Archives of pathology最新文献

An ultrastructural study of the cerebral arteries obtained at autopsies on humans from infancy to old age was done. Intimal thickenings at bifurcations in infancy and childhood constantly showed various quantities of cellular debris that were seemingly dervied from the cellular constitutents of the wall, together with thickening, lamination, redundancy, and separation of basement membranes from the related cells. The extracellular lipid appeared to be derived from the transformation of cellular debris. Basement membrane changes indicated a serious disturbance in the relationship of mural cells to the connective tissues that was suggestive of interference with cohesion of the vessel wall. These morphological changes, hitherto overlooked, were more pronounced with age and in overt atherosclerosis, and were remakable similar to those induced experimentaly by hemodynamic stress.

A 13-year-old girl had a history of an upper-quadrant abdominal mass for about six months. On exploratory laparotomy, multiple discrete large nodules were seen in the spleen. Histologically, the spleen had the unusual appearance of lymphangioma, in that there was a tremendous proliferatiion of endothelial cells that formed either papillary projections in the lumina of the cavernous lymphatic vessels or a solid mass of cells without the lumina. The changes were suggestive of sarcomatous transformation, but the evidence was not conclusive. A term "lymphangioendothelioma" is proposed for this multinodular tumor.

The affinity for antiserum to the multipotent lipotropic hormone (beta-LPH) was tested by immunohistochemical staining of all known cell types in normal and certain abnormal mouse, rat, and human pituitaries. Results indicate that beta-LPH has ACTH, MSH, LH and StH(GH) immunologically cross-reacting determinants. Affinities of anti-LPH for TtH and MtH (prolactin) were not detected in normal pituitaries, but thyrotropic tumor cells reacted with anti-LPH. Absorption experiments confirm that the single polypeptide hormone of the pituitary, beta-LPH, is coded for ACTH and MSH activities. The multi-functional hormone, LPH probably is secreted by the adrenotropes. In addition to ACTH and MSH, it probably contains other antigenic and biologic determinants. Some of these may accentuate its lipotropic activities; others may be incidental. These are points calling for further correlated structural, biologic, and immunologic investigations.

Eelectron microscopy has disclosed the presence of intracytoplasmic lumina within breast cancer cells. These structures can be recognized with the light microscope by their sharp, round outlines and thick walls. Their identification in large numbers may provide additional support for the breast origin of a metastatic tumor. Three illustrative cases in which demonstration of intracytoplasmic lumina was diagnostically helpful are presented.

During a recent outbreak of Lassa fever in Sierre Leone, a 20-year-old woman developed an acute febrile disease with tonsillar exudates and hemorrhagic manifestations. Lassa virus was isolated in cell cultures from pharyngeal secretions and pleural fluid and was identified by complement fixation. Typical arenavirus particles were observed in these infected cell cultures. In a liver biopsy specimen, diffuse hepatocellular damage and focal necroses were evident, with a spectrum of liver cell change, ranging from slight vacuolizaiton to frank lysis. Virus was frequently observed in nearby extracellular spaces and was clearly associated with hepatocytes rather than sinusoidal cells. The demonstration for the first time of Lassa virus particules in human tissue provides direct evidence that the virus is responsible for the observed pathologic changes.

Displacement of cerebellulr tonsillar tissue into the subdural and subarachnoid space around the spinal cord was found at autopsy in eight patients who had had a variety of neurological diseases. The common factors were brain swelling and prolongation of survival by the respirator from 14 to 96 hours. Superimposed massive edema and intravitam autolysis caused by the artificial prolongation of life was the final outcome and is the most important factor in the pathogenesis of this condition. Unless the spinal cord has been examined, many pathological changes will not be appreciated.

Biopsy specimens of skeletal muscle from a family that had three female siblings with clinical features of recessive-type myotonia congenita were examined by light and electron microscopy. Fibers examined by the former technique appeared normal. Although some variation in size and shape of mitochondria and sarcomere fragmentation were focally observed by electron microscopy in affected members, they were also encounted in those without clinical manifestations. Importantly, no changes in sarcolemma, sarcoplasmic reticulum, or transverse tubular system were encountered. Capillary basement membrane thickness was within normal limits. The evidence strongly suggests that myotonia congenita represents an entity distinct from myotonia dystrophica and that its pathogenesis may be related to a biochemical rather than ultrastructal aberration.

Congenital hepatic fibrosis (CHF) is a morphologic entity characterized by (1) abnormal fibrous septation, (2) preservation of the basic lobular architecture, and (3) hyperplasia and dilatation of bile ductules. Congenital hepatic fibrosis may present as a cause of portal hypertension in adolescents, in young adults, and, rarely, in older adults. It is this form of the disorder that has been emphasized in the literature. However, CHF may also be seen in association with the infantile polycystic kidney syndrome. In the latter, the hepatic disorder is usually clinically silent. Cholangiocarcinoma is a rare complication of comgenital hepatic fibrosis, with only two previously documented cases reported, to our knowledge. We report a third case and suggest that CHF may represent a dysplastic hamartoma that, with prolonged survival, may eventuate in the development of intrahepatic biliary neoplasia.