[Morphological and immunohistological bases for a modern classification of glomerular nephropathies].
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Biomedical subjects
Publications and source records attributed to M Melato.
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After a brief bibliographical introduction the author's report on 14 cases of cavernous degeneration of the optic nerve, based upon the study of 1,831 autoptic cases. All the subjects examined showed lesions of a senile degenerative type in the vessels afferent to the retro-laminar segment of the optic nerve. The pathogenetic mechanism of the lesion under examination seems therefore to be attributable to ischaemic cause of a chronic type. Myopia and glaucoma, if present, would also seem to contribute, as they cause disorders of the blood system in this region.
The authors, after presenting a review of research work on amyloidosis of the islets of Langerhans,, provide the information obtained from their study of a random sample of 200 autopsies. Special attention was paid to the correlation between amyloidosis of the islets of Langerhans, diabetes mellitus and aging. The analysis of the sample would show there is a close relationship between the general process of aging and insular amyloid deposits; diabetes mellitus would then occur, increasing the amount of the above-mentioned deposits only in patients of a more advanced aged.
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This study was carried out in order to define the histochemical behaviour of the substance present in follicles of normal parathyroid glands obtained at routine autopsies. It was noticed that these follicles with typical amyloid staining properties are constantly present in old persons; furthermore the amyloid in question presents histochemical characteristics which identify it as Apudamyloid. With this in mind we studied the possible, concomitant, systemic, amyloid microdeposits; we noticed that intrafollicular Apudamyloid of the parathyroid gland is often encountered together with immune deposits which are sometimes present in the same gland though not necessarily in the follicles.
The number of mast cells in the islets of Langerhans in 60 cases was determined in an autopsy study. The 60 patients were divided into 4 groups, distinguishing between those with diabetes, insular amyloidosis, those with both these pathological conditions and those with neither diabetes nor insular amyloidosis. As compared with the control group, it was discovered that there was a sharp increase in mast cells in the group with insular amyloidosis and in the group with diabetes; the number of mast cells tended to increase even more in the presence of both pathological conditions. With these data in hand, it is assumed that the increase in mast cells in the islets of Langerhans is not only due to the presence of amyloidosis, but that it is also brought about as a direct consequence of diabetes.
A case of gastric heterotopia of the tongue and one of heterotopic gastric mucosa of the oesophagus are described. From a comprehensive review of the world literature it appears that the present case of lingual gastric heterotopia is only the eighth so far reported and the first occurring in a woman. The site of the polypoid formation medially in the body of the tongue and its presence since birth indicate a congenital malformation. As to the observation of heterotopic gastric mucosa in the oesophagus, it is worth noting that the aberrant tissue was located in a wide area between two sites of squamous carcinoma of the oesophagus. Primary adenocarcinoma of the upper third of the oesophagus is extremely rare and its histogenesis becomes even more controversial when consideration is given to some of the features of the case presented. In particular, the hypothesis that adenocarcinoma may arise from heterotopic gastric epithelium is doubtful and does not explain the origin of all adenocarcinomas in the upper third of the oesophagus. The assumption that it may arise from oesophageal glands and/or from tracheobranchial rests remains well-founded.
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This report describes a 25-year-old man who died due to extensive cystic medionecrosis of the aortic wall complicated by both an acute and an ancient dissection. The very unusual finding of an intravascular papillary endothelial hyperplasia, also known as Masson's pseudoangiosarcoma, in the dissected wall is reported given its resemblance to a hemangiosarcoma.
One hundred consecutive cases of hepatocellular carcinoma (HCC) in cirrhosis observed at autopsy were studied and their pathological aspects were compared with those reported in the literature. The results, which are representative of HCC epidemiology in a geographical area where cirrhosis is mostly due to alcohol abuse, show that similarities in the architectural pattern of HCC and weight of the liver exist between our material and samples with different aetiology and epidemiology. A relationship between the histological grade of HCC and its propensity to metastasize was demonstrated. The reported better prognosis of clear cells per se could not be confirmed, although clear cell HCC occurred exclusively in grade 2. It was also demonstrated that the relationship between grading and staging was strongly influenced by the association of HCC with cirrhosis, which is a fact that is usually overlooked by the common staging (and grading) methods.