A clinical case of combination between papillary and medullary carcinomas situated in one lobe of thyroid gland is represented. The patient was a 66 year-old female with clinical data for goiter and thyroid scanning revealing a functioning (hot) nodule. Immunohistochemical and ultrastructural evaluation, alongside with routine histological staining were applied for identification of both tumors. Papillary carcinoma cells proved to be pancytokeratin positive and negative for carcinoembryonic antigen and calcitonin. Medullary carcinoma cells showed expression of carcinoembryonic antigen and calcitonin and histochemical methods demonstrated stromal deposits of amyloid. The opportunities for concomitant malignant transformation of thyroid follicular and parafollicular (C) cells are discussed.
The aim of this study was to examine the development of chorionic villous trees during early periods of normal intrauterinal and ectopic (tubal) pregnancies, and to study the structural specializations on the free surface of mature placental villi by scanning and transmission electron microscope (SEM and TEM). In order to study the structures of placental villi between 28 and 34 days old (pc), early, 6-8 week normal and ectopic, and full term human placenta samples were obtained from legal curettage and hysterectomized cases, and spontaneous deliveries, and tissues samples were prepared for SEM and TEM. Three-dimensional configurations of the developing chorionic villous trees were observed as large main villus groups, covered with abundant microvilli of different size and diameters. It appeared that the chorionic villous trees which emerged from the chorionic plate divided gradually into branches of which ramifications originated as buds. These buds gradually grew and were transformed into shoots. The number of developing new villi appeared to increase gradually from 28 days to 9 weeks (pm) of gestation. From the 4th week onwards the massive trophoblastic sprouts were observed on the surface of main chorionic villi which transformed into primary, secondary and tertiary villous trees. When the placental villi formation in ectopic pregnancy was compared with the intra-uterinal pregnancy, an arrested development was remarkable. The configurations of ectopic placental villi seemed to be disparate, such as curved lines or compressed and wrinkled positions so that the three dimensional aspect had been wizened. The ramification and new villi formation seen as in the normal placenta were not only decreased but also infrequent. Some placental villi samples displayed a gradually thinning terminal region. Trophoblastic degenerations were frequently found on the surface of ectopic villi ultrastructurally. According to these results, we comment that in ectopic pregnancy the placental villi formation and development could have been delayed. At term, some specialized structural modifications were observed on the free surface of the mature placental villi. The presence of some dome-like balloonings and many crateriform hollows were the most striking features of the mature intermediate and terminal villi. According to the increasing physiological needs of the growing fetus, these special structures that are related to lung-like and kidney-like functions and named "nephropneumonic-like units", formed in the mature placental barrier. We have observed that these special units were showing a smooth surface similar to an inflated balloon.(ABSTRACT TRUNCATED AT 400 WORDS)
Biopsy sections taken from liver tissue near and far away from metastases were investigated histologically, histochemically, electronmicroscopically and immunohistochemically in order to establish collagenization and extracellular matrix (ECM) formation in the space of Disse. Extratumoral tissue far away from metastases showed perisinusoidal fibrosis (van Gieson positive), moderate immunoreaction with anticollagen IV antibody, and expressed collagen formation in the space of Disse. Liver tissue near metastases showed strongly expressed paratumoral fibrosis and moderate perisinusoidal fibrosis, dilatation of Disse space with discontinuous basement membrane (BM) formation, and a lot of collagen bundles. Ito cells acquired features of transitional cells (TSC) or myofibroblast (MF)-like cells. Based on these results it is concluded that there were sinusoidal changes in extratumoral tissue, probably provoked by some cytokines released from tumoral cells.
In older male rats we found fuchsinophilic granula which appeared both singly and in bale-shaped arrangements in the cytoplasm of the epithelias of proximal, subcapsularly located renal tubuli. In its further development it became apparent that they formed small round-shaped clusters which stained with buffered thionine. These clusters finally united to larger ovoid or cone-shaped homogen formations which detached from cytoplasm and appeared unobstructedly in the lumen of canaliculi and in deeper nephron sections, too. The reason why the authors named these formations "xanthoid" is attributable to their yellowish color. They consist of proteoglycans, are PAS-negative, and resistant to oxidation and lipoid solvents. They appeared both in male rats investigated in a series of toxological tests and in control animals. Female animals were not investigated. In test series carried out later, they could not be found for which reason further investigations were not possible.
We present here ultrastructural findings in three composite tumours having giant cell fibroblastoma--dermatofibrosarcoma protuberans components occurring in adult patients. We further hypothesize that these 3 tumours belong to the group of neoplasms that can show giant cell fibroblastoma, dermatofibrosarcoma protuberans, dendritic pigment cell, myxoid, and fibrosarcomatous differentiation. We consider the giant cell fibroblastoma areas of the tumours to represent a well-differentiated component of these neoplasms.
