Biomedical subjects
Publications and source records attributed to F Eckert.
Pseudo-Kaposi's sarcoma developed in a 51-year-old man 2 years after placement of an arteriovenous shunt for hemodialysis. Data from histopathologic, immunohistologic, and histochemical studies, electron microscopy, and DNA-cytometric analysis are presented.
We report the case of a spontaneously regressing lymphocytic lesion on the neck of a 76-year-old man. Routine histopathological examination revealed a heterogeneous infiltrate composed of both lymphoid follicles and preferentially perifollicular and interfollicular sheets of large atypical cells. Immunohistologically, large atypical cells were positive for Ki-1/Ber-H2 (CD30), anti-Il-2 (CD25), Ber T9, anti-HLA-DR, Leu-5b (CD2), T3 (CD3), Leu-3 (CD4), Leu-1 (CD5) and, occasionally, Leu-M1 (CD15); that is, they showed an arrangement and immunophenotype similar to those of perifollicular Ki-1 positive cells in reactive lymphoid tissue. In contrast, antibodies To15 (CD22), anti-immunoglobulins, and anti-CALLA (CD10) stained polyclonal B-cells restricted to lymphoid follicles and small clusters representing remnants of follicles. We suggest that this lesion be termed "follicular lymphoid hyperplasia of the skin with high content of activated T-helper cells."
Skin biopsies were collected from 15 patients with cutaneous tumors morphologically similar to Ki-1+ anaplastic large cell (ALC) lymphoma of the lymph nodes, including Ki-1+ ALC lymphoma of childhood. The histology and immunophenotype of these cutaneous tumors are reported and follow-up data on the patients are given. The tumorous infiltrates were composed of large, sometimes very bizarre cells with one nucleolus or multiple nucleoli. All tumor cells expressed the lymphoid cell activation antigen Ki-1 (CD30) in conjunction with CD25 and the beta-chain of the T cell receptor. In 11 patients, Ki-1+ cutaneous tumors developed primarily in the skin. In nine patients, these were restricted to the skin in follow-up periods ranging from 3 months to 6 years. Two patients developed lymph node involvement after 2 months and 2 years, indicating the spreading potential of these cutaneous tumors. Morphologic and immunophenotypical identity of the atypical cells found in primary cutaneous ALC lymphoma, in regressing atypical histiocytosis (RAH), and in lymphomatoid papulosis (LyP) of type A, together with the protracted clinical course in all three conditions, suggests that primary cutaneous ALC lymphoma, RAH, and LyP of type A represent clinical variants of the same lymphoma entity. Secondary development of Ki-1+ ALC skin tumors was observed in two patients with cutaneous T cell lymphomas of mycosis fungoides type. These secondary Ki-1+ ALC lymphomas of the skin showed rapid systemic progression similar to the primary lymphonodal Ki-1+ ALC lymphomas. Concomitant or subsequent occurrence of Ki-1+ ALC tumors in cutaneous T cell lymphomas thus may be a bad prognostic sign.
A 74-year-old patient presenting with a subcutaneous tumor on his right upper arm is reported. Clinical examination led to the suspicion of a lipoma, cyst, and subcutaneous metastasis. Microscopical and immunohistological investigations allowed diagnosis of the tumor as a spindle cell lipoma. The most important aspect of differential diagnosis of this benign tumor is the exclusion of liposarcoma.
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Well-defined clusters of plasmacytoid T cells were identified in two cases of lymphoid hyperplasia of the skin. With the use of paraffin-embedded and frozen sections and 46 different antibodies, the antigenic profile of plasmacytoid T cells was obtained. Corresponding to plasmacytoid T cells in reactive and neoplastic lymph node conditions, plasmacytoid T cells of the skin were devoid of most T-cell-restricted differentiation antigens CD2, CD3, CD5, and CD8 while expressing monocyte/macrophage-related antigens recognized by Ki-M6 and Ki-M7. In addition, plasmacytoid T cells were positive for CD4, CD45, HLA class II antigens (HLA-DR, Leu-10, MB3, LN2, LN3) and the transferrin receptor. Furthermore, they reacted with anti-Leu-8, MB1, Ki-B3 (CD45R), and MT1. Thus plasma-cytoid T cells are considered to be mononuclear cells with monocyte/macrophage differentiation rather than T lymphocytes. In addition, our findings substantiate the concept that plasmacytoid T cells may function as a hitherto unrecognized subgroup of antigen-presenting cells in the skin.
