Human lymph node morphology as a function of age and site.

Cervical, axillary, cubital, inguinal, popliteal, and mesenteric lymph nodes from subjects of various ages who had died a sudden death were examined histologically. Care was taken to establish by morphometry the proportional distribution in lymph node cross-sections of cortical, paracortical, and medullary areas. In addition, numbers and surface areas of cross-sectioned germinal centres were registered. Important differences related to age and anatomical site of lymph nodes were established by this survey. Germinal centre formation, particularly evident in infants and children, less so in young adults, and often absent in ageing individuals, was most impressive in lymph nodes normally exposed to antigenic stimulation (mesenteric and cervical lymph nodes). Paracortical and medullary areas exhibited a slight but gradual reduction with advancing age. Replacement of lymphatic parenchyma by fat tissue (lipomatous atrophy) was a characteristic of more peripheral lymph nodes usually subjected to little antigenic stimulation, that is, cubital, axillary, and popliteal nodes. It should be emphasised that both age-related and regional differences have to be taken into account in a meaningful functional interpretation of lymph node morphology.

Clonality assessment in blood of patients with mantle cell lymphoma.

The presence of circulating neoplastic cells at diagnosis was assessed in the blood of patients presenting with mantle cell lymphoma (MCL) to determine the feasibility of a diagnostic molecular assay. Blood samples from 16 patients with pathologically reviewed MCL were analysed for the t(11;14)(q13;q32) translocation by the polymerase chain reaction (PCR): 7 (44%) were found positive. The remaining cases were examined by PCR for the presence of circulating neoplastic B-cells by amplifying the third complementarity region (CDR3) of immunoglobulin heavy chain genes and the immunoglobulin light kappa chain deletion rearrangements. A further 7 (44%) patients showed the presence of clonal lymphoma cells, leaving only 2 (12%) of cases negative for circulating lymphomatous cells. This study suggests that there is a high incidence of lymphoma cells in the blood of patients presenting with MCL. PCR for these clonal cells may be diagnostically useful.

[Lymphocytic gastritis]. / Gastrite à lymphocytes.

Lymphocytic gastritis is characterised by an accumulation of lymphocytes in the epithelium of the gastric mucosa. This form accounts for 4.5% of chronic B-gastritis and manifests itself by dyspepsia, anorexia and weight loss. The course is benign, as 12 of 19 patients recovered within 24 to 36 months in Haot's studies. Macroscopically it appears with nodules, erosions, thickened mucosal folds, or diffuse varioliform pattern. The gastric corpus is preferentially involved. The etiology is unknown. Some authors have hypothesized an abnormal immune response to a local antigen, i.e. Campylobacter pylori.

[Blastoma of the lung--a rare malignancy. Case report]. / Das Blastom der Lunge--ein seltenes Malignom. Fallbericht.

Pulmonary blastoma--so called because of its histological resemblance to fetal lung--is a rare malignant neoplasm, which tends to relapse locally and metastasize mainly in the first years, has a poor 5-year prognosis, and shows a potential radio-chemosensitivity. We report our findings and therapeutic approach in a case of a 64-year-old male.

[Sacral chordoma: a consideration in low back pain]. / Sakrales Chordom: bei Kreuzschmerzen daran denken.

We present the case of a sacral chordoma (S3-S5). Its diagnostic problems as well as its pathological properties and the epidemiologic situation are discussed. The therapy and the surgical procedure are outlined.

[Correlation between immuno-morphological parameters of regional lymph nodes and the mortality of patients with stage I and II bronchial squamos cell carcinoma]. / Korrelationen zwischen immunmorphologischen Parametern regionärer Lymphknoten und der Uberlebenszeit operierter Patienten mit bronchialen Plattenepithelkarzinomen der Stadien I und II.

