12E7 Antigen ; Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Child ; Diagnosis, Differential ; Heart Neoplasms ; metabolism ; pathology ; surgery ; Heart Ventricles ; pathology ; Humans ; Male ; Neurilemmoma ; metabolism ; pathology ; Neurofibroma ; metabolism ; pathology ; Solitary Fibrous Tumors ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Adolescent ; Chondrosarcoma ; pathology ; surgery ; Douglas' Pouch ; pathology ; surgery ; Female ; Humans ; Peritoneal Neoplasms ; pathology ; surgery ; Soft Tissue Neoplasms ; pathology ; surgery

OBJECTIVETo study the morphological, ultramicrostructural and pathological changes of tissues from a patient with severe acute respiratory syndrome (SARS).

METHODSOne autopsy case of diagnosed SARS was investigated. Lung puncture was performed immediately after the patient died, and the autopsy was done after 12 h. The specimens from lymph nodes, spleen, small intestine, colon and bone marrow were studied by immunohistochemical technique. The antibodies used included CD20, CD45RO (UCHL-1), CD4, CD8, CD68 and CD34.

RESULTSThe principal lesions of the SARS case consisted of acute lobular intrastitial pneumonia, hyaloid membranes of pulmonic alveoli and hyperplasia and shedding of alveolar epithelium of. Virus-like inclusions occasionally contained cytoplasm of the alveolar epithelium, which were positive by histochemical staining. The adjacent blood-vessels were changed by hyperplasia and enlargement. The structures of lymph nodes and spleen were damaged with lymph follicles depletion and splenic nodules atrophy. The specific changes included reduction of lymphocytes and hyperplasia of histiocytes, depletion of the follicles of small intestine and colon wall, decreased hyperplasia of the bone marrow and increased number of the megakaryocyte. Meanwhile, in the immunohistochemical study, CD(20)(+) B cells were fully expressed in lymph nodes and spleen, and the CD45RO (UCHL-1)(+) T cells were scatteredly expressed. The number of CD4(+) help T cell was markedly decreased, while the number of CD8+ poisonal T cells increased, and the ratio of the former and latter was no more than 0.5. Under the electronic microscopy observation, virus-like particles with 80 - 160 nm diameter and halo or garland envelope were found in mononuclear macrophage and cytoplasm of alveolar epithelium.

CONCLUSIONThe specific lesions of SARS consist of lobular intrastitial pneumonia with the formation of hyaline membranes of lung, haemorrhage, necrosis, inflammation of blood vessels and the damages of extralung lymphohemopioetic system. The damages were very similar to the pathological features of tissues infected by human immunodeficiency virus, in which numbers of T cells decreased and CD(4)(+) T cell/CD(8)(+) T cell ratio was no more than 0.5. According to the virus-like particles found in lung of the SARS case, it is considered that these virus-like particles may be a new kind of coronavirus which caused the "atypical pneumonia".

Humans ; Immunohistochemistry ; Lung ; pathology ; Lymph Nodes ; pathology ; Male ; Microscopy, Electron ; Middle Aged ; Myocardium ; pathology ; Severe Acute Respiratory Syndrome ; pathology

Giant cell tumor of bone (GCTB) seldom occurs in the head or face. This article reported a case that GCTB occurred simultaneously in the temporal bone and mandibular condyle, and analyzed their clinical and pathological features.
Bone Neoplasms ; Giant Cell Tumor of Bone ; Humans ; Mandibular Condyle ; pathology ; Mandibular Neoplasms ; Temporal Bone ; pathology

OBJECTIVETo study the clinicopathologic features, immunophenotype and differential diagnosis of sclerosing epithelioid fibrosarcoma (SEF).

METHODSEight cases of SEF were investigated by light microscopy and immunohistochemistry.

