胶质肉瘤的临床病理研究

为探讨胶质肉瘤的临床病理特征、组织发生学及预后，观察了12例胶质肉瘤，其肿瘤均发生于大脑半球，颞叶多见。肿瘤半数界限清楚，质硬。随访10例，9例死亡，平均生存8个月，1例生存3年2个月。部分病例HE染色切片中难以确定梭形肿瘤细胞来源。通过电镜及胶质纤维酸性蛋白、Mac387、波形蛋白、第Ⅷ因子相关抗原免疫组织化学染色观察，证实肿瘤中均含胶质母细胞瘤和恶性纤维组织细胞瘤成分，仅1例尚含骨肉瘤成分。其组织起源为原始多潜能间叶细胞。     

Severe early-onset polyneuropathy in insulin-dependent diabetes mellitus. A clinical and pathological study.

BACKGROUND AND METHODS. The pathophysiologic features of diabetic neuropathy, a common and disabling long-term complication of diabetes mellitus, are poorly understood. We studied five patients, 22 to 34 years old, in whom an uncommonly severe symmetric polyneuropathy developed soon after the onset of insulin-dependent diabetes. Their autonomic function and nerve conduction were studied, and sural-nerve biopsy specimens were examined by light and electron microscopy. Other causes of neuropathy were carefully excluded. RESULTS. Four patients had autonomic dysfunction with postural hypotension, fainting, diarrhea, and Argyll Robertson pupils and peripheral neuropathy with loss of sensation of pain and changes in temperature that followed a pattern suggestive of a length-dependent degeneration of nerve fibers. In contrast, the fifth patient had muscle weakness and atrophy of limb extremities, with "glove and stocking" sensory loss, but little autonomic dysfunction. In the biopsy specimens of sural nerves, the mean (+/- SD) density of myelinated fibers was reduced to 20 +/- 14 percent of that measured in five control patients, and the density of unmyelinated fibers was reduced to 6 +/- 4 percent of that in the controls. Regenerating fibers accounted for 38 +/- 11 percent of the myelinated axons. Abnormalities of the myelin sheath affected 33 +/- 21 percent of the isolated fibers, and axonal degeneration 11 +/- 8 percent. Dying-back fibers, a characteristic of the centripetal degeneration of peripheral axons, were also identified. The dying-back process progressed at the rate of a few hundred micrometers per day. CONCLUSIONS. Early-onset symptomatic polyneuropathy in patients with diabetes mellitus is characterized by the loss of both myelinated and unmyelinated nerve fibers. Spontaneous axonal regeneration is remarkably frequent, even when neuropathy is severe.     

胃肝样腺癌病理形态学分析

目的：探讨胃肝样腺癌的病理组织学特点及生物学行为。方法：分析经手术及病理证实的胃肝样腺癌１１例,并应用免疫组化染色及电镜观察。结果：胃肝样腺癌,光镜下最具特征的组织学表现为玻璃样小体,广泛性侵犯静脉,免疫组化ＡＦＰ、ＡＡＴ、ＡＣＴ阳性,ＨＣＧ阴性;电镜下,可见癌细胞围成腔样,类似于毛细胆管结构,腔面有微绒毛,细胞膜相连处有连接复合体。随访１￣５年,死亡６例,其中５例死于胃肝样腺癌广泛转移,１例死于     

A pathological study of arterial prostheses surgically excised after overt clinical infection.

