Infective endocarditis associated with cell wall-deficient bacteria. Electron microscopic findings in four cases

Although cell wall-deficient bacteria have been isolated in vitro from cases of endocarditis, no pathogenic role has been established for these forms in human disease. One criterion difficult to satisfy is the demonstration of these variants in human tissue, and electron microscopic documentation has not been reported. Cardiac valvular vegetations from four cases of endocarditis were examined by electron microscopy because of unusual histologic features of minimal inflammation and organization and small organisms that stained poorly by Gram stain. Although cell wall-complete bacteria were identified in the specimens, each showed the presence of cell wall-deficient forms within the vegetations; these variants predominated in three cases. Since manifestations of infective endocarditis were present in three cases and conventional cultures were negative, the evidence indirectly suggests a pathogenic role for these aberrant bacteria in human disease.     

整装培养人鼻咽癌细胞系的胞质和伪足内质网的电镜观察

应用高锰酸钾固定法对人鼻咽癌细胞系ＣＮＥ－２Ｚ及其不同克隆细胞株Ｌ２，Ｈ２，Ｌ４的整装培养条件下细胞内，尤其是细胞伪足内的内质网系统进行了比较观察，发现内质网在上述细胞浆中呈连续的网状分布，在部分叶状伪足和片状伪足的基底部．可见巢状的内质网结构，某些丝状伪足内可见单枝游离的内质网，因而推测内质网在细胞伪足内的存在可能与伪足的功能活动有一定的关系，ＣＮＥ－２Ｚ母系与其不同克隆细胞株的内质网系统在形态     

Calcifying aponeurotic fibroma: A clinicopathologic study of 22 cases arising in uncommon sites

Calcifying aponeurotic fibroma is a rare soft tissue tumor that primarily occurs in children and adolescents and has a strong predilection for the distal portion of the extremities, especially the hands and feet. This report describes 22 previously unpublished cases arising in uncommon sites. Fifteen patients were male, and seven were female (age range, 2 to 43 years; median age, 9 years). The process typically presented as a painless mass and was present from 2 weeks to 11 years before resection. Sites of involvement were the back (n = 8), knee region (n = 5), thigh (n = 3), forearm (n = 3), elbow (n = 2), and arm, not otherwise specified (n = 1). The lesions were often adherent to dense fibrous connective tissue (eg, tendon, fascia, or periosteum) and ranged from 1.0 to 5.0 cm in maximum dimension. The process typically had an irregular contour and a firm, fibrous consistency. Sometimes minute foci with a calcific appearance were evident grossly. Microscopic examination showed spindled fibroblasts with a fascicular growth pattern and scattered epithelloid cells bordering chondroid foci with or without mineralization. Immunoreactivity was present for vimentin (six of six), muscle-specific actin (three of six), smooth muscle actin (three of six), CD99 (five of five), CD34 (one of six), CD57 (one of six, trace), EMA (two of six, trace), 5100 protein (five of six), CD68 (five of five), and progesterone receptor (one of six). The tumors were managed by local excision (n = 20), incomplete local excision (n = 1) and biopsy only (n = 1). Follow-up information was available for 10 patients with a median follow-up interval of 94 months. Five patients (50%) developed one or more recurrences. Familiarity with this entity should help to avoid confusion with other processes, including infantile and extraabdominal fibromatoses, a chondroma of soft parts, and a fibrous hamartoma of infancy.     

JC病毒样颗粒可直接转运进入细胞核

目的探讨JC病毒(JCV)病毒样颗粒(VLP)是否可以直接转运进入细胞核。方法心用JCV主要外壳蛋白VP1体外表达、重组VIP，在其表面标记异硫氰基荧光素(FTTC)，同时在其内部包裹荧光染料Cy3，感染培养的HeLa细胞和SVG细胞，荧光显微镜观察VLP入核转运。结果HeLa和SVG细胞感染包裹Cy3的FTTC-VLP时，FTTC与Cy3同时出现于细胞核内相同部位；而感染FTTC—VP1与Cy3混合物时，FTTC虽可在细胞核内检测到，但Cy3信号几乎消失。包裹Cy3的VIP用SDSPAGE展开，荧光显像后行考马斯亮蓝(CBB)染色，发现Cy3和VLP移行至不同部位，证明Cy3不能与VP1结合，提示VLP以完整的颗粒形式转运进入细胞核。应用包裹外源性DNA的VLP感染培养的HeLa和SVG细胞，发现包裹的DNA在细胞浆和细胞核内均可检测到，提示JCV入核过程与VIP相同。结论VLP可以不经裂解直接转运进入细胞核，JCV入核转运可能与VLP相同。     

