Aging process of the acetabular labrum--an electron-microscopic study

We have studied the aging process of the labrum of the hip using scanning and transmission electron-microscopes. The materials consisted of 22 human hip joint acetabula. Disruption and irregular ridges were evident on the uppermost superficial layer and the superficial layer of the labrum in their fifties of age. Collagen fibers composing the labrum increased in density and sectional area in the specimens of subjects up to their twenties, but decreased in those of subjects in their thirties. At the joint of the labrum and articular cartilage, a bundle of fibers approximately 20 microns in diameter was observed to extend from the labrum to the cartilage, reinforcing the bond of these components. Disruption of this area starting on the acetabular side and leaving fibers of the labrum of about 400 to 500 microns on the cartilage side was more frequent in the specimens of subjects in their fifties of age. The changes with aging in the collagen fibers along with concentration of the stress of weight bearing at the point where the labrum meets the cartilage, may have some effect on the well-fitting of the acetabulum and femoral head.     

Clinical study of carcinoma of the penis

We reviewed six cases of carcinoma of the penis seen at our department during the last 12 years. The mean age and mean followup period were 56 +/- 11 years and 53 +/- 42 months, respectively. Inguinal lymphadenopathy was evident in all patients, one of whom was diagnosed as having nodal metastasis because of the persistence of adenopathy after antimicrobial therapy. Four patients, had Jackson Stage 1, 1 Stage 2 and 1 Stage 3 cancer. The patient with Stage 3 cancer underwent total penectomy and bilateral inguinal lymphadenectomy. He died of cancer 2 years after the operation. The 5 patients with stage 1 or 2 underwent partial penectomy without lymphadenectomy. Pathological examination showed moderately differentiated squamous cell carcinoma (SCC) in 2 patients with stage 2 and 3 cancer, well differentiated SCC in 3 and verrucous carcinoma in the other patient with stage 1 cancer. Prophylactic external radiation therapy to the groin was performed in 3 of the 4 patients with invasion to corpus spongiosum (pT2). Two of the 3 patients developed mild radiation dermatitis, and no major complications were observed. The 5 patients with clinically negative nodes showed no evidence of recurrence after surgery. As reported by others, inguinal node metastasis appears to worsen the prognosis of patients with carcinoma of the penis.     

Secretory component of cystic craniopharyngiomas: a mucino-histochemical and electron-microscopic study

Ten cases with cystic craniopharyngioma were investigated. Histologically, eight of them belonged to the adamantinomatous group and two were squamous epithelial type. Histochemical investigation revealed mucin secretion in microcysts, and electron microscopy demonstrated zymogen granules in the epithelial cells. When the protein content of the cyst fluid was analyzed by polyacrylamide-gel electrophoresis, the electrophoretic pattern and immunological properties were found to be similar to the normal human serum control. The results of the morphological study suggest that cystic craniopharyngiomas have a secretory component in addition to the classical histological structures.     

Maxillofacial synovial sarcoma. Light- and electron-microscopic study of two cases.

The light microscopy and ultrastructural features of two maxillofacial synovial sarcomas are presented. By light microscopy, one of the tumors revealed the typical biphasic pattern while the other was predominantly fibrosarcomatous. Ultrastructurally, both cases revealed a biphasic pattern. Epithelial-like cells displayed abundant mitochondria, Golgi profiles, electron-dense bodies, cytolysosomes, and thin filaments. Stromal cells were spindle-shaped and provided with smaller cytoplasm and scant organelles, mainly consisting of profiles of rough endoplasmic retuculum, mitochondria, and free ribosomes. Pseudoglandular spaces lined by cuboidal to flattened epithelial-like cells with apical microvilli were numerous. Basal lamina and intercellular junctions were prominent in one case, but sparse in the other. The most undifferentiated tumor revealed many intercellular clefts containing filopodia among the epithelial-like cells; occasional intracyltoplasmic lumina were also present. These findings are somewhat similar to those reported in normal and nonneoplastic diseases of the synovium. However, the location of the tumors in areas normally devoid of synovium suggests one more that they might arise from nonspecialized primitive mesenchyme.     

Benign histiocytic tumor of lung. A light- and electron-microscopic study.

We describe an unusual benign pulmonary neoplasm which was composed entirely of histiocytes and a few chronic inflammatory cells and which posed difficult diagnostic problems. The differential diagnosis is discussed, and the usefulness of electron microscopy in interpreting unusual pulmonary tumors is emphasized.     

