Insertion and recovery of a new retrievable vena caval filter. Work in progress.

A new retrievable inferior vena cava (IVC) filter was tested in nine pigs. Insertion was through a 14 French sheath using both the femoral and jugular approaches. All insertions were successful, and there was a 100% postinsertion IVC patency rate (8/8 pigs at one week and 1/1 pig at one month). Addition of an apical hook to the filter design allowed transjugular retrieval of two filters at one week postinsertion. Three of nine filters migrated to the upper IVC. The filter's design allows paraxial blood flow despite trapped thrombus and inhibits filter tilting. In vitro, the filter captured 95% to 100% of 5 X 5 mm clots. If problems with migration can be solved, the new filter may provide effective short- and long-term prophylaxis against pulmonary embolism.

Correlation between presence of clonal rearrangements of immunoglobulin heavy chain genes and B-cell antigen expression in Hodgkin's disease.

Southern blot analysis of Hodgkin's disease (HD), although often compromised by the small number of abnormal cells present in the tissue, have tended to favor a B-cell derivation of the Hodgkin's and Reed-Sternberg (HRS) cells in cases of nodular sclerosis (NS) and mixed cellularity (MC) Hodgkin's disease. Eighteen frozen and 29 paraffin-embedded sections of lymph node specimens from 29 patients with pretreatment HD (22 NSHD and 7 MCHD) were studied by molecular analysis and immunohistochemistry to determine the phenotype of HRS cells. All cases were reviewed and showed typical morphology and CD45-, CD30+, CD15+, BLA.36+ HRS cells. In 11 of 29 (38%) cases, HRS cells were reactive with at least one B-cell marker (CD20, CD79a, MB2), 7 of 29 (24%) cases showed reactivity with the T-cell marker CD3, and 11 of 29 (38%) cases displayed a "null" phenotype. By using a polymerase chain reaction (PCR) and consensus primers for the V and J regions of the immunoglobulin heavy chain (IgH) gene, the authors were able to detect B-cell clonality in 9 of 18 (50%) frozen samples of HD analyzed. IgH gene rearrangement was present in 8 of 15 (53%) NSHD and in 1 of 3 (33%) MCHD. In five of nine (56%) of these cases, HRS cells were reactive with at least one B-cell marker, whereas one case expressed the T-cell marker CD3. The other three cases with IgH gene rearrangement showed a "null" immunophenotype. IgH gene analysis was negative in all remaining CD3+ cases and in two other cases that expressed B-cell markers by immunohistology. Southern blotting failed to detect rearrangement of the T-cell receptor beta-chain gene and immunoglobulin heavy and light genes in any of these cases. The results show that PCR represents a specific and sensitive technique for the detection of IgH gene rearrangements in cases of Hodgkin's disease. The results also suggest a lymphoid B-cell derivation of HRS cells in a high proportion of the cases.

Benign müllerian lymph node inclusions. An unusual case with implications for pathogenesis and review of the literature.

Endosalpingiosis with psammoma bodies within an intramammary lymph node presented as microcalcifications on mammography in the right breast of a 64-year-old woman. The radiographic differential diagnosis included primary breast carcinoma. The histologic differential diagnosis included metastatic papillary carcinoma, particularly of thyroid origin. To our knowledge, this is the first reported case of endosalpingiosis occurring above the diaphragm. The unusual location of these inclusions has relevant implications concerning their pathogenesis. Moreover, it is important for pathologists to be aware that endosalpingiosis may occur and mimic carcinoma at sites distant from the female pelvis.

Epithelioid hemangioendothelioma of soft tissue: report of a case with ultrastructural observations.

The ultrastructure of an epithelioid hemangioendothelioma arising in the soft tissues of the neck of an 18-year-old female is reported. Comparison with similar tumors in other sites from the authors' electron microscopy files indicates that diffuse nonspecific intermediate filaments, pinocytotic vesicles, intracytoplasmic lumens, and pericytic cells are frequent but variable features of this neoplasm.