Langerhans Cell Sarcoma: A Case Report Demonstrating Morphological and Immunophenotypical Variability within a Single Lesion.

Langerhans cells are antigen presenting dendritic cells and tumours arising from these are rare. The tumours arising from these dendritic cells are divided into two categories according to a WHO classification: Langerhans cell histiocytosis and Langerhans cell sarcoma. It is the degree of atypia and clinical aggressiveness that distinguishes the two subtypes.

A pathologist's survey on the reporting of sessile serrated adenomas/polyps.

Aim: The purpose of this survey was to ascertain reporting habits of pathologists towards sessile serrated adenomas/polyps (SSA/P).

Methods: A questionnaire designed to highlight diagnostic criteria, approach and clinical implications of SSA/P was circulated electronically to 45 pathologists in the UK and North America.

Results: Forty-three of 45 pathologists agreed to participate.

One cancer destroys another: short report of a myeloid sarcoma causing ischaemic necrosis of an adenocarcinoma.

We present a highly unusual case and histological images of a patient who underwent complete resection of a perforated caecal adenocarcinoma caused by angiodestruction of the proximal vasculature by a distinct acute myeloid infiltrate. Both tumours were removed in their entirety at one visit to theatre and the patient remains well and in remission 18 months later.

An unusual case of Epstein-Barr virus driven lymphoproliferative disorder of the conjunctiva which mimicked a high grade lymphoma: a sheep in wolf's clothing.

Lymphoid proliferations represent 25-33% of acquired sub-epithelial conjunctival lesions which are excised or biopsied in patients over 15 years of age. These lesions are reported in association with Epstein-Barr virus (EBV). One such case of EBV associated spontaneously regressed monoclonal B cell infiltrate in conjunctiva that mimicked a large B cell lymphoma is reported.

Risk factors for acquisition of endemic blastomycosis.

Background: Blastomycosis is potentially fatal, but environmental risk factors for acquiring blastomycosis are not well established.

Method: Matched cross-sectional questionnaire of 112 patients with history of blastomycosis and 118 control subjects in Manitoba and northwestern Ontario.

Results: The most common tissues involved with blastomycosis were pulmonary, skin and soft tissues, and bone.

Computed tomographic scan evaluation of pulmonary blastomycosis.

Background: Blastomycosis is an uncommon granulomatous pulmonary and extrapulmonary infectious disease caused by the thermally dimorphic fungus Blastomyces dermatitidis. Diagnosis may be delayed or difficult because of varied presentation. The characteristics of blastomycosis on computed tomographic (CT) scan of the chest are not well characterized.

Clinical characteristics and outcomes in patients with pulmonary blastomycosis.

Background: Blastomycosis is an uncommon granulomatous infection caused by the thermally dimorphic fungus Blastomyces dermatitidis. The most frequent clinical infections involve the lung, skin, and bone. Pulmonary manifestations range from asymptomatic self-limited infection to severe diffuse pneumonia causing respiratory failure.

Seasonal variations in the clinical presentation of pulmonary and extrapulmonary blastomycosis.

Blastomycosis is a granulomatous infection caused by the thermally dimorphic fungus, Blastomyces dermatitidis, for which seasonal variation has been proposed. We conducted a retrospective review of medical records of 324 patients with blastomycosis in Manitoba and northwestern Ontario. The average age of patients at the time of diagnosis was 39+/-20 (range, 0-85) years.

An association of multiple well differentiated liposarcomas, lipomatous tissue and hereditary retinoblastoma.

Well differentiated liposarcoma (atypical lipomatous tumour) is a low grade tumour, with no metastatic potential unless dedifferentiation supervenes. When superficial, it recurs locally only occasionally after marginal excision. We present a patient in whom bilateral childhood retinoblastoma was followed by later development of massive confluent areas of low grade liposarcoma and lipomatous tissue affecting the upper extremities and trunk.

Extranodal lymphomas presenting as soft tissue sarcomas to a sarcoma service over a two-year period.

Non-Hodgkin's lymphoma usually presents with lymphadenopathy at multiple sites but can also involve any part of the musculoskeletal system. Occasionally the presentation is with a soft tissue mass. The presentation of large, superficial lymphomatous masses is similar both clinically and radiologically to that of soft tissue sarcomas.

Large variation in t(11;14)(q13;q32) and t(14;18)(q32;q21) translocation product size is confirmed by sequence analysis of PCR products.

Polymerase chain reaction is commonly used to detect t(11;14)(q13;q32) and t(14;18)(q32;q21) chromosomal translocations associated with mantle cell lymphoma and follicular lymphoma. We tested a total of 482 samples from patients with suspected non-Hodgkin's lymphoma and sequenced unusual-sized t(11;14)(q13;q32) and t(14;18)(q32;q21) products from 33 of these patients. BCL-1 or BCL-2 gene rearrangements were confirmed in 23 of 33 patients (70%).

Biphasic solitary fibrous tumour: a report of two cases with epithelioid features.

We present two cases of solitary fibrous tumour (SFT) showing biphasic morphology with a spectrum of malignant epithelioid components. Slides prepared from formalin-fixed and paraffin-embedded tissue from both cases were stained with haematoxylin and eosin and by immunohistochemistry. Interphase fluorescent in situ hybridisation studies were performed in both cases using paraffin-embedded tissue to look for the t(X;18) translocation, thereby to exclude synovial sarcoma.

GIST (gastro-intestinal stromal tumour) of the gallbladder: a case report.

The authors report a case of a gastrointestinal stromal tumour (GIST) of the gallbladder. GISTs are rare mesenchymal tumours of the gastrointestinal tract, mesentery and omentum. GISTs are characterized by the expression of the KIT protein, a transmembrane tyrosine kinase receptor for stem-cell factor.

Quantitation of cyclin D1 over-expression using competitive fluorescent reverse transcription polymerase chain reaction: a tool for the differential diagnosis of mantle cell lymphoma.

Mantle cell lymphoma is characterized by the presence of the t(11;14)(q13;q32) translocation that causes over-expression of the BCL-1 gene and consequent overproduction of its gene product cyclin D1. We have developed a competitive fluorescent reverse transcription polymerase chain reaction assay for the detection and semiquantitation of cyclin D1 over-expression. Using this assay a definitive ratio of the expression of cyclin D1 to cyclins D2 and D3 can be determined, provided good quality RNA is available.

Distribution of the interleukin-8 receptors, CXCR1 and CXCR2, in inflamed gut tissue.

There is increasing evidence to suggest that the potent neutrophil chemoattractant interleukin-8 (IL-8) has an important role in the pathogenesis of inflammatory bowel disease. IL-8 mediates its actions via two cell surface receptors, CXCR1 and CXCR2. This paper describes the distribution of these IL-8 receptors in the normal gastrointestinal tract and how this is modified in ulcerative colitis (UC).

Amplification of PCR products in excess of 600 base pairs using DNA extracted from decalcified, paraffin wax embedded bone marrow trephine biopsies.

Aims: To establish a robust method of extracting DNA from paraffin wax embedded bone marrow trephine (PBMT) biopsies for the amplification of relatively long polymerase chain reaction (PCR) products.

Method: Xylene and ethanol were used to remove paraffin wax from eight formalin fixed, EDTA decalcified PBMT biopsies and DNA extraction was performed using a Qiagen QIAamp tissue kit. The DNA samples were amplified using nine different PCR primers sets, including those used to detect chromosomal translocations (t(11;14) and t(14;18), and clonal B cell populations.

Tumour responding accessory cells in testicular seminoma: an immunohistochemical study.

Aim: To investigate the role of accessory cells (and other chronic inflammatory cells) in the host immune response to testicular seminoma by defining their immunophenotypic characteristics and topographical arrangement.

Methods And Results: A panel of antibodies applicable to paraffin-embedded tissues was employed to characterize the host chronic inflammatory response in eight cases of classical testicular seminoma. The antibodies were directed against CD45RO, CD20, CD68, acid cysteine proteinase inhibitor (ACPI), MAC387, muramidase (MUR), S100 protein, Factor XIIIa, CD21 and HLA Class II.

The accessory cell populations in ulcerative colitis: a comparison between the colon and appendix in colitis and acute appendicitis.

We present an immunohistochemical study of accessory cells in acute appendicitis and ulcerative colitis (UC). By comparing these two diseases, it is possible to distinguish between changes associated with inflammatory bowel disease and those resulting from nonspecific intestinal inflammation. Nine total colectomy specimens from patients with UC, in which the appendix was also involved, were compared with nine cases of acute appendicitis.

A study of accessory cells in the acquired lymphoid tissue of helicobacter gastritis.

This paper presents a description of the patterns of distribution of accessory cells in helicobacter gastritis and low-grade gastric MALT lymphomas. The use of gastric resection specimens afforded abundant, well-orientated lymphoid tissue. Fifteen cases were selected from patients with MALT lymphomas, three with gastritis alone, and six histologically normal controls.

Lectin binding reveals divergent carbohydrate expression in human and mouse Peyer's patches.

The nature of cell-associated carbohydrates in the human intestine that may mediate transepithelial transport of bacterial and dietary lectins and their processing by the lymphoid cells of Peyer's patches is not known. Because the cell surface carbohydrate receptors for lectins may vary in different species, the glycoconjugates of human and mouse follicle-associated epithelium and gut-associated lymphoid tissue were compared. A panel of 27, mainly recently isolated, lectins were used to identify glycoconjugate expression in M-cells, enterocytes, goblet cells, lymphocytes and macrophages in mouse and human intestine.

Cranial fasciitis of the orbit and maxilla: extensive resection and reconstruction.

A case of cranial fasciitis of childhood is described. This extensive cranio-orbital-facial lesion in a 3-month-old baby necessitated radical resection and immediate orbital and anterior cranial fossa reconstruction. The particular requirements of reconstruction in the infant are emphasised.