Neuroendocrine components of the bronchopulmonary tract: hyperplasias, dysplasias, and neoplasms

The dispersed neuroendocrine (NE) system is represented in the bronchopulmonary tract by the solitary neuroendocrine cells and the neuroepithelial bodies (NEBs). Immunohistochemically, neuron-specific enolase, serotonin, bombesin, and calcitonin are demonstrable in both components, whereas leu-enkephalin is demonstrable only in solitary NE cells. The precise function of and interplay between these two components under physiologic and pathologic conditions are not entirely clear. Current indications are that NEBs act as intrapulmonary chemoreceptors sensitive to hypoxia and hypercapnia, whereas solitary NE cells may have a paracrine, regulatory function. Even less clear is the possible role of solitary NE cells and NEBs in the processes associated with intrauterine and neonatal pulmonary growth and maturation. Various experimental manipulations have resulted in proliferation of solitary NE cells and NEBs. Of particular interest is the apparently selective proliferative effect on NEBs shown by several nitroso compounds. Diethylnitrosamine administration to hamsters for several weeks results in an increase in the number of NEBs and an increase in the number of cells per NEB. These hyperplastic NEBs express the same immunoreactive hormones as their normal counterparts. However, when NEB cells from diethylnitrosamine-treated hamsters are cultured in vitro a notable proportion of the resulting endocrine cells express ACTH immunoreactivity. Interestingly, the neoplasms that eventually develop in these hamsters are not comprised of NE cells. Studies on human bronchi from specimens resected for various types of neoplasms and for bronchiectasis with and without associated chronic obstructive pulmonary disease have revealed frequent hyperplasias of solitary NE cells and NEBs. In about 10% of the specimens, dysplastic aggregates of solitary NE cells and NEBs are found. Unexpected "microcarcinoids" and tumorlets are also seen. The mildly and moderately hyperplastic solitary NE cells and NEBs tend to express the hormones indigenous to the bronchi, whereas in the severely hyperplastic and dysplastic cells, "ectopic" hormones may also be expressed; the latter include predominantly ACTH and vasoactive intestinal polypeptide. A distinct hyperplasia of NEBs has been found in the lungs from individuals living at altitudes ranging from 3400 to 4300 meters; these changes may represent an adaptive response to chronic hypoxia parallel to the hyperplastic carotid paraganglia that may be found in the same type of population. Bronchopulmonary NE neoplasms comprise a spectrum that includes typical carcinoids, well-differentiated NE carcinomas, and NE carcinomas of intermediate and small cell types. Typical carcinoids are predominantly central, display little if any pleomorphism, are richly granulated by electron microscopy, and by immunohistochemistry express predominantly, although not exclusively, hormones indigenous to their site of origin.(ABSTRACT TRUNCATED AT 400 WORDS)     

Influence of neuroendocrine tumor cells on proliferation in prostatic carcinoma

Neuroendocrine (NE) tumor cells in prostatic carcinoma (PCa) may influence tumor proliferation by a paracrine stimulus. The role of NE tumor cells is discussed controversially. This study investigates the influence of NE tumor differentiation on proliferation in PCa. Neuroendocrine differentiation, Ki-67, and Polo-like kinase 1 were studied immunohistochemically in 73 consecutive prostatectomies. Polo-like kinase 1 (PLK1) expression was also studied by Western and Northern blot analysis. Tumors were classified as high NE (HNE) and low NE differentiated (LNE), and depending on the growth pattern, with solitary and clusters of NE tumor cells. Low NE differentiated tumors were defined as less than 30 and HNE as 30 or more NE tumor cells per hot spot. Patients were followed by serum prostate-specific antigen (PSA) analysis. Neuroendocrine differentiation was present at least focally in 70% of tumors; 57% were HNE and 43% LNE. Solitary NE tumor cells were more often found in low-grade PCa, whereas clusters of NE tumor cells were more frequent in high-grade PCa. PLK1 messenger RNA and protein as well as Ki-67 were overexpressed in tumor tissue compared with tumor-free tissue. A stronger proliferation as determined by Ki-67 and PLK1 expression was present in HNE tumors compared with LNE tumors and in tumors with clusters in contrast to tumors with solitary NE tumor cells. Analysis for PSA relapse-free survival showed an earlier progression in HNE than in LNE tumors and in PCa with clusters of NE tumor cells. A significant and clustered NE differentiation in PCa may lead to an increased proliferation and earlier tumor progression, whereas few and solitary NE tumor cells have no prognostic impact.     

