Mesotheliomas with deciduoid morphology: a morphologic spectrum and a variant not confined to young females.

Deciduoid mesotheliomas are rare with only four previously reported cases, all affecting the peritoneum of young females. We describe another six cases (three men and three women; age range 52-65 yrs, median 55 yrs; five peritoneal and one pleural). Three patients had an occupational history of asbestos exposure. The deciduoid appearance predominated in four cases, whereas in two it represented a minor component within conventional tubulopapillary epithelioid mesothelioma. All tumors were strongly cytokeratin-positive (including CK5/6) and all showed at least focal staining for thrombomodulin, HBME-1, and calretinin. All were negative for epithelial mucin (D/PAS), CEA, BerEP4, LeuM1 (CD15), CD21, CD35, and S100 protein. Five of six cases (83%) were vimentin-positive and two (33%) were focally positive for alpha-smooth muscle actin. A differential diagnosis of gastrointestinal autonomic nerve tumor (GANT) had been initially considered from the morphology of one case, and we found positivity for some of the "neuronal" markers described in GANTs. This prompted us to apply such a panel to the other five tumors, accepting that the cytokeratin positivity encountered in all of our cases would exclude GANT. All cases of deciduoid mesothelioma (100%) were positive for PGP 9.5 and NSE and four of six (66%) were positive for NKI/C3. Weak focal staining (<5% cells) for synaptophysin was seen in two of six tumors. All cases were chromogranin-negative. All cases examined by electron microscopy showed desmosomes and smooth microvilli without rootlets but no neuroendocrine granules. In conclusion, a deciduoid morphology appears to be part of the histopathologic spectrum encountered in epithelioid mesothelioma. This variant is not confined to female patients and occurs over a wider age range than previously recognized. The overlapping immunophenotype with GANTs illustrates that caution should be exercised when interpreting positivity for "neuronal" markers in this context. An immunohistochemical panel that includes cytokeratins should always be used.

Cellolite (Merocel): a new form of neurosurgical patty. Evaluation of histological responses in rats.

Cellolite and cottonoid were compared with regard to histological reactions provoked when they were left in contact with the rat brain. Pieces of each material were implanted in 27 rats either extra- or intracerebrally for 48 hours or 28 days. Histological findings suggest that the use of Cellolite for neurosurgery would be unlikely to cause adverse reactions any worse than those caused by cottonoid.

Fatal Clostridium perfringens infection of a liver cyst.

We report a case of Clostridium perfringens infection of a pre-existing hepatic cyst leading to a fatal outcome.

Barrier properties of vernix caseosa.

Experiments are described which show that vernix caseosa has a mechanical barrier effect if it is deposited in an unbroken layer. Specific antibacterial properties were not detected in vernix. It is suggested that vernix is best left on a newborn infant because of its mechanical obstruction to bacterial passage.

Haemangioma of the fallopian tube. Case report.

I present the sixth report of a patient with a haemangioma of the Fallopian tube and the first from the United Kingdom. The patient presented with an acute abdomen due to haemoperitoneum.

Cerebellar astrocytomas in children and young adults.

A clinical and pathological review of 43 cases of cerebellar astrocytomas in children and young adults was undertaken. Thirty-one of the 36 surviving patients were examined by computed tomography. Twelve patients with asymptomatic tumour were detected. Histology was necessary to identify the higher risk "diffuse" group, but no histological features helped to identify tumours liable to recur. Improvements in the prognosis may occur with long term CT scanning.

Rhabdoid tumour of the bladder: a histological, ultrastructural and immunohistochemical study.

A rapidly fatal bladder tumour which had the features of a rhabdoid tumour was studied by sequential biopsies and at autopsy. This is the first rhabdoid tumour recorded at this site and the first in which there was co-existent transitional cell carcinoma. The possibility that rhabdoid tumour is histogenetically heterogeneous is discussed.

Carcinosarcoma of the urinary bladder. A light, immunohistochemical and electron microscopical case report.

A case of urinary bladder carcinosarcoma (UBCS) is reported with light, immunohistochemical and electron microscopical findings. The tumour consisted of a squamous cell carcinoma, variable spindle cell stromal elements compatible with fibrosarcoma, and rhabdomyoblasts. Intermediate filament co-expression of cytokeratin and vimentin was shown by immunohistochemistry. Electron microscopy (EM) confirmed the nature of the three components, and indicated some similarities between the three cell-types present. Comparisons with the previous UBCS in the literature are made.

Metastasis of carcinoma to meningioma and glioma.

A case of frontal meningioma harbouring a metastasis from a previously treated breast carcinoma, and a case of metastatic carcinoma into a frontal glioma are reported.

The value of anticarcinoembryonic antigen, human milk factor globulin, and antikeratin antibodies in differentiating mesothelioma from lung carcinoma.

Monoclonal anticarcinoembryonic antigen (antiCEA), human milk factor globulin (HMFG2), and antikeratin antibodies were assessed for their value in the differential diagnosis of pleural mesothelioma (53 cases) and carcinoma of the lung (60 cases) in material from necropsies. In 40 of the cases pleural biopsies were also studied in the same manner. AntiCEA was found to be the best discriminating antibody for most types of mesothelioma; HMFG2 was slightly less valuable but a useful additional tool. Antikeratin was the least useful. For both antiCEA and HMFG2 antibodies, however, the proportion of carcinomas staining was smaller than in previous studies and this, combined with the positive staining of some mesotheliomas, reduces the value of the reactions in the individual case. Medical panels adjudicating compensation claims should not use these reactions as the sole criteria in deciding the origin of the tumours in these cases.

An outbreak of respiratory syncytial virus infection in a continuing-care geriatric ward.

A small outbreak of respiratory syncytial virus infection in a continuing-care geriatric ward during the period December 1982 to March 1983 is reported. It demonstrates that respiratory syncytial virus infection can cause serious lower respiratory tract infection even in patients without any previous history of chest disease.