Applied pathology最新文献

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.

A histochemical and ultrastructural study of the testes, epididymides and spermatic cords from 6 adult men with amyloidosis secondary to several diseases is described. Amyloid fibrils, consisting mainly of AA protein, were deposited in the walls of blood vessels of the testis, epididymis and spermatic cord, as well as in the tunica propria of the seminiferous tubules. The seminiferous epithelium showed slight hypospermatogenesis. Many Leydig cells exhibited unstained 'bar' or 'arc'-shaped cytoplasmic areas similar to the cholesterol deposits of Leydig cells in adrenoleukodystrophy.

Cyanamide is a drug frequently used as aversion therapy in chronic alcoholism. A chronic hepatocytic lesion induced by cyanamide has been described by a member of our team over the last few years. It consists of distinctive cytoplasmic inclusion bodies, similar to those observed in Lafora's disease. The inclusion body-bearing liver cells resemble the ground-glass hepatocytes observed in type B viral infections. This hepatocytic lesion is predictable and reproducible in the rat liver. The high frequency of alcoholic patients with inclusion bodies observed in Spain is striking in contrast with the scarcity of cases published abroad. The medicine commonly used in Spain contains plain cyanamide, while Temposil used in Canada and Dipsan used in Scandinavia contain its calcium form (calcium carbimide). In an attempt to discover if the chemical nature of the drug is an important determinant in the development of the lesion, the present study was carried out using groups of Wistar rats. One group received cyanamide and the other one calcium carbimide. The drug was placed in the stomach via a cannula, daily, at a dose of 16 mg/kg body weight, for 25 weeks. The characteristic inclusion bodies were only found in the group receiving plain cyanamide.

Preparation of sections from undecalcified bone marrow biopsies embedded in glycol methacrylate (GMA, Technovit 7100) is reported. The beneficial effect of vacuum for a better penetration of resin into the hard tissue is assumed. Preserved details of 2- to 3-microns-thick sections of bone marrow specimens from various haematological malignancies yield a proper diagnosis and use of some histochemical methods on immature leukaemic cells is also possible. The use of embedding medium Technovit 7100 in the bone marrow histopathology is widely recommended for its simple, quick usage and non-toxic properties. An additional advantage is that blocks can be cut with ordinary steel knives (Histoknife H).

The morphologic features of amyloidosis associated with long-term hemodialysis for chronic renal failure were studied in a series of 16 patients in all of whom immunohistochemical evidence of beta 2-microglobulin-related amyloidosis was obtained. Osteoarticular involvement was present in 15 cases, as demonstrated in synovial biopsies, articular fluid sediments, three surgically obtained femoral heads, and 1 autopsied case. Amyloid was found in synovial membrane, articular cartilage and capsule. Osseous lesions due to amyloid infiltration were found in 2 cases with spontaneous fracture of the femoral neck. Thirteen patients had also amyloid in tissues obtained from carpal tunnel. Systemic involvement was demonstrated in 8 patients by means of rectal biopsies, abdominal fat aspiration biopsies, surgical specimens and autopsy. Deposition in the muscular layer of the gastrointestinal tract was found in 3 cases. Nodular subendothelial deposits in vessels of multiple sites seem to be characteristic of this type of amyloidosis. Immunohistochemical reactions for beta 2-microglobulin and P component were strongly positive in amyloid deposits of all cases. According to our results, abdominal fat aspiration biopsy has little value for screening purposes, whereas the study of articular fluid sediment is highly sensitive as a diagnostic method in patients with articular effusions.

The presence of progesterone receptor (PR), productive fibrosis (PF), axillary nodal status and tumor size are important prognostic variables in breast cancer. In this study we have analyzed the relationship between these four parameters in 78 ductal infiltrating carcinomas of the breast. No relationship was found between PF and the presence of lymph node metastatic disease: however, in the tumors with positive nodes, a limited metastatic diffusion (1-3 lymph nodes) was significantly associated with PF (p less than 0.05). Our study failed to demonstrate any relation between estrogen receptor (ER) and both presence and extension of nodal involvement; in contrast, the tumors with limited metastatic diffusion (1-3 lymph nodes) had a significantly higher prevalence of PR positivity (p less than 0.05). Furthermore, PF was strongly associated with PR (p less than 0.001) and less well with ER (p less than 0.05). The simultaneous presence of PR and marked PF was strongly correlated with limited metastatic involvement of the axilla (p less than 0.007). Tumor size was correlated with the number of positive nodes (p less than 0.001), but not with PR or PF. The results demonstrate that PR status, PF and tumor size are related to limited metastatic diffusion of the axilla: furthermore PF and PR have been shown to be strongly related and we have demonstrated that, at least in ductal infiltrating carcinoma, the simultaneous presence of them identifies a subset of tumors with low metastatic capacity independently of tumor size.

An autopsy case of neoplastic angioendotheliomatosis (NAE) in a 65-year-old male is reported. At autopsy, the paraaortic lymph node was slightly enlarged, and bilateral swelling of adrenal glands was found. Histologically, multifocal proliferation of atypical cells was seen in the sinusoid or in the lumen of blood vessels throughout many organs, but there was little invasion of the parenchyma by these cells. From these findings, it was diagnosed as NAE. Immunohistochemically, these atypical cells showed positive reaction to the antileukocyte common antigen, anti-MB-1, LN-1, and LN-2, and negative reaction to the anti-Ki-1, anti-MT-1, anti-kappa, anti-lambda, and antifactor-VIII-related antigen. These findings showed that the atypical cells of NAE were of B lymphocyte origin.

We present two cases of cystadenofibroma of the fallopian tube in 2 patients of 49 and 32 years, respectively. The first tumor was a chance finding in a hysterosalpingo-oophorectomy because of multiple leiomyomas. The second tumor appeared in a pregnant woman; the tumor was considered in an echographic study as an ectopic pregnancy. This tumor was a borderline cystadenofibroma. The second case is the first report of cystadenofibroma of the fallopian tube associated with pregnancy.

The reported incidence of cytokeratin and vimentin intermediate filament coexpression is rapidly expanding. An up-do-date list of the instances in which this occurs is presented and the implications of this event are discussed.