[Expression of CD34 and CD117 in juxtaglomerular cell tumor of kidney]. / Exprese CD34 a CD117 v nádoru z juxtaglomerulárních bunek ledviny.

Juxtaglomerular cell tumor (JGCT) is an uncommon tumor of the kidney, typically found in young adults. Patients with this tumor suffer from hypertension, hyperaldosteronism and hypokalaemia. Expression of renin and intracytoplasmatic rhomboid crystals or granules in electron microscopic picture are diagnostic features of this tumor. CD34 and CD117 immunoreactivity have recently been reported as helpful markers of JGCT.

Autofluorescence (safe) bronchoscopy and p21/ki-67 immunostaining related to carcinogenesis.

Archival biopsy materials from 20 randomly selected asymptomatic volunteers from the Czech uranium miners (CZ UM) risk group (n=98) were examined for p21 and ki-67 immunostatning. There were 16 areas with normal respiratory epithelium and 22 areas with bronchial intra-epithelial neoplasia (IEN). Normal and IEN areas were identified by autofluorescence (System Autofluorescence Endoscopy, SAFE-1000) and monitored during 1998-2002. The majority of specimens from areas with normal autofluorescence intensity with ciliated columnar bronchial epithelium showed strong predominantly cytoplasmic p21 positivity. The SAFE monitoring divided areas of decreased autofluorescence intensity with early stage IEN lesions into two groups. Persistent lesions (P)-showing a spectrum of p21 cytoplasmic staining ranging from negative or isolated negativity to weak or moderate positivity combined with higher proliferative capacity proved by ki-67 nuclear staining. Disappearing lesions (D)-showing strong cytoplasmic p21 positivity and negative ki-67 staining. The IEN lesions were classified into three groups based on p21/ki-67 immunostaining: proliferative lesions at risk (R) with low or without p21 plasma immunostaining combined with high ki-67 nuclear reactivity; ambiguous lesions (A) including cases combining strong p21 cytoplasmic positivity with high ki-67 nuclear reactivity or p21 cytoplasmic negativity with ki-67 negativity staining patterns; the quiescent lesion group (Q) was characterized by strong p21 cytoplasmic positivity and negative ki-67 immunostaining.

[Apoptosis and expression of bcl-2 protein in invasive ductal adenocarcinoma of the pancreas]. / Apoptóza a exprese bcl-2 proteinu u invazivního duktálního adenokarcinomu pankreatu.

Apoptosis plays a central role in the development and/or progression of cancer. There are several methods for detection of apoptotic cells in tissue sections including light and electron microscopy, in situ nick end-labeling (ISEL), TdT-mediated dUTP nick-end labeling (TUNEL) and immunohistochemical detection of proteins associated with apoptosis. Apoptosis was assessed by the monoclonal antibody M30 CytoDEATH (M30), which is specific for neo-epitope in cytokeratin 18 that becomes available at an early caspase cleavage during apoptosis. Expression of bcl-2 protein was evaluated, because bcl-2 protein plays an important role in the regulation of apoptosis. Twenty-six invasive ductal adenocarcinomas of the pancreas were studied immunohistochemically with antibodies M30 and bcl-2. The mean apoptotic index (AI, the percentage of apoptotic cells of the total tumor cells number) was 2.75%. High AI (> 10%) was observed in 4 cases of the 26 pancreatic carcinomas (15%). Protein bcl-2 was expressed in 3 cases (11.5%). The AI did not correlate with the expression of protein bcl-2. In conclusion, the detection of neo-epitope in cytokeratin 18 by monoclonal antibody M30 can be used for quantification of apoptotic cells with immunohistochemical techniques in tissue sections. It is a new approach to evaluate apoptosis in pancreatic carcinomas. The low positivity of bcl-2 expression in pancreatic adenocarcinomas suggests that bcl-2 protein does not play a central role in pancreatic tumorigenesis and cancer progression.

[Segmental absence of intestinal musculature]. / Segmentální chybení strevní svaloviny.

