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Tamm-horsfall protein: structure and biological properties
298
ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA
Pathology (1980), 12, April
HISTOLOGICAL PATTERNS OF CUTANEOUS B CELL AND T CELL LYMPHOMAS
A. S-Y. LEONG Department of Histopathology, The Queen Elizabeth Hospital, Woodville, S.A. Investigations of lymphoreticular malignancies attempt currently to correlate morphology with immunological function. While attention has been centred primarily on the lymph node, it has not been widely appreciated that the pattern of cutaneous infiltration by malignant lymphocytes also reflects their functional properties. Six cases of malignant lymphoma other than mycosis fungoides and Sezary syndrome were selected to demonstrate the histological patterns of cutaneous involvement. Surface marker studies identified 3 cases to be of B lymphocyte origin and the others showed characteristics of T lymphocytes. Each group revealed a distinctive histological pattern of infiltration. The B cell lymphomas were located in the middle and deeper parts of the dermis, with prominent sparing of the superficial dermis and preservation of the grenz zone. The malignant B lymphocytes never involved the epidermis and showed a sharp demarcation from the surrounding dermal collagen. Morphologically. the cells were a mixture ofcleaved cells with discernible nuclear folds and non-cleaved cells with vesicular nuclei and pink nucleoli. The pattern of skin involvement by malignant T lymphocytes was quite different. All 3 cases were characterized by a band-like infiltrate of atypical lymphocytes in the superficial dermis. These cells obliterated the papillary dermis, and many of the atypical lymphoid cells displayed prominent nuclear folds. There was focal exocytosis of these cells into acantholytic spaces within the epidermis to form classical Pautrier abscesses. These features were indistinguishable from that which characterizes mycosis fungoides and its leukaemic counterpart, Sezary syndrome. It is proposed that epidermotropism is a phenomenon that is not only limited to mycosis fungoides and Sezary syndrome, but may be a property common to other subpopulations of T lymphocytes as evidenced by our cases. There are also increasing reports which suggest that mycosis-like cells can be seen in a variety of skin conditions which involve non-neoplastic transformation of T lymphocytes. Preliminary data suggest that the homing of T lymphocytes to the skin may be related to the presence of metal-binding proteins on the cells although the mechanics of this skin-T lymphocyte interaction presently remains unclear. COMBINED X-RAY ANALYSIS AND ELECTRON MICROSCOPY OF Z1NC IN OYSTER TISSUE
D. G. LmroN & W. JABLONSKI Centre for Environmental Studies and Cenrral Scienw Luhoratory. University of Tasmania, Hobart Contamination of the marine environment with zinc, as well as posing a hazard to human health, is suspected of causing ecological disruption. Histochemical and physical methods of analysis were applied to the native oyster. Ostrea angasi, to determine the cytopathological effects of zinc accumulation within its tissue and to explain its tolerance for this heavy metal. Specimens were collected from sites in the Derwent Estuary, where commercially grown oysters, containing up to 103; of their dry weight as zinc, had previously been responsible for cases of food poisoning. Oysters were also gathered from the east coast of Tasmania. Tissue was fixed in H,S-saturated glutaraldehyde and prepared for light and electron microscopy (CTEM). The concentration of zinc in the peri-intestinal tissue was determined by atomic absorption spectrophotometry and the element located histochemically by the sulphide-silver and alkalinedithizone techniques. Thin sections were examined in an Hitachi HS-7S transmission electron microscope, and both thin and thick sections were examined in a JEOL JXA-50A combined scanning electron microscope (SEM) and electron probe microanalyser. The concentration of zinc in the intestinal tissue was the same order of magnitude (104 pg/g dry weight) in all specimens and the tissue reaction was the same in all instances. Zinc was widely distributed beneath the epithelium of the digestive tract and located within the cytoplasm of phagocytic cells. These zinc-laden cells were also seen within the intestinal epithelium. Large numbers of phagocytes beneath the basement membranc were associated with a fibrous tissue reaction. Intracellular zinc in the CTEM was in the form of electron dense, ring-like structures (1 jrm in diameter), which appeared as bright spherules in the SEM. The presence of zinc in these granules was confirmed by energy dispersive (EDAX) and wavelength dispersive systems of X-Ray analysis. TAMM-HORSFALL PROTEIN: STRUCTURE AND BIOLOGICAL PROPERTIES
A. R. MCGIVEN, J. S. HUNr & W. A. DAY Department ofPathology. Christchurch Clinical Sclzoolof Medicine. University of' Otago, NeMi Zealand Tamm-Horsfall protein (THP). which is a prominent component of urinary casts, is a glycoprotein with a molecular weight of 7 x 10" composed of subunits of lo5 daltons and contains approximately 23',$ carbohydrate. Electron
ABSTRACTS OF ANkWAL MEETING
1979 299
microscopic studies after adsorption with horseradish peroxidase reveal a zig-zag pattern of periodicity 2 I nm, and a flattened helical structure is proposed. Biologically some T H P preparations stimulate cell division in normal human lymphocytes. Recent work suggests this may reflect the presence of glucose in stimulatory preparations. This mitogenic property must he taken into account in evaluatingcellular autoimmunity against T H P in patients with renal disease. As T H P is secreted by cclls in the ascending limb of the loop of Henle and distal convoluted tubule, its detection in Bowman’s space may prove to be a useful sign of intrarenal urinary reflux.
