HIV-related malignant lymphomas

Summary The clinical and laboratory records of 13 patients with HIV-related lymphomas diagnosed between 1983 and 1987 are reviewed. 8 cases were classified as high-grade Non-Hodgkin-lymphomas (NHL), 4 as low-grade NHL (including 2 plasmocytomas), and one as Hodgkin's disease (HD). 11 of the 12 NHL were of the B-cell lineage. The mean patient's age was 39 years. At initial staging evaluation extranodal disease was present in 10 patients, in one of them as primary central nervous system (CNS) lymphoma; 9 patients presented with stage III or stage IV involvement. 9 patients were eligible for multidrug chemotherapy. In 5 cases an initial complete remission (CR) was observed, followed, however, by CNS relapse within a few months in 3 patients. 3 patients did not respond to chemotherapy and died within 4 to 6 weeks. Of the 9 patients treated chemotherapeutically, 5 died within 1 to 5 months, 1 is still alive in CR and 3 are still alive in partial remission (PR).Abbreviations CDC Centers for Disease Control - CNS central nervous system - CR complete remission - HD Hodgkin's disease - HIV human immune deficiency virus - NHL non-Hodgkin's-lymphoma - PR partial remission     

Distribution of neurofilament protein and neuron-specific enolase in peripheral neuronal tumours

Summary Peripheral neuronal tumours were studied by the peroxidase-antiperoxidase (PAP) method for the presence of the neurofilament protein (NFP) and neuron-specific enolase (NSE). All cases of ganglioneuromas and ganglioneuroblastomas were positive for NFP and NSE. Both markers were observed only in tumour cells showing differentiation towards ganglion cells. Of the 14 cases of neuroblastoma, 8 were positive for NFP and 12 were positive for NSE. NSE was detected in most neuroblastic tumour cells. However, NFP was found in neuroblasts with signs of differentiation, such as nuclear enlargement, but not in immature, small round cells. NFP was present in cell bodies as well as in cytoplasmic processes of partially differentiated neuroblasts. The majority of pseudorosettes showed no NFP stain. Thus, antibodies against both NFP and NSE are useful in the diagnosis of peripheral neuronal tumours. Moreover, the presence of NFP seemed to be related to the degree of tumour cell differentiation.     

Distribution of melanoma specific antibody (HMB-45) in benign and malignant melanocytic tumours

Summary The distribution of a recently produced melanoma specific antibody (HMB-45) has been evaluated histochemically on paraffin sections in a large panel of melanocytic and non melanocytic tumours. Results have been compared with the presence of S-100 protein. HMB-45 was shown to be a highly specific antibody being present only in melanomas, junctional melanocytes and histogenetically related neoplasms such as melanocytic neuroectodermal tumour of infancy and, at low levels, on a proportion of peripheral nerve sheath tumours. The high specificity of HMB-45 antibody, coupled with the greater sensitivity of S-100, makes the combined use of these markers practical in the differential diagnosis of skin tumours and of metastatic lesions of uncertain primary site.This work was supported by the Associazione Italiana per la Ricerca sul Cancro, Milano and Ministero Pubblica Istruzione (60%), Roma. Aldo Scarpa is supported by a Scholarship from the Associazione Italiana per la Ricerca sul Cancro, Milano     

晚发性抑郁症患者血清神经元特异性烯醇化酶及与认知功能的关系

目的观察晚发性抑郁症(LOD)患者血清神经元特异性烯醇化酶(NSE)的变化情况并探讨其与认知功能的关系。方法分别检测35例晚发性抑郁症患者(LOD组)、35例老年健康者(对照组)血清NSE水平,以简易智能状态检查量表(MMSE)评定LOD患者认知功能,以17项汉密尔顿抑郁量表(HAMD)评定抑郁的严重程度。结果 1LOD组血清NSE水平显著高于对照组,差异有统计学意义(t=4.504,P0.001);2LOD患者MMSE评分显著低于对照组,差异有统计学意义(t=-3.457,P0.01);3LOD患者血清NSE水平与MMSE评分负相关(r=-0.388,P0.05),MMSE评分与HAMD评分负相关(r=-0.413,P0.05)。结论晚发性抑郁患者血清NSE增高,并与其认知功能的改变存在相关性。     

Immunocytochemical reactivity of breast cancer tissue with antibodies to neuron-specific enolase and an adenocarcinoma-associated glycolipid antigen