Herein we describe a case of 33-year old woman repeatedly affected by incomplete ileus. Primary segmental absence of lamina muscularis propria has been found in this patient. Histological examination revealed areas of small intestine with total absence of muscularis propria followed by areas of the intestinal wall characterised by normal histological structure. No necrosis, inflammation, and fibrosis supporting the secondary origin of this lesion was found.

[Latent membrane protein LMP-1 in Hodgkin's lymphoma]. / Latentní membránový protein LMP-1 u Hodgkinova lymfomu.

The authors examined using the antibody against latent membrane protein (LMP-1) a group of 169 patients with Hodgkin's lymphoma (age 2 to 82 years). From the total number of 169 patients 48 (28%) patients were positive when tested with this antibody. In the whole group the following histological types were represented most frequently: type II (nodular sclerosis) 83 (49%) patients, and type III (mixed cellularity) 70 (41%) patients. Type I (lymphocytic predominance) was not represented. In type IV (lymphocyte depletion) there were three cases (1.7%). Type V (lymphocyte rich) was represented by 13 patients (7.6%). The frequency of positive cases was in these histological types as follows: type II 14 cases (17% of 83 cases), type III 28 cases (40% of 70 cases), type IV 2 cases (66% of 3 cases). type V 4 cases (30% of 13 cases). Distribution of positive cases by age: in children under 10 years a positive finding was recorded in 80%. In old people above the age of 80 years there was a 100% positivity (only two patients were examined). The smallest number of positive cases was in the third decade (of 26 patients 4% were positive). LMP-1 positivity was most frequent in male patients--in 37 (of 96 examined patients) and in 11 female patients (of 73 examined) The frequency of LMP-1 in Hodgkin's lymphoma is consistent with similar studies in economically developed countries. A markedly higher incidence of positive cases in the lowest and highest age groups and gender differences are striking and so far there is no unequivocal explanation for them.

Detection of Epstein-Barr virus in Hodgkin's lymphoma (patients in the Czech Republic).

The frequency of EBV demonstrated in patients with Hodgkin's lymphoma (HL) shows geographical variability. In the present study, we investigated the frequency of EBV in HL patients in the Czech Republic. The presence of EBV was determined by immunohistochemistry (IHC) with anti LMP-1 antibody and by in situ hybridization (ISH) method for EBERs. We studied 142 cases with HL. The age of patients ranged from 4 to 82 years. The male to female ratio was 1.2 (males 55.6%). In the series of 142 patients 47 (33%) positive cases were found. The incidence of EBV-positive results was significantly, higher in males than in females (70.2 vs. 29.7%, p = 0.023). Five patients were found in the age group below 10 years. They were positive with LMP-1 antibody and for EBERs in ISH method. The same results were discovered in two patients above the age of eighty. The most frequent histologic types of HL were nodular sclerosis (64 cases) and mixed cellularity (62 cases), respectively. The former type contained 16 EBV-positive cases (25%) and the latter 24 (38%) positive cases. The lymphocyte depletion type 2 (67%); lymphocyte rich type 5 (38%). EBV-positivity examined by ISH and IHC methods determined not only diagnostic Hodgkin cells and Reed-Sternberg cells but also small lymphocytes. In IHC method were small lymphocytes positive in 11 cases, more sensitive ISH revealed 32 positive cases.

[Plexiform fibrohistiocytic tumor of soft tissues and bone]. / Plexiformní fibrohistiocytární nádor mekkých tkání a kosti.

Plexiform fibrohistiocytic tumor is a rare lesion which has been reported only in the dermis and subcutis so far. We present two cases in this location and an additional one localized in the proximal epiphysis of the tibia. A case with crural location showed predominance of plexiform tumorous nodes with fibrohistiocytic arrangement. The nodes were composed of spindle-shaped myofibroblasts with admixture of histiocytes and giant multinucleated osteoclast-like cells. In another case the tumor of axillary soft tissues featured mostly plexiform bundles of spindle-shaped myofibroblast-like cells reacting positively with actin and CD 68 antibodies; ultrastructurally, they contained numerous dense lysosomal inclusions with myelin figures. The bone tumor was composed of hyalinized fibroblastic component with disperse fibrohistiocytic nodes. Despite a semimalignant character of the lesion there was no recurrence in our cases during the 2-6 year postoperative period.

