Gastrointestinal endocrine cell hyperplasia in celiac disease: a selective proliferative process of serotonergic cells

Untreated celiac disease is characterized by gastrointestinal endocrine cell hyperplasia (ECH). This study investigated the constitutive nature of the ECH. Ten duodenal biopsies showing villous atrophy from adult celiacs were evaluated against ten sex- and age-matched controls. The mean number of endocrine cells per unit length of mucosa in the celiacs was compared with the control group using the Student t test. These values, respectively, were as follows: Churukian-Schenk method, 52.4 versus 29.6 (P = 0.001); Fontana-Masson, 32.5 versus 18.4 (P = 0.016); chromogranin, 33.4 versus 23.6 (P = 0.017); serotonin, 44.7 versus 26.7 (P = 0.006); somatostatin, 5.0 versus 5.4 (P = 0.631); and gastrin, 0.37 versus 0.37 (P = 1.000). There was thus ECH as shown by the first four stains with, in some areas, the endocrine cells continuously abutting against each other to form linear profiles. With respect to specific hormonal products, only serotonin showed ECH. These results suggest that the ECH in celiac disease is not a haphazard process but, instead, a selective proliferation of certain endocrine cell types.

Androgen receptor and the testes influence hypertension in a hybrid rat model

The objective of this study was to determine if males with a deficient androgen receptor would develop hypertension when crossed with a hypertensive parent. Female King-Holtzman rats (n = 15), heterozygous for the testicular feminization (Tfm) gene, were crossed with male spontaneously hypertensive rats (SHR), and blood pressure was measured weekly from 5-14 weeks in the F1 hybrid males. Approximately 50% of the F1 hybrid males were Tfm males and androgen receptor-deficient, and 50% were normal. Blood pressure in the parent King-Holtzman males, Tfms, and female rats was also followed for the same time period. The F1 normal male hybrids had a significantly higher (p less than 0.05) systolic blood pressure than the Tfm hybrid males after 12 weeks (195 +/- 8 versus 170 +/- 8 mm Hg, respectively). Blood pressure in the male and Tfm Holtzman rats was 120 +/- 5 mm Hg and 110 +/- 6 mm Hg, respectively. Castration lowered blood pressure by 38 mm Hg in the hybrid males and 27 mm Hg in the Tfm hybrids. Female F1 hybrids also showed a pressure rise above that of female Holtzman controls (155 +/- 6 mm Hg versus 110 +/- 6 mm Hg, p less than 0.01) but lower than the F1 males and Tfm hybrids. Ovariectomized females with testosterone implants did not show an elevation in blood pressure. Plasma electrolytes, norepinephrine, and cholesterol were not significantly different between normal and Tfm hybrid males. The results suggest that the presence of an androgen receptor and a testis-derived factor mediate the blood pressure rise in the hybrid males.(ABSTRACT TRUNCATED AT 250 WORDS)

Epithelial changes following bone marrow transplantation: cytological atypia and epithelial endocrine cells

This report describes the histological and immunocytochemical findings in gastrointestinal biopsies and skin of a patient with chronic granulocytic leukaemia which progressed to blastic transformation, who was then treated with chemotherapy and total body irradiation followed by allogeneic bone marrow transplantation. The gut showed endocrine cells in the lamina propria and these had an immunophenotype similar to the glandular epithelium at the sites studied (stomach, duodenum and rectum), supporting the idea that the endocrine cells of the gut are more resistant to the effect of radiation, chemotherapy and graft-versus-host disease (GVHD) than are other cell types in the epithelium, and that lamina proprial endocrine cells are epithelially derived in this situation. Epidermis and gut epithelium also showed marked atypia due to the conditioning regimen and GVHD, and this case illustrates the possibility of misdiagnosis of carcinoma in this increasingly common situation. An additional, unusual feature of this case was the presence of a B-cell UCHL1 + ve lymphoma of the colon at autopsy, 122 days post-transplantation.