TWO RECENT CASES OF EXOTIC SUPERFICIAL PARASITISM
B. MCMILLAN, J. MACFARLAY, R. SILVERTON*, D. GEE& T. R ~ v d*Schoolyf Piihlic, Hrultlr untl Tropicul Mc.dicine. S~tinej,Horrr.sl>), mii Kir-ring-gui Ilospirul, S ~ d t i e lcirld ~ tRoyui Norrh Shore Hospital. Sjdnej 1 CornirriuAis serin1i.c. An 18-yr-old male presented in July 1978 with a subcutaneous nodule of 3 wk duration on the medial aspect ofthe right upper arm. On excision, the larval form (Counurus) of the dog tapeworm. Multiceps. was demonstrated. The patient had been employed as a station hand on a property at Scone in the Hunter River area of N.S.W. He owned 2 dogs and there were about a dozen other dogs on the property which were often fed on rabbits. Mulricrps seriulis is the only species of the genus known to he present in Australia. In N.S.W., 2.5”;, of dogs are infected. The normal intermediate host of the parasitism is the rabbit. This record. which probably indicates an immune deficiency on the part of the patient, is thc first in Australia and about the eighth in the literature. 2 Etcippic fascioliusis During the second week of April 1979 a 48-yr-old French woman noted a well defined. f r m , moderately Gxed nodule, partly underlying the sternomastoid in the anterior triangle of the neck on the left side. A provisional diagnosis of lymphoma was made. She was otherwise well and had had an unrelated cholecystectomy 3 years previously. At operation, a densely adherent lymph node was submitted for frozen section arid on examination a lymphadenitis with numerous eosinophilic granulomata of parasitic origin was demonstrated. The patient had lived in Australia since 1964 except for visits to France every 2 yr. The family had a grazing property in the Kyogle area of N.S.W. where watcrcress abounded and was eaten on their yearly visits. is uncommon and this is the first known record in Etnpic fascioliasis due to the liver-fluke. Fusiioku ~ic~~~ufpic~-r, Australia.
LYMPHO-EPITHELIAL AND LYMPHOID TUMOURS AND TUMOUR LIKE CONDITIONS OF SALIVARY GLANDS
R. MOTTERAMPatliolog~~ Dryiurtrircwt of the C’uticcr Iri.sri~irrc~of C’rcforiu These conditions are of various types. They may be inflammatory in nature. rcsult from the b e n i p growth o f vestigial tissue or be neoplastic. Lyniphocytic sialadenitis, either focal or dilfuse. bears thc eponymous label of Mikulicr’sdisease. It consists ofan infiltration and proliferation of normal lymphocytes within the lobules ofthe salivary gland. This is associated with atrqphy and loss of acinar tissue. There is also a coincidental proliferation of the ductular epithelium to form compact epi-inyoepithelial islands. These islands are scen embedded amongst the lymphoid tissue which has replaced the acinar parenchyma. The parotid gland is closely associated with lymphatic tissue. and glandular inclusions of ductular type may be found in the nodes ofthe area. This ductitlar element may proliferate in an adenoinatous manner and become cystic. Such an example is the distinctive Warthin’s papillary cystadenoma lymphomatosum where the lymphoid clement I S small in amount and follicular in type. Another example is Ihe nodular benign lymphoepithelial lesion. which is iisually solitary, encapsulated and set amidst the parenchyma ol’ the parotid gland. I t consists of a mass of normal lymphocytes amongst which are found rather scanty streams and islands of epithelial tissue. The parotid gland may be the site of orisin of lymphomas, inore especially of the nodular type. Here the glandular parenchyma is replaced by the lymphoma, often lobule by lobule, with extension ofthe disease tirst to the local and subscquenily to the regional nodes. lmmediately adjacent t o the lymphomatous infiltrate. lymphocytic sialadenitis with benign reactive follicles may be found. hut epi-myoepithelial islands are rarely sccn. This mixture of benign ~ t n d malignant lymphatic tissue can complicate the histological interpretation of the condition.
ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA
Pathology (1980), 12, April
HISTOLOGICAL PATTERNS OF CUTANEOUS B CELL AND T CELL LYMPHOMAS
A. S-Y. LEONG Department of Histopathology, The Queen Elizabeth Hospital, Woodville, S.A. Investigations of lymphoreticular malignancies attempt currently to correlate morphology with immunological function. While attention has been centred primarily on the lymph node, it has not been widely appreciated that the pattern of cutaneous infiltration by malignant lymphocytes also reflects their functional properties. Six cases of malignant lymphoma other than mycosis fungoides and Sezary syndrome were selected to demonstrate the histological patterns of cutaneous involvement. Surface marker studies identified 3 cases to be of B lymphocyte origin and the others showed characteristics of T lymphocytes. Each group revealed a distinctive histological pattern of infiltration. The B cell lymphomas were located in the middle and deeper parts of the dermis, with prominent sparing of the superficial dermis and preservation of the grenz zone. The malignant B lymphocytes never involved the epidermis and showed a sharp demarcation from the surrounding dermal collagen. Morphologically. the cells were a mixture ofcleaved cells with discernible nuclear folds and non-cleaved cells with vesicular nuclei and pink nucleoli. The pattern of skin involvement by malignant T lymphocytes was quite different. All 3 cases were characterized by a band-like infiltrate of atypical lymphocytes in the superficial dermis. These cells obliterated the papillary dermis, and many of the atypical lymphoid cells displayed prominent nuclear folds. There was focal exocytosis of these cells into acantholytic spaces within the epidermis to form classical Pautrier abscesses. These features were indistinguishable from that which characterizes mycosis fungoides and its leukaemic counterpart, Sezary syndrome. It is proposed that epidermotropism is a phenomenon that is not only limited to mycosis fungoides and Sezary syndrome, but may be a property common to other subpopulations of T lymphocytes as evidenced by our cases. There are also increasing reports which suggest that mycosis-like cells can be seen in a variety of skin conditions which involve non-neoplastic transformation of T lymphocytes. Preliminary data suggest that the homing of T lymphocytes to the skin may be related to the presence of metal-binding proteins on the cells although the mechanics of this skin-T lymphocyte interaction presently remains unclear. COMBINED X-RAY ANALYSIS AND ELECTRON MICROSCOPY OF Z1NC IN OYSTER TISSUE
D. G. LmroN & W. JABLONSKI Centre for Environmental Studies and Cenrral Scienw Luhoratory. University of Tasmania, Hobart Contamination of the marine environment with zinc, as well as posing a hazard to human health, is suspected of causing ecological disruption. Histochemical and physical methods of analysis were applied to the native oyster. Ostrea angasi, to determine the cytopathological effects of zinc accumulation within its tissue and to explain its tolerance for this heavy metal. Specimens were collected from sites in the Derwent Estuary, where commercially grown oysters, containing up to 103; of their dry weight as zinc, had previously been responsible for cases of food poisoning. Oysters were also gathered from the east coast of Tasmania. Tissue was fixed in H,S-saturated glutaraldehyde and prepared for light and electron microscopy (CTEM). The concentration of zinc in the peri-intestinal tissue was determined by atomic absorption spectrophotometry and the element located histochemically by the sulphide-silver and alkalinedithizone techniques. Thin sections were examined in an Hitachi HS-7S transmission electron microscope, and both thin and thick sections were examined in a JEOL JXA-50A combined scanning electron microscope (SEM) and electron probe microanalyser. The concentration of zinc in the intestinal tissue was the same order of magnitude (104 pg/g dry weight) in all specimens and the tissue reaction was the same in all instances. Zinc was widely distributed beneath the epithelium of the digestive tract and located within the cytoplasm of phagocytic cells. These zinc-laden cells were also seen within the intestinal epithelium. Large numbers of phagocytes beneath the basement membranc were associated with a fibrous tissue reaction. Intracellular zinc in the CTEM was in the form of electron dense, ring-like structures (1 jrm in diameter), which appeared as bright spherules in the SEM. The presence of zinc in these granules was confirmed by energy dispersive (EDAX) and wavelength dispersive systems of X-Ray analysis. TAMM-HORSFALL PROTEIN: STRUCTURE AND BIOLOGICAL PROPERTIES
A. R. MCGIVEN, J. S. HUNr & W. A. DAY Department ofPathology. Christchurch Clinical Sclzoolof Medicine. University of' Otago, NeMi Zealand Tamm-Horsfall protein (THP). which is a prominent component of urinary casts, is a glycoprotein with a molecular weight of 7 x 10" composed of subunits of lo5 daltons and contains approximately 23',$ carbohydrate. Electron
ABSTRACTS OF ANkWAL MEETING
1979 299
microscopic studies after adsorption with horseradish peroxidase reveal a zig-zag pattern of periodicity 2 I nm, and a flattened helical structure is proposed. Biologically some T H P preparations stimulate cell division in normal human lymphocytes. Recent work suggests this may reflect the presence of glucose in stimulatory preparations. This mitogenic property must he taken into account in evaluatingcellular autoimmunity against T H P in patients with renal disease. As T H P is secreted by cclls in the ascending limb of the loop of Henle and distal convoluted tubule, its detection in Bowman’s space may prove to be a useful sign of intrarenal urinary reflux.
TWO RECENT CASES OF EXOTIC SUPERFICIAL PARASITISM
B. MCMILLAN, J. MACFARLAY, R. SILVERTON*, D. GEE& T. R ~ v d*Schoolyf Piihlic, Hrultlr untl Tropicul Mc.dicine. S~tinej,Horrr.sl>), mii Kir-ring-gui Ilospirul, S ~ d t i e lcirld ~ tRoyui Norrh Shore Hospital. Sjdnej 1 CornirriuAis serin1i.c. An 18-yr-old male presented in July 1978 with a subcutaneous nodule of 3 wk duration on the medial aspect ofthe right upper arm. On excision, the larval form (Counurus) of the dog tapeworm. Multiceps. was demonstrated. The patient had been employed as a station hand on a property at Scone in the Hunter River area of N.S.W. He owned 2 dogs and there were about a dozen other dogs on the property which were often fed on rabbits. Mulricrps seriulis is the only species of the genus known to he present in Australia. In N.S.W., 2.5”;, of dogs are infected. The normal intermediate host of the parasitism is the rabbit. This record. which probably indicates an immune deficiency on the part of the patient, is thc first in Australia and about the eighth in the literature. 2 Etcippic fascioliusis During the second week of April 1979 a 48-yr-old French woman noted a well defined. f r m , moderately Gxed nodule, partly underlying the sternomastoid in the anterior triangle of the neck on the left side. A provisional diagnosis of lymphoma was made. She was otherwise well and had had an unrelated cholecystectomy 3 years previously. At operation, a densely adherent lymph node was submitted for frozen section arid on examination a lymphadenitis with numerous eosinophilic granulomata of parasitic origin was demonstrated. The patient had lived in Australia since 1964 except for visits to France every 2 yr. The family had a grazing property in the Kyogle area of N.S.W. where watcrcress abounded and was eaten on their yearly visits. is uncommon and this is the first known record in Etnpic fascioliasis due to the liver-fluke. Fusiioku ~ic~~~ufpic~-r, Australia.
LYMPHO-EPITHELIAL AND LYMPHOID TUMOURS AND TUMOUR LIKE CONDITIONS OF SALIVARY GLANDS
R. MOTTERAMPatliolog~~ Dryiurtrircwt of the C’uticcr Iri.sri~irrc~of C’rcforiu These conditions are of various types. They may be inflammatory in nature. rcsult from the b e n i p growth o f vestigial tissue or be neoplastic. Lyniphocytic sialadenitis, either focal or dilfuse. bears thc eponymous label of Mikulicr’sdisease. It consists ofan infiltration and proliferation of normal lymphocytes within the lobules ofthe salivary gland. This is associated with atrqphy and loss of acinar tissue. There is also a coincidental proliferation of the ductular epithelium to form compact epi-inyoepithelial islands. These islands are scen embedded amongst the lymphoid tissue which has replaced the acinar parenchyma. The parotid gland is closely associated with lymphatic tissue. and glandular inclusions of ductular type may be found in the nodes ofthe area. This ductitlar element may proliferate in an adenoinatous manner and become cystic. Such an example is the distinctive Warthin’s papillary cystadenoma lymphomatosum where the lymphoid clement I S small in amount and follicular in type. Another example is Ihe nodular benign lymphoepithelial lesion. which is iisually solitary, encapsulated and set amidst the parenchyma ol’ the parotid gland. I t consists of a mass of normal lymphocytes amongst which are found rather scanty streams and islands of epithelial tissue. The parotid gland may be the site of orisin of lymphomas, inore especially of the nodular type. Here the glandular parenchyma is replaced by the lymphoma, often lobule by lobule, with extension ofthe disease tirst to the local and subscquenily to the regional nodes. lmmediately adjacent t o the lymphomatous infiltrate. lymphocytic sialadenitis with benign reactive follicles may be found. hut epi-myoepithelial islands are rarely sccn. This mixture of benign ~ t n d malignant lymphatic tissue can complicate the histological interpretation of the condition.