Early morphometric diagnosis of cutaneo cutaneous T cell lymphomas

Early morphometric diagnosis of cutaneo cutaneous T cell lymphomas

|32 c.L. ~ Woldringh, ed./Abstracts of electron microscopy conference Ne~rological examination demonstrated minor pyramidal, as well as cerebellar, ...

186KB Sizes 1 Downloads 60 Views

|32

c.L. ~ Woldringh, ed./Abstracts of electron microscopy conference

Ne~rological examination demonstrated minor pyramidal, as well as cerebellar, symptoms. EEG showed a status of 'petit mal variant'. Four years after the first symptoms had occurred, m u s c l e biopsy was performed. P A S - s t a i n i n g on frozen sections and 1 m i c r o n epon sections d e m o n s t r a t e d a large amount of glycogenlike material. U l t r a s t r u c t u r a l analysis showed B - g l y c o g e n particles both subsarcolemmal and between myofibrills. In both regions B - g l y c o g e n is also present in m e m b r a n e - b o u n d lysosomal structures. Two special types of inclusion bodies are d e m o n s t r a t e d and discussed. Because of clinical and u l t r a s [ r u c rural features, we conclude M y o c l o n u s epilepsy, Lafora's type. E L E C T R O N M I C R O S C O P Y OF P R O L A C T I N PRODUCING CHR~OPHOBE PITUITARY ADENOMAS K. P. Dingemans, R. A.

K.

J. Assies~ M. Klene,

the adenoma cells and the p r o l a c t i n levels of the individual patients. The average granule size was almost identi ~ cal in all cases. Quite u n e x p e c t e d l y / however, ~ranule counts indicated that small numbers of granules per cell c o r r e s p o n d e d w i t h high serum p ~ o l a c t i n levels, and vice versa. Apparently, sparsity of granules should be r e g a r d e d as a sign of active s e c r e t i o n rather than as a sign of low p r o d u c t i o n of hormone. EARLY M O R P H O M F T R I C D I A G N O S I S OF C U T A N E O C U T A N E O U S T CELL L Y M P H O M A S E. M. van der Loo, C. J. L. M. M e i j e r , E. A. van der Velde, P. Kuiper, P. van der Valk, ~. A. van V l o t e n * and C. J. Cornelisse Dept. o f P a t h o l o g y University Medical The N e t h e r l a n d s

and *Dermatology, Center, Leiden,

de Vos

Laboratory for Patholbgical ~natomy and L a b o r a t o r y for E n d o c r i n o l o g y , Wilhelmina Gasthuis, Amsterdam, The N e t h e r l a n d s

In recent years, there has been a renewed interest in p i t u i t a r y adenomas. This is due to the improved surgical, immunohistochemical, and e l e c t r o n mic r o s c o p i c a l t e c h n i q u e s , but e s p e c i a l l y to the d e v e l o p m e n t of a r a d i o i m m u n o a s s a y for serum prolactin. The i n t r o d u c t i o n of the p r o l a c t i n assay led to the c o n c l u s i o n that m a n y chromophobic p i t u i t a r y adenomas are not h o r m o n a l l y inactive, as p r e v i o u s l y assumed, but produce prolactin. M a n y efforts have b e e n m a d e to correlate the u l t r a s t r u c t u r e of the adenomas with the nature, and e s p e c i a l l y w i t h the q u a n t i t y of the h o r m o n e produced. One of the results of these inv e s t i g a t i o n s was the r e a l i z a t i o n that sparsely g r a n u l a t e d adenomas do not n e c e s s a r i l y have a lower h o r m O n e - p r o d u c ing a c t i v i t y than those in w h i c h larger numbers of granules can be d e t e c t e d electron microscopically. More precise c o n c l u s i o n s on the r e l a t i o n b e t w e e n granule content and h o r m o n e p r o d u c t i o n have not been drawn, in all p r o b a b i l i t y m a i n l y b e c a u s e the serum p r o l a c t i n level was d e t e r m i n e d in o n l y l i m i t e d Numbers of patients. W e s t u d i e d the u l t r a s t r u c t u r e of p r o l a c t i n - p r o d u c i n g p i t u i t a r y adenomas of p a t i e n t s in w h o m the p r e o p e r a t i v e serum p r o l a e t i n levels w e r e d e t e r m i n e d . No C o n s i s t e n t c o r r e l a t i o n could b'e d e t e c t e d b e t w e e n the general u l t r a s t r u c t u r e of

