We report here on five new cases of solid and cystic papillary neoplasm (SCPN) of the pancreas diagnosed by fine-needle aspiration cytology (FNAC). All cytologic samples were obtained by ...ultrasonography, and the smears were conventionally fixed and stained. Special histochemical and immunocytochemical stains were also performed in some samples. Cytology revealed in all but one case numerous pseudopapillary structures composed of fibrovascular stalks lined with one or more layers of bland-appearing, uniform tumor cells. The tumor cells had round-to-oval euchromatic nuclei with frequently folded smooth contours and one or two small nucleoli. Their cytoplasm often contained eosinophilic, PAS-positive, and diastase-resistant inclusions. Foamy cells, psammoma bodies, blood, and cellular debris were found in the background. The criteria for the differential diagnosis versus other pancreatic lesions are discussed in some detail, as is the role of immunocytochemistry (ICC). In the literature, only 28 cases of cytologically investigated SCPN have been reported to the best of our knowledge. The most helpful criteria for the conclusive identification of SCPN by FNAC include the pseudopapillary arrangement with bland-appearing tumor cells, and, especially, the finding of acidophilic, PAS-positive, and diastase-resistant cytoplasmic granules.
Between 1950 and 1981, 31 patients with mesothelioma were treated at the University of Minnesota. An average of 0.2 to 0.6 patients were seen per year between 1950 and 1970, and since 1970 there has ...been an average of 1.4 to 2.4 patients per year. Twenty‐seven of the 28 patients with malignant mesothelioma are known or presumed dead. Mesotheliomas occurred in all areas of Minnesota, and 28.6% of the patients had a definite history of asbestos exposure. This was also a probable cause of the disease in an additional 25% of patients. The clinical findings and course of the disease were similar to other series. The median survival of all patients was eight months. Doxorubicin‐treated patients survived a median of 16 months (range, 2–36 months). Malignant mesothelioma is being increasingly recognized in Minnesota and has a grim prognosis in spite of doxorubicin therapy.
Recent reports have suggested that the immunodetection of tumor cells in bone marrow of small-cell lung cancer (SCLC) patients is by far more effective than traditional cytohistological methods and ...that this may be clinically relevant. This study aimed to evaluate whether the level of detection of tumor cells in bone marrow is affected by different immunostaining methods. Using two anti-NCAM monoclonal antibodies (MAbs), we compared four different “sandwich” methods on cytospin preparations of the N592 human SCLC cell line and of bone marrow aspirates from 37 SCLC patients. Our data indicate that the combination of the alkaline phosphatase-anti-alkaline phosphatase and streptavidin-biotin-alkaline phosphatase complex methods provides the best results in terms of sensitivity and specificity, and of intensity of immunoreaction and absence of staining background. Moreover, bone marrow micrometastases detected by this method were prognostically relevant and identified, among patients with apparently limited disease according to conventional staging procedures, a subgroup with shorter survival. We suggest that the choice of a sensitive immunostaining technique may significantly increase the detection rate of SCLC cells in bone marrow, mirroring the biological aggressiveness of the disease. (J Histochem Cytochem 47:1075–1087, 1999)
The young lady with bilateral renal masses BEDOGNA, V; LUPO, A; MONTEMEZZI, S ...
Nephrology, dialysis, transplantation,
04/1999, Letnik:
14, Številka:
4
Journal Article
The pancreases of 17 patients who had cystic fibrosis with and without diabetes mellitus were evaluated at autopsy by routine staining and immunohistochemical methods for insulin, glucagon, ...somatostatin, and pancreatic polypeptide. Qualitative assessment of the number of islets of Langerhans and the degrees of exocrine pancreatic atrophy, fibrosis, and fat replacement was made for each pancreas. Quantitative assessment of islet composition was performed in 15 of the 17 based on the immunochemical reactivity of each cell type. Nondiabetic patients with cystic fibrosis in the latter part of the first decade of life have classic fibrocystic changes of the pancreas, with some persisting exocrine tissue, islets that appear normal, and prominent nesidioblastosis. The latter process may protect these patients from glucose intolerance. Young adult diabetic patients with cystic fibrosis have total loss of exocrine pancreas with fat replacement, lack of nesidioblastosis, a qualitative decrease in the number of islets, fibrosis of and amyloid deposits in islets, decreased numbers of insulin-containing cells in each islet, and atrophy of islet cells, probably resulting from progressive ischemia. Although the potential exists for an increasing incidence of diabetes mellitus in patients with cystic fibrosis as their life spans increase, individual variation occurs in this disease.
