摘要:

The proliferative activity of the haematopoietic and plasma cells in bone marrow was evaluated under normal and neoplastic conditions, by means of a sequential double immunostaining technique, using monoclonal antibody MIB‐1 recognizing the cell proliferation‐associated nuclear antigen Ki‐67, and antibodies against glycophorin‐C, myeloperoxidase, factor VIII‐related antigen, and immunoglobulin light chains. Fifty‐eight B5 fixed, paraffin‐embedded bone marrow biopsies were analysed, including 11 normal controls, 10 cases of myelodysplasia, 14 cases of chronic myeloproliferative disorder, eight cases of acute non‐lymphoid leukaemia, and 15 cases of myeloma. In normal marrows, the highest proliferative activity was noticed in the erythroid cells (75% to 95%; mean 90%), in comparison with myeloid precursors (15% to 80%; mean 38%), and megakaryocytes (10% to 20%; mean 14%); no Ki‐67 positive plasma cells were found. In all investigated haematological disorders, the expression of MIB‐1 by erythroid cells was similar to that observed in controls. Similarly, the percentage of MIB‐1+ myeloid precursors in chronic myeloproliferative disorders and myelodysplasia largely overlapped the values observed in normals, and comparable values were also found in the blast cells from acute non‐lymphoid leukaemia type M1 and M2. These findings suggest that the evaluation of either erythroid or myeloid proliferative activity is of little value in the differential diagnosis between these myeloproliferative disorders. By contrast, the obvious increase of Ki‐67 expression of megakaryocytes in chronic myeloproliferative disorders, with labelling also of micro‐megakaryocytes, might sustain the diagnosis in controversial cases. Since cases of mature myeloma showed less than 2% of Ki‐67 positive cells, evaluation of proliferative activity is of no value in the differential diagnosis with reactive plasmacytosis. The sequential double immunophenotyping for Ki‐67 antigen and for haematopoietic cell lineage‐associated markers can be applied in a consistent manner to routine bone marrow biopsies to evaluate proliferating cells in

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00302.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Cytokeratin antibodies have been widely used for the identification of trophoblast cells in the placental bed, following their invasion from the developing conceptus. Their identification centres upon the expression of cytokeratin in epithelial cells, from which trophoblast cells are derived. Our recent observations indicate that this strict relationship may be more complex than was thought. Cryostat and paraffin sections of human decidua and myometrium, taken from the placental bed and the uterotomy cut, were examined immunocytochemically for cytokeratins using ten antibody clones selected to identify different cytokeratin proteins and antigenic epitopes. Biopsy specimens were obtained from normal and pathological pregnancies (pre‐eclampsia, fetal retardation, amnioninfection, hysterorrhexis, placenta praevia) at the time of caesarean section (26–41 weeks of pregnancy). Antibodies against nine clones, CAM 5.2, MNF 116, AE1/AE3, CK5, KS‐B17.2, CY‐90, M20, E3, and 34βE12 identified, as expected, syncytial giant cells and mononuclear trophoblasts within the placental bed and glandular epithelial cells throughout the uterus. In addition, they stained numerous fusiform cells that were classified by established criteria to represent smooth muscle cells, both within blood vessels and myometrium. No staining differences were observed between normal and pathological disorders. These results indicate that cytokeratin antibodies CAM 5.2, MNF 116 and AE1/AE3, and other antibodies targeting proteins 8 and 18, cross‐react with epitopes expressed in cells other than giant trophoblastic cells and mononuclear trophoblasts in the uterus and, thus, caution has to be used when such antibodies are used for the diagnostic characterization of tissues related to the pla

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00303.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Determination of DNA ploidy is useful in the diagnosis and classification of hydatidiform mole. Most reports of ploidy analysis in molar tissue have used DNA flow cytometry. Although image analysis cytometry offers theoretical advantages over flow cytometry, there have been few reports of ploidy analysis by image analysis in hydatidiform mole. We selected 47 cases and measured DNA ploidy by flow cytometry and image analysis cytometry in complete hydatidiform mole, partial hydatidiform mole and non‐molar abortion. The two cytometry modalities were compared using kappa statistics. There was reasonable overall agreement between the two modalities (κ= 0.69) and when ploidy was stratified into diploid/polyploid and triploid categories there was near perfect agreement (κ= 0.93). Aneuploid cell populations, which were not evident on flow cytometry, were identified by image analysis in a significant proportion of complete and partial hydatidiform moles and in a small number of non‐molar abortions. Flow cytometry and image analysis cytometry yield comparable ploidy information, useful in the diagnosis and classification of hydatidiform mole. Image analysis cytometry offers greater sensitivity in the detection of small non‐diploid cell populations but the significance of this latter finding is un

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00304.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In this study of 55 cases of granulomatous lymphadenitis of various aetiologies, both haematoxylin and eosin stained and unstained sections were examined by light and polarizing light microscopy for crystals within epithelioid histiocytes. This investigation was prompted by a case of granulomatous lymphadenitis in which the identification of ovoid birefringent structures within epithelioid histiocytes led to an initial false suggestion of foreign body reaction. Identical single, small, ovoid or biconvex, intensely birefringent crystals, invisible by ordinary light microscopy, were found within the cytoplasm of mononuclear epithelioid histiocytes in 37 cases. There was only minor crystal loss with routine H&E staining. The sections were also examined by scanning electronmicroscopy in secondary and backscattered electron imaging modes and 27 cases were found to contain biconvex crystals which were shown on X‐ray energy dispersive spectroscopic microanalysis to be consistent with calcium oxalate. There was a good quantitative correlation between light and scanning electron microscopy. Tissue from the index case was also examined by transmission electronmicroscopy, and electron dense crystals were identified. We confirm the previous findings of ovoid oxalate crystals in a variety of granulomatous conditions including Mycobacterial infection, sarcoidosis and Crohn's disease. Ovoid crystals of calcium oxalate, a common finding in granulomatous lymphadenitis, appear to be endogenously derived, and should be more widely recognized in order to avoid misdiagnosis of foreign body reactio

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00305.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Review of a series of 98 eyes removed at autopsy from 86 AIDS patients identified 12 cases (14%) showing varying degrees of microscopic calcium oxalate deposition. The oxalate crystals were birefringent using polarisation microscopy and were stained histochemically by the silver nitrate‐rubeanic acid method (Yasue), a stain considered to be specific for calcium oxalate. In two cases, the deposition was extensive and involved the surface of the ciliary processes, ciliary body and pars plana of the retina, the retinal and optic nerve blood vessel wall, a few retinal pigment cells, and the anterior inner sclera. A lesser degree of intraocular involvement was observed in the remaining 10 cases. In all but two eyes, where a peripheral active area of cytomegalovirus retinitis was present, no other significant microscopical abnormality was found. Clinically, these patients were asymptomatic. At autopsy, oxalate deposits were found in the kidney and/or thyroid in seven of the patient

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00306.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We describe distinctive arterial lesions in endomyocardial biopsies from patients with human cardiac allografts. The lesions affected principally the media of small arteries and consisted of misorientation of smooth muscle cells and fibrosis. This remodelling was most prevalent in the subadventitial zone, but sometimes extended to involve the full thickness of the media. In the most extreme cases medial smooth muscle cells ran parallel to the long axis of the vessel and were segregated into small bundles and single cells separated by collagen which merged with the adventitial fibrosis. The intima was always normal. Abnormal arteries were present in 16% of 603 consecutive biopsies from 44 patients, and 39% of lesions occurred in 16% of patients. No lesions were found in endomyocardial biopsies from 25 non‐transplanted patients, nor in mucosal biopsies from both transplanted and non‐transplanted patients, confirming that the appearances were not due to biopsy artefact. There was early arterial remodelling in biopsies within two weeks of transplantation and none of the stages resembled vascular rejection. Fifty per cent of biopsies from some patients contained arterial lesions, suggesting that in susceptible patients they are com

