Histopathological Point Of View Research Articles

Histopathology of human American cutaneous leishmaniasis before and after treatment.

Chemical therapy for the treatment of leishmaniasis is still inadequate, and a number of drugs and therapeutic programs are being tested. Besides treatment, the ultimate goal is an effective cure, and histopathological analyses of the lesion cicatrices constitute an important measure of treatment success, or otherwise, in this respect. In this paper, we describe histopathological patterns in cases of American cutaneous leishmaniasis in 32 patients from the municipality of Caratinga, Minas Gerais, Brazil, before and after treatment with the following therapeutic methods: 1) leishvacin + glucantime; 2) leishvacin + BCG associated with glucantime; 3) glucantime; 4) leishvacin + BCG. Lesion fragments were collected from all patients by biopsy prior to, and approximately 30 days after, each treatment which resulted in a clinical diagnosis of cure. Following the analysis of slides, the preparations were described from a histopathological point of view and grouped taking into account the prevalence or significance of the characteristic elements. This process resulted in the following classification: 1. exudative reaction (ER); 2. exudative giant cell reaction (EGCR); 3. exudative productive reaction (EPR); 4. exudative productive giant cell reaction (EPGCR); 5. exudative productive necrotic reaction (EPNR); 6. necrotic exudative reaction (NER); 7. productive exudative reaction (PER), 8. productive giant cell reaction (PGCR); 9. productive exudative giant cell reaction (PEGCR); 10. productive exudative giant cell granulomatous reaction (PEGCGR); 11. productive reaction (PR) and 12. productive cicatricial (cure) reaction (PCR). After this analysis, it was noted that clinical cure did not always coincide with histopathological cure.

Possibility of defense against colorectal tumor by foamy cells.

To investigate the difference between colorectal adenocarcinomas with white spots (foamy cells) and those without white spots, clinically and histopathologically, we examined 112 cases of colorectal adenocarcinomas in this study. Thirty-two cases were diagnosed as submucosal invasive adenocarcinoma and 80 as advanced adenocarcinoma. They were classified into two groups: with white spots and without white spots. Submucosal tumors and squamous epithelial-origin tumors were excluded. In each case we looked for evidence of lymph node and liver metastases. Immunoreactive staining for macrophages, foamy cells, T cells, and B cells was also performed. We found a significant difference in the incidence of lymph node metastasis between the two groups with advanced carcinoma. White spots (foamy cells) were present at some distance from carcinoma cells. We conclude that foamy cells might have a beneficial role. From a histopathological viewpoint they can be considered a possible physical defense wall, an index of immune response activation. Clinically, it is important not to overlook any lesion.

Frontal lobe degeneration of non-Alzheimer type

Frontal lobe degenerative dementias, the second largest degenerative dementia group after Alzheimer's disease, is dominated by frontal lobe degeneration of non-Alzheimer type. It is classified in a group also containing Pick's disease, progressive aphasia and dementia in motor neuron disease. Frontal lobe degeneration of non-Alzheimer type is clinically marked by frontal lobe symptoms and frontotemporal reduction of blood flow. From a histopathological point of view it is characterized by gliosis, microvacuolation, neuronal atrophy-loss and 40–50% loss of synapses in three superficial cortical laminae of the frontal convexity and anterior temporal cortex, while the deeper laminae are little or not changed. The structural changes of Alzheimer's disease including amyloid, Levy body dementia and Pick's disease are entirely lacking. A strong heredity points to a genetic cause as yet undefined.

Neuropathology of dentatorubropallidoluysian atrophy

We examined 12 autopsy cases of dentatorubropallidoluysian atrophy (DRPLA). We confirmed the commonly or often recognized neuropathological findings in DRPLA as follows: 1, thickening of the skull bone; 2, atrophy of the brain; 3, degeneration of the dentate nucleus and its afferent fibers; 4, degeneration of the globus pallidus‐subthalamic nucleus system; 5, atrophy of the tegmentum of the brain stem especially in the pons; 6, symmetrical necrotic small foci of the ventro‐lateral portion of the pontine tegmentum; 7, degeneration of the striatum; 8, degeneration of the superior colliculus; 9, degeneration of the gracile nucleus; 10, degeneration of the pyramidal tract; 11, mild degeneration of the cerebellar cortex; 12, mild degeneration of the cerebral cortex; and 13, degeneration of the cerebral white matter. From the histopathological point of view, DRPLA is clearly distinguished from Machado‐Joseph disease and myoclonus epilepsy associated with ragged‐red fibers. We also examined the clinico‐pathological correlations in three clinical groups which were classified as juvenile type, early adult type and late adult type. We noted that in juvenile type presenting with progressive myoclonus epilepsy syndromes as the main clinical features of DRPLA, degeneration of the globus pallidus was more severe than that of the dentate nucleus, and atrophy of the brain stem and spinal cord was mild. We also noted that in late adult type presenting with cerebellar ataxia and choreoathetoid involuntary movements without myoclonus or epilepsy or either, degeneration of the dentate nucleus was more severe than that of the globus pallidus, and severe atrophy of the brain stem and spinal cord.

