Basophilic staining in pulmonary alveolar proteinosis. Report of three cases

Material filling the alveoli in pulmonary alveolar proteinosis has been shown to be eosinophilic by hematoxylin-eosin (HE) staining of lung tissue. No previous evidence has suggested a different result from a frozen section. We noted three cases, in 1972, 1973, and 1982, of basophilic staining of this characteristic alveolar material on unfixed, frozen sections; these cases later showed the usual eosinophilic properties when HE staining was performed at room temperature on formaldehyde solution-fixed, paraffin-embedded sections. These observations are important in that failure to recognize this possibility may initially lead the surgical pathologist away from the correct diagnosis or falsely suggest a problem in stains or staining techniques.

Association of an extracellular protein (chondrocalcin) with the calcification of cartilage in endochondral bone formation

We examined bovine fetal epiphyseal and growth plate cartilages by immunofluorescence microscopy and immunoelectron microscopy using monospecific antibodies to a newly discovered cartilage-matrix calcium-binding protein that we now call chondrocalcin. Chondrocalcin was evenly distributed at relatively low concentration in resting fetal epiphyseal cartilage. In growth plate cartilage, it was absent from the extracellular matrix in the zone of proliferating chondrocytes but was present in intracellular vacuoles in proliferating, maturing and upper hypertrophic chondrocytes. The protein then disappeared from the lower hypertrophic chondrocytes and appeared in the adjoining extracellular matrix, where it was selectively concentrated in the longitudinal septa in precisely the same location where amorphous mineral was deposited in large amounts as demonstrated by von Kossa staining and electron microscopy. Mineral then spread out from these "nucleation sites" to occupy much of the surrounding matrix. Matrix vesicles were identified in this calcifying matrix but they bore no observable morphological relationship to these major sites of calcification where chondrocalcin was concentrated. Since chondrocalcin is a calcium-binding protein and has a strong affinity for hydroxyapatite, these observations suggest that chondrocalcin may play a fundamental role in the creation of nucleation sites for the calcification of cartilage matrix in endochondral bone formation.

Renal oncocytoma. A clinicopathologic study

Seven cases of renal oncocytomas are described. Two cases were from recent surgical and autopsy material seen within a period of ten months. Four cases were reclassified as renal oncocytomas from a 20 year review of 63 renal cell carcinomas removed operatively. One case was identified from a nine year review of 31 renal cell carcinomas coded in our autopsy files. All patients were males; mean age was 69 years. The smallest tumor measuring 0.3 X 0.3 X 0.3 cm represents the smallest renal oncocytoma reported. The largest tumor weighed 2350 g. It is the largest renal oncocytoma so far reported in the literature. Two of the cases were found in polycystic kidneys. None of the seven patients presented with symptoms related to the tumors and the subsequent clinical course was benign in all cases. Differential diagnosis from renal cell carcinoma is discussed in terms of light and electron microscopic and radiologic aspects. The previously reported cases in the literature are reviewed.

Malignant pleural mesothelioma presenting as superior vena cava syndrome

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Papillary fibroelastoma of the heart. Report of six cases

Papillary fibroelastoma is a rare cardiac lesion, mostly encountered as an incidental finding at the time of autopsy but occasionally seen during life. Although this condition generally is asymptomatic, a few cases had been associated with clinical problems, such as embolic phenomena, angina pectoris, outflow tract obstruction, and sudden death. We studied six examples of this lesion, five occurring on the cardiac valves and one on the left ventricular septum. In one, the lesion was detected by echocardiography, which represents to our knowledge only the third published case in which the lesion was visualized by this diagnostic procedure and only the fourth in which the lesion was seen during life. We believe that echocardiography is sensitive in the detection of this often small, intracardiac lesion, useful in evaluating whether a case, by virtue of its size or location, carries a significant risk of causing clinical problems and therefore requires treatment.

Coexistence of chronic lymphocytic leukemia and Hodgkin's disease

Two cases with coexistent chronic lymphocytic leukemia (CLL) and Hodgkin's disease (HD) are reported. The HD was discovered on biopsy specimens of enlarged lymph nodes, four and two years, respectively, after the initial diagnosis of CLL. Although CLL and HD are usually regarded as two distinct lymphoproliferative disorders, 35 cases of HD complicating CLL have been reported. A review of this literature and the author's two cases suggest that the coexistence of these two entities represent separate and unrelated lymphoproliferative disease. The use of lymphocyte cell surface marker analysis in the second case supports this conclusion.

Ameloblastoma of the maxilla with distant metastases and hypercalcemia

A case of metastatic ameloblastoma of the maxilla with secondary hypercalcemia in a 54-year-old man is presented. After treatment with surgery, chemotherapy, and radiotherapy, the patient was found to have multiple metastases and severe hypercalcemia associated with high levels of parathormone-like substance in the peripheral blood. At autopsy he was found to have widespread metastases and nephrocalcinosis.

Noncaseating granulomas of the pancreas. Probable sarcoidosis

The patient presented with evidence of common bile duct obstruction and at surgery had narrowing of the distal common bile duct secondary to noncaseating granulomas of the pancreas, most probably sarcoidosis. Although pancreatic sarcoid is rare, this entity should be included in the differential diagnosis of pancreatic disease.

Chromatin-negative Klinefelter's syndrome with focal megalencephaly

At autopsy, 72-year-old white male with chromatin-negative Klinefelter's syndrome, mental retardation, psychotic behavior, and carcinoma of the lung was noted to have right unilateral focal cerebral and cerebellar megalencephaly with broad gyri, a cytoarchitectually abnormal cortex, and thickened cerebral vessels. Literature about the neuropathology of Klinefelter's syndrome and several cases of other chromosome aberrations (XYY and XO syndromes) are reviewed. These neuropathological changes are thought to be related to clinical manifestation.

Localization of proteoglycan monomer and link protein in the matrix of bovine articular cartilage: An immunohistochemical study

Using monospecific antisera and immunofluorescence microscopy, proteoglycan monomer (PG), and link proteins were demonstrated throughout the extracellular matrix of bovine articular cartilage. A narrow band of strong pericellular staining was usually observed for both molecules, indicating a pericellular concentration of proteoglycan monomer: this conclusion was supported by dye-binding studies. Whereas PG was evenly distributed throughout the remaining matrix, more link protein was detectable in interterritorial sites in middle and deep zones. Well-defined zones of weaker territorial staining for link protein stained strongest for chondroitin sulfate. Trypsin treatment of cartilage resulted in a loss of most of the PG staining, but some selective retention of link protein, particularly around chondrocytes in the superficial zone at and near the articular surface. This residual staining was largely removed if sections were fixed after chondroitinase treatment. After extraction of cartilage with 4M guanidine hydrochloride, only PG remained and this was concentrated in the superficial zone. These observations are shown to support the concept of aggregation of PG and link protein with hyaluronic acid (HA) in cartilage matrix, and the binding of PG and link protein to HA, which is attached to the chondrocyte surface. Culture of cartilage depleted of PG and link protein by trypsin demonstrated that individual chondrocytes can secrete both PG and link proteins and that the organization of cartilage matrix can be regenerated in part over a period of 4 days.

Intrathoracic lipomas. Report of three cases and review of the literature with emphasis on endobronchial lipoma

Intrathoracic lipomas are rare, benign neoplasms of unknown origin, with symptoms depending primarily on their location and size. They frequently represent on incidental roentgenographic finding and are clinically significant in that they may simulate malignant tumors and, when located endobronchially, may cause irreparable lung damage. Three cases of intrathoracic neoplasms are reported herein, and the English literature on the subject reviewed. In some cases, bronchoscopic examination may yield the diagnosis of endobronchial lipoma but, in general, thoracotomy is required for diagnosis. A more complete classification is suggested and the preferred mode of treatment is discussed.

Superficial temporal-middle cerebral artery anastomosis associated with glioblastoma multiforme

The authors report a case in which glioblastoma multiforme was intimately associated with a surgical anastomosis of the superficial temporal artery to a branch of the middle cerebral artery.

Influence of hippocampectomy on gastric ulcer in rats

Hippocampectomized male rats were prepared, and the incidence as well as severity of gastric ulceration upon restraint were compared with those of normal control animals and controls with localized damage to the cortex over the hippocampus. In another experiment, observations on gastric ulceration were made without restraint in hippocampectomized animals, normal controls, controls with cortical damage, vagotomized animals and animals that received hippocampectomy as well as vagotomy. Both in restrained and unrestrained states, the incidence of animals with ulcer as well as the number and the total area of ulcers per stomach were significantly larger in the hippocampal animals than they were in the other animal groups. Vagotomy abolished the effect of hippocampectomy upon gastric ulceration in the unrestrained state. We infer that the hippocampus helps to protect the stomach from ulceration partly by controlling vagal activity.

Influence of ginseng on mating behavior of male rats

Experiment on the mating behavior of male albino rats paired with receptive females established that in comparison with control animals, males under the influence of ginseng (a) began ejaculation earlier and repeated the action more often in a 45-minute observation period and (b) deposited more copulation plugs in 10 days. The data suggest that ginseng facilitates the mating behavior of male rats.

Effect of hippocampectomy on sleep patterns in cats

The study was planned to see if the hippocampus has an influence on fast wave sleep (FWS) as well as on slow wave sleep (SWS). From 8 male cats EEG, EMG and EOG were recorded for 24 h, first under normal conditions, secondly after cortical damage to the dorsal marginal portion of posterior ectosylvian gyrus, and thirdly following hippocampectomy done through the cortical damage. From the records, SWS, FWS and the sleep state (defined as a sequence of SWS or SWS-FWS phases between two successive waking states) were measured in terms of their occurrence, the mean duration and the total time they occupied in the day, night and 24 h. In addition, sleep sequences were classified according to the number of constituent sleep phases. Cortical damage did not affect SWS, FWS, or sleep state with regard to their occurrence, the mean duration, and the total time they occupied in 24 h. Nor did it affect the proportion of short and long sequences. The circadian variation of sleep was clearly retained. Hippocampectomy significantly reduced the total time occupied by sleep state, SWS and FWS, increased the occurrence of sleep state and SWS phase against decreased incidence of FWS phase, and reduced the mean duration of sleep state and SWS phase. Hippocampectomy also significantly increased the occurrence of sleep sequences with only one SWS phase at the cost of sequences with alternating SWS and FWS phases. Following hippocampectomy, the circadian variation of sleep was not only retained, but actually exagerated. The hippocampus in inferred to facilitate the FWS as well as the SWS phase of sleep.