Neuropathological examination of the alterations of the intrinsic innervation in multiple sclerosis cystopathy.

Morphometric analysis of the innervation pattern of the stromal layer of the urinary bladder was done on biopsies from 88 patients with definite multiple sclerosis (MS). The biopsies were stained for acetylcholinesterase and for S100 protein, and a semiquantitative score was assigned. Nearly 30% of the samples showed increased immunoreactivity for S100, indicating Schwann cell hyperplasia. In 16% a decreased S100 immunoreactivity was found, the significance of which is unclear. More than 90% had normal acetylcholinesterase activity. No correlation could be demonstrated for age, sex, severity and duration of the disease, the presence of cystitis and type of detrusor dysfunction. The finding of altered S100 immunoreactivity in MS bladders could indicate that MS also affects the peripheral nervous system and is not limited to the central nervous system as classically described. This finding warrants further investigations.

[Innervation density in the stroma and the muscular tunica in biopsies of the normal and pathologic bladder]. / La densité de l'innervation dans le chorion et la tunique musculeuse dans des biopsies de vessie normale et pathologique.

Twenty-eight open urinary bladder biopsies were stained using a peroxidase-antiperoxidase technique for S100 to demonstrate the innervation pattern in three different patient groups. The nerve profiles in the subepithelial stroma and in the musculosa were counted and compared. There was a definite correlation between nerve density in both layers. Examination of superficial bladder biopsies is reliable in the assessment of the innervation pattern of neurogenic and non-neurogenic bladder disorders.

Vasoactive intestinal polypeptidergic innervation of human urinary bladder in normal and pathological conditions.

Urinary bladder biopsies from 31 multiple sclerosis patients, 9 diabetics, 5 patients after transtrigonal phenolization and 20 control patients were stained for acetylcholinesterase, S100 and vasoactive intestinal polypeptide (VIP). The VIP immunoreactivity was not decreased in all neuropathic bladders and its depletion was not related to cholinergic depletion. There was no correlation between bladder over- or underactivity and VIP content. VIP can act as a modulator of detrusor function in normal conditions. The significance of its depletion in neurogenic bladders needs further elaboration.

Diabetic cystopathy: neuropathological examination of urinary bladder biopsies.

Neuropathological examination of bladder biopsies was done on 14 patients with severe insulin-dependent adult-onset diabetes and compared with the acetylcholinesterase and S100 staining of 38 control specimens. A decrease in acetylcholinesterase activity, due to axonal degeneration was found in all cases. An increase in S100 positivity was found in the majority and is due to Schwann cell proliferation as a regeneration attempt after demyelination or axonal degeneration. When acetylcholinesterase activity decreases and an S100 density increase is found in a patient with diabetes, this combination is highly suggestive of thorough diabetic cystopathy amenable to early symptomatic treatment.

Endoscopic biopsies for quantitative nerve density evaluation of the urinary bladder.

Nerve density in the lamina propria from endoscopic and open bladder biopsies is compared in normal and pathologic urinary bladders. A semiquantitative appreciation of nerve density is obtained by counting the fibers in a number of high power fields after S100 staining. Nerve density scoring on endoscopic biopsies is reliable and reproducible and can be applied in the assessment of neurogenic and nonneurogenic bladder disorders.

Histochemical assessment of the intrinsic innervation of the normal urinary bladder.

In order to assess the normal intrinsic innervation pattern, an enzyme histochemical acetylcholinesterase and two immunohistochemical (S100 protein and neurofilaments) stainings were done on 38 normal urinary bladder specimens. The nerve density was calculated as a mean number of nerve fibers counted per high power field. S100 staining after adequate fixation proved to be similar to the acetylcholinesterase technique, avoids freezing manipulation, is easier to read and permits normal conventional histological examination. Neuropathology of bladder biopsies is an easily available diagnostic method in current neurourological practice.

Solitary benign schwannoma in the psoas muscle.

Schwannomas, which also are referred to as neurinoma or neurilemmoma, are rare. We report a case of a solitary benign schwannoma in the psoas muscle, which was not associated with von Recklinghausen's disease. The tumor was excised successfully. Its appearance on clinical examination is described, the preoperative investigations and operative findings are presented, and the literature is reviewed.

Isolated condyloma acuminatum of the bladder in a patient with multiple sclerosis: etiological and pathological considerations.

We report a solitary condyloma acuminatum of the bladder without cutaneous, anogenital or urethral involvement in a patient with multiple sclerosis who had an indwelling suprapubic catheter. The lesion was treated by endoscopic resection.

The histological characterization of ALIP in the myelodysplastic syndromes.

Bone marrow biopsies of patients with a myelodysplastic syndrome (MDS) may, in the absence of an increased number of blasts in the bone marrow smears, contain small clusters of immature precursors. The presence of these cell nests, previously described as "abnormal localized immature precursors" or ALIP, bears a strong prognostic value predisposing patients to early death with an increased risk to develop myeloid leukaemia. In order to describe and delineate this histological characteristic more precisely, we compared bone biopsies of patients with MDS, used in these previous studies, with bone marrow biopsies performed for staging procedures in patients with Hodgkin's disease, non-Hodgkin's lymphoma and carcinoma. From this comparison we conclude that immature precursors are readily differentiated from proerythroblasts, myeloblasts and small-sized megakaryocytes, and that they most probably represent precursors of the myelo-monocytic-erythroid series. A clearcut increase in their number, mostly resulting in the formation of small clusters, is only found in biopsies from patients with MDS.

Fibroepithelial polyps of the ureter. Etiology, diagnosis, treatment and pathology.

In order to draw attention to this rather rare condition affecting all age groups, 4 cases of fibroepithelial polyps of the ureter are reported. Conservative surgery is mandatory after adequate preoperative work-up. The pathological findings, incidence and diagnostic and therapeutic modalities are discussed and some etiological factors proposed.

CT diagnosis of larynx chondrosarcoma.

The authors describe a patient with a palpable anterior neck mass and a submucosal swelling at the level of the vocal cords. Computed tomography (CT) revealed a tumour of the laryngeal skeleton. Pathologic diagnosis was a moderately well differentiated chondrosarcoma.

Sonographic appearance of normal lymph nodes.

Normal lymph nodes appear sonographically as somewhat flattened hypoechogenic structures. Chronic inflammation, obesity, and degenerative changes leading to benign fatty replacement of lymphoid tissue are responsible for the variations seen with high-resolution ultrasonography. These fatty deposits, beginning in the center of the lymph node and progressing toward the periphery, are easily recognized as highly reflective defects in the hypoechogenic lymphoid tissue.