Glycogen in neuroblastomas. A light- and electron-microscopic study of 40 cases

A light- and electron-microscopic review of 40 cases diagnosed at Children's Hospital of Pittsburgh as ganglioneuroblastoma, neuroblastoma, or small round cell tumor-probably neuroblastoma disclosed four cases that contained abundant glycogen. Two were unquestionable neuroblastomas by electron microscopy; one was primary in the adrenal gland, the other in the mediastinum. In the third case, a paraspinal tumor, the light-microscopic appearance was suggestive or neuroblastoma, but no catecholamine granules or neural processes were demonstrated in the material available for electron microscopy. The fourth case was an undifferentiated malignant tumor in the pectoralis muscle of a 12-year-old girl. By electron microscopy, neural processes were demonstrated and the tumor was classified as peripheral neuroblastoma. Of the remaining 36 cases, electron microscopy readily indicated a diagnosis of neuroblastoma or glangioneuroblastoma in 35 of them. In the other case, the tissue had been fixed in formalin and only a few catecholamine granules were found after an extensive search.     

Renin-producing ovarian tumor. A case report with immunohistochemical and electron-microscopic study

A 39-year-old woman presented with arterial hypertension. Examination of the patient revealed elevated plasma renin activity, hyperaldosteronemia, hypokalemia, and a pelvic mass. Subsequently, an 11-cm right ovarian tumor mass with histologic features of an unusual stromal cell tumor was resected. Immunohistochemical studies demonstrated renin production by tumor cells. Organelles resembling mature renin granules were identified by electron microscopy. Although blood pressure normalized after the initial surgery, the hypertension resumed with later recurrence of the tumor. We believe the tumor originated from renin-secreting ovarian stromal cells, possibly granulosa cells.     

The intestinal and rectal epithelial lymphocyte in AIDS. An electron-microscopic study

Injury to the gastrointestinal tract may be mediated in part by the intraepithelial lymphocyte. In this study, we utilized electron microscopy to define the morphological appearance of 86 intestinal and 55 rectal intraepithelial lymphocytes observed in 11 patients with acquired immunodeficiency syndrome (AIDS), and one patient with AIDS-related lymphadenopathy syndrome. The data obtained from intraepithelial lymphocytes of AIDS are compared to those from 106 normal intestinal epithelial lymphocytes and 52 untreated celiac sprue epithelial lymphocytes. The AIDS epithelial lymphocyte possesses more organelles and appears "activated." Eighty-four percent of AIDS epithelial lymphocytes and 44% of normal epithelial lymphocytes possess lysosomal granules. There are 3.3 lysosomal granules/AIDS epithelial lymphocyte and 1.0 lysosomal granule/normal epithelial lymphocyte. Lymphocytes in AIDS usually possess multiple surface projections, which indent and make point contact with adjacent epithelial cells. Thirty-four percent of AIDS epithelial lymphocytes, 23% of sprue epithelial lymphocytes, and 2% of normal epithelial lymphocytes appear "activated." Lymphocytes in AIDS are "activated" in both the presence and absence of gastrointestinal pathogens. Epithelial lymphocytes are increased in intestinal, but not in rectal, AIDS tissue. Mucosal injury, including single cell necrosis, is minimal in the AIDS tissue. We speculate that the "activated" epithelial lymphocyte in AIDS, often possessing large lysosomes, could function as a cytotoxic effector in the development of gastrointestinal immune injury reported to be present in some patients with AIDS.     

Malignant fibrous xanthoma of retroperitioneum

Fibrous xanthomas of the retroperitoneum are rare. A case is reported. The most valuable diagnostic procedure is tissue-culture technique where the neoplastic histiocytic origins of these tumors can be confirmed.     

Clinical study of penis-conserving treatment for carcinoma of penis

We retrospectively reviewed 9 patients with squamous cell carcinoma of the penis who were treated with penis preservation between April 1988 and January 2008. Six patients had recurrence and 4 patients died of cancer. Patients treated with penis preservation had a significantly higher. Future studies are needed on a larger number of cases.     

Epithelial cells in symptomatic Rathke's cleft cysts. A light- and electron-microscopic study

Epithelial cells composing symptomatic Rathke's cleft cysts were examined electron microscopically in two cases, and the fine structures were compared with those of the mucosa in the normal sphenoid sinus, of the normal choroid plexuses, and of a craniopharyngioma with goblet and ciliated cells. The Rathke's cleft cysts were composed of a single or pseudostratified epithelial layer abutting on the connective tissue. The epithelial cells were of four different kinds of cells, such as goblet, ciliated, flat, and basal cells. The flat cells containing bundles of tonofilaments and desmosomes were the squamous cells. They were present in a single-epithelial layer in both cases. The basal cells were present as small, wedge-shaped cells, even if the number was very small. The epithelial cells in Rathke's cleft cysts were more similar to those of the mucosa in the sphenoid sinus and those of a craniopharyngioma with goblet and ciliated cells than those of the choroid plexus. This study indicates the close relationship between Rathke's cleft cysts and mucosa in the sphenoid sinus or craniopharyngioma with ciliated and goblet cells.     

Renal involvement in canine leishmaniasis. A light-microscopic, immunohistochemical and electron-microscopic study

In a prospective survey in the Isle of Elba, 413 dogs affected by naturally acquired Leishmania infantum infection were identified out of a controlled population of 1,500 resident mongrel dogs. In all the 34 randomly selected dogs of different breed, age, and duration of disease, the presence of glomerular lesions which defined mainly two categories of glomerulonephritis (GN) was observed. The first group was characterized by mesangial-cell proliferation either with focal features (11 dogs), or with a diffuse pattern (10 dogs). The second group (12 dogs) showed the typical findings of segmental membrano-proliferative GN; amyloid deposits were seen in the glomerular tuft and interstitium in 1 dog. Immunohistochemical investigation revealed granular deposits of IgG, IgM, and C3 both in mesangial areas as well as on glomerular capillary walls. Granular immune deposits om the tubular basement membrane were also found in 31 out of 34 dogs examined. With ultrastructural investigation, subendothelial and mesangial electron-dense deposits were revealed. Age, sex, serum creatinine, BUN, duration of disease, anti-Leishmania antibody titers, and immune complexes did not discriminate between the types of observed GN, while proteinuria did. The study shows that the renal involvement is the natural sequela in dogs infected with L. infantum, and that the kidney lesions are characterized by immunologically mediated glomerular and tubular damage.     

Surgical therapy of penis shaft induration in congenital penis deviation and induratio penis plastica]

The therapy of Peyronie's disease is an operative one primarily. Indication for the operative treatment is the penile deviation which prevents the patient from intercourse. The method of choice is plaque excision and subsequent corporoplasty with dermal graft. Good long-term results can also be achieved with a sole straightening of the penile shaft without plaque excision. However, this procedure (Nesbit's operation) results in a shortening of the length. In patients who are suffering from an additional erectile dysfunction an implantation of a penile prosthesis is done accompanied by plaque excision and a corporoplasty with alloplastic material (Dacron, Goretex). In 80% of all cases good postoperative results can be achieved with the operative treatment of Peyronie's disease. Patient's satisfaction is very good with all procedures described above. The exact diagnosis of the erectile quality seems to have a prognostic value for the postoperative result.     

A light- and electron-microscopic histopathological study of human bladder mucosa after intravesical resiniferatoxin application

OBJECTIVE: To determine the morphology of bladder mucosa and the integrity of its mucin coat in patients with detrusor hyper-reflexia treated with intravesical resiniferatoxin. PATIENTS AND METHODS: Seven patients with detrusor hyper-reflexia were treated intravesically with resiniferatoxin dissolved in 10% ethanol in saline (50 nmol/L solution in two and 100 nmol/L in five). Patients were clinically evaluated by a voiding chart and filling cystometry before and 3 months after each resiniferatoxin application. In addition, they underwent cystoscopy and bladder biopsies at 22-33 months after the first instillation and at 7-23 months after the last one. Tissue samples for light microscopy were fixed in 4% paraformaldehyde, embedded in paraffin and stained with haematoxylin-eosin or periodic acid-Schiff reagent (PAS). Those for electron microscopy were fixed in 5% glutaraldehyde and embedded in resin. RESULTS: The resiniferatoxin instillation was not painful. Three months after treatment the mean voiding frequency decreased and five incontinent patients became continent. The maximum cystometric capacity increased in all patients; at cystoscopy the bladders appeared normal. On light microscopy the urothelium was of normal morphology and stained with PAS in the luminal cells and in the basement membrane. Mononuclear inflammatory cells were occasionally apparent in the lamina propria. On electron microscopy epithelial cells were visible in a thick basal lamina. Superficial cells had the usual irregular contour and contained numerous membrane-coated vesicles. In the lamina propria, unmyelinated axonal profiles with occasional varicosities could be identified. CONCLUSIONS: Intravesical resiniferatoxin improved urinary frequency, incontinence and bladder capacity in patients with detrusor hyper-reflexia, causing no morphological change in the bladder mucosa. The PAS reactivity of the carbohydrate moieties present in the mucin coat and the basement membrane was unchanged by resiniferatoxin.     

Hamartomatous polyps in Peutz-Jeghers syndrome. A light-, histochemical, and electron-microscopic study

Multiple hamartomatous polyps from two patients with Peutz-Jeghers syndrome were studied using histochemical, electron-microscopic, and light-microscopic means. Using normal intestinal mucosa as control, mucosubstances containing sulfate, hexose and glycogen, as well as neutral and acid mucins, were detected. Electron-microscopic findings in different cellular populations of hamartomatous and normal mucosa were also evaluated. The results indicated the hamartomatous nature of such polypoid formations in Peutz-Jeghers syndrome. Review of the literature supports the possibility of genetic predisposition of these patients to develop unusual types of neoplasms in unexpected localizations.