Intranuclear inclusion bodies in liver of chronic hepatitis B with delta infection

Seventy-two patients with HBsAg-positive chronic hepatitis were studied for serum antibody to delta antigen (anti-HD) by radioimmunoassay. Delta antigen (HDAg) in liver of the 72 patients was also studied immunohistochemically using peroxidase-labeled anti-HD. In one of the 72 patients, high titers of anti-HD and intrahepatic HDAg were detected. In this patient, HDAg was localized mainly in nuclei and occasionally in the cytoplasm of hepatocytes. By immunoelectron microscopy, HDAg was observed diffusely in some hepatocytic nuclei, but their nucleoli, perichromatin and heterochromatin were devoid of HDAg. Occasionally, inclusion body-like ring-shaped or irregularly shaped aggregates of HDAg were observed in nuclei. At higher magnification, these aggregates consisted of an HDAg-positive amorphous substance and microtubular structures. In their vicinity, scattered HDAg-positive granules were also present. By conventional electron microscopy, similar inclusion bodies composed of a clustered amorphous substance and microtubular structures 10-20 nm in diameter, together with 20-30 nm irregular granules were observed in hepatocyte nuclei, but no core of Dane particles were found. These novel intranuclear structures were not observed in other patients with chronic hepatitis B. It is suggested that they may represent the characteristic ultrastructure associated with delta infection.     

Polyomavirus inclusion bodies in chicken caecal epithelium

In this case report we describe the light microscopic and transmission electron microscopic appearance of polyomavirus inclusions in caecal epithelial cells from a chicken with diarrhoea and intestinal parasites. The DNA in situ hybridization technique demonstrated that the polyomavirus reported here is different from polyomaviruses observed in psittaciformes. The chicken polyomavirus described may share some homologous base sequences with psittaciforme polyomavirus; however, the viruses are different. Clinicians and pathologists should be aware that polyomavirus can infect chickens and that polyomavirus inclusion bodies can be found in chicken caecal epithelial cells.     

Alpha-1-antitrypsin Pi S phenotype and liver cell inclusion bodies in alcoholic hepatitis.

Typical liver cell inclusions of alpha-1-antitrypsin deficiency were found in a patient with the Pi S phenotype and acute alcoholic hepatitis. It is suggested that the inclusions resulted from the combined effects of the S phenotype and alcohol and, on the basis of the known chemistry of the variant antitrypsins, that the lowered serum concentration of antitrypsin associated with the S allele may be due to hepatic holdup.     

Familial encephalopathy with neuroserpin inclusion bodies

We report on a new familial neurodegenerative disease with associated dementia that has presented clinically in the fifth decade, in both genders, and in each of several generations of a large family from New York State-a pattern of inheritance consistent with an autosomal dominant mode of transmission. A key pathological finding is the presence of neuronal inclusion bodies distributed throughout the gray matter of the cerebral cortex and in certain subcortical nuclei. These inclusions are distinct from any described previously and henceforth are identified as Collins bodies. The Collins bodies can be isolated by simple biochemical procedures and have a surprisingly simple composition; neuroserpin (a serine protease inhibitor) is their predominant component. An affinity-purified antibody against neuroserpin specifically labels the Collins bodies, confirming their chemical composition. Therefore, we propose a new disease entity-familial encephalopathy with neuroserpin inclusion bodies (FENIB). The conclusion that FENIB is a previously unrecognized neurodegenerative disease is supported by finding Collins bodies in a small kindred from Oregon with familial dementia who are unrelated to the New York family. The autosomal dominant inheritance strongly suggests that FENIB is caused by mutations in the neuroserpin gene, resulting in intracellular accumulation of the mutant protein.     

Smooth muscle inclusion bodies in slow transit constipation

Slow transit constipation (STC) is a disorder of intestinal motility of unknown aetiology. Myopathies, including those characterized by the finding of inclusion bodies, have been described in enteric disorders. Amphophilic inclusion bodies have been reported in the muscularis externa of the colon of STC patients. This study formally tested the hypothesis that these represent a primary muscle disorder, specific to STC. In a systematic, blinded, dual observer qualitative and quantitative analysis, colonic and ileal tissue from patients with STC (n=36) were compared with selected control populations: total colonic aganglionosis (n=10), Chagas' disease (n=6), isolated rectal evacuation disorders (n=6), and a control population of a range of ages (n=80). All sections were stained with haematoxylin and eosin and periodic acid Schiff. Further immunostains were used in an attempt to determine inclusion body composition. Round or ovoid (4-22 microm diameter) amphophilic inclusions increased in number in normal subjects with age. Inclusions were more frequent in idiopathic STC than in age-matched controls or rectal evacuation disorders [ileum (33% vs. 9%), ascending (50% vs. 19%, p<0.05), and sigmoid colon (43% vs. 20%)] and were very frequent in the sigmoid (71%) of patients with STC arising after pelvic surgery. The number of inclusions per unit area was significantly higher in patients with STC (p<0.001). Inclusions were found in all Chagas' patients, but not with aganglionosis. It was not possible to determine inclusion body composition, despite the use of a wide range of conventional and immunostains. This study demonstrates that inclusion body myopathy is identifiable in patients with STC and that it may arise secondary to denervation.     