Summary The immunocytochemical reactivity of breast cancers to antibodies raised against neuron-specific enolase (NSE), carcinoembryonic antigen (CEA) and an adenocarcinoma-associated glycolipid antigen (IR-14) was studied in relation to the long-term outcome of the neoplastic disease.The patients whose tumours exhibited reactivity with the IR-14 and anti-NSE antibodies had a considerably better 5-year and long-term survival than those without such reactivity. Assessment of DNA-ploidy of the tumour cells was also relevant for long-term prognosis, immunohistochemistry giving additional prognostic information among aneuploid tumours. Reactivity with polyclonal CEA antibodies was of no prognostic value.It is suggested that tumors carrying the IR-14 reactive epitope, which was originally isolated from circulating antigen-antibody complexes, might evoke a favourable immune response and thus improve the survival of the patient.     

神经元核心抗原和神经元特异性烯醇化酶在人胚胎脊髓发育阶段的表达

目的 探讨神经元核心抗原（NeuN）和神经元特异性烯醇化酶(NSE)在人胚胎脊髓发育阶段的分布规律及其表达意义。 方法 应用免疫组织化学法检测第2、3、4个月龄段,共16例人胚胎,脊髓前角、后角中NeuN和NSE的表达、分布状况。 结果 在脊髓后角处：第2个月胚龄段,NeuN呈阴性表达, 部分细胞呈NSE阳性表达;第3个月胎龄段,部分细胞开始呈NeuN阳性表达,NSE则呈广泛阳性表达;第4个月胎龄段,NeuN阳性细胞表达数量和强度均较前增高,NSE阳性表达与第3个月龄相似。在人胚胎脊髓前角处： 第2～4个月龄段,NeuN和NSE呈广泛阳性表达。 结论 人胚胎脊髓发育第2～4个月龄段,NeuN和NSE阳性表达在脊髓的前角处早于后角,NeuN和NSE参与脊髓神经元的发育成熟过程。     

神经纤维丝蛋白、神经烯醇化酶和突触素在人胚胎舌组织中的表达

目的 探讨神经纤维丝蛋白（NF）、神经烯醇化酶(NSE)和突触素(SYN)在人胚胎舌组织不同发育阶段的分布特征。 方法 应用免疫组织化学法,检测第2～4个月胎龄段共16份人胚胎舌组织内NF、NSE和SYN蛋白的表达,分析其变化规律。 结果 第2～4个月龄段,NF、NSE和SYN蛋白在人胚舌组织内均有阳性表达。随着胎龄的增大,NF、NSE和SYN在舌组织内阳性表达数量增多,表达强度逐渐增强。第2个月龄时,NF、NSE和SYN蛋白呈少量弱阳性表达,阳性表达强度值分别是135.83±24.62、136.57±15.23和139.84±21.40。第3个月龄时,NF、NSE和SYN阳性表达强度值分别是96.04±23.37、94.89±22.52和90.65±21.08。第4个月胎龄时,NF、NSE和SYN阳性表达强度值分别是79.02±20.90、76.78±21.27和83.43±25.90。应用 One-Way ANOVA和 LSD-t统计学方法,分析第2～4个月龄段人胚胎舌组织内NF、NSE和SYN蛋白的各自阳性表达强度值,P＜0.01。 结论 第2～4个月龄段,人胚胎舌组织内NF、NSE和SYN的表达强度值随胎龄增大而降低,它们均参与调控人胚胎舌内神经系统和舌肌的分化发育。     

新生儿缺氧缺血性脑病神经元烯醇化酶变化的研究

目的　探讨新生儿缺氧缺血性脑病时神经元烯醇化酶的变化,为HIE的诊断和治疗提供依据。方法　采用病历对照研究,将实验组分为三组:轻、中、重度HIE分别为2 1、4 9、8例;正常对照组73例。测定其血中神经元烯醇化酶的浓度变化。比较各组间检测指标的差异。结果　实验组NSE水平明显高于对照组,组间有显著性差异,P <0 .0 1:且实验组轻、中、重度间有显著性差异,P均<0 .0 5。结论　NSE水平与HIE的病情严重程度相关,是反映HIE严重程度比较客观的指标。     

Immunohistochemical positivity for neuron-specific enolase and Leu-7 in malignant mesotheliomas.

The discovery of immunostaining for neuron-specific enolase (NSE) and Leu-7 in a small cell mesothelioma prompted us to study some putative immunohistochemical markers of neuroendocrine differentiation in malignant mesotheliomas and to examine any diagnostically important immunohistochemical distinctions or similarities between malignant mesothelioma and other histologically similar lung tumours. Most mesotheliomas were positive for NSE (96 per cent) and Leu-7 (70 per cent) and positivity for these two markers was also found in small cell carcinomas (NSE 25 per cent, Leu-7 81 per cent) and adenocarcinomas (NSE 28 per cent, Leu-7 28 per cent) but carcinosarcomas were positive for only NSE (44 per cent). Chromogranin A positivity was found only in occasional small cell carcinomas (6 per cent) and adenocarcinomas (6 per cent). No tumour was positive for bombesin. The high incidence of NSE and Leu-7 positivity in mesotheliomas is an important original observation because it guards against the unjustified exclusion of mesothelioma from a differential diagnosis on the basis of positivity for these two markers.     

Mucosal mantle cell (centrocytic) lymphomas

The morphology, phenotype, genotype and clinical behaviour of four cases of mantle cell lymphoma (centrocytic lymphoma) presenting primarily in mucosa (two gastric, one in large bowel and one tonsillar) are reviewed. Their relationship with the broader group of mantle cell and mucosa-associated lymphoid tissue (MALT) lymphomas is also discussed. All four tumours showed a monomorphic picture of mantle cells (centrocytes) arranged in a diffuse, or vaguely nodular, pattern. Scattered non-neoplastic germinal centres were entrapped within the tumour cells, although there was no follicular colonization. In two cases distinct epithelial infiltration by tumour cells was observed. All four tumours had a CD19, CD20, CDS, IgD, Leu8 immunophenotype, whereas KiM1P and CD10 expression were absent. DRC antibody showed loose aggregates of dendritic cells in three of four cases. Three cases showed PRAD-1/Cyclin D1 overexpression by Northern blot analysis. Although we were not able to detect bcl -1 rearrangement in the major translocation cluster (MTC) breakpoint, the possibility of bcl -1 rearrangement involving other cluster breakpoints cannot be ruled out. The four cases evolved as a disseminated disease, involving either peripheral lymph nodes, spleen or bone marrow. The biological behaviour of mantle cell lymphoma presenting in mucosa appears, irrespective of localization or macroscopic presentation, similar to that of nodal mantle cell lymphoma. Their tendency to dissemination contrasts with MALT lymphomas, which tend to remain localized, and from which mucosa mantle cell lymphoma must be distinguished. The presence of lymphoepithelial lesions does not seem to be a useful differential feature, since occasional epithelial infiltration was seen in two cases. Reactivity with CD5 appears to be especially useful in distinguishing these, since all four cases were clearly positive, in contrast with what is usually found in MALT lymphomas.     

神经烯醇化酶、突触素和神经纤维丝蛋白在人胚胎心脏组织中的表达

目的探讨神经烯醇化酶(NSE)、突触素(SYN)和神经纤维丝蛋白(NF)在人胚胎心脏组织不同发育阶段的分布特征。方法应用免疫组织化学法,检测第2~4个月胎龄段共16份人胚胎心脏组织内NF、NSE和SYN蛋白的表达,分析其变化规律。结果第2~4个月龄段,NF、NSE和SYN蛋白在人胚胎心脏组织内均有阳性表达。随着胎龄的增大,NF、NSE和SYN在心脏组织内阳性表达强度值逐渐降低。第2个月龄时,NSE、NF和SYN蛋白呈少量阳性表达,阳性表达强度值分别是86.79±7.75、133.03±13.61和114.32±11.12。第3个月龄时,NSE、NF和SYN阳性表达强度值分别是81.89±9.62,119.91±11.70和93.13±13.63。第4个月胎龄时,NSE、NF和SYN阳性表达强度值分别是72.18±11.97,107.02±10.89和91.17±13.81。应用One-Way ANOVA和LSD-t统计学分析第2~4个月龄段人胚胎心脏组织内NSE、NF和SYN蛋白的各自阳性表达强度值,P0.05。结论第2~4个月龄段,NSE、NF和SYN均在人胚胎心肌组织内表达和呈现特定的分布规律,随胎龄增大,心肌组织内NF、NSE和SYN的表达强度逐渐增强。     

Epithelioid malignant schwannoma

Summary We report a light and electron microscopic, immunohistochemical, clinical and prognostic study of 14 patients with epithelioid malignant schwannoma. In 8 patients the tumour involved a major nerve. The tumours were rather small in most instances, the largest diameter being less than 5 cm in 7 cases. Light microscopically, they showed highly cellular areas of epithelioid, polygonal or rounded cells characteristically forming cords and rows and arranged in nodules of varying size. Spindle cell sarcoma areas as in classical malignant schwannoma were seen in 9 cases, and neurofibromatous areas in one case. Four cases were entirely epithelioid in appearance. Electron microscopically the epithelioid tumour cells showed nuclei with mostly even contours containing one or two trabecular or reticular nucleoli, cytoplasmic projections, intra-cytoplasmic myelin-like figures, intercellular junctions and discontinuous, sometimes multilayered external lamina material. The ultrastructural findings indicate that epithelioid malignant schwannoma is a tumour of neural crest derivation having features of Schwann cell differentiation. Immunohistochemically, S-100 protein was demonstrated in 7 tumours and neuron specific enolase in 3. There was a female predominance, 9/14, and a median age of 38.5 years (range 17-74). The extremities, including the hip and shoulder regions, were the most common sites, 12/14. The tumour proved highly malignant; 9 of 14 patients were dead at the time of follow-up and a high incidence of metastasis (7 of 14) was observed.     

颅脑损伤患者血清S-100B和神经元特异性烯醇化酶的检测

目的探讨颅脑损伤患者血清S鄄100B和神经元特异性烯醇化酶(NSE)的变化及其临床意义。方法用双抗体夹心ELISA法检测30名健康人和108例颅脑损伤患者血清S鄄100B和NSE水平。结果108例颅脑损伤患者在伤后12h血清S鄄100B水平[(1.24±0.32)滋g/L]较对照组[(0.38±0.12)滋g/L]升高,重型、中型和轻型颅脑外伤患者的血清NSE浓度均明显高于对照组的NSE浓度(P<0.01);而不同组别颅脑外伤患者血清NSE水平差异亦有显著性(P<0.05)。结论血清S鄄100B和NSE检测可作为诊断早期脑损伤的指标之一。     

A study of malignant lymphomas in Iran,based on the updated Kiel classification

Summary One hundred and sixty-two consecutive cases of malignant lymphoma were collected from two diagnostic centres in north and south Iran. Tissue samples were examined by immunohistological methods, and the non-Hodgkin's lymphomas were classified according to the updated Kiel classification. The distribution of the different types of malignant lymphoma in this study is compared with the situation in Western countries.     

Comparative evaluation of neural tissue antigens--neurofilament protein (NF), peripherin (PRP), S100B protein (S100B), neuron-specific enolase (NSE) and chromogranin-A (CgA)--in both normal and inflamed human mature dental pulp

The immunohistochemical detection of neurofilament protein (NF), peripherin (PRP), S100B protein (S100B), neuron-specific enolase (NSE) and chromogranin-A (CgA) has been studied in nerve fibres and bundles of human dental pulp. This was done in order to identify possible differences in the distribution pattern of the above markers between normal and inflamed pulp and, further, to evaluate their potential use as peripheral markers of dental innervation as well as objective markers for the determination of the extent of inflammation. Both normal and inflamed human dental pulp showed positive immunolabelling for NF, S100B and NSE and lack of labelling for PRP and CgA protein. An increased density of NF, S100B and NSE immunoreactive nerve fibres was observed in inflamed pulp samples compared to non-inflamed. The findings of this study suggest the possible application of NF, S100B and NSE as markers of dental innervation. Furthermore, they may be useful for the determination of the extent of pulpal inflammation, and might be utilized in alternative modalities of biological pulp therapy to reduce the inflammation process. The absence of CgA immunolabelling implies the presumptive absence of neuroendocrine antigens, while further research is required in order to clarify the involvement of PRP in dental pulp.     

Ki-1 lymphomas in childhood: Immunohistochemical analysis and the significance of epithelial membrane antigen (EMA) as a new marker

Summary Two cases of Ki-1 lymphomas in childhood were analyzed immunohistochemically and immunoelectron microscopically. They expressed Hodgkin's disease associated antigen, Ki-1, interleukin-2 receptor (IL2R), OKT9, and HLA-DR. Histologically, the tumour cells were large in size with abundant cytoplasm and atypical nuclei. Lymph node involvement was characterized by parafollicular and marginal sinus infiltration. These features were identical to those reported in Ki-1 lymphomas. Electron microscopically tumour cells had abundant cytoplasmic organelles with pleomorphic nuclei but had no specific granules. Some tumour cells had marked interdigitation of cell membrane. Immunoelectron microscopically Ki-1 was positive on cell membrane. Tumour cells had no T-cell or B-cell antigens except for Leu-3 (T4). Unexpectedly they expressed epithelial membrane antigen (EMA) strongly. EMA was positive on cell membrane and in the cytoplasm. EMA was detected effectively in paraffin-embedded sections. Among the malignant lymphomas in childhood tested, two cases were EMA-positive. The pattern of EMA-reactivity and the histology were very similar to Ki-1 lymphomas. These results strongly suggest that Ki-1 lymphomas in childhood may arise from non-lymphoid haematopoietic cells and that EMA can be used as a new marker to distingish certain type of Ki-1 lymphomas in childhood.     

Malignant peripheral neuroectodermal tumours of childhood and adolescence

Summary Seventeen cases of malignant peripheral neuroectodermal tumour (MPNT) were studied by means of light microscopy, immunohistochemistry and electron microscopy. There were nine males and eight females. The mean age of the 17 patients was 10 years with a range of seven months to 20 years. The vast majority of tumours was located in the trunk. Histologically, they closely resembled Ewing's sarcoma, although minor differences were obvious. Special findings included ganglion cells and Flexner rosettes. In 10/11 cases positive staining for neuron-specific enolase (NSE) was obtained. Five of 10 tumours were positive for protein S-100. Three contained vimentin, two neurofilaments and one vimentin, neurofilaments and GFAP. Neurosecretory granules were noted in the three cases studied. Five patients died, three are alive with disease and five patients are alive without evidence of disease. It is concluded that these tumours form a homogeneous group, although the grade of differentiation varies. The prognosis in most cases is poor. Distinction from Ewing's sarcoma is possible by staining for NSE and by electron microscopy.This study was supported in part by a grant from the Bundesminister für Arbeit und Sozialordnung     

Reticulin fibre content of bone marrow infiltrates of malignant non-Hodgkin's lymphomas (B-cell type,low malignancy) — a morphometric evaluation before and after therapy

Summary A morphometric study was performed on bone marrow infiltrates of non-Hodgkin's lymphomas (B-cell type, low malignancy) to evaluate the content of argyrophilic (reticulin) fibres in the various subtypes before and after therapy. In congruence with the corresponding lymph node lesions, subtypes consisted of lymphocytic lymphoma — chronic lymphocytic leukaemia (CLL,n = 39), centroblastic-centrocytic lymphoma (CB-CC,n = 35), lymphoplasmacytoid immunocytoma (LPI,n = 22) and finally hairy cell leukaemia (HCL,n = 21). In comparison with control specimens, morphometric measurements on trephine biopsies (initial staging procedure) disclosed a borderline or minimal increase in reticulin in CLL and moderate fibrosis in CB-CC and LPI, whereas HCL had the greatest increase in fibres. The marrow surrounding focal or patchy lymphoma infiltrates of CLL and CB-CC displayed no relevant changes in fibre density with respect to the control samples. Following chemotherapy, repeated trephine biopsies (restaging procedure) were obtainable from 38 patients. There was no significant decrease in the fibre content of CLL, CB-CC and LPI infiltrates. In HCL an incomplete reduction was recorded after interferon treatment. So-called benign lymphoid lesions may be distinguished from focal-patchy infiltrates of CB-CC and LPI not only by showing a central localization, but also by the absence of significant amounts of reticulin. However, considering the density of the reticulin fibres, a clear-cut discrimination of these lymphoid aggregates from an early nodal-central growth pattern of CLL is not feasible in many cases.     

Immunohistochemical differential diagnosis of granulocytic sarcomas and malignant lymphomas on formalin-fixed material

Summary A panel of monoclonal antibodies (anti-CD45 [common leukocyte antigen], Ki-B3, L26, MT1, UCHL1, anti-CD15 [X-hapten], anti-neutrophil granule protein elastase [NP57]), anti-lysozyme, and the naphthol-ASD-chloroacetate reaction were applied to two cases of granulocytic sarcoma (GS) for evaluation of their utility in differentiating GS from malignant lymphoma. Lysozyme and naphthol-ASD-chloroacetate esterase were found to be the most reliable markers for detection of the myeloid nature of the tumour cells. GS infiltrated solely the mucosa of the nasal cavity in one case, while in the other it involved both the nasal cavity and maxillary sinus with simultaneous eruptions on the skin of the trunk. In both cases, peripheral blood and bone marrow findings were inconspicuous at the time of diagnosis of GS.