Lymphocytic thyroiditis in fine-needle aspirates: differential diagnostic aspects.

This study assessed the morphological criteria for the diagnosis of various types of lymphocytic thyroiditis in fine-needle aspirates. Of 950 aspirates, 121 revealed lymphocytic thyroiditis, including Hashimoto's thyroiditis (partly confirmed by serological or histological examination) and focal thyroiditis adjacent to neoplasms. The diagnosis of Hashimoto's thyroiditis was easy when the aspirated material was adequate and contained oxyphilic cells; in the fibrous type, diagnosis was rather difficult. Focal thyroiditis may be confused with Hashimoto's thyroiditis, especially when adjacent to neoplasm. Surgical exploration should be performed in cases of severe lymphocytic thyroiditis revealed by fine-needle aspiration with repeatedly negative antibody titers in order to exclude neoplasm.

Therapeutic effect of bovine albumin in the experimental fat embolism syndrome.

The toxic effects of the free fatty acids (FFA) are responsible for the initiation and the clinical manifestations of the fat embolism syndrome (FES). Serum albumin binds to the FFA and by producing atoxic compounds it has a therapeutic effect on the syndrome. In this study we applied bovine albumin to 48 Sprague-Dawley rats which were previously submitted to intravenous infusions of FFA solutions (oleic, palmitic, stearic). The histopathologic lesions observed in their lungs were compared to those of 50 control animals suffering from the FES. The administration of 0.5% bovine albumin solution intravenously and 0.2% intraperitoneally, especially when it was synchronous to the FFA infusion and not metachronous, resulted in substantial and statistically significant therapeutic effects.

Immunohistochemical study of ras oncogene expression in endometrial and cervical human lesions.

The Y13 259 monoclonal antibody to the ras p21 protein was used in an immunohistochemical assay to study the levels of ras p21 in human uterine lesions as compared to normal tissue. Out of 73 hysterectomies obtained we have examined ras p21 expression in separately made sections from the endometrium, the cervix and leiomyomas found in the same specimens. A total of 155 tissue sections were finally evaluated and included: 55 endometrial mucosae (normal, hyperplastic and atrophic), 13 leiomyomas, 60 cervicitis (mild, moderate and severe with or without dysplasia), 3 in situ and 7 invasive carcinoma of the cervix, 12 invasive adenocarcinoma of the endometrium and 5 endometrial adenocarcinomas, which involved the cervical canal. Out of the 73 hysterectomy specimens 27 lesions were malignant and showed elevated expression of ras p21. The remaining 128 were normal or atrophic mucosae and benign or premalignant lesions, which were mostly negative. However, all cases of severe cervicitis and dysplasias and 6 out of the 12 hyperplastic endometrial lesions were found to be moderately or highly positive. Our results suggest that elevated expression of ras oncogenes may play an important role in the development of human uterine lesions.

[Breast cancer in adipose breasts]. / Cancer mammaire des seins adipeux.

The authors have studied breast cancer in fatty breasts in an attempt to prove their observations that Wolfe's classification "N1" on mammography was not necessarily "normal". Two groups of women, the first called group "A" consisting of 384 women with cancer of the breast, and group "B", the control group of 400 women who had no abnormality in the breast, were studied and correlated for epidemiological, thermographic, mammographic, and anatomo-pathological parameters. The following epidemiological factors were studied: age, marital status, profession, age at menarche and at menopause, menstrual behaviour, age at the first pregnancy that went to term, parity (live and still births), type of delivery, length of breast feeding, number of abortions, use of hormones, and family history of cancer of the breast. In the thermographic studies: the topography of the heat pattern, the primary pathological signs and the thermic state were studied. In mammography: the mammographic appearance after Wolfe and the presence of microcalcifications was studied. In group "A" the following histological group parameters were studied: which breast, in which quadrant the nodule was situated, the type of breast the contour and size of the tumour, the number of axillary nodes removed, the histological type of the cancer, the histological grade of the malignancy, vascular invasion, details about the skin and the areola, calcifications, lymphocytic infiltration of the stroma, multicentricity, the co-existence of cystic disease of the breast and invasion of the axillary nodes. All these above-mentioned parameters were correlated with: the age, the existence of previous pregnancies at term, the macroscopic type of the breast and the mammographic type according to Wolfe. The breasts were divided into three macroscopic types: fatty, fibrous and intermediate. The correlation of the mammographic type according to Wolfe showed that types N1 and P1 corresponded to fatty and partially intermediate types. In group "A" the macroscopically fatty as compared with the other type of breasts showed a more extensive degree of infiltrations: vascular (76.5%), skin (90.3%), areolae (88.9%) and lymphocytic (80.1%), as well as a higher percentage of axillary metastases (57.7%).