Lymphocytic traffic and homing into target tissue and the generation of endocrine autoimmunity.

Endocrine autoimmunity is known to be characterized by the presence of specific autoantibodies and from the histopathological point of view by lymphocytic infiltration in the target tissue. The presence of mononuclear cell infiltrates is the pathological hallmark of most endocrine diseases characterized by an autoimmune process directed against antigens expressed on endocrine cells. Infiltrating cells can usually be detected by biopsy or by using other, non-invasive, techniques. However, in endocrine tissue such as the islets of Langerhans and the adrenal glands it is difficult to perform biopsies and diagnosis of the autoimmune process is dependent mainly upon detection of specific autoantibodies. A crucial aspect of endocrine autoimmunity and of all processes of organ specific autoimmunity is why and how lymphocytes migrate from primary lymphoid tissue to their specific targets. This occurs mainly through contact with specific adhesion molecules which enable lymphocytes to adhere to the endothelial vessels in close proximity to the target tissue. In this review we discuss the homing of peripheral mononuclear cells into target endocrine tissues and the mediating role of adhesion molecules.

A Long Term Survival Case of Malignant Schwannoma of Cervical Region

This paper describes a malignant schwannoma which was detected in the left cervical region of a 60-year-old man. It must have been well advanced from a histopa thological viewpoint as well, since it was refractory through and through. Since its primary growth in 1984, it has recurred time and again for 10 years, slightly shifting its position from one site to another. The tumor has ultimately failed to resolve despite 4 surgeries, radio therapy, and chemotherapy.

Neuroendocrine characteristics in bronchogenic adenocarcinoma and its clinical relevance

For many years there has been a considerable clinical and scientific interest in the classification of malignant lung tumors. From a histopathologic point of view the World Health Organization (WHO) has put effort into the morphologic subtyping of malignant lung tumors and more than 90% of the tumors fall into the four main groups: squamous cell carcinoma, small cell carcinoma (SCLC), large cell undifferentiated carcinoma and adenocarcinoma [ 11. Small cell carcinoma and squamous cell carcinoma have been considered as smoking related and have been considered as the most common cell types. However, the picture has now changed especially in US with an absolute and relative increase in the incidence of adenocarcinoma [2,3]. The reason for this is still not quite clear. From a therapeutic point of view the classification into “small cell carcinoma” (SCLC) and “nonsmall cell carcinoma” (NSCLC) has for many years been sufficient for clinicians because of the chemosensitivity of the SCLC-tumors and the potential for therapeutic success in contrast to the clinical experience with the NSCLC. While therapeutic progress has been limited in the last decade, the biologic understanding of lung tumors has evolved considerably. The histogenetic relationship between the histologic types has been put into a new perspective by the recognition of expression of neuroendocrine markers. Bronchial carcinoids and small cell lung cancer together with other tumors of the diffuse neuroendocrine system have been characterized by the presence of neuroendocrine markers, i.e. dense core granules, high levels of the key amine handling enzyme L-dopadecarboxylase and production of various hormones and neuropeptides [4-6]. These features are shared by their putative progenitors, pulmonary endocrine cells. At the same time morphologic variations and especially mixed histologies were recognized by the pathologists [I. Furthermore, by the establishment of numerous lung cancer cell lines it was noted that even within one main histologic type there were different clones with different biologic

Prediction of effectiveness of long term β -blocker therapy for dilated cardiomyopathy from a histopathological viewpoint

Prediction of effectiveness of long term β -blocker therapy for dilated cardiomyopathy from a histopathological viewpoint

小児の亜急性壊死性リンパ節炎の１例ならびにその文献的考察

An 8-year-old boy with subacute necrotizing lymphadenitis (SNL), a disorder initially described in Japan, is presented. This entity is usually said to have such representative clinical symptoms as lever-up, swelling of lymph nodes, and leukocytopenia. The disease is a non specific inflammation, although it has necrotized lymph nodes, like malignant neoplasm on one side but a specific inflammation from the histopathological point of view on the other side. And this lesion exists mainly in the cervical lymph node.At the same time, we review the japana Centra Revuo Medicina (1984-1988) to pick up all the case reports of this entity, in order to clarify the clinical findings of this lesion.