Infection caused regarding vascular grafts in vascular surgery still remains a major problem. To reduce this problem and the complications which follow, the surgeon must be able to apply the best surgical management and also be confident with the vascular substitute used. There are two important factors to be considered: the biomaterial must have low propensity to infection and good stability if and when infected. In an attempt to verify this problem, 93 vascular grafts surgically excised for overt infection were examined. Techniques used for examinations were gross morphology, histopathology and scanning electron microscopy (SEM) evaluation. There were 23 human umbilical vein (HUV) grafts, 51 Dacron grafts and 19 expanded polytetrafluoroethylene (ePTFE) grafts. Histopathological signs of infection were absent in 57% of the ePTFE and Dacron grafts and in 17.4% of the HUV grafts. The latter were more heavily histologically infected and in some cases the walls were destructed. Histopathological signs of infection were seen on all the prosthetic walls in 36% of all the specimens and were mainly on the external portion of the grafts for the remaining prostheses. Bacteria were seen in respectively 21.7, 15.7 and 20% of the HUV, Dacron and ePTFE grafts with the Gram stain and in 86.9, 84.3 and 94.7% with SEM. The implantation period was shorter for the bioprostheses compared to that of the synthetic grafts because of the site and the indication of implantation. The stability of the bioprostheses was lower compared to that of the synthetic grafts when infected, leading to a breakdown of the wall along the length of the graft. The infection was found on the external capsule of the grafts rather than on the luminal surface.     

成人小脑髓母细胞瘤的临床及病理研究

目的探讨成人小脑髓母细胞瘤的临床病理特点、组织发生学及影响预后的因素。方法对我院１９７４～１９９５年间２７例成年人（≥１６岁）小脑髓母细胞瘤进行了观察。结果本组年龄１６～５５岁，平均２５．８岁，肿瘤发生于小脑蚓部２１例，小脑半球６例。随访２１例，７例已生存２．５～１７年，１４例死亡。平均生存时间４１．６个月。１年生存率为７１．４％，５年及１０年生存率均１４．３％。组织学类型：经典型１４例，促纤维增生型１３例。结论通过电镜观察及突触素、神经元特异性烯醇化酶和胶质纤维酸性蛋白免疫组化染色观察，证实髓母细胞瘤是具有向神经元及胶质细胞双向分化潜能的原始神经外胚叶肿瘤。影响预后的因素包括年龄、肿瘤部位、治疗手段以及组织学类型     

Ventricular aberrant bands and hypertrophic trabeculations. A clinical pathological correlation

We reviewed the clinical, hemodynamic, and pathology data of 22 patients with dilated congestive cardiomyopathy and 13 patients with ischemic heart disease who underwent heart transplantation, primarily to improve the pathological definition of left ventricular (LV) and right ventricular (RV) aberrant bands and hypertrophic trabeculations. Overall prevalence of aberrant bands was 37% in th LV and 28% in the RV. Similar values for hypertrophic trabeculations were 43% and 28%, respectively. Compared with ischemic heart disease, our patients with dilated congestive cardiomyopathy had similar ventricular size and wall thickness, but had a higher prevalence of LV aberrant bands (p = .005) and LV hypertrophic trabeculations (p = .01). Aberrant bands were associated, both in the LV and RV, with dilated cavities (p less than .05), whereas hypertrophic trabeculations were associated with more ventricular hypertrophy and smaller LV size. Following morphological and histological analysis of the aberrant bands, we propose their division into two categories: genuine or primary bands (probably congenital in origin) and secondary bands, which most probably represent trabecular structures that develop a free cavitary course following pathological changes in the ventricular wall structure and cavitary geometry. Compared with the muscular RV bands situated mostly in the distal portion of the ventricle, LV bands were usually fibrotic and had at least one point of insertion in the inflow or outflow tract. The pattern of trabecular hypertrophy was also different in the two ventricles. Ventricular arrhythmias and thrombi occurred equally in patients with and without bands or trabeculations.     

A pathological study of bovine alimentary mycosis.

A 10-year study showed that 45 of 692 cattle aged > 6 months had systemic mycosis and, of these, 38 had alimentary mycosis. The percentages of these 38 cattle with lesions in various sites were: rumen (73.7), omasum (71.1), abomasum (34.2), reticulum (21.1), intestine (15.8), omasoabomasal orifice (7.9) and tongue (2.6). Infections in both the forestomachs and abomasum occurred in 31.6 per cent; mucormycosis was found in 94.7 per cent and aspergillosis in 31.6 per cent; 26.3 per cent (10 cattle) had complicated infections with both Mucorales and Aspergillus and eight of these animals had mixed lesions of both mucormycosis and aspergillosis. Macroscopically, focal haemorrhagic necrosis was seen in all 38 cattle. Histologically, thrombosis, coagulative necrosis and hyphae typical of the order Mucorales or of Aspergillus spp. were found. Many of the cattle were also affected by ruminal acidosis-inducing factors (ruminal atony 81.6 per cent, mastitis 63.2 per cent, "downer cow syndrome" 57.9 per cent and parturition 50.0 per cent), which may have predisposed to alimentary mycosis.     

