Neuroblastoma. A study of the clinicopathological features influencing prognosis based on the analysis of 54 cases.

The retrospective analysis of 54 cases of neuroblastoma taken from the files of the Department of Pathology, University of Santiago Hospital, Spain, and the Ludwig-Aschoff Institute of Pathology, University of Freiburg, Germany confirmed the validity and significance of various clinical and histopathological features when trying to establish the prognosis and the proper therapeutic approach in a given case of neuroblastoma. When the age of the patients was compared to survival it was shown that all but three of the patients older than 2 years of age had died from tumor within ten months. In contrast, there was a 37.5% five-year survival rate among patients who were 24 months of age or younger at the time of diagnosis and treatment. The primary tumor was located in the adrenal gland in 27 cases (50%), in 9 cases (17%) the tumor was retroperitoneal but extra-adrenal, and in the remaining 18 patients (33%) the tumor arose from the paravertebral sympathetic ganglia. Adrenal primaries behaved in an extremely aggressive manner as all but three patients with tumors at this location were dead within 18 months. Retroperitoneal extra-adrenal neuroblastomas followed an almost equally poor outcome with only one five-year survivor (11%). In contrast, 49% of the patients with paravertebral neuroblastoma had survived five years and a further 33% were alive with shorter follow-up. According to histological criteria, there were 6 grade I tumors, 15 grade II and 33 grade III tumors in our series. All grade I tumors were clinical stage I at diagnosis and all are alive 2 to 3 1/2 years later.(ABSTRACT TRUNCATED AT 250 WORDS)

Solid cell nests of the thyroid: light microscopy and immunohistochemical profile.

The morphological, histochemical, and immunohistochemical findings of seven cases of solid cell nests (SCNs) of the thyroid are described. Light microscopy showed two cell types forming the SCNs, which we refer to as "main cells" and "C cells." In all cases "mixed thyroid follicles" (a unique structure lined by follicular epithelium and epidermoidlike cells) were observed in which the histochemical study confirmed the presence of intraluminal acid mucins. Adult adipose tissue and cartilage were found in one case and foci of cartilage were observed in another case in association with the SCN. Immunohistochemical studies showed positivity of "main cells" for carcinoembryonic antigen (CEA), high- and low-molecular weight keratins, neurotensin, and somatostatin. "C cells" were positive for calcitonin, calcitonin gene-related peptide (CGRP), and chromogranin. The two cell types in SCNs were consistently negative for thyroglobulin. Neuron-specific enolase (NSE)-positive cells were found in the vicinity of the SCN. The unusual association of adipose tissue and cartilage as well as the results of the extended immunohistochemical study in this series provides further support to the belief that SCNs and "mixed thyroid follicles" represent remnants of the ultimobranchial body and should be considered normal components of the thyroid gland.

Granular cell tumor of the eye (myoblastoma): ultrastructural and immunohistochemical studies.

The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.

[Cholesterol embolism: an infrequent cause of ischemic ulcers of the lower extremities]. / Embolismo de colesterol: una causa poco frecuente de úlceras isquémicas de las extremidades inferiores.

A case of cholesterol embolism with digital ulcerations is reported. Pathologic anatomy, Radiologic images, symptomatology and treatment of such pathology are discussed.

Ultrastructure of chondroid syringoma: role of the myoepithelial cell in the development of the mixed tumor of the skin and soft tissues.

The ultrastructure of a chondroid syringoma is described. The tumor nests are formed by clumps, solid cords and tubular structures distributed diffusely throughout a stroma of varying density. Two different types of cells form this tumor: dark cells forming the inner layer of the tubuloalveolar and ductal structures and having epithelial features, and light cells which form the outer layer of the tubular structures and show myoepithelial differentiation. The myoepithelial cells seem to be responsible for the production of the chondroid areas and thus the mixed appearance of the tumor. The epithelial cells forming the solid nests of the tumor show intracytoplasmic luminal formation and other features that favor the origin of chondroid syringoma from the eccrine sweat gland duct.