Papillary neoplasia of the breast: immunohistochemically defined myoepithelial cells in the diagnosis of benign and malignant papillary breast neoplasms.

The presence or absence of myoepithelial cells (ME) has been considered as an important feature in the differential diagnosis of benign and malignant papillary lesions of the breast. We evaluated the distribution of myoepithelial cells in formalin-fixed paraffin-embedded tissue sections of 25 papillomas and 18 papillary carcinomas by ABC immunoperoxidase technique with antibodies to muscle actin (HHF-35) and high molecular weight (HMW) keratin (clone 34BE12, cytokeratins 1, 5, 10, and 14; reacting preferentially with ME cells) and an antiserum to S-100 protein. Also included in the study were eight cases of micropapillary ductal carcinoma in situ (DCIS) having a few fibrovascular cores and five peripheral papillomas with accompanying ductal carcinoma in situ or atypical hyperplasia. The antibodies to muscle actin were sensitive and relatively specific for ME cells of the breast and uniformly labeled ME cells in all 25 papillomas. ME cells were absent or extremely sparse in papillary carcinomas. They were present focally in some of the fibrovascular cores of the micropapillary DCIS, and a mixed pattern was observed in peripheral papillomas with areas of carcinoma. HMW keratin was variably expressed in ME cells in most cases with positive internal controls and was present in several normal ductal and papilloma epithelial cells but not in epithelial cells of papillary carcinomas. HMW keratin, although less specific for ME cells, was a useful adjunct because of its reactivity with ME cells as well as hyperplastic epithelial cells in papillomas, which resulted in a combined positive reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Extracranial skull base chondrosarcoma.

Chondrosarcoma of the skull base is a rare neoplasm. The most common presenting symptoms are hoarseness, dysphagia, and diplopia, which is associated with palsies of cranial nerves X, IX, and VI. The temporal bone is the most common site of tumor origin, followed by the sphenoid bone. These tumors must be differentiated from chordoma, chondroid chordoma, osteogenic sarcoma, enchondroma, and meningioma. Diagnosis is made by patient history, radiologic imaging, and biopsy. The treatment is surgical excision followed by radiation therapy. Five-year survival rates for grades I, II, and III are 90, 81, and 43%, respectively.

Malignant angioendothelioma. Cytologic, histologic and ultrastructural findings.

Cells of a malignant angioendothelioma in pleural fluid were studied by light and electron microscopy. They occurred singly and clustered, with peripheral, pleomorphic nuclei containing finely particulate chromatin and one or two nucleoli. The cytoplasm was pale and finely vacuolated. Ultrastructural findings were those of endothelial cells: cytoplasmic pseudopodia, tight junctional complexes, cytoplasmic filaments and pinocytotic vesicles.

Diabetic neuroarthropathy (Charcot's joint).

The pathologic aspects of an uncommon complication of diabetes mellitus, destructive arthropathy (Charcot's joint), were studied. The peripheral nerve demyelination resulting in clinically demonstrable deficits in perception of pain and vibration and in reflexes in the lower extremities reinforces the neurogenic role in this complication.

Ultrastructure of the gallbladder paraganglia.

The ultrastructure of the paraganglia in the gallbladder is identical to that of other nonchromaffin paraganglia featuring granule-bearing chief cells with many axons ensheathed by supporting cells. Synapses between axons, chief cells, and axons and chief cells are common. Ultrastructural similarities to the carotid body, proven to be a chemoreceptor, support a similar function for these paraganglia. An endocrine function is also suggested by the partial similarity of their structure to that of Zuckerkandl's organ.

Paraganglia in the human gallbladder.

Paraganglia found in the subserosa of nine of ten surgically removed gallbladders had morphologic features and staining characteristics similar to those of other sites. Although they were not difficult to locate in subserial sections, their sparseness and smallness explains the rarity with which they have been encountered in the routine histologic gallbladder examination. The strong, finely granular argyrophilia of the chief cell cytoplasm in all of the glomera studied offer a simple means of identifying them when only a portion of the structure is viewed.