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Helicobacter heilmannii gastritis: case reports and literature review
ABSTRACTS
immunoreactivity with synaptophysin and chromogranin-A. The duodenal lump was also a 2.5 mm well-differentiated NET, comprised of nests of bland epithelioid cells with granular cytoplasm, extending from the lamina propria into muscularis mucosae. Along with synaptophysin and chromogranin-A it was also positive for gastrin, indicative of a functional gastrinoma. Discussion: This rare case is reported to illustrate the pathophysiology of the occurrence of type 2 gastric NETs arising in the setting of MEN-1.
LYMPHOEPITHELIOMA-LIKE CARCINOMA OF THE FEMALE URETHRAL ORIFICE A. Devadass and B. Lockett Department of Anatomical Pathology, Medlab Central, Palmerston North, New Zealand Aims: We present the first reported case of a lymphoepitheliomalike carcinoma (LELC) affecting the female urethral orifice with regional lymph node metastases. Methods: An 86-year-old patient presented with light per vaginal (PV) bleeding for several months. A papillomatous growth was seen at the urethral orifice with contact bleeding. There was bilateral inguinal and left external iliac lymphadenopathy strongly suspicious of malignancy. The urethral lesion was excised and bilateral inguinal lymph node biopsies performed. Results: Histological examination showed an exophytic, polypoid tumour arising in urethral mucosa. Superficial aspects of the tumour had features of a conventional moderately differentiated squamous cell carcinoma. In the LELC areas, undifferentiated epithelial cells were arranged in cords and sheets surrounded by a heavy lymphoplasmacytic infiltrate. The tumour cells were positive for p16 immunostaining, however high risk human papillomavirus (HrHPV) testing was negative. Discussion: This is the first reported case of a LELC affecting the urethral orifice. The tumour cells stained negative for Epstein– Barr virus-encoded small RNA (EBER) which is expected as Epstein–Barr virus (EBV) is only implicated in the pathogenesis of nasopharyngeal lymphoepithelioma and LELC arising from foregut derivatives. The tumour stained positive for p16 but being negative for HrHPV infection, this significance is uncertain.
HELICOBACTER HEILMANNII GASTRITIS: CASE REPORTS AND LITERATURE REVIEW Nada Dickinson1, Simon Nazaretian1,2 and Siamak Sakhaie1 1Department of Anatomical Pathology and Cytology, Healthscope Pathology, Clayton, and 2Department of Anatomy and Developmental Biology, Monash University, Vic, Australia We report two cases of Helicobacter heilmannii gastritis, in a 59-year-old woman and in a 61-year-old man. Helicobacter heilmannii is a spiral organism first observed in the gastric mucosa of dogs in 1881. Reports of a spiral bacterium morphologically distinct from Helicobacter pylori, found in human gastric mucosa, were first published in 1987.1 This organism was referred to as Gastrospirillum hominis by the authors. A subsequent report by Heilmann and Borchard2 of a series of patients harbouring a flagellated, helical, urease producing organism distinct from Helicobacter pylori led to the renaming of the organism to
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Helicobacter heilmannii in honor of Heilmann who died shortly after the report was accepted for publication. Helicobacter heilmannii is the most common non-pylori species in humans, with an estimated incidence of 0.3%1 and typically produces a less severe gastritis and often less severe symptoms than Helicobacter pylori. It responds to conventional Helicobacter pylori eradication regimens. References 1. McNulty CA, Dent JC, Curry A, et al. New spiral bacterium in gastric mucosa. J Clin Pathol 1989; 42: 585–91. 2. Heilmann KL, Borchard F. Gastritis due to spiral shaped bacteria other than Helicobacter pylori: clinical, histological, and ultrastructural findings. Gut 1991; 32: 137–40.
