- Email: [email protected]
Nucleic acid and monoclonal antibody probes, applications in diagnostic microbiology
BOOK REVIEWS
1. Scheithauer BW: Tumors of the meninges: Proposed modifications of the World Health OrEantzation classification. Acfa Neuropathol 80:343-
supporting a diagnosis of a primary mutinous adenocarcinoma of lung with signet-ring cells, as Kish et al described.
3.54, I990
2. Manicel JCL Sung JH: Pathology (part ?) 25:159-192. 199n
of meningiomas.
Pathol .4nnual
MARIANO C. AL.L.E~v.MD Providence Memorial Hospital El Paso, TX
I. Kish JK, Ro JI’, Ayala .4G, et al: Primary mutinous adenocarcinoma of the lung with signet-ring cells. Hrw PATWOI.20: 1097-I 102.I989
An Additional Case of Primary Adenocarcinoma of the Lung With a Signet-Ring Cell Component
The above letter was referred to the authors question, who ojfer the following reply:
To thy f%itor:---Dr Janet K. Kish et al recently drew attention to primary mutinous adenocarcinoma of the lung with signet ring-cells and documented five cases, comparing the histochemical staining of various signet-ring cell carcinomas as well as the clinical histologic and prognostic implications of this tumor.’ I read their article with great interest because I had the opportunity to observe a similar case. The patient, a 55.year-old man, presented with a 2year history of progressive diffuse left pleural thickening with entrapment of the underlying lung, preventing its full expansion. The clinical impression was that of left-sided fibrothorax versus mesothelioma. He underwent left thoracotomy and decortication with subsequent expansion of the lung and great clinical improvement. Histologic examination of the decortication specimen demonstrated adenocarcinoma, signet-ring cell type, at that time thought to be metastatic. Dr Albert0 Ayala and Dr Jae Y. Ro reviewed the material and concurred with our diagnosis. Thorough physical examination, including upper and lower gastrointestinal series failed to demonstrate a primary site of origin. Fourteen lnonths after the operation, the patient had radiologic evidence of a small residual tumor in the left pleural cavity; however, he is doing relatively well without treatment and without evidence of tumor elsewhere, strongly
JAE Y. Ro, MD ALBERTO G. AYALA. MD
The University M.D. Anderson Houston, TX
NY, Marcel
Dekker,
of Texas (:ancer Center
I. Kish JK. Ro Jy, Ayala AC;. et al: Primary mutinous adenocarcinoma of the lung with signet-ring . cells. HUM PATHOI.20: 1097--l 102. I989 2. Rutala RM: Neuroendocrine markers in pulmonarv adenocarcinoma with stgnet-ring cells. HUM PATHOL21: 1082. 1990 (letter) 3. Sarma DP. Hoffmann EO: Primary signet-rmg cell rarcim>ma of the lung. HC’MPAI HOI. ?1:459, 1990 (letter)
mosomal DNA analyses in epidemiology, and restriction endonuclease analyses. The final seven chapters of this section discuss the use of nucleic acid probes for detection of clinically significant bacteria, with special emphasis on Campylobacter sp, Salmonella sp, mycoplasms, yeasts, and malaria. Part II deals with monoclonal antibody-based immunoassays. The first two chapters discuss practical methods for making and purifying monoclonal antibodies. The following 11 chapters detail progress in the use of monoclonal antibodies for diagnostic microbiology. Microorganisms discussed in individual chapters include Chlumvdiu tracho-
Nucleic Acid and Monoclonal Antibody Probes, Applications in Diagnostic Microbiology. B. Swaminathan and G. New York.
in
To the Editor:-We had a chance to review Dr Allen’s case in consultation and agreed with his diagnosis of a signet-ring cell carcinoma (SRCC), most likely a lung primary involving the pleura. Since our report of five cases of primary adenocarcinoma of the lung with SRCC components appeared in HUMAN PATH~LOCY in 1989,’ Butala reported two cases, Sarma and Hoffmann reported one case, and now Dr Allen is reporting an additional case. These cases undoubtedly provide further support that SRCC can occur as a primary tumor in the lung. Although we believe that SRCC of the lung is a distinctive histologic variant of adenocarcinoma, its clinical importance remains to be defined.
