Carcinosarcoma of the esophagus. An immunohistochemical and electron microscopic study

Immunohistochemical and electron microscopic examinations were made of a carcinosarcoma of the esophagus in an 80-year-old man. An immunohistochemical examination showed that sarcomatous spindle cells were vimentin-positive, whereas squamous carcinoma cells were keratin-positive. No coexistence of vimentin and keratin in a single tumor cell was found. Electron microscopically, the sarcomatous spindle cells were characterized by well-developed rough endoplasmic reticulum, abundant intermediate filaments, and the occasional presence of peripheral aggregates of microfilaments. No definite desmosomes were identified among these cells. These results appear to indicate that most of the spindle-shaped tumor cells assume fibroblastic cellular features and synthesize the intermediate filament protein usually expressed in mesenchymal cells, even though such tumor cells could be epithelial in origin.     

Pathology of Listeria infection in murine severe combined immunodeficiency. A study by immunohistochemistry and electron microscopy

Mice bearing the scid mutation lack functional T and B lymphocytes and partially resist infection with the intracellular pathogen Listeria monocytogenes. In this study, we describe the histopathologic features of the infection in scid mice. Infected scid showed hyperplasia of mononuclear cells in lymphoid organs without any evidence of granulomas nor of lymphoid cell development. Mononuclear phagocytes in various tissues of infected scid mice had markedly enhanced expression of class II histocompatibility molecules (or Ia molecules). Furthermore, Ia expression was also found in endothelial and epithelial cells of many organs in the later stages of infection. These results confirm that scid mice have a mechanism for activation of Ia antigen expression, which is independent of lymphocyte function.     

Intraoperative diagnosis of osseous eosinophilic granuloma by touch preparation: Report of two cases with immunohistochemistry and electron microscopy

We report two cases of eosinophilic granuloma (Langerhans cell histiocytosis) of bone, the diagnosis of which was made by intraoperative cytological evaluation of touch preparation. The clinical, cytologic, histologic, immunohistochemical, and electron microscopic findings are presented. Our cases demonstrate and further support that intraoperative cytologic analysis by touch preparation is a very useful method of diagnosis during intraoperative consultation on a bony specimen. Diagn Cytopathol 1996;14:68–71. © 1996 Wiley-Liss, Inc.     

Studies into gastrinomas and combined carcinomatous carcinoid tumors. Optical light- and electron microscopy and immunohistochemistry

The clinical, microscopic, immunohistochemical and ultrastructural features of 7 gastrinomas and 1 combined carcinoma-carcinoid tumor were evaluated. The tumors were located in the pancreas or duodenal wall in 6 cases, and on extragastro-enteropancreatic sites in 2 (liver or peripancreatic lymph node). All patients had the Zollinger-Ellison syndrome, 3 of them with additional bleeding and 1 with diarrhea. One patient with gastrinoma had additional tumors characteristic of the MEN-I syndrome. Immunohistochemistry showed gastrin and neuron-specific enolase-positivity in all of the tumors. Somatostatin was found in 4 cases, and single cell glucagon, pancreatic polypeptide. S-100 protein, keratin as well as carcino-embryonic antigen positivity in another few. Additional hormone production did not appear to be connected with biological behaviour of the tumors or with the clinical symptoms.     

少枝胶质细胞瘤的形态观察

目的研究少枝胶质细胞瘤（ＯＤＧ）的超微结构及组织学特性。方法用光镜，部分用电镜及免疫组化观察６５例ＯＤＧ。结果根据ＷＨＯ有关ＯＤＧ病理分级，６５例中Ⅰ级１９例，Ⅱ级３２例，Ⅲ级１４例。结论ＯＤＧ中瘤细胞出现胶质微丝是异质性分化的结果。除按瘤细胞分化程度分级外，细胞密度、核分裂数亦有重要意义。     

Carcinosarcoma of the urinary bladder. Report of a case with electron microscopy and review of the literature

A case of carcinosarcoma of the urinary bladder in a 33-year-old man is presented. The tumor developed from the left anterolateral wall and protruded into the vesical lumen. The excised tumor revealed that more than 99% was sarcomatous component with the appearance of an osteochondrosarcoma. Small foci of papillo-tubular carcinoma were scattered in the sarcomatous area. The histological features, histogenesis and treatment of carcinosarcoma of the bladder are discussed in relation to the literature.     

组织细胞坏死性淋巴结炎的诊断和鉴别诊断

目的 探讨组织细胞坏死性淋巴结炎(KD)的诊断与鉴别诊断。方法 选择46例KD,5例非特异性淋巴结炎(NLD),5例非霍奇金淋巴瘤(NHL),5例霍奇金淋巴瘤(HD),5例猫抓病(CSD)和5例结核性淋巴结炎(TBL),做了组织学、免疫组织化学EnVision法观察,其中6例KD和2例NHL做了电镜观察。结果 KD可有增殖,坏死和黄色瘤样三种病理组织学图像,但其基本的组织学特点为：淋巴结边缘契形淡染病灶和副皮质区融合性淡染病灶,病灶内单核样组织细胞明显增生,出现新月体样组织细胞,凋亡细胞或核碎片增多,无或很少见中性粒细胞等。免疫组织化学标记,灶性的组织细胞CD68和MPO阳性。电镜下可见病灶内增生的单核样组织细胞、新月体样组织细胞、凋亡小体和周围散在T淋巴细胞。结论 典型的KD由于其形态变化多样,有时需与其他淋巴结病仔细鉴别。这时仔细寻找KD的形态学特点,结合组织学、免疫组织化学和电镜观察,有助于确定KD的诊断。     

Carcinosarcoma of the stomach. A case report with light microscopic, immunohistochemical, and electron microscopic study

Carcinosarcoma of the stomach is an uncommon lesion of uncertain histogenesis. Light microscopic, immunohistochemical, and electron microscopic examinations of the tumor in the present case favor the view that these carcinosarcomatous tumors may arise from mesenchymal (or sarcomatous) transformation of carcinoma cells.     

Carcinosarcoma of the stomach. A case report with light microscopic, immunohistochemical, and electron microscopic study

A carcinosarcoma of the stomach in a 66-year-old man is reported. The tumor which had a diameter of 4 cm was an ulcerofungating mass in the posterior wall of the antrum. Histologically it was composed of well-differentiated adenocarcinoma admixed with sarcomatous elements which showed chondrocytic differentiation on light and electron microscopy. The sarcomatous areas were multifocally scattered in the central portion of the tumor and intimately blended with adenocarcinoma cells. CEA immunoreactivity was found not only in the adenocarcinoma but also in the transitional sarcomatous cells, supporting the hypothesis that this tumor might derive from mesenchymal metaplasia of a primarily epithelial neoplasm.     

Pleomorphic lipoma. A light and electron microscopy study

A case report is given of a pleomorphic lipoma in a 41 year old man. This article reviews the histopathologic and clinical features of this rare neoplasm. Characteristics distinguishing it from liposarcoma are presented.     

胃肠道间质瘤的光镜、免疫组织化学和超微结构的观察

目的 研究胃肠道间质瘤（GISTs）的光镜,电镜形态特点和免疫组织化学在诊断中的价值,探讨肿瘤的组织来源和分型。方法 对GISTs进行光镜和超微结构的观察,用EnVision二步法免疫组织化学方法检测波形蛋白,CD117（c-kit),CD34等8种抗原标记物在肿瘤中的表达情况。结果 65例GISTs占同期消化系统间叶性肿瘤的85．5％（65／76）;其中梭形细胞为主的有46例,伴有上皮样细胞的有13例,单纯由上皮样细胞组成的有6例,瘤细胞呈长,短梭形和圆形,胞质弱嗜酸,常见核端空泡,有时呈印戒样或透明细胞样;排列呈旋涡状,栅栏状或弥漫性巢状。超微结构表现出树枝样突起,神经内分泌颗粒,桥粒样连接等神经分化特点,或（和）胞质内出现密斑,密体等肌性分化。免疫组织化学显示肿瘤组织中抗原标记物表达阳性率波表蛋白为100％（65／65）,CD11793．8％（61／65）,CD3478．5％（51／65）。结论 GISTs是消化道最常见的间叶性肿瘤,光镜形态与真性肌源性和神经源性肿瘤极为相似,电镜和CD117,CD34等免疫标记物配合使用可对其做作出正确诊断,GISTs可能起源于多潜能的,卡哈尔间质细胞样的前体细胞。     

Contribution of immunohistochemistry and electron microscopy for the diagnosis of meningeal hemangiopericytomas. 15 case reports

Meningeal hemangiopericytomas (HPC) are rare CNS tumors with a pour prognosis compared to meningiomas. In order to define diagnosis criteria, we performed an immunohistochemical and ultrastructural study in respectively 15 and 5 meningeal HPC. The following antibodies anti-KL1, EMA, vimentin, CD34, factor VIII, alpha-smooth actin, estrogen and progesteron receptors (RE, RP) were used in paraffin embedded sections whereas anti-NCAM and E-cadherin antibodies were used on frozen sections when available. We can differentiate meningeal HPC from meningioma because of a complete lack of immunostaining with epithelial markers as well as with NCAM antibody or RE and RP receptors. Besides a positivity with CD34 and alpha-smooth actin antibodies was always observed even focally in HPC. On the other hand, solitary fibrous tumor showed a strong and diffuse positivity with anti CD34 and anti-vimentin antibodies. Electron microscopy can be helpful in some instances showing membrane basal-like substance and absence of desmosomes.     

Morphological features of cat thalamo-parietal projection fibers investigated by PHA-L immunohistochemistry and electron microscopy.

Thalamo-parietal fibers originating from the ventroanterior-ventrolateral (VA-VL) complex in the cat were labeled with Phaseolus vulgaris leucoagglutinin (PHA-L) and examined by light and electron microscopy. PHA-L (2.5% aqueous solution) was injected iontophoretically through micropipets with anodal current pulses into the VA-VL complex. PHA-L-labeled terminals were distributed in the lateral and the suprasylvian gyri in the superficial and deep cortical layers. In layer I, horizontal varicose fibers and terminals were conspicuous in the upper one-third and were widely distributed. In the deeper cortical layers (layers III-V), varicose fibers and terminals were detected in moderate numbers. Electron microscopic examination revealed that the labeled terminals formed asymmetrical synapses on the dendritic spines of spiny neurons. These morphological findings appeared to be consistent with our previous intracellular recordings in this cortex.     

Wide-field electron microscopy. A rapid method for the study of histologic material that provides a bridge between light and electron microscopy.

Wide fields of tissue can be rapidly examined by electron microscopy by use of Formvar films for the support of ultrathin sections on slot grids. The intervention of the grid bars of conventional mesh grids is avoided, and a continuous micrograph of the specimen at scanning magnifications can be obtained. Enough material is sublimed from the section and the supporting film by deliberate exposure to the electron beam to permit one to obtain an image with good contrast. This method of examination, which takes in all about two hours, permits examination of an extensive area of tissue in relation both to its topography at low magnifications and to its ultrastructural detail, and accordingly adds to electron microscopy a dimension characteristic of the lower powers of the light microscope. It offers the histopathologist the option of using micrographs taken during the scanning survey of a tissue to detect regions that can be readily re-examined at high magnification in the same ultrathin section.     

Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations

We report a case of carcinosarcoma of the esophagus characterized by ductal and myoepithelial differentiation. A 61-year-old man was operated on for a polypoid tumor of the distal esophagus. Histologically, this tumor was composed of ductal structures and sarcomatous spindle cells surrounding the ducts at the central area of the tumor. The tumor was also composed of squamous cell and basaloid carcinoma in the periphery. Immunohistochemically, a few spindle cells surrounding the ductal structures showed immunopositivity for alpha-smooth muscle actin and S-100 protein. Electron microscopy revealed that the spindle cells had tonofilament and pinocytic vesicles in the cytoplasm, and basal lamina adjacent to the cytoplasmic membrane. Both of the results strongly supported the suggestion that the spindle cells may be myoepithelial cells. Basaloid carcinoma showed a gradual transition to chondrosarcomatous cells producing the matrix, which had both immunopositivities for S-100 protein and cytokeratin. Therefore, chondrosarcomatous cells may be derived from carcinoma cells. The histogenesis of this tumor may be associated with a totipotent stem cell of esophageal mucosa, which has the potential to differentiate into squamous cells, ductal cells or myoepithelial cells.     

Gastric plasmacytoma with rod-shaped intracytoplasmic inclusions. Report of a case studied by light and electron microscopy and immunohistochemistry

A 78-year-old man with primary gastric plasmacytoma showing massive rod-shaped intracytoplasmic inclusions is presented. The patient was initially diagnosed as having a benign gastric ulcer and underwent partial gastrectomy. Around the ulcer of the resected stomach specimen, diffuse proliferation of plasma cells with massive rod-shaped intracytoplasmic inclusions was noticed by light microscopy. Immunohistochemically, these cells were found to contain IgM-kappa-type immunoglobulin upon peroxidase-antiperoxidase (PAP) staining. Electron microscopy showed that the intracytoplasmic inclusions were localized in the rough endoplasmic reticulum and had a lattice structure with a periodicity of about 120 A.     

Hürthle-cell lesions of the thyroid: a combined study using transmission electron microscopy, scanning electron microscopy, and immunocytochemistry

Hürthle cell transformation found in 2 nodular goiters, 2 cases of Hashimoto's thyroiditis, 4 follicular adenomas, 3 follicular carcinomas, 2 papillary carcinomas and 1 anaplastic carcinoma were studied by transmission electron microscopy, scanning electron microscopy and immunocytochemistry. Ultrastructural features of Hürthle cells were identical in non-neoplastic and neoplastic lesions. Cells crammed with mitochondria, showing abnormalities in size, shape and content were prominent in most cases. The presence of distinct smooth-surfaced cells interspersed with cells with many microvilli is almost a pathognomonic scanning electron microscopic feature of benign and malignant Hürthle cell lesions. Most Hürthle cells stained positively for thyroglobulin in all cases, but no immunoreactivity for CEA and calcitonin was found.     

The diagnostic utility of immunohistochemistry and electron microscopy in distinguishing between peritoneal mesotheliomas and serous carcinomas: a comparative study.

The histologic distinction between peritoneal epithelioid mesotheliomas and serous carcinomas diffusely involving the peritoneum may be difficult, but it can be facilitated by the use of immunohistochemistry and electron microscopy. D2-40 and podoplanin are two recently recognized lymphatic endothelial markers that can be expressed in normal mesothelial cells and mesotheliomas. The purpose of this study is to compare the value of these new mesothelial markers with those that are commonly used for discriminating between mesotheliomas and serous carcinomas, and also to determine the current role of electron microscopy in distinguishing between these malignancies. A total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas of the ovary (15 primary, 30 metastatic to the peritoneum) were investigated for the expression of the following markers: D2-40, podoplanin, calretinin, keratin 5/6, thrombomodulin, MOC-31, Ber-EP4, B72.3 (TAG-72), BG-8 (Lewis(Y)), CA19-9, and leu-M1 (CD15). All 40 (100%) of the mesotheliomas reacted for calretinin, 93% for D2-40, 93% for podoplanin, 93% for keratin 5/6, 73% for thrombomodulin, 13% for Ber-EP4, 5% for MOC-31, 3% for BG-8, and none for B72.3, CA19-9, or leu-M1. All 45 (100%) serous carcinomas were positive for Ber-EP4, 98% for MOC-31, 73% for B72.3, 73% for BG-8, 67% for CA19-9, 58% for leu-M1, 31% for keratin 5/6, 31% for calretinin, 13% for D2-40, 13% for podoplanin, and 4% for thrombomodulin. After analyzing the results, it is concluded that Ber-EP4 and MOC-31 are the best negative mesothelioma markers for differentiating between epithelioid mesotheliomas and serous carcinomas. The best discriminators among the positive markers for mesotheliomas are D2-40, podoplanin, and calretinin. From a practical point of view, Ber-EP4 and MOC-31, in combination with calretinin, and/or D2-40 or podoplanin allow the differential diagnosis to be established between mesothelioma and serous carcinoma in nearly all instances. As a clear distinction could be made between these two malignancies in all of the cases in which electron microscopy was performed, this technique can be very useful in establishing the correct diagnosis when the immunohistochemical results are equivocal or further support of a diagnosis of either mesothelioma or serous carcinoma is needed.     

Contribution of immunohistochemistry, electron microscopy, and cell culture to the characterization of nonfunctioning pituitary adenomas: A study of 40 cases

We studied 40 endocrinologically inactive pituitary adenomas by immunohistochemistry, electron microscopy, and cell culture in order to determine the incidence of gonadotropic adenomas and to classify nonfunctioning adenomas. Immunohistochemical studies using a large panel of monoclonal and polyclonal antibodies identified the following nonfunctioning adenomas: 20 gonadotropic adenomas, four silent corticotropic adenomas, one plurihormonal adenoma, and 15 nonsecreting adenomas. Among nonsecreting adenomas, ultrastructural study of 13 cases identified seven null cell adenomas and six oncocytomas. Silent corticotropic adenomas were classified into subtypes I, II, and III according to Kovacs and Horvath. Most often, gonadotropic adenomas displayed a varying number of oncocytic cells, characteristic secretory granules, and a prominent Golgi apparatus. Postembedding immunoelectron microscopy was performed on eight gonadotropic or nonsecreting adenomas, but this technique did not provide any additional information. Six gonadotropic adenomas and 10 so-called nonsecreting adenomas were studied in primary cell cultures. The six gonadotropic adenomas and seven of the 10 nonsecreting adenomas released gonadotropins in the culture medium. The use of in vitro results as a supplementary diagnostic criterion allowed classification of the 40 nonfunctioning adenomas as follows: 27 gonadotropic adenomas, four silent corticotropic adenomas, one plurihormonal adenoma, and eight nonsecreting adenomas. These results demonstrate a high proportion of gonadotropic adenomas among nonfunctioning adenomas (67.5%) and the usefulness of several techniques in characterizing this type of pituitary adenoma.