Comparative pathological studies are carried out in drug research using disease models and indicator systems in order to assess the effectiveness and the tolerance of test substances. Basis of these experiments in risk assessment is the exposure of humans in the environment, in occupation or as patients. According to the problem, the evaluation of the studies is done using qualitative morphological and/or quantitative morphometric methods. The assessment of the results obtained in experimental studies has to be done from the point of view to extrapolate from animals to humans. In this context, the problem of animals experimentation is pointed out. Finally, aspects of risk minimization and risk acceptance are discussed briefly.
The study was aimed to evaluate possible relation between the probability of brain stem gliosis at the autopsy in infants who died of SIDS and of other known causes of death and some major infants characteristics. 131 infants (78 boys, 53 girls) who died in St. Petersburg in 1983 to 1989 of SIDS and 60 infants (37 boys, 23 girls) who died suddenly during the same period of time of other than SIDS known causes of death without signs of inborn malformations, tumours and intrauterine infections entered the study. Stepwise logistic regression was used in data analysis. No statistically significant association was found between the probability of brain stem gliosis and the following explanatory variables: gender, gestational and calendar age, weight at birth and at death. It was shown that the probability of brain stem gliosis depended of the cause of death (whether SIDS or not) and postconceptional age, two variables interacting. The probability of brain stem gliosis decreased with growing postconceptional age in the infants from both groups, less prominent in SIDS babies. The findings may serve an argument that delayed brain myelination and maturation is more often the case in the babies who died of SIDS, and that excessive brain stem gliosis may serve a marker of biological immaturity in a part of SIDS victims.
We report on six patients with tumours of visceral organs (three patients with endometrial adenocarcinoma with squamous cell differentiation, one patient with atypical hyperplasia of endometrium, and two patients with adenocarcinoma of the colon with squamous cell differentiation), where unquestionable differentiation into shadow cells was observed. In all six cases the shadow cells were found mostly in the morules of immature squamous cells. The shadow cells were morphologically identical, on the light microscopical and ultrastructural level, to similar cells found in pilomatricomas. They were often accompanied by granulomatous giant cell reaction and calcification.
Visualization and analysis of nucleolus organizer regions (NOR) by a silverstaining is a well accepted method in cytological and histological tumor diagnostic. For specific staining of the NOR the AgNOR-method developed by HOWELL and BLACK (1980) and PLOTON et al. (1986) is performed. One major disadvantage of the AgNOR-method is the instability of the reaction products and therefore the short durability of the slide preparations. A modification of the AgNOR-method, the PEG-Th-staining, leads not only to a longer durability of the reaction products but also to a better contrast within the sections. Main characteristic of the PEG-Th-staining is a postfixation of the specific silver precipitations for 5 min in a 5% sodium thiosulfate solution. It could be proven by image analysis that there is no significant difference between the morphometric parameters evaluated on AgNOR- and PEG-Th-stained sections. Therefore results evaluated on PEG-Th-stained sections are absolutely comparable to those obtained on sections stained with the AgNOR-method thus providing the advantage of a longer durability of the reaction products and easier evaluation.
In 10 cases of senile dementia of Alzheimer's type (AD) a systematic post-mortem ultrastructural analysis was performed. Attention was paid mainly to the presence of autolysosomes in the neuropil of the brain cortex. Autolysosomes appeared as osmiophilic dense bodies (DB) which originated in synaptic terminals and peripheral nerve-cell processes. DBs contained sequestrated cellular material wrapped by pinched off, invaginated cell membrane. DB were very frequent also in fields where no senile plaques (SP) and/or nerve-cell processes with paired helical filaments (PHF) were present. Abnormal fermentative degradation of DBs and their possible negative influence on the plasmatic flow in nerve-cell processes is discussed.
A case of a malignant cerebral astrocytoma containing bone in a 56-year old woman is reported. In spite of total removal and radiotherapy the tumour recurred and the patient died 18 months postoperatively. The histological features and immunohistochemical findings are presented. The literature is reviewed and probable mechanisms by which these mesodermal derivatives develop in neuroepithelial neoplasms are discussed.
The apocrine carcinoma is a rare type of invasive breast carcinomas. Characteristic features of this neoplasm are shown by the eosinophilic granular cytoplasm with apical snouts and strong expression of GCDFP-15. A review of 2000 available primary breast carcinomas identified 6 examples (0.3%) based on the definition. Architecturally, these tumors displayed either a solid-tubular or a papillary growth pattern, while cytologically the lesions were composed of large columnar epithelial cells with marked anisonucleosis and numerous PAS-positive diastase-resistant cytoplasmic granules. Immunohistochemically, apocrine breast carcinomas showed abundant GCDFP-15, CEA an c-erbB-2 oncoprotein. Electron microscopic analysis revealed the presence of numerous secretory granules. The differential diagnostic problems of apocrine breast carcinomas and malignant tumors mimicking them are discussed.