BOOK REVIEWS
Prakash (eds). pages, $150.
of the article
1989, 717
Diagnostic microbiology is undergoing significant changes as a result of the application of biotechnology to the detectison and identification of microorganisms that cause disea:je or product spoilage. This book deals with the application of nucleic acid hybridization and monoclonal antibody technology to diagnostic microbiology. Rapid detection methods are desperately needed in diagnostic microbiology to improve patient care in clinical microbiology and to institute rapid remedial measures in quality control in industrial processes. Rapid, sensitive, noncultural diagnostic methods are of particular significance for the detection of microorganisms that either grow slowly (eg, Mycobacterium SF)) or are difficult to culture (eg, viruses, chlamydia. mycoplasma). This book is organized into two parts. Part I deals with nucleic acid detection and characterization of microorganisms. The first chapter provides a basic, in-depth overview of the principles of nucleic acid hybridization. Subsequent chapters address nonradioactive labeling of nucleic acid probes. DNA probes to ribosomal RNA, plasmid and chro-
mat&
Treponemn
pallidurn,
Nekseria
gonorrheae,
ikycobacterin
A and B streptococci, Brucella sp, Salmonella sp, Campylobncter sp, Clostridium difSicile and its toxins, and coliform bacteria. Finally, separate chapters address mycotoxin detection by immunoassay and provide an overview of the use of monoclonal antibodies for diagnostic microbiology in the clinical laboratory. The final chapter of the book provides a brief overview of. more recent developments, including polymerase chain reaction and Qbeta replicase technology, fluorescent DNA probes, and updates in hybridoma technology. This is a comprehensive text suitable for clinical laboratory microbiologists, clinicians, and researchers entering this field. It is well written and carefully documented. This book is recommended strongly as an excellent reference sp, groups
403
HUMAN PATHOLOGY
regarding the current status nostic microbiology-BRucE Pathology, Rock, AR
University
of probe
technology
E. DUNN, MD, of Arkansas for Medicul
Volume 22, No. 4 [April 1991)
in diag-
Department of Sciences, Little
Atlas and Text of Aspiration Biopsy Cytology. Baltimore, MD, Williams & Williams, 1990, $79.50.
K. C. Suen. 273 pages,
Dr Suen draws on his extensive experience with fine needle aspiration to write and illustrate this effective overview. With the exception of the central nervous system and the bones, virtually every organ or organ system is discussed. The approach emphasizes the study of smear pattern at low magnification as well as the details of cellular morphology. Each diagnostic entity is introduced by a brief review of pertinent clinical considerations and key observations from the cytopathology literature. To this is often added a summary of the author’s experience. Thus, cytologic findings are described and illustrated in the context of the broad clinical picture. Each section concludes with a concise discussion of diagnostic pitfalls. It is in these discussions that the author’s experience is most apparent. The reader is not only cautioned against possible mistakes in interpretation, but is alerted to clinical or radiographic findings that should influence selection of a final diagnosis or list of possible diagnoses. Dr Suen places importance on making diagnoses that closely resemble those originating in the laboratory of surgical pathology. To support this important goal, he provides tumor classifications that are in tune with contemporary surgical pathology. This is most apparent in the discussions of soft tissue tumors and the malignant lymphomas. With rare exceptions, the illustrations depict fixed, he-
matoxylin-eosin-stained material. Since all are black and white, the reader will appreciate very little difference between these and the anticipated appearance of Papanicolaou-stained material. Some would prefer more illustration and discussion of air-dried, Romanovsky-stained material, since the current trend in many centers is concurrent use of both fixed and dried preparations. The photographs are generally of high quality. A few (mostly of histologic sections) are slightly out of focus. The chapter bibliographies include a moderate number of well-chosen references, which appear to be current through 1988. The final chapter is a brief overview of diagnostic immunocytochemistry in fine needle aspiration. This will serve to suggest possibilities for resolution of difficult cases. Very useful ground rules regarding controls, diagnosis by antibody panels, false-positive staining, and false-negative staining are given. This book achieves the stated goal of creating a “practical guide” to aid pathologists, residents, and cytotechnologists in fine needle aspiration interpretation. Its strengths include discussion of both common and uncommon conditions and a description of the appropriate clinical contexts in which a given diagnosis should be considered. The reader will benefit from the warnings about potential pitfalls that are offered by an experienced cytopathologist. Those requiring detailed discussions of specific entities or more complete literature reviews will need to consult additional sources. Finally, this book is both concise and informative. Those preparing for board examinations in either pathology or cytotechnology may find it a very efficient means of r&%.-MICHAEL W. STANLEY, MD, Senior- Puthologiit, Department neapoliy,
