Solid cell nests of the thyroid: light microscopy and immunohistochemical profile.

The morphological, histochemical, and immunohistochemical findings of seven cases of solid cell nests (SCNs) of the thyroid are described. Light microscopy showed two cell types forming the SCNs, which we refer to as "main cells" and "C cells." In all cases "mixed thyroid follicles" (a unique structure lined by follicular epithelium and epidermoidlike cells) were observed in which the histochemical study confirmed the presence of intraluminal acid mucins. Adult adipose tissue and cartilage were found in one case and foci of cartilage were observed in another case in association with the SCN. Immunohistochemical studies showed positivity of "main cells" for carcinoembryonic antigen (CEA), high- and low-molecular weight keratins, neurotensin, and somatostatin. "C cells" were positive for calcitonin, calcitonin gene-related peptide (CGRP), and chromogranin. The two cell types in SCNs were consistently negative for thyroglobulin. Neuron-specific enolase (NSE)-positive cells were found in the vicinity of the SCN. The unusual association of adipose tissue and cartilage as well as the results of the extended immunohistochemical study in this series provides further support to the belief that SCNs and "mixed thyroid follicles" represent remnants of the ultimobranchial body and should be considered normal components of the thyroid gland.

The rhabdomyoblast in mixed Müllerian tumors of the uterus and ovary. An immunohistochemical study of myoglobin in 25 cases.

Forty per cent of 25 uterine and ovarian mixed müllerian tumors contained stainable myoglobin that was present in the abundant cytoplasm of large rounded tumor cells. Intracytoplasmic cross striations identified rhabdomyoblasts in 32% of the cases, but were difficult to find. The authors believe that the immunoperoxidase technic successfully demonstrates skeletal muscle differentiation in a high proportion of mixed müllerian tumors and may be employed as a suitable diagnostic aid. However, the nonspecific staining of benign and malignant squamous elements should be interpreted with caution.

Solitary fibrous tumor of the thyroid.

A case of solitary fibrous tumor (SFT) of the thyroid in a 43-year-old woman with a multinodular goiter is reported. This is the first case of SFT described in the thyroid. On histologic, immunohistochemical, and ultrastructural examination, the tumor was identical to SFT of the pleura and other organs. Despite its rarity, SFT should be included in the differential diagnosis of spindle-cell tumors of the thyroid, along with anaplastic carcinoma, spindle-cell medullary carcinoma, and several types of mesenchymal tumors.

Neuroblastoma. A study of the clinicopathological features influencing prognosis based on the analysis of 54 cases.

The retrospective analysis of 54 cases of neuroblastoma taken from the files of the Department of Pathology, University of Santiago Hospital, Spain, and the Ludwig-Aschoff Institute of Pathology, University of Freiburg, Germany confirmed the validity and significance of various clinical and histopathological features when trying to establish the prognosis and the proper therapeutic approach in a given case of neuroblastoma. When the age of the patients was compared to survival it was shown that all but three of the patients older than 2 years of age had died from tumor within ten months. In contrast, there was a 37.5% five-year survival rate among patients who were 24 months of age or younger at the time of diagnosis and treatment. The primary tumor was located in the adrenal gland in 27 cases (50%), in 9 cases (17%) the tumor was retroperitoneal but extra-adrenal, and in the remaining 18 patients (33%) the tumor arose from the paravertebral sympathetic ganglia. Adrenal primaries behaved in an extremely aggressive manner as all but three patients with tumors at this location were dead within 18 months. Retroperitoneal extra-adrenal neuroblastomas followed an almost equally poor outcome with only one five-year survivor (11%). In contrast, 49% of the patients with paravertebral neuroblastoma had survived five years and a further 33% were alive with shorter follow-up. According to histological criteria, there were 6 grade I tumors, 15 grade II and 33 grade III tumors in our series. All grade I tumors were clinical stage I at diagnosis and all are alive 2 to 3 1/2 years later.(ABSTRACT TRUNCATED AT 250 WORDS)

Jacalin, another marker for histiocytes in paraffin-embedded tissues.

Jacalin is a lectin which reacts with D-galactose. We have tested jacalin on 75 samples of different formalin- and alcohol-fixed tissues. A consistent cytoplasmic stain of the histiocytes was observed in paraffin-embedded tissues in all cases studied of reactive sinus histiocytosis, macrophages in clear centres of follicular hyperplasia, in tuberculosis granulomas and in osteoclast-like giant cells in a breast carcinoma. We failed to find any clear binding of jacalin to the cells of eosinophilic granulomas, giant cell tumors of tendon sheath, pleomorphic malignant fibrous histiocytomas, Hodgkin's disease, melanomas, nevi or signet ring cell carcinomas of the breast and stomach. It seems that jacalin is a good marker for free histiocytes/macrophages, not for fixed histiocytes and tumors related to them. This lectin might play a role in differential diagnosis with histiocyte mimicking processes.

