Histopathology
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Comparative Study
Morphological and immunohistochemical investigation of non-Hodgkin's lymphoma combined with Hodgkin's disease.
Twenty cases with a morphological picture highly suspicious for a combination of non-Hodgkin's lymphoma and Hodgkin's disease were investigated. The infiltrates of Hodgkin's disease differed from those of non-Hodgkin's lymphoma in their cellular component of Hodgkin and Sternberg-Reed cells and the irregularity in the fibre pattern. Based upon histological and immunohistochemical criteria the 20 cases were divided into three groups. ⋯ Group 3 (n = 5) consisted of four chronic lymphocytic leukaemias of B type and one lymphoplasmacytoid immunocytoma. In these cases no combination with Hodgkin's disease could be diagnosed apart from the presence of partially CD15 positive Hodgkin and Sternberg-Reed cells. The following conclusions were drawn: anti-CD15 (LeuM1 and 3C4/C3D-1) can neither confirm nor exclude Hodgkin's disease since, while they do not detect Hodgkin and Sternberg-Reed cells in all cases of Hodgkin's disease, they do recognize Hodgkin and Sternberg-Reed cells in some B-cell lymphomas; anti-CD30 (Ber-H2) reacted with Hodgkin and Sternberg-Reed cells in all cases of Hodgkin's disease and also detected these cells in cases of non-Hodgkin's lymphoma.
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The clinical, morphological and immunological findings in nine cases of relapsing lymphocyte predominance Hodgkin's disease (LPHD) are examined. Six patients had initial biopsies demonstrating nodular lymphocytic and/or histiocytic (L&H) LPHD; Leu-M1 was not expressed by any of the atypical cells in these cases. All six demonstrated one or more recurrences of nodular L & H LPHD; four are currently free of disease, one died of non-Hodgkin's lymphoma and another died of leukaemia. ⋯ The initial biopsy from the final patient was histologically interpreted as focal involvement by LPHD, but interfollicular Hodgkin's disease was considered after the Leu-M1 stain revealed additional atypical cells. The disease relapsed and the patient died with typical nodular sclerosing Hodgkin's disease. The pattern of the relapses supports the concept that the histological entity of LPHD may include several distinct clinicopathological subgroups.
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Adult respiratory distress syndrome (ARDS) represents a common pathway of damage to the lungs by a wide variety of different agents. The important aetiological factors and mechanisms of lung injury are considered. ⋯ Probably the most important of these is oxygen. This gas is said to produce interstitial pulmonary fibrosis but this concept is once again questioned.
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A clinicopathological correlation of the lungs on 68 cases dying from burns was carried out. The patients were divided into two main groups. Those in which the burns were the main cause of death (30 cases) and the others that had other serious underlying pathology as well as burns (38 cases). ⋯ Interstitial fibrosis was present in only 8/30 cases where burns were the main cause of death, and in some of these there were other causes for the fibrosis. No correlation was found between the presence of hyaline membranes, interstitial fibrosis and the percentage or duration of oxygen therapy. These findings once again question the validity of the concept of oxygen toxicity in man.
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The structure of bronchial plugs was examined in 12 lobectomy specimens from patients with bronchocentric granulomatosis and mucoid impaction, two bronchial biopsies from patients with mucoid impaction, sections from one post-mortem showing evidence of mucoid impaction and bronchocentric granulomatosis as well as aspergilloma with tissue invasion and from post-mortems on eight patients who had died during a persisting exacerbation of their asthma. In both mucoid impaction and asthma eosinophils were arranged in layers within the mucus, but the pattern of lamination was different in the two groups. In asthma the layers of eosinophils appeared as whorls and eddies. ⋯ The histological appearance of even small fragments of such plugs is diagnostic of allergic bronchopulmonary fungal disease with mucoid impaction. In all our cases bronchocentric granulomatosis appears to have been a complication of allergic bronchopulmonary aspergillosis with mucoid impaction. The clusters of inspissated eosinophils so typical of the peripheral lesion of bronchocentric granulomatosis appear to be fragments of the mucus plugs formed in the larger bronchi.