Biomedical subjects

E Kaiserling

Publications and source records attributed to E Kaiserling.

At least 163 records · Page 9Linked to original sources

PubMed1990

Spindle cell neoplasms of lymph nodes of probable reticulum cell lineage. True reticulum cell sarcoma?

Primary spindle cell neoplasms involving hematolymphoid organs are extremely rare. We present four cases of spindle cell neoplasms of unusual phenotype arising within lymph nodes. Two of the four cases showed morphologic and immunophenotypic features suggestive of interdigitating reticulum cell lineage; these cases expressed several macrophage antigens and S-100 protein but not CD1. The other two cases showed evidence suggestive of dendritic reticulum cell lineage. Both cases expressed HLA-DR, several macrophage antigens, complement receptors C3b and C3d; one case expressed R4/23; both showed the presence of desmosomes on ultrastructural examination. A germline configuration for the immunoglobulin heavy chain and beta-T--cell receptor genes was detected in all four cases. Of the two patients in the first group, one had local recurrence of tumor; the other died of widespread metastases. Of the two patients in the second group, both are alive and well at 12 and 27 months follow-up, respectively.

Adult↗

PubMed1990

Neuroendocrine differentiation in hepatoblastoma. An immunohistochemical investigation.

Hepatoblastoma exhibits a wide range of epithelial and mesenchymal lines of differentiation. Neuroendocrine differentiation in this tumor has not previously been reported. We investigated seven hepatoblastomas of different subtypes (five pure epithelial hepatoblastomas, including one small-cell hepatoblastoma, and two mixed hepatoblastomas) using a broad panel of antibodies against epithelial, mesenchymal, neural, and neuroendocrine markers, alpha-1-antitrypsin (alpha 1-AT), alpha-1-antichymotrypsin (alpha 1-ACT), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), serotonin, and 14 regulatory peptides. Chromogranin A-immunoreactive neuroendocrine tumor cells, some of which also exhibited immunoreactivity for serotonin and somatostatin, were found in the fetal and embryonal parts of the mixed hepatoblastomas. The osteoid-like material in the mixed hepatoblastomas contained cells with immunoreactivity for chromogranin A, neuron-specific enolase, keratin, and alpha 1-AT, alpha 1-ACT, AFP, and CEA, in addition to S-100 protein and vimentin. Parallels to the neuroendocrine differentiation in hepatoblastomas are found in tumors of the gastrointestinal tract and bronchopulmonary tree. These tumors may also exhibit a neuroendocrine component; that is, multidirectional differentiation may occur, as in hepatoblastoma. The immunoreactivity of some of the cells of the osteoid-like material for keratin, alpha 1-AT, alpha 1-ACT, AFP, CEA, and chromogranin A suggests that these cells--and probably the surrounding material--are of epithelial origin.

Antibodies↗

PubMed1990

Blood findings in generalized mastocytosis: evidence of frequent simultaneous occurrence of myeloproliferative disorders.

Blood findings in 61 cases of generalized mastocytosis (GM) were evaluated. The cases were divided into two major variants: Systemic mastocytosis (SM; n = 34) with urticaria pigmentosa-like skin lesions, and malignant mastocytosis (MM; n = 27), without skin involvement. The following results were obtained: (1) Significant differences between MM and SM were found in the main haematological parameters (erythrocyte, platelet and leucocyte counts and haemoglobin level); normal values were found in 16 of the SM cases, but never in MM. (2) The main pathological findings were: in SM, anaemia (9/34) and leucocytosis (5/34); and in MM, leucocytosis (19/27), monocytosis (14/27), eosinophilia (12/27), bicytopenia (12/27, mostly anaemia with thrombocytopenia), basophilia (10/27) and isolated anaemia (7/27). (3) The major finding was a significant difference between MM and SM in the incidence of myeloproliferative disorders (MPD), myelodysplasia and mast cell leukaemia (MCL): these disorders occurred in 23 (92%) MM patients, but only in two (6%) SM patients (P less than 0.001). The four instances of MCL and two of myelodysplasia all occurred with MM. Of the 19 cases of MPD, six (SM, 1; MM, 5) were acute variants (acute myeloid and myelomonocytic leukaemias) and 13 (SM, 1; MM, 12) were chronic variants. No case of malignant lymphoma was noted. (4) The blood picture in 10 of 13 chronic MPD cases represented an atypical chronic myeloid leukaemia for which the preliminary descriptive term 'mastocytosis-associated MPD' is proposed. (5) A survey of 103 published cases (SM, 77; MM, 26) yielded similar findings, including a high incidence of MPD and MCL in MM. These findings add further weight to the argument for recognizing SM and MM as two separate entities.

Adult↗

PubMed1990

Intradecidual T lymphocytes lack immunohistochemically detectable T-cell receptors.

The decidua apparently plays a major role in immune tolerance to the semiallogeneic embryo. In the present study we applied the immunohistochemical ABC method to investigate the expression of CD3, TCR alpha/beta and TCR gamma/delta molecules on intradecidual T cells with a panel of mAbs. Whereas intradecidual T cells expressed readily detectable amounts of CD3, they lacked immunohistochemically detectable amounts of either alpha/beta or gamma/delta TCR heterodimers on their cell surface. Peripheral blood smears of the same patients showed normal expression of alpha/beta and gamma/delta TCR on CD3+ T cells. The specific absence of (alpha/beta or gamma/delta) TCR molecules on the surface of intradecidual T cells could be one of the decisive factors in tolerance of the maternal immune system towards the fetus.

Cells, Cultured↗

PubMed1990

Use of monoclonal antibody KP1 for identifying normal and neoplastic human mast cells.

The monoclonal antibody KP1 (CD68) was used to stain normal and neoplastic monocytes and macrophages in routinely processed, paraffin wax embedded tissue: mast cells also exhibited strong, consistent cytoplasmic immunoreactivity. Light microscopic findings were corroborated by electron microscopical and immunocytochemical findings. The predominant sites of immunoreactivity were the specific intracytoplasmic granules of the mast cells. All mast cell subtypes--that is, normal and reactive mast cells, such as those in lymph nodes exhibiting chronic non-specific lymphadenitis, and malignant or neoplastic mast cells in various types of mastocytosis--reacted with this antibody. This finding is of diagnostic importance, because mast cell proliferation could be mistaken for histiocyte proliferation. It also supports the hypothesis that mast cells derive from the bone marrow.

Antibodies, Monoclonal↗

PubMed1990

Immunoreactivity of human tissue mast cells: nonspecific binding of primary antibodies against regulatory peptides by ionic linkage.

Tissue mast cells (TMC) are known to react with antibodies against various regulatory peptides (RP). The specificity of such reactions was investigated by various methods in this study. When normal immunohistochemical staining procedures were employed. TMC in the vermiform appendix and in a cutaneous mastocytoma reacted with antibodies against ACTH, Leu-enkephalin, Met-enkephalin, and peptide histidine isoleucine (PHI). Antibody specificity was tested by absorption controls, and staining specificity by varying the concentration of the primary antibodies and the pH and sodium chloride concentration of the buffer used for rinsing and diluting. In absorption controls, staining of the TMC by anti-PHI was diminished but staining by anti-ACTH, anti-Leu-enkephalin, and anti-Met-enkephalin remained unchanged. Unlike control reactions, immunostaining of TMC with antibodies against RP exhibited marked dependence on antibody concentration and the pH and sodium chloride concentration of the buffer. Alkalization of the buffer led to an obvious increase in the reaction with antibodies against RP, and lowering the pH to 6.0 usually resulted in abolition of the reaction. These results indicate that the immunostaining of TMC with antibodies against RP, including PHI, was nonspecific. It is postulated that the granules of TMC bind certain antibodies by a cation-exchange mechanism involving ionic interactions with positively charged groups in the F(ab')2 and/or Fc segments.

Antibodies↗

PubMed1989

Liver findings in generalized mastocytosis. A clinicopathologic study.

