Pancreatic beta-cell replication in streptozotocin-diabetic rats: the effect of liver compensatory growth on intraportally engrafted islets.

Early studies showed that compensatory liver growth after anterior portal branch ligation (aPBL) may restore normoglycemia in streptozotocin (STZ)-diabetic rats, in which a subtherapeutic islet mass was previously transplanted into the liver. We hypothesized that this effect could be related to islet regeneration at the graft site. This study was designed to characterize the proliferative response of the intraportally transplanted islets, shortly after aPBL. Male Wistar-Furth rats were used as syngeneic islet donors and/or recipients. STZ-diabetic rats were divided in four groups: groups 1 and 2 underwent selective 250-islet transplantation (Tx) into the posterior liver lobes, followed by aPBL 10 days later; rats were killed 24 h (n = 9) and 48 h (n = 10) after aPBL, respectively; groups 3 and 4 underwent selective 250-islet Tx into the posterior liver lobes, followed by sham aPBL 10 days later; rats were killed 24 h (n = 3) and 48 h (n = 3) after aPBL, respectively. Two hours before killing, all animals were injected with 5'-bromo-2'-deoxyuridine (BrdU; 50 mg/kg, i.v.). Liver sections were immunostained for insulin and BrdU, and both hepatocyte and islet cell labeling index (LI) were calculated. Islet cell LI was 2.30+/-1.18% in group 1, 2.23+/-1.00% in group 2, 0.43+/-0.29% in group 3, and 0.39+/-0.21% in group 4 (group 1 vs. group 3: p<0.02; group 2 vs. group 4: p<0.01). Hepatocyte LI was 2.50+/-2.14% in group 1, 15.0+/-7.6% in group 2, 0.12 +/-0.04 in group 3, and 0.11+/-0.03% in group 4, respectively (group 1 vs. group 2: p<0.02; group 1 vs. group 3: p<0.001; group 2 vs. group 4: p<0.001). Our study showed that intraportally transplanted islets undergo a concurrent proliferative response after aPBL, although with a lower extent and a different timing when compared with the liver-cell response.

Epithelioid haemangioendothelioma of the lung imitating clinical features of pulmonary histiocytosis X.

A young male who was a heavy smoker presented with spontaneous right pneumothorax. A high resolution computed tomography scan showed disseminated nodules up to 1 cm in diameter; the greatest majority of which were sited in the centrilobular zone, though some abutted on the pleural surface. Surgical lung biopsies allowed a diagnosis of epithelioid haemangioendothelioma. The neoplastic tissue infiltrated the wall of bronchioles, partially obliterating them and the visceral pleura. These two histological aspects could be considered as concomitant mechanisms for the appearance of spontaneous pneumothorax. Epithelioid haemangioendothelioma should be added to the list of lung diseases in young heavy smokers that can begin with a spontaneous pneumothorax.

Diffuse panbronchiolitis observed in an Italian male.

We describe a case of a 43 year old man who presented with productive cough, dyspnea, severe obstructive ventilatory failure and diffuse micronodular shadows on chest roentgenogram. Bronchoalveolar lavage fluid analysis showed an increased total cellularity sustained by a huge neutrophilia. Sweat test was negative. Transbronchial lung biopsy and autopsy showed unit lesion of diffuse panbronchiolitis. This report represents, to the best of our knowledge, the first case of diffuse panbronchiolitis observed in Europe.

Transbronchial lung biopsy and bronchoalveolar lavage in diagnosis of diffuse infiltrative lung diseases.

We investigated 801 patients with lung infiltrates who underwent transbronchial lung biopsy (TBB) and performed cytologic studies of lavage fluid of 491 patients who also underwent bronchoalveolar lavage (BAL). A specific histopathological diagnosis was made in 232 cases (29%). Histopathological changes consistent with the clinical pattern were present in 296 cases (37%). The diagnostic yield of TBB was 66%. Routine evaluation of BAL fluid allowed us to make a specific diagnosis in 49 cases. The role of the pulmonary pathologist in the interpretation of TBB and BAL specimens is discussed.