ABSTRACT
Subjective grading of bladder carcinoma is a good predictor of the clinical outcome in those patients whose tumours are grade 1 or grade 3. However, in grade 2 tumours, which account for 45% of cases, grading has little predictive value in an individual patient. We have complemented the use of subjective grading with measurement of nuclear area and used a calculation of the distribution of nuclear sizes as a predictor of the clinical course. When subjective grading was complemented by morphometry the outcome was correctly predicted in 55 of 58 cases and all cases with poor clinical outcome were identified.
Subject(s)
Carcinoma, Transitional Cell/pathology , Urinary Bladder Neoplasms/pathology , Carcinoma, Transitional Cell/ultrastructure , Cell Nucleus/pathology , Humans , Prognosis , Urinary Bladder Neoplasms/ultrastructureABSTRACT
In this study two measurements of nuclear size, the mean area and the size distribution curve of nuclear area, were used to differentiate between two polar groups: nuclei from non-neoplastic urothelium and nuclei from transitional cell carcinomas of bladder with a poor clinical outcome. Wide separation of these groups is necessary if a measurement is to be used to assess tumour grade where the morphometric differences are intermediate between such polar groupings. Separation between two groups was best achieved using a weighted distribution of nuclear size and this is a means of objective scoring of urothelial tumours.
Subject(s)
Carcinoma, Transitional Cell/pathology , Cell Nucleus/pathology , Urinary Bladder Neoplasms/pathology , Carcinoma, Transitional Cell/ultrastructure , Humans , Image Processing, Computer-Assisted , Prognosis , Urinary Bladder/ultrastructure , Urinary Bladder Neoplasms/ultrastructureABSTRACT
Twenty-two cases of immunoproliferative small intestinal disease (IPSID) were studied with an immunoperoxidase technique. Sixteen of these had serologic evidence of alpha heavy chain disease (AHCD) and have a characteristic immunochemical pattern that allows a diagnosis on jejunal biopsy. kappa-light chain was found in a case of AHCD in the benign appearing plasma cell proliferation and in the associated malignant lymphoma suggesting that failure of light chains is not constant in AHCD. Four cases of IPSID showed secretion of polyclonal IgA in the plasma cell infiltrate providing evidence that some cases may be associated with secretion of complete IgA molecules. This polyclonal pattern is suggestive of a reactive process. Two cases of IPSID without evidence of AHCD showed an immunohistochemical pattern characteristic of AHCD and may represent nonsecreting forms of the disease. Alternatively they may be secreting nondetectable amounts of AHCD protein or an abnormal protein not recognized by standard antisera.
