic population in melanocytic dysplasia, our data showed that nonatypical melanocytes were indistinguishable from melanocytes of common acquired nevi, while the atypical melanocytes were close to melanoma cells. The importance of atypical melanocytes is stressed in the diagnosis of melanocytic dysplasia.

A case of thymic atypical carcinoid with Cushing's syndrome and unfavorable clinical course is reported. Immunohistochemical analysis reveals distinct staining of tumor cells for ACTH, neuron-specific enolase, chromogranins (CG) and S-100 protein and with PHE-5 monoclonal antibody. At an ultrastructural level, the cells are undifferentiated with only a few neurosecretory granules. In the present case, immunohistochemical stainings for CG and with PHE-5 antibody seem reliable diagnostic tools, easily demonstrating the neuroendocrine nature of the neoplasm. NSE immunoreactivity can be an additional criterion. S-100-positive cells, which are present throughout the tumor, recall 'sustentacular cells', described in other neuroendocrine tumors.