摘要:

Lesions of the gastrointestinal tract with massive tissue eosinophilia may present a difficult diagnostic problem. In a series of 250 gastrointestinal lymphomas drawn from the files of St Bartholomew's and St Mark's Hospitals there were 28 cases of a lymphoma with distinctive histological features, characterized by a massive tissue eosinophilia. Two of these tumours were present in the stomach and 26 in the small intestine. Eight of the latter were associated with coeliac disease. On low power examination a zoning phenomenon was regularly seen and fissuring ulceration, with perforation and fistula formation, was a common finding. The tumour cells were large and pleomorphic with irregular nuclear morphology and prominent nucleoli. Eosinophils were the predominant inflammatory cell associated with the lymphoma but plasma cells, epithelioid histiocytes and small lymphocytes were also present. Vascular changes were prominent. Involved lymph nodes showed gross expansion of the paracortex by tumour. Immunohistochemical studies showed that this lymphoma was probably of T‐cell origi

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02616.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Fifty‐seven of 469 major salivary glands excised for various reasons were found to contain granulomas. The aetiologies were tuberculosis (eight parotid, one sublingual), sarcoidosis (two parotid), calculous duct obstruction (34 submandibular), carcinomatous duct obstruction (four submandibular, one sublingual) and undetermined (four submandibular, three parotid). The tuberculous glands showed caseation in the majority of cases but two cases consisted predominantly of discrete granulomas with minimal necrosis. The sarcoid granulomas were typically non‐caseating but a few were centrally necrotic. The cases of calculous and carcinomatous duct obstruction contained single to multiple small granulomas which contained mucin and were related to ruptured ducts. It is suggested that the frequency of calculi and the mixture of serous and mucous acini in the submandibular gland account for the distribution of obstructive granulomas. This study establishes calculous sialadenopathy as a major cause of granulcmatous sialadeni

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02617.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Punch biopsies of skin were taken from allogeneic marrow recipients routinely before transplantation, at 14–22 and 90–107 d after grafting and in the event of a clinical rash. Three histological appearances were encountered: graftversushost disease (GvHD), epidermal abnormalities, and normal. Graftversushost disease was characterized by epidermal basal vacuolation, spongiosis and individual cell necrosis associated with mononuclear cell infiltration of the upper dermis and lower epidermis, while epidermal abnormalities were identical to GvHD but without the mononuclear cell infiltrate. Graftversushost disease occurred only in patients receiving marrow unpurged of T‐cells while epidermal abnormalities occurred with equal frequency in recipients of purged and unpurged marrow and were also noted in a high proportion of pre‐transplant biopsies. Patients whose skin biopsies exhibited epidermal abnormalities showed no greater incidence of subsequent clinical or histological GvHD than those with normal biopsies. For these reasons, we conclude that epidermal abnormalities cannot be regarded as a minor manifestation of GvHD as has often been previously assumed. We also conclude that they cannot be regarded as the cause of a rash as, unlike GvHD, the incidence was not significantly different in patients with and without rashes. The cause of epidermal abnormalities is not entirely clear; cytotoxic drugs and irradiation appear to play a part but their occurrence in patients with previously normal post‐transplant biopsies suggests that other factors may also be important. Some patients with strong clinical evidence of GvHD had negative biopsies; these should be regarded with caution especially within the first 24 h after the onset of a rash as the diagnostic histological picture may take time to develop. In some cases, GvHD was confined to pilosebaceous units; this seems to represent a minor form of the disease with only a limited capacity for progression. Dysplastic epidermal changes which have previously been attributed to the use of cyclosporin A were found with equal frequency in patients who did not receive this drug and must therefore have some ot