CHRONIC VASCULAR REJECTION – A COMMON FINDING IN THE LUNG ALLOGRAFT IS ASSOCIATED WITH FEATURES OF ANTIBODY MEDIATED REJECTION J. E. Dunning1, N. Chin2, G. Westall2,3, G. Snell2,3 and C. A. McLean1,3 Departments of 1Anatomical Pathology, 2Allergy Immunology and Respiratory Medicine, The Alfred Hospital, and 3Department of Medicine, Central Clinical School, Monash University, Melbourne, Vic, Australia Aims: To determine the frequency of chronic vascular rejection (CVR) in the lung allograft and its association with donorspecific antibodies (DSA) in the serum, and features of acute antibody-mediated rejection (AMR) in transbronchial biopsies (TBBx). Methods: We retrospectively analysed the lung allografts of transplant recipients for CVR and collated their prior TBBx and Luminex test (for DSA) results. We longitudinally studied a cohort of lung transplant recipients and recorded Luminex tests, TBBx and survival data. Fisher’s exact test and Kaplan–Meier survival analysis were performed. Results: CVR was identified in 58.62% of lung allografts (n ¼ 31), and was associated with DSA (p ¼ 0.0043). DSA-positive patients with a TBBx featuring interstitial neutrophils (IN) within 50 days post-transplant (excluding concurrent infection or cellular rejection) were likely to develop CVR (p ¼ 0.0174). In the longitudinal study, 45.64% of patients were DSA positive (n ¼ 195); these patients were more likely to record a TBBx featuring IN (as per above specifications; p ¼ 0.0376), and had worse long-term graft function (p ¼ 0.0015). Conclusion: CVR is common in lung allografts. The presence of DSA and TBBx features of acute AMR should heighten suspicion for the potential development of CVR and graft failure.
PHEOCHROMOCYTOMA-PARAGANGLIOMA DUE TO GERMLINE SDHB MUTATION IN CHILDREN ARE COMMON Amalika Edirisinghe and Amanda Charlton Department of Histopathology, The Children’s Hospital at Westmead, NSW, Australia Introduction: Pheochromoctyoma-paraganglioma syndrome (PHEO-PGL) due to SDH germline mutation is easily identified by loss of SDHB by immunohistochemistry. Pham et al. showed a
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
immunoreactivity with synaptophysin and chromogranin-A. The duodenal lump was also a 2.5 mm well-differentiated NET, comprised of nests of bland epithelioid cells with granular cytoplasm, extending from the lamina propria into muscularis mucosae. Along with synaptophysin and chromogranin-A it was also positive for gastrin, indicative of a functional gastrinoma. Discussion: This rare case is reported to illustrate the pathophysiology of the occurrence of type 2 gastric NETs arising in the setting of MEN-1.
LYMPHOEPITHELIOMA-LIKE CARCINOMA OF THE FEMALE URETHRAL ORIFICE A. Devadass and B. Lockett Department of Anatomical Pathology, Medlab Central, Palmerston North, New Zealand Aims: We present the first reported case of a lymphoepitheliomalike carcinoma (LELC) affecting the female urethral orifice with regional lymph node metastases. Methods: An 86-year-old patient presented with light per vaginal (PV) bleeding for several months. A papillomatous growth was seen at the urethral orifice with contact bleeding. There was bilateral inguinal and left external iliac lymphadenopathy strongly suspicious of malignancy. The urethral lesion was excised and bilateral inguinal lymph node biopsies performed. Results: Histological examination showed an exophytic, polypoid tumour arising in urethral mucosa. Superficial aspects of the tumour had features of a conventional moderately differentiated squamous cell carcinoma. In the LELC areas, undifferentiated epithelial cells were arranged in cords and sheets surrounded by a heavy lymphoplasmacytic infiltrate. The tumour cells were positive for p16 immunostaining, however high risk human papillomavirus (HrHPV) testing was negative. Discussion: This is the first reported case of a LELC affecting the urethral orifice. The tumour cells stained negative for Epstein– Barr virus-encoded small RNA (EBER) which is expected as Epstein–Barr virus (EBV) is only implicated in the pathogenesis of nasopharyngeal lymphoepithelioma and LELC arising from foregut derivatives. The tumour stained positive for p16 but being negative for HrHPV infection, this significance is uncertain.
