role of orcien alcian blue in the discrimination between dysplasia and reactive hyperplasia in ulcerative colitis

30 cases of different stages of ulcerative colitis were stained by Hx and E and orcien alcian blue to study the mucin changes in cases of dysplasia and reactive hyperplasia. 6 out of the 8 villous patterns encountered, although no morphologic evidence of dysplasia is encountered, yet the histochemical results were markedly deviated from normal. All 8 cases with adenomatous patterns proved to reveal mucin changes in the form of sialomucins predominance. The lining mucosa away in cases of ulcerative colitis revealed a predominance of sialomucins and it is called transitional mucosa which must be regarded with great caution

study of the nature of hyaline cells in pleomorphic salivary gland adenomas

Twenty two specimens of plemorphic salivary gland adeoma were examined by haematoxylin and eosin, to detect the presence or absence of hyaline cells. Eight cases [36%] exhibited this cell, and gave positive staining results with monoclonal antiacatin antibodies. The dual presence of actin in addition to cytokeratin, which has already been demonstrated in the cytoplasm of these cells in previous studies, supports the hypothesis of a myoepithelial origin for such cells

Tuberculous breast lumps: a retrospective clinico-pathological study

A retrospective study of 11 patients with tuberculous breast lumps was conducted, with special attention to the diagnostic problem. All were females ranging in age from 20 to 57 years. The tuberculous nature was suggested clinically in 2 cases while in 9 cases, the initial diagnosis was a suspected carcinoma. The histopathological examination diagnosed the breast lump to be tuberculous in the 11 cases. In 9 cases with enlarged ipsilateral axillary lymph nodes, these were proved tuberculous on pathological examination. However, demonstration of the tubercle bacilli in the histologic sections was possible in only 2 out of the 9 lymph node specimens and in none of the 11 breast lumps. The bacteriologic confirmation through culture was positive in 6 cases, ngeative in 3 cases and could not be done in 2 eases. The results emphasize the importance of clinical awareness that tuberculosis can be a cause of a breast lump and the reliability of the histopathological diagnosis of tuberculosis particularly the demonstration of caseation. In all cases, satisfactory treatment was achieved by antituberculous drugs. The role of surgery was limited to complete excision of the breast lump and biopsying the enlarged axillary lymph nodes

Angiogenesis in breast carcinoma: a histopathologic and genetic study

43 heparinized blood samples and 100 controls were obtained from the NEMROCK out patient clinic and subjected to HLA typing by the micro-droplet lymphocytotoxicity technique, to determine the HLA pattern of patients with breast cancer with respect to mild [< 15 percent SA], moderate [15-55 percent] and marked [> 55 percent SA] angiogenic activity, observed quantitatively by the point counting method in 43 surgical biopsies from these patients, sent to the Department of Pathology, Cairo University. Patients exhibiting minimal angiogenesis were found to be significantly associated with a high frequency of HLA-AIO antigen, [P < 0.005, RR 3.59], whereas patients exhibiting moderate to marked angiogenesis did not show any genetic pattern, thereby indicating that some form of protective genetic mechanism occurs in certain patients with breast carcinoma preventing the host to some degree from eliciting neovascularization of the tumour stroma, hence limiting the clinical progress of the neoplasm and accounting to some extent for the individual variations in the clinical outcome commonly observed in mammary carcinoma

behavioral significance of actin in mammary carcinoma

31 radical mastectomy specimens comprising 13 invasive lobular and 18 invasive duct carcinomas, in addition to 6 normal breast tissue samples, were stained by haematoxylin and eosin and peroxidase labelled anti-actin monoclonal antibodies, for the determination of the actin content of such neoplasms and its relationship to the behavior of the tumour. It was noted that the more aggressive types as duct carcinomas, high grade tumours and those which have already widely spread [stages III-IV], contained the greatest amount of intracytoplasmic actin in the tumour cells, indicating a possible significant active role for such cytoskeletal proteins in helping to increase the motility of tumour cells and in invading their surrounding milieu

Ultrastructural features of synovial sarcoma

A synovial sarcoma is a malignant soft tissue tumour composed of gland-like structures within a background of spindle cells. The tumour is of interest to pathologists for a number of reasons. A biphasic pattern is uncommon among human neoplasms and raises questions concerning the histogenesis of the tumour. Despite a fancied resemblance by light microscopy to normal synovium, only a few of the reported cases have been related to synovial joints, and a monophasic variant composed of only spindle cells has been described. We have studied 55 synovial sarcomas by electron microscopy, including 7 biphasic and 48 monophastic tumours, and have compared the neoplastic epithelial cells to those of normal human synovium, and the spindle cells to those sarcomas that resemble monophasic synovial sarcoma by light microscopy. There is not a close resemblance between the epithelial cells of biphasic synovial sarcomas and the lining cells of the normal synovial membrane, suggesting that the designation is a misnomer. The spindle cells of monophasic synovial sarcomas are similar to those in biphasic tumours supporting the concept that the monophastic form is a synovial sarcoma variant. The spindle cells of the tumours differ ultrastructurally from neoplastic fibroblasts, and electron microscopy is consequently useful to confirm the diagnosis of monophasic synovial sarcoma

