Detection of Fungi in Tissue Sections Using Peroxidase-labeled Lectins

A battery of 8 peroxidase-labeled lectins was tested on sections of paraffin-embedded human tissues to determine which lectin could be used in the microscopic diagnosis of fungi. The lectin hitochemistry was more clearly in identifying Candida, Aspergillus, Mucor, and Cryptococcus than fluorescein isothiocyanate-labeled lectins because these fungi were fluorescent in sections of paraffin-embedded tissue under ultraviolet illumination. Five lectins, from Ricinus communis (RCA-120), Lens culinaris (LCA), Ulex europaeus (UEA-1), Canavalin eniformis (ConA), and Triticum vulgare (WGA), were found to react with fungal pathogens commonly encountered in nosocominal infections. Three lectins, from Arachis hypoaea (PNA), Phaseolus vulgaris (PHA-E), and Dolichos biflorus (DAB) were stained weakly or not at all with fungi

Double Staining Method for Identification of Cyst Walls and Intracystic Bodies of Pneumocystis carinii in Histologic Sections

The acquired immune deficiency syndrome (AIDS) is characterized by opportunistic infections including pneumonia caused by Pneumocystic carinii. As a staining method for Pneumocystis carinii, modified Grocott\u27s methenamine silver method has been used routinely. This procedure can identify the cyst walls of Pneumocystis carinii, but, can not identify the intracystic bodies of Pneumocystis carinii. The author has applied the method using ammoniacal silver and Giemsa staining, and found that this is a consistently reliable staining procedure for the cyst walls and intracystic bodies of Pneumocystis carinii. Moreover, this new method may detect mature and immature cysts of Pneumocystis carinii

Iron Accumulation and Presence of Hepatitis B Core Antigen in Hepatocellular Carcinoma in Hemochromatotic Liver

An autopsy case of hepatocellular carcinoma combined with hemochromatosis and hepatic cirrhosis were studied with iron accumulation and hepatitis B virus. Iron accumulation was confirmed by Prussian blue reaction. A positive reaction for hepatitis B surface antigen and hepatitis B core antigen were investigated by immunoperoxidase methods. Hepatocellular carcinoma with hepatitis B core antigen is accompanied by iron accumulation. This suggests that hepatitis B core antigen produces degeneration or collapse of genes of hepatocellular carcinoma resulting in iron metabolism disorder

Safety Considerations for Human Immunodeficiency Virus Infection in Pathology Department Workers Exposed to Infected Materials and Patients

The risk of occupational transmission of human immunodeficiency virus (HIV) to health care workers with intensive exposure to HIV infected patients was considered, because the author autopsied an acquired immunodeficiency syndrome (AIDS) patient in February 1990. A few case reports suggested that the risk of HIV infection incurred when health care workers are exposed to blood or body fluids of HIV infected patients through accidental needle-stick exposure or contamination of an open wound or mucous membrane. For the prevention of AIDS, the pathologists and staff must use double-gloves, gown, mask, apron, shoes cover, medical cap, undershirt, pant, and goggle when in contact with AIDS patient-related materials during postmortem procedure and treatment of surgical speciments

Beta-Subunit of Human Chorionic Gonadotropin in Malignant Lymphoma : An Immunohistochemical Study

We present a rare case of a 77-year-old Japanese man with malignant lymphoma associated with production of beta-subunit of human chorionic gonadotropin in the cytoplasms of lymphoma cells in the lymph nodes. By immunoperoxidase staining, numerous tumor cells were reacted with beta-subunit of human chorionic gonadotropin. To the best of our knowledge, production of beta-subunit of human chorionic gonadotropin in the cytoplasm of lymphoma cells has not been reported. This patient evidences that beta-subunit of human chorionic gonadotropin may be produced by tumor cells, therefore, beta-subunit of human chorionic gonadotropin may be used as a tumor maker in some malignant lymphoma patients

Immunohistochemical Detection of Hepatitis B Core Antigen in the Bile Duct Epithelia

One hundred liver specimens of hepatitis B surface antigen positive cases were used for this study. The localization of hepatitis B core antigen in the bile duct epithelia was investigated by immunoperoxidase method. In three cases, hepatitis B core antigen was detected not only in the nuclei of the bile duct epithelia, but also in the cytoplasms of the bile duct epithelia. These findings suggested that hepatitis B virus may replicate in the bile duct epithelia. The resons for distribution of hepatitis B core antigen in the nuclei of the bile ducts are not known. A possible explanation may be that intrahepatic bile ducts develop from hepatocytes. To the best of our knowledge, morphologic localization of hepatitis B core antigen in the nuclei of the bile duct epithelia has not been reported previously

Adult T-cell Leukemia-lymphoma associated with Metastatic Calcification and Acute Pancreatitis under Hypercalcemic Condition