Pulmonary endocrine cells in various species in the Himalaya

The numbers, morphology and distribution of pulmonary endocrine cells in goats, sheep and the yak and its interbreeds with cattle, dzos and stols, were studied after their demonstration by means of the peroxidase-antiperoxidase technique with a polyclonal antiserum raised in the rabbit to human neuron-specific enolase, a marker for neuroendocrine cells. The numbers, morphology and distribution were related to species and not to residence at high altitude. Pulmonary endocrine cells were common and mainly distributed as solitary cells in the epithelium of the bronchial tree in sheep. They were much less common and found mainly as clusters in the alveolar capillary walls in goats and in the yak and its interbreeds with cattle.     

Solitary ganglioneuroma of the ileo-cecal valve

Ganglioneuromas may occur in the small and large intestine as either solitary lesions or, more commonly, as multiple lesions (ganglioneuromatosis). The former are very rare, whereas ganglioneuromatosis may be associated with von Recklinghausen's disease and multiple endocrine neoplasia (MEN) type II B. We described the clinicopathologic features of a case of solitary polypoid ganglioneuroma of the ileocecal valve. The lesion was endoscopically diagnosed in a 27 year old man, with a history of abdominal pain. No association with von Reckling-hausen's disease or MEN was identified. Mutational analysis for RET was negative. Microscopically, the tumor consisted of a proliferation of well differentiated Schwann cells and ganglion cells in the lamina propria. The solitary polipoid ganglioneuroma is invariably benign. It shows no evidence of recurrence after total excision.     

The taste cell-related diffuse chemosensory system

Elements expressing the molecular mechanisms of gustatory transduction have been described in several organs in the digestive and respiratory apparatuses. These taste cell-related elements are isolated cells, which are not grouped in buds, and they have been interpreted as chemoreceptors. Their presence in epithelia of endodermal origin suggests the existence of a diffuse chemosensory system (DCS) sharing common signaling mechanisms with the "classic" taste organs. The elements of this taste cell-related DCS display a site-related morphologic polymorphism, and in the past they have been indicated with various names (e.g., brush, tuft, caveolated, fibrillo-vesicular or solitary chemosensory cells). It may be that the taste cell-related DCS is like an iceberg: the taste buds are probably only the most visible portion, with most of the iceberg more caudally located in the form of solitary chemosensory cells or chemosensory clusters. Comparative anatomical studies in lower vertebrates suggest that this 'submerged' portion may represent the most phylogenetically ancient component of the system, which is probably involved in defensive or digestive mechanisms. In the taste buds, the presence of several cell subtypes and of a wide range of molecular mechanisms permits precise food analysis. The larger, 'submerged' portion of the iceberg is composed of a polymorphic population of isolated elements or cell clusters in which the molecular cascade of cell signaling needs to be explored in detail. The little data we have strongly suggests a close relationship with taste cells. Morphological and biochemical considerations suggest that the DCS is a potential new drug target. Modulation of the respiratory and digestive apparatuses through substances, which act on the molecular receptors of this chemoreceptive system, could be a new frontier in drug discovery.     

Morphology of GNAT3-immunoreactive chemosensory cells in the nasal cavity and pharynx of the rat

Solitary chemosensory cells and chemosensory cell clusters are distributed in the pharynx and larynx. In the present study, the morphology and reflexogenic function of solitary chemosensory cells and chemosensory cell clusters in the nasal cavity and pharynx were examined using immunofluorescence for GNAT3 and electrophysiology. In the nasal cavity, GNAT3-immunoreactive solitary chemosensory cells were widely distributed in the nasal mucosa, particularly in the cranial region near the nostrils. Solitary chemosensory cells were also observed in the nasopharynx. Solitary chemosensory cells in the nasopharyngeal cavity were barrel like or slender in shape with long lateral processes within the epithelial layer to attach surrounding ciliated epithelial cells. Chemosensory cell clusters containing GNAT3-immunoreactive cells were also detected in the pharynx. GNAT3-immunoreactive cells gathered with SNAP25-immunoreactive cells in chemosensory clusters. GNAT3-immunoreactive chemosensory cells were in close contact with a few SP- or CGRP-immunoreactive nerve endings. In the pharynx, GNAT3-immunoreactive chemosensory cells were also attached to P2X3-immunoreactive nerve endings. Physiologically, the perfusion of 10 mM quinine hydrochloride (QHCl) solution induced ventilatory depression. The QHCl-induced reflex was diminished by bilateral section of the glossopharyngeal nerve, suggesting autonomic reflex were evoked by chemosensory cells in pharynx but not in nasal mucosa. The present results indicate that complex shape of nasopharyngeal solitary chemosensory cells may contribute to intercellular communication, and pharyngeal chemosensory cells may play a role in respiratory depression.     

Immunocytochemical localization of peptides in the endocrine pancreas of the snakes Vipera aspis and Natrix maura

The endocrine pancreas of Vipera aspis and Natrix maura has been investigated by immunocytochemistry for the presence of six peptides reported to occur in Mammals or in Reptiles. Gastrin/CCK and PP were absent in the endocrine cells, VIP was located within nerve terminals only. Insulin, Glucagon, and Somatostatin were localized both in Vipera and Natrix, generally with a ring of D (Somatostatin) cells surrounding a core of Glucagon (A) and Insulin (B) producing cells; however frequent clusters of D cells are intermingled with the other endocrine cells. Statistical evaluations on the percentages of these 3 cell types showed preponderance of A cells in Natrix whereas in Vipera no significant difference was found between the number of A and B cells. The D cells showed a uniform distribution in the pancreas of the 2 studied species, in any case with a percentage slightly inferior to those of B cells.     

An unusual bronchial carcinoid tumor: Light and electron microscopy

An unusual bronchial carcinoid tumor was studied by light and electron microscopy. The tumor cells, which appeared to be monotonously uniform in hematoxylin and eosin stained sections, were found to be morphologically heterogeneous at the ultrastructural level with regard to the size, number, and morphology of the endocrine granules. Presumptive endocrine granules were seen in all tumor cells, but some cells contained only small round granules (2000largest diameter), other cells contained large round granules (some with as large a diameter as 1.0 μ), and some cells contained large polymorphic granules. Many of the cells stained positively at the light microscopic level when selective stains for endocrine cells were applied. All types of granules showed argyrophilia at the ultrastructural level. Numerous clusters of endocrine cells were observed in the otherwise normal bronchial and bronchial glandular epithelium. The spectrum of granule morphologies, as seen in the tumor cells, was displayed in cells of the intraepithelial clusters. Some mucous cells and sparsely ciliated cells within these clusters contained argyrophilic granules. Multiple continuities existed between the epithelial endocrine cell clusters and the underlying tumor mass. The intraepithelial clusters represent foci of carcinoma in situ, the genesis of which is discussed.     

PAS-lead hematoxylin as a stain for small-granule endocrine cell populations in the lungs,other pharyngeal derivatives and the gut

Epithelial cells of the several subtypes that comprise the small-granule cell population of the respiratory system are little studied, partly because adequate silver, monoamine fluorescence and other specific light microscopical preparations have been more difficult to obtain than in the gut and other organs possessing diffuse endocrine systems. Periodic acid-Schiff (PAS) in combination with MacConaill-Solcia's lead hematoxylin has in our hands proven dependable for routine staining of serial 2-m?m glycol methacrylate sections used in mapping the distributions of these cells along the airway. In lungs of mice, hamsters, kittens, and fetal rabbits, typical small-granule cells stain weakly or not at all with lead hematoxylin alone, hence are easily overlooked. PAS adds to the cytoplasm a diffuse magenta coloration; and because it is diastase-resistant, less brilliant than that of mucus but more so than bronchiolar cell secretions, and finer textured than lysosomal staining of other cells present, the effect is to highlight small-granule cells whether solitary or in clusters. Additional PAS staining of basement membranes and lead hematoxylin staining of cilia enhance the combined stain's resolving power. In thyroid gland, parafollicular cells stand out boldly against follicular elements; in small intestine, hematoxylin-positive endocrine cells are well differentiated from absorptive, mucous, and Paneth cells that surround them. Using a complementary monoamine fluorescence technique on plastic sections of lungs from control and 5-hydroxytryptophan-pretreated animals prior to staining, we can show that fluorescent epithelial cells are identical with those stained by PAS-lead hema-toxylin.     

PAS-lead hematoxylin as a stain for small-granule endocrine cell populations in the lungs, other pharyngeal derivatives and the gut.

Epithelial cells of the several subtypes that comprise the small-granule cell population of the respiratory system are little studied, partly because adequate silver, monoamine fluorescence and other specific light microscopical preparations have been more difficult to obtain than in the gut and other organs possessing diffuse endocrine systems. Periodic acid-Schiff (PAS) in combination with MacConaill-Solcia's lead hematoxylin has in our hands proven dependable for routine staining of serial 2-micrometer glycol methacrylate sections used in mapping the distributions of these cells along the airway. In lungs of mice, hamsters, kittens, and fetal rabbits, typical small-granule cells stain weakly or not at all with lead hematoxylin alone, hence are easily overlooked. PAS adds to the cytoplasm a diffuse magenta coloration; and because it is diastase-resistant, less brilliant than that of mucus but more so than bronchiolar cell secretions, and finer textured than lysosomal staining of other cells present, the effect is to highlight small-granule cells whether solitary or in clusters. Additional PAS staining of basement membranes and lead hematoxylin staining of cilia enhance the combined stain's resolving power. In thyroid gland, parafollicular cells stand out boldly against follicular elements; in small intestine, hematoxylin-positive endocrine cells are well differentiated from absorptive, mucous, and Paneth cells that surround them. Using a complementary monoamine fluorescence technique on plastic sections of lungs from control and 5-hydroxytryptophan-pretreated animals prior to staining, we can show that fluorescent epithelial cells are identical with those stained by PAS-lead hematoxylin.     

Quantitative immunocytochemistry shows calcitonin gene-related peptide-like immunoreactivity in lung neuroendocrine cells is increased by chronic hypoxia in the rat

We have previously shown that the vasodilator calcitonin gene-related peptide (CGRP) is increased in pulmonary neuroendocrine cells in response to hypoxia. To quantify the change, we have now examined lung of adult male Wistar rats exposed to hypoxia (FIO2 = 0.1) for 1 wk and littermate controls. Sections of lung were immunostained simultaneously using rabbit antiserum to rat alpha-CGRP with the peroxidase antiperoxidase technique. The area and integrated optical density of each group of endocrine cells were measured using an image analyzer. For each animal, the summed integrated optical density of endocrine cells divided by the sum of their areas was used as a measure of CGRP-like immunoreactivity. The intensity of immunostaining of endocrine cells in the respiratory portion of the lung was 43% greater than that of endocrine cells along the conducting airways (P less than 0.001). The intensity of staining was increased by approximately 12% (P less than 0.04) after 7 d of hypoxia with no apparent difference in the response of central and peripheral endocrine cells. Measurements of staining intensity of CGRP-coupled agarose beads indicated that a 12% change in staining intensity corresponded to a 15 to 20% change in the concentration of CGRP or CGRP-like immunoreactive material. The supra-optimal dilution technique (measurement of the increase in the number of immunoreactive cells upon sequential immunostaining with a supra-optimal and then an optimal dilution of primary antiserum) detected the increase in CGRP-like immunoreactivity after 7 d of hypoxia with a high degree of statistical significance (P less than 0.005) using the same number of sections.     

The role of hypoxia inducible factor 1 (HIF-1) in hypoxia induced apoptosis

Apoptosis can be induced in response to hypoxia. The severity of hypoxia determines whether cells become apoptotic or adapt to hypoxia and survive. A hypoxic environment devoid of nutrients prevents the cell undergoing energy dependent apoptosis and cells become necrotic. Apoptosis regulatory proteins are delicately balanced. In solid tumours, hypoxia is a common phenomenon. Cells adapt to this environmental stress, so that after repeated periods of hypoxia, selection for resistance to hypoxia induced apoptosis occurs. These resistant tumours probably have a more aggressive phenotype and may have decreased responsiveness to treatment. The key regulator of this process, hypoxia inducible factor 1 (HIF-1), can initiate apoptosis by inducing high concentrations of proapoptotic proteins, such as BNIP3, and can cause stabilisation of p53. However, during hypoxia, antiapoptotic proteins, such as IAP-2, can be induced, whereas the proapoptotic protein Bax can be downregulated. During hypoxia, an intricate balance exists between factors that induce or counteract apoptosis, or even stimulate proliferation. Understanding the regulation of apoptosis during hypoxia and the mechanisms of resistance to apoptosis might lead to more specific treatments for solid tumours.     

Morphology of GNAT3‐immunoreactive chemosensory cells in the rat larynx

The upper airways play important roles in respiratory defensive reflexes. Although solitary chemosensory cells and chemosensory cell clusters have been reported in the laryngeal mucosa of mammalian species, the distribution and cellular morphology of chemosensory cells remain unclear. In the present study, the distribution and morphology of solitary chemosensory cells and chemosensory cell clusters were examined by immunofluorescence for GNAT3 on whole‐mount preparations of the rat laryngeal mucosa. Electrophysiological experiments were performed to analyze the respiratory reflexes evoked by bitter stimuli to the laryngeal cavity. In the whole area of the laryngeal mucosa, the numbers of GNAT3‐immunoreactive solitary chemosensory cells and chemosensory clusters were 421.0 ± 20.3 and 62.7 ± 6.9, respectively. GNAT3‐immunoreactive solitary chemosensory cells were mainly distributed in the mucosa overlying epiglottic and arytenoid cartilage, and chemosensory clusters were mainly distributed on the edge of the epiglottis and aryepiglottic fold. GNAT3‐immunoreactive solitary chemosensory cells were slender with elongated processes or had a flask‐like/columnar shape. The number of GNAT3‐immunoreactive cells in chemosensory clusters was 6.1 ± 0.4, ranging between 2 and 14 cells. GNAT3‐immunoreactive cells in the cluster were variform and the tips of apical processes gathered at one point at the surface of the epithelium. The tips of apical cytoplasmic processes in solitary chemosensory cells and cells in the cluster were immunoreactive for espin, and faced the laryngeal cavity. Physiological experiments showed that the application of 10 mm quinine hydrochloride to the laryngeal cavity decreased respiratory frequency. The present results revealed the chemosensory field of the larynx and the morphological characteristics of the laryngeal chemosensory system for respiratory depression.     

Increased intracellular levels of calcitonin gene-related peptide-like immunoreactivity in pulmonary endocrine cells of hypoxic rats

The mammalian respiratory tract contains innervated groups of endocrine cells which are believed to respond to hypoxia. We have demonstrated the involvement of a specific regulatory peptide produced by the cells, calcitonin gene-related peptide (CGRP), in this response. Cells immunoreactive for CGRP or for protein gene product 9.5 (PGP 9.5), a general marker of nerves and endocrine cells, were quantified in sections of lungs from hypoxic (21 days, 10 per cent O2) and normoxic rats. An immunostaining method employing supra-optimal dilutions of primary antiserum was used. This detects variations in antigen concentration which may be masked if the routine, optimal dilution is used. The number of CGRP-immunoreactive endocrine cells was significantly (P less than 0.001) greater in the lungs of hypoxic rats (76.9 +/- 10.1 cells/cm2, mean +/- SEM) compared with controls (19.7 +/- 2.4). However, the numbers of PGP 9.5-immunoreactive cells were the same in both groups (81.3 +/- 12.2, hypoxic; 79.5 +/- 9.8 control), suggesting that the total number of endocrine cells did not change. It is concluded therefore that the apparent increase in CGRP-immunoreactive endocrine cells in hypoxic rat lungs is due to increased intracellular levels of the peptide. Since CGRP is a vasodilator, this could have important implications in the vasoconstrictor response to hypoxia.     

Calcitonin as a marker for diethylnitrosamine-induced pulmonary endocrine cell hyperplasia in hamsters

Immunoreactive calcitonin (iCT) has been localized in solitary endocrine cells and in clusters of these cells, called neuroepithelial bodies, in human and hamster lungs. It has been demonstrated that hyperplasia of hamster lung endocrine cells occurs following exposure to diethylnitrosamine (DEN), a systemic carcinogen. In the present study we have investigated iCT as a hormonal correlate of DEN-induced pulmonary endocrine cell hyperplasia in hamsters. Hamsters were given 3 mg of DEN per animal, subcutaneously, twice a week and then serially sacrificed at 2, 4, 8, and 12 weeks. By immunocytochemistry, iCT-containing cells could be demonstrated in thyroids, tracheal glands, and throughout the airway epithelium. At 8 or 12 weeks of DEN exposure, one to eight neuroepithelial bodies with iCT-containing cells were identified per square centimeter of lung sections, in contrast to zero to one neuroepithelial bodies/cm2 in control hamsters. By radioimmunoassay, pulmonary iCT increased significantly at 8 weeks of DEN exposure, amounting to 3.5-fold the control values at 12 weeks. Serum iCT increased at 4 weeks of exposure and by 12 weeks had tripled (183 +/- 62 pg/ml, mean +/- SD, p less than 0.001), as compared with control animals. Subsequently, DEN was stopped for 4 weeks, and the levels of both serum and lung iCT decreased, although they remained higher than those of controls. The serum and lung iCT of control hamsters was constant throughout the experiment (49 +/- 26 pg/ml and 1754 +/- 489 pg/gm of wet weight, mean +/- SD, respectively). Thyroidal iCT levels of exposed hamsters did not differ from those of the controls; both increased progressively. The DEN-exposed animals had retarded growth as compared with the controls. Column chromatography using superfine Sephadex G-75 demonstrated that both DEN-exposed and control lungs contained iCT with a predominant molecular size corresponding to the dimer of synthetic human calcitonin; whereas thyroidal iCT was mostly monomeric (approximately 3,500 daltons). The increase of pulmonary iCT correlates well with the 4-fold increase of pulmonary endocrine cells, reported earlier following similar DEN exposure. We conclude that iCT levels of hamster sera and lungs can be used as a biochemical parameter to monitor hyperplasia of the pulmonary endocrine cells in these animals.     

Is the macrophage the stimulating cell?

Using CAF1 spleen cells to stimulate parental strain BALB/c spleen cells in a mixed lymphocyte culture, column separation of responding cells increased their response whereas the same treatment of stimulating cells reduced their activity approximately 95 per cent. Peritoneal macrophages from CAF1 mice were found to stimulate BALB/c spleen cells poorly if present in comparable numbers or if they were cultured for 24 hours before adding responding cells. However, if the F1 macrophages were in contact with the BALB/c cells for only 4 hours, their stimulating effect was increased strikingly. Under these conditions BALB/c macrophages had no effect. It is concluded that the macrophage is probably the most effective stimulating cell and may be the only cell with this capability.     

Small-granule APUD cells in relation to airway branching and growth: a quantitative, cartographic study in Syrian golden hamsters

Small-granule APUD cell clusters and their clear-cell precursors were mapped in serial 2-micron glycol methacrylate-embedded, periodic acid-Schiff (PAS)-lead hematoxylin-stained sections of 13-, 14-, and 15-day fetal hamster lungs. Every sixth section was drawn from a camera lucida projection on tracing paper. Each tracing included the profiles of nonalveolated air passages and the locations of small-granule cell clusters and solitary clear cells. Airways containing ciliated cells and those surrounded by condensed mesoderm were also labeled. Single clear cells were rare in fetal hamster lung. Of 2,368 endocrine cell loci identified in the three fetal age groups examined, only 14 were single clear cells. A preliminary survey of the entire left and right lungs showed that the pattern of airway and small-granule cell development in the infracardiac lobe was similar to that occurring in the remainder of the lung; this lobe was accordingly considered a model for the whole lung, and the ontogeny of its small-granule cell population was quantitated and compared with results of similar quantitative mapping of this lobe in an adult animal (Hoyt et al., 1982a,b). Along the lobar bronchus of the 13-day infracardiac lobe and proximal portions of its main branches, small-granule cell clusters occurred most often near airway intersections. As the number and density increased in subsequent fetal stages, small-granule cell clusters became conspicuous along internodal bronchial segments. In distributing bronchioles, the population density of small-granule cell clusters decreased between 13 and 14 days but more than doubled by day 15. Unlike human lungs, where centrifugally developing small-granule cell clusters are firmly established in terminal bronchioles well before birth, most peripheral bronchioles in fetal hamster were devoid of small-granule cell clusters, even at 15 days, one day before birth. Comparison of numerical population densities in this lobe of fetal and adult lungs indicates that small-granule cell clusters continue to form past day 15 and suggests that they are considerably more numerous in adult than fetal lung.     

Pulmonary endocrine cells in pulmonary arterial disease

Pulmonary endocrine cells containing bombesin or calcitonin have been identified in human lungs by the peroxidase-antiperoxidase method. The numbers of such cells were greatly increased in patients with plexogenic pulmonary arteriopathy whether that condition was associated with primary pulmonary hypertension or with pulmonary hypertension from intracardiac shunts. The numbers of endocrine cells tended to be increased, but to a lesser extent in patients with pulmonary hypertension and medial hypertrophy of the muscular pulmonary arteries in the absence of plexogenic arteriopathy. Increased numbers of endocrine cells comprised both greater numbers of solitary cells and a pronounced clustering, often of a disorganized nature.     

The cytological features and DNA content of cervical adenocarcinoma

The relationship among cytological features, DNA content, and degree of histological differentiation of cervical adenocarcinoma was investigated in an attempt to discover a more accurate means of screening for this cancer. In highly differentiated adenocarcinoma (so-called adenoma malignum), the nuclei were only somewhat more irregular in size and shape than those of normal columnar epithelial cells. The cells were arranged in slightly multilayered clusters. The cells of well-differentiated adenocarcinoma were usually columnar in shape, and they exfoliated side by side in clusters. In moderately differentiated adenocarcinoma, solitary cells with markedly atypical nuclei were combined with multilayered cell clusters. The cells from poorly differentiated adenocarcinoma were roundish, occurred as solitary cells or irregularly overlapping cell clusters, and showed markedly atypical nuclei. As the degree of histological differentiation decreased, as determined by measurement of the DNA content of the cells, the DNA distribution covered a wider range in terms of ploidy, and the number of cells exceeding tetraploid DNA content increased.