Immunoreactive endometritis.

A benign polyclonal lymphoid proliferation of the endometrium which bears morphological resemblance to the malignant lymphoma is found among women with bleeding disturbances. Seven previous cases have so far been reported in the literature. A retrospective examination of 11,648 endometrial specimens revealed 287 examples of chronic endometritis (2.5%) of which 29 displayed lymphoid proliferation. We found no evidence of malignant haematologic disorder after a median observation of 68 months and no positive association with prior or present infectious disease. Histological follow-up of ten patients showed that changes could persist for up to 12 months. We name this benign condition 'immunoreactive endometritis'.

Interstitial nephritis and glomerulonephritis in visceral leishmaniasis in a dog. A case report.

Renal involvement characterized by interstitial nephritis and glomerulonephritis is reported in a case of visceral leishmaniasis in a dog. Focal interstitial inflammatory infiltrates including lymphocytes and plasma cells together with collections of histiocytes containing Leishmania donovani organisms were found in the renal cortex. The glomeruli showed diffuse mesangial cell proliferation, thickening of the capillary wall and focal, segmental glomerulosclerosis. By electron microscopy, finely granular electron dense deposits were shown in subendothelial, intramembranous as well as subepithelial locations. It is suggested that the interstitial nephritis was caused by the presence of parasitic elements in the renal interstitium, whereas the glomerular involvement may have been due to deposition of antigen-antibody complexes.

Identification of Epstein-Barr virus-infected cells in tonsils of acute infectious mononucleosis by in situ hybridization.

In situ hybridization with 35S-labeled Epstein-Barr virus (EBV) probes was applied to paraffin sections of tonsils from seven patients with clinical, serologic, and morphologic evidence of acute infectious mononucleosis. EBV genomes were demonstrated in activated lymphoid B blasts in the interfollicular and perifollicular zones in all these cases. However, in no case could EBV be identified in epithelial cells. These results are at variance with the current concept which attributes a central role to the tonsillar epithelium in primary EBV infection.

Demonstration of in vitro synthesis of human papilloma viral proteins from hand and foot warts.

HPV particles purified from [35S]-methionine labeled and unlabeled halves of single hand and foot warts have been fractionated into empty, light full, and heavy full particles by buoyant density gradient centrifugation, and their proteins analyzed by two-dimensional gel electrophoresis (IEF and NEPHGE) and visualized by either fluorography or silver staining. The L1 coat protein (54 Kd) was found in trace amounts in unmodified and slightly modified forms in the labeled empty and light full particles but could not be detected in the labeled heavy particles. L1 appeared to exist in the three unlabeled particle types in differentially modified forms. A putative L2 protein was also found to be modified (74-80 Kd) and was found preferentially in the unlabeled heavy full particles. The commercial cross-reactive BPV antibody recognized a labeled 58-Kd protein found predominantly in the empty and light full particles and a pair of proteins (41-42 Kd) found unlabeled in the heavy full particles. Besides L1, there were several other proteins (IEF 40 Kd; NEPHGE 42, 38, and 36 Kd) which were detected labeled in the empty particles and in increasing unlabeled amounts in the light full and heavy full particles. Four proteins (IEF 66, 13 and 11 Kd, and NEPHGE 9 Kd) were found exclusively in the full particles and may be involved in packing the viral genome. These observations suggest that a virus particle assembly pathway exists from the empty particles, via the light full, to the mature heavy full particles.

[Acute tonsillectomy in infectious mononucleosis]. / Akut tonsillektomi ved mononucleosis infectiosa.

Enlargement of the pharyngeal tonsils in infectious mononucleosis (MI) is frequently an important component of the clinical picture but pronounced obstruction of the upper respiratory passages is rare. An analysis of 11 cases of infectious mononucleosis with varying degrees of pharyngeal obstruction is presented. During the acute phase of the disease, tonsillectomy was performed and also adenoidectomy in four of the cases. The patients improved rapidly after the operation and were discharged after an average of four days. No noteworthy complications of the operation occurred. An unexpectedly great number of cases of abscess formation were found at operation. Histological examination of the tonsils revealed changes in the lymphoid tissue which were characteristic but not specific for infectious mononucleosis together with extensive necrosis of the tonsillar surface. On the basis of this investigation, the authors consider that acute tonsillectomy is indicated in infectious mononucleosis with threatening occlusion of the upper airway and in cases of suspected peritonsillar abscess. In cases of slight or moderate respiratory obstruction, acute tonsillectomy may be considered in the therapeutic deliberations if the course of the condition is protracted and steroid treatment does not have the desired effect.