Although the liver is one of the four organs most often involved in generalized mastocytosis (GM), little is known about macroscopic and microscopic liver findings in this rare disease. This study included 182 patients with GM (confirmed in most by bone marrow histologic study), comprising 52 cases of our own and 130 reported in the literature. Hepatomegaly was found in 131 (72%) of the 182 patients, cirrhosis in seven (4%), and periportal fibrosis in 25 (14%). Mast cell (MC) infiltration of the liver was confirmed histologically in 77 (42%). Liver specimens were available for further histologic investigation in 11 of our own cases of GM. Nine of these contained MC aggregates. Mast cells were found predominantly in the portal tracts but numerous MC also were loosely scattered throughout the sinusoids. Diagnostic confusion of GM with reactive lesions of the liver is unlikely to occur since MC, according to our own observations and the available literature, are found only in very low numbers in normal liver tissue, where they occur mainly in the portal tracts. Reliable identification of MC does, however, require special stains, like Giemsa, toluidine blue, or naphthol AS-D chloroacetate esterase.

Adult↗

PubMed1989

Lectin-binding studies of a human skin mastocytoma.

A solitary mastocytoma of the skin was investigated to assess the lectin-binding pattern of human mast cells. Of 18 Fluorescein-labelled lectins tested, nine reacted with mast cell granules. While lectins recognizing N-acetylgalactosamine or fucose residues did not stain mast cells, lectins with binding sites for N-acetylglucosamine, alpha-methyl mannopyranoside, galactose, complex carbohydrates of N-acetyl-lactosamine type and sialic acid gave a positive reaction.

Humans↗

PubMed1989

Freeze-fracture investigation of the red pulp of human spleen.

This study concerns the morphology of the human spleen in freeze-fracture replicas and compares this with the findings in ultrathin sections. The material investigated consisted of two spleens resected at gastrectomy and one resected because of splenomegaly in a case of hairy cell leukaemia. The current concepts concerning the ultrastructure of the spleen were generally confirmed with the freeze-fracture technique. The sinus walls were found, as expected, to consist of closely fitting endothelial cells, which were identifiable in freeze-fracture replicas by numerous caveolae of the cell membrane. Contrary to the opinion upheld in the literature, the sinus endothelial cells were occasionally found to be connected by desmosomes or maculae adhaerentes. Corresponding to the finding of desmosomes in ultrathin sections, focal collections of intramembranous particles were observed in freeze-fracture replicas and a positive immunohistochemical reaction for desmoplakin in the sinuses was found at the light microscopic level. The view generally held in the literature that sinus endothelial cells can exhibit tight junctions was not confirmed. However, such junctions were found between vascular endothelial cells. The ring fibres of the sinuses, which are closely connected to the sinus endothelial cells through contractile fibres, apparently have various functions. Firstly, they contribute towards maintaining mechanical stability. Secondly, they represent basement membranes through which exchange occurs between the sinus endothelial cells and their surroundings. This is indicated by the caveolae and vesicles that are often found here in large numbers and in focal collections. Hairy cells exhibit no features in freeze-fracture replicas to suggest a cytogenetic relationship to interdigitating reticulum cells.

Basement Membrane↗

PubMed1989

Carcinoid tumour of the middle ear. A morphological and immunohistochemical study with comments on histogenesis and differential diagnosis.

Primary carcinoid tumours of the middle ear are extremely rare, only nine cases having been reported. However, their true incidence is probably greater, since they are very difficult or impossible to distinguish from adenomas and adenocarcinomas with conventional histological stains. We describe the clinical, histological, immunohistochemical and ultrastructural findings in a carcinoid tumour of the middle ear in a 50-year-old woman. Immunohistochemical studies on non-neoplastic middle ear mucosa undertaken to investigate the histogenesis of such tumours are also reported. Histologically, the tumour consisted of both solid areas and areas of tubular structures containing intraluminal mucus. All the tumour cells reacted with the anti-keratin antibody KL 1; some were argyrophil and reacted with antibodies against neuron-specific enolase, chromogranin A, Leu-7, serotonin, pancreatic polypeptide, glucagon and lysozyme. Electron microscopy revealed dense core granules in the tumour cells. Endocrine cells could not be detected in non-neoplastic middle ear mucosa. Pancreatic-polypeptide-like immunoreactivity was demonstrated immunohistochemically in all three other published cases of carcinoid tumour of the middle ear investigated for this peptide, and glucagon-like immunoreactivity was also exhibited by one of these. Since carcinoid tumours of the middle ear often, as in this case, exhibit some degree of glandular differentiation, immunohistochemical or electron-microscopic investigation to detect neuroendocrine differentiation is of particular importance in adenomatous middle ear neoplasms.