BOOKS RECEIVED
Books for rerlieur or l~~slq may be Sent to A. J. Hough, Jr, MD, Department of Pathology, College of Mediune. 4301 W Markham, Little Rock, AR 72205. Bookr will be reviewed at the dixretzon of the Book Reuaew Editor. The followzng book, were receivrd in January 1991. Surgical Pathology Techniques. D. G. Lowe and I. M. Jeff.rey. St Louis, MO, Mosby-Year Book, 1990. 144 pages, $69.50. Surgical Pathology of the Nervous System and Its Covering, ed 3. Peter C. Burger, Bernd W. Scheithauer. and F. Stephen Vogel. New York, NY, Churchill Livingstone, 1990,737 pages, $139.95. Organ-Specific Autoimmunity (Immunology SerieslSP). Pierluigi E. Bigazzi, Georg Wick, and Konrad Wither. New York. NY, Marcel Dekker, 1990, 408 pages, $125. Molecular Diagnostics in Pathology. Cecilia M. Fenoglio-Preiser and Cheryl L. Willman. York, PA, Williams & Wilkins, 1991, 379 pages, $67. Functional Endocrine Pathology, vols I and II. Kalman Kovacs
404
of Pathology MN
Hewnepin
County
Medical
Center,
Min-
and Sylvia L. Asa. St Louis, MO, Mosby-Year Book. 1991, 1,013 pages (combined), $199.95 (combined). Hereditary Nephritis (contributions to Nephrology, vol SO). A. Sessa. M. Meroni, and G. Battini. Basel. Switzerland, Karger, 1990, 168 pages. $118. Color Atlas of Clinical Oral Pathology. Brad W. Neville. Douglas D. Damm. Dean K. White, and Charles A. Waldron. Malvern. PA, Lea & Febiger, Inc. 1990, 381 pages, $89.50. Tumor Suppressor Genes (Immunology Seriesl51). George Klein. New York. NY, Marcel Dekker, 1990, $99.75. Current Surgical Pathology. Michael J. Warhol. Philadelphia, PA, Decker, 1990. 144 pages. The Metabolic and Molecular Basis of Acquired Disease (two ~01s). R. D. Cohen. B. Lewis, K. G. M. M. Alberti, and A. M. Denman, Philadelphia, PA, Saunders, 1990, 2.248 pages (set), $295. Color Atlas of Heart Disease. George Sutton and Kim Fox. Philadelphia, PA, Lippincott, 1990, 276 pages, $89.50. Coloscopy. Louis Burke, Donald A. Antonioli, and Barbara S. Ducatman. East Norwalk, CT, Appleton and Lange, 1990. 221 pages, $75.
1. Scheithauer BW: Tumors of the meninges: Proposed modifications of the World Health OrEantzation classification. Acfa Neuropathol 80:343-
supporting a diagnosis of a primary mutinous adenocarcinoma of lung with signet-ring cells, as Kish et al described.
3.54, I990
2. Manicel JCL Sung JH: Pathology (part ?) 25:159-192. 199n
of meningiomas.
Pathol .4nnual
MARIANO C. AL.L.E~v.MD Providence Memorial Hospital El Paso, TX
I. Kish JK, Ro JI’, Ayala .4G, et al: Primary mutinous adenocarcinoma of the lung with signet-ring cells. Hrw PATWOI.20: 1097-I 102.I989
An Additional Case of Primary Adenocarcinoma of the Lung With a Signet-Ring Cell Component
The above letter was referred to the authors question, who ojfer the following reply:
To thy f%itor:---Dr Janet K. Kish et al recently drew attention to primary mutinous adenocarcinoma of the lung with signet ring-cells and documented five cases, comparing the histochemical staining of various signet-ring cell carcinomas as well as the clinical histologic and prognostic implications of this tumor.’ I read their article with great interest because I had the opportunity to observe a similar case. The patient, a 55.year-old man, presented with a 2year history of progressive diffuse left pleural thickening with entrapment of the underlying lung, preventing its full expansion. The clinical impression was that of left-sided fibrothorax versus mesothelioma. He underwent left thoracotomy and decortication with subsequent expansion of the lung and great clinical improvement. Histologic examination of the decortication specimen demonstrated adenocarcinoma, signet-ring cell type, at that time thought to be metastatic. Dr Albert0 Ayala and Dr Jae Y. Ro reviewed the material and concurred with our diagnosis. Thorough physical examination, including upper and lower gastrointestinal series failed to demonstrate a primary site of origin. Fourteen lnonths after the operation, the patient had radiologic evidence of a small residual tumor in the left pleural cavity; however, he is doing relatively well without treatment and without evidence of tumor elsewhere, strongly
JAE Y. Ro, MD ALBERTO G. AYALA. MD
The University M.D. Anderson Houston, TX
NY, Marcel
Dekker,
of Texas (:ancer Center
I. Kish JK. Ro Jy, Ayala AC;. et al: Primary mutinous adenocarcinoma of the lung with signet-ring . cells. HUM PATHOI.20: 1097--l 102. I989 2. Rutala RM: Neuroendocrine markers in pulmonarv adenocarcinoma with stgnet-ring cells. HUM PATHOL21: 1082. 1990 (letter) 3. Sarma DP. Hoffmann EO: Primary signet-rmg cell rarcim>ma of the lung. HC’MPAI HOI. ?1:459, 1990 (letter)
mosomal DNA analyses in epidemiology, and restriction endonuclease analyses. The final seven chapters of this section discuss the use of nucleic acid probes for detection of clinically significant bacteria, with special emphasis on Campylobacter sp, Salmonella sp, mycoplasms, yeasts, and malaria. Part II deals with monoclonal antibody-based immunoassays. The first two chapters discuss practical methods for making and purifying monoclonal antibodies. The following 11 chapters detail progress in the use of monoclonal antibodies for diagnostic microbiology. Microorganisms discussed in individual chapters include Chlumvdiu tracho-
Nucleic Acid and Monoclonal Antibody Probes, Applications in Diagnostic Microbiology. B. Swaminathan and G. New York.
in
To the Editor:-We had a chance to review Dr Allen’s case in consultation and agreed with his diagnosis of a signet-ring cell carcinoma (SRCC), most likely a lung primary involving the pleura. Since our report of five cases of primary adenocarcinoma of the lung with SRCC components appeared in HUMAN PATH~LOCY in 1989,’ Butala reported two cases, Sarma and Hoffmann reported one case, and now Dr Allen is reporting an additional case. These cases undoubtedly provide further support that SRCC can occur as a primary tumor in the lung. Although we believe that SRCC of the lung is a distinctive histologic variant of adenocarcinoma, its clinical importance remains to be defined.
BOOK REVIEWS
Prakash (eds). pages, $150.
of the article
1989, 717
Diagnostic microbiology is undergoing significant changes as a result of the application of biotechnology to the detectison and identification of microorganisms that cause disea:je or product spoilage. This book deals with the application of nucleic acid hybridization and monoclonal antibody technology to diagnostic microbiology. Rapid detection methods are desperately needed in diagnostic microbiology to improve patient care in clinical microbiology and to institute rapid remedial measures in quality control in industrial processes. Rapid, sensitive, noncultural diagnostic methods are of particular significance for the detection of microorganisms that either grow slowly (eg, Mycobacterium SF)) or are difficult to culture (eg, viruses, chlamydia. mycoplasma). This book is organized into two parts. Part I deals with nucleic acid detection and characterization of microorganisms. The first chapter provides a basic, in-depth overview of the principles of nucleic acid hybridization. Subsequent chapters address nonradioactive labeling of nucleic acid probes. DNA probes to ribosomal RNA, plasmid and chro-
mat&
Treponemn
pallidurn,
Nekseria
gonorrheae,
ikycobacterin
A and B streptococci, Brucella sp, Salmonella sp, Campylobncter sp, Clostridium difSicile and its toxins, and coliform bacteria. Finally, separate chapters address mycotoxin detection by immunoassay and provide an overview of the use of monoclonal antibodies for diagnostic microbiology in the clinical laboratory. The final chapter of the book provides a brief overview of. more recent developments, including polymerase chain reaction and Qbeta replicase technology, fluorescent DNA probes, and updates in hybridoma technology. This is a comprehensive text suitable for clinical laboratory microbiologists, clinicians, and researchers entering this field. It is well written and carefully documented. This book is recommended strongly as an excellent reference sp, groups
403
HUMAN PATHOLOGY
regarding the current status nostic microbiology-BRucE Pathology, Rock, AR
University
of probe
technology
E. DUNN, MD, of Arkansas for Medicul
Volume 22, No. 4 [April 1991)
in diag-
Department of Sciences, Little
Atlas and Text of Aspiration Biopsy Cytology. Baltimore, MD, Williams & Williams, 1990, $79.50.