Histological changes in tracheobronchial and bronchopulmonary lymph nodes of patients with operable (i.e. stages T 0/2, N 0/1, M0) bronchogenic squamous cell carcinoma were examined histometrically. Out of 29 patients 10 survived less than 12 months and 19 lived longer than two years after surgery. Quantitive methods were employed for measuring structural changes in lymph node sections at the histological and cellular level. The following parameters reflecting both cellular and humoral immune responses correlated with survival: relative numbers of large lymphoid cells and mitotic figures in the paracortical "thymus dependent") area; volume of the follicular (predominantly B-cell) cortex and volume of germinal centers. Pronounced accumulation of histiocytes or dust-loaded marcrophages in the paracortex and presence of "empty" lymph sinusoids (i.e. without sinushistiocytosis) correlated inversely with survival. Besides the theoretical importance and considerations of a documented immune response, such data could help in identifying high risk groups within the same stage of bronchogenic carcinoma of a given type.

Amyloid-containing renal interstitial cell nodules (RICNs) associated with chronic arterial hypertension in older age groups.

A highly significant correlation is demonstrated between the presence in older persons of medullary renal interstitial cell nodules (RICNs) containing amyloid and increased heart weight indicative of chronic arterial hypertension. By contrast, the population with amyloid-free RICNs 1) showed heart weights comparable to those of controls and 2) had a mean age about 11 years less (56.7 +/- 9.6 vs 68 +/- 12 years) than the group with amyloid-containing RICNs. In a series of 55 autopsy cases presenting with RICNs, no individual was younger than 30 years. In two cases, in which fresh material was available, histochemical reactions suggested that the RICNs contained APUD amyloid. It is speculated that fully functional RICNs may evolve on a compensatory base counteracting an increase in mean arterial blood pressure and that the deposition of amyloid within RICNs could be associated with, or be an expression of, a reduced endocrine function of these structures, finally resulting in the development of arterial hypertension.

[Unusual autoimmune and neoplastic associated diseases in Sjogren's syndrome]. / Ungewöhnliche autoimmune und neoplastische Begleiterkrankungen bei Sjögren-Syndrom.

In an unselected series of 12 patients with Sjögren's syndrome the following autoimmune diseases were observed: severe myxedema due to Hashimotos thyroiditis in four, subclinical thyroid hypofunction in one, diffuse hyperthyroidism in one, glomerulonephritis in two, chronic active hepatitis in one, lupus erythematodes disseminatus in three (one with idiopathic thrombocytopenic purpura), classical rheumatoid arthritis in two. A rare familial occurrence was seen in two sisters. The only male in this group exhibited coexistence of a benign adenolymphoma of the parotid gland (Warthin's tumor) with a malignant non-Hodgkin lymphoma.

[Cytomegalovirus pneumonia in primarily healthy adults]. / Zytomegalievirus-Pneumonie beim primär gesunden Erwachsenen.

The case is reported of an 18-year-old woman hospitalized with severe dyspnea and high temperature. Chest X-ray showed pneumonia with interstitial and air-space consolidation patterns. Serologic tests revealed a cytomegalovirus infection (CMV). The blood findings showed anemia of infectious origin. Liver biopsy was consistent with CMV-hepatitis. CMV-pneumonia in an otherwise healthy patient is extremely rare; a review of the literature revealed only four other cases.

[Localized fibrous tumor of the pleura. 2 case reports and differential diagnoses]. / Der lokalisierte fibröse Tumor der Pleura. Zwei Fallvorstellungen und ihre Differentialdiagnosen.

The localized fibrous tumors of the pleura are rare neoplasms, also known as "benign pleural fibromas" or "localized mesotheliomas", but those names are inaccurate. The tumors are composed of undifferentiated mesenchymal cells, intermediate and differentiated fibroblasts and collagenous interstitial tissue. Their origin is normally the submesothelial layer of the visceral pleura. Mesothelial differentiation is not present. The grading of malignancy doesn't correlate with final outcome, adequacy of surgical excision being the most important factor. This neoplasm may recur but retain its basical histologic features. The positive results for vimentin and negative results for cytokeratin antibodies help to distinguish the localized fibrous tumors from the mesothelioma. We present too cases and their diagnostic possibilities.

[Correlation between endoscopy and histology of 48 cases of superficial stomach cancer]. / Corrélation endoscopie-histologie dans 48 cas de cancers superficiels de l'estomac.