RESULTSThere were five males and three females. Clinically, most patients presented as a slowly growing mass. Six tumors were located in the extremities or limb girdles, and two in the trunk. Grossly, most lesions were relatively well-circumscribed with a nodular or lobulated appearance. They ranged from 2.0 to 10.5 cm in size (mean 6 cm). On sectioning, they had a gray-whitish cut surface and were firm in consistency. Microscopically, the tumors were composed of uniformly round or polygonal epithelioid cells with clear to eosinophilic cytoplasm. The tumor cells were arranged predominantly in single strands or cords and embedded in a heavily hyalinized matrix. In some areas, nests, sheets, acini or alveolar structures were also noted. Nuclei atypia and brisk mitotic activity was not evident. The mitotic count measured less than 1 per 10 high power fields. However in two cases, focal areas exhibited increased cellularity, nuclei atypia and higher mitotic activity, resembling conventional fibrosarcoma. Immunohistochemically, the tumor cells showed diffuse and strong positivity for vimentin and focal or weak positivity for EMA. There was no expression for AE1/AE3, S-100 protein, HMB45, alpha-SMA, MSA, desmin, CD34, bcl-2, CD30 and LCA. Follow-up information in six patients revealed local recurrence in 3 cases and lung metastasis in 1 case.

CONCLUSIONSSEF is a rare variant of fibrosarcoma. Despite the relatively bland appearance and low mitotic activity, the tumor is capable of local recurrence and distant metastasis. Thus, it should be considered and treated as a low to intermediate grade sarcoma. SEF needs to be differentiated from a variety of benign or malignant tumors exhibiting epithelioid features and sclerotic stromal response.

Adult ; Diagnosis, Differential ; Extremities ; Female ; Fibrosarcoma ; metabolism ; pathology ; secondary ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Soft Tissue Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism

OBJECTIVETo evaluate the progression in morphologic changes of lungs in SARS patients.

METHODSFour cases of SARS with lung tissue samples available (including one for ultrastructural examination) were enrolled into the study. Histochemical study for VG, Masson, reticulin, orcein, PAS, sirius red stains and immunohistochemical study for vimentin, desmin, smooth muscle actin, HHF-35, CD34, F8, collagen types I and III were also performed.

RESULTSAccording to the morphologic changes, lung lesions in SARS were subcategorized into 3 phases: acute exudative inflammation, fibrous proliferation and the final fibrotic stage. Two cases belonged to the acute exudative phase, in which the course was less than 20 days. The principal lesions consisted of acute alveolar exudative inflammation, hyperplasia of alveolar epithelium, necrosis, alveolar hyaline membrane formation, alveolar desquamation and focal fibroplasia. The acute exudative protein was PAS-positive. There was an increase in reticulin fiber formation. The reactive fibroblasts were highlighted by desmin and vimentin. One case belonged to the fibroproliferative stage, in which the course was around 25 days. Major lesions included proliferative interstitial pneumonia with early pulmonary fibrosis. There was also evidence of organizing pneumonia, with an increase in reticulin fiber formation, which had a glomeruloid appearance on special stain. The mesenchymal cells showed either myofibroblastic (which expressed desmin, HHF-35, smooth muscle actin and vimentin) or fibroblastic (which expressed vimentin only) differentiation. Fibroelastosis and fibroplasia was also noted. The remaining case belonged to the fibrotic stage, in which the course was around 75 days. The main features included diffuse fibrosis and honeycomb change, which were highlighted by sirius red stain. Immunohistochemistry showed mainly types I and IV collagen fibers. In all lesions, there was also an increase of number of CD68-positive macrophages.

CONCLUSIONSThe morphologic progression in lungs of SARS patients is characterized by the development of increased fibrosis. The primitive mesenchymal cells, hyperplastic alveolar epithelial cells and macrophages play an important role in the pathogenesis.

