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G D Levine

Publications and source records attributed to G D Levine.

11 recordsLinked to original sources

The ultrastructure of the normal human thymus: a study of 36 cases.

Electron microscopy of the normal human thymus demonstrates a supporting framework of epithelial-reticular cells with long branchticular cell processes lie lymphocytes, macrophages, and rare myoid cells. Both small and large lymphocytes are evident. No desmosomes are observed between the lymphocytes and the epithelial-reticular cells. Macrophages are most numerous in the cort(x were they often contain phagocytized nuclear debris. The possible functional significance of the above-described fine structural features is discussed.

Child

Thymic hyperplasia and neoplasia: a review of current concepts.

Although the term thymic hyperplasia is used most commonly to indicate the occurrence of germinal centers in the thymus, cognizance must be taken of the fact that such centers may occur in apparently normal thymuses in both children and adults. A concept of thymic compartmentalization is proposed with origin of germinal centers in the perivascular space (extraparenchymal compartment) of the thymus. These germinal centers contain a high percentage of B lymphocytes in contrast to the true thymic parenchyma. Although the significance of germinal centers in the thymus parenchyma. Although the significance of germinal centers in the thymus in myasthenia gravis remains controversial, removal of nonneoplastic thymus in this condition is of proven therapeutic value. A variety of neoplasms originating in the thymus have previously been lumped together under the single term "thymoma." It is apparent, however, that thymoma, thymic carcinoid, various lymphomas, and germ cell tumors that arise in the thymus differ not only pathologically but also in their clinical behavior. Thymoma is regarded as an epithelial neoplasm and ultrastucturally is characterized by many desmosomes and tonofilaments. The lymphocytes do not behave in a malignant manner, and lymphomas of the thymus should be sharply separated from true thymoma. Poorly differentiated thymic carcinoma and histiocytic lymphoma may be distinguishable only by the electron microscopic demonstration of desmosomes and filaments in the thymic carcinoma. The evidence that Hodgkin's disease of the thymus ("granulomatous thymoma") is not a variant of thymoma appears overwhelming. Lymphoblastic lymphoma of the thymus is a distinctive neoplasm that is especially prevalent in teenage males. High levels of terminal transferase characterize the lymphoblasts and there is a striking tendency for leukemia to occur. Thymic carcinoid is usually nonfunctional, although one-third of the reported cases are associated with Cushing's syndrome. On light microscopy a ribbon pattern and punctate necroses are characteristic of thymic carcinoids. Electron microscopic demonstration of many dense core granules is invaluable in establishing this diagnosis. An important clue to the diagnosis of thymic seminoma (a neoplasm that shows the same radiosensitivity as its testicular counterpart) is the frequent presence of epithelioid and giant cell granulomas and germinal centers. Separation of the various thymic neoplasms described not only is justifiable on pathologic grounds but is often essential for appropriate patient investigation and treatment.

Adolescent

A spindle cell varient of thymic carcinoid tumor. A clinical, histologic, and fine structural study with emphasis on its distinction from spindle cell thymoma.

We describe the clinical, histologic, and fine structural features of two thymic carcinoid tumors that had a major spindle cell component, and present the reason for classifying our two cases as variants of thymic carcinoid tumors. These tumors pursued an aggressive clinical course, demonstrated histologic features such as vascular invasion and mitotic activity, ultrastructurally contained numerous dense-core granules, and lacked prominent tonofilaments and well-formed desmosomes. Radiotherapy, even for apparently encapsulated cases, may be indicated for this aggressive mediastinal neoplasm, which can be clearly separated from the thymoma by clinical, histologic, and fine structural criteria.

Adult

Nodular lymphoma: an ultrastructural study of its relationship to germinal centers and a correlation of light and electron microscopic findings.

This study describes the ultrastructural findings in 16 cases of nodular lymphoma, and compares these with normal germinal centers in order to determine the possible germinal center origin of the lymphomas. Long branching desmosome-associated dendritic reticulum cells, characteristic of germinal centers, were found in all 16 cases of nodular lymphoma. Desmosomes were observed only between dendritic cells and not between lymphoid cells, and they were seen in only 1 of 7 cases of diffuse lymphoma. Cells comprising the nodular lymphomas share cytologic features, such as nuclear blebs and marked nuclear indentations, with germinal center cells. It appears that nodular lymphomas have a close anatomical relationship to germinal centers, although their actual origin from these sites is not established by this study. They are composed of lymphoid cells; we have no evidence to confirm the view that nodular lymphomas are derived from dendritic cells. Light and electron microscopic findings have been compared in order to establish the nature of large "histiocyte-like" cells in the nodular lymphomas. Many of these cells appear to represent transformed lymphocytes rather than histiocytes. They are more numerous in so-called mixed "histiocytic" lymphocytic lymphomas than in poorly differentiated lymphocytic lymphomas, which otherwise are ultrastructurally similar. This study casts doubt upon the existence of a mixed lymphocytic and histiocytic lymphoma within the spectrum of the nodular lymphomas, and indicates that a cytologic continuum exists between cells interpreted as poorly differentiated lymphocytes and those heretofore identified as histiocytes.

Adult

The normal human thymic vasculature: an ultrastructural study.

Electron microscopy of the normal human thymus demonstrates a characteristic vascular-parenchymal relationship. The vascular lumen is always separated from the thymic parenchyma by: the endothelial cell cytoplasm, a muscular coat in arterioles and veins, the vascular basal lamina, a perivascular space containing collagen fibers and cells, the epithelial-reticular cell basal lamina and the epithelial-reticular cell cytoplasm. The width of this perivascular space is proportional to the size of the vessel it surrounds; it is wide around the vessels in the septa and at the cortical-medullary junction, but narrow around capillaries. While many cells are present in this space around larger vessels, only collagen is observed around the capillaries. Lymphocytes are the predominant cell type in the space; however, plasma cells, eosinophils, histiocytes, polymorphonuclear leukocytes, mast cells and unidentified granulated cells are also seen. The vascular complex described above may function as a blood-thymus barrier, as the initial site of exposure of the lymphocytes to circulating antigen and as the route of lymphocytes from the thymus.

Arteries

The fine structure of thymoma, with emphasis on its differential diagnosis. A study of ten cases.

In this study, thymoma is defined as a neoplasm of the epithelial-reticular framework cells of the thymus. As in the normal thymus, these cells regularly displayed branching tonofilaments, macuale adherens, elongated processes, and basal lamina. These characteristics proved useful in the differential diagnosis of thymoma from a variety of anterior mediastinal tumors including thymic carcinoid, lymphoma, germinoma (seminoma type), and fibrous mesothelioma. Lymphocytes in the thymomas often showed mitotic activity and a moderate degree of transformation. The significance of this and the gland-like spaces, vacuolated epithelial cells, starry-sky appearance, emperipolesis, and perivascular spaces is discussed.

Adolescent