Immunohistochemistry of a gross cystic disease fluid protein (GCDFP-15) of the breast. A marker of apocrine epithelium and breast carcinomas with apocrine features

Gross cystic disease fluid is a pathologic secretion from breast composed of several glycoproteins, including a unique 15,000-dalton monomer protein, GCDFP-15. By the immunoperoxidase technique, GCDFP-15 was localized in the apocrine metaplastic epithelium lining breast cysts and in apocrine glands in the axilla, vulva, eyelid, and ear canal. In normal breast tissue, a few individual epithelial cells within lobules and small ducts were focally positive for GCDFP-15. Fourteen of 30 breast carcinomas stained positively for GCDFP-15. Of 16 carcinomas with apocrine features, 12 stained positively. Benign and malignant lesions from other tissues, including lung, colon, ovary, endometrium, stomach, prostate, liver, esophagus, and kidney, revealed no immunoreactivity. The only cells of "non-apocrine" tissues that contained GCDFP-15 were serous cells of the submandibular salivary gland, submucosal glands of the bronchi, and accessory lacrimal glands. Phylogenetically, these tissues have biologic features in common with apocrine glands. This report is the first to characterize GCDFP-15 as a specific tissue marker of apocrine epithelium.

Immunoperoxidase staining for involucrin: a potential diagnostic aid in cervicovaginal pathology

Involucrin, a protein subunit of keratinocyte cross-linked envelopes, is a distinctive marker for suprabasal differentiation in stratified squamous epithelium. Immunoperoxidase staining for involucrin was used to evaluate paraffin sections of tissue obtained by colposcopically directed biopsies of infectious, metaplastic, and dysplastic lesions of the cervix and vagina. Areas of normal squamous epithelium, papillary and flat condyloma acuminatum, and mature and immature squamous metaplasia showed positive staining in 99 per cent of samples lacking significant inflammation and in 60 per cent of those with moderate or severe inflammation. In contrast, only 19 per cent of the squamous cell dysplasias, even those without much inflammation, showed positive staining, and no area with moderate or severe inflammation showed positive staining. These findings indicate that expression of involucrin is modulated by cellular pathologic features and microenvironment. We suggest that immunoperoxidase staining for involucrin may be useful in distinguishing mild dysplasia from immature metaplasia and flat condyloma in some biopsy specimens in which routine histologic examination yields an indeterminate diagnosis.

Immunohistochemical demonstration of epithelial differentiation in adamantinoma of the tibia

The nature of the neoplastic cells in a case of adamantinoma of the tibia was studied with an immunocytochemical method. The antigens investigated were factor VIII-related antigen and keratin, as markers for endothelial cells and epithelial cells, respectively. The tumor cells of adamantinoma stained strongly for keratin but were completely negative for factor VIII-related antigen. These results strongly suggest that cells of tibial adamantinomas are of epithelial rather than endothelial nature, thus confirming previous light-microscopic observations and electron-microscopic studies performed on this tumor. Although the negativity for factor VIII-related antigen does not rule out by itself the presence of an endothelial component, the fact that the tumor cells are positive for keratin makes this possibility highly unlikely. Additional cases of this entity should be studied with these cytoplasmic markers in order to confirm the findings here presented.

T-cell lymphoblastic lymphoma with subsequent acute nonlymphocytic leukemia: a case report

A case of T-cell lymphoblastic lymphoma is described in which the patient presented with a characteristic mediastinal mass and lack of bone marrow involvement. Immunologic studies of the surface phenotype of the malignant cells in a pleural effusion with monoclonal antibodies revealed the cells to be of thymic origin and distinguished them from the surface phenotypes seen in T-cell acute lymphoblastic leukemia. Twenty-five months after presentation with lymphoma, the patient developed an acute nonlymphocytic leukemia. With the improved prognosis seen in lymphoblastic lymphoma with intensive combination chemotherapy, it is expected that more cases of subsequent acute nonlymphocytic leukemia will be seen. In view of the natural history of lymphoblastic lymphoma to develop into lymphoblastic leukemia, it is important to be alert to a complicating nonlymphocytic leukemia.