M y c o s i s f u n ~ o i d e s (MF) and S~zary's symdrome (SS) are cutaneous T cell lymphomas, u l t r a s t r u c t u r a l l y c h a r a c t e r ized by the p r e s e n c e of lymphoid cells, w i t h deep and n a r r o w nuclear indentations, called c e r i b r i f o r m m o n o n U c l e a r cells (CMCs). CMCs are not specific for ~ and SS. They have also been described in b e n i g n chronic skin lesions. D i f f e r e n t i a t i o n b e t w e e n early MF lesions and benign chronic skin lesions is often difficult. A l t h o u g h in s~ch cases D N A - c y t o p h o t o m e t r y has given further d i f f e r e n t i a t i o n , there still remain d i a g n o s t i c problems. In this study we have tried to diffe r e n t i a t e b e t w e e n early MF lesions and benign chronic skin lesions by m e a s u r i n g the f r e q u e n c y of CMCs in c o m b i n a t i o n w i t h the degree of n u c l e a r indentation. The d e g r e e of nuclear i n d e n t a t i o n was e x p r e s s e d in a s i z e - i n d e n e n d e n t dimensionless parameter, the nuclear contour index (nci) of w h i c h is f o r m u l a t e d as perimeter surface area½" N u c l e a r shape and n u c l e a r size of lymphoid cells were m e a s u r e d by c o m p u t e r a s s i s t e d m o r p h o m e t r y from EM m i c r o g r a p h s of skin biopsies. At least 70 l y m p h o i d cells w e r e m e a s u r e d at random. Mononuclear p h a g o c y t e s w e r e easily recognized by the p r e s e n c e of lysosomes in the cytoplasm. F r o m the t r a i n i n g set c o n s i s t i n g of 12 skin b i o p s i e s from p a t i e n t s w i t h c l i n i c a l l y and h i s t o l o g i c a l l y p r o v e n MF (n=8) and SS (n=4) as example of m a l i g n a n t cases and skin b i o p s i e s of chronic b e n i g n skin lesions, an alloca-

C.L. Woldringh, ed./Abstracts of electron microscopy conference

tion rule could be d e f i n e d u s i n g s t a t i s tical d i s c r i m i n a n t analysis. The A l l o c discriminant analysis program version 3 s e l e c t e d the 70th and 25th p e r c e n t i l e of the nci d i s t r i b u t i o n as the best d i s c r i m i n a t i n g v a r i a b l e s b e t w e e n the m a l i g n a n t and the b e n i g n group. When the t r a i n i n g set was u s e d as a test set a 100% c o r r e c t c l a s s i f i c a t i o n was found w i t h a p o s t e r i o r p r o b a b i l i t y > 95%. W h e n the d a t a from skin b i o p s i e s from 10 p a t i e n t s s u s p e c t for c u t a n e o u s T cell l y m p h o m a w e r e u s e d as a test set, 4 p a t i e n t s c l a s s i f i e d as b e n i g n and 6 as malignant. In the 2 years of f o l l o w - u p none of the 4 b e n i g n - c l a s s i f i e d p a t i e n t s d e v e l o p e d a lymphoma. Of the 6 p a t i e n t s c l a s s i f i e d as m a l i g n a n t , 5 d e v e l o p e d m y c o s i s fungoides. One p a t i e n t has a persistent dermatitis now lasting 3 years, w h i c h was o r i g i n a l l y i n t e r p r e t e d as the r e s u l t of gold i n j e c t i o n s he rec e i v e d for his r h e u m a t o i d a r t h r i t i s . Alt h o u g h this t h e r a p y has s u b s i d e d for 2 years, he still has skin l e s i o n s s u s p e c t for MF. T h e s e r e s u l t s s h o w that early d i a g n o s i s of c u t a n e o u s T cell l y m p h o m a by this m e t h o d is p o s s i b l e , b e f o r e a definite histological diagnosis could be made.

c a p s i d s is t y p i c a l for Sendai. In addition, the c y t o p l a s m of these cells contained vacuoles filled with unusual s t r u c t u r e s , p o s s i b l y v i r a l in nature. The i m p o r t a n t role of the e l e c t r o n m i c r o s c o p e in o b t a i n i n g a q u i c k and r e l i a b l e d i a g n o s i s in r e s p i r a t o r y disease with a suspected viral etiolgoy is e m p h a s i z e d . References i.

2.