钙化性腱膜纤维瘤6例临床病理分析

目的探讨钙化性腱膜纤维瘤(calcifying aponeurotic fibroma,CAF)的临床病理学特征。方法回顾性分析6例CAF的临床资料、病理学形态及免疫表型并复习相关文献。结果 CAF好发于青少年的手掌与足底,常为缓慢生长的孤立性无痛结节。镜下可见增生的纤维母细胞、散在分布的钙化小灶及软骨小岛。免疫表型:瘤细胞表达vimentin、HHF-35、Calponin、S-100和CD68等。结论 CAF是一种罕见的具有局部侵袭性的软组织肿瘤,结合临床特点、特征性组织学形态可确诊。反复微小创伤及间充质细胞分化可能与CAF的发生相关。     

Giant fibroma of the lung

Summary The authors report the case of a 78-year-old male patient with an inoperable giant lung tumour diagnosed 5 years prior to death. Fine needle cytological examination at that time was interpreted as indicative of malignancy. In the following years the tumour grew very slowly without signs of infiltration or metastatic spread. On radiological examination sharp limitation of the tumour was evident. Recurrent pleural effusions occurred and the patient died from cardiorespiratory insufficiency.Autopsy revealed a giant fibroma, well vascularized but without signs of malignancy. The diagnosis was confirmed by immunohistochemical and electron microscopic examinations.     

Chondromyxoid fibroma of the distal phalanx of the great toe: A tumor with unusual histological findings

Chondromyxold fibroma (CMF) rarely arises in the distal phalanx of the foot and less than 20 cases have been reported In the literature. It has also been known to show a wide spectrum of histology mlmlcking other primary bone tumors. An unusual case of CMF arising in the dlstal phalanx of the left great toe is reported because of Its unique anatomic site of origin and histology. A 53-year-old female presented with a slow growing, painful great toe of the left foot which she had had for 3 years. She had first noticed the mass 25 years ago. On admission, plain X-ray revealed an osteolytic mass with a sclerotic margin expanding to the distal phalanx of the great toe. Interestingly, the lesion was microscopically composed of hypercellular chondromyxoid lobules separated by hypocellular fibrous tissue, which is in contrast to the typical histology of CMF. In addition, the lesion showed an aggregate of tumor cells with pleomorphic multinucleate or giant nuclel within the chondromyxold matrix, which were not similar to the osteoclast-llke type. Perhaps these unusual histologlcal findings may be associated with its long duration and presenting location.     

Electron microscopic findings of human auricular appendages

Summary Auricular appendages were obtained from 20 patients ranging in age from 4 to 64 years with chronic heart diseases at the time of operation and observed with an electron microscope. Myo-endocardial fibrosis was seen in the majority of cases. Proliferation of smooth muscle cells was noticed in the areas of thickened myo-endocardial spaces. These smooth muscle cells played an important role in the production of ground substance, collagen, and elastic fibers in the fibrotic lesions.Microfibrils and elastic tissue were also observed in close association with the basement membrane of cardiac muscle cells and capillaries.Cytoplasmic filaments were observed both dispersed and aggregated in bundles in the endothelial cells on the thickened endocardium.On leave of absence from Second Department of Pathology, School of Medicine, Gunma University, Maebashi, Japan.     