Surgical evaluation of histology assessment of activity in cirrhosis: a suggested grading system

Histopathological assessment of activity in liver cirrhosis, is a very important parameter amongst others, in the determination of the clinical and surgical outcome of patients. The currently used Modified Child's classification, is a clinicolaboratory scoring system [Pugh et al, 1973], which does not include the variable of activity. As there is no sharp distinction between chronic active hepatitis and cirrhosis with activity; the latter has now been termed as active cirrhosis; and cirrhosis divided into active or inactive irrespective of the aetiological factor. In this study 60 cases of Modified Child A and B categories, with past history of bleeding varices, were subjected to splenectomy and devascularization. A wedge biopsy was submitted for histopathologic examination, to determine the degree of activity, the most marked of which has been termed grade III, moderate grade II, mid grade I and absent activity as cirrhosis grade 0. G 0 and G I cases passed through a smooth postoperative period, whilst G II and G III cases showed high mortality and morbidity rates. Numerical consideration of the activity grade in conjunction with Modified Child's score is tried. There is a statistically significant change in categorization and surgical outcome in the mortality and morbidity cases. A preoperative pathological grading of activity, via needle biopsy is hence advisable. This important parameter has to be considered in conjunction with the Modified Child's scoring system, as it reflects system, as it reflects itself heavily on both categorization and the surgical outcome

multicenter cytological survey for the earlier detection of cancer cervix in Egyptian females preliminary results of the Egyptian/IAEA/WHO project [6/004] brachytherapy for cancer cervix uteri in the developing countries

Early detection of precancerous and cancerous lesions of the cervix uteri, has reduced the mortality and altered favourably the outcome of the management of such conditions. In some developing countries carcinoma of the cervix [CCU] is highly prevalent. Late clinical stage presentation prevails, consequently low cure rates [< 20%] are obtained. Cytodiagnostic policies are either Nation-wide [low and high risk females] or limited to hospital patients [Gynaecology out patients; mainly high risk group]. The Egyptian/IAEA/WHO Brachyrherapy project [6/004], is a pilot exercise which.includes a limited hospital oriented cytodiagnosis service, to detect early cases of precancerous and cancerous epithelial changes. The system includes: a reference cytodiagonesitc center Nuclear Medicine and Radiation Oncology Center Kasr El Einy "NEMROCK" as well as the Pathology Department, Cairo University. 17 cytology collection posts in the affiliated hospitals and 6 peripheral cytodiagnositcs labs in Teaching and General Hospilals.The present material represents a sample which remains to reach a total of 60-100, 000. However the analysis of the available cytology material of the project and that of Cairo University Hospilals, showed the following.A lotal of 6488 cases [2035 from the project's affiliated hospitals and 4453 cases from Cairo Universily Gynaecology Department. Cervical intraepithelial neoplasia [CIN I, II and Ill] was detected in 277 cases [4.2%]. The mean age was 37.3 years. Although risk factors are basicaly the same as in the Euro-American series, yet only some are of significance in Egyptians.probably owing to the prevailing value system and the socio-cultural affliation of the majority of the population

Intra and extracellular glycosaminoglycans - a helpful prognostic index

The intra and extracellular glycosaminoglycans [GAGS] were determined quantitatively and qualitatively for 36 breast carcinoma specimens. These cases were followed up for up to 10 years and sections were stained with haematoxylin and eosin, PAS, Alcian blue in addition to pretreatment with hyaluronidase [bovine testicular type] and toluidine blue which were subjected to microspe-ctrophotometric examination for estimation of their mucopolysaccharide [MPS] content. Malignant tumours showed an abnormal marked increase of their GAG content especially at the invasive border, not only was there an increase amount of GAGS but also an associated change in the chemical type of GAG present, such as the appearence of sulphate varieties in substantial amounts. The intracellular compartment showed a patchy distribution of acid MPS which were increased in high grade rapidly deteriorating cases, whilst stationary cases displayed neutral varieties. These findings may shed light on the importance of the role played by MPS and their constituent GAGS in the control of growth, speed and prognosis of such neoplasms

comparative study of the pattern of distribution of epithelial mucins in colonic and mammary carcinoma