3.

c. Zurcher, J. D. Burek, M. C. J. van Nunen, S. P. Meihuizen. A naturally occurring epizootic caused by Sendai virus in breeding and aging rodent colonies..i. Infection in the mouse. Lab. Anim. Sci. 27:955-62, 1977. R. W. Compans, N. J. Dimmock, H~ MeierEwert, An electron microscopic study of the influenza virus-infected cell. In: The biology of large RNA viruses, ed. R. D. Barry, B. W. J. Mahy (New York: Academic Press, 1970~, pp. 8~-i08. R. W. Darlington, A. Portner, D. W. Kingsbury, Sendai virus replication--an ultrastructural comparison of productive and abortive infections in avian cells. J. Gen. Virol. 9:169-77, 1970.

RAPID DIAGNOSIS IN M I C E

OF V I R A L P N E U M O N I A

SCANNING AND TRANSMISSION ELECTRON M I C R O S C O P Y IN THE I M M O T I L E C I L I A S Y N D R O M E ( K A R T A G E N E R SYNDROME)

F. G. de Groot, C. Z u r c h e r

S. P. M e i h u i z e n ,

A. J. P. V e e r m a n I, L. v a n D e l d e n 2, L. F e e n s t r a 3 , W. L e e n e ~

I n s t i t 6 t e for E x p e r i m e n t a l G e r o n tology, TNO, R i j s w i j k , N e t h e r l a n d s D u r i n g N o v e m b e r a n ~ D e c e m b e r 1974, an e p i z o o t i c of r e s p i r a t o r y d i s e a s e o c c u r r e d in the r o d e n t c o l o n y of the R E P - I n s t i t u t e s TNO~ An i n c r e a s e in prew e a n i n g m o r t a l i t y was f o u n d in s e v e r a l m o u s e strains. L a t e r on, c l i n i c a l p n e u m o n i a was o b s e r v e d in adult m i c e (3-30 m o n t h s of age). Histopathological examination showed interstitial pneumonia with atypical hyperplastic bronchialand bronchiolar e p i t h e l i u m ; this p i c t u r e was s u g g e s t i v e of an i n f l u e n z a - l i k e v i r a l i n f e c t i o n . E l e c t r o n m i c r o s c o p y s h o w e d c y t o p l a s -• m i c i n c l u s i o n bodies, l o c a l i z e d in p n e u m o c y t e s type II and a l v e o l a r m a c r o U phages. These cytoplasmic • inclusion b o d i e s c o n s i s t e d of large m a s s e s of s t r a i g h t h o l l o w f i b r i l s of 16-18 n m i n d i a m e t e r , a r r a n g e d in •a rigi d p a r a c r y s t a l l i n e a r r a y , : s u r r o u n d e d by m o r e r a n d o m ly d i s p e r s e d f i b r i l s . . . . T h e s e s t r u c t u r e s are c o n s i s t e n t w i t h the m o r p h o l o g y of p a r a m y x o v i r u s nucleo-• c a p s i d s as d e s c r i b e d in the l i t e r a t u r e . The l o n g s t r a i g h t shape of~ t h e s e n u c l e o -

133

iDepartment of Pediatrics, 2Department of S u b o e ! l u l a r Pathology, 3Department of O t o r h i n o l a r y n g o l o g ~ , Free University, A m s t e r d a m , • and " L a b o r a t o r y of H i s t o l o g y and Cell Biology, University of Amsterdam, A m s t e r d a m , N e t h e r l a n d s Recently cilial abnormalities have b e e n shown to e x i s t in K a r t a g e n e r s s y n d r o m e (=situs i n v e r s u s w i t h c h r o n i c sinusitis and bronchiectasis). Cilia of the r e s p i r a t o r y e p i t h e l i u m and s p e r m tails are i m m o t i l e in this syndrome. Since, it has b e e r d i s c o v e r e d t h a t i m m o t i l e c i l i a can a l s o o c c u r w i t h a nor ~ mal situs i n t e s t i n a l i s . H e n c e the d e s ignation 'immotile cilia syndrome'l. • We s t u d i e d b i o p s i e s of the n a s a l ~ m u c o s a • o f a patien£, female, 6% y e a r s old, . w i t h S i t u s inversus, and a h i s t o r y of c h r o n i c s i n u s i t i s and b r o n c h i t i s . B r o n c h o g r a p h y at the age of 5 had conf i r m e d the e x i s t e n c e of b r o n c h o p a t h y ; b r o n c h i e c t a s e s , h o w e v e r , • c o u l d not be demonstrated. •• • P h a s e • c o n t r a s t m i c r o s c o p y of' f r e s h biopsymaterial, S u s p e n d e d in G e y t i s s u e c u l t u r e m e d i u m , pH 7 . 2 , w i t h o u t a d d i t i o n of fenol red, s h o w e d the c i l i a £o b e immotile,