Characterization of alpha1-antitrypsin in the inclusion bodies from the liver in alpha 1-antitrypsin deficiency.

alpha1-antitrypsin was isolated from periodic acid-Schiff-positive inclusion bodies from the hepatocytes of patients with alpha1-antitrypsin deficiency and further purified to enable more detailed chemical analysis. Amino acid and cyanogen bromide fragmentation studies showed a close similarity between hepatic and serum (PiMM) antitrypsin in contrast to the carbohydrate analysis, which revealed markedly deficient glycosylation of hepatic antitrypsin. A complete lack of sialic acid and a relative deficiency of all other carbohydrate components could fully explain the difference of approximately 6000 daltons in molecular size between the two proteins. The accumulation of hepatic globules is probably related to the physical properties of the defective antitrypsin, which include marked insolubility and tendency toward aggregation. The results strongly suggest an abnormal amino acid sequence in the peptide chain of the deficient antitrypsin. The interference with glycosylation may be related to steric hindrance.     

Eosinophilic neuronal inclusion bodies in the temporal lobe.

Intracytoplasmic neuronal inclusion bodies were found in the temporal lobe of an elderly woman. The oval or rod-shaped inclusion bodies were eosinophilic, showed bright red staining with azan, and were about half the size of the nucleus of a large neuron. They were non-argyrophilic and non-congophilic. Ultrastructurally, the inclusion bodies consisted of aggregates of filamentous materials showing partial periodicity. Among inclusion bodies reported up to now, the present ones resembled some described previously as "thalamic inclusions", but were different with regard to their partial filament periodicity, and unusual in that they were located in the deep layer of the temporal lobe and not in the thalamic nuclei.     

Intracytoplasmic inclusion bodies in hepatocytes during prolonged extracorporeal circulation

Hyaline inclusion bodies appeared in hepatocytes of acutely congested livers produced by prolonged extracorporeal circulation. The inclusions were positive by PAS, PTAH and Ziehl-Neelsen staining and were colored light green to green by Masson's trichrome staining. In methylene blue-stained sections, they were divided into two groups, pale to light blue (Type I) and dark blue (Type II). By electron microscopy, small vacuolar structures which contained small amounts of flocculent material appeared near the vascular pole of hepatocytes at early stages of the experiment. With lapse of time, they became larger and had compact amorphous material. These inclusions corresponded to the Type I inclusions seen by light microscopy. By electron microscopic cytochemistry, these inclusions were usually positive to the acid phosphatase reaction and negative to the DAB reaction. With an increase in serum free hemoglobin, electron-dense inclusions corresponding to the Type II inclusions appeared in the hepatocytes. They were strongly positive to the DAB reaction. Large ones were usually positive to the acid phosphatase reaction in the peripheral narrow rim. Large invaginations of cytoplasmic membranes and large hydropic vacuoles were observed at the late stage of the experiment. They contained frequently fibrin strands or a few erythrocytes. Autophagic vacuoles and myelin figures were also increased in the hepatocytes at the late stage of the bypass circulation.     