Primary causes of perinatal death. An autopsy study of 556 cases in Greek infants.

The primary causes of death in 556 autopsy cases of perinatal death during the six years from 1979 through 1984 are discussed. On the basis of the clinical data and gross and microscopic findings, each case was assigned to one of the following categories of primary causes of death: a pulmonary hyaline membrane disease, infection, malformation, anoxia, immaturity, maternal causes, other causes, and unaccounted for Definitions of perinatal infant diseases, essential points of diagnosis, and statistics relating to perinatal infant death are also discussed.

Mucosal hyperplastic polyps of the stomach. Do they have any potential to malignancy?

Gastric mucosal polyps were studied in gastric biopsies, taken from 481 patients who had been operated on for benign peptic ulcer. The material was classified according to the type of operation in the following 4 groups: Billroth-II resection, gastroenterostomy, pyloroplasty with vagotomy and Billroth-I resection. As control group served 1520 nonoperated patients with no ulcer or malignancy. The diagnosed polyps were classified in inflammatory, hyperplastic and neoplastic. Neoplastic polyps were observed only in the nonoperated stomachs with an incidence of 0.5%. The incidence of the hyperplastic polyps was 12.1% for Billroth-II resection, 14.9% for gastroenterostomy and 2.6% for the control group, with a significant difference between the operated and the nonoperated stomachs. The hyperplastic polyps constituted the commonest histological type of polyp in all the groups. The majority of them was observed close to the gastroenterostomy and it seems that there is a relation between their frequency and the time elapsed after the operation. A high degree of epithelial dysplasia in hyperplastic polyps was found in 22.2% of Billroth-II resection patients, in 6.3% of gastroenterostomy patients and in only 2.6% of the control group, with a significant difference between the operated and the nonoperated stomachs.

Spindle cell carcinoma (pseudosarcoma) of the anus: a light, electron microscopic and immunocytochemical study of a case.

We report a case of polypoid spindle cell squamous carcinoma (pseudosarcoma) occurring in the anal canal. Electron microscopic findings and the demonstration of keratin by an immunoperoxidase method, gave clear cut evidence of the epithelial nature of the sarcomatoid cells forming this tumour. To our knowledge, this is the first reported case in the literature.

Primary gastrointestinal malignant lymphomas. A morphologic and immunohistochemical study.

Thirty-nine primary gastric and 22 intestinal malignant lymphomas collected from 1969 to 1980 have been studied morphologically and immunohistochemically. Eighteen of the 61 gastrointestinal lymphomas were of low-grade malignancy (9 lymphoplasmacytoid/cytic, 3 centrocytic, 6 centroblastic/centrocytic) and 43 were of high-grade malignancy (14 centroblastic, 7 lymphoblastic, 22 immunoblastic malignant lymphomas) according to the Kiel classification. The peroxidase-antiperoxidase (PAP) method was used in 53 of the 61 cases. Twenty-seven of them revealed a monoclonal positivity for intracytoplasmic IgS: kappa light chains in 18 and lambda light chains in 7 cases. Two cases represented alpha chain disease, revealing only a heavy chain positivity. The most frequent staining pattern of the lymphoma cells was that of kappa/mu. Cells with a mixed centrocytic and plasma cell configuration (centrocytoid plasma cells) proved to be positive for intracytoplasmic IgS. Lymphoma cells of all tested cases proved to be negative for all histiocytic markers. Histologically and immunohistochemically, the Greek cases of primary gastrointestinal malignant lymphomas seem to resemble "western" type lymphomas.

