Epithelial membrane antigen expression by meningiomas, and the perineurium of peripheral nerve.
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Biomedical subjects
Publications and source records attributed to J M Theaker.
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Oral involvement is unusual in cases of Von Recklinghausen's neurofibromatosis. A case is described of a patient who presented for treatment of an enlarged maxillary tuberosity and the management of such cases is discussed.
Neoplastic angioendotheliosis is a rare condition, most commonly presenting with a bizarre neurological illness associated with multifocal cerebral infarction due to the occlusion of small blood vessels by neoplastic cells. The histogenesis of the malignant cells is controversial with previous suggestions of an endothelial, epithelial or lymphoid origin. We have studied a case immunohistologically using a panel of monoclonal and polyclonal antibodies recognizing a range of lymphoid, endothelial and epithelial antigens. The results indicate that the malignant cells were of B-lymphoid origin. We also report a second case in which a patient with a high grade B-cell non-Hodgkin's lymphoma developed multiple painful skin nodules which showed the histological features of neoplastic angioendotheliosis. These findings support the view that neoplastic angioendotheliosis is a lymphoma with a propensity to localize and proliferate in small blood vessels throughout the body.
One hundred and eighty five consecutive liver biopsies were immunostained using anti-alpha-1-antitrypsin to assess the use of routine immunohistochemistry in the diagnosis of alpha-1-antitrypsin (AAT) deficiency. About half the livers showed staining of hepatocytes for alpha-1-antitrypsin, but most of these livers showed a panlobular pattern, possibly indicating increased synthesis of AAT. Only ten contained periportal granules, said to be typical of AAT deficiency. In cases in which serum was also available for quantitation and phenotyping there was no absolute relation between staining pattern, phenotype, and serum concentrations: the immunohistological screening technique, therefore, has limitations in the diagnosis of AAT deficiency in liver biopsy specimens.
Thirteen meningiomas of varying light microscopic features were studied immunohistologically using a panel of monoclonal antibodies directed against epithelial, mesenchymal, and neural components. All 13 meningiomas showed expression of epithelial membrane antigen, vimentin, and S100 protein, as did normal meninges. Five of the 13 meningiomas also showed focal expression of cytokeratins, with double labelling showing expression of cytokeratins and vimentin by different cells. The cytokeratin expression was especially noticeable in cells surrounding the hyaline bodies of meningiomas. These results provide further evidence that meningiomas have features of both mesenchymal and epithelial tissues.
In order to elucidate the origin of giant cells in giant cell myocarditis a case has been studied immunohistologically using monoclonal antibodies against a variety of antigens, including those associated with muscle and macrophages. The results strongly suggest that the giant cells are derived from macrophages rather than the muscle cells.
A patient with adult polycystic liver and kidney disease presented with haematemesis and melaena and was found to have raised serum creatinine, aspartate transaminase, and alkaline phosphatase values; hypoalbuminaemia; and a prolonged prothrombin ratio. She also had oesophageal varices. With haemodialysis her aspartate transaminase activity fell to normal but she remained hypoalbuminaemic with a prolonged prothrombin ratio. She died after three weeks. Although hepatic cysts do occur in adult polycystic kidney disease, they have been thought not to cause major liver disease. The hepatic cysts in this patient, however, did appear to be associated with portal hypertension and impaired hepatocellular function.
An acquired ventricular septal defect led to the formation of an unusual aneurysm within and overlying the posteroinferior part of the interventricular septum. This is a rare complication of a myocardial infarction and may not have been reported before. The aneurysm probably developed because of a combination of the anatomical localisation of the small ventricular septal defect and the long survival of the patient after its formation.