Actins ; metabolism ; Adult ; Collagen Type I ; metabolism ; Desmin ; metabolism ; Humans ; Lung ; metabolism ; pathology ; Male ; Middle Aged ; Pulmonary Fibrosis ; pathology ; Severe Acute Respiratory Syndrome ; metabolism ; pathology ; Vimentin ; metabolism

OBJECTIVETo explore the expression of vascular endothelial growth factor (VEGF) and its receptors (flt-1 and flk-1) in the retina of retinopathy of prematurity (ROP), and its relation to the alteration of retinal blood vessels.

METHODSEighty-six newborn Sprague-Dawley rats were randomly divided into hyperoxia and air groups, then each group was further divided into 1, 3, 7 and 14 days subgroups. The rats in hyperoxia group inhaled 75% oxygen and ROP model was thus set up. These animals were sacrificed respectively after 1, 3, 7 and 14 days, then the retinal endothelial cells were marked by CD34 to observe the change of retinal blood vessels. The expression of VEGF, flt-1 and flk-1 in the retina was measured by immunohistochemistry.

RESULTSThe retinal capillary density index (RCDI) in control group increased as days went on (F = 21.589, P < 0.01, but it was the least on the 7th day in hyperoxia group, after the rats had been returned to air for 7 days, RCDI increased significantly (F = 67.885, P < 0.01); In the control group, the expression of VEGF and flk-1 was the strongest in the retina on the 7th day, the result had significant difference as compared with the 1st and 14th day (P < 0.05). The expression of VEGF and flk-1 on the 7th day in hyperoxia group was weaker than that of control group (P < 0.05). But on the 14th day in hyperoxia group, they were stronger than that of control (P < 0.05). The localization of the expression of flt-1 was changed when blood vessels altered, but there was no significant difference in expression intensity as a whole (P > 0.05).

CONCLUSIONWhen the premature retina was exposed to hyperoxia, the expression of VEGF and flk-1 was reduced, and retinal blood vessels were also decreased; but the expression of VEGF and flk-1 was stronger in retina when premature rats were exposed to relative hypoxia, and the retinal blood vessels also increased significantly. It is concluded that VEGF and flk-1 may play important roles in the development of retinal blood vessels and its change in ROP. However, flt-1 has less effect compared with flk-1.

Animals ; Animals, Newborn ; Disease Models, Animal ; Female ; Hypoxia ; Immunohistochemistry ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Vascular Endothelial Growth Factor ; analysis ; Retina ; chemistry ; pathology ; Retinal Diseases ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; analysis

OBJECTIVETo analyze the clinical features, morphology and biologic behavior of primary malignant myoepithelioma (MME) of salivary glands.

METHODSThe H&E sections of 16 MME cases were reviewed. Immunohistochemical study using EnVision method for cytokeratin (CK), epithelial membrane antigen (EMA), vimentin, S-100 protein, desmin, muscle-specific actin (MSA), smooth muscle actin (SMA), Myo, proliferation cell nuclear antigen (PCNA), leukocyte common antigen (LCA) and glial fibrillary acidic protein (GFAP) was carried out.

RESULTSOf the 16 patients studied, 6 were males and 10 were females. Their ages ranged from 12 to 65 years (with an average age of 44 years). The tumor occurred predominantly in the parotid gland and minor salivary gland of the palate. Common clinical features included sudden and rapid tumor growth, superficial ulceration, bony destruction and nerve infiltration. Seven of the 16 patients developed local recurrences, while 2 patients had metastasis in the lymph nodes of submandibular or other cervical regions. Most tumors infiltrated adjacent normal salivary gland, adipose, muscular and bony tissues. The extent of local invasion however varied. Histologically, MME showed a wide range of morphologic appearance, with various combinations of clear, spindle, epithelioid or plasmacytoid cells. The tumor cells were atypical and demonstrated high mitotic activity. In this study, 9 cases were composed predominantly of clear tumor cells. Immunohistochemically the tumor cells were positive for CK, EMA, MSA, desmin and S-100 protein.