For the assessment of proliferative activity of malignant tumors several methods can be used. The method having been used at first has been the determination of mitotic index, playing an important role as a part of various grading systems until now. Besides of DNA cytometry, flow cytometry, determination of bromodeoxyuridine labeling index (BrdUr-LI) and immunohistochemical analysis of proliferation-associated antigens (e.g. Ki-67, PCNA), for several years AgNOR analysis has been used as a new technique, giving reproducible, exact results of proliferative activity of malignant tumors. Valuable information about proliferative activity of cells can be gained already by counting the AgNOR number per nucleus. Moreover the use of digital image analysis provides information about size and distribution of AgNORs. Evidently these data are more important than AgNOR number. In the hands of experienced pathologists and under standardized conditions AgNOR staining and AgNOR quantification are a valuable completion of established methods.
The aim of this paper is to give a short review on the nucleolus. In particular, we focused on the relationship of nucleolar ultrastructure with rRNA synthesis and processing. We also gave rapid data on organization of rRNA genes. Finally, we also focused on AgNOR proteins and the organization of "AgNOR granules".
Unusual intracytoplasmatic inclusions were found in urinary bladder neurons in dogs. The plate-like inclusions were composed of thin filaments, and when viewed en face, appeared as oval or angular bodies with regular lattice work array. When viewed in a transverse section, they were of rod-like shape and were composed of longitudinal filaments and transverse bars. The inclusions were observed in all ganglia of the urinary bladders studied. Three-dimensional reconstruction of the inclusions was made, using a tilting device. By means of this reconstruction, it could be demonstrated that their ultrastructure is similar to that of Hirano bodies which occur in human neurons of the central nervous system in cases of neurodegenerative diseases. The authors suggest that unusual intraneuronal inclusions represent a peculiarity in cytoskeletal protein assembly typical of canine urinary bladder neurons.
This is the first full-scale analysis on the paraganglia of the urinary bladder (PUB) by means of histological examination of a large number of autopsy cases. PUB were demonstrated by routine histology in 51.8% of the cases examined. PUB were present in any portion of the urinary bladder as well as in any layer of its mural structure. Immunohistochemistry revealed strong to moderate positivity for chromogranin A and neuron-specific enolase, respectively. A moderate immunoreactivity for S 100 protein was demonstrated in the sustentacular cells of PUB. There has been a statistically significant male preponderance in the incidence of PUB. Contrary to the general consensus, PUB degenerate very slowly throughout the entire lifetime. Middle-aged and elderly subjects suffering from chronic lung diseases exhibit a statistically significant increase in the incidence of PUB, suggesting chronic hypoxemia as a stimulant for the persistence of PUB.
We report about the case of a 34-year-old male patient suffering from a combination of Bourneville-Pringle disease and a metastasizing gastrinoma. As far as we know this association has hitherto not been described in the literature. We believe that a gastrinoma could develop against the background of the general tissue dysplasia which tuberous sclerosis represents. In our opinion, gastrinomas should be included into the tuberous sclerosis complex as a new form of possible association.
The occurrence of granulomatous epithelioid cell reaction, hyperplasia of lymphatic paracortex and existence of histiocytosis of the intermediary-medullary sinuses observed on sections of lymph nodes of 582 patients suffering from high-risk melanomas, examined during a ten-year period, have been established as reliable indicators of survival. On the other hand, lymphocytic infiltrative processes of the lymph node capsule, medullar plasmocytosis, and hyperplasia of germinal centres have been seen as indicators of a bad prognosis. Lymphocytic paracortical depletion and a predominance of postcapillary venules within the T zone were found to be less important in patients with a low chance of survival. We were able to establish a connection between lymphonodular parameters and the survival rate of the patients. In a multivariate test we found that there were four factors for statistical ascertainment of the prognosis of melanoma patients with lymphadenectomy: mitotic rate of primary tumour, lymphocytic infiltration of the lymph node capsule, existence of paracortical hyperplasia, and sex of the patient.
Paraffin-embedded surgical specimen from 47 Hürthle cell tumours of the thyroid gland were examined for DNA content by image cytometry to assess the diagnostic and prognostic utility of ploidy determination in oxyphilic tumors. Both adenomas (31 cases) and carcinomas (16 cases) were studied. As a control for the algorithm of DNA-interpretation, 10 randomly selected normal thyroid tissues were analysed. All control cases showed normal diploid DNA content. Among the Hürthle cell tumours, aneuploid peaks were present in 15 adenomas (48%) and in 13 carcinomas (81%). These findings demonstrate a limited value of aneuploidy as diagnostic feature for malignancy in Hürthle cell tumours of the thyroid. In view of prognosis, there is no unfavourable predictive prognostic value for abnormal DNA content in histologically benign Hürthle cell tumours. No metastases or recurrences occurred in this group during a mean follow up period of 4.4 years. Three patients with aneuploid carcinomas and local recurrences or metastases had higher levels of basic DNA indices. This suggests that aneuploidy has a prognostic value for histologically defined carcinomas.
