Metastatic hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, with the highest incidence in regions with high prevalence of chronic viral hepatitis infection, especially hepatitis B infection. HCC commonly metastasises to lungs, lymph nodes, adrenal gland and bones, including the skull. The overall prognosis of patients with metastatic HCC is poor. Randomised clinical trials are needed, which evaluate new treatment strategies and stratify patients on the basis of recent staging criteria and known prognostic indicators. This review presents a case report that illustrates the distinctive pathological features of metastatic HCC, along with a brief review of pathological features, staging, treatment and prognosis.

Evaluation of the platelet surface by fluorescence flow cytometry.

Flow cytometry has significantly contributed to cell biology, especially with use of tagged monoclonal antibodies. Discovery of specific platelet surface membrane receptors has helped to elucidate the pathogenesis of several platelet related disorders. Concomitantly, monoclonal antibodies to specific receptors have also been developed. Using fluorescent antibody techniques, small populations of platelets with distinct characteristics can be analyzed efficiently. Monoclonal antibodies, e.g., (AP-3), specific for glycoprotein, IIIa and (6DI), directed against an epitope close to the VWF binding site, have already been employed,--the latter by fluorescence flow cytometry. In addition to studies of primary surface membrane disorders, flow cytometry has been applied to measurements of surface immunoglobulin and C3 on individual platelets in autoimmune and alloimmune thrombocytopenia. Flow cytometry may also be utilized for platelet crossmatching. This simple, specific and non-radioactive technique can effectively provide accurate platelet surface data in a small clinical laboratory.

Immunohistopathology of papillary cystadenoma lymphomatosum (Warthin's tumor).

A retrospective study of various benign salivary gland neoplasms was designed to study the frequency distribution and density of immunoglobulins (Igs) located within their various tissue compartments. Buffered-formalin fixed, paraffin embedded sections of Warthin's tumor, cystadenoma, oncocytoma, autoimmune thyroiditis, normal salivary gland, and reactive peripheral lymph node were obtained and processed via the peroxidase-antiperoxidase method following trypsinization to re-expose antigenic sites. The subepithelial and parafollicular zones of Warthin's tumor show an Ig density distribution (IgA greater than or equal to IgG) much greater than IgM, but the relative densities in the germinal center are (IgG = IgM) much greater than IgA. In contrast, the normal salivary gland displays almost exclusively IgA positive cells with only an occasional IgG or IgM positive cell. In general, the three salivary gland neoplasms considered all display a relatively similar frequency distribution with (IgA greater than or equal to IgG) much greater than IgM and much greater densities of all Igs than encountered in the normal salivary gland; however, the densities of IgA and IgG positive cells are greatest in Warthin's tumor. A similar frequency distribution of immunocytes in the parafollicular zone of autoimmune thyroiditis and Warthin's tumor is noted with an increased density of all Igs occurring in autoimmune thyroiditis. A significant increase in the density of IgA immunocytes is noted in the germinal centers of autoimmune thyroiditis. A comparison of Warthin's tumor with a reactive peripheral lymph node shows a marked increase in the density and frequency of IgA in the parafollicular zone in the former lesion, and significant elevations of IgG and IgM in the latter process both in the parafollicular zone and in the germinal centers. No data generated by this study support an autoimmune etiology of Warthin's tumor. Histopathologically, the oncocytoma appears to represent a pathologic entity distinctly different from papillary cystadenoma lymphomatosum. Our data tend to support the hypothesis that Warthin's tumor arises within ectopic salivary gland elements trapped within paraparotid or intraparotid lymph nodes during embryogenesis. The cystadenoma appears to represent a similar pathologic process arising in salivary gland elements independent of lymphoid tissue.

Cystic degeneration and calcification following ischemic paralysis of the leg.

Increased pressure within a closed space which leads to a compromise of the circulation and function of tissues is referred to as a compartmental syndrome. The resulting changes range from the mild reversible ones to extensive necrosis and fibrosis. Rarely, a cystic calcified mass may develop in the affected area years after the onset of ischemia. Two such cases which involve the lower limb have been reported by Gallie. The authors report one new case of late cystic degeneration and calcification following ischemic paralysis of the leg.