Mesothelioma: profile of keratin proteins and carcinoembryonic antigen: an immunoperoxidase study of 20 cases and comparison with pulmonary adenocarcinomas

The distribution of keratin proteins and carcinoembryonic antigen (CEA) in 20 diffuse pleural malignant mesotheliomas and 20 adenocarcinomas of the lung was determined with the use of an indirect immunoperoxidase method. Keratin proteins were identified in all of the mesotheliomas, with strong staining observed in 17 of the cases. Tumor cells of various histologic types (tubular, papillary, solid, and spindle) revealed staining for keratin proteins. A variety of staining patterns were observed, but the homogeneous pattern predominated, in either a diffuse (16 cases) or focal form (4 cases). CEA was usually absent (11 cases), but weak or equivocal staining was also observed (8 cases), and 1 case uniquely exhibited moderate staining for CEA. In contrast, adenocarcinomas of the lung usually stained weakly or negatively (18 cases) for keratin proteins and exhibited a predominantly peripheral staining pattern. All cases, however, stained strongly or moderately for CEA. The profile of strong keratin staining and weak or absent CEA staining appears characteristic of mesotheliomas and may be diagnostically useful in defining the epithelial element of these neoplasms and in distinguishing them from adenocarcinomas.

Immunologic characterization and ultrastructural correlations for 125 cases of B- and T-cell leukemias: studies of chronic and acute lymphocytic, prolymphocytic, lymphosarcoma cell and hairy cell leukemia, Sézary's syndrome, and other lymphoid leukemias

Peripheral blood from 125 patients (160 specimens) with various types of lymphoid leukemias was evaluated for B- and T-cell markers (E rosettes, C3 and Fc receptors, and surface immunoglobulin). B-cell leukemias (comprised 82% of the series and included chronic lymphocytic leukemia (69/71 cases), acute lymphocytic leukemia (1/18 cases), lymphosarcoma cell leukemia (15/18 cases), prolymphocytic leukemia (one case), plasma cell leukemia (one case), hairy cell leukemia (12/12 cases), and leukemic phase of "histiocytic" lymphoma and Waldenström's macroglobulinemia (one case each). Within the B-cell group, certain leukemias exhibited distinct patterns of lymphocyte surface markers. Three cases of lymphosarcoma cell leukemia revealed both T and B cell markers (E-rosette formation and monoclonal SIg). T-cell leukemias comprised 12% of the series and included chronic lymphocytic leukemia (2/71 cases), acute lymphocytic leukemia (11/18 cases), and Sézary's syndrome (2/2 cases). In eight cases of acute lymphocytic leukemia, the majority of the cells demonstrated no definable markers (non-B, non-T cell type). Ultrastructural studies, performed in selected cases, were correlated with immunologic findings. Distinctive morphologic features were observed for different variants of B- and T-cell leukemias. Neoplastic cells of T-cell leukemias revealed a greater nuclear irregularity than B-cell proliferations, as assessed by the nuclear contour index (ratio of circumference to the square root of the nuclear area). The cytoplasmic feature most predictive of immunologic cell type was abundant rough endoplasmic reticulum, suggesting plasmacytoid differentiation, observed in some B-cell proliferations.

Non-Hodgkin's lymphoma of large multilobated cell type. A clinicopathologic study of ten cases

Recently, the authors described a distinct variant of T-cell lymphoma characterized morphologically by large multilobated nuclei, and clinically by a predilection for extranodal sites and a favorable prognosis. In a retrospective study of 75 cases of "histiocytic" lymphomas observed during a 13-year period, ten additional cases of this unusual variant of non-Hodgkin's lymphoma were identified. Features similar to those of the initial group of cases included a predominant extranodal distribution, particularly involving skin, subcutaneous tissue, and bone, and a favorable response to therapy. However, the retrospective cases differed in that systemic symptoms were infrequent and gonadal involvement was not observed. Recognition of this morphologically distinct subtype of non-Hodgkin's lymphoma is of diagnostic, therapeutic, and prognostic significance.

