[Quality control at the Istituto di Anatomia e Istologia patologica at the Università di Bologna]. / Controllo di qualità dell'Istituto di Anatomia e Istologia patologica dell'Università di Bologna.

The growing importance in medical practice of a standardized diagnosis in cyto- and histopathology and the recent recommendations for the adoption of standardized schemes for quality control in anatomic pathology by International Committees stimulated the medical staff of the Institute of Anatomic Pathology of the University of Bologna to adopt a pertinent method. The method used by the Department of Pathology of the Yale University (New Haven, Connecticut, USA) was chosen. A Committee for the quality control was appointed and two kinds of controls were set up: an External Quality Assessment (review of the difficult cases by external experts, slide seminars) and an Internal Quality Assessment performed by the members of the Committee on the diagnostic and laboratory routine of the Institute. Such a survey is periodically monitored during the monthly meetings of the Committee and described in the monthly reports. The present paper illustrates the method adopted and the preliminary results obtained in order to stimulate the discussion of such a critical theme in contemporary Anatomic Pathology at a national level.

Reactivity of monoclonal antibody (mAb) GD9 with a cytoplasmic antigen preserved in formalin-fixed, paraffin-embedded gastrointestinal tumors.

In order to develop monoclonal antibodies to tumor associated antigens which are preserved in formalin-fixed, paraffin-embedded tissues, BALB/c mice were immunized with a formalin-fixed paraffin-embedded melanoma lesion. One of the resulting monoclonal antibodies, monoclonal antibody (mAb) GD9, stained formalin-fixed, paraffin-embedded melanoma lesions. When tested with a large panel of normal tissues from adults and from two fetuses of 4 and 16 week gestation and of benign and malignant tumors of different embryological origin, the mAb GD9 stained normal small bowel mucosa, areas of gastric intestinal metaplasia, the 6 pancreatic carcinoid tumors tested and a high percentage of gastrointestinal tumors. In the latter group, the reactivity with well differentiated tumors was higher than with poorly differentiated ones. Furthermore, the percentage of malignant cells stained by mAb GD9 in differentiated tumors was higher than in poorly differentiated ones. In the latter, the staining was diffuse and granular, while in the former, the staining was located in the cytoplasm close to the glandular lumen. The reactivity of mAb GD9 with colon carcinomas did not correlate with the Duke's staging and with the clinical course of the disease. The results of the immunohistochemical staining of normal tissues and benign and malignant lesions suggest that the specificity of mAb GD9 is different from that of previously described monoclonal antibodies which recognize tumor associated antigens expressed by tumors of the gastrointestinal tract.

Incidence of intratubular germ cell neoplasia in androgen insensitivity syndrome.

Gonadal histology was investigated by means of conventional microscopy in 6 patients with complete androgen insensitivity syndrome, in 11 with incomplete androgen insensitivity syndrome, and in 3 with 5 alpha-reductase syndrome. Twelve subjects were prepubertal and 8 pubertal. In all patients gonadal tissue was removed as a prophylactic measure and no patients gave rise to any clinical suspicion of a tumour. Eight patients with incomplete androgen insensitivity syndrome, 5 of whom (62.5%) were prepubertal, showed intratubular germ cell neoplasia and in 6 of them it was bilateral. Histochemical and immunohistochemical analysis showed considerable agreement between atypical morphological aspects and positive response to Schiff's periodic acid and to staining with the anti-placenta alkaline phosphatase antibody. Our patients were characterized by one of the highest reported incidences of intratubular germ cell neoplasia, particularly at prepubertal age. These findings would seem to indicate that a rethink is needed concerning the general opinion that patients with androgen intensivity syndrome have practically no risk of developing malignancy, and that orchidectomy is not advisable before puberty is completed.

Sclerosing stromal tumor of the ovary. A hormonal, histochemical and ultrastructural study.

Three new cases of sclerosing stromal tumor of the ovary have been studied by hormonal, immunohistochemical and electron microscopic analysis. The results confirm that this tumor may have hormonal activity. Ultrastructural study shows findings different from those previously reported. The authors propose an origin from the ovarian stroma with luteinization of stromal tumor cells.