Objective To investigate the microenvironment of the thymus on lymphocytes, dendritic cells and epithelial cells were studied in patients with myasthenia gravis.Methods (1) The thymus specimens of 25 cases were examined using light microscopy,in which 10 were males,15 females with an average age of 31 years old. The lymphoid tissue with proliferation was in 13 cases, without proliferation in 12 cases. Additionally, 7 cases had congenital heart disease (the average age was 27 years old) and the thymus of an infant (1 case) was examined. (2) Immunohistochemical staining for CD1a?CD4?CD8?CD20?CD45RO?S 100?CKPan and EMA were performed onto the specimens. Some of them with positive dendritic cells on S 100 and CD1a were counted. Results (1) It showed that the positive cells of CD1a located at cortical areas of the thymus with or without lymphoid tissue proliferation in MG and non MG cases. However, there were some positive cells in the medulla, Hassall corpuscles and the vascular space areas of the thymus. (2) The CD4 staining was negative. (3) The expression of CD8 and CD45RO was expressed in the medulla, peripheral areas of the Hassall corpuscles and vascular space of the thymus. (4) CD20 was expressed in the medulla and the germinal central areas. (5) The expression of S 100 for dendritic cells were 23.5 and 47.5 per 100 mm 2 in both having medullary follicular hyperplasia and no follicular hyperplasia groups. The CD1a were 2.1, 3.8 per 100 mm 2, respectively. The statistic was significant as compared with both groups with or without proliferation of thymus medulla. (6) The expression of CK was located in the cortex, medulla and Hassall corpuscles. But EMA, CEA were negative. Conclusions (1) There were expressions of suppressive T cells (CD8) and B lymphocytes (CD20) with or without the thymus medullary lymphoid follicular hyperplasia. (2) The changes of numerous quantity of the dendritic cells on the thymus were displayed which showed a relation to the proliferation of T, B lymphocytes and the formation of germinal central of thymus.It suggested that the dendritic cells and the other stromal cells of the thymus may serve as an important role in MG occurrence.

Objective　To analyse the clinical manifestations, pathoogical and immunohistochemica l features of 9 cases of primary cutaneous CD30-positive anaplastic large cell ly mphoma (ALCL) in order to improve the criteria for its early and differential diagnosis. Methods　 Histopathological method was used to study the morphological characteristics. Immunohistochemical stainings (SP or ABC method) for leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelium membran e antigen (EMA), cytokeratin (CK) and HMB45 were applied to the routine para ffin sections of all the 9 cases. Results　 The 9 cases of primary cutaneous CD30-pos itive ALCL consisting of 6 males and 3 females, aged 31 to 84 years (mean 58.2 years). All patients presented with subcutaneous masses or papular eruptions on lower trunk and extremities. Histopatholoically, the lesions were composed of nu merous large round, oval or pleomorphic cells with abundant cytoplasm, amphophil ic or basophilic, and large nucleus with distinct nucleolus. Mitosis was often o bserved. Multinucleated giant cells and Reed-Sternberg cells may be seen. The n e oplastic cells displayed positive antigen markers for CD30 in 9 cases, 6 positiv e for CD45RO and 3 cases negative for both CD45RO and CD20. Two patients died of metastasis, 2 patients experienced recurrence and 5 patients still well during follow-up. Conclusions　 Primary cutaneous CD30-positive ALCL is a morphologically distinctive neoplasm with a comparatively favorable prognosis. This tumor can be differentiated from other malignant tumors on the basis of histopathologic feat ures and positive CD30 which is of significance.

OBJECTIVETo examine 10 cases with primary cutaneous CD30-positive anaplastic large cell lymphoma (ALCL), analyze their clinical manifestations and pathological and immunohistochemical features, and improve early diagnosis of this disease.

METHODSWe studied the morphological characteristics of primary cutaneous CD30-positive ALCL using histopathological methods. Leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelial membrane antigen (EMA), cytokeratin (CK) and HMB45 antibodies were used to determine the expression of their respective antigens from routine paraffin samples of the patients.

RESULTSTen patients (7 men and 3 women, aged 31 to 84 years) complained of subcutaneous masses or papular eruptions over their lower trunks and extremities. Histopathologically, the lesions were composed of numerous large round or oval pleomorphic cells. The cytoplasm was usually abundant, amphophilic or basophilic, and finely vacuolated. Nuclei were commonly eccentrically localized and lobated or horseshoed in shape, and multinucleated giant cells and Reed-Sternberg-like cells were seen. Nucleoli were generally multiple and large. Of the 10 patients, tumor cells displayed positive antigen expression of CD30 in all cases, positive CD45RO in 6 cases, positive CD20 in only 1 case, but negative CD45RO and CD20 expressions in 3 cases. Two patients died at 7 weeks and 3.4 years of follow-up, respectively.

CONCLUSIONOur study highlights the importance of histopathologic features and positive CD30 staining for differentiation of this disease from other malignant skin tumors.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-1 Antigen ; analysis ; Leukocyte Common Antigens ; analysis ; Lymphoma, Large-Cell, Anaplastic ; diagnosis ; immunology ; pathology ; Male ; Middle Aged ; Skin Neoplasms ; diagnosis ; immunology ; pathology