[EBV-positive Hodgkin's lymphoma in children under 10 years]. / EBV pozitivní prípady Hodgkinova lymfomu u detí do deseti roku.

The number of EBV-positive child patients with HL varies in different countries and regions. In developing countries the number of child patients with this disease is higher than in the patient population of economically advanced countries. The authors examined 24 patients under 10 years with Hodgkin's lymphoma. Twenty patients were males, four females. In ten cases according to histological examination type II of HL was involved--nodular sclerosis (7 boys, 3 girls). In 14 instances the authors detected the mixed cellularity type (13 boys and 1 girl). EBV positivity was assessed immunohistologically by means of the antibody against LMP-1 and EBER-1 by the method of in situ hybridization. In 20 EBV positive HL 18 boys and 2 girls were affected. EBV positivity was proved in 83%. The marked intersexual difference in different EBV positive HL has not been explained unequivocally so far. The authors proved, that 14 EBV positive HL were type III--mixed cellularity. In 6 cases the type of nodular sclerosis was involved. The authors assume that marked positivity of child patients is associated with the initial massive EBV infection. EBV positive tumour cells are to a considerable extent removed by the immune apparatus and thus in the second and third decade EBV negative patients predominate.

[Pathology of the pancreas. Analysis of 172 resection specimens]. / Patologie pankreatu. Rozbor sestavy 172 resekátu.

New sophisticated surgical methods enabled interventions on pancreas which kept remaining without attention of gastrointestinal surgeons for a long time because of previously unsolvable reasons. Pancreatic resection specimens enter now the biopsy diagnostics the correct interpretation of which needs a perfect technology of processing. Biopsy under CT monitoring, fibroscopical techniques combined with contrast investigation, biochemical, cytological and bioptic analyses of samples brought new diagnostic aspects into pancreatic disorders. The authors present a classification analysis based on their group of 172 resection specimens from 165 patients: tumor lesions are represented by 52 specimens, inflammatory lesions by 112 specimens, 8 cases are of another nature or are lacking in a clear diagnostic classification. Bioptic investigation can settle the diagnosis of very rare nosological entities which were distinguished before only in necroptic material (adult nesidioblastosis, Schwachman-Diamond syndrome associated with ductal carcinoma of the head of pancreas, and others).

Detection of Bronchial Neoplasia in Uranium Miners by Autofluorescence Endoscopy (SAFE-1000).

The increase in the detection rate for premalignant changes of bronchial epithelium was studied in 56 symptom-free volunteers from the risk group of Czech uranium miners (mean age 50.69 years, mean WLM 21.06 (1 Working Level Month is equal to the absorption of latent energy of 2.08 x 10(-5) J/m(3) in one month, i.e. 170 working hours)) by the additional employment of the System of Autofluorescence Endoscopy (SAFE-1000 Pentax) to conventional white-light bronchoscopy, comparing results with those of bronchial biopsy histopathology examination. Histopathology using hematoxylin and eosin staining confirmed intraepithelial neoplasias in 15 areas in 10 persons. White-light bronchoscopy sensitivity was 21.05%, and specificity 93.7% which an autofluorescence bronchoscopy sensitivity was 78.95% and specificity 81.89%.

[Gangliocytic paraganglioma of the duodenum]. / Gangliocytární paragangliom duodena.

Gangliocytic Paraganglioma of the duodenum is rare neuroendocrine tumor. This type of the tumor can cause bleeding into the gastrointestinal tract and epigastric pain in this region. It can be difficult to differentiate this tumor from the primary tumor of the head of the pancreas growing secondary to the duodenum. The authors describe one such misdiagnosed case treated finally successfully by hemipancreatodecodenectomy.

[Effect of H. pylori eradication regimes on the proliferation index of gastric mucosa]. / Vliv eradikacních rezimuu H. pylori na proliferacní index zaludecní sliznice.

