Correspondence ackn owledgements British Lung Foundation UK and Lung Pathology Departmental Funds for funding. M Tsoumakidou J Zhu Z Wang A Thorley 1 S Kemp 1 T Tetley 1 P K Jeffery Lung Pathology, Department of Gene Therapy, and Lung Cell Biology, Section of Airways Disease, National Heart & Lung Institute, Imperial College London, London, UK 1. Vermaelen K, Pauwels R. Pulmonary dendritic cells. Am. J. Respir. Crit. Care Med. 2005; 172; 530–551. 2. Demedts I, Brusselle G, Vermaelen K et al. Identification and characterization of human pulmonary dendritic cells. Am. J. Respir. Cell Mol. Biol. 2005; 32; 177–184. 3. Tsoumakidou M, Tzanakis N, Papadaki HA et al. Isolation of myeloid and plasmacytoid dendritic cells from human broncho- alveolar lavage fluid. Immunol. Cell Biol. 2006; 84; 267–273. 4. Todate A, Chida K, Suda T et al. Increased numbers of dendritic cells in the bronchiolar tissues of diffuse panbronchiolitis. Am. J. Respir. Crit. Care Med. 2000; 162; 148–153. 5. Witherden IR, Vanden Bon EJ, Goldstraw P et al. Primary human alveolar type II epithelial cell chemokine release: effects of cigarette smoke and neutrophil elastase. Am. J. Respir. Cell Mol. Biol. 2004; fixation. The metal suture is later trimmed off, allowing perpendicular slices to be made across the lung ⁄ pleural tissue, permitting detailed analysis. One issue not covered in any detail in the review is that of occupational dust-related pathology and emphysema. Assessment of emphysema is particularly important at autopsy in this regard, as it is used to substantiate ⁄ refute medicolegal claims by relatives of the deceased. It is vital to try to inflate postmortem lung tissue (in a similar manner) for ideal quantification of disease and, even if whole mount lung tissue sections are not available, small, adequately inflated lung samples can produce significant information that can be tested in the legal setting. In addition, it is worth considering other occupa- tional disease, particularly in relation to metal fumes. Cadmium exposure (for example) can produce signifi- cant emphysematous change many years after expo- sure. 2 Retention of some lung tissue for mass spectroscopy can be particularly useful if one is considering metal or other chemical-related disease. Finally, whilst I would entirely concur with the pathological approach to classification given in the review, I would suggest that any analysis of lung parenchyma must be cross-correlated against respira- tory function tests and other clinical information. Of particular value is computerized tomography ⁄ magnetic resonance imaging in terms of extrapolation of small biopsy ⁄ autopsy sample histology in order to derive full appreciation of overall pulmonary pathology status. 3 S K Suvarna Advances in the pathology of COPD Department of Histopathology, Northern General Hospital, Sheffield, UK DOI: 10.1111/j.1365-2559.2007.02816.x Sir: I read with great interest the very detailed and helpful review on emphysema, 1 and agree this is the gold standard approach to assessment of lung tissue for chronic obstructive pulmonary disease (COPD). Regret- tably, autopsy and tissue retention issues in the UK have led to problems with examining lung parenchyma in this format and in most cases only small samples of tissue can be retained for COPD assessment. For surgical samples, often submitted as thoraco- scopic (video-assisted thorascopic surgery) samples with wire suture material at the margins, I would recommend inflation of these samples upon receipt in the laboratory by injecting formalin (by syringe ⁄ needle) into the lung parenchyma through the pleura, until the sample looks adequately inflated for ideal 1. Wright JL, Churg A. Advances in the pathology of COPD. Histopathology 2006; 49; 1–9. 2. Churg A, Colby TV. Diseases caused by metals and related com- pounds. In Churg A, Green FHY eds. Pathology of occupational lung disease, 2nd edn, Baltimore: Williams and Wilkins, 1998; 77–128. 3. Muller NL, Fraser RS, Lee KS, Jokhoh T. Diseases of the lung. Radiological and pathological correlations. Philadelphia: Lippincott Williams & Wilkins, 2003; 239–254. Myofibroblastoma of the male breast: a rare entity of increasing frequency that can be diagnosed on needle core biopsy DOI: 10.1111/j.1365-2559.2007.02808.x Sir: Myofibroblastoma is a rare benign mesenchymal tumour that was first described by Wargotz et al. in 2007 The Authors. Journal compilation 2007 Blackwell Publishing Ltd, Histopathology, 51, 552–580.
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