摘要:

Given the pivotal role of the B‐cell follicle in B‐cell proliferation, and the fact that the follicle centre has the highest proliferation fraction of any structure in the body, it would be reasonable to expect that the potential for the development of aberrant (neoplastic) growth within it would be relatively high, especially when compared to other lymphoid compartments. However, in all current lymphoma classifications only one entity, namely follicular lymphoma, is acknowledged as having any relation to the follicle. As knowledge of the immunophenotype and function of the normal follicle has increased, it has become evident that many lymphomas, including some examples of Hodgkin’s disease, are related to the B‐cell follicle and as a consequence manifest a follicular growth pattern. This has implications for the pathogenesis of these tumours and may point the way to novel therapeutic

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-473.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Sections from 95 skin lesions excised at pigmented lesion clinics in England and Scotland were studied by eight histopathologists in order to evaluate consistency in the use of histopathological terms for features of diagnostic and prognostic importance for cutaneous malignant melanoma. The level of agreement (kappa) amongst the panel improved after discussion and re‐definement of criteria for several features. These included, architectural and nuclear atypia, pagetoid infiltration and radial and vertical growth phases. A high level of agreement was achieved for an overall benign or malignant diagnosis (κ = 0.77) but use of more specific terms such as benign naevi with atypia and melanoma ≤0.76 mm thickness, was associated with only an intermediate level of agreement. Of the original diagnosis of melanoma, 17% were re‐classified by the panel as benign with atypia and 2% reported to be benign were judged to be melanoma. This reflected the high proportion of borderline lesions in the study. The use of standardized diagnostic criteria with precise definitions has been shown to improve consistency in diagnosis and it is recommended for general application. From this should emanate more reliable incidence figures for thin melanoma, and improved understanding of the nature of these early lesions, to the benefit of patient and clinician alike. The poor concordance in distinguishing severe dysplasia in the junctional component of melanocyte proliferations from melanomain situand superficial dermal invasion improved only modestly despite intensive efforts. Since melanomain situand severe dysplasia cannot be distinguished by objective measurements and since their clinical management is the same, the panel suggests that attempts to separate them in diagnostic reports should be discontinued and they could both be referred to as melanocytic intraepidermal neoplasia (MIN). If it becomes accepted that dermal invasion without a vertical growth component can also be managed identically to MIN, then this invasive radial phase may be appropriately referred to as microinvasion and linked to MIN for the purposes of clinica

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-464.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

We performed an immunohistochemical analysis to investigate the expression of p53 protein in a panel of 18 laryngeal squamous cell carcinomas, 15 primary tumours and three in relapse, previously analysed by us for the presence of p53 gene mutations. Dysplastic and/or normal surrounding mucosa was evaluated in 15 different tumours. The results of our study are the following: (1) expression of p53 protein was observed in one out of five tumours positive for p53 gene mutations (20%) and in 10 out of 13 (80%) negative cases; (2), p53 protein over‐expression was frequently observed in normal and/or dysplastic mucosa surrounding either wild‐type (7/11) or mutated p53 tumours (2/4); (3), p53 immunoreactive cells showed a pattern of distribution in normal and mildly/moderately dysplastic mucosa (basal layers), different from that in severely dysplastic mucosa (whole thickness). These data further support the hypothesis that p53 protein over‐expression may be a marker of the earliest phases of multistep tumorigenesis in laryngeal squamous cell carc

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-466.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

We studied the immunohistochemical expression of inducible adhesion molecules, integrins and extracellular matrix proteins in 10 cases of glioblastoma multiforme in order to investigate their angiogenesis, local invasiveness, poor metastasizing properties and their lack of tumour infiltrating leukocytes. In glioblastomas endothelial proliferations represent the majority of vascular structures; they were positive for endothelial markers (vWF, CD31, VE‐cadherin) and negative for macrophage markers (CD68, PAM‐1). Immunohistologically, they were subtyped into:1solid‐glomeruloid ICAM‐1, α2β1, α3β1, α5β1negative;2channelled‐branching ICAM‐1 negative and α2β1, α3β1, α5β1positive;3channelled‐telangiectatic ICAM‐1, α2β1, α3β1, α5β1positive. In channelled proliferations, the expression and distribution of tenascin and merosin in the basal membrane was similar to that of normal brain vessels. The expression of all these molecules might indicate different steps of maturation of endothelial proliferations. The majority of endothelial proliferations may be immunohistologically considered as incomplete vascular structures; this might account for the low metastasizing tendency and low recruitment of leukocytes by these tumours. Neoplastic astrocytes were GFAP‐1, ICAM‐1, VCAM‐1, α2β1, α3β1and α5β1immunoreactive and α6β4negative; this allows them to interact with extracellular matrix proteins and might, in part, explain the