Bone disease in long-term hemodialysis patients with low dialysate aluminium.

The dialysis unit in Sunderland uses softener water treatment with low Al concentration (dialysate mean Al 22 micrograms/L) but employs continuous oral Al (OH)3 to control serum phosphate. Thirty-one patients, 22 males and 9 females, with a mean age of 45 years, maintained on hemodialysis for a mean of 48 months were studied. Patients had higher Al concentrations than normal controls (p less than 0.001) and the postdialysis serum Al levels were also significantly higher than the predialysis levels. Twenty-four of 31 patients had evidence of hyperparathyroidism on radiology but only 4 of 31 had fractures. From a histopathological point of view, the patients were found to have no lesions (4 patients), osteitis fibrosa alone (17 patients), and osteitis fibrosa combined with osteomalacia (5 patients). The effect of 1-alpha(OH)D3 treatment was checked by repeated bone biopsies. One case of the last group showed no improvement of osteitis fibrosa, while osteomalacia progressed to severe. We conclude that both antacids and dialysate contribute to the serum and tissue Al accumulation in Sunderland Renal Unit, where over a period of ten years only one patient developed Al-related osteomalacia.

Left hemiblocks revisited from the histopathological viewpoint

Left hemiblocks revisited from the histopathological viewpoint

A progress report of a patient with disseminated cutaneous cardidiasis.

<h3>To the Editor.—</h3> Alopecia neoplastica was discussed in theArchivesby Nelson (105:120, 1972). The following summary from my article about breast cancer may be of interest to your readers.¹ Metastases from breast cancers causing sclero-atrophic alopecia are rare but they show a family likeness: on the one hand, spherical shape, complete loss of hair, changes in the pilo-sebaceous orifices, depressions and discrete nodules; on the other hand, infiltration and adherence to the underlying tissues with an inflammatory look recalling lupus erythematodes. These characteristics, although transitory (usually a few months), seem to us to be enough, in a woman, to support the diagnosis of metastases and their mammary origin. These metastases usually change more or less rapidly in the direction of the two other types of secondary cancer, inflammatory, and nodular. From the histo-pathological point of view, it can be difficult formally to assert a mammary origin confronted with

Relationship between early gastric cancer and gastric ulcer from the histopathological point of view

Relationship between early gastric cancer and gastric ulcer from the histopathological point of view

Etude comparative des epithéliomas médullaires du corps thyroïde avec et sans stroma amyloïde

Besides the medullary cancer with an amyloid stroma of the thyroid which is a well known entity there are other histopathological aspects of medullary cancer without amyloid stroma which have been relatively little studied. There can be confusion from histopathological view-point because the amyloid stroma can be present in the primitive tumour and absent in metastases or vice versa. To find out whether these two pathological aspects correspond to one or two morbid entities, the clinical and biological aspects of 24 medullary cancers with amyloid and 10 without amyloid which were observed at the Gustave Roussy Institute between 1933 and 1968 have been compared. The study of the medullary carcinomas with amyloid stroma shows that the tumour mass as well as the lymph nodes are tender and that the diffuse adenopathy is often very difficult to delineate. It confirms the familial character of the disease (we have the case of a family in which this kind of cancer appears in three generations), as well as the existence of classical associations, especially a diarrhoea which fluctates with the disease, multiple neuromas of the mucous membranes and malformations of the amyothropic type. The clinical characters of medullary cancers without amyloid stroma are different. They predominate in males. Tumours and lymph nodes are not tender. No associated signs have been observed. The lymph nodes and distant metastases are similar to those of other thyroid cancers. From a biological view-point we observed the presence of thryocalcitonine in the tumour or the plasma of all patients with medullary cancers with amyloid stroma in which it was looked for. In a case of medullary cancer without amyloid stroma there was no thyrocalcitonine in the plasma. The survival time in cancers with amyloid stroma is similar of our series with that of other epitheliomas of the thyroid. The survival in medullary cancers without amyloid stroma is much shorter, approaching that of the anaplastic cancers of the thyroid. Consequently medullary carcinomas with and without amyloid stroma must be considered as separate entities since they differ clinically, biologically and in regard to prognosis.

ESQUISTOSSOMOSE MANSONI

ESQUISTOSSOMOSE MANSONI