Intracellular myoglobin--a specific marker for skeletal muscle differentiation in soft tissue sarcomas. An immunoperoxidase study

Intracellular myoglobin represents an excellent marker for specific characterization of normal (adult and fetal) and malignant skeletal muscle cells in paraffin sections. With an immunoperoxidase indirect sandwich technique for detection of intracellular myoglobin, positive staining was observed in 13 of 17 rhabdomyosarcoma specimens including 5 of 7 of the alveolar type, 5 of 5 of the embryonal type, and 3 of 5 of the pleomorphic type. Initial fixation in Zenker's-acetic acid solution gave optimal staining, but satisfactory results were obtained with fixation in formalin, Bouin's, and B5 solutions. Other types of sarcomas (13 cases) and other types of tumors (24 cases) that sometimes mimic rhabdomyosarcoma on histologic examination gave negative results. The immunoperoxidase method affords a sensitive and specific method for identifying rhabdomyoblasts in tissue on the basis of intracellular myoglobin and is of use in distinguishing rhabdomyosarcomas from other sarcomas and from malignant tumors of other types.

Intracellular hemoglobin-a specific marker for erythroid cells in paraffin sections. An immunoperoxidase study of normal, megaloblastic, and dysplastic erythropoiesis, including erythroleukemia and other myeloproliferative disorders

Intracellular hemoglobin represents an excellent marker for specific characterization of normal, megaloblastic, or dysplastic erythroid cells in paraffin sections. Using an immunoperoxidase indirect sandwich technique for detection of intracellular hemoglobin, erythroid cells at all stages of maturation were readily identified in bone marrow biopsies (58 specimens total) with a) normal erythropoiesis, b) megalobastic erythropoiesis, and c) various myeloproliferative disorders, including erythroleukemia. In other tissues (6 spleens, 2 lymph nodes, 1 liver) with extramedullary hematopoiesis, erythroid cells were similarly defined on the basis of this immunohistochemical method. Initial fixation in Zenker's-acetic acid solution (employed for bone marrow biopsies), B5 solution, or formalin, appeared equally effective in preserving the antigenicity of intracellular human hemoglobin. This sensitive and specific immunoperoxidase technique for erythroid cell characterization is particularly applicable to tissues with abnormal erythropoiesis, in which precise cell identification generally presents a diagnostic problem.

Antigenic separation of a nonkinin-generating TAMe esterase from human urinary kallikrein and immunohistochemical comparison of their localization in the kidney

Two urinary enzymes that cleave alpha-N-p-tosyl-L-arginine methyl ester (TAMe) have been separated and utilized to elicit monospecific antisera; only one, urinary kallikrein (urokallikrein), had kinin-generating activity. The nonkinin-generating TAMe esterase and urokallikrein were antigenically unrelated. Immunoperoxidase studies of normal human kidney revealed localization of nonkinin-generating TAMe esterase to epithelial cells of the distal tubule, including the ascending thick limb, the macula densa region, and some areas of convoluted tubule. Immunoreactivity for urokallikrein was confined to reabsorption droplets of proximal tubules and to focal segments of the distal convoluted tubules. Electrophoretic, antigenic, and immunohistochemical studies have established that urokallikrein and a nonkinin-generating TAMe esterase represent two distinct renal distal tubule enzymes.

Immunoblastic sarcoma of the T cell type: an ultrastructural study of five cases

Ultrastructural studies of five T cell immunoblastic sarcomas revealed morphologic features that uniquely distinguished this variant of non-Hodgkin's lymphoma. Immunoblastic sarcomas of T cell type were characterized by large lymphoid cells with striking electron-lucent cytoplasm with few organelles. Neoplastic cells of B cell immunoblastic sarcomas (5 cases) clearly differed, in that they contained numerous cytoplasmic polysomal aggregates and long, irregular strands of rough endoplasmic reticulum, occasionally with dilated cisternae. Light microscopic features were correlated with these ultrastructural distinctions. T immunoblasts correspond to large lymphoid cells with pale to clear cytoplasm, in contrast to B immunoblasts, which exhibit amphophilic cytoplasm and/or plasmacytoid differentiation. These morphologic characteristics may be helpful in identification and classification of immunoblastic sarcomas of T and B cell types.