Fine needle aspiration cytology in two cases of chondromyxoid fibroma of bone and review of literature

We report the cytological features of two cases of chondromyxoid fibroma (CMF) confirmed by histopathology examination. First case was a 40‐year‐old male who presented with a foot swelling, and the second case was a 16‐year‐old male with a lesion at the angle of jaw. A fine needle aspiration cytology (FNAC) was performed in both the cases. In first case, a correct diagnosis of CMF could be offered on FNAC. In the second case, though the cytology diagnosis was a sarcoma considering the cytological, radiological and clinical features, the histopathological examination confirmed the same to be a CMF. The cases are being discussed to highlight the usefulness of FNAC to diagnose these uncommon benign bone lesions and the potential pitfalls in the cytological diagnosis of chondroid lesions. Diagn. Cytopathol. 2013;41:904–908. © 2012 Wiley Periodicals, Inc.     

Electron microscopic findings in hepatic allograft rejection.

Orthotopic liver transplantation is today an accepted surgical procedure for patients with irreversible, end-stage liver disease. Between 1988 and 1993, seven patients (one patient twice) received liver grafts for end-stage liver disease at Howard University Hospital, Washington, DC. In conjunction with the transplant procedure, a total of 32 liver needle biopsy specimens were submitted to the pathology department. Almost half of all liver graft failures are attributed to acute, or in a lesser degree, to chronic rejection. The purpose of this study was to describe the ultrastructural findings in acute cellular rejection and to correlate the ultrastructure with the histology. The key ultrastructural features of acute cellular rejection were: a mixed cellular inflammatory infiltrate in the portal tract, bile duct damage by immunocytes with reduplication of the epithelial basement membrane, endotheliitis, and intramitochondrial crystalline inclusions. It was concluded that electron microscopic investigation significantly contributes to better understanding the immunopathologic mechanism underlying liver allograft rejection.     

Electron microscopic findings of polyglucose reacting with iodine

The reaction product of iodine and native glycogen or polyglucose synthesized histochemically by glycogen synthetase or phosphorylase with branching enzyme was studied in the paraboloid of the chick retina by light and electron microscopy. Native glycogen in the paraboloid stained brown, while histochemically synthesized polyglucose stained brown or purple. Electron microscopy revealed that the paraboloid in all experimental groups appeared to have many vacant spaces at the sites of polyglucose particles, as after the amylase digestion test. Native and histochemically synthesized polyglucose particles themselves looked like fine granules or appeared to have various densities in electron micrographs. These findings suggest that native or histochemically synthesized polyglucose particles are partly masked by the iodine atoms involved in the amylase channel in electron micrographs.     

Electron microscopic findings for diagnosis of breast lesions

The normal mammary gland can be roughly divided into the large duct close to the nipple and the terminal duct located within the lobulus. Both the large duct and the terminal duct are composed of epithelial cells and myoepithelial cells. The epithelial cells can be divided into light and dark cells using electron density. Heterochromatin is the predominant type of chromatin found in normal mammary glands. The cytoplasm of myoepithelial cells contains a number of fine filaments that possess dense patches. The myoepithelial cells of the large duct have a large process with a crablike appearance that protrudes from the cytoplasm. The myoepithelial cells of the terminal duct, by contrast, assume a relatively flat form and are approximately parallel to the epithelial-stromal junction. If the nuclei of the epithelial cells of normal mammary glands and benign breast lesions are compared with those of malignant breast lesions, the latter are primarily oval or circular in shape whereas the former often show marked notches. The predominant chromatin is heterochromatin in noncancer cells and euchromatin in cancer cells. The intracytoplasmic lumen (ICL) can be roughly divided into two types. The ICL is frequently seen in breast cancers, especially scirrhous carcinoma and lobular carcinoma. Invasive ductal carcinoma can be divided into three types: papillotubular carcinoma, solid-tubular carcinoma, and scirrhous carcinoma. Scirrhous carcinoma can be divided into two subtypes: scirrhous carcinoma in the broader sense of the term (characterized by scirrhous invasion of the stroma by papillotubular carcinoma or solid-tubular carcinoma), and scirrhous carcinoma in the narrower sense of the term (characterized by linear or cluster-like invasion of the stroma without forming ducts). Ultrastructural characteristics of scirrhous carcinoma in the narrow sense are bright cytoplasm (seen in most cells) and euchromatin (seen in all cells of this type of carcinoma). In cases of papillotubular carcinoma, solid-tubular carcinoma, and scirrhous carcinoma in the broad sense, euchromatin is predominant but sporadic cells with heterochromatin are also seen. Adenoid cystic carcinoma and carcinoid tumor of the breast are histological types of breast carcinoma that show characteristic features under an electron microscope. Ultrastructurally, the former shows a pseudocyst and true lumen whereas the latter presents numerous neuroendocrine granules within the cytoplasm. Breast carcinoma shows several ultrastructural characteristics that are useful in differential diagnosis. Therefore, it is advisable to take electron microscopic findings into account when evaluating or diagnosing breast lesions.     