Metastatic calcification due to hypercalcemia in adult Tcell leukemia-lymphoma (ATL) associated with osteolytic change for activation of osteoclasts are reported. These cases of serum calcium were at a high level, 15.1 and 19.4 mg/dl (normal range 8.4-10.4 mg/dl). Metastatic calcification was detected in the tubules of kidneys, in the pulmonary alveolar septa of lungs, in the myocardium, in the muscular layer of stomach, in the lower portion of media of aorta, in the mucosa of stomach, in the tubules of testis, and in the liver by von Kossa\u27s silver nitrate method for calcium. Scattered osteoclasts were seen around the cortex of the bone. ATL cells stained with parathyroid hormone-related protein (PTHrP) by immunohistochemical procedure. Thus, PTHrP is an important bone resorption-stimulating factor of hypercalcemia in ATL. We have investigated the incidence of acute pancreatitis in ATL, and in the other diseases. Of the 317,325 autopsy cases, 632 were ATL; the numbers of the acute pancreatitis cases of them were 1,833 (0.58%) and 25 (4.0%), respectively. The odds ratio from 2 x 2 table is 7.17 and Peason\u27s Chi-square statistics with one degree of freedom is 126, which is highly significant. Therefore, it was suggested that there is a close correlation between acute pancreatitis and hypercalcemia in patients with ATL. We proposed a new theory for the correlation between acute pancreatitis and hypercalcemia in ATL that all the hypercalcemic patiens exhibited high levels of nephrogenous cyclic adenosine monophosphate (NcAMP) stimulating pancreatic secretion in the extralobular ductal system of the pancreas and thus resuling in acute pancreatitis due to occlusion of the pancreatic duct

Immunohistochemical Characteristics of Histiocytes in Lymph Node Associated with Yellow-Brown Bodies

Yellow-brown bodies were observed in the sinusoids of lymph nodes and histiocytes. The authors confirmed immunohistochemical reactivity of alpha-1-antichymotrypsin, lysozyme, and alkaline phosphatase in non-phagocytic histiocytes, and phagocytic histiocytes which contained yellow-brown bodies. Histiocytes with yellow-brown bodies were not reacted to alpha-1-antichymotrypsin, lysozyme, and alkaline phosphatase. On the other hand, histiocytes without yellowbrown bodies were reacted to alpha-1-antichymotrypsin, lysozyme, and alkaline phosphatase

Proliferating Cell Nuclear Antigen (PCNA), Nucleolar Organizer Regions (AgNORs), and Mitotic Indeces in Nasopharyngeal Carcinoma

Proliferative activity of nasopharyngeal carcinoma (NPC) using 20 biopsy cases obtained from southern China were analyzed by immunolabelling with the monoclonal antibody of proliferating cell nuclear antigen (PCNA), the numbers of interphase silver stained nucleolar organizer regions (AgNORs), and mitotic indices. Nucleolar organizer regions (NORs) are loops of ribosomal DNA (rDNA) occurring in the nucleoli of cells, which transcribe to ribosomal RNA (rRNA) and ultimately direct ribosome and protein formation. PCNA is a nuclear protein synthesized in the nucleus late in G1 phase, peaking during S phase and subsiding during G2 and M phases of the cell cycle. These may indicate that PCNA and AgNORs are present at different stages of the cell cycle. The authors found that 28% of differentiated non-keratinizing carcinoma type of NPC and 18% of undifferentiated carcinoma type of NPC were positively stained by PCNA. The mean AgNOR counts for differentiated non-keratinizing carcinoma type of NPC, and undifferentiated carcinoma type of NPC were 1.8 and 1.2, respectively. The mean mitotic counts for differentiated non-keratinizing carcinoma type of NPC and undifferentiated carcinoma type of NPC were 3.4 and 2.1, respectively. Therefore, it is suggested that PCNA labelling immunoreactivity may be correlated with AgNORs score and mitotic indeces, thus in NPC, these number and size have been regarded as markers of cell proliferative ability

T-cell Rich B-cell Cross-reacting Nasopharyngeal Carcinoma

Immunohistochemical analysis was carried out to examine infiltration of lymphocytes in the tumor nests of nasopharyngeal carcinoma (NPC) using 38 biopsy cases obtained from southern China. These cases were divided into 3 groups according to their prominent pattern associated with the cell and the tissue differentiation using the World Health Organaization (WHO) classification as follows: (i) 6 cases of squamous cell carcinoma (16%), (ii) 25 cases of differentiated non-keratinizing carcinoma (66%), (ii) 7 cases of undifferentiated carcinoma (18%). All tumor tissues reacted diffusely with MB-1, however, these did not react with L26 (CD20), 4KB5 (CD45R), MT-1, and leukocyte common antigen (LCA). In the tumor nests, normal lymphocytes were observed in squamous cell carcinoma type (50%), differentiated non-keratinizing carcinoma type (72%), and undifferentiated carcinoma type (86%). Therefore, it is suggested that a large number of infiltrating non-neoplastic T-cells may be related to good prognosis. T-cell-rich B-cell lymphomas (TCRBCLs) are recently described as unusual non-Hodgkin\u27s lymphomas associated with predominance of reactive T-cells. Therefore, the mechanism of T-cell lymphocyte infiltration adjacent to the tumor cell is considered that these T-cell infiltrates may be the passive response to cytokine secretion by the tumor cells