Intrathyroid salivary gland-type tissue in multinodular goiter.

We report a case of intrathyroid salivary gland tissue in a 66-year-old Caucasian female with multinodular goiter. Lobules of well differentiated seromucinous salivary glands were found in close relationship with cartilage and fat, and intimately associated with normal thyroid follicles and solid cell nests (SCN) of the thyroid gland. This is the first report of non-neoplastic intrathyroid salivary gland tissue. We conclude that this heterotopic tissue probably arises from the SCN as ultimobranchial vestigial structures.

Cardiac echinococcosis with pulmonary embolism.

The case of a 37-year-old Italian man with cardiac involvement by echinococcus granulosus is presented. The patient showed symptoms of severe cardiac failure and died suddenly on cardiorespiratory arrest. Autopsy revealed a ruptured parent hydatid cyst attached to the right ventricular wall and massive embolism, by daughter cysts, of the right branch of the pulmonary artery. Although cardiac involvement is present in only 0.5% to 3% of all cases of echinococcal disease, it represents a very serious clinical condition which is followed by sudden death in 29% of the cases of ruptured cysts.

Sea-blue histiocyte syndrome. A secondary degenerative process of macrophages?

A case of sea-blue histiocyte syndrome occurred in a 5-year-old boy. Associated laboratory findings include increased levels of hepatic phospholipids and glycosphingolipids, increased serum alkaline phosphatase level, and increased 24-hour urine mucopolysaccharide value. Bone marrow and liver biopsies and excision of chronically enlarged tonsillar tissue were performed. Macrophages that stained sea-blue with Wright-Giemsa stain were found in all tissues. Electron microscopic studies showed degenerating histiocytes packed with abundant loosely arranged myelin figures, some containing fingerprint-like cores formed by concentrically arranged lamellae with a periodicity of 45 A. These ultrastructural findings are compared with those obtained in other reported cases of the sea-blue histiocyte syndrome, as well as with those found in other clinical conditions in which degenerative macrophages are present. We conclude that the sea-blue histiocyte syndrome is a clinical entity that is associated with a variety of disease states; this entity is characterized by the presence of degenerating macrophages in various organs.

Granular cell tumor of the eye (myoblastoma): ultrastructural and immunohistochemical studies.

The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.

[Oropharyngeal synovial sarcoma. Report of one case]. / Sarcoma sinovial de orofaringe. Aportacíon de un caso.

Synovial sarcoma is a malignant growth of the soft parts of young people, scarcely of the head and neck. The tumor classic is two-phase composed by epithelial and spindle cells. The AA. report a new case of synovial sarcoma located in the oropharynx and the treatment followed, and discuss as well the histology and the origin of these tumors.

[Neurinoma of the thyroid gland]. / Neurinoma de localización tiroidea.

Schwannomas are solitary neurogenic tumors that arise from cells of the neural sheat. They grow slowly and represent a proliferation of Schwann cells. Extracranial neurogenic tumors of the head and neck are uncommon. We describe a case of solitary cervical schwannoma placed in the thyroid area. And recall the histology, the nerves more frequently involved, diagnostic tests and the treatment of these nervous tumors.

[Mucocele of maxillary sinus]. / Mucocele del seno maxilar.

The term mucocele designates a cyst developing from a sinus mucosa, generally the frontal and/or ethmoidal sinuses. Maxillary sinus localization is exceptional however and raises numerous diagnostic problems in daily practice. The antral mucoceles are potentially destructive lesions, often secondary to Caldwell-Luc procedure. In this article are described in some detail the clinical, radiological and histopathological features of true antral mucoceles.

[Mucoepidermoid carcinoma of the larynx. A case report and review of literature]. / Carcinoma mucoepidermoide de laringe. Aportación de un caso y revisión de la literatura.

A new case of mucoepidermoid carcinoma of the larynx is presented. The microscopic differential diagnosis of mucoepidermoid carcinoma, the several cells stem with its malignancy degrees and its repercussion on prognostic and possible treatments of this rare growth are stressed. A review of the literature is set aside.

[Cholesterol embolism: an infrequent cause of ischemic ulcers of the lower extremities]. / Embolismo de colesterol: una causa poco frecuente de úlceras isquémicas de las extremidades inferiores.

A case of cholesterol embolism with digital ulcerations is reported. Pathologic anatomy, Radiologic images, symptomatology and treatment of such pathology are discussed.