CONCLUSIONSIn general, MME is a rare and low-grade malignant salivary gland tumor. It carries a low potential for lymph node or distant metastasis but relatively high tendency for local recurrences, resulting in destruction of adjacent soft and bony tissues. The biologic behavior also varies, depending on the site of involvement. Morphologic diagnosis of MME can be difficult in view of the wide spectrum of histologic changes. A definitive diagnosis however is possible with the application of immunohistochemistry.

Adolescent ; Adult ; Aged ; Cytokines ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Myoepithelioma ; metabolism ; pathology ; Neoplasm Recurrence, Local ; Parotid Neoplasms ; metabolism ; pathology ; Retrospective Studies ; Salivary Gland Neoplasms ; metabolism ; pathology ; Salivary Glands, Minor ; pathology

OBJECTIVETo study the infection of human cytomegalovirus (HCMV) and herpes simplex virus type II (HSV-I) and the morphological characteristics of the infected spermatogenic cells in the semen of infertile men.

METHODSWe washed and concentrated the spermatogenic cells obtained from 83 semen samples of infertile men, extracted DNA and then screened HCMV and HSV-II by polymerase chain reaction (PCR). Immunocytochemistry (ICC) was used to detect the expression of correlative virus antigens of the positive semen cells, and the cytology smear was employed to observe the morphological changes of the spermatogenic cells under the microscope after cytology staining.

RESULTSOf all the semen samples, 8 were HCMV positive, 4 HSV-II positive, but none were both HCMV and HSV-II positive. HCMV late antigens were positively and HCMV early antigens negatively expressed in the spermatogenic cells of the 8 HCMV positive cases. In the 4 HSV-II positive cases, 3 were positively and 1 weakly positively expressed. In the semen of the 12 positive cases were found large numbers of immature spermatogenic cells, with different manifestations of apoptosis, such as chromatin pycnosis, vacuoles, damaged nuclear membrane, and apoptotic bodies, but without virus infection-induced specific morphological alteration. Sperm concentration of the positive group was significantly lower than that of the negative (P < 0. 05).

CONCLUSIONSpermatogenic cells infected by HCMV and HSV-II may cause pathologic lesions and affect spermatogenesis. Morphologically, the infected spermatogenic cells may undergo some pathologic alteration, such as apoptosis. The rate of HCMV infection is higher among infertile males with pathologic cells in the semen.

Adult ; Antigens, Viral ; analysis ; Cytomegalovirus ; genetics ; immunology ; Cytomegalovirus Infections ; pathology ; virology ; DNA, Viral ; genetics ; Herpes Simplex ; pathology ; virology ; Herpesvirus 2, Human ; genetics ; immunology ; Humans ; Immunohistochemistry ; Infertility, Male ; pathology ; virology ; Male ; Polymerase Chain Reaction ; Semen ; cytology ; virology ; Spermatozoa ; cytology ; virology

OBJECTIVETo explore the risk factors for Guillain-Barre syndrome.

METHODSCase-control study design was used in 51 cases of Guillain-Barre syndrome, and 51 matched controls. All of the 51 cases in this study had been examined by electrophysiology. Serum IgG antibodies specific for C. jejuni were determined in all the subjects by ELISA. Each case and control were interviewed using an ad hoc questionnaire, including his/her demographic information, onset of the illness, their personal hygiene and so on.

RESULTSThe study showed that Guillain-Barre syndrome was associated with a few factors, such as polio vaccine immunization before onset of illness (OR=7.27), no hand washing after defecation and before meals (OR=6.15). Infection of C. jejuni was strongly associated with the illness (OR=9.5, P<0.001).

CONCLUSIONIt is suggested that occurrence of Guillain-Barre syndrome may correlate to infection of C. jejuni and poor personal hygiene in children.

Adolescent ; Campylobacter Infections ; complications ; Campylobacter jejuni ; pathogenicity ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Guillain-Barre Syndrome ; epidemiology ; etiology ; microbiology ; Hand Disinfection ; Humans ; Immunoglobulin G ; analysis ; Infant ; Male ; Poliovirus Vaccines ; adverse effects ; Risk Factors