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00307.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The clinicopathological features of nine cases of recurrent thymomas have been studied. At presentation, all cases were histologically classified as thymomas with cortical differentiation, including predominantly cortical thymoma, cortical thymoma and well‐differentiated thymic carcinoma. In five cases the morphological features of the recurrence(s) were suggestive of a histological progression of the tumour from predominantly cortical thymoma to cortical thymoma and/or well‐differentiated thymic carcinoma, usually associated with a more advanced clinical stage, the latter indicating a clinical progression. These findings suggest that all types of thymoma with cortical differentiation are histologically and histogenetically related neoplasms, associated with a more aggressive clinical behaviour and a significant risk of recurrence. The overall outcome of patients with recurrent thymoma in this series was poor, since six patients (66.6%) died due to the disease, 2–14 years after the first diagnosis. The clinical implication of our findings is that thymomas with cortical differentiation always need careful follow‐up, even in those cases which are not obviously invasive a

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00308.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Although spindle cell haemangioendothelioma was initially described as a low‐grade angiosarcoma, recent reports have suggested that it is a reactive or benign vascular proliferation. In order to assess the proliferative activity in spindle cell haemangioendothelioma, 12 cases, one of which was associated with Maffucci's syndrome, were immunohistochemically analysed with antibodies against proliferating cell nuclear antigen (PCNA), Ki‐67 and p53. DNA flow cytometry was performed on six of the 12 cases. Seven of the 12 patients had multiple nodules or papules. Although two cases recurred once and twice, respectively, after surgery, there was no evidence of metastasis. Immunohistochemically, the percentages of PCNA, Ki‐67 and p53 positive tumour cells ranged from 0.1% to 6.4% (mean 3.3%), 0.1% to 14.9% (3.5%) and 0.1% to 2.8% (1.1%), respectively, indicating a low proliferative activity and a low p53 expression in this tumour. All seven lesions from the six cases examined flow cytometrically were DNA diploid with proliferative indices (S + G2/M‐phase fractions) ranging from 4.9% to 19.5% (mean, 10.9%). These findings are compatible with a bland‐looking histological picture and an indolent clinical course of spindle cell haemangioend

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00309.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Rheumatic fever is still the leading cause of acquired heart disease in children and young adults in developing countries. Recent reports have documented a rising incidence of rheumatic fever in both the USA and Europe. The disease is characterized by specific lesions in the heart muscle and valves called Aschoff nodules. The Aschoff nodule has been neglected in the last few decades as most of the studies were conducted in the 1960s on autopsy tissues. This study examines Aschoff nodules using heart valve material obtained at valve surgery with updated commercially available immunohistochemical antibodies to determine the phenotypic characteristics of the cells involved in the formation of these lesions. Fifteen cases of rheumatic valvulitis, as indicated by the presence of Aschoff nodules, were examined. The Anitschkow and Aschoff cells stained prominently with macrophage markers. Three stages of nodules with Aschoff and Anitschkow cells were identified: stage 1, central fibrinoid necrosis without lymphocytes, stage 2 with occasional T lymphocytes (<10) and stage 3 with lymphoid aggregates containing both T‐ and B‐lymphocytes (with occasional admixed macrophages). We propose that the stage 1 lesion is the earliest granulomatous stage with the lymphoid aggregates being a later stage in the development of Aschoff nodules. The Aschoff and Anitschkow cells demonstrated mitotic activity and stained with antibodies to the proliferation cell nuclear antigen (PCNA) suggesting that the multinucleated giant cells may be formed, at least partially, by nuclear division rather than fus

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00310.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Using immunohistochemical techniques ovarian carcinoid tumours can be shown to contain a wide variety of neuro‐hormonal peptides but clinical effects, apart from the carcinoid syndrome, are very rare. Non‐islet cell tumours with documented hyperinsulinaemic hypoglycaemia are also rare. This is the first recorded case of an ovarian strumal carcinoid associated with hyperinsulinaemic hypoglycaemia. Concurrent skin hyperpigmentation is believed to have resulted from the effects of tumour derived α‐melanocyte stimulating hormone or an antigenically similar, biologically active p

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1995.tb00311.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY