EB病毒感染与中线恶性网织细胞增多症

使用一个针对ＥＢ病毒编码的小分子ＲＮＡ（ＥＢＥＲ）的寡核苷酸探针对１９例中线恶性网织细胞增多症病变组织进行了原位杂交检测，并配合免疫表型分析。结果为：（１）本组病例中１８／１９例（９４．７％）的病变组织中的异形淋巴样细胞表达Ｔ细胞分化抗原。ＣＤ３阳性１５例，ＵＣＨＬ１阳性９例，其中二者均阳性６例，但各例中的异形淋巴样细胞均未表达Ｂ细胞及组织细胞分化抗原；（２）ＥＢＥＲ原位杂交检测的阳性数高（１５／     

Phenotypic modulation in cisplatin-resistant cloned cells derived from transplantable rat malignant fibrous histiocytoma

The histogenesis of malignant fibrous hlstlocytoma (MFH) was studled using clsplatln (CDDP)-resistant MT-R8 and MT-R9 cells derlved from cloned undlfferentiated MT-8 and flbrohlstlocytic MT-9 cells, resoecthfely, which had been established from transplantable rat MFH. CDDP concentrations requlred for 50% suppression of prollferation of MT-R8 and MT-R9 cells were 5.4– and 3.3-fold greater than those of parental MT-8 and MT-9, respectively. MT-R8 and MT-Rg showed the higher positive rates to histimytic lysosomal/ antigenic (ED1 and ED2) markers. The number of a-smoath muscle actin (SMA)-positive cells significantly Increased in MT-RB; SMA-positlve cells were also obsenred in MT-R9, but no difference was seen between MT-9 and MT-R9. MT-R8 and MT-R9 expressed both histiwytic and myofibroblastic phenotypes. However, the histology of subcutaneous tumors induced in syngeneic rats by MT-R8 and MR-R9 did not always reflect their in vitro nature. MT-R8 developed undiffer-entlated sarcomas similar to parental MT-8 tumors. In contrast, MT-R9 induced tumors with polytypic histologies such as the storiform growth pattern, neoplastlc growth of granular cells and myofibroblasts, osteosarcoma-like areas, collagen-rich areas containing well-developed fibroblasts and areas involvlng many lipoblasts. These In vivo observatfons suggest the multidlrectional differentiation of MT-R9 cells. Phenotypic modulation of rat MFH cells seemed to be easily induced by CDDP. A possible histogenesis of MFH was discussed based on the data collected.     

Granzyme B-positive primary gastric T-cell lymphoma: gastric T-cell lymphoma with the possibility of extrathymic T cell origin

A case of primary gastric T-cell lymphoma, which was positive for granzyme B, is reported. The patient was a 47-year-old Japanese female who complained of a dull upper abdominal pain. Radiographic and endoscopic examinations revealed an ulcerative infiltrative lesion in her stomach. Following the confirmation of a high-grade malignant lymphoma, a distal gastrectomy with regional lymph nodal dissection was performed. The histology of the gastric lesion revealed a malignant lymphoma of the diffuse pleomorphic type without lymph nodal involvement. Immunohistochemistry revealed that the tumor cells were positive for LCA, CD3, TIA-1 and granzyme B, but were negative for CD4, CD8, CD56, CD30, L-26, EMA, TCR alpha/beta and TCR gamma/delta. Because the tumor cells showed T cell nature with cytotoxic activity proved by TIA-1 and granzyme B, and without evidence of further maturation of T cell, a malignant lymphoma originating from extrathymic-derived T cells was suggested.     

Transforming growth factor J3 type II receptor (TGFpRII) mutation in gastric lymphoma without mutator phenotype

A new mutation in the serine-threonine klnase domain of the transforming growth factor β type II receptor (TGFpRII) was found in a case of diffuse, B cell non-Hodgkin's lymphoma of the stomach. A mfssense mutation (ACA to GCA, Thr to Ala) was detected In exon 5, and a wild type allele was also present. This Is the first naturally occurring mutation in the klnase domain of this gene identified in human primary lymphoma. The replication error at three loci was negative, and the poly A tract of exon 3, which is frequently a target of mismatch repair genes, was intact. Malignant lymphoma of B cell origin in the stomach Is an addition to an expanding catalogue of tumors with TGFβRII alterations, and the biological sequelae of the change in the functional domain and the clinical characteristics of the patient in this study are intriguing.     

CYTOLOGIC FEATURES OF ASCITES IN MALIGNANT FIBROUS HISTIOCYTOMA OF THE COLON

The cytologic features of ascitic fluid in a case of malignant fibrous histiocytoma (MFH) of the colon are described. At autopsy, two solid tumor masses were found around the ascending and transverse colon, accompanied by about 3,000 ml of ascites. Tumor cells had infiltrated diffusely into the outer layers of almost all of the gastrointestinal wall, simulating peritonitis carcinomatosa. Cytologic examination of the ascites revealed various kinds of tumor cells; short spindle-like cells, multinucleated giant cells, and round cells with an invaginated nuclear margin, forming small clusters. These cytologic findings were considered to be very useful in the diagnosis of MFH, especially in cytologic examinations of ascites. ACTA PATHOL JPN 38: 921 ∼ 928, 1988.     

家猪心脏纤维支架的大体解剖

目的　观察猪心纤维支架 ,为猪心的研究和比较解剖学积累资料。方法　取甲醛固定后的猪心2 7例 ,液态塑料浸渍的塑化猪心 5例 ,解剖显示纤维支架后用游标卡尺进行观测。结果　猪心左纤维三角的三边分别平均为 17 4 1± 1 99mm、18.96± 3.2 6mm和 17.6 4± 2 .4 4mm ;右纤维三角三边分别为 15 .83± 2 .11mm、16 .19± 1.94mm和 2 0 .96± 2 .6 2mm ;二尖瓣环、三尖瓣环的周长平均为 73.0 0± 9.71mm ,6 8.89±7.2 4mm ;主动脉瓣环和肺动脉瓣环直径分别为 18.4 4± 2 .89mm和 16 .0 3± 2 .6 3mm ;猪Todaro腱呈扁带状 ,走行部位较深 ,且分支较人心多 ,长度为 2 0 98± 4 2 0mm。结论　猪心纤维支架与人类形态结构相似 ,但瓣环周长和Todaro腱形态有一定差别。     

Malignant fibrous histiocytoma arising in a recurrent chordoma

Summary We present the case of a sacrococcygeal chordoma which recurred 15 years after the radical removal as a soft tissue tumor in the gluteal musculature. This tumor consisted of two parts: a chordoma without symptoms of aggressive cellular proliferation and a malignant fibrous histiocytoma. During the following 4 years several local recurrences of the malignant fibrous histiocytoma occurred in the gluteal musculature. The patient finally died of lung metastases. No chordoma tumor tissue was found in the lungs, in the gluteal musculature or in the sacrococcygeal bone area. Histology including electron microscopy revealed no proof of a transition of chordoma into malignant fibrous histiocytoma. It must be assumed that the secondary soft tissue tumor originated from residual chordoma cells which were implanted during the operation of the primary tumor. It remains unclear whether the malignant fibrous histiocytoma arose from mesenchymal stromal cells within the chordoma or directly from primitive neuroectodermal chorda cells which possess the ability to differentiate into a variety of cell types including mesenchymal cells.     

铁蛋白鉴别胸腹液良恶性质的临界值选择

探讨铁蛋白ferrztin,Ft在鉴别胸腹液良、恶性质的临界值。用RIA法测定218份由不同病因引起的胸腹液标本铁蛋白(pleuraleffusionferritin,PFt)及其同期血清铁蛋白(SFt)。依据临床确诊资料,将标本进行良、恶性病例分组,比较两组PFt、SFt,计算PFt/SFt比值,用ROC曲线选择PFt用于良、恶性质鉴别的最佳临界值。结果表明,良性组PFt为142.4±38.6μg/L,SFt为89.7±43.5μg/L,PFt/SFt为1.46±0.55;恶性组PFt为576.5±239.1μg/L,SFt为189.6±81.7μg/L,PFt/SFt为3.67±1.48;PFt用于鉴别胸腹液良、恶性质的临界值为400μg/L。以恶性积液PFt≥400μg/L、PFt/SFt≥3,良性积液PFt<400μg/L、PFt/SFt<3为实验诊断标准鉴别胸腹腔积液的良、恶性质,灵敏度为84.5%、特异性为87.5%,准确性为92.8%。     

Paraffin-immunohistochemical Analysis of 26 Non-Hodgkin's Malignant Lymphomas n the Endemic Area of Human T-cell Leukemia Virus Type 1

A study was conducted to evaluate the usefulness of paraffin immunohistochemistry for histopathological classification of non Hodgkin's malignant lymphomas (NHML). The phenotypes of lymphoma cells and other cells were examined using 11 monoclonal and 3 polyclonal antibodies by the ABC method on paraffin-embedded tissue sections of 226 cases of NHML, comprising 94 B cell lymphomas (B ML) and 132 T cell lymphomas (T-ML). In 219 NHML cases (96.8%), lymphoma cells reacted with more than one of these antibodies. A set of MB 1, Mx pan B, L26, LN 1, LN 2 and antiimmunoglobulin light chain antibodies characterized each subtype of B MLs, categorized according to the Kiel classification. Mantle-zone lymphoma (MzML) was added as one subtype. L26 stained the largest number of B MLs (82.8%). B cell chronic lymphocytic leukemia (B CLL) was labeled most frequently by MB 1. MzML was characterized by reactivity of lymphoma cells with LN 2 and by the appearance of monoclonal immunoglobulin light chain along the cell membrane. Follicle center cell lymphomas were stained by LN 1 and LN 2, although a small number of proliferating cells were labeled by LN 1 in B CLL, MzML and the im-munocytoma lymphoplasmacytic/cytoid variant. MT 1 and/or UCHL-1 showed various degrees of reactivity with the cell membranes of lymphoma cells in 94.8% of T-MLs. Among the T cell pleomorphic lymphomas of Suchi and Lennert, the adult T cell leukemia/lymphoma type, defined by stippled heterochromatin distribution and peculiar huge cells, reacted selectively (p<0.05) with anti phospho-kinase C antibody. Anaplastic large cell T-ML reacted with a set of Ber H2, LN 2 and Leu Ml. In T zone lymphomas without hyperplastic follicles, angioimmuno-blastic lymphadenopathy with dysproteinemia type T-ML, lymphoepithelioid cell lymphomas and some pleomorphic lymphomas comprising clear large lymphoma cells, there were many intermingling B cells, and their constitution varied. In some lymphoblastic lymphomas of both the T cell and B cell type, phenotypes of T cells and B cells were expressed. Consequently, it was shown that paraffin immunohistochemistry was useful for the practical histopathological diagnosis of NHML even in the area where human T cell leukemia virus type 1 is endemic.     

Malignant Melanoma of Soft Parts Involving the Head and Neck Region: Review of Literature and Case Report

Malignant melanoma of soft parts (MMSP) was originally described as a distinct entity by Enzinger in 1965 and was termed “clear cell sarcoma of tendons and aponeuroses” because of its association with tenosynovial structures. It has been shown immunophenotypically and ultrastructurally that this tumor is derived from neuroectoderm and shares a number of features with cutaneous melanoma. Over 95% of MMSPs present in the extremities, with the head and neck region (1.9%) being an unusual site. This study presents an additional case of MMSP of the head and neck region involving the posterior cervical region in a 15-year-old Hispanic male and reviews the literature on MMSP. Ultrastructural examination showed rudimentary cell attachments, smooth cell membranes, discontinuous basal lamina, scanty glycogen, and occasional premelanosomes in some tumor cells. Cytogenetic analysis showed a reciprocal translocation between the long arms of chromosomes 12 and 22 [t(12:22)(q13;q12.2)], characteristic for MMSP and not seen in cutaneous melanoma. Survival in MMSP has been correlated with tumor size, tumor necrosis, and ploidy status. Overall reported clinical outcome for this tumor is as follows: died of disease, 45%; alive with disease, 23%; no evidence of disease, 30%; and died of other causes, 2%. MMSP represents a distinct entity with a characteristic ultrastructural appearance and a tumor defining cytogenetic translocation.