We have studied 12 cases of cutaneous atypical fibroxanthoma using immunohistochemistry to demonstrate lysozyme, alpha-1-antitrypsin, S-100-protein, receptors for peanut agglutinin, and intermediate filaments. Results were compared with immunostaining in 24 cases of other so-called fibrohistiocytic tumours. In addition 2 cases of atypical fibroxanthoma and 6 cases of fibrohistiocytic tumours were stained by monoclonal antibodies specific for the monocyte cell lineage (Ki-M1, Ki-M2, Ki-M6, Ki-M7, Ki-M8, OKM-1 and Leu-M1) and double-stained by monocyte-markers and Ki-67. The immunophenotype of atypical fibroxanthoma was rather similar to the marker profile found in malignant fibrous histiocytoma. All atypical fibroxanthomas were positive for vimentin and negative for epithelial markers. Monocyte lineage-specific determinants could be demonstrated in varying amounts in cells suggestive of being reactive. In contrast proliferating--Ki-67 positive--cells did not express monocyte/macrophage related antigens in atypical fibroxanthoma and malignant fibrous histiocytoma both. As to the histogenesis of these tumours our findings speak in favour of a derivation from primitive mesenchymal cells rather than from histiocytes.
A 57-year-old patient suffered from a cutaneous centroblastic polymorphic non-Hodgkin lymphoma. This tumour first occurred 6 years ago and showed local relapses after two surgical excisions without any internal manifestations. The tumour had unusual morphological features with a sarcomatous growth pattern and numerous multilobated nuclei, which first led to the diagnosis of a malignant fibrous histiocytoma. Additional immunohistological studies of both the primary tumour and the lesions demonstrated the presence of lymphocytic marker proteins and allowed the definitive classifications as a high-grade malignant non-Hodgkin lymphoma of the B-cell type.
A 57-year-old male patient suffering from angiosarcoma of the scalp is reported. The clinical picture was highly characteristic, showing an ulcerated reddish tumour without clear demarcation. However, the histological characterization was more difficult and a final diagnosis could only be established with immunohistochemistry using antibodies directed against several endothelial cell antigens.
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Bone-marrow biopsies and smears from 59 patients with reactive plasmocytosis (22), multiple myeloma (24), solitary plasmocytoma (3) and monoclonal gammopathy of undetermined significance (MGUS) (10) were examined. To demonstrate cytoplasmic immunoglobulin the immunoperoxidase method was applied and evaluated quantitatively. Immunohistology yielded different ranges in kappa/lambda ratio for reactive plasmocytosis (0.4-3.5), multiple myeloma (less than or equal to 0.1 and greater than or equal to 11.2) and MGUS (0.2-3.0). As a result this method seems to be helpful in characterizing a plasmocytosis and distinguishing overt myeloma from monoclonal gammopathy of undetermined significance and reactive plasmocytosis. A differentiation of monoclonal gammopathy of undetermined significance from reactive plasmocytosis is not possible histologically and immunohistologically.
Sixteen cases of anaplastic carcinoma (ACA) and 4 cases of malignant haemangioendothelioma (HAE) of the thyroid were studied by light microscopy and immunohistochemistry. Seven cases of ACA and 3 cases of HAE were characterized by coexpression of immunohistological features of epithelial and vascular endothelial cells. Expression of vimentin was common to all tumours investigated. The present study provides evidence that ACA and HAE are partially closely related tumours showing alternating differentiation. This speaks in favour of a common neoplastic cell with the potential for epithelial and vascular endothelial differentiation.