HELICOBACTER HEILMANNII GASTRITIS: CASE REPORTS AND LITERATURE REVIEW Nada Dickinson1, Simon Nazaretian1,2 and Siamak Sakhaie1 1Department of Anatomical Pathology and Cytology, Healthscope Pathology, Clayton, and 2Department of Anatomy and Developmental Biology, Monash University, Vic, Australia We report two cases of Helicobacter heilmannii gastritis, in a 59-year-old woman and in a 61-year-old man. Helicobacter heilmannii is a spiral organism first observed in the gastric mucosa of dogs in 1881. Reports of a spiral bacterium morphologically distinct from Helicobacter pylori, found in human gastric mucosa, were first published in 1987.1 This organism was referred to as Gastrospirillum hominis by the authors. A subsequent report by Heilmann and Borchard2 of a series of patients harbouring a flagellated, helical, urease producing organism distinct from Helicobacter pylori led to the renaming of the organism to
S63
Helicobacter heilmannii in honor of Heilmann who died shortly after the report was accepted for publication. Helicobacter heilmannii is the most common non-pylori species in humans, with an estimated incidence of 0.3%1 and typically produces a less severe gastritis and often less severe symptoms than Helicobacter pylori. It responds to conventional Helicobacter pylori eradication regimens. References 1. McNulty CA, Dent JC, Curry A, et al. New spiral bacterium in gastric mucosa. J Clin Pathol 1989; 42: 585–91. 2. Heilmann KL, Borchard F. Gastritis due to spiral shaped bacteria other than Helicobacter pylori: clinical, histological, and ultrastructural findings. Gut 1991; 32: 137–40.
CHRONIC VASCULAR REJECTION – A COMMON FINDING IN THE LUNG ALLOGRAFT IS ASSOCIATED WITH FEATURES OF ANTIBODY MEDIATED REJECTION J. E. Dunning1, N. Chin2, G. Westall2,3, G. Snell2,3 and C. A. McLean1,3 Departments of 1Anatomical Pathology, 2Allergy Immunology and Respiratory Medicine, The Alfred Hospital, and 3Department of Medicine, Central Clinical School, Monash University, Melbourne, Vic, Australia Aims: To determine the frequency of chronic vascular rejection (CVR) in the lung allograft and its association with donorspecific antibodies (DSA) in the serum, and features of acute antibody-mediated rejection (AMR) in transbronchial biopsies (TBBx). Methods: We retrospectively analysed the lung allografts of transplant recipients for CVR and collated their prior TBBx and Luminex test (for DSA) results. We longitudinally studied a cohort of lung transplant recipients and recorded Luminex tests, TBBx and survival data. Fisher’s exact test and Kaplan–Meier survival analysis were performed. Results: CVR was identified in 58.62% of lung allografts (n ¼ 31), and was associated with DSA (p ¼ 0.0043). DSA-positive patients with a TBBx featuring interstitial neutrophils (IN) within 50 days post-transplant (excluding concurrent infection or cellular rejection) were likely to develop CVR (p ¼ 0.0174). In the longitudinal study, 45.64% of patients were DSA positive (n ¼ 195); these patients were more likely to record a TBBx featuring IN (as per above specifications; p ¼ 0.0376), and had worse long-term graft function (p ¼ 0.0015). Conclusion: CVR is common in lung allografts. The presence of DSA and TBBx features of acute AMR should heighten suspicion for the potential development of CVR and graft failure.
PHEOCHROMOCYTOMA-PARAGANGLIOMA DUE TO GERMLINE SDHB MUTATION IN CHILDREN ARE COMMON Amalika Edirisinghe and Amanda Charlton Department of Histopathology, The Children’s Hospital at Westmead, NSW, Australia Introduction: Pheochromoctyoma-paraganglioma syndrome (PHEO-PGL) due to SDH germline mutation is easily identified by loss of SDHB by immunohistochemistry. Pham et al. showed a
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.