The histologic organization of lymphoid and nonlymphoid (epithelial and interdigitating) cells in a thymoma has been compared to that of the normal thymus. Enzyme and immunohistochemical methods were ...applied, using both conventional antisera (to cytokeratin) and monoclonal antibodies (to epithelial cells, HLA-DR and lymphoid subsets). Throughout the tumor, the epithelial cells shared phenotypical similarities with the epithelial cells of thymic medulla (RFD-4 positive, cytokeratin strongly positive, and HLA-DR essentially negative). On the other hand, the lymphoid cells were heterogeneous in phenotype and distribution, and "mimicked" the distribution seen in the normal infant thymus. Immature thymocytes of cortical type (TdT+, OKT6+, OKT3-) were predominant in the areas with moderate lymphocytic infiltration (ML). Mature T-lymphocytes (TdT-, OKT6-, OKT3+) were found mainly in areas with scanty lymphocytes (SL) together with an additional population of HLA-DR positive interdigitating and HLA-DR+, OKT6+ Langerhans'-type cells. These findings indicate that in thymoma tissue, the lymphoid elements of cortical type are apparently surrounded by an inappropriate (medullary) epithelium.
Eight cases of human thymoma have been analyzed on cryostat sections with the monoclonal antibody Ki67, which reacts with cells in the proliferative phases of the cell cycle. The aim was to assess ...the proportion of proliferating thymocytes among lymphoid cells in the thymoma samples. In all cases a large number of cells (mean, 58.75%; range, 35-80%), recognized as thymocytes by morphology and lack of cytokeratin expression in a combined immunohistochemical assay, exhibited nuclear Ki67 staining. These findings differ from the reactivity pattern observed in age-matched nonneoplastic thymuses where lower growth activity of cortical thymocytes was observed (15-20% Ki67+ cells). Intensive thymocyte proliferation in thymomas may represent one of the factors which lead to autoimmunity in myasthenia gravis and thymomas.
The enzyme glycyl-proline-naphthylamidase (dipeptidyl-amino-peptidase IV), (DAP-IV) has been histochemically analysed in normal and pathological specimens of different lymphoid tissues. In all the ...tissues examined, the enzyme appeared to be highly specific for T cells. Using chloroformacetone fixation and sections of proper thickness, DAP-IV could be successfully demonstrated in cortical thymocytes, which exhibited weak reactivity, as well as in medullary thymocytes which showed a more intense and variable reactivity. A similar reactivity was observed in T cells of peripheral blood, lymph node, and spleen. Various acute lymphoblastic and nonlymphoblastic leukemias and malignant lymphomas were studied using the histochemical method for DAP-IV. Malignant cells from all the acute leukemias and from the B-cell lymphomas were DAP-IV unreactive, while strong reactivity was observed in one case of T-CLL and one case of T-PLL. The possible relationship of DAP-IV positivity pattern with T-cell maturation and its potential use as a diagnostic tool in lymphoproliferative disorders are discussed.
A typical case of biphasic synovial sarcoma was studied using enzyme histochemistry. A marked difference between the staining characteristics of the spindle cells and the epithelial-like cells was ...demonstrated by reactions for various hydrolytic enzymes. The epithelial-like cells exhibited a strong reactivity for alkaline phosphatase, acid phosphatase, adenosine triphosphatase and nonspecific esterase, whereas spindle-cells were completely unreactive when tested for these enzymes. This is, to our knowledge, the first report demonstrating differences in the enzymatic pattern of the two cell populations which compose synovial sarcoma.
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