The relationship between different endoscopic (gross appearance, diameter, localization, morphological type according to the Japanese Endoscopic Society) and histological parameters (type of cancer according to Lauren, tumor infiltration, association with metaplastic chronic gastritis) were analyzed retrospectively in 48 patients operated on for early gastric cancer. Endoscopy and histology provided a preoperative diagnosis of malignancy in 89.6% of the cases. With endoscopy alone the results were 23% malignancy, 44% suspicious and 33 benign. The antrum was the preferential site and type III the most frequent form. 62% of early gastric cancers were of the intestinal type and the average age of the patients was higher than for the diffuse type. Metaplastic chronic gastritis was associated in 67% of the intestinal type and in 21.5% of the infiltrating type. The degree of tumor infiltration was related to the diameter of the lesion, irrespective of the histological type. Since a malignant or suspicious lesion was diagnosed in only 67% by endoscopy alone, it is imperative to perform several biopsies of all gastric lesions, including even the smallest: 11 cancers of type III and IIc in this series had a diameter inferior to 1 cm and had been classified endoscopically as benign.

Immunomorphological lymph node changes in patients with operable bronchogenic squamous cell carcinoma.

Histological changes in tracheobronchial and bronchopulmonary lymph nodes of patients with operable (i.e. stages T1/2, N0/1, M0) bronchogenic squamous cell carcinoma were examined histometrically. Out of 29 patients, 10 survived less than 12 months and 19 lived longer than two years after surgery. Quantitative methods were employed for measuring structural changes in lymph node sections at the histological and cellular level. The following parameters reflecting both cellular and humoral immune responses correlated with survival: relative numbers of large lymphoid cells and mitotic figures in the paracortical ("thymus-dependent") area; volume of the follicular (predominantly B-cell) cortex; and volume of germinal centers. Pronounced accumulation of histiocytes or dust-loaded macrophages in the paracortex and presence of "empty" lymph sinusoids (i.e. without sinuhistiocytosis) correlated inversely with survival. In addition to the theoretical importance and considerations of a documented immune response, such data could help in identifying high risk groups within the same stage of bronchogenic carcinoma of a given type.

[A case of metastasizing paraganglioma of the larynx]. / Ein Fall von metastasierendem Paragangliom des Larynx.

The case of a 68-year-old woman who died of a metastasizing paraganglioma of the larynx is reported. The diagnostic problems related with this disease and its relationship with the tumors of the APUD system are particularly discussed.

[Familial myeloproliferative syndrome]. / Syndrome myéloprolifératif familial.

The case histories of three patients with hematologic disorders are reviewed. The patients are members of the same family composed of three brothers and two sisters. Two have osteomyelofibrosis and one essential thrombocythemia. Hematologic, enzymatic, cytogenetic, immunocytologic and immunogenetic investigations allow the following conclusions: - all the 5 siblings have identical blood group and rhesus factor (0+); - there is an HLA identity in the 5 siblings characterized by the alleles: A2, A3, B5, B7 (w4, w6); - the white blood cell alkaline phosphatase is not increased; - no monoclonality can be shown; - the chromosome Ph 1 is absent. In the second (osteomyelofibrosis) and third (essential thrombocythemia) patient an additional chromosome has been found, while the caryotype of the other three siblings, including the first patient with osteomyelofibrosis, is normal.

Distinct kinetic responses in vivo of cortical thymocytes of ageing mice to primary as compared to secondary peripheral antigenic stimulation.

We have studied cellular kinetic changes in the thymic cortex of ageing mice as a function of time after primary and secondary stimulation with aluminum phosphate adsorbed tetanus toxoid via the hind leg footpads. Absolute numbers of DNA synthesizing cortical thymocytes per cross-section of the thymus were computed from combined data obtained by planimetry, counts of cell density (cellularity) and assessment of the labelling index, 1 h after injection of (methyl-3H)-thymidine. The proliferative activity of these cells in the outer fourth of the thymic cortex reached a peak exceeding significantly control values by 45% 14 days after primary, but not secondary, peripheral antigenic stimulation. We conclude that the cortical thymocyte population responded in a distinct manner to the first immunization as opposed to the booster injection of the same antigen.