NEDD8 protein is involved in ubiquitinated inclusion bodies

Proteolysis by the ubiquitin-proteasome system is considered to play a pathological role in several degenerative diseases that involve ubiquitinated inclusion bodies. In recent years, several ubiquitin-like proteins have been isolated, but it is uncertain whether their roles are associated with protein degradation through the ubiquitin-proteasome system. NEDD8 (neural precursor cell-expressed and developmentally down-regulated gene), which consists of 81 amino acid residues, possesses the highest sequence similarity to ubiquitin. Recent studies have indicated that NEDD8 is covalently ligated to cullin family proteins, which are components of certain ubiquitin E3 ligases, by a pathway analogous to that of ubiquitin. Thus, by focusing on the structural and functional association between NEDD8 and ubiquitin, it would be of interest to know whether the NEDD8 system is involved in pathological disorders of the ubiquitin-proteasome system. This study has examined the immunohistochemical distribution of NEDD8 protein by using a highly purified antibody in normal tissues and in tissues known to contain ubiquitinated inclusions. NEDD8 protein expression was widely observed in most types of tissues. Furthermore, accumulation of the NEDD8 protein was commonly observed in ubiquitinated inclusion bodies, including Lewy bodies in Parkinson's disease, Mallory bodies in alcoholic liver disease, and Rosenthal fibres in astrocytoma. Two of ten cases of neurofibrillary tangles and senile plaques from patients with Alzheimer's disease showed intense staining for NEDD8 as well as for ubiquitin. These findings suggest the possibility that the NEDD8 system is involved in the metabolism of these inclusion bodies via the ubiquitin-proteasome system.     

Lethal osteosclerotic skeletal dysplasia with intracellular inclusion bodies

We report an apparently previously undescribed form of lethal osteosclerotic skeletal dysplasia in a 30-week male fetus with micromelic shortness of the limbs. Radiographic findings at necropsy included increased density in all bones, most marked in the skull, mandible, and pubis. The ribs were very short, abnormally modeled, and wide anteriorly. The vertebrae were posteriorly hypoplastic and wedged, particularly in the cervical and lumbar regions. The femora and tibiae were short with wide distal metaphyses, undermodeled diaphyses, and coxa vara. The humeri, radii, and ulnae were also short and undermodeled with proximal and distal flare. Chondro-osseous morphology showed short chondrocyte columns, extension of hypertrophic cells into the metaphysis, and overgrowth of perichondral bone. In the resting cartilage there were large chondrocytes containing a homogeneous material staining pink with von Kossa trichrome, gray with toluidine blue, and black with silver methenamine. The cortical bone was lacking and the trabecular bone was hypercellular, thick, and coarse. Ultrastructurally, the resting zone chondrocytes were large and round with condensed chromatin and dilated loops of rough endoplasmic reticulum. The radiographic and histopathologic findings in this case are unique and differ from those seen in other reported lethal osteosclerotic skeletal dysplasias.     

Fine structure of inclusion bodies in hepatic cells of chickens naturally affected with inclusion body hepatitis

The fine structure of intranuclear inclusion bodies in the hepatic cells of chickens naturally affected with inclusion body hepatitis was studied comparing them with the inclusions seen with light microscopy. Ultra-structurally the inclusions were classified into two types depending on whether they contained virus particles or not. The first type consisted of virus particles, granular material and loose granular material, and sometimes concentric-circular lamellae enclosing the virus core. It is suggested that the virus particles are adenoviruses. This type corresponded to the basophilic inclusions seen with light microscopy. The second type was without virus particles and was subdivided into two forms, one consisting of fibrillar-granular material and the other of crystals composed of filaments. These corresponded to the eosinophilic inclusions seen with light microscopy. Eosinophilic inclusions were present in all 20 cases of inclusion body hepatitis, whereas the basophilic inclusions were present in only six. The presence of adenovirus particles might suggest that they are the aetiology of this condition, although they were present in only six of the 20 cases examined. The significance of the inclusions without viral particles was not adequately elucidated, but it was suggested they are degenerating material present in cells dying from the effects of the viral infection.     

Seborrheic inclusion cyst of the skin positive for cytoplasmic inclusion bodies and HPV antigen

Seborrheic inclusion cyst (SIC) is a very rare variant of epidermal cyst of the skin. SIC shows seborrheic keratosis (SK)-like lesion in epidermal cyst. SIC is extremely rare; only 6 case reports have been published in the English literature. However, no immunohistochemical study of SIC has been reported. A 41-year-old Japanese man noticed a subcutaneous tumor in the neck. Physical examination showed slightly mobile tumor in the subcutaneous tissue, and total excision was performed. Grossly, the tumor (1 x 1 x 0.8 cm) was cyst containing atheromatous keratin. Microscopically, the lesion is a cyst containing keratins. About one half of the cyst showed features of epidermal cyst consisting of mature squamous epithelium with granular layers. The other one half showed SK-like epidermal proliferation. The SK-like area showed basaloid cell proliferation with pseudohorn cysts. No significant atypia was noted. Many eosinophilic cytoplasmic inclusion bodies were noted in the SK-like area. Immunohistochemically, the SK-like area was positive for pancytokeratin AE1/3, pancytokeratin CAM5.2, p63, and Ki-67 (labeling=8%) and HPV, but negative for p53. The pathological diagnosis was SIC.