Superficial collagenous fibroma: immunohistochemical,ultrastructural, and flow cytometric study of three cases,including one pemphigus vulgaris patient with a dermal mass

Collagenous fibroma (desmoplastic fibroblastoma) is an extremely rare benign soft tissue tumor of fibroblastic origin. The majority of reported cases have been located in the deep subcutis, fascia, aponeurosis, or skeletal muscle of the extremities, limb girdles, or head and neck regions. There has been no mention of underlying diseases in patients who developed this tumor. We here report an additional three cases of superficial collagenous fibroma, one of which was a dermal lesion occurring in the abdomen of a 26-year-old male patient with a 5-year history of pemphigus vulgaris prior to development of the tumor. To the best of our knowledge, an association between collagenous fibroma and pemphigus vulgaris has not previously been reported. The remaining two tumors were located in the superficial subcutaneous tissue of the infrascapular area and right foot, respectively. There was no tumor recurrence or metastasis during follow up of 18, 25, and 47 months, respectively. All three tumors were well-circumscribed and unencapsulated without infiltrating borders. Histologically, the common denominator of all three cases was paucicellular proliferation of spindle or stellate fibroblasts enmeshed within an extensively collagenous background. Immunohistochemically, there was diffuse strong staining for vimentin and intense focal reaction for smooth muscle actin in two tumors tested. Electron microscopy revealed features consistent with a fibroblastic or myofibroblastic lineage. Flow cytometry in two cases demonstrated a diploid DNA content with low S-phase fractions, which correlated with minimal MIB-1 nuclear labeling (less than 1%) and benign behavior of this entity.     

硬化性纤维瘤四例临床病理学分析

目的:探讨硬化性纤维瘤的临床病理学特点、诊断和鉴别诊断。方法:回顾性分析4例硬化性纤维瘤的临床资料和免疫表型,并复习文献。结果:男性3例,女性1例,均为成年人,平均年龄47.5岁。临床上表现为皮肤缓慢性生长的无痛性结节,分别位于左中指、右足、左腹股沟和右耳下,平均直径1.2 cm。镜下观察,肿瘤位于真皮内,呈境界清楚的圆形或卵圆形结节状。主要由席纹状排列的胶原纤维组成,其中1例胶原纤维呈同心圆状排列,类似环层小体。胶原纤维间常见裂隙,可见稀疏的梭形纤维母细胞。梭形纤维母细胞表达CD34,不表达S-100蛋白、细胞角蛋白和上皮膜抗原等标志物。采用荧光原位杂交检测PDGFB(22q13),结果显示均无PDGFB基因重排。局部切除后随访显示均无局部复发。结论:硬化性纤维瘤是一种少见的良性纤维性肿瘤,因镜下显示明显的席纹状结构,并可表达CD34,可被误诊为隆突性皮肤纤维肉瘤(特别是硬化型)。     

Ⅲ期鼻咽癌免疫细胞反应与生物学行为及预后的关系

目的 探讨４３例Ⅲ期鼻咽癌Ｔ,Ｂ淋巴细胞,巨噬细胞及郎格汉斯细胞的浸润反应与其生物学行为及预后的关系。方法 应用免疫组化ＳＰ法对４３例Ⅲ期鼻咽癌免疫细胞反应与生物学行为及预后的关系进行分析,结果 ４３例Ⅲ期鼻咽癌郎格汉斯细胞及巨噬细胞浸润阳性表达率分别为６０％（２６例）,７２％（３１例,ＣＤ６８阳性）,５１％（２２例,溶菌酶阳性）,它们均与患者的５年生存率呈正相关（Ｐ〈０．００５和Ｐ〈０．０５）