Pulmonary endocrine cells in infancy and childhood

Lung sections from 22 infants and children who died of noncardiopulmonary diseases (control) and from 12 infants with hyaline membrane disease/bronchopulmonary dysplasia (HMD/BPD) were immunostained for bombesin (BOM), calcitonin (CT), calcitonin gene-related peptide (CGRP), leu-enkephalin (ENK), and serotonin (5HT). The numbers of immunoreactive cells per millimeter airway epithelial length were counted and determined by morphometry. In lungs from the control group, BOM-immunoreactive (IR) solitary cells (SCs) were numerous at the bronchiolar level, and remained so for 4 to 7 months after birth. The number of CT-IR SCs increased markedly around term. At the bronchial level these cells continued to increase postnatally apparently in inverse proportion to the number of BOM-IR SCs in later childhood. The number of CGRP-IR SCs was high only during the neonatal period. 5HT-IR SCs were relatively few and showed no clear developmental change in number. No unequivocal ENK-IR SCs were observed in any case. BOM-IR neuroepithelial bodies (NEBs) were observed more frequently than any other type of NEBs and remained relatively numerous throughout childhood. In lungs of infants with HMD/BPD, endocrine cells of all types except for ENK-IR cells were markedly increased in number during periods of regeneration, to the chronic stage. It is concluded that each of these types of pulmonary endocrine cell demonstrates a characteristic developmental pattern in distribution and frequency during infancy and childhood, probably reflecting the various functional roles of these cells in early life. In HMD/BPD, there is alteration in the number and/or peptide and serotonin content of pulmonary endocrine cells, possibly a result of acute hypoxia, oxygen administration, and epithelial regenerative activity.

Development of neuroendocrine tumors in the gastrointestinal tract of transgenic mice. Heterogeneity of hormone expression

Expression of hormones in endocrine tumors and derived cell lines of transgenic mice carrying insulin-promoted oncogenes has been investigated by histochemical, immunohistochemical, ultrastructural, and radioimmunologic means. Tumors of the pancreas, small intestine, mesentery, and liver were examined. Insulin-immunoreactive cells were prevalent in pancreatic tumors, with a significant subpopulation of pancreatic polypeptide-immunoreactive elements. Conventional ultrastructural and immunogold analysis identified insulin-storing beta granules in pancreatic tumor cells. In contrast, the largest immunoreactive subpopulation of intestinal tumors expressed secretin (53% of total cells), followed by proglucagon-related peptides (15%), glucose-dependent insulinotropic polypeptide (7%), gastrin (7%), pancreatic polypeptide (2%), neurotensin (2%), and somatostatin (1%). No detectable immunoreactivity for either insulin or serotonin was observed. Electron microscopy and immunogold labeling showed that intestinal tumor cells contained secretin-storing S-type granules. Lymph node and liver tumors contained secretin-immunoreactive cells with ultrastructural features similar to those of intestinal tumors. In addition, high levels of circulating insulinlike and secretinlike immunoreactants were detectable. Analogous hormone profiles were identified in tumor cell lines and culture media. Large T-antigen immunoreactivity was detected in all the nuclei of neoplastic cells, as well as in insulin-immunoreactive elements of non-neoplastic islets and pancreatic ducts and in some secretin-immunoreactive cells of small intestinal mucosa. These data indicate that neuroendocrine tumors arise both in beta cell and S-cell subpopulations of transgenic mice.

Intestinal differentiation in ovarian mucinous tumours

Fifty-five ovarian mucinous tumours, 22 benign, 16 borderline and 17 malignant, were examined for intestinal differentiation (ID). This was defined by the presence of one or more of endocrine, absorptive, goblet or Paneth cells, and identified by routine haematoxylin and eosin as well as histochemical and immunoperoxidase techniques. Twenty benign (91%), 14 borderline (88%) and all malignant tumours contained foci of ID. The frequency of ID was not significantly different between the mucinous tumour types (chi-squared test for independence). Follow-up was available on all patients with borderline tumours: 14 were stage Ia, including both cases without ID, and 2 were stage Ic at presentation. All are alive and free of disease at 9-39 months (median 15.5 months). We conclude that the presence of ID in borderline mucinous tumours is unlikely to be of prognostic significance, and that a subdivision of these tumours into müllerian and intestinal types is unnecessary.

Human chorionic gonadotropin alpha-subunit in endocrine cells of fibrotic and neoplastic lung. Its mode of localization and the size profile of granules

To investigate the nature of various endocrine cells immunoreactive for human chorionic gonadotropin (hCG alpha) in the lung, immunoelectron microscopic study was performed on fibrotic adult lungs and endocrine neoplasms of the lung. The mode of localization of hCG alpha and the size profile of hCG alpha granules were different among endocrine cells under various proliferative conditions. The population of hCG alpha granules in the grouped type of endocrine cells was more variable with a shift to smaller size (mean area: 1.395 x 10(-2) microns 2, mean maximum diameter: 149.8 nm), than that in solitary ones (1.493 x 10(-2) microns 2, 155.4 nm). Tumorlet endocrine cells had larger hCG alpha granules (1.800 x 10(-2) microns 2, 171.3 nm) without change of SD of size parameters. In carcinoid tumors, the size profile of hCG alpha granules was considerably different from that in the three types described above. Moreover, hCG alpha granules were significantly smaller in size in carcinoid tumors without lymph node metastasis (2.295 x 10(-2) microns 2, 189.8 nm) than those in malignant carcinoid tumors with metastasis (3.368 x 10(-2) microns 2, 230.5 nm). The population of hCG alpha granules in atypical endocrine tumor was the parallel shift to a larger scale (6.251 x 10(-2) microns 2, 307.5 nm) from that of malignant carcinoids and the distribution pattern was different from that in benign carcinoids. In small cell carcinoma of the lung, hCG alpha immunoreaction was preferentially present in perinuclear space and dilated rough endoplasmic reticulum. The mode of localization of hCG alpha and the size profile of hCG alpha granules, representing specific features of intracellular processing of hCG alpha, may be closely related with some qualitative changes in the neoplastic process of pulmonary endocrine cells.

Longevity and age-related pathology of LVG outbred golden Syrian hamsters (Mesocricetus auratus)

A colony of male Lakeview Golden (LVG) Syrian hamsters has been maintained for the last nine years as a source of various tissues for cellular aging studies. Observations on this colony also yielded data on survival time and physical and pathological manifestations of aging in this strain. Based on 150 spontaneous deaths, the median life span was found to be 19.5 months. The maximum life span was 36 months and the minimum 6 months. A cross-sectional pathological survey of sacrificed and spontaneously dying members of the population revealed a low rate of neoplasia and a variety of degenerative lesions that increased with age. These observations of a varied pathology and a low frequency of neoplasia provide justification for the continued development of the male LVG Syrian hamster as an animal model system for use in studies on the mechanism of both in vivo and in vitro aging.

Diethylnitrosamine-induced pulmonary endocrine cell hyperplasia and its association with adenomatosis and adenocarcinoma in rabbits

Pulmonary endocrine cells are suspected of being the precursors for small cell carcinoma of the lung (SCCL). The purpose of this study was to determine whether Diethylnitrosamine (DEN) can induce SCCL in rabbits. New Zealand white rabbits were injected subcutaneously with 20 mg/kg body weight of DEN, twice per week, starting when they were 1 week old. Controls received saline vehicle only. The animals were sacrificed 6 to 8.5 months after the first injection and lung tissues were processed for light microscopy. Using serotonin (5-HT) as a marker for the endocrine cells, tissue sections were stained immunohistochemically by the avidin-biotin complex method. In both control and DEN-treated animals, serotonin-immunoreactive cells organized into neuroepithelial bodies (NEBs). There was an apparent increase in the size, number, and stainability of NEB in DEN-injected animals. A majority of these NEBs were localized in the alveolar duct region. Small foci of adenomatosis and well-differentiated adenocarcinomas, which sometimes coexisted with hyperplastic pulmonary endocrine cells, were also found in the DEN-treated rabbits.

[Anaplastic tumor of the bladder with neurosecretory granules and benign courses]

We report on a 59-year-old female patient with a bladder tumor that was initially classified as anaplastic (undifferentiated) tumor. Posteriorly, electron microscopic and immunohistochemical analyses of the specimen revealed a neuroendocrine tumor distinct from a paraganglioma. The origin and prognosis of bladder carcinoids and small cell undifferentiated carcinomas are discussed. The authors indicate that the level of bladder wall infiltration is the most important prognostic parameter in these type of tumors.

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.

Endocrine cells in the intrahepatic biliary tree in normal livers and hepatolithiasis

Endocrine cells in the intrahepatic biliary tree were examined histochemically and immunohistochemically in human infants and adults, as well as in patients with hepatolithiasis. Endocrine cells were sparse but found rather constantly in normal infant livers as well as in adult livers. Almost all endocrine cells were of argyrophil cells or somatostatin-containing cells, and they were usually found in the extramural peribiliary glands in normal livers. On the other hand, in hepatolithiasis in which there were marked proliferation of the peribiliary glands and hyperplasia of surface-lining epithelia, many kinds of endocrine cells were seen in the extramural and intramural peribiliary glands, as well as in the lining epithelial layer. Furthermore, these endocrine cells were hyperplastic in the affected intrahepatic bile duct in two patients with hepatolithiasis. These data suggested that argyrophil cells and somatostatin-containing cells are physiologically present in the intrahepatic biliary tree, and many kinds of other endocrine cells newly appear and even proliferate in hepatolithiasis. These findings imply the participation of reported action of these hormones on bile flow in normal livers and hepatolithiasis.

