Clear cell variant of thyroid carcinoma

Three carcinomas composed of a variable proportion of clear cells, oxyphil cells, and cells with combined oxyphil and clear cell features are reported. Cytologically, these tumors were included in the category of oxyphil cell variant of follicular carcinoma. In regard to pattern, two were entirely follicular, and one had follicular and papillary areas. The biologic behavior of these tumors, however, was consistent with that of follicular carcinomas. The clear cell change could be the result of chronic TSH overstimulation. This may explain the variable histological patterns, nuclear features, and biologic behavior associated with these tumors. These tumors bear a striking histologic resemblance to metastatic renal cell carcinoma and clear cell neoplasms from other sites. Immunocytochemical stain for thyroglobulin proved to be a specific and sensitive method for identification of these tumors.

Malignant schwannoma presenting as a skin mass. Confirmation by the demonstration of myelin basic protein within tumor cells

A malignant spindle cell tumor with features of a malignant schwannoma presented as a skin mass in the neck of a 13-year-old child. The histologic diagnosis was supported by the demonstration of myelin basic protein within the atypical cells using a monoclonal antibody to myelin basic protein and an unlabelled antibody peroxidase-antiperoxidase technique.

Severe thyroid atrophy due to prolonged ingestion of thyroid hormone for treatment of obesity

Severe thyroid atrophy was found at the autopsy of a 39-year-old white woman who died of myocarditis, probably of viral etiology. Prolonged ingestion of thyroid hormone for the treatment of obesity appears to be the only plausible explanation for the atrophy, secondary to suppression of the pituitary thyrotrope.

A survey of cutaneous neural lesions for the presence of myelin basic protein. An immunohistochemical study

The presence of myelin basic protein (MBP) within a skin neoplasm would support its derivation from Schwann's cells, since this substance is routinely present within Schwann's cells in the peripheral nervous system. Using a monoclonal antibody prepared against MBP and an unlabeled antibody peroxidase-antiperoxidase assay, we surveyed a variety of skin lesions suspected of being derived from Schwann's cells to determine whether MBP was present. Myelin basic protein was detected within the cytoplasm of cells composing benign solitary schwannoma (neurilemmoma) and neurofibroma, confirming the association of these lesions with proliferation of Schwann's cells. Myelin basic protein was not found in a variety of intradermal and compound nevus cell nevi nor in malignant melanoma. This negative finding supports electron microscopic evidence suggesting that nevus cells have no relationship to Schwann's cells even though some nevus cell arrangements suggest Schwann's cell derivation under the light microscope.

Immunohistochemical markers for prostatic cancer

In a patient with an unclassifiable primary or metastatic neoplasm, with or without a history of prostatic cancer, immunostaining for PA or PSAP may prove invaluable. The procedure is simple, rapid, inexpensive, and extremely accurate in demonstrating the prostatic origin of tumors. It should be noted however, that the specificity of results is entirely dependent upon the specificity of the primary antibody, which should be meticulously defined before the procedure is used for diagnostic purposes.

Orbital leiomyosarcoma

A 36-year-old man had a six-month history of painless swelling in the medial orbit. Surgical exploration of this mass revealed a leiomyosarcoma. The tumor was entirely removed, as was all local surrounding tissue.

Carcinoembryonic antigen in normal, preneoplastic and neoplastic gallbladder epithelium

Carcinoembryonic antigen (CEA) was found in normal epithelium, premalignant lesions, and all histologic types of carcinomas of the gallbladder. Immunocytochemical staining for CEA was limited to the apical surface of normal epithelium. In premalignant lesions and in carcinomas, the staining was more extensive, occurring within the cytoplasm and gland secretions. These findings show that the presence and the pattern of distribution of CEA in normal and neoplastic gallbladder epithelium closely resemble that in other gastrointestinal epithelia.

Fibrous papule: an immunohistochemical study with an antibody to S-100 protein

We studied twenty biopsies taken from fibrous papules which were located in the central part of the face. The lesions, which were characteristic histologically, did not contain S-100 protein within the stellate cells in the papillary dermis, nor was this substance found in mesenchymal cells with some features of nevus cells. In control studies, S-100 protein was found using an unlabeled antibody peroxidase-antiperoxidase technic within nevus cells composing junctional intradermal, and compound nevi, Spitz nevi, and halo nevi. It therefore seems unlikely that fibrous papule represents a form of degenerated nevus as some investigators have proposed.

Prekeratin in spindle cell tumors of the skin

A variety of benign and malignant skin lesions was stained for the presence of prekeratin using an unlabeled antibody peroxidase-antiperoxidase method and an antibody raised against human prekeratin protein. No prekeratin could be detected in benign or malignant lesions derived from melanocytes, and prekeratin could not be found in atypical fibroxanthoma, Kaposi's sarcoma, angiosarcoma, dermatofibrosarcoma protruberans, and leiomyosarcoma. Paget's cells did not contain prekeratin. Varying staining intensities were observed in keratinocytic atypical hyperplasias. Of particular interest is the observation that many spindle cell lesions that were difficult to identify with 100% assurance from routine stains could be positively identified as squamous cell carcinoma after prekeratin was found in the atypical cells.

Granular cell tumors of the skin contain myelin basic protein

Myelin basic protein, a substance found in neural structures, has been demonstrated in cutaneous granular cell tumors using a monoclonal antibody generated against myelin basic protein and an immunoperoxidase method. The substance was not found in fibrohistiocytic skin lesions. The presence of myelin basic protein in granular cell lesions of the skin supports the concept that this lesion is related closely to nerve structures.

Immunoreactive prekeratin in Brenner tumors of the ovary

In an attempt to further characterize benign, proliferating, and malignant Brenner tumors, immunoperoxidase staining for prekeratin was undertaken in a group of these neoplasms as well as in a variety of histologically different tumors of the ovary. All Brenner tumors reacted positively for prekeratin, whereas none of the other epithelial or sex cord-stromal tumors of the ovary stained. On the basis of these findings, we conclude that prekeratin might be a useful marker for differentiating malignant Brenner tumors from histologically similar, poorly differentiated ovarian neoplasms.

Thyroglobulin in carcinoma of the thyroid: an immunohistochemical study

To determine the value of thyroglobulin as an immunohistochemical marker for thyroid neoplasms, we studied 42 primary thyroid carcinomas, 38 metastatic carcinomas, and four sarcomas involving the thyroid gland. All follicular and papillary carcinomas, regardless of their morphologic variation, stained positively for thyroglobulin, whereas the medullary carcinomas, metastatic tumors, and sarcomas showed negative staining reactions. The only small-cell variant of follicular carcinoma and ten of 14 spindle and giant cell carcinomas showed the lowest thyroglobulin reactivity. It is concluded that immunohistochemical demonstration of thyroglobulin is a sensitive and specific method of identifying thyroid carcinomas of follicular cell origin.

Paget's disease of the skin. A unifying concept of histogenesis

Utilizing the peroxidase antiperoxidase technique we explored the presence and the distribution of carcinoembryonic antigen (CEA) in seven cases of mammary and sixteen of extramammary Paget's disease of skin. In every case positive immunostaining was observed in all the Paget's cells and the underlying tumor (where one was present), whereas intervening keratinocytes and melanocytes did not stain. CEA was also present in the cells and secretions of normal eccrine and apocrine glands. Our observations confirm that Paget's cells are of glandular origin.

Carcinoembryonic antigen in sweat-gland carcinomas

Using standard immunoperoxidase techniques, four cases of malignant sweat-gland carcinoma were examined for the presence of carcinoembryonic antigen (CEA). This substance was universally present in these lesions in spite of their wide spectrum of histologic features. CEA was mainly localized within the cytoplasm of tumor cells and in the lumina of neoplastic glands. The findings indicate that the presence of CEA in malignant skin adnexal tumors could help to identify and categorize these lesions as derived from eccrine or apocrine adnexal epithelium.

Sinus histiocytosis with massive lymphadenopathy: a case with unusual skin involvement and a therapeutic response to vinblastine-loaded platelets

A patient with sinus histiocytosis with massive lymphadenopathy had unusual skin lesions and progressive internal involvement. Both aspects responded dramatically to the administration of vinblastine-loaded platelets. Vinblastine-loaded, idiopathic thrombocytopenic purpura antibody-coated platelets are a rationale therapy for a disease characterized by the presence of actively phagocytosing histiocytes.

Recurrent cancer of the cervix following radical hysterectomy and pelvic node dissection

Forty patients with recurrence following radical surgery for early invasive cancer of the cervix were studied. Fifty-eight percent of the recurrences were observed within the first 12 months after surgery and 83% within the first 2 years. The site of recurrence was found to influence diagnosis, symptomatology, clinical findings, prognosis, cause of death, and therapy. The prognosis for patients with recurrent cervical cancer was poor, with only 5 patients (13%) surviving free of disease after 5 years. One patient is presently alive and without disease for more than 2 years. Patients who did not receive a potentially curative course of radiation therapy at the time of diagnosis of the recurrence had a poor prognosis. None of the patients managed by exenterative procedures or chemotherapy survived. Guidelines are suggested for follow-up after primary radical hysterectomy and pelvic node dissection.

Carcinoembryonic antigen in benign sweat gland tumors

Carcinoembryonic antigen was demonstrated in sweat gland adenomas by immunostaining using standard immunoperoxidase techniques. Carcinoembryonic antigen could not be found in adnexal tumors derived from the pilar and sebaceous apparatus. The demonstration of this specific antigen in certain sweat gland tumors may be helpful in the recognition and classification of these kinds of lesions.

Hemangioblastomas: histogenesis of the stromal cell studied by immunocytochemistry

Twenty-one cases of hemangioblastoma from the cerebellum, spinal cord and retina were studied using the unlabeled antibody peroxidase-antiperoxidase technique with antibodies directed against glial fibrillary acidic protein (GFAP) and factor VIII related antigen (VIIIR:Ag). In 19 of 21 cases studied with anti-GFAP, astrocytes were identified peripherally, and in 13 cases they were found centrally within the tumor. In no instance did stromal cells react positively for GFAP. Sixteen cases with anti-VIIIR:Ag antibody were examined, and in all cases many stromal cells showed positive staining. It is concluded that the stromal cells were of endothelial origin. The occasional stromal cells that other investigators have identified as reacting positively for GFAP may represent stromal cells capable of ingesting extracellular GFAP derived from reactive astrocytes within the tumor, or they may be lipidized astrocytes.

Early electrophysiologic and anatomic alterations in cat ventricular muscle after coronary artery ligation

The effect of coronary artery ligation on electrophysiologic properties of cat ventricular muscle cells was studied. Depression of resting potential, action potential rate of rise and amplitude was observed in infarcted cells, 30 min to 5 days after ligation. Action potential duration was markedly shortened in acute stages (30-120 min) but gradually lengthened to above control by 48 h. Anatomic sequelae included oedema, loss of fibre striation and cellular necrosis.