摘要:

Spindle cell haemangioendothelioma is an uncommon vascular lesion, of which 35 cases have been previously reported. A further 20 cases are reported herein. These lesions affected a wide age range in both sexes, and showed a predilection for the extremities. Twelve patients had multiple lesions and, in these cases, local progression over many years but no true recurrence was typical. None of the 20 patients developed metastases. but one later developed an angiosarcoma. Individual cases were associated with congenital lymphoedema, Klippel‐Trenaunay syndrome and early‐onset varicose veins.Histologically, in addition to the admixture of cavernous spaces and solid spindle cell/epithelioid cell areas, the presence both of irregularly distributed and perivascular smooth muscle cells and of malformed variably‐sized vessels at the periphery of almost every lesion was noted in each case. Reticulin staining, immunohistochemistry and electronmicroscopy revealed the presence of primitive vessel formation and partial endothelial differentiation in the solid spindle cell areas. Combining these data with those from previously published series, it is suggested that spindle cell haemangioendothelioma is a non‐neoplastic lesion (rather than a borderline malignancy as it is currently regarded) and that its development correlates with histological and/or clinical evidence of a malformed vasculature at the affect

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00849.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

We report a case of epithelioid haemangioendothelioma involving both lung and liver. The tumour cells were positive for factor‐VIII‐related antigen. Immunohistochemical analysis of various basement membrane components in tumour tissue of lung and liver showed striking differences. In the liver tumour there was selective expression of collagen IV, with minimal and focal amounts of laminin and basement membrane‐associated heparan sulphate proteoglycan. In the lung tumour nodules, in contrast, all these basement membrane components were present. These patterns of basement membrane expression closely resemble those of normal liver and lung basement membrane respectively. We suggest that this provides evidence that epithelioid haemangioendothelioma arises from local endothelial cell proliferation and that it supports the assumption of a multicentric rather than metastatic origin when multiple tumour deposits are

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00850.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Wilms' tumour (nephroblastoma), the commonest malignant renal tumour of childhood, is thought to be derived from metanephric blastema and a majority of cases show the classical triphasic pattern of blastema, stroma and epithelium, There is usually little difficulty in making a correct histological diagnosis, but problems can arise due to the extraordinary potential of metanephric blastema to differentiate into a wide variety of heterologous tissues. Here we probably for the first time, two cases of Wilms' tumour which contained prominent quantities of neuroglial tissue. The classification of these cases as Wilms' tumours rather than renal teratomas is discussed.

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00851.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

An immunocytochemical and cytophotometrical analysis of 30 renal cell carcinomas was carried out in order to investigate the expression of cytokeratin and vimentin in relation to the ploidy and mitotic index. Thirty renal cell carcinomas were studied using monoclonal antibodies CAM 5.2 and anti‐vimentin in a biotin‐streptavidin staining procedure. The renal cell carcinomas were classified according to the criteria of Furhman with a nuclear grading from I to IV. All carcinomas expressed cytokeratin, whereas co‐expression with vimentin was present only in 53%. Expression for both intermediate filaments was present in aneuploid tumours with a marked nuclear pleomorphism and was more frequently related to a tubulo‐papillary and pseudosarcomatous growth pattern. It is suggested that vimentin expression in renal cell carcinomas may be useful as a prognostic index in addition to nuclear grade, DNA content, mitotic rate and tumou

