摘要:

Diffuse interstitial pulmonary fibrosis is the end result of alveolar damage which may occur as a sudden acute incident or as a slowly developing process. Potentiating factors include release of enzymes and generation of oxygen radicals by granulocytes. Evidence from studies on broncho‐alveolar lavage fluid and from immunocyto‐chemistry indicate that an autoimmune process has an important but, as yet, not clearly defined role in initiating the disease. The fibrosis is probably due to proliferation of small clones of fast growing fibroblasts of a specific phenotype. Bronchiolitis obliterans, organizing pneumonia, idiopathic pulmonary fibrosis, usual interstitial pneumonia and desquamative interstitial pneumonia represent different aspects of the same condition. Their varied morphological appearances probably reflect the fact that tissue has been taken at different stages in the development of the dise

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01135.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A survey of 69 children presenting with recurrent or persistent haematuria and submitted to percutaneous renal biopsy at this hospital over a 17‐year period, was performed to establish the incidence of thin basement membrane nephropathy (TBMN). A diagnosis of primary glomerular disease was established in 44 (IgA nephropathy in 16, Alport's syndrome in 13 and other varieties of glomerulonephritis in 15). Of the remaining 25 patients in whom light microscopical and immunochemical examination revealed no abnormalities, material for electron microscopy was available in 11. In eight of these (five of whom had a family history), TBMN was diagnosed on the basis of ultrastructural morphometric evaluation of glomerular basement membrane thickness. Assuming a similar proportion of the remaining 14 patients with renal biopsy specimens normal by light microscopy had TBMN, the probable frequency of this abnormality in the whole series would be 26%, very similar to that of IgA nephropathy. In the eight TBMN patients the mean glomerular basement membrane thickness ranged between 181 and 236 nm, whilst in ‘control’ biopsies from children with ‘minimal change’ nephrotic syndrome or IgA nephropathy, the mean thickness ranged between 242 a

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01136.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We studied kidney sections from 15 cases of polyarteritis using an immunocytochemical technique to demonstrate cells containing immunoreactive renin. Ten cases of classical polyarteritis nodosa showed hyperplasia of renin‐containing cells in areas of renal cortex with histological evidence of ischaemia—appearances indistinguishable from those seen in renal artery stenosis. Histologically normal cortex showed little or no immunostainable renin. In the ischaemic areas there was loss of the normal gradient of renin‐containing cells from superficial to deep cortex. In many cases this gradient was abolished or even reversed; in some cases most renin‐containing cells were in juxtaglomerular apparatuses. This alteration in the distribution of immunoreactive renin has only been described in renal artery stenosis in man. In five cases of microscopic polyarteritis there were fewer than normal numbers of renin‐containing cells.We suggest that in classical polyarteritis nodosa, focal ischaemia causes activation of the renin‐angiotensin system analogous to the changes caused by renal artery stenosis. This may be important in the pathogenesis of hypertension in this condition. By contrast, in microscopic polyarteritis, the appearances of the juxtaglomerular apparatus and the reduced amounts of immunostainable renin suggest suppression of reni

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01137.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

In 10 kidneys removed for hypertension due to renal artery stenosis, the histological appearances varied from negligible ischaemic damage to end‐stage ischaemic atrophy. We stained the renin‐containing cells in tissue sections using an antiserum to pure human renin and an immunoperoxidase technique. In all kidneys there was hyperplasia of the renin‐containing cells both in juxtaglomerular apparatuses (JGAs) and in arteries outside the JGA, where these cells extended proximally as far as the Interlobular arteries. We mapped the distribution of renin‐containing cells and found them in all zones of the renal cortex; in three kidneys they were predominantly in the superficial cortex; in four they were distributed more evenly throughout the width of the cortex; but in three kidneys the normal gradient was reversed, with most of the cells being in the juxtamedullary cortex and, in two of the cases, little or no stainable renin in the superficial cortical JGAs. We suggest that these abnormalities in the distribution of renin‐containing cells could affect both the pattern of intrarenal blood flow and the site in the kidney at which secreted renin enters

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01138.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Three patients are described who presented with a large colonic adenoma in which a solid, undifferentiated carcinomatous component was found on microscopic examination. Despite small size (1.0 and 1.5 cm) and submucosal location in two cases, the tumours had metastasized to regional lymph nodes and the liver and death ensued at 4, 11 and 18 weeks after surgery. Immunocytochemistry was positive for carcino‐embryonic antigen, low molecular weight cytokeratins and neuron specific enolase in all three cases and scanty dense core granules of neurosecretory type were found in one of two examined by electron microscopy. These ‘neuroendocrine’ carcinomas are compared with ‘pure’ adenomas and ‘ordinary’ poorly differentiated adenocar‐cinomas of the colon from which they differ, mainly by lack of glandular differentiation and mucus secretion, although two adenocarcinomas also showed patchy reactivity for neuron specific enolase. The term ‘neuroendocrine’ may be disputed but is now well established to describe a tumour that runs a uniquely aggressive course and for which radical surgery alone ca

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01139.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Endocrine‐paracrine (EP) cells are normal cellular constituents of the human genitourinary tract. We examined the distribution and immunostaining profile of EP cells in von Brunn's nests and glandular metaplasia in the supramontanal (proximal) prostatic urethra of adult males and in prostatic ducts of the male fetal urethra. In 15/17 transurethral prostatic resection specimens there were argyrophilic cells and/or serotonin and neuron‐specific enolase containing cells in von Brunn's nests/glandular metaplasia and in the supramontanal prostatic urethra. All seven fetal specimens examined contained EP cells and five had focal calcitonin immuno‐reactivity in prostatic ducts and ductal buds. One adult resection specimen had focal staining for human chorionic gonadotrophin and no case showed staining for somatostatin. These results further support the contention that von Brunn's nests and glandular metaplasia are probably normal urothelial variants in the adult supramontanal prostatic ur

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01140.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Eight histopathologists, based at different hospitals, who had previously examined 100 consecutive colposcopic cervical biopsies were circulated with the results of the initial study. The slides were then ‘reblinded’ and re‐examined by the pathologists who, as before, assigned them into one of six diagnostic categories. The degree of Interpathologist agreement for the seven observers who returned usable responses was characterized by kappa statistics and compared to the corresponding figures for the same observers from the previous study. Although some of the observers showed significant alterations in their diagnostic practices there was persistent poor agreement for CIN 1 and 2, mediocre agreement for CIN 3 and excellent agreement for invasive carcinoma. Intra‐observer agreement was consistently better than inter‐observer agreement for each of the diagnostic categories. Significant differences were found among observers in the degree of intra‐observer variability. The 20 cases in which there was most disagreement were re‐examined by one of the authors who compared these with 20 biopsies which caused little disagreement. Disagreement was considered to be associated with florid papilloma‐virus changes, basal cell hyperplasia and severe inflammation in varying combinations. On the basis of these findings we suggest changes in the terminology

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01141.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Using immunoperoxidase procedures on paraffin sections, we have investigated the distribution pattern of tissue polypeptide antigen (TPA) in follicular adenomas, (20 cases), follicular carcinomas (23 cases), papillary carcinomas (10 cases), anaplastic carcinomas (eight cases) and medullary carcinomas (four cases). Normal thyroid tissue surrounding adenomas was also tested as a control. Our results document positivity for TPA in follicular, papillary and medullary carcinomas, whereas no reactivity was encountered in follicular adenomas and anaplastic carcinomas. These immunohistochemical data were compared with serological levels of TPA and the findings were discordant only for anaplastic carcinomas. We contend that the demonstration of TPA, possible in alcohol‐ or formalin‐fixed tissues, may prove to be of value in the differential diagnosis of thyroid adenomas from carcinomas of follicular cell ori

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01142.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We describe 13 cases of a peculiar lymphoid tumour containing very large numbers of reactive histiocytes. The tumours occurred in young patients (mean age 14.8 y) who presented with systemic symptoms and superficial lymphadenopathy. Microscopic examination revealed a diffuse effacement of lymph node structure due to the presence of histiocytes intermingled with a variable number of anaplastic large lymphoid cells. The latter, in some cases, were isolated, while in others they were arranged in clusters or were diffusely present in residual sinuses. The large anaplastic cells expressed the activation markers CD30 (Ki‐1), CD25 (interleukin‐2 receptor), CD70 (Ki‐24) and Ki‐27, as well as varying combinations of T‐associated molecules. The histiocytes expressed lysozyme and the CD11b (C3bi‐R), CD11c (p150, 95) CD14, CD68 (KPI) and Ber‐Mac3 antigens. Double staining with the antibody Ki‐67 demonstrated that the proliferating components were the CD30‐positive cells and not the histiocytes. T‐cell receptor beta gene rearrangements were shown in three cases tested. The patients responded well to aggressive chemotherapy and nine are still alive, eight in complete remission. It is suggested that the tumour represents a well‐defined clinico‐pathological entity originating from

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01143.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0309-0167    

DOI:10.1111/j.1365-2559.1990.tb01144.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY