Hyperplastic lymphoid tissue in HIV/AIDS: an electron microscopic study

The purpose of this study was to characterize the ultrastructure of lymphoid tissue from HIV/AIDS patients and to evaluate it as a reservoir and source of HIV. HIV has been demonstrated in lymph nodes and tonsils and adenoids, by immunohistochemistry (IHC), in situ hybridization (ISH), and transmission electron microscopy (TEM), to be associated with germinal center (GC) follicular dendritic cells (FDC). The presence of HIV in the larger gastrointestinal tract-associated lymphoid tissue (GALT) has been much less studied. Whether FDC themselves are productively infected by HIV in any of the lymphoid sites is controversial. Lymph nodes, tonsils, and gastrointestinal biopsies were fixed in neutral buffered glutaraldehyde and prepared for TEM. Mature HIV particles were abundant in GC of hyperplastic lymph nodes, tonsils, and the GALT. They were enmeshed within an electron-dense matrix associated with an all-encompassing branching FDC network of processes. HIV particles were seen budding from both FDC and lymphocytes. The greatest numbers of particles were seen in hyperplastic lymphoid tissue from untreated individuals and in lymph nodes co-infected with opportunistic organisms, such as Mycobacterium avium complex. In addition to HIV, unidentifiable "particles" of varying sizes, possibly including other viruses, were regularly seen in association with FDC. Ultrastructural study graphically demonstrated the abundance of HIV particles associated with the complex FDC network of hyperplastic lymph nodes, tonsils, and GALT. HIV was shown to productively infect FDC, as well as lymphocytes.     

Metastatic testicular rhabdomyosarcoma--a report of two cases

Rhabdomyosarcoma is the most common type of soft tissue sarcoma in children. The tumor spreads by local extension, to regional lymph nodes, or by distant metastases. Metastatic spread to the testicle has been rarely described. The authors describe 2 boys who were found to have intratesticular metastases after presenting with primary tumors in their extremities. The first patient, an 11-year-old boy presented with primary disease in his left foot and an enlarged testicle. Rhabdomyosarcoma was found histologically in both the foot and the testicle. A second boy 17 years of age had a primary tumor involving the left upper extremity treated with amputation, chemotherapy, and radiotherapy. A relapse was noted 2 years later in the left testicle and was treated with orchiectomy. The authors discuss the implications and the management of this rare presentation of metastatic rhabdomyosarcoma.     

Anemia with Positive Direct Coombs' Test Induced by Trypan Blue

An anemia with a positive direct and indirect Coombs' test was induced inWistar strain rats by injection of the dye trypan blue. The anemia was characterized by a shortened red cell survival time, increased osmotic fragility andreticulocytosis. There was an associated leukopenia and thrombocytopenia.The positive Coombs' tests were regarded as a nonimmunologic phenomenaand attributed to the protein binding properties of the dye. Splenomegaly andlymphadenopathy were constant findings in the anemic animals. Splenectomydid not alter the course of the anemia. The pathway of erythrocyte destructionwas thought to involve the sequestration and destruction of protein coatedcells in the spleen, lymph nodes and liver.

Submitted on June 12, 1961 Accepted on August 14, 1961     

Percutaneous intracardiac direct-current shocks in dogs: arrhythmogenic potential and pathological changes

In 12 dogs, a total of 65 direct-current (DC) shocks of 100-300J were delivered through a standard USCI6F tripolar electrodecatheter to selected sites in the heart. Severe arrhythmiaswere more frequent after electric shocks of high energy to theventricles and AV-nodal or His-bundle region than after comparableshocks to the left or right atria. There was a direct relationshipbetween the strength of the electric shocks, and the extentand severity of the injury. Application of 300 J shocks ledto massive necrosis and damage to all components of the myocardiumincluding the walls of small blood vessels. However, perforationof the atrial and ventricular walls or septum did not occurin any of the animals (mean follow-up period 97 days: range8 to 167 days). Percutaneous DC shocks up to 250 J proved tobe a safe technique for closed-chest ablation of conductiontissue in dogs. These might be of value for patients with arrhythmiasrequiring electrical ablation of accessory pathways or focisituated in various sites in the heart.     

Cyclin D1 expression and early breast cancer recurrence following lumpectomy and radiation

Purpose: The purpose of this study was to determine the prognostic significance of cyclin D1 (cycD1) levels in ipsilateral breast tumor recurrence (IBTR) following lumpectomy and radiation therapy.

Methods and Materials: A total of 98 patients (49 patients with IBTR and 49 matched cases without IBTR) selected from our conservatively treated breast cancer population served as the patient population for the current study. All patients were treated with lumpectomy followed by radiation therapy to the intact breast to a total median dose of 64 Gy. The patients were followed in our clinic with a median follow-up of 13 years. Immunohistochemical analysis of cycD1 in these 98 early-stage breast cancer patients was performed using a polyclonal antibody generated against the human cycD1 protein. All clinical, pathologic, and molecular variables were entered into a computerized data base for statistical analysis.

Results: Low levels of immunohistochemically detected cycD1 protein correlated with IBTR (p = 0.001), but there was no association between cycD1 protein levels and metastatic disease, axillary lymph node involvement, distant disease-free survival (DDFS), and overall survival (OS). Subgroup analysis revealed that for early breast tumor relapses (within 4 years of initial breast tumor diagnosis), low levels of cycD1 were associated with IBTR (p = 0.004), but cycD1 expression was not prognostic for IBTR from breast cancer patients with late relapses (p = NS).

Conclusion: These studies provide in vivo evidence for the prognostic and biologic significance of cycD1 expression in determining response to radiation therapy in breast cancer patients.     

Prognostic implication of apoptosis and angiogenesis in cervical uteri cancer

Purpose: A retrospective study was performed to investigate the relationship between spontaneous apoptosis and angiogenesis uterine cervix squamous cell carcinoma patients. The prognostic value of each (and both) of these biologic parameters was also tested.

Methods and Materials: The pathologic materials of 40 cervical uteri squamous cell carcinoma patients were examined and immunohistochemically stained to determine the tumor angiogenesis (tumor microvascular score), using factor VIII-related antigen, and their tumor apoptotic index (AI), using the TdT-mediated dUTP nick end-labeling (TUNEL) method. Three patients were Stage I, 18 were Stage II, 15 were Stage III, and 4 were Stage IV (FIGO classification). All patients were treated with radical radiotherapy and all had follow-up for more than 2 years.

Results: The mean AI was 15.1 ± 12.8, with a median of 8.3. The mean tumor microvascular score was 3 9.7 ± 14.4, with a median of 3 8. The patients’ age and tumor grade did not seem to significantly affect the prognosis. On the other hand, AI and angiogenesis (tumor microvascular score) were of high prognostic significance. The 3-year disease-free survival (DFS) rate for the patients having AI above the median was 78% (confidence interval [CI] 69–87%), compared to 32% (CI 22–42%) for those having AI below the median. The DFS was 18% (CI 9–27%) for patients having an angiogenesis score above the median, while it was 86% (CI 78–94%) for those patients having a score below the median.

Conclusion: Determination of both tumor microvascular score and AI can identify patients with the best prognosis of 100% DFS (with low angiogenesis score and high AI). Women with a high score and low AI had the worst prognosis (DFS = 3%, CI 1–5%). Moreover, high AI can compensate partially for the aggressive behavior of tumors showing a high rate of angiogenesis.     

脑多形性黄色瘤型星形细胞瘤1例及文献复习

目的：了解多形性黄色瘤型星形细胞瘤（pleomorphic xanthoaslrocytoma,PXA）的病理特点及其与预后的关系。方法：通过HE及免疫组织化学染色法对1例PXA患者进行临床病理观察与预后分析。结果：Ki-67增殖指数（PI）为3．87％,偶见病理核分裂像,本例于手术确诊后半年死于复发。结论：PXA的Ki-67增殖指数的增高（一般〈1％）及病理核分裂像对评估预后有一定的参考价值。