Future trends in cervical cancer.

The identification of the close association of certain types of human papillomavirus with the development of cervical cancer should lead to an extensive revision of appropriate health policies. Having taken into account the drawbacks inherent in the existing data (stemming from the use of varying nomenclature, diagnostic methods and reliability, registration and screening practices) it is possible to conclude that the incidence of HPV infections, all premalignant and malignant stages of cervical cancer are, or will soon be, increasing in several countries. This rate of increase is fastest for the younger age groups and is despite the introduction of various forms of screening. These trends therefore indicate an urgent need to adopt policies to avert an unnecessary increase in fatalities due to cervical cancer. It is therefore recommended to: (1) establish a routine diagnostic method which can identify either the type of HPV present or the lesions which are progressing; (2) determine the incidence of HPV infections in the general population; (3) disseminate to medical personnel, teachers, and other members of society existing knowledge concerning the dangers associated with this virus and relevant to preventing its further spread; (4) introduce an effective population screening campaign for all sexually active women, preferably involving a yearly examination at a colposcopy clinic; (5) intensify basic and applied HPV research, especially that which could lead to a deeper understanding of viral transmission and infection, identification of cofactors which promote cervical lesion progression, or to the production of a vaccine.

Periferal cystic hyperplasia of the prostate gland.

Cystic transformation of the periferal prostate affecting at least 10 cm3 of tissue was found in 19 out of 300 consecutive prostatic glands at autopsy. The etiology is probably multifactorial and no correlation is found with nodular hyperplasia or carcinoma. Periferal cystic hyperplasia may be a cause of palpatoric enlargement of the prostate and thus may be a differential diagnostic possibility to nodular hyperplasia or cancer.

Prostatic calculi.

The presence of calculi in 300 whole prostates from consecutive autopsies were investigated by the Faxitron imaging technique. Calculi were found in 99% of the prostates, their number and size increasing with age. They were mainly localized in the ducts in the borderzone between the middle lobes and the periferal prostate posterolaterally, but often some were also found anteriorly in the centreline. Calculi were never seen in the middle lobes. We found no statistically significant relation between the number, size or localization of calculi and other morphological or pathological parameters. Prostatic calculi seem to be a part of the normal process of aging, and do in only exceedingly rare cases assume any clinical importance.

The type of human papillomavirus present in cervical infections can be determined by the occurrence of specific marker proteins.

Four different proteins have been identified on high resolution two dimensional gels of [35S] methionine labelled human cervical biopsies whose expression correlates with the presence of papillomavirus. They are all basic proteins having molecular weights in the region of 48 to 50 kd and are normally expressed individually in different lesions unless the lesion results from a co-infection of two virus types. Comparison of the occurrence of these marker proteins with the actual HPV type present, determined by in situ filter hybridisation, has shown that two are found exclusively with HPV types 6/11 while the other two are found with types 16/18.

Collagenous colitis.

Repeated colonic and rectal biopsies from a 47-year-old woman with chronic watery diarrhoea showed an approximately 50 micrometer thick subepithelial band-like collagenous deposit. The histopathological and clinical picture was consistent with the recently described condition of 'collagenous colitis'.

Gastric carcinoma I. The reproducibility of a histogenetic classification proposed by Masson, Rember and Mulligan.

The purpose of the present paper has been to examine the reproducibility of the classification of gastric carcinomas, as proposed by Mulligan and Rember. Two microscopic slides from each of one hundred randomly selected specimens of gastric carcinoma, obtained by gastrectomy or gastric resection, were classified independently by both authors. Neither of the authors knew which slides originated from the same specimen. The inter-examiner reproducibility rate was 79 per cent. The reproducibility rates of the diagnoses with two independent slides from the same tumour was 74 per cent with examiner I and 80 per cent with examiner II.