Carcinoma↗

PubMed1989

Squamous cell carcinoma of the gastric stump. A case report and review of the literature.

Adenosquamous and pure squamous cell carcinomas of the stomach are very rare. This report is apparently the first published case of pure squamous cell carcinoma of the gastric stump. It occurred in a 67-year-old patient 37 years after Billroth II resection. This case satisfied the criteria established in the literature for the diagnosis of gastric squamous cell carcinoma. A diagnosis of adenosquamous carcinoma was excluded by extensive histologic investigation of a large number of tissue samples--a total 122 sections from 25 blocks--that revealed neither glandular structures nor mucin. The tumor stroma contained an unusually large number of eosinophils. Immunohistochemically, the tumor cells reacted with a monoclonal antibody against keratin (KL1), but not with antibodies against neuroendocrine or endothelial markers, or alpha 1-antichymotrypsin. The tumor may possibly originate from ectopic squamous epithelium, squamous metaplasia of the gastric mucosa, or an undifferentiated mucosal stem cell. However, we excluded an endothelial origin (which has been proposed by other authors) on the basis of immunohistochemical findings.

Aged↗

PubMed1989

In situ immunophenotyping of lymphocytes in human bone marrow: an immunohistochemical study.

Lymphoid cells in human bone marrow are either assembled focally or occur in a diffuse, loosely scattered infiltrate. While the focal lesions are easily detected, the lymphoid cells of the diffuse infiltrate are hardly recognizable with conventional stains. Quantitative immunohistological analysis of 103 trephine biopsies, including cases with reactive disorders (e.g. myeloid hyperplasia, aplastic anaemia) and neoplastic processes (e.g. myeloproliferative disorders, B-cell non-Hodgkin's lymphomas) and some specimens with normal architecture yielded the following results: (1) Various antibodies recognizing B cells (L26, 4KB5, MB1, Ki-B3), T cells (UCHL1, MT1) and NK cells (Leu-7) are effective in paraffin-embedded bone marrow sections, thus enabling analysis of the in situ distribution of normal lymphocyte subsets and subtyping of lymphomatous infiltrates. (2) The lymphocytes of the diffuse infiltrate constituted about 1-5% of all nucleated cells in normal bone marrow. (3) In the diffuse infiltrate, T lymphocytes were regularly observed in higher numbers than B cells, and Leu-7+ cells were rare or virtually absent, irrespective of the diagnosis. (4) The focally assembled lymphoid cells were mainly B lymphocytes, but many T cells were always intermingled. This was true for both reactive follicles and neoplastic lymphomatous infiltrates, which generally cannot be differentiated on the basis of immunohistological findings alone.

Antibodies, Monoclonal↗

PubMed1989

Bacterial lymphadenitis with the picture of a lymphoepithelioid cell lymphoma--Lennert's lymphoma.