Pulmonary endocrine cells in chronic bronchitis and emphysema

Pulmonary endocrine cells have been studied according to their immunoreactivity for neuron-specific enolase, gastrin-releasing peptide (GRP), calcitonin, leucine-enkephalin, and serotonin in the lungs of subjects with chronic bronchitis and emphysema. The overall population was significantly greater in comparison with matched controls. The change was most marked in lobes affected by pneumonic consolidation, and did not affect equally the sub-populations of cells as identified by their content of peptide; the difference was much greater for calcitonin-containing cells than for those immunoreactive for GRP. This change may be the basis of the hypercalcitoninaemia and hypercalcitoninuria which have been reported in patients with inflammatory pulmonary disease.

Duodenal adenomas in familial adenomatous polyposis: their structure and cellular composition with particular reference to endocrine hyperplasia

134 duodenal biopsies from 14 patients with familial adenomatous polyposis were evaluated by light microscopy for the presence of adenoma. Staining reactions for endocrine cells were applied. 90 biopsies contained adenoma, almost all of the tubular type (98%) with dysplasia, ranging from mild to moderate. Accompanying hyperplasia of argyrophil and argentaffin endocrine cells was found in 91% and 64% of the adenomas, respectively. Based on histological criteria it is concluded that the risk of carcinoma development in the duodenum could equal that in colon and rectum. The observation of endocrine hyperplasia is new, and further investigations are needed before the significance of this finding can be evaluated.

Pulmonary blood vessels and endocrine cells in subacute infantile mountain sickness

A male infant of 16 months, of the Han race, died from subacute infantile mountain sickness in Lhasa (3600 m). At necropsy there was right ventricular hypertrophy secondary to muscularization of the pulmonary arteries and arterioles thought to have been induced by hypobaric hypoxia. In addition, there was intimal proliferation of myofibroblasts in the pulmonary arterioles, venules and veins. There were increased numbers within the bronchioles of pulmonary endocrine cells, containing calcitonin and bombesin, which could be related to hypoxia or trophic effects on the pulmonary vasculature. The relation of delayed effects of hypoxia to primary pulmonary hypertension is considered in this study.

Electron microscopic studies of endocrine hyperplasia in duodenal adenomas in familial adenomatous polyposis

Electron microscopical studies on endocrine cell hyperplasia of duodenal adenomas from five patients with familial adenomatous polyposis were performed. All the endocrine cell types normally found in the duodenal mucosa were identified. A constant feature was proliferation of duodenal-enterochromaffin cells but an increase in the number of all other endocrine cell types apart from pyloric-gastrin cells and somatostatin cells, was also observed. Certain types of intestinal endocrine cells (the intestinal enterochromaffin cell and the glicentin cell) are rare cells in the normal duodenal mucosa. The finding of these cells may indicate increased biological aggressivity.

Tumour pathology of the neuron-paraneuron system and its evolutionary background, with special attention to neuro-endocrine differentiation in prostate and mammary carcinomas

From results of phylogenetical investigations of the neuron-paraneuron or neuroendocrine system it is known that cells producing hormonal peptides appear first in the nervous system, then also as disseminated cells of an open or closed type in the mucosa of the alimentary tract, and, lastly, as the parenchyma of the classical endocrine glands. In all these three parts of the neuroendocrine system the parenchymal cells can undergo neoplastic transformation, expressing "eutopic" and/or "ectopic" peptide hormones and/or biogenic amines. The neuro-paraneuronal tumours arising in the central or peripheral nervous system in man are rare. In contrast, they are more common when they originate from the disseminated neuroendocrine cells in the gut mucosa, and when they arise in the endocrine glands. Here, a broad spectrum of histopathologically benign or malignant neoplasms, hyperplastic nodules, and other tumour-like lesions occur, some of which are associated with well-known clinicopathological entities. Typical examples are the gastrointestinal carcinoids, pancreatic insulomas, pituitary adenomas, medullary thyroid carcinomas, and phaeochromocytomas. The fact that neoplastically transformed cells of some traditionally non-endocrine tumours, e.g., mammary and prostatic carcinomas, can undergo neuroendocrine differentiation has recently become well established. The "malignancy potential" of neuroendocrine carcinomas and that of the paraneuronally differentiated cells of prostatic and mammary carcinomas have both been studied by means of cytochemical DNA assessments of the nuclei of the tumour cells, applying a recently developed deparaffinisation-disintegration procedure using archival material. So far, it seems as if about 1/4 of common gut carcinoids show a DNA distribution pattern of the "aneuploid" type, whereas the other 3/4 are "euploid" i.e., show a "diploid" or "diploid/tetraploid" DNA distribution pattern. The cell nuclei in areas in prostatic and mammary carcinomas with high amounts of paraneuronally differentiated cells displayed to a greater extent "euploid" DNA patterns than those in areas of the same carcinomas without such paraneuronal cells. Thus, the "malignancy potential" of the neoplasms of neuro-paraneuronal cells seems to be rather low.