Eradication regimes with the blocking agent of the proton pump and without it do not influence the activity of cell division after treatment of Helicobacter pylori (H.p.) when using cytoflowmetric evaluation. The non-significant difference in proliferation activity of the gastric mucosa after treatment of H.p. can be also a sign of more rapid repair of the gastric mucosa after elimination of the inflammatory elements.

[Tests for teaching pathologic anatomy]. / Testy pro výuku patologické anatomie.

A teaching database for pathology was prepared comprising around 1250 questions. Five answers belonged to each question, only one of them being correct. Preparation of questions was partly based on testing sets from Medical School of the University of Loma Linda, Ca., partly on those used in 2nd Department of Pathology, Masaryk University Medical School, Brono. In addition, set of computer programmes for automatic generation, printing and evaluation of tests was prepared. They were verified with Brno students.

[Bronchopulmonary dysplasia]. / Bronchopulmonální dysplazie.

Bronchopulmonary dysplasia is a most frequent contemporary lesion of the lung in early childhood. It is characterized by clinical symptoms (neonatal respiratory distress syndrome) and by X-ray picture reflecting progressive morphological changes in the respiratory tract, i.e. in trachea, bronchi, bronchioles, and pulmonary acini, followed by interstitial pulmonary lesion. As usual, bronchopulmonary dysplasia is forerun by hyaline membranes and may be associated with or followed by interstitial emphysema. Pathogenetic participants are toxicity of highly concentrated and long administered oxygen, artificial mechanical ventilation with an intermittently positive pressure, barotrauma first of immature lung causing emphysema and pneumothorax and pneumomediastinum, lung edema, shortage of A and E vitamins and ceruloplasmin deficiency. Morphological changes in bronchopulmonary dysplasia are alike diffuse alveolar damage in bigger children or adults. Nevertheless, neonatal changes differ from later pulmonary lesion by evolving in an immature tissue and by being complicated with necrotizing "obstructive" bronchiolitis.

[Histiocytosis X and the orbit in children]. / Histiocytóza X a detská ocnice.

Histiocytosis X, a clinical entity which was not defined and classified exactly so far, is manifested by a varied range of clinical manifestations. In rare instances the affection of the orbit is the only and first symptom of the disease. The authors present an account of three children. In one isolated affection of the orbit with a non-inflammatory swelling of the external portion of the upper eyelid was the first symptom of the disease. In the other two patients with the acute multifocal form of histiocytosis X exophthalmos developed only 3 and 7 months resp. after establishment of the diagnosis. In the discussion of symptoms, the prognosis and treatment the authors are inclined to believe that at present the prognosis of multifocal form of the disease is not always adverse. In the frequently difficult differential diagnosis of orbital lesions histiocytosis X should be considered as one of the possible causes of affections of the orbit in children.

[Viral and chlamydial diseases of the uterine cervix--histocytological correlates]. / Virové a chlamydiové afekce cípku delozního histo-cytologické koreláty.

A retrospective analysis of 919 consecutive cervical biopsies from the year 1987 showed three different types of lesion--unspecified lymphocytic endocervicitis, herpetic changes and coilocytic changes. Attention was concentrated on their histo-cytologic picture as well as on a coincidence of dysplasia and collocytosis.

[Congenital neuroblastomas]. / Kongenitální neuroblastomy.

A group of 2,576 autopsies of children of the age of 0 to 15 years (made between 1978 and 1987) comprised 14 congenital (neonatal) tumours (among 93 tumorous lesions). Teratomas were the most frequent congenital tumours followed by neuroblastomas (4 and 3 cases). Neuroblastomas grew from cervical and thoracoabdominal sympathicus and from the right adrenal medulla. The most frequent and most extent hematogenic dissemination concerned liver, microscopical examination found dissemination in various organs as well as a lymphatic spread to regional lymph nodes (in 2 cases). One case was characterized by an exclusive continual destructive growth in retroperitoneum and posterior mediastinum with 2 macroscopical secondaries in skeleton. Pathognomic differentiated structures were always found by light microscopy. Differential diagnosis of round cell tumours of infancy was discussed with a concise exposure of symptomatology and autoptic findings of neuroblastomas according to congenital cases from literature.