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00852.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The histopathological features of orthotopic liver grafts were studied in 107 serial specimens from 25 patients, to assess the prevalence, possible pathogenesis and prognostic implications of hepatocellular ballooning. Ballooned hepatocytes were found in 46 (54%) of 8 5 biopsies taken five or more days after transplantation from 16 patients. They were not found in any of the protocol biopsies taken at the time of the operation. Ballooning usually appeared in the second week after transplantation, and in most patients persisted to the time of the latest biopsy studied. The affected cells were always found in acinar zone 3, and sometimes also in other zones. Forty‐four of the 46 biopsies with ballooning were taken during a period of clinical and biochemical cholestasis. In 13 of the 16 patients the degree of ballooning paralleled the severity of the cholestasis. Electronmicroscopy of affected hepatocytes showed conspicuous dilatation of the cisternae of the rough endoplasmic reticulum rather than the classical features of cholestasis. It was therefore concluded that ballooning was associated with but not directly caused by bile retention. There was no obvious association between ballooning and cellular rejection, sepsis, immunosuppressive therapy or parenteral nutrition. The most severe early ballooning was associated with serum transaminase levels over 1000 IU/l within 48 h of transplantation, suggesting that ischaemia was one of the pathogenetic factors. Hepatocellular ballooning did not in itself appear to have sinister short‐term prognostic implicat

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00853.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Mild to moderate liver injury to the orthotopically transplanted liver may result from acute rejection, mild ischaemia, or viral hepatitis. Because these conditions are often clinically indistinguishable, liver biopsy is frequently helpful. We previously characterized and reported the morphological spectrum of mild‐to‐moderate ischaemic injury from 170 liver biopsies (51 liver transplant patients). During this review, we found eight patients with a diffuse hepatocyte ballooning pattern. This pattern had some similarity to ‘preservation injury’ described by others, and in fact seven of the eight patients had these changes within the first 2 weeks post‐transplant. However, two of the seven patients also displayed these changes up to 6 months post‐transplant and the eighth patient developed these histological patterns only after the early post‐transplant period. Follow‐up data on patients with diffuse hepatocyte ballooning showed that some reverted to normal histology, some transformed to well‐delineated perivenular ballooning, and some progressed to perivenular necrosis and/or infarction. Only when superimposed perivenular necrosis became apparent did the Injury become irreversible, necessitating allograft removal or resulting in death. The pathogenesis of diffuse hepatocyte ballooning is unclear. However, the association of some of the cases with ‘preservation injury’ pattern in the early post‐transplant period and the progression of others to necrosis and infarction, suggest an ischaemi

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00854.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Survival for melanoma patients with thick primary tumours is notoriously short. A small number of patients with tumours>5.5 mm thick do, however, have protracted survival intervals. Attempts were made to account for this phenomenon by means of histological, cytometric and HLA serotyping analyses. Patients with thick lesions surviving more than 10 years were matched–by sex, age, anatomical site of primary lesion, stage of disease and, whenever possible, by initial surgical therapy–to patients dying of their disease within 5 years. This case‐control study on 13 long‐term survivors and 13 short‐term survivors did not show that any of the following attributes of the primary lesion were useful in predicting survival: Clark's level of invasion, ulceration, mitotic rate, host inflammatory response, tumour regression, tumour necrosis, vascular invasion, satellitosis, radial or vertical growth phase, predominant cell type, histogenetic type, borders, DNA quantification and cytomorphometry. HLA serotyping of long‐term survivors showed an excess of antigen DQwl compared with the general population, although this excess was not statistically

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00855.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Open lung biopsy in a 3 8‐year‐old female with Pringle‐Bourneville syndrome and recurrent pneumothorax revealed a micronodular pneumocyte II hyperplasia, a new entity probably associated with the tuberous sclerosis syndrome. The lesion caused an obstruction of the alveolar lymphatic vessels and alveolar ducts, resulting in an emphysema‐like picture. This cystic dilation of alveoli and draining lymphatics followed by rupture caused the recurrent pneumothorax. The epithelial pneumocytic nature of the lesion was confirmed by immunohistochemistry and electronmic

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00856.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A case of extramammary Paget's disease of the vulva giving rise to an invasive microacinar adenocarcinoma is presented. Extramammary Paget's disease of the vulva is rare and documented detailed cases associated with unequivocal dermal invasion exceptional. We have reviewed the literature with particular reference to such cases.

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00857.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1991.tb00858.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY