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P J Spaander

Publications and source records attributed to P J Spaander.

25 records · Page 2Linked to original sources

Morphometric characterization of diffuse large-cell (histiocytic) lymphomas.

From 28 large-cell lymphomas, defined by marker studies, enzyme histochemistry, and electron microscopy as large noncleaved follicle center cell tumors (lnc FCC), B-immunoblastic or true histiocytic lymphomas, morphometric cell parameters, including nuclear size and shape, cytoplasmic area, and cytoplasm-to-nucleus ratio, were measured. Moreover, size, number, and location of nucleoli in the nuclei of the characteristic cells of lnc FCC and B-immunoblastic lymphoma were determined. Statistical evaluation of the data showed the nuclear shape to be the most sensitive parameter in the differentiation of true histiocytic lymphoma from lnc FCC and B-immunoblastic lymphomas. With nucleolar parameters lnc FCC could be differentiated from B-immunoblastic lymphoma: lnc FCC had a higher mean number of nucleoli per cross-section of nucleus and more eccentrically located nucleoli. Moreover, the measurements show that the differences in number and location of nucleoli between large noncleaved follicle center cells and B-immunoblasts are smaller than generally described in the literature. Our results show that it is possible to differentiate by morphometry between lnc FCC, B-immunoblastic, and true histiocytic lymphomas.

Analysis of Variance↗

The implications of subjective recognition of malignant cells in aspirations for the grading of prostatic cancer using cell image analysis.

A pilot study of selective morphometry was performed in smear preparations from fine needle aspirates of six cytologically graded prostatic carcinomas. Given the instruction to select carcinoma cells with large nuclei for measurement, cytotechnologists and a cytopathologist differed in the selection of cells from grade III tumors. The cytotechnologists had discarded large bare atypical nuclei because they assumed that these were degenerated cells. Transmission electron microscopy, using an open-face embedding technique, demonstrated, however, that these cells were not degenerated but were poorly differentiated carcinoma cells that had lost their cytoplasm during smear preparation. It is obviously of great importance for the morphometric discrimination of grade I and grade III carcinomas that such bare atypical nuclei be included in the selections of cells to be measured. Our data indicate that the measurement of 20 selected cells per smear preparation is sufficient for accurate morphometric grading and that such measurements are reproducible.

Biopsy, Needle↗

Malignant lymphoma of true histiocytic origin: histiocytic sarcoma. A morphological, ultrastructural, immunological, cytochemical and clinical study of 10 cases.

Ten tumors of true histiocytic origin (Histiocytic Sarcoma) are presented. The tumor cells were identified as histiocytes by immunological, cytochemical and ultrastructural criteria (cytoplasmic lysozyme activity, presence of C3 and Fc gamma receptor, strong acid phosphatase and alpha-naphthyl acetate esterase activity, presence of lysosomes, absence of cell junctions and evidence of phagocytosis). The tumors identified in this way showed the following histological characteristics: diffuse proliferation of large tumor cells with ample cytoplasm, containing granular or occasionally diffuse diastase resistant PAS positive material, erythrophagocytosis, and haemosiderin pigment. The large or enormous nuclei were irregular, with occasional deep indentations, sharply defined nuclear membrane, coarse chromatin and conspicuous nucleoli. Despite the uniformity of these criteria differences in presence of alpha 1-antitrypsin, alpha 1-antichymotrypsin and 5 Nucleotidase activity and the number of lysosomes in the cytoplasm were found. The findings are suggestive of a spectrum of cytological in these Histiocytic Sarcomas. The clinical picture ranged from monolocalization in a lymphoid organ to that of a diffuse Malignant Histiocytosis. The relationship between good response to therapy and complete remission and the absence of alpha 1-antitrypsin and a high number of lysosomes is discussed.

Adult↗

Human chorionic gonadotrophin and alpha-fetoprotein in testicular germ cell tumours: a retrospective immunohistochemical study.

A series of testicular germ cell tumours (46 seminomas and 27 non-seminomas) was studied immunohistochemically with regard to the presence of alpha FP and HCG. In three seminomas, HCG reactive syncitiotrophoblast-like giant cells (STLG) were found. Immunoreactive alpha FP did not occur in seminomas. In differentiated mature teratomas HCG or alpha FP could not be demonstrated. In embryonal carcinomas with or without teratoma (MTI/MTU/MTT) HCG immunoreactivity was found in 83%, usually localized in STLG. In 75% of these tumours alpha FP could be demonstrated. This protein was localized in foci of endodermal sinus or yolk sac differentiation, but also in single cells and cell clusters in areas of embryonal carcinoma. In some cases syncitial cells were present which contained both HCG and alpha FP. Immunostaining of tumour markers appeared not to provide important additional criteria for classification of these tumours in the currently available classifications. The significance of HCG containing STLG in seminomas deserves further investigation. Prospective studies of embryonal carcinoma with or without teratoma (MTI/MTU/MTT) will be necessary to evaluate the possible prognostic importance of the presence of alpha FP or HCG or both.

Chorionic Gonadotropin↗

The bone marrow in Hodgkin's disease: the non-involved marrow.

One hundred and nineteen methacrylate-embedded trephine biopsy specimens from 80 patients with Hodgkin's disease are reviewed. Although marrow involvement was found in 4% of the untreated patients, the present study was mainly concerned with the marrow unaffected by specific infiltrates and in negative specimens. The non-involved bone marrow in Hodgkin's disease invariably showed alterations of three types; stromal damage, inflammatory infiltration, and disturbed haematopoiesis. Each of these features can be found in the absence of one or both of the others. In severe examples, all three of these components usually occur simultaneously, giving histological pictures that mimic Hodgkin-specific infiltrates, sometimes in association with clinical suggestions of bone marrow involvement or replacement. But trephine biopsies of sufficiently high histological quality offer alternative explanations for the pancytopenia, for instance intramedullary phagocytosis, reactive sclerosing inflammation resembling auto-immune disorders, or a disturbance of haematopoiesis itself. This disturbance could be due to a defect inherent in the haematopoiesis associated with Hodgkin's disease, possibly predisposing for leukaemia in longterm survivors who have received chemotherapy and/or irradiation. The disturbed erythropoiesis proved to be strongly correlated with the stage of the disease at the time of biopsy. This finding could contribute to staging procedures, when laparotomy is contraindicated.

Adolescent↗

Correlation of scintigraphy with short interval autopsy in malignant focal liver disease: a study of 59 cases.

The accuracy of scintigraphy in focal liver disease was evaluated by comparing the scintigraphic and autopsy findings in 59 patients. The interval between scintigraphy and autopsy was not more than a few weeks. The overall agreement rate was 49 in 59 (83%), with four out of 26 (15%) false positive and six out of 33 (18%) false negative reports. Defects smaller than 2 1/2 cm were the principal source of false negative reports. The accuracy of interpretation in cases with liver weights up to 2000 g was significantly (P less than 0.025) lower than for higher weights. Detection of a single focal lesion by scintigraphy was found to be unreliable (only two out of 13 correct). Estimation of spleen weights by scintigraphy was disappointing. Liver weight estimates were somewhat more satisfactory.

Adult↗