[Effect of phenytoin on Purkinje cells in the cerebellum]. / Die Wirkung von Phenytoin auf die Purkinjezellen des Kleinhirns.

We have examined the effect of chronic administration of phenytoin on Purkinje cells of cerebellum in adult mice. After daily intramuscular administration of phenytoin for a period of six months no difference in the number of Purkinje cells could be found between the treated and control animals.

The effects of bilateral adrenalectomy on the fine structure of the rat myocardium.

The subcellular effects of bilateral adrenalectomy on the rat myocardium were examined on 50 male rats. The animals, divided into groups of ten, were killed 3, 17, 18, 19 and 21 after adrenalectomy. The early changes consisted of moderate intracellular edema of many cardiac muscle cells and disarrangement of their myofibrils. The late changes consisted of prominent intracellular edema of many cardiac muscle cells, destruction of numerous myofibrils, dilatation of the sarcoplasmic reticulum and accumulation of numerous irregular mitochondria in subsarcolemma areas of the sarcoplasm. The lipofuscin granules seemed to be increased in number. Many endothelial cells were edematous and platelet aggregations filled the lumen of some small vessels.

An immunocytochemical study of the distribution of lysozyme, a1-antitrypsin and a1-antichymotrypsin in the normal and pathological gall bladder.

We have studied the distribution of lysozyme (Ly), a1-antitrypsin (a1AT) and a1-antichymotrypsin ( a1AChy ) in the normal, chronically inflamed and neoplastic gall bladder mucosa using the peroxidase-anti-peroxidase (PAP) method. Ly was absent from the normal mucosa but it was found only in areas of glandular metaplasia of true antral type and in crypts of possible early metaplastic nature in cases of chronic cholecystitis. a1AT and a1AChy were also found in such metaplastic areas, but their presence was also observed immunohistochemically in areas of essentially normal and in non-metaplastic, chronically inflamed gall bladder mucosa. The possible local production of these substances by gall bladder epithelial cells is discussed. Ly, a1AT and a1AChy were also found in various histological types of adenocarcinoma of the gall bladder in varying degrees of frequency and intensity, unrelated to the histological type and invasiveness of the tumour.

[Morphological findings in lymph nodes, spleen and liver in the rat following treatment with polyvinylpyrrolidone and trypan blue (light microscopy studies)]. / Morphologische Befunde an Lymphknoten, Milz und Leber der Ratte nach Behandlung mit Polyvinylpyrrolidon und Trypanblau (lichtmikroskopische Untersuchungen).

Lymph nodes, spleen and liver from 36 rats were studied by light microscope following prolonged administration of PVP and TB. When PVP had been administrated, the invasion of all the organs by large foam cells of RES was apparent while the structure of the organs had been destroyed. The animals which had received PVP combined with TB had less reticuloendotheliosis of the organs while their structure was maintained to a greater extent. The latter animals also had greater cellular reaction. All the rats showed obvious cachexia which was more apparent in those having received only PVP.

Carcinoembryonic antigen detection by immunocytochemical methods in carcinomas of the colon and stomach.

CEA was studied in paraffin sections from 50 cases of colonic and 50 cases of gastric adenocarcinoma using immunoperoxidase and immunofluorescence techniques. CEA was positive more frequently in colonic (86 per cent) than in stomach carcinoma (76 per cent). Immunoperoxidase was found to be the more sensitive technique for the detection of CEA in both organs. The non-neoplastic peritumoral colonic mucosa was more often CEA positive than was the peritumoral gastric mucosa. CEA was found more often, and the intensity of the staining was stronger in well-differentiated colonic and gastric carcinoma than it was in poorly differentiated carcinoma. No relation was found between the presence of CEA in colonic and gastric carcinoma and the stages of the disease. CEA was detected more frequently in carcinomas of the left colon than in carcinomas of the right colon.

[Experimental administration of di-N-butyl-nitrosamine (DBN) in rats. Carcinogenic activity in the urinary bladder]. / Experimentelle Verabreichung von Di-n-Butylnitrosamin (DBN) bei Ratten. Untersuchung der karzinogenen Wirkung in der Harnblase.

