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Monocytosis and preleukaemia
60
THE COLLEGE OF PATHOLOGISTS OF AUSTRALIA
4. It is apparent, therefore, that similar end products of disturbed development in embryos can be reached by different pathways, a situation with its parallels in postnatal pathology. MONOCYTOSIS AND PRELEUKAEMIA
DEMPSTER, A. G. Department of Pathology, Medical School, Dunedin, New Zealand The association of monocytosis with a leukaemoid bone marrow picture and other haematological abnormalities may present a diagnostic dilemma. Review of Dunedin Hospital records covering the last 15 yr. revealed 7 cases showing these features where these initial findings were subsequently regarded as preleukaemic. A further 3 cases were also presented where similar changes suggested an early preleukaemic state. Morphological studies of bone marrow aspirates and correlation with clinical and post-mortem details indicated that these cases formed a unique group in the spectrum of chronic leukaemia. This group appeared to be a distinct entity differing from the few reported cases of chronic monocytic leukaemia. Cells resembling transition forms between primitive cells of the myeloid series and rnonocytes were consistently seen in the bone marrow. Features of chronic granulocytic leukaemia were lacking. I t was suggested that these cases should be regarded as a separate category of chronic leukaemia. EPIDERMAL ANTIGENS I N CUTANEOUS DYSPLASIA AND NEOPLASIA IN HAIRLESS MICE
MULLER,H. K. & SUTHERLAND, R. C. Department of Pathology, Momsh University, Melbourne, Victoria Tissue-specific antigen deletion is a feature of experimental and human tumours, including squamous cell carcinomas in man and mouse. Th e patterns of epidermal antigens were correlated with the histology of proliferative skin lesions induced in hairless mice, with U.V. light (wavelength 2800-3200 8)and as a comparison, Zmethylcholanthrene. Epidermal hyperplasia occurred in 3-8 wk., dysplastic changes in 2-4 mth. and squamous cell carcinomas from 4 mth. onwards. Antigenic changes in the treated skins were assessed by the indirect immunofluorescent method, using sera from patients with (a) pemphigus vulgaris, which stains the intercellular areas and cell membranes of normal epidermal cells, and (b) bullous pemphigoid, which stains the basement membrane zone of normal epidermis. Antigen deletion was not detected in hyperplastic lesions. Early dysplastic lesions showed focal loss of epidermal cell membrane staining in the 2 or 3 layers of cells immediately above the basement membrane zone; the staining of the associated basement membrane zone remained normal. With malignant change and invasion of the dermis, loss of epidermal cell membrane antigenicity was almost complete, except in isolated areas where the neoplastic cells had differentiated towards more typical squames. With invasion, the basement membrane zone staining became irregular, granular, or completely lost, particularly in regions where tumour cells were deep in the dermis. It was suggested that loss of epidermal cell membrane antigens in dysplastic lesions is an index of dedifferentiation towards malignancy. Loss of basement membrane zone antigenicity is associated with tumour invasion into the dermis. ADENOID CYSTIC CARCINOMA OF CERVIX
BELL, J. R. Department of Pathology, Mater Misericordiae Hospital, Brisbane, Queensland Adenoid cystic carcinoma may occur in the cervix and its histology is identical with that noted in other sites. The lesion is to be distinguished from adenosquamous neoplasms and basaloid variants of squamous cell carcinoma. The turnow should not provide a diagnostic problem for the pathologist, assuming an awareness of its existence in this site. It may occur in pure form or be associated with squamous carcinoma either in situ or invasive. Only a small number of reports have appeared in recent literature and this paper added a further case. Presentation in a 72-yr.-old woman was characteristic, with vaginal bleeding and back pain. Diagnosis was made on biopsy of a gross lesion and treatment instituted.
THE COLLEGE OF PATHOLOGISTS OF AUSTRALIA
4. It is apparent, therefore, that similar end products of disturbed development in embryos can be reached by different pathways, a situation with its parallels in postnatal pathology. MONOCYTOSIS AND PRELEUKAEMIA
DEMPSTER, A. G. Department of Pathology, Medical School, Dunedin, New Zealand The association of monocytosis with a leukaemoid bone marrow picture and other haematological abnormalities may present a diagnostic dilemma. Review of Dunedin Hospital records covering the last 15 yr. revealed 7 cases showing these features where these initial findings were subsequently regarded as preleukaemic. A further 3 cases were also presented where similar changes suggested an early preleukaemic state. Morphological studies of bone marrow aspirates and correlation with clinical and post-mortem details indicated that these cases formed a unique group in the spectrum of chronic leukaemia. This group appeared to be a distinct entity differing from the few reported cases of chronic monocytic leukaemia. Cells resembling transition forms between primitive cells of the myeloid series and rnonocytes were consistently seen in the bone marrow. Features of chronic granulocytic leukaemia were lacking. I t was suggested that these cases should be regarded as a separate category of chronic leukaemia. EPIDERMAL ANTIGENS I N CUTANEOUS DYSPLASIA AND NEOPLASIA IN HAIRLESS MICE
MULLER,H. K. & SUTHERLAND, R. C. Department of Pathology, Momsh University, Melbourne, Victoria Tissue-specific antigen deletion is a feature of experimental and human tumours, including squamous cell carcinomas in man and mouse. Th e patterns of epidermal antigens were correlated with the histology of proliferative skin lesions induced in hairless mice, with U.V. light (wavelength 2800-3200 8)and as a comparison, Zmethylcholanthrene. Epidermal hyperplasia occurred in 3-8 wk., dysplastic changes in 2-4 mth. and squamous cell carcinomas from 4 mth. onwards. Antigenic changes in the treated skins were assessed by the indirect immunofluorescent method, using sera from patients with (a) pemphigus vulgaris, which stains the intercellular areas and cell membranes of normal epidermal cells, and (b) bullous pemphigoid, which stains the basement membrane zone of normal epidermis. Antigen deletion was not detected in hyperplastic lesions. Early dysplastic lesions showed focal loss of epidermal cell membrane staining in the 2 or 3 layers of cells immediately above the basement membrane zone; the staining of the associated basement membrane zone remained normal. With malignant change and invasion of the dermis, loss of epidermal cell membrane antigenicity was almost complete, except in isolated areas where the neoplastic cells had differentiated towards more typical squames. With invasion, the basement membrane zone staining became irregular, granular, or completely lost, particularly in regions where tumour cells were deep in the dermis. It was suggested that loss of epidermal cell membrane antigens in dysplastic lesions is an index of dedifferentiation towards malignancy. Loss of basement membrane zone antigenicity is associated with tumour invasion into the dermis. ADENOID CYSTIC CARCINOMA OF CERVIX
BELL, J. R. Department of Pathology, Mater Misericordiae Hospital, Brisbane, Queensland Adenoid cystic carcinoma may occur in the cervix and its histology is identical with that noted in other sites. The lesion is to be distinguished from adenosquamous neoplasms and basaloid variants of squamous cell carcinoma. The turnow should not provide a diagnostic problem for the pathologist, assuming an awareness of its existence in this site. It may occur in pure form or be associated with squamous carcinoma either in situ or invasive. Only a small number of reports have appeared in recent literature and this paper added a further case. Presentation in a 72-yr.-old woman was characteristic, with vaginal bleeding and back pain. Diagnosis was made on biopsy of a gross lesion and treatment instituted.