Morphological findings in fatal drug addiction. An investigation of injection marks, endocrine organs and kidneys

Tissue sections from injection marks from 30 drug addicts and sections from endocrine organs and kidneys from an additional 33 addicts were studied together with endocrine organs and kidneys from 20 'normal' persons. All 83 persons were submitted for medico-legal autopsy at the Institute of Forensic Medicine in Copenhagen. In fresh injection marks haemorrhage in dermis and subcutis was present histologically in all cases. Acute inflammation was present in 38% and acute inflammation together with chronic changes in 41%. Fibrotic thickening of vein wall was seen in 14% and thrombosis in 10%. Birefringent foreign material occurred in 35%. In old injection marks and scars chronic inflammatory changes were observed in 93%, fibrotic thickening of vein wall in 20% and thrombosis in 10% of the cases. Birefringent material occurred in 17%. By comparison of changes in injection marks with the size and histological changes in the corresponding axillary lymph nodes, there was a tendency to a relation between chronic inflammatory changes in old injection marks/scars and enlargement of the lymph nodes in question, but no correlation to the histological degree of immunoactivity. Regarding alterations in the endocrine organs and the kidneys no important differences were demonstrated between drug addicts and 'normal' persons.

Endocrine cell hyperplasia and appendiceal carcinoids

As endocrine tumours in a number of organs may arise in a background of hyperplasia, the density of endocrine cells in appendices from ten patients with carcinoid tumours was compared with that in appendices from ten age- and sex-matched control patients. Crypt and lamina propria endocrine cells were quantified separately. The density of argentaffin endocrine cells in the crypts was significantly higher in appendices with carcinoid tumours when compared with the controls. No difference was found in non-argentaffin endocrine cells, and no difference was found in either argentaffin or argyrophil endocrine cells in the lamina propria. While it is possible that carcinoid tumours induce an increase in the number of enterochromaffin (EC) cells in the background mucosa, it is considered more likely that EC cell hyperplasia predisposes to the development of carcinoid tumours of the appendix.

Pulmonary adenoma and endocrine cell hyperplasia in Syrian golden hamster treated with 4-nitroquinoline 1-oxide

Chronic effects of 4-nitroquinoline 1-oxide (4 NQO) on the lungs of Syrian golden hamsters were studied. 4 NQO was subcutaneously injected weekly for 3 weeks at a dose of 20 mg/kg body weight. The animals were sacrificed at the 65th and 80th experimental weeks. Two cases of pulmonary adenomas were demonstrated in the 10 4 NQO-treated animals at the 80th week, and the tumor cells contained cytoplasmic lamellar inclusion bodies. In a previous study, we reported 4 NQO- induced pulmonary endocrine cell hyperplasias in the 4 NQO-treated hamster after the 20th experimental week (Jpn. J. Cancer Res., 77, 1986). In the present study, 12 pulmonary endocrine cell hyperplasias were recognized in serial sections of the 24 treated animals. The hyperplastic lesions showed positive immunoreactivity to calcitonin. The hyperplastic lesion did not develop to pulmonary endocrine cell neoplasm.

Neuroendocrine differentiation in the glandular peripheral nerve sheath tumor. Pathologic distinction from the biphasic synovial sarcoma with glands

We studied eight glandular peripheral nerve sheath tumors and seven biphasic synovial sarcomas with glands with the objectives of (a) characterizing the nerve sheath tumors, especially with respect to a possible neuroendocrine differentiation, and (b) identifying features that could be used to distinguish between the two lesions. In a mainly immunohistochemical study, neuroendocrine differentiation of glandular cells was observed in five of eight (62.5%) nerve sheath tumors. The neuroendocrine cell markers found included chromogranin (five of eight cases), serotonin (four of seven cases), pancreatic polypeptide (two of five cases), and gastrin (two of six cases). These findings--together with histological, histochemical, and ultrastructural observations made in this and in other studies--point to a foregut type of intestinal differentiation for the glands in a majority of glandular peripheral nerve sheath tumors. Specific histological and immunohistochemical differences between the nerve sheath tumors and the synovial sarcomas were identified. The main histological differences were a sharp distinction between the spindle and glandular cells of the former but not the latter lesion, and the presence of goblet-type cells only in the glandular peripheral nerve sheath tumors. Major immunohistochemical differences included neuroendocrine differentiation and reactivity for S-100 protein and CEA (seen only or mainly in the nerve sheath tumors), and the reactivity of spindle cells of only the biphasic synovial sarcomas for epithelial membrane antigen.