Peliosis hepatis: a complicating finding in a case of biliary colic.

A 33-year-old woman was referred for an ultrasound of the abdomen because of biliary colic. The symptoms had started 2 months after giving birth to her first child. The ultrasound showed gallstones, but it also revealed multiple focal liver lesions that were initially thought to be malignant. The examination was supplemented with a CT scan, contrast-enhanced ultrasound (CEUS) and MRI. The lesions were suspected to be peliosis hepatis-a rare morphological entity characterised by multiple blood-filled cavities in the liver. Because of uncertainty as to the aetiology of the lesions demonstrated at CEUS and MRI, the diagnosis was definitively confirmed by large-size needle biopsies. Regular size biopsies were initially insufficient for diagnosis. The use of oral contraceptives for several years or the recent pregnancy may have been the cause of peliosis hepatis in this patient.

Double-staining chromogenic in situ hybridization as a useful alternative to split-signal fluorescence in situ hybridization in lymphoma diagnostics.

BACKGROUND: Malignant lymphomas are classified based on morphology, immunophenotype, genetics and clinical features. The pathological diagnosis is generally considered difficult and prone to mistakes. Since non-random chromosomal translocations are specifically involved in specific entities, their detection is an important adjunct for increasing the reliability of the diagnosis. Recently, split-signal fluorescence in situ hybridization has become available as a robust method to detect chromosomal breaks in paraffin-embedded formalin-fixed tissues. A bright field approach would bring this technology within the reach of every pathology laboratory. DESIGN AND METHODS: Our study was initiated to determine the consistency between chromogenic in situ hybridization and fluorescence in situ hybridization, both using split-signal probes developed for the detection of chromosomal breaks. Five hundred and forty cases of 11 lymphoma entities and reactive, benign lymphoid tissues, collected from eight different pathology laboratories, placed on 15 fluorescence in situ hybridization pre-stained tissue microarray slides, were double stained for the chromogenic hybridization. For each core morphology and actual signal were compared to the original fluorescence hybridization results. In addition, hematoxylin background staining intensity and signal intensity of the double-staining chromogenic in situ hybridization procedure were analyzed. RESULTS: With respect to the presence or absence of chromosomal breaks, 97% concordance was found between the results of the two techniques. Hematoxylin background staining intensity and signal intensity were found to correspond. The overall morphology after double-staining chromogenic in situ hybridization had decreased compared to the initial morphology scored after split-signal fluorescence in situ hybridization staining. CONCLUSIONS: We conclude that double-staining chromogenic in situ hybridization is equally reliable as fluorescence in situ hybridization in detecting chromosomal breaks in lymphoid tissue. Although differences in morphology, hematoxylin staining and chromogenic signal intensity vary between the tumor entities none of the entities appeared more easy or difficult to score.

[Solid tumors. Classification based on molecular biology, prognosis and therapy]. / Solide tumorer. Molekylaerbiologisk baseret klassifikation, prognose og terapi.

The introduction of molecular techniques into the routine diagnostic analysis of solid tumours has been slower than for hematological neoplasias, both because the former in general genetically are more heterogeneous and because their tumour cells are less accessible. This review presents examples of methods which can be used in the identification of risk groups, classification and prognosis of tumours, detection of minimal residual disease, choice of therapeutic strategy and tracing of possible hereditary cases. It is concluded that molecular laboratories should be established in connection with departments of pathology at the larger hospitals and that further development should take place through close collaboration between pathologists, molecular biologists, and clinicians.