Immunoperoxidase localization of keratin in human neoplasms: a preliminary survey

The distribution of intracellular keratin was studied in a variety of human tumors using a previously described immunoperoxidase technique employing antikeratin antibodies. Squamous cell carcinomas, transitional cell tumors, and mesotheliomas exhibited strong reactivity with antikeratin antibodies. Mammary adenocarcinomas were either negative or weakly positive. In the lung, an organ which can give rise to several morphologically distinct forms of carcinoma, only the squamous cell type stained strongly for keratin; undifferentiated lung carcinomas were negative, and adenocarcinomas were either negative or weakly positive. Colonic, renal, and prostatic adenocarcinomas were negative. Sarcomas, lymphomas, and neural tumors were uniformly negative. The analysis of intracellular keratin by the immunoperoxidase technique appears helpful in establishing the epithelial nature of primary or metastatic poorly differentiated neoplasms.

Immunohistochemical localization of keratin in normal human tissues

Immunohistochemical identification of intracellular keratin was achieved using an indirect antibody technique on paraffin-embedded human tissue. A study of numerous tissues confirms that keratins are abundant in all layers of squamous epithelia, in the ducts of epithelial-derived glands, and in the epithelia of the respiratory and urinary tracts. Using an immunoperoxidase technique which offers increased histologic resolution, we have shown that the basal or reserve cells of the tracheal, bronchial, prostatic, and cervical gland epithelia are the predominant keratin-containing cells in these tissues. The normal differentiation of basal cells into nondividing, superficial columnar cells is accompanied by the loss of cytoplasmic keratin proteins. Foci of epithelial squamous metaplasia stain intensely with antikeratin antibodies and presumably represent an exaggerated proliferation of the keratin-containing basal cells. Alveolar respiratory epithelium, acinar cells of various glands, and many mesodermal tissues (muscle, hematopoietic, and lymphoid tissue, nerve, and connective tissue) were devoid of keratin proteins. The ability to identify keratin proteins within fixed, embedded tissue (including those known to lack tonofilament bundles) may prove useful in the study of tissue histogenesis and carcinogenesis, and in the pathologic assessment of poorly differentiated malignant neoplasms and tumors of controversial cellular origin.

alpha-Naphthyl acetate esterase activity--a cytochemical marker for T lymphocytees. Correlation with immunologic studies of normal tissues, lymphocytic leukemias, non-Hodgkin's lymphomas, Hodgkin's disease, and other lymphoproliferative disorders

Cytochemical identification of T lymphocytes on the basis of alpha-naphthyl acetate esterase (NAE) activity was compared with immunologic markers for cell suspensions and/or cryostat sections of 113 specimens. Nonneoplastic tissues (peripheral blood, lymph nodes, spleens, tonsils, thymus, and pleural fluid) and specimens from various lymphoproliferative disorders, including acute and chronic lymphocytic leukemia, lymphosarcoma cell leukemia, hairy cell leukemia, non-Hodgkin's lymphomas of B-and T-cell types, and Hodgkin's disease, were evaluated. T (E-rosetting) cells demonstrated several patterns of NAE reactivity: 1) a strong globular reaction product, the most specific pattern for T-cell identification, 2) granular cytoplasmic staining, or 3) no reactivity. B lymphocytes revealed a granular pattern of NAE staining, were devoid of enzyme, or, in rare instances, exhibited strong NAE activity. Percentages of lymphoid cells with strong (globular) NAE activity closely paralleled T-cell (E-rosette) values in the majority of cases, with the best correlations observed for peripheral blood studies. However, discordant results were noted for some neoplastic and nonneoplastic tissues, including cases of T-cell lymphoma or leukemia. Markedly discrepant results were noted for thymic lymphocytes, most of which revealed E-rosette formation and weak or absent NAE activity. Lymph nodes involved by Hodgkin's disease demonstrated a heterogeneous pattern of staining in E-rosetting cells and in Reed-Sternberg variants. Cryostat section studies of reactive lymph nodes and nodular lymphomas demonstrated strong NAE staining in lymphoid cells of T-cell (interfollicular, internodular) areas, with little or no positivity in follicles or nodules (B-cell areas). NAE staining patterns further suggested that T cells comprise part of the follicular cuff and possibly represent a minor population of some neoplastic nodules. Although NAE determinations do not represent a consistently reliable alternative to immunologic methods for T-cell identification, this easily applicable cytochemical marker is complementary to other techniques in assessing neoplastic or nonneoplastic tissues, particularly cryostat sections. (Am J Pathol 97:17--42, 1979).

Sequential cleavage of proinsulin by human pancreatic kallikrein and a human pancreatic kininase

A pancreatic endopeptidase localized to the beta-cells of the pancreas by immunohistochemical techniques has been purified to homogeneity by following its functional and antigenic characteristics as a glandular kallikrein (EC 3.4.21.8). The enzyme gave a single stained band on alkaline disc gel electrophoresis which corresponded in location with the kinin-generating activity eluted from a replicate gel, was of 54,000 molecular weight by gel filtration, was devoid of caseinolytic activity, elicited a monospecific antiserum in a rabbit, and gave a line of complete identity with a single constituent in pancreatic extract, crude urine, and purified urokallikrein when analyzed with monospecific antibody to urokallikrein. The pancreatic glandular kallikrein generated three cleavage products of increasing anodal mobility from bovine and porcine proinsulin, and the presence of pancreatic kininase or bovine carboxypeptidase B increased the quantity of these products. Although the conversion products did not correspond to diarginyl- and monoarginylinsulin, the product of intermediate mobility was also obtained when proinsulin was treated with a low concentration of trypsin in the presence of kininase. The most rapidly migrating product did correspond to desalanylinsulin in the reference standard. Kininase alone had no action on proinsulin, and aprotinin prevented cleavage by kallikrein alone or in combination with kininase. Although the chemical structure of the proinsulin cleavage products has not been established, human pancreatic kallikrein is considered a putative activator of proinsulin because of its location in the beta-cell, its preferential action on proinsulin and kininogen as compared to azocasein, and its capacity to generate insulin intermediate products that are further modified by human pancreatic kininase or bovine carboxypeptidase B.

Non-Hodgkin's lymphomas: an ultrastructural study correlating morphology with immunologic cell type

Ultrastructural studies were performed on 40 B-cell and 14 T-cell lymphomas of non-Hodgkin's type (NHL). Most B-cell lymphomas were comprised of neoplastic cells with morphologic features compatible with a follicular center cell origin. Dendritic reticulum cells and their desmosome-associated processes, characteristic of germinal centers, were observed in all 11 cases of nodular poorly differentiated lymphocytic lymphoma and in one of two cases of nodular "histiocytic" lymphoma, but were not identified in the lymphomas with a diffuse growth pattern. Desmosomes were observed between dendritic reticulum cells and were not found between lymphoid cells. Large neoplastic cells comprising lymphomas of "histiocytic," mixed lymphocytic "histiocytic," and "undifferentiated" types were characterized ultrastructurally and immunologically as lymphoid cells. Malignant lymphomas of well and moderately well differentiated lymphocytic types (7 cases) revealed B-cell markers, and represented a distinct homogenous group of neoplasms, with electron microscopic features most closely resembling follicular cuff lymphocytes. T-cell malignancies included lymphoblastic lymphomas (3 cases), large cell ("histiocytic") lymphomas (4 cases), lymphoepithelioid cell ("Lennert's") lymphomas (2 cases), mycosis fungoides (3 cases) and diffuse poorly differentiated lymphocytic lymphomas (2 cases). A consistent finding in the T-cell proliferations was the presence of small and/or large lymphoid cells with extremely irregular and/or convoluted nuclei, which occurred in varying proportions and with variable degrees of nuclear complexity. The nuclear irregularity evident in the neoplastic T cells was distinguishable from that observed for lymphoid cells of B-cell lymphomas. In comparing the cytoplasmic features of the T- and B-cell neoplasms ultrastructurally, the only distinguishing feature was the presence of well developed granular endoplasmic reticulum with dilated cisternae, i.e., plasmacytoid features, predictive of a B cell origin.

Identification of human glandular kallikrein in the beta cell of the pancreas

To determine the cellular localization of glandular kallikrein in the human pancreas, immunohistochemical studies were performed with a monospecific antibody against the antigenically identical urinary kallikrein (urokallikrein). The localization of glandular pancreatic kallikrein to the beta cells of the islets was the same as that of insulin in normal human pancreas and in two islet-cell tumors. When beta cells were lacking in islet-cell tumors or in the pancreas of a patient with juvenile-onset diabetes, kallikrein antigen was not detectable. Anti-urokallikrein absorbed with purified urinary or pancreatic kallikrein no longer identified a pancreatic antigen, whereas absorption with insulin had no effect. The beta-cell localization of human pancreatic kallikrein, an endopeptidase that, in concert with carboxypeptidase B, converts bovine proinsulin to a polypeptide with the electrophoretic mobility of insulin, suggests that pancreatic kallikrein may be involved in the physiologic activation of proinsulin.

Characterization of non-Hodgkin's lymphomas using multiple cell markers. Immunologic, morphologic, and cytochemical studies of 72 cases

Tissues from 72 cases (87 specimens) of various non-Hodgkin's lymphomas were analyzed for cell markers using multiple techniques. Cell suspensions were evaluated for E, EAC, and IgGEA rosette forming cells; Fc receptor cells; and surface immunoglobulin bearing cells. Cryostat section studies topographically defined EAC binding cells. Cytochemical determinations and immunoperoxidase methods for detection of intracellular immunoglobulin and lysozyme complemented other techniques in evaluating infiltrates containing large neoplastic cells. B-cell malignancies comprised 58 cases (80%) of this series and included well and moderately well differentiated lymphocytic lymphomas (10/10); nodular (23/23) and diffuse (10/18) poorly differentiated lymphocytic lymphomas; and lymphomas of mixed lymphocytic-"histiocytic" (3/3), "undifferentiated" (3/3), and "histiocytic" (9/13) types. Nodular lymphomas were characterized as B-cell neoplasms but also revealed a prominent population of T lymphocytes (39 +/- 12%). Alkaline phosphatase activity, a cytochemical marker for lymphoid cells of follicular cuffs, was most consistently observed in B-cell lymphomas of moderately well differentiated lymphocytic type (4/6 cases). In some diffuse lymphomas, cryostat section studies (EAC rosettes) suggested a pre-existing nodular proliferation. One unusual B-cell lymphoma of large cell type exhibited IgGEA rosette formation and a strong receptor for the Fc portion of IgG. Ten lymphomas (14%) were of T-cell type and were represented by cases of diffuse poorly differentiated lymphocytic lymphoma (5/18, including 3 lymphoblastic lymphomas), Sézary syndrome (1), mycosis fungoides (1), and a cytologically distinctive large cell ("histiocytic") lymphoma (3/13). Acid phosphatase activity was a consistent marker for the T-cell malignancies, some of which also revealed alpha-naphthyl butyrate esterase activity. No true histiocytic lymphomas were detected. Three cases of diffuse poorly differentiated lymphocytic lymphoma and one "histiocytic" lymphoma were null.

Profile of intracytoplasmic lysozyme in normal tissues, myeloproliferative disorders, hairy cell leukemia, and other pathologic processes. An immunoperoxidase study of paraffin sections and smears

Intracytoplasmic lysozyme (muramidase) may be readily identified in paraffin sections of tissues fixed in formalin or Zenker's acetic acid and in smears of peripheral blood or bone marrow using an immunoperoxidase technique. Sites of intracellular lysozyme in normal human tissues and in various specimens from patients with myeloproliferative and lymphoproliferative disorders, hairy cell leukemia, granulomatous diseases, toxoplasmic lymphadenitis, and other pathologic processes were defined by this method. Intracellular lysozyme was demonstrated in mature and immature neutrophilic and eosinophilic myeloid cells, in monocytic cells, and in some types of histiocytes and had a limited distribution in normal tissues. The neoplastic cells of hairy cell leukemia were devoid of intracytoplasmic lysozyme. Identification of intracellular lysozyme, as determined by the immunoperoxidase technique, was compared with various cytochemical methods, particularly chloroacetate esterase and alpha-naphthyl butyrate esterase studies, for detection and characterization of myeloid cells, monocytes, and histiocytes.

Specific identification of intracellular immunoglobulin in paraffin sections of multiple myeloma and macroglobulinemia using an immunoperoxidase technique

Paraffin-embedded tissues of 47 cases of multiple myeloma and 4 cases of macroglobulinemia were studied by the immunoperoxidase indirect sandwich technique for identification of intracytoplasmic immunoglobulin. Specific immunoglobulin with a single heavy and/or light chain was readily detected in the neoplastic cells. Studies were performed on iliac crest bone marrow biopsies which had been fixed and decalcified using Zenker's-acetic acid solution and on tissues from various sites which had been fixed in formalin. An excellent correlation was obtained between the specific immunoglobulin detected intracellularly in the plasma cells or lymphoplasmacytic cells and the monoclonal immunoglobulin found in serum or urine of these cases. The immunoperoxidase technique represents a sensitive and specific method for identifying intracellular immunoglobulin in paraffin-embedded tissues.

Testosterone metabolism in benign and malignant breast lesions

Tissues from a variety of breast lesions were incubated with 14C-testosterone (17beta-hydroxy-4-androsten-3-one). Conversion to 14C-5alpha-dihydrotestosterone (17beta-hydroxy-5alpha-androstan-3-one) and 14C-androstenedione (4-androsten-3,17-dione) was measured. Normal breast tissue showed formation of 14C-androstenedione but no formation of 14C-5alpha-dihydrotestosterone. Fibroadenomas showed a high degree of testosterone metabolism forming both 14C-androstenedione and 14C-5alpha-dihydrotestosterone. The adenocarcinomas of the breast, contrary to a previous report in the literature, showed no conversion to 14C-5alpha-dihydrotestosterone. The data suggest that formation of 5alpha-dihydrotestosterone is a predominant metabolic pathway in fibroadenoma.

Intestinal anisakiasis. First case report from North America

The first case of intestinal anisakiasis in North America is described. This parasitic disease is recognized as a public health hazard in Japan and Europe. Man becomes infected with a larval form of the nematode Anisakis by consuming raw or undercooked fish containing the parasite. Typically, patients present with acute abdominal syndromes. Clinical and reontgenographic features may cause confusion with regional enteritis. Histologically, a striking oesinophilic granulomatous reaction occurs. Anisakiasis is most effectively prevented by discouraging the consumption of raw fish.

Immunologic characterization of the mononuclear cell infiltrates in rheumatoid synovia, in rheumatoid nodules, and in lip biopsies from patients with Sjögren's syndrome

Two subcutaneous rheumatoid nodules and 8 rheumatoid synovia from patients with rheumatoid arthritis (RA); and 2 parotid glands, 1 "pseudolymphoma," and 6 lip biopsies from patients with Sjogren's syndrome (SS) were studied to identify mononuclear cells. The palisading mononuclear cells in subcutaneous nodules had a surface membrane receptor for complement. B lymphocytes surrounded by larger numbers of non-B lymphocytes were found in RA synovium and between salivary ducts of SS lip biopsies. A "pseudolymphoma" obtained from a patient with SS consisted primarily of B lymphocytes. The predominant mononuclear cell in rheumatoid synovia and salivary glands in patients with RA and SS do not have surface membrane receptors from complement and are thus probably T lymphocytes or null cells.