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-471.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Cardiac myxoma is an enigmatic tumour thought to arise from primitive cardiac mesenchymal cells. Factor XIIIa+ dendrophages are tissue histiocytes that are active in tissue repair and thrombosis. To explore whether factor XIIIa+ dendrophages play a role in cardiac myxoma morphogenesis, we stained four cases with an antiserum against coagulation factor XIIIa (FXIIIa). We also used antibodies recognizing CD34, CD31, and S‐100 protein. Samples of valvular endocardium from 12 and 16 week fetuses and two adult autopsies were compared with the four myxomas. All cardiac myxomas had rounded and dendritic FXIIIa+ cells admixed with more numerous CD34+ spindle and stellate myxoma cells. The CD34+ cells formed multicellular syncytia and capillary sprouts. Many of these syncytial structures also expressed CD31 and, to a lesser extent, S‐100 protein, strongly in two cases and more focally in two. Fetal subendocardium was composed of CD34+ stellate fibroblast‐like cells invested with scattered FXIIIa+ histiocytes; no S‐100+ cells were detected. Our findings confirm that cardiac myxomas are composed of CD34+ primitive subendocardial cells. These cells show a capacity for CD31+ endothelial differentiation. In cardiac myxoma, the CD34+ myxoma cells are accompanied by numerous FXIIIa+ dendrophages, the presence of which suggests abnormal organizing thrombus‐like differentiation in cardiac myxoma morp

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-470.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The reliability of stereotactic core biopsy in the diagnosis of malignant and premalignant breast lesions was assessed in comparison to excision biopsy in patients with non‐palpable suspicious breast lesions detected in a mammography breast screening programme. Fifty‐two cases of malignancy and nine of atypical ductal hyperplasia were diagnosed on the programme during the two year period July 1993 to June 1995; two patients did not have excision biopsy. Stereotactic core biopsies and representative sections from 59 excision specimens from the same patients were assessed ‘blind’ by one pathologist. All 51 cancers diagnosed on stereotactic core biopsy were confirmed to be malignant on excision biopsy. There was 96% concordance between stereotactic core biopsy and excision biopsy for the diagnosis of invasive orin situcancer, and 78% concordance for the type of cancer. The stereotactic core biopsy and excision biopsy diagnoses were: invasive ductal carcinomas (39 on stereotactic core biopsy vs. 33 on excision biopsy), mucinous carcinomas (1 vs. 2), invasive lobular carcinomas (3 vs. 8), andin situcarcinomas (8 vs. 8), two of which had invasive cancer present only in the stereotactic core biopsy. Of the nine cases of atypical ductal hyperplasia diagnosed on stereotactic core biopsy, eight had an excision biopsy, six showed low nuclear gradein situor invasive cancer, one had a 3mm focus of high grade invasive ductal cancer and one was atypical ductal hyperplasia. In the invasive ductal carcinoma group stereotactic core biopsy underestimated tumour grade: in nine cases (31%) the cancer at excision was of a higher grade. Stereotactic core biopsy is a reliable alternative to excision biopsy in the diagnosis of breast cancer, however, stereotactic core biopsy may underestimate tumour grade in invasive ductal carcinoma and may not differentiate between invasive ductal carcinoma and lobular carcinoma. It is recommended that the diagnosis of atypical ductal hyperplasia on stereotactic core biopsy be followed by excision biopsy, as stereotactic core biopsy underestimates the presence of cancer in thi

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-463.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

A total of 122 specimens of colorectal cancer were re‐assessed in relation to the reporting of invasive growth pattern (expanding vs. infiltrating) and presence or absence of peritumoral lymphocytic infiltrate as used in the Jass prognostic classification. Jass agreed with 69% of cases reported as infiltrating and 90% of those reported as expanding. This parameter was distributed similarly amongst Dukes B and C cases in the original assessment (P = 0.27), whereas in the reviewed data infiltrating cases were more likely to be staged as Dukes C (P = 0.04). Jass agreed with 44% of lymphocyte present and 94% of lymphocyte absent assessments. The original lymphocyte assessments showed no significant differences in distribution between Dukes A and B cases (P = 0.12) or B and C cases (P = 0.75), whereas the reviewed data showed significant differences for A vs. B (P = 0.015) and B vs. C cases (P = 0.0025). Criteria for assessment were circulated to eight observers who revisited 20 of the cases in which there was disagreement. Consensus agreement with Jass was achieved in nine of 10 cases for invasive growth pattern and seven of 10 cases for lymphocyte infiltration (with two being evenly split). Most observers showed at least fair levels of agreement with Jass and some achieved excellent levels of agreement. This study indicates that assessment of criteria used in the Jass prognostic system for colorectal cancer is less than optimal in routine practice, but is improved through the provi

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-467.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Eighteen cases of endocervical tubal metaplasia (tubal metaplasia) and 16 cases of adenocarcinomain situwere reacted immunohistochemically for carcinoembryonic antigen (CEA) and vimentin. Whereas CEA was more frequently positive in adenocarcinomain situcases (63%) than in tubal metaplasia cases (39%), vimentin was not expressed in adenocarcinoma but was positive in 78% of cases of tubal metaplasia.

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-462.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-468.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

ISSN:0309-0167    

DOI:10.1046/j.1365-2559.1996.d01-474.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY