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Amyloidosis in a case of canine systemic lupus erythematosus.

Concurrent systemic lupus erythematosus (SLE) and amyloidosis (renal and splenic) are reported in a 7-year-old female miniature Schnauzer. Treatment of tissue sections with potassium permanganate and dilute sulphuric acid prior to staining with Congo red indicated that the amyloid in this case is composed of AA protein (i.e. reactive systemic amyloid or so-called secondary amyloid). The rare association of amyloidosis and SLE, in both man and the dog, and the association with granulomatous pneumonia and leukopenia in this case are discussed.

Amyloidosis↗

Epithelial odontogenic tumours in domestic animals.

Epithelial odontogenic tumours are uncommon, poorly understood and often difficult to diagnose, oral neoplasms. Dental organ pre-ameloblasts and basal lamina induce development of mesenchymal cells into odontoblasts, which produce dentin and induce pre-ameloblasts to mature into secretory ameloblasts. These reciprocal sequential inductive interactions between dental epithelium and mesenchyme form the basis for classifying epithelial odontogenic tumours. There are three tumours classified as non-inductive: ameloblastoma characterized by cords and islands of stellate reticulum with peripheral palisades of polarized columnar cells, adenomatoid ameloblastoma which has acini, rosettes and ducts of polarized columnar cells and stellate reticulum and calcifying epithelial odontogenic tumour which contains foci of Congo-red-positive material surrounded by pleomorphic polygonal epithelial cells. There are five tumours in which induction of mesenchymal tissue is evident: ameloblastic fibroma with characteristics of ameloblastoma plus proliferation of closely associated pulp-like mesenchyme; dentinoma consisting of masses of dentin, often with minimal cellular component; ameloblastic odontoma which contains palisaded epithelium and stellate reticulum as in ameloblastoma, as well as foci of dentin and/or enamel; complex odontoma which is a disorderly array of dentin, enamel, ameloblastic epithelium and odontoblasts; and compound odontoma containing denticles with well-organized tooth morphology. This paper reviews the embryogenesis of teeth and describes six types of epithelial odontogenic tumours in 13 animals. The literature concerning these tumours in nearly 250 animals is reviewed. The most commonly reported tumour is ameloblastoma and the species in which all types are most commonly reported is the dog.

Animals↗

AA amyloid-associated gastroenteropathy in a horse.

Systemic amyloidosis involving the digestive tract is described in an 11-year-old Morgan stallion. The disease was characterized clinically by weight loss, ptyalism, anaemia, persistent mature neutrophilia, hypoalbuminaemia and hypergammaglobulinaemia. The D-xylose absorption test indicated malabsorption. Necropsy revealed oral, oesophageal and gastric ulcers and reddened segments of small bowel mucosa with scant haemorrhages. Microscopically, amyloid deposits were found throughout all tissue layers of the digestive tract, except the serosa. Deposits of amyloid were most apparent in the small bowel mucosa and submucosal arteries. Amyloid was also present in the spleen and lymph nodes and to a lesser extent in the liver, kidneys, lungs, pancreas and bone marrow. All amyloid deposits gave the typical histochemical reaction for AA amyloid with the KMnO4-Congo red stain procedure and immunohistochemical cross-reactivity was demonstrated with antisera to both canine and bovine protein AA by the peroxidase-antiperoxidase technique. The cause of the amyloidosis was not identified, although the haematological and serological data were compatible with an underlying chronic inflammatory process.

Amyloidosis↗

Fluorescent staining for leukocyte chemotaxis. Eosinophil-specific fluorescence with aniline blue.

To overcome problems associated with the quantitation of human eosinophil chemotaxis in micropore filters, we have developed a fluorescent method of specifically staining eosinophils in chemotactic filters. A neutral solution of aniline blue yielded bright green fluorescent staining of the cytoplasmic granules of eosinophils. Other leukocytes and contaminating neutrophils potentially present with eosinophils did not fluoresce with aniline blue. The fluorescent staining eosinophils within filters provided bright, non-fading images that facilitated visual microscopic counting and were of sufficiently high contrast, unlike those with conventional eosinophil stains, to allow image analyzer based enumeration of eosinophil chemotactic responses at levels through the filters. Although not cell type-specific, congo red and ethidium bromide also provided high contrast, fluorescent images of all leukocyte types within chemotactic filters. Fluorescent staining with aniline blue constitutes a rapid, stable and eosinophil-specific stain that facilitates the visual or image analyzer-based quantitation of eosinophil chemotaxis.

Aniline Compounds↗

Direct double antibody sandwich immunoassay for Pseudomonas aeruginosa elastase.

A direct sandwich enzyme immunoassay was developed in order to quantify Pseudomonas aeruginosa elastase. As a solid phase the wells of a microtitre plate were coated with specific IgG and horseradish peroxidase labelled IgG was used as the second antibody. The detection limit of the assay was 0.26 ng/ml and a good agreement was found with elastolytic activity determined using elastin-Congo red. This assay was simple, specific, sensitive and reproducible, and permits the determination of low levels of elastase.

Cystic Fibrosis↗

Diagnostic value of abdominal fat tissue aspirate in familial amyloid polyneuropathy.

To confirm amyloid deposition we performed aspiration biopsy of abdominal fat tissue in 14 patients with type I familial amyloid polyneuropathy (FAP). All patients, about half of whom were at an early stage of disease and lacking severe neurological disabilities, showed positive amyloid deposition in preparations stained with Congo red. On light and electron microscopic examinations deposits of amyloid were observed around fat cells and small vascular walls, and among collagen bundles. All patients in the study were demonstrated to have a variant transthyretin in their sera by radioimmunoassay. Abdominal fat tissue aspiration can be easily performed with an ordinary syringe and is very sensitive for detecting amyloid deposition. The procedure is valuable in the diagnosis of type I FAP patients with actual deposition of amyloid substance, even at an early stage.

Abdomen↗

Histopathology and fine structure of the brain in six cases of Creutzfeldt-Jakob disease from western India.

Light and electronmicroscopic changes in 5 formalin-fixed brains, and one glutaraldehyde-fixed brain biopsy, from patients with Creutzfeldt-Jakob disease in the age range of 45 to 65 years, are described. These 6 patients (out of 7 reported clinically earlier and 2 unreported) had classical manifestations with progressive dementia, pyramidal signs and myoclonic jerks. Light microscopy showed neuronal and nerve fibre loss, moderate or severe spongiform change, astrocytic proliferation and absence of inflammatory reaction. Electronmicroscopy confirmed the characteristic membranous profiles of the 'cysts' and 'daughter cysts' constituting the spongiform change. The membranes were generally dark and thin, either concentrically arranged or splitting and with stray pale broad segments. The one glutaraldehyde-fixed brain biopsy specimen showed cisterns of RER in close proximity to these 'cysts', suggesting the source of proteinous material of these membranes. Though mainly in the neurones and dendrites of the cortex, at times they were seen in the myelinated fibres also, a few of which showed dystrophic axons bearing dense bodies. One of the 6 patients had cerebellar signs also, and a total duration of the neurological illness of 36 months, as against 2-8 months in the 5 other patients. The histopathological examination of her brain revealed less spongiform change, and many cerebral cortical glial whorls, the centre of which showed PAS-positive and congo-red-positive material representing amyloid. Fine structural examination confirmed the glial whorls, and the filamentous nature of amyloid in the plaques, which resembled Kuru plaques. All brains also showed more or less intraneuronal lipofuscin.

Amyloid↗

Calcifying odontogenic cysts with intracellular amyloid-like material.

Intracellular deposits of amyloid as defined by positive Congo red staining with green polarization birefringence and standardized toluidine blue staining with pink-red polarization birefringence were observed in the epithelial lining of three cases of calcifying odontogenic cysts. It is suggested that this material is not true amyloid but, rather, a dengenerative product of the epithelial cells as has been described in calcifying epithelial odontogenic tumor (Pindborg tumor).

Adult↗

Oral amyloidosis: a late complication of multiple myeloma.

Amyloidosis as a complication of multiple myeloma carries with it grave prognostic implications, and the median survival of myeloma patients following a diagnosis of amyloidosis is only 4 months. This article describes a patient who survived 6 years with kappa light chain myeloma, but only 4 months after the development of oral amyloid deposits. Oral amyloidosis may be clinically difficult to distinguish from fibrous, neurogenous, or salivary gland pathosis; however, histologic specimens stained with Congo red have a characteristic "apple green" appearance when examined microscopically with polarized light.

Amyloidosis↗

Oral amyloidosis: two unusual case presentations.

Two cases of oral amyloidosis are reported. In each case there were unusual oral manifestations. In the first case the patient's only complaints were of recurrent swelling of the submandibular glands and xerostomia. The diagnosis of amyloidosis was determined from a labial salivary gland biopsy. In the second case an enlarged tongue had produced displacement of the teeth, causing malocclusion. The resulting difficulty in chewing stimulated the patient to seek advice. In each case the diagnosis was confirmed by electron microscopy, Congo red staining, and serum and urine electrophoresis.

Aged↗

Localized primary amyloid tumor of the parotid gland.

We report a case of primary amyloid tumor (amyloidoma) of the left parotid gland. To the best of our knowledge this is the first case of this tumor in a parotid gland to be reported in the English literature. Congo red staining with prior potassium permanganate incubation confirmed the localized primary type of amyloid. Immunocytochemical studies demonstrated staining for immunoglobulin A, lambda and kappa light chains within the amyloid deposits and in the cytoplasm of the lymphocytes, and plasma cell aggregates. Ultrastructural examination showed characteristic findings of straight, nonbranching fibrils, measuring 80 to 100 A in length, that were diagnostic of amyloid. The patient had no symptoms and no clinical or laboratory evidence of systemic amyloidosis or multiple myeloma at a 1-year follow-up examination.

Aged↗

Detection of a cytolytic toxin in the venom of the stonefish (Synanceia trachynis).

The venom of the stonefish, Synanceia trachynis, contains a cytolytic toxin which is antigenic and ammonium sulfate-precipitable, and has a pI of ca 5.7 and an Mr of ca 158,000. The toxin is a potent but narrow-spectrum cytolysin which is lytic in vitro for rabbit, dog, rat, and guinea pig erythrocytes, in that order, but is largely or completely inactive against sheep, cow, human, monkey, mouse, goat, horse, burro and cat erythrocytes. Fractionation of the venom by molecular sieve fast protein liquid chromatography and isoelectric focusing did not separate the haemolytic activity from the venom's lethal and vascular permeability-increasing activities. Also, the three activities were destroyed by heat, proteases, Congo red, potassium permanganate and stonefish antivenoms. The results suggest that the haemolytic, lethal and vascular permeability-increasing activities of stonefish venom are properties of the same molecule, a previously unrecognized, membrane-damaging protein toxin.

Ammonium Sulfate↗

Familial amyloidotic polyneuropathy type 1 in Kumamoto, Japan: a clinicopathologic, histochemical, immunohistochemical, and ultrastructural study.

Seventeen autopsy and five biopsy cases of familial amyloidotic polyneuropathy were examined clinicopathologically, histochemically, immunohistochemically, and ultrastructurally. In the autopsy cases, amyloid deposits were predominant in the peripheral nerve tissues, autonomic nervous system, choroid plexus, cardiovascular system, and kidneys. Amyloid involvements in the anterior and posterior roots of the spinal cord, spinal ganglia, thyroid, and gastrointestinal tract were also frequent. In the cardiac conduction system, amyloid deposition was prominent in the sinoatrial node and in limbs of the intraventricular bundle. In the sural nerve biopsy, besides amyloid deposits, degenerative changes of nerve fibers and Schwann cells were detected ultrastructurally, and the morphometric analysis showed a marked reduction in the number of myelinated fibers which correlated with the clinical stage. Amyloid deposits were resistant to pretreatment with potassium permanganate in Congo red staining, and transthyretin was confirmed immunohistochemically as a major component of amyloid deposits, along with the presence of serum amyloid P-component. Besides the amyloid deposits, transthyretin was proven in the liver cells, epithelial cells of the choroid plexus, and pancreatic islet A cells, suggesting that the transthyretin produced by these cells is secreted, transferred into tissues, and deposited in situ as the major component of amyloid in this disorder.

Adult↗

Tracheobronchial AL amyloidosis: histologic, immunohistochemical, ultrastructural, and immunoelectron microscopic observations.

We have studied three cases of localized amyloidosis in the lower respiratory tract. Amyloid was nodularly or diffusely deposited in the lamina propria of the tracheobronchial mucosa. Its nature was confirmed by Congo red staining with green birefringence on polarized microscopy. "Tracheobronchopathia osteoplastica" also was demonstrated. Plasma cells and lymphocytes were scant in the amyloid mass. Few fibroblasts and even fewer macrophages were seen. The number of plasma cells was not increased in the bone marrow in any of our cases. Amyloid fibrils were demonstrated by electron microscopic examination. The amyloid P component was detected by immunohistochemical methods. The precursor protein of amyloidosis was shown to be amyloid L protein by the postembedding protein-A gold technique with anti-light chain antisera. The role of the plasma cells in amyloid formation, however, could not be ascertained. Based on these observations, amyloid fibril formation in tracheobronchial amyloidosis appears to be related to light chains secreted by local plasma cells, combined with amyloid P, calcium, and other factors.

Adult↗

Isolated atrial amyloidosis: a clinicopathologic study indicating increased prevalence in chronic heart disease.

Congo red screening of 211 consecutive cardiac biopsy specimens obtained during cardiac surgery from 167 patients revealed 26 (16%) instances of isolated atrial amyloidosis (IAA). The ages of IAA-positive patients ranged from 25 to 52 years (mean age, 39 years). Twenty-three (88%) IAA-positive biopsy specimens were from patients with chronic rheumatic heart disease (CRHD) while three (12%) were from patients with an atrial septal defect (ASD). The prevalence of IAA in the CRHD patients was 23%, appreciably higher than that in the ASD patients (15%) and in other patients with atrial biopsies. The prevalence of IAA in both CRHD and ASD patients was significantly higher (P < .001) than in controls. Controls consisted of 247 healthy adults who were autopsied after traumatic deaths, with an age range of 18 to 89 years (mean age, 38 years). Only seven (3%) control subjects were IAA positive; all were over 40 years of age. Isolated atrial amyloidosis deposits were permanganate resistant and immunohistochemically positive for human amyloid P (AP) protein and negative for human amyloid-associated (AA) protein and immunoglobulin light chains. They were observed as fine congophilic and birefringent deposits in intramyocardial vessel walls, along the myocardial sarcolemma, and in the subendocardium. There was associated myocyte hypertrophy but no atrophy. Electron microscopy demonstrated typical nonbranching amyloid fibrils. It is postulated that stretching of the atria in chronic heart disease results in a raised prevalence of IAA. Recent reports that IAA contains atrial natriuretic peptide, a polypeptide hormone product of atrial myocytes, supports this view.

Adolescent↗

Scrapie prions aggregate to form amyloid-like birefringent rods.

A large scale purification protocol employing zonal rotor centrifugation has been developed for scrapie prions. The extensively purified fractions derived using this protocol contained only one major protein, designated PrP, and rod-shaped particles. The rods measured 10 to 20 nm in diameter and 100 to 200 nm in length by negative staining; no other particles were consistently observed. SDS denaturation caused the rods to disappear, prion infectivity to diminish, and PrP to become sensitive to protease digestion. Arrays of prion rods ultrastructurally resembled purified amyloid and showed green birefringence by polarization microscopy after staining with Congo red dye. The rods appear to represent a polymeric form of the scrapie prion; each rod may contain as many as 1,000 PrP molecules. Our findings raise the possibility that the amyloid plaques observed in transmissible, degenerative neurological diseases might consist of prions.

Amyloid↗

Infrequency of slime production by urinary isolates of Staphylococcus saprophyticus.

The production of slime by 130 urinary isolates of Staphylococcus saprophyticus, cultured from symptomatic females in the general community, was tested by growing them on Congo red agar. Fourteen of 130 strains (11%) were found to produce slime, 112 strains (86%) did not produce any detectable slime, while four strains (3%) gave an indeterminate result. Slime production does not appear to be an important virulence factor of S. saprophyticus causing urinary tract infection in females of child-bearing age.

Bacteriological Techniques↗

Analysis of a method for testing azo dyes for mutagenic activity in Salmonella typhimurium in the presence of flavin mononucleotide and hamster liver S9.

A protocol for assessing the mutagenic activity of azo dyes derived from mutagenic or potentially mutagenic aromatic amines was evaluated, using 4 model compounds. This protocol is based upon one developed in Sugimura's laboratory with modifications, including the use of flavin mononucleotide (FMN) rather than riboflavin to reduce the azo compounds to free amines, and hamster liver S9 rather then rat liver S9 for metabolic activation. The protocol developed differs from the standard Ames Salmonella plate incorporation assay in 5 ways: (1) uninduced hamster liver S9 rather than Aroclor 1254-induced rat liver S9 is used; (2) 150 microliters of S9 is used rather than the maximum of 50 microliter of S9 used in the standard assay; (3) FMN is added to the cofactor mix; (4) the cofactor mix is modified to include exogenous glucose 6-phosphate dehydrogenase, NADH, and 4 times the standard amount of glucose 6-phosphate; and (5) a 30-min "pre-incubation" step is used before addition of top agar. We found that each of these 5 changes is necessary for optimal mutagenic activity of azo dyes derived from the mutagenic aromatic amines benzidine, o-tolidine or o-dianisidine. The use of hamster liver S9 rather than rat liver S9 was also required for optimal mutagenic activity of benzidine itself. Rat liver S9 inhibited the ability of hamster S9 to activate benzidine to a mutagen. The presence in rat liver S9 of an inhibitor of the metabolic activation of benzidine may account for the failure of benzidine and a benzidine dye (Congo red) to be strongly mutagenic when tested with this type of S9.

Azo Compounds↗