AID Biology: A pathological and clinical perspective

Activation-induced cytidine deaminase (AID), primarily expressed in activated mature B lymphocytes in germinal centers, is the key factor in adaptive immune response against foreign antigens. AID is responsible for producing high-affinity and high-specificity antibodies against an infectious agent, through the physiological DNA alteration processes of antibody genes by somatic hypermutation (SHM) and class-switch recombination (CSR) and functions by deaminating deoxycytidines (dC) to deoxyuridines (dU), thereby introducing point mutations and double-stranded chromosomal breaks (DSBs). The beneficial physiological role of AID in antibody diversification is outweighed by its detrimental role in the genesis of several chronic immune diseases, under non-physiological conditions. This review offers a comprehensive and better understanding of AID biology and its pathological aspects, as well as addresses the challenges involved in AID-related cancer therapeutics, based on various recent advances and evidence available in the literature till date. In this article, we discuss ways through which our interpretation of AID biology may reflect upon novel clinical insights, which could be successfully translated into designing clinical trials and improving patient prognosis and disease management.     

Acromesomelic dysplasia: Radiologic,clinical, and pathological study

We report a 51-year-old woman with aeromesomelic dysplasia. Pathologic studies on adult bone are reported. Hydrocephalus and mild oligophrenia are additional findings.     

Salivary gland tumors in Uganda: clinical pathological study

Background

The incidence of salivary gland tumors is claimed to be influenced by geographical and racial factors. The pathological classification and nomenclature of salivary gland tumors as defined by WHO classification (1991), is accepted world-wide but little is available in the literature regarding the spectrum of salivary gland tumors in Africa in the basis of this classification. Such efforts would allow comparison and justify any differences between the black African population and the rest of the world.

Objective

To outline the clinicopathological features of salivary gland tumors in Uganda.

Setting

Makerere University, Faculty of Medicine, Department of Pathology.

Methods

All epithelial tumors from major and minor salivary glands accessioned from 1979 to 1988 were analyzed in respect to sex and age of patients, anatomical location of the tumor and histological type. The histological diagnosis of each individual tumor was based on the 1991 WHO classification of salivary gland tumors.

Results

During the span of 10 years, 268 cases of salivary gland tumors were diagnosed. Of these, 113 (42.2%) were males, 148 (55.2%) females and in the remaining seven (2.6%) cases, the sex was not specified. The age range of the 247 patients with recorded ages was from 0.5 to 80 years. The mean age at diagnosis was 38.1 (SD =17.03) with the median of 38.0 years. Thirty four percent of tumors originated from the parotid, 33.2% from the submandibular and 32.8% from minor salivary glands. No tumor was implicated from the sublingual gland. There were a total of 125 (46.6%) malignant tumors and 143 (53.4%) benign tumors. The mean age of patients with malignant lesions (43.1 years; SD=16.75; median=44.00 years) was 9.6 years older than those with benign tumors (mean=33.5 years; SD=16.0; median=30.00 years). Pleomorphic adenoma was the most common benign tumor (74.8%), followed by myoepithelioma (9.8%). No Whartin''s tumor was encountered. The malignant tumors were dominated by adenoid cystic carcinoma (28.8%) followed by mucoepidermoid carcinoma (21.6%).

Conclusion

The pattern of distribution of salivary gland tumors in black African population seems to differ from that of Western series in that; i) females are more affected than males, ii) there is a low proportion of tumors from the parotid gland and high proportion of tumors from the submandibular and minor salivary glands, iii) the parotid and minor salivary gland tumors have more probability of being malignant than those tumors from the submandibular gland iv) the newly categorized pathological entities are common and v) Whartin''s tumor is extremely rare in black African population.