Human pathology
-
Renal biopsy specimens from patients with systemic lupus erythematosus (SLE) rarely show changes that are pathogenetically and morphologically unrelated to SLE. The morphology and behavior of these nonlupus nephritides are not well known. Two hundred fifty-two renal biopsies performed on 224 patients with SLE collected from 3,036 native kidney biopsies performed between 1975 and 1998 were reviewed, and those that showed nonlupus nephritides (index biopsies) were selected for studies. ⋯ Nonlupus nephritides may occasionally be encountered in SLE patients, regardless of clinical or serologic disease activity. These renal lesions display a broad morphologic spectrum in which FSGS seems most frequent. Renal biopsy plays a crucial role in identifying these lesions, which may have prognostic and therapeutic implications distinct from those of lupus nephritis.
-
Eleven cases are described of an unusual, benign, fibro-osseous lesion of rib previously reported under a variety of designations, including painless fibro-osseous lesion resembling osteoid osteoma, symmetrical fibro-osseous dysplasia, focal Erdheim-Chester disease, and fibro-osseous pseudotumor. All patients were adults, most of whom were asymptomatic, the lesion discovered by bone scans done to rule out metastatic disease. A single rib was involved in eight patients and multiple ribs in three. ⋯ Histologically, all lesions showed a bland fibrous stroma in which resided an anastomosing network of bone trabeculae, having a zonal pattern of maturation from metaplastic woven to mature lamellar bone, with or without an associated xanthomatous component. Seven patients had a history of previous trauma, three with fractured ribs. Considering the relative infrequency of solitary rib lesions attributable to metastatic disease, it is proposed that in most cases there is no need for a diagnostic rib resection for these incidentally discovered, posttraumatic reparative lesions.
-
Comparative Study Clinical Trial
Colonic histopathology in untreated celiac sprue or refractory sprue: is it lymphocytic colitis or colonic lymphocytosis?
Colonic histopathology in some patients with untreated celiac sprue and refractory sprue has been said to be indistinguishable from lymphocytic colitis, but there have been no objective comparisons on which this is based. The purpose of this study was to determine the prevalence and to characterize the nature of colonic histopathology at the time of diagnosis in patients with celiac or refractory sprue. Colonoscopic biopsy specimens obtained at the time of diagnosis from 16 patients with celiac sprue, six patients with refractory sprue, nine patients with lymphocytic colitis, and five normal controls were analyzed blindly by histological and morphometric methods, quantitating the number and specific subtypes of inflammatory cells within the lamina propria and epithelium. ⋯ However, colonic intraepithelial lymphocytes in lymphocytic colitis were mostly CD8-positive, whereas those in the colitis of refractory sprue rarely were. Mild colonic lymphocytosis in patients with untreated celiac sprue should be distinguished from lymphocytic colitis by the lack of surface epithelial abnormalities, the lack of increased cellularity of the lamina propria, and the lack of ongoing watery diarrhea after treatment with a gluten-free diet. In contrast, colonic histopathology in refractory sprue is indistinguishable from lymphocytic colitis, although immunohistochemical differences do exist.
-
MOC-31 is a monoclonal antibody that has recently become commercially available that recognizes an epithelial-associated, transmembrane glycoprotein often expressed in epithelial tumors. Although some authors have indicated that MOC-31 immunostaining can assist in distinguishing epithelial mesotheliomas from metastatic adenocarcinomas to the pleura, others have concluded that this marker has no value in separating these conditions. ⋯ The staining in the two positive mesotheliomas was restricted to a few cells, in contrast to the pulmonary adenocarcinomas and most of the other carcinomas where it was often strong and diffuse. It is concluded that MOC-31 can be useful in separating epithelial pleural mesothelioma from pulmonary adenocarcinoma or from other epithelial malignancies involving the pleura.
-
Recent information is limited regarding pathological features of the malignant lymphomas of Africa, other than Burkitt's lymphoma. In this study, we apply modern techniques and nomenclature to classify 73 lymphomas from a central histopathology laboratory serving 40 mission hospitals in Kenya. We were particularly interested in the frequency of recently recognized lymphomas and the incidence of Epstein-Barr virus in various lymphoma subtypes. ⋯ Of note, none of five Burkitt's-like lymphomas expressed EBER 1. One of two informative cases of peripheral T cell lymphoma, and four of nine cases of Hodgkin's disease were EBER 1 positive. In summary, T cell lymphomas and recently recognized B-lineage non-Hodgkin's lymphoma subtypes do not appear to be particularly common in East Africa.