K. C. Suen. 273 pages,
Dr Suen draws on his extensive experience with fine needle aspiration to write and illustrate this effective overview. With the exception of the central nervous system and the bones, virtually every organ or organ system is discussed. The approach emphasizes the study of smear pattern at low magnification as well as the details of cellular morphology. Each diagnostic entity is introduced by a brief review of pertinent clinical considerations and key observations from the cytopathology literature. To this is often added a summary of the author’s experience. Thus, cytologic findings are described and illustrated in the context of the broad clinical picture. Each section concludes with a concise discussion of diagnostic pitfalls. It is in these discussions that the author’s experience is most apparent. The reader is not only cautioned against possible mistakes in interpretation, but is alerted to clinical or radiographic findings that should influence selection of a final diagnosis or list of possible diagnoses. Dr Suen places importance on making diagnoses that closely resemble those originating in the laboratory of surgical pathology. To support this important goal, he provides tumor classifications that are in tune with contemporary surgical pathology. This is most apparent in the discussions of soft tissue tumors and the malignant lymphomas. With rare exceptions, the illustrations depict fixed, he-
matoxylin-eosin-stained material. Since all are black and white, the reader will appreciate very little difference between these and the anticipated appearance of Papanicolaou-stained material. Some would prefer more illustration and discussion of air-dried, Romanovsky-stained material, since the current trend in many centers is concurrent use of both fixed and dried preparations. The photographs are generally of high quality. A few (mostly of histologic sections) are slightly out of focus. The chapter bibliographies include a moderate number of well-chosen references, which appear to be current through 1988. The final chapter is a brief overview of diagnostic immunocytochemistry in fine needle aspiration. This will serve to suggest possibilities for resolution of difficult cases. Very useful ground rules regarding controls, diagnosis by antibody panels, false-positive staining, and false-negative staining are given. This book achieves the stated goal of creating a “practical guide” to aid pathologists, residents, and cytotechnologists in fine needle aspiration interpretation. Its strengths include discussion of both common and uncommon conditions and a description of the appropriate clinical contexts in which a given diagnosis should be considered. The reader will benefit from the warnings about potential pitfalls that are offered by an experienced cytopathologist. Those requiring detailed discussions of specific entities or more complete literature reviews will need to consult additional sources. Finally, this book is both concise and informative. Those preparing for board examinations in either pathology or cytotechnology may find it a very efficient means of r&%.-MICHAEL W. STANLEY, MD, Senior- Puthologiit, Department neapoliy,
BOOKS RECEIVED
Books for rerlieur or l~~slq may be Sent to A. J. Hough, Jr, MD, Department of Pathology, College of Mediune. 4301 W Markham, Little Rock, AR 72205. Bookr will be reviewed at the dixretzon of the Book Reuaew Editor. The followzng book, were receivrd in January 1991. Surgical Pathology Techniques. D. G. Lowe and I. M. Jeff.rey. St Louis, MO, Mosby-Year Book, 1990. 144 pages, $69.50. Surgical Pathology of the Nervous System and Its Covering, ed 3. Peter C. Burger, Bernd W. Scheithauer. and F. Stephen Vogel. New York, NY, Churchill Livingstone, 1990,737 pages, $139.95. Organ-Specific Autoimmunity (Immunology SerieslSP). Pierluigi E. Bigazzi, Georg Wick, and Konrad Wither. New York. NY, Marcel Dekker, 1990, 408 pages, $125. Molecular Diagnostics in Pathology. Cecilia M. Fenoglio-Preiser and Cheryl L. Willman. York, PA, Williams & Wilkins, 1991, 379 pages, $67. Functional Endocrine Pathology, vols I and II. Kalman Kovacs
404
of Pathology MN
Hewnepin
County
Medical
Center,
Min-
and Sylvia L. Asa. St Louis, MO, Mosby-Year Book. 1991, 1,013 pages (combined), $199.95 (combined). Hereditary Nephritis (contributions to Nephrology, vol SO). A. Sessa. M. Meroni, and G. Battini. Basel. Switzerland, Karger, 1990, 168 pages. $118. Color Atlas of Clinical Oral Pathology. Brad W. Neville. Douglas D. Damm. Dean K. White, and Charles A. Waldron. Malvern. PA, Lea & Febiger, Inc. 1990, 381 pages, $89.50. Tumor Suppressor Genes (Immunology Seriesl51). George Klein. New York. NY, Marcel Dekker, 1990, $99.75. Current Surgical Pathology. Michael J. Warhol. Philadelphia, PA, Decker, 1990. 144 pages. The Metabolic and Molecular Basis of Acquired Disease (two ~01s). R. D. Cohen. B. Lewis, K. G. M. M. Alberti, and A. M. Denman, Philadelphia, PA, Saunders, 1990, 2.248 pages (set), $295. Color Atlas of Heart Disease. George Sutton and Kim Fox. Philadelphia, PA, Lippincott, 1990, 276 pages, $89.50. Coloscopy. Louis Burke, Donald A. Antonioli, and Barbara S. Ducatman. East Norwalk, CT, Appleton and Lange, 1990. 221 pages, $75.