Three cases with the typical light microscopic picture of lymphoepithelioid cell lymphoma (so-called Lennert's lymphoma) were investigated by electron microscopy. Surprisingly, Lennert's lymphoma could be excluded in two cases. These two cases exhibited, in addition to pleomorphic lymphocytes and epithelioid cells, macrophages with accumulations of bacteria, indicating that a bacterial infection was the cause of the disease. By comparing the typical case of Lennert's lymphoma with the other cases, we found several criteria for distinguishing between Lennert's lymphoma and bacterial lymphadenitis. In bacterial lymphadenitis: (1) small and medium-sized lymphocytes exhibited a wide cytological spectrum whereas the lymphocytes in Lennert's lymphoma were relatively uniform; the lymphocytes with prominent lysosome-like granules found in Lennert's lymphoma were not seen; (2) cytology and distribution of epithelioid cells were similar to those in Lennert's lymphoma; (3) epithelioid venules contained recirculating lymphocytes, which were rarely found in Lennert's lymphoma; (4) numerous interdigitating reticulum cells, fibroblasts and myofibroblasts were seen, but not in Lennert's lymphoma; (5) focal increase in reticulin fibres was the main difference in light microscopy; (6) rod-shaped bacteria were accumulated in the cytoplasm of a few macrophages. The presence of bacteria could not be demonstrated unequivocally by light microscopy. In both cases the large number of intracytoplasmic bacteria suggests that this unusual and until now unknown lymphadenitis is the result of an infection caused by facultative intracellular parasitic bacteria. The outcome of bacterial lymphadenitis that gives the false impression of Lennert's lymphoma is uncertain. Cure was achieved in one of our cases. The other patient died before therapy was commenced.

Adult↗

PubMed1988

Lymph node morphology after allogeneic bone marrow transplantation for chronic myeloid leukemia: a histological and immunohistological study focusing on the phenotype of the recovering lymphoid cells.

A histological and immunohistological analysis of lymph nodes after allogeneic bone marrow transplantation (BMT) was performed to investigate the microarchitecture of the lymphatic tissue and the phenotype of the recovering lymphoid cells. The study included four patients with chronic myeloid leukaemia who had died between 0.5 and 12 months after transplantation. The study yielded the following results: 1. All lymph nodes, irrespective of length of the survival period, exhibited severe atrophy of the lymphoreticular tissue with marked depletion of lymphocytes and dilatation of the sinuses. The number of lymphoid cells increased considerably with time after transplantation. 2. The main constituents of the recovering immune system were mature T lymphocytes (CD4+ and CD8+ cells in nearly equal numbers) and macrophages. The earliest signs of recovery of the immune system could already be detected 0.5 month after BMT. 3. Extreme paucity of B lymphocytes was a prominent finding in all lymph nodes studied. True lymphatic follicles and germinal centres were never detected. 4. Polytypic plasma cells were seen in low or moderate numbers mainly in the lymph node sinuses, while neither marked plasmacytic hyperplasia nor even a monotypic pattern were found. 5. Immune-accessory reticulum cells were detected only in the lymph nodes of the patient who survived 12 months. 6. Natural killer cells occurred only in low numbers irrespective of the duration of survival after BMT. Altogether, the histopathological lymph node findings clearly reflect the marked long-standing depression of the immune responses seen after allogeneic bone marrow transplantation. Since three of the four patients had shown signs of acute or chronic graft-versus-host disease, the histological findings presumably do not fully reflect the normal reconstitution of the immune system, but may have been modified by phenomena related to graft-versus-host disease.

Adolescent↗

PubMed1988

Interdigitating reticulum cells in dermatopathic lymphadenitis: freeze-fracture and ultrathin-section morphology.

Dermatopathic lymphadenitis is a non-neoplastic lesion found with various chronic skin lesions and associated with hyperplasia of the thymus-dependent (T) areas. These areas consist chiefly of interdigitating reticulum cells (IDC's), which are known to be accessory cells for T-cell-dependent immune reactions. The most characteristic features of IDC's are the bizarre-shaped cell nucleus, numerous cytoplasmic processes, deep cytoplasmic invaginations, and a close topographical relationship to surrounding (T) lymphocytes. The cytoplasmic processes of IDC's do not interdigitate with adjacent lymphocytes, as previously reported in the literature, but show close interdigitations with the processes of neighboring IDC's. With the freeze-fracture technique it can be seen that IDC's exhibit a characteristic distribution of intramembranous particles (IMP). While, for example, macrophages, epithelioid cells and lymphocytes display a clearly greater number of IMP on the P face than on the E face, IDC's show an equally high particle density on both the P face and the E face. The organelle content of IDC's in dermatopathic lymphadenitis varies considerably. Tubular profiles, the Golgi apparatus and vesicles may be increased in number. Birbeck granules are also found in IDC's, but only rarely. Variations in the numbers of the different cytoplasmic organelles may be a reflection of varying degrees of metabolic activity of IDC's.

Dendritic Cells↗

PubMed1988

Hodgkin cells in freeze-fracture replicas.

Lymph nodes from six patients with Hodgkin's disease (three with the nodular sclerosing subtype, one with mixed cellularity and two with the lymphocyte-predominant subtype) were analysed by electron microscopy in freeze-fracture replicas and thin sections. Two main variants of Hodgkin cell could be identified in the nodular sclerosing and mixed cellularity subtypes. (1) Hodgkin cells with wide cytoplasm and short, smooth- and rough-surfaced tubular profiles of endoplasmic reticulum (ER) unevenly scattered in the cytoplasm. (2) Hodgkin cells with well developed rough ER. In freeze-fracture replicas the ER was seen to consist of both short and long tubules, some of the latter forming anastomoses with each other. Both cell types possessed branching cytoplasmic processes. A P-face rich in intramembrane particles (IMP) and an E-face with few IMP were common to both Hodgkin cell types. These cells do not, therefore, possess the membrane features characteristic of interdigitating reticulum cells, thus refuting the previously held belief that Hodgkin cells, in particular lacunar cells, are related to interdigitating reticulum cells. The cytoplasmic structures and membrane characteristics of Hodgkin cells in the lymphocyte-predominant subtype (L & H cells) are similar to other Hodgkin cells in that they may show a high content of rER, and the P-face of these cells contains more IMP than the E-face. Both characteristics support the theory put forward in the literature (based on immunohistochemical findings) that these are lymphoid cells (immunoblasts or immature plasma cells).

Freeze Fracturing↗

PubMed1988

Interdigitating reticulum cells in lymph nodes of Sézary syndrome. Freeze-fracture and ultrathin-section morphology.

Lymph nodes with extensive leukemic infiltration from three patients with the Sézary syndrome were examined in ultrathin sections and in freeze-fracture replicas. Sézary cells (SC) and interdigitating reticulum cells (IDC) were the predominant cell types in the lymph nodes. Both were closely connected with each other by apparently interdigitating cytoplasmic processes. The projections between these cells were, in the main, processes from the IDC. In freeze-fracture replicas these cellular processes did not appear as interdigitations but were more bubble-like, and for this reason these cells are imprecisely described by the term "interdigitating." The SC were seen to possess only short cytoplasmic processes. The frequent polar grouping of cell organelles in SC in the region of the contact zone with IDC and the high organelle content of IDC ('activated IDC') could be the morphologic expression of intense interaction between IDC and SC. IDC displayed three features in freeze-fracture which are not specific to the Sézary syndrome, but should be applicable to IDC in general: (1) they exhibited an approximately equal density of intramembrane particles in both the E-face and the P-face, (2) some of the intramembrane particles in the P-face were assembled in clusters and (3) the surface showed bubble-like formations of the cytoplasmic processes. On the basis of these properties it was possible to distinguish IDC from macrophages and lymphocytes in freeze-fracture replicas.

Antigen-Presenting Cells↗

PubMed1988

Multiple lipid islands of the colonic mucosa. A light and electron microscopic study.

Light and electron microscopic findings in a case of multiple lipid islands of the sigmoid mucosa are described. The patient apparently represents the second case with these lesions published in the medical literature. Lipid droplets were found in histiocytes, pericytes, smooth muscle cells, and Schwann cells. Pathological alterations of the nervous system in lipid islands have not been described before. The accumulation of lipids in different cell types of the colonic mucosa and the alterations of nervous elements are probably due to toxic factors reaching the cells either from the intestinal lumen or from the blood stream. The term "lipid proctitis (colitis)" does not appear to be useful because the lipid islands are obviously no disease sui generis but an epiphenomenon of other pathological processes. Pathological differential diagnosis and clinico-pathological correlation of colorectal lipid islands are briefly discussed.

Colon, Sigmoid↗