Melanoma and pregnancy with placental metastases. Report of a case.

The authors report on the case of a 33-year-old white woman who developed melanoma during pregnancy, with widespread metastatic disease involving the placenta. The melanoma developed during two consecutive pregnancies and was untreated throughout the course of both. The patient died with widespread metastases shortly after attempted Cesarean delivery of her second child. Histopathologic and immunohistochemical studies were made with anti-S-100 protein and HMB45 antibodies. The authors discuss the possible influence of pregnancy on the prognosis of melanoma.

Appearance of T-cell subpopulations during the time course of beryllium-induced granulomas.

Employing monoclonal antibodies that identify T-helper/inducer or T-suppressor/cytotoxic cells, we investigated the T-lymphocyte subsets in hypersensitivity granulomas developed after beryllium salt injection. T-helper/inducer cells were detected at all stages of the lesions, including early nonspecific inflammatory lesions seen at 3 weeks after injection. They formed clusters intermingled with the mononuclear phagocytes in granulomatous lesions, but were not found among the epithelioid cells. In contrast, T-suppressor/cytotoxic cells were slow to appear in the lesions and constituted very small numbers in mature epithelioid cell granulomas of 9-11 weeks. These findings suggest that T-helper/inducer cells may be responsible for the evolution of the perivascular infiltrate of mononuclear cells. Furthermore, appearance of T-helper/inducer cells without T-suppressor/cytotoxic cells may contribute to the development and organization of epithelioid cells and their maturity in the granulomatous lesions.

Immunohistochemical demonstration of S-100 protein antigen-containing cells in beryllium-induced, zirconium-induced and sarcoidosis granulomas.

S-100 protein has been detected in epidermal Langerhans cells, interdigitating reticulum cells, and large mononuclear cells of cutaneous T-cell lymphomas. Experimental data imply these cells are involved in the presentation of antigens and/or maturation of T-lymphocytes. The authors studied the morphology and distribution of S-100 protein antigen-containing cells in cutaneous sarcoidosis and metal-induced granulomas, both immunogenic and foreign-body types, with light and electron microscopic immunoperoxidase technics. Immunological reaction was seen in Langerhans cells, peripheral nerves, and granulomatous lesion dendritic cells. The latter showed a large, irregular nucleus and branching cytoplasm. They intermingled with other mononuclear cells in the granulomas but not with organized epithelioid cells. Morphometric quantification of dendritic cells in the three types of granulomas revealed statistically significant differences (P less than 0.005) and electron microscopy demonstrated their typical cytoplasmic appearance, without Birbeck granules. The increased number of dendritic cells in immunogenic granulomas, and their shared antigenic components with Langerhans cells suggest they act as accessory cells in eliciting the granulomatous response.