Di-N-butyl-nitrosamine (DBN) was administered in a suspension with dimethylsulfoxide (DMSO) to 80 rats in doses of 10 and 40 mg/kg/day. The carcinogen was given to the animals in groups of 40 either orally or subcutaneously. The animals were exposed to the carcinogen for a maximum of 320 days. In one group of animals, hypertrophia and hyperplasia affected the whole epithelium of the bladder. In the other group, hyperplasia was intense enough to be considered as carcinomatous. A third group developed papillomatous carcinomas, which occupied the whole interior of the bladder.

Demonstration of alpha 1-antitrypsin in paraffin sections of hepatoma and cirrhosis.

Alpha 1-antitrypsin has been examined in formalin-fixed, paraffin-embedded liver specimens from Greek patients with cirrhosis (35 cases) and hepatoma (55 cases) by peroxidase-antiperoxidase (PAP) method. Ring-like AAT globules were found in the non-neoplastic cells in 12% of the cases of hepatoma and in 11% of the cases of cirrhosis. Atypical globules were seen in neoplastic cells in 5.4% of the cases of hepatoma and in 17% of the cases of liver cirrhosis. A diffuse fine granular pattern of AAT distribution was present in 31% of the cases of hepatoma in the neoplastic cells and in 27% of those in the non-neoplastic cells. The relatively high incidence of ring-like AAT-globules, and of atypical globules in cases of hepatoma and cirrhosis is not in agreement with the extremely low gene frequency of Z allele in a Greek population of patients with cirrhosis and hepatoma. Thus, there is some doubt whether AAT-globules in the liver represent a histopathologic marker of genetically determined AAT deficiency. A relationship between AAT deposits and the degree of differentiation of hepatoma was noted in this series. AAT-positive cells were found in 55% of moderately differentiated, in 29% of highly differentiated and in 20% of poorly differentiated hepatomas.

Recurrent aortic occlusion due to malignancy.

A 62-year-old male had repeated episodes of aortic bifurcation occlusion by malignant masses of the same histologic type as the previously excised adenocarcinoma of the ascending colon. In spite of an extensive investigation of the lungs, heart and aorta no trace of the origin and the route of dissemination of the carcinomatous masses was found. Severe suspicion arises of massive malignant direct invasion of the aorta from the local recurrence of the tumor of the descending colon excised 3 years previously.

Prognostic significance of histologic host response in cancer of the large bowel.

Histologic material from 156 patients treated with surgery for cancer of the large bowel was studied with regard to tumor host interaction and with particular emphasis on the reactions of the regional lymph nodes. Prognostic evaluation of the tumor included the extent of the primary lesion according to Dukes' classification and the grade of differentiation of the carcinoma. Morphologic evidence of host resistance was judged by the presence and degree of lymphoplasmacytic infiltration of the tumor and the reactions of the regional lymph nodes, which were classified in four histologic patterns: lymphocyte predominance, germinal center predominance, lymphocyte depletion, and unstimulated. Of the factors evaluated, those that appeared to correlate best with five-year survival were the stage of the disease, the grade of differentiation of the carcinoma, the degree of lymphoplasmacytic infiltration of the tumor, the lymphocyte predominance pattern, and, to a lesser degree, the germinal center predominance pattern. None of the other morphologic features related to lymph nodes showed favorable prognostic significance. The relationship of morphology to host immune mechanisms is discussed.

Osmiophilic cytoplasmic inclusions in the lymph node post-capillary venules of the guinea pig.

A hitherto unknown pleomorphic osmiophilic inclusion was found in te endothelial cells of the guinea pig lymph node post-capillary venules; its diameter ranges from 0.4 to 2.2 micrometers, it is bound by a single membrane and consists of heavily dense granular area interrupted by irregularly spaced light bands. Occasionally, irregularly arranged membranous profiles in the granular matrix are also seen. It appears that the formation of this unique inclusion is related to the sex hormonal environment but its significance is yet unknown.