55 carcinoma specimens [31 colonic and 24 breast] and 18 postmortem controls were studied to determine the pattern of epithelial mucin [sulpho and sialomucin] distribution in tumour and tumour bed regions. All cases were stained by haematoxylin and eosin and subjected to the high iron diamine technique. Extracellular sulphomucins were observed to appear actually within the carcinomatous tissues, 83% of breast cancers displayed diffuse, patchy and pericellular condensations in both tumour and tumour bed regions whereas in colonic carcinoma cases examined a much lower precentage of cases displayed this feature [6.4%]. Extracellulary, the main pattern of distribution being patchy particularly around groups of cells and varying from breast carcinomatous tissue patterns Sialomucins although hardly detected in the extracellular matrix under normal conditions have been seen to make a prominent appearance with malignant transformation yet in a small percentage of cases [8%] and 3.2% of mammary and colonic malignancies. The intracellular compartment sialomucins varied greatly from normal tissues, thus in breast carcinoma the undetectable sulphomucins in healthy tissue made their appearance as prominent intracytoplasmic deposits in 79% of cases, the sialomucins in 8% whilst in colonic carcinoma the normally abundant sulpho and sialomucins were apparent intracytoplasmically in 25% and 16% of specimens respectively. It thus appears, that there might not be an alteration that could be shared by all tumours alike. Instead such materials are tisssue specific and it is likely that each tumour has its own epithelial mucin profile which may help in identification of metastasis when the cellular elements are highly undifferentiated

Connective matrix changes in breast carcinoma: a histochemical and genetic study

Histochemical and microspectrophotometric studies were carried out on 44 postmastectomy biopsies, to detect the various types of mucopolysaccharides [MPS]. A preponderance of acid MPS was observed in 95 percent of cases, concentrated mainly at the invasive border of the tumour, calling attention to the role of this material in tumour invasion as well as in nutrition, since 73 percent of tumours with diameters above 5 cms were associated with high MPS levels, The Histocompatility [HLA] tests carried out on 88 blood samples from Egyptian cancer breast patients, showed high risk antigens differing in frequency from the 100 control group and varying in nature from other racial groups. Not only were HLA-B5 and BIS associated with susceptibility to carcinoma, but they also appeared to be associated with high tissue levels of MPS as well as with the desmoplastic stromal reaction, incriminating a tumour-dependent, genetically controlled spnthetic process. Other matrix changes observed: elastosis in 52 percent of specimens, both within and away from the tumour in addition to fragmentation of the reticular fibers in 71 percent of cases, especially the high grade neoplasms and patients presenting with a rapid clinical deterioration in the first three years of their disease

Angiogenesis: a helpful prognostic index in carcinoma of the breast

38 breast cancer cases and 6 normal postmortem breast tissue samples were obtained from the Department of Pathology, Kasr El Einy Hospital during the period of 1979-1981. Clinical data pertaining to follow up of the cases in the NEMROCK out patient clinic were obtained from the clinicians files. The chosen blocks were cut into 5 micro sections and stained with haematoxylin and oeosin, and newly formed thin walled capillary vessels were counted using a counting graticule to determine the percentage surface face area occupied by these vessels in relation to the surface area of the section examined, so as to study the relationship between the increase in the number of vessels with respect to the clinical progress of the disease. All 38 cases showed evidence of the existence of some degree of angiogenesis, varying from a mild degree < 15 percent of total surface area, to a moderate degree 15-55 percent and a marked degree > 55 percent of the total surface area. The control group on the other hand did not display this feature. It was thus observed that a strong statistically significant relationship existed in cases exhibiting moderate to marked degrees of angiogenesis and the rapid deterioration of the clinical course during the first 4 years since diagnosis, whereas those patients with stationary clinical courses exhibited a mild degree of angiogenesis. Such findings therefore denote that angiogenesis can be considered as a helpful sign in predicting the behavioral outcome of mammary carcinomas, in addition to the fact that if the process of neovascularization could be arrested, the patient may have a better chance of survival

histopathological study of grade associated angiogenic responses in mammary carcinoma

65 Radical mastectomy specimens were sent to the Pathology Department of Kasr El Einy Hospital and 10 postmortem breast samples were subjected to routine light microscopy, to determine the histological type and the grade of the tumour. This was followed by determining the degree of angiogenesis in the tissues examined using a graduated eye piece [point counting method] and the degrees of neovascularization were divided into minimal < 15 percent of total surface area, moderate 15-55 percent and marked > 55 percent SA. It was apparent from the results that as the tumour grade increased there was a proportionate increase in host tissue neovascularization, it thus may be assumed that the actual degree of neovascularization possibly enhances tumour cell aggressiveness and hence the histological grade increases. Another finding of some importance was that duct carcinomas appeared to be more likely to produce pronounced angiogenic responses in the tissues than lobular types; this may in part explain the more aggressive behaviour of the duct carcinoma group compared to the lobular neoplasms