High-performance liquid chromatography accelerator mass spectrometry: correcting for losses during analysis by internal standardization.

A method was developed to account for analytical losses of (14)C-analyte when determining the concentration in biological samples using chromatographic separation and analysis by accelerator mass spectrometry. From the equations of J. Vogel and A.H. Love (in: A.L. Burlingame (Ed.), Methods in Enzymology, Academic Press, New York, 2005), new equations were derived to describe the isotopic dilution of a chromatographically isolated (14)C-analyte. The analytical recovery for each sample was determined by the use of the UV response for nonlabeled analyte, as an internal standard against a standard curve. The slope of the curve was substituted into the equations to provide a method of accurately determining the analyte concentration.

Cystic renal cell carcinoma: arose as a simple cyst, recurred repeatedly as a multicystic mass and finally presented as a solid mass.

An unusual case of cystic renal cell carcinoma in a 70-year-old Japanese male is reported. He had had a simple renal cyst removed 1 year ago. On presentation the right kidney was surrounded by multiple translucent cysts, which varied in size from 1 to 50 mm. The cyst walls were lined by single-layered cuboidal epithelium. The differential diagnosis included cystic mesothelioma, cystic lymphangioma and multicystic dysplastic kidney. An immunohistochemical and ultrastructural study and flow cytometric analysis of DNA ploidy were performed. The tumor was differentiated to such an extent that it was difficult to diagnose as carcinoma; however, it recurred repeatedly. Three and a half years after initial presentation the tumor had invaded the ileum with the pathological change to be almost solid when viewed grossly and, microscopically, showed tubulo-papillary structures in addition to a cystic pattern. The DNA ploidy pattern revealed a near-diploid aneuploid in the early specimen and a polyploid aneuploid in the last specimen.

Clinicopathologic study of 97 cases of small renal cell carcinomas using DNA flow cytometric analyses.

The incidence of small renal cell carcinomas (RCC) has increased recently as diagnostic imaging techniques have improved. The indications for partial nephrectomy for small RCC confined to the kidney are still controversial. Ninety-seven small RCC 2.5 cm or smaller, including incidental, occult, and dialysis associated carcinomas obtained at surgery or autopsy were examined. Various clinicopathologic parameters were assessed and survival was analyzed using the Kaplan-Meir method. Seventy-eight cases were incidental carcinomas. Carcinomas caused death in five cases, four of which had initial signs of metastatic disease. Differences in survival between patients with expansive and invasive (intermediate and infiltrating) growth patterns, solid and other structural patterns, clear and other cell types, grade 1 and higher grades of nuclear atypia, and with and without lymph node metastasis were statistically significant. All surgical cases were alive except one who died of another disease. Poor prognostic factors seen in five fatal autopsy cases included invasive growth pattern, solid structural pattern, spindle cells, grade 3 nuclear atypia, and Bellini duct carcinoma. Small RCC may be treated with partial nephrectomy provided they do not show these features, although there is low risk of recurrence or development of de novo cancer.

Endovascular papillary angioendothelioma-like tumour associated with lymphoedema.

A case of endovascular papillary angioendothelioma-like tumour associated with lymphoedema is described. Microscopically, the tumour was composed of anastomosing vascular channels, some of which contained papillary projections, producing tuft-like or glomeruloid appearances. The dermis also showed moderate lymphoedema and lymphocytic infiltrate. The tumour resembled endovascular papillary angioendothelioma but also had several features that differed from typical examples: occurrence in an old patient and less prominent endothelial hobnail features and lymphocytic infiltrate. Three types of proliferating cells were observed: 1 mature flattened endothelial cells, which were strongly positive for endothelial markers (factor VIII-related antigen, CD31, CD34) and bound ulex europaeus agglutinin 1;2 immature endothelial cells with round nuclei and vacuolated or pale cytoplasm, which were strongly positive for CD31 and muscle-specific actin (HHF35) and focally positive for other endothelial markers; and 3 stromal spindle cells in papillary or glomeruloid areas, which were positive for vimentin, HHF35, and alpha-smooth muscle actin but negative for desmin. The tumour was diploid by flow cytometry. The patient was well without disease twelve months after the excision. We postulate that this tumour was caused by circulatory disturbance, namely lymphoedema associated with syringomyelia and a Charcot's joint.

Antigenicities of enteropathogenic Escherichia coli, lysozyme, and alpha-1-antichymotrypsin on macrophages of genitourinary malacoplakia.

Seven cases of genito-urinary malacoplakia were analyzed histologically, ultrastructurally and immunohistochemically in a comparison with two cases of xanthogranulomatous pyelonephritis. Immunohistochemically, von Hansemann cells and Michaelis-Guttmann bodies, both hallmarks for the diagnosis of malacoplakia, showed a common antigenicity for enteropathogenic Escherichia coli as cytoplasmic granules of varying sizes. These microscopic manifestations corresponded ultrastructurally to a series of phagolysosomal degradations of coliform bacilli. Serogroups against E. coli OK antigens, which were positive for malacoplakic cells, were not confined to a particular group. Macrophages of xanthogranulomatous pyelonephritis did not show the E. coli antigenicity. Antigenicity of lysozyme and alpha-1-antichymotrypsin on the von Hansemann cells was equivocal, but these enzymes were strongly positive on macrophages of xanthogranulomatous pyelonephritis. The macrophages of both malacoplakia and xanthogranulomatous pyelonephritis were positive for antihuman macrophage antibody. These results indicate that malacoplakia depends mainly on infection by a non-specific strain of enteropathogenic E. coli and may arise from defective digestive enzyme activity of infiltrating macrophages. Immunohistochemical analysis using antisera against E. coli OK antigens, lysozyme and alpha-1-antichymotrypsin was useful in identifying the prediagnostic stage of malacoplakia and in differentiating the lesion from xanthogranulomatous pyelonephritis.