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02618.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The distribution of cytokeratin antigens during embryogenesis of the kidney and in 57 renal tumours has been studied using immunocytochemical techniques. A polyclonal antiserum to epidermal prekeratins and the monoclonal antibodies CAM 5.2 and PKK1 have been used to identify cytokeratins of different molecular weights. The ureteric bud‐derived structures expressed large molecular weight cytokeratins. The tubular component of the kidney expressed cytokeratins detected by CAM 5.2 and PKK1. During glomerular development there was transient expression of low molecular weight cytokeratins by the visceral glomerular epithelium but in the adult kidney only the parietal epithelium expressed cytokeratins. Tubules in nephroblastomas contained low molecular weight cytokeratins but the blastema did not. Some ureteric bud‐derived structures were identified in six nephroblastomas. Renal carcinomas expressed low molecular weight cytokeratins. Four collecting duct carcinomas were studied; these all expressed the large molecular weight cytokeratins found in collecting duct epithelium. These results indicate that the cytokeratin phenotype of renal tumours is unchanged from that of the normal epithelial ce

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02619.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The distribution in renal tumours of 3‐fucosyl‐N‐acetyl lactosamine has been studied by using the monoclonal antibodies AGF 4.36 and AGF 4.48 and immunoperoxidase methods on tissue sections. Seven of 19 nephroblastomas and 12 of 30 renal cell carcinomas contained the epitope. In nephroblastomas the epitope was found on the terminals of type B tubules in six cases and in one case on the type A or neoplastic tubules. In renal carcinoma the antigen was found on the surface of tumour cells. The results suggest that in kidneys bearing nephroblastomas ureteric bud elements may grow into the tumour from the adjacent k

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02620.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A case of extrarenal malignant rhabdoid sarcoma arising in the pelvic soft tissues of a 12‐year‐old girl is described. By routine light microscopy the tumour resembled, in some areas, an embryonal rhabdomyosarcoma and, in other areas, a neuroblastoma. Electron microscopy revealed characteristic cytoplasmic aggregates of intermediate filaments, often with central clusters of organelle membranes surrounded by these filament. Immunohistochemical stains showed strong cytoplasmic reactivity for vimentin. Staining for cytokeratin, myoglobin, desmin, neurofilaments, neurone specific enolase, S‐100 protein and leucocyte common antigen was negative. A histogenetic origin from primitive mesenchymal cells is favoured. We strongly support the use of electron microscopy for the definitive diagnosis of small round cell undifferentiated sarcomas of chil

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02621.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Three cases of an unusual diffuse sclerosing variant of papillary carcinoma of the thyroid occurring in young adults are reported. The tumour is characterized by diffuse involvement of one or both lobes of the thyroid, marked squamous metaplasia, numerous psammoma bodies, extensive interstitial fibrosis and heavy lymphocytic infiltration with formation of germinal centres. Lymphatic and vascular permeation was found in all three cases. An interesting finding was the presence of irregularly disposed thin bundles of smooth muscle within the fibrous stroma, presumably a result of splaying of the smooth muscle of vessel walls by the sclerotic process. The papillary areas of the tumour stained for thyroglobulin and cytokeratin, while the squamous areas stained strongly for cytokeratin but not for thyroglobulin. The tumours were negative for calcitonin and carcinosmbryonic antigen, but showed weak staining for S‐100 protein. Numerous S‐100 positive Langerhans/interdigitating reticulum cells were scattered within the tumour islands and the lymphoid infiltrate, suggesting an immunological reaction mediated by these antigen‐presenting

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02622.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A case of a low‐grade mucoepidermoid tumour showing an unusual pattern of extensive central keloid‐like sclerosis is reported. The sparsity of tumour islands renders recognition of its neoplastic nature difficult. It is postulated that the sclerosis results from exaggerated post‐inflammatory scarring due to extravasation of mucin from the tumour into the s

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02623.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A case of adenosquamous carcinoma of the gallbladder showing extensive spindle transformation is presented. By light microscopy, areas showing interwoven fascicles of fusiform, poorly differentiated cells closely resembling a sarcoma were seen to merge imperceptibly with areas showing more obvious glandular and squamous cell features. Immunocytochemistry utilizing tissue‐specific antibodies against intermediate filaments demonstrated the exclusive presence of prekeratin antibodies in both components of the tumour, thus establishing the epithelial nature of this neoplasm. The importance of immunological phenotyping in the differential diagnosis of epithelial tumours of the gallbladder showing pseudosarcomatous features is underscore

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02624.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1987.tb02625.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY