Control specimens for immunocytochemistry in liquid-based cytology.

OBJECTIVE: Immunostaining necessitates the use of positive as well as negative controls, which is usually an easy procedure in immunohistochemistry (IHC). To find suitable control specimens for immunocytochemistry (ICC) is, on the other hand, a challenging task and to the best of our knowledge is not sufficiently dealt with in the English literature. The aim of this trial was to develop an applicable method to select, collect, process and store control specimens for ICC using liquid-based cytology (LBC). METHODS: The study included 21 different antibodies, which were known to react with at least one of the cellular components from tonsils, serous fluids and bronchial washings. The LBC specimens from the tonsils were collected as SurePath™ specimens (BD, Bencton, Dickinson and Company) by brushing the cut-surface of a fresh tonsil and then immersing the brush head into the SurePath™ vial. The serous fluids and bronchial washings were fixed in CytoRich Red™ (BD). Some of the cellular suspensions from the tonsils and equal amounts of the serous fluid and the bronchial washings were also mixed as a cocktail. Unstained SurePath slides were then prepared on the PrepStain™ (BD) Non-GYN Program, and the unstained and dry slides were then stored at 5 °C to test the effect of storage on the preservation of the antigenicity. ICC was then performed on BenchMark-XT™. RESULTS: Cellular components in unstained SurePath™ slides reacted positively with relevant antibodies. Slides that were stored for up to 40 days did not loose staining intensity. CONCLUSION: Specimens from body fluids and cell-suspensions that are collected by brushing the cut-surface from different types of fresh tissues or organs can be used as control specimens either separately or as mixtures. Dry and unstained slides can then be prepared and stored in a refrigerator for at least 40 days without loosing staining intensity.

Cervical cancer screening in Denmark.

Denmark is divided into 15 counties and it is up to regional politicians and the health authority in each county to organise the cervical screening programmes. The National Board of Health issued national guidelines and recommendations for the cervical cancer screening back in 1986, and these guidelines are now, in 1998, almost fully implemented. In this study, a literature review on cervical cancer screening in Denmark, review of local guidelines, personal interviews with pathologists and collection of information about the education of cytotechnologists in Denmark was carried out. In Denmark in 1997 90% of women aged 23-59 years and 46% of women aged 60-74 years were covered by organised screening. A total of 650000 smears were taken annually. This figure corresponds to screening of all Danish women aged 25-59 years on average, every second year. The national recommendation is screening every third year. Thus, as the incidence of cervical cancer in Denmark is decreasing, we could probably move towards a longer screening interval. However, before the Danish recommendations are changed, more detailed data on the actual performances of screening programmes are warranted.

Ultrasonographically guided fine-needle aspiration biopsy of intrathoracic tumors.

PURPOSE: Evaluation of diagnostic accuracy and complication frequency at ultrasonographically guided fine-needle aspiration biopsy of intrathoracic tumors. MATERIAL AND METHODS: A total of 134 ultrasonographically guided percutaneous fine-needle aspiration biopsies were performed on 128 patients with intrathoracic tumors abutting on the pleura. A cytologic diagnosis was obtained in 119 patients (93%). RESULTS: In 83 patients, cytologic malignancy was found; in 34, benignity; and in 2, cellular atypia. A total of 117 diagnoses were correct and 2 diagnoses were false-positive. A malignancy subtyping based on the cytologic aspirates was made in 80 patients. In 40 (93%) of 43 histologically proven subtypes, the subtyping was correct. The complication frequency in terms of pneumothorax was 3.7%. CONCLUSION: Ultrasonographically guided percutaneous fine-needle aspiration biopsy is a safe and reliable method of establishing the cytologic diagnosis of intrathoracic tumors.

Multiple pulmonary chondrohamartomas in trachea, bronchi and lung parenchyma. Review of the literature.

Multiple pulmonary chondromatous hamartomas (MPCH) are rare, and MPCH with tracheal involvement have not been, to the best of our knowledge, reported before. Furthermore, there is no agreement in the literature about the origin of these tumours. We report a case of MPCH involving trachea, bronchi and lung parenchyma, incidentally found at the autopsy of a 88-year-old woman who died of acute myocardial infarction, and we review the literature about MPCH. We conclude that there appear to be two different types of multiple pulmonary chondromatous hamartomas; those presented in young patients often linked to gastric leiomyoblastomas and catecholamine-producing paragangliomas (Carney syndrome) with high mortality, and those presented in elderly patients, which seems to be compatible with life.

Multinucleated stromal giant cells of the uterine cervix.

A prospective clinicopathological study including 100 consecutive hysterectomies and 100 consecutive cone specimens to investigate the frequency and pathogenesis of multinucleated stromal giant cells (SGCs) in the uterine cervix is presented. Sections containing SGCs were analyzed by immunohistochemical methods for the presence of cytokeratin, S-100 protein, factor VIII, desmin, muramidase, alpha 1-antichymotrypsin, and vimentin. Tissue for electron microscopy was punched out of four paraffin blocks from four different cases. SGCs were not found in patients < 30 years old, but their incidence increased with age until the sixth decade, at which time they were found in 42% of patients. We found at the same time that the incidence of SGCs declines in the seventh decade. SGCs were not related to any inflammatory or granulomatous lesion, and their presence was independent of other clinical parameters, such as hormonal therapy, history of trauma on the uterine cervix, pregnancy, or parity in general. Immunohistochemical and ultrastructural analyses support the concept of a fibroblastic-histiocytic origin of SGCs. SGCs in the uterine cervix may reflect a physiological tissue reaction during the transition from the fertile to the postmenopausal state.

[Comparison of endometrial changes in extra and intrauterine pregnancies. A clinical patho-anatomic study]. / Sammenligning af endometrieforandringer ved intra- og ekstrauterin graviditet. Klinisk pato-anatomisk undersøgelse.

Endometrial scrapings from 3 x 50 patients with spontaneous abortions (SA), terminations of pregnancy (PA) and extrauterine pregnancies (EG), respectively, were examined and compared with the clinical conditions. Fibrinoid deposits and isolated cytokeratine-positive cells in the decidua were only observed in cases of uterine pregnancy (IG). Arias-Stella's phenomenon in combination with decidua was observed equally frequently in IG and EG. Decidual reaction in the endometrium was observed in all of the patients with IG in contrast to the group with EG in which approximately 1/3 did not show the decidual reaction. Absence of the decidual reaction with or without Arias-Stella's phenomenon in pregnant women is, therefore, evidence of EG.

Transabdominal chorionic villi sampling for first trimester fetal diagnosis. First 26 pregnancies followed to term.

A consecutive series of 26 women followed to term after first trimester transabdominal chorionic villi sampling is presented. The clinical application of transabdominal chorionic villi sampling (TA-CVS) seems to have certain advantages, especially from the patients' point of view, but also in regard to successful sampling and to the complication ratio. The results in this clinical trial revealed no cases of abortions, no signs of placental damage and no cases of vaginal bleeding or infections.

Primary malignant fibrous histiocytoma of the lung. A case report.

A case of malignant fibrous histiocytoma of the lung is presented and the literature concerning this rare tumour is reviewed. The advisability of postoperative chemotherapy in the cases remains to be clarified and further data are required to establish the optimum management.

Congenital neuroblastoma in a fetus with multiple malformations. Metastasis in the umbilical cord as a cause of intrauterin death.

A fetus that died in utero between the 16th and 20th week of gestation exhibited multiple malformations and tumour tissue, retroperitoneally and in both adrenals, histologically compatible with neuroblastoma. In the cord there was a metastasis occluding the vessels, the possible cause of the intrauterin death.

Müllerian adenosarcoma of the endometrium: review of the literature and report of two cases.

The author reports two cases of müllerian adenosarcoma (MAS) in the endometrium in patients aged 60 and 73 years. Both were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. The 60-year-old patient is alive without signs of recurrence or metastases 3 years after the operation. The other patient, who received postoperative vaginal radium therapy, died of disseminated abdominal metastases 7 months after the operation. Only two cases of MAS leading to death within less than 1 year have been reported so far.

Barytoma of the rectum.

Two cases of barytoma of the rectum in a 33-year-old female and an 81-year-old male are presented. The cases were detected 4 1/2 and 3 months, respectively, after a barium enema. The morphologic, histochemical and radiologic findings are described. The pathogenesis and the differential diagnosis are then discussed in the light of the literature.

Carcinoid tumor of the uterine cervix.

A case of well differentiated carcinoid in the uterine cervix in a 60-year-old white woman is presented, with histochemical and ultrastructural examinations. The patient was treated by hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection. No systemic endocrine manifestations were detected. The patient is alive and free from recurrence 11 months after detection of the tumor.

Lobular carcinoma in situ occurring in adenolipoma of the breast. Report of a case.

A case of malignant transformation in adenolipoma of the breast is presented. It is generally agreed that adenolipomas are benign lesions, but it must be kept in mind that a certain risk of malignant transformation exists due to the glandular tissue content. In order to establish the correct diagnosis high quality films and close collaboration between radiologist, breast surgeon and pathologist are important.