Human pathology
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Because diffuse alveolar damage, bronchiolitis obliterans-organizing pneumonia, and usual interstitial pneumonia are all related to acute lung injury, we postulated that the proliferative activity of fibroblasts and epithelium would be similar in all 3, and that of fibroblasts would be similar to skin scars. Ki-67 staining was assessed in 16 usual interstitial pneumonia, 9 bronchiolitis obliterans-organizing pneumonia, and 8 diffuse alveolar damage cases, 5 incidental fibroblast foci, 5 skin scars, and 5 keloids. The proliferative activity of alveolar macrophages was also measured and compared with that of 10 respiratory bronchiolitis cases. ⋯ Our results suggest different reactions to acute injury in usual interstitial pneumonia and bronchiolitis obliterans-organizing pneumonia compared with diffuse alveolar damage. The similar low proliferative activity of fibroblasts in usual interstitial pneumonia and keloids supports the hypothesis of abnormal wound healing in usual interstitial pneumonia. The high proliferative activity of macrophages in usual interstitial pneumonia suggests a role in the pathogenesis of usual interstitial pneumonia.
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Randomized Controlled Trial Multicenter Study
Randomized comparison of virtual microscopy and traditional glass microscopy in diagnostic accuracy among dermatology and pathology residents.
Virtual microscopy is being used in medical schools to teach histology and pathology. It is also being used in resident education, in-training examinations (dermatology), and certification examinations (pathology). There are, however, few studies comparing its diagnostic accuracy and acceptability compared with traditional glass slides. ⋯ The order of administration of virtual versus glass slides did not affect the percentage of questions answered correctly. Most residents supported the use of virtual microscopy as a learning aid, whereas fewer favored its use in testing (79% versus 44%, respectively). Residents performed similarly in making dermatologic diagnoses using virtual slides compared with glass slides despite the residents' preference for the latter.
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Usual interstitial pneumonia is an almost uniformly fatal form of fibrosing interstitial lung disease. It is the most common idiopathic interstitial pneumonia, and currently, there is no effective therapy. Lung biopsy is often needed for diagnosis, and pathologists must be able to recognize its features and distinguish it from other interstitial lung diseases that have a better prognosis and a more favorable response to therapy. This review is an attempt to clarify the diagnostic pathologic features of usual interstitial pneumonia and to provide guidelines for its distinction from other interstitial lung diseases that enter the differential diagnosis.
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The major differential diagnostic problem presented by atypical polypoid adenomyofibroma (atypical polypoid adenomyoma) (APA), which usually affects young women, is the exclusion of well-differentiated endometrial carcinoma invading the myometrium. This distinction, however, is of great clinical importance from the standpoint of treatment because reproductive conservation is feasible for patients with APA. Recently, CD10, known to be a marker of endometrial stromal cells, was reported to be also expressed in cells immediately surrounding the neoplastic glands invading the myometrium [Am J Surg Pathol 27 (2003) 786-789; Mod Pathol 16(1) (2003) 22-27]. ⋯ In conclusion, this study demonstrated differences in the CD10 immunoreactivity or immunostaining pattern between the stromal components of APA and myoinvasive endometrial carcinoma. This difference should lead to a more accurate diagnosis of APA (pseudo-myoinvasive lesion). Furthermore, the histogenesis of APA may perhaps be explained by "myofibromatous metaplasia" of the endometrial stromal cells.