PubMed Health⌕ Search

Biomedical subjects

P Rippstein

Publications and source records attributed to P Rippstein.

17 recordsLinked to original sources
PubMed1994

Primary intracranial pleomorphic angioleiomyoma--a new morphologic variant. An immunohistochemical and electron microscopic study.

BACKGROUND: Angioleiomyomas usually are benign subcutaneous neoplasms that occur most often in extremities of middle-aged individuals. Very few cases have been described in other locations; none along the neuroaxis. An intracranial example of angioleiomyoma displaying unusual morphologic features not seen in the typical peripheral variants of this tumor is described. METHODS: The tumor was studied with conventional histology, immunohistochemistry with morphometric calculation of proliferation index, immunoelectron microscopy, and DNA flow cytometry. RESULTS: The tumor was composed of large epithelioid and pleomorphic cells filled with intermediate filaments positive for desmin and vimentin. Scattered cells also expressed myosin and muscle-specific actin. Smooth muscle cell differentiation was confirmed by ultrastructural demonstration of subplasmalemmal dense bodies, attachment plaques, and discontinuous basal lamina. The proliferation index with proliferating cell nuclear antigen (PCNA) monoclonal antibody was 75.78%, whereas it was only 4.22% with Ki67 monoclonal antibodies adopted to paraffin material (MIB-1). CONCLUSION: The tumor represents a unique morphologic variant of a pleomorphic angioleiomyoma. Cellular pleomorphism and a strong reaction for PCNA in numerous cells suggested that the lesion was malignant. However, the absence of mitotic figures, a small number of Ki-67-positive cells, a diploic DNA pattern, and a low proliferation index in flow cytometry all supported the concept that this neoplasm represented an unusual histologic variant of benign angiogenic leiomyoma. Encapsulation and demarcation of the surgical specimen and the survival of the patient for more than 4 years without recurrence after resection support this interpretation.

Adult↗
PubMed1994

Unusual immunostaining pattern of chromogranin in normal urothelium and in transitional cell neoplasms.

We report an unusual pattern of immunostaining for chromogranin A in 24 transitional cell carcinomas (TCC). Positive immunostaining was seen with chromogranin A antisera in 10 of 16 urinary bladder TCC, neither of 2 prostatic TCC, 3 of 3 ureteral TCC and 2 of 3 metastatic TCC. This staining was demonstrated within the cytoplasm of transitional cells at all levels of the neoplastic epithelium, including cells near the basement membrane and at the free surface (umbrella cells). In 5 of 7 cases there was also immunoreactivity of the non-neoplastic urothelium. Immunostaining with neuron-specific enolase and synaptophysin was negative in all of these cases and no neuro-secretory granules were identified in 7 cases examined by electron microscopy. This pattern of immunostaining is probably due to reactivity with chromogranins or certain chromogranin-like proteins in the transitional cells, particularly in the umbrella cells.

Carcinoma, Transitional Cell↗
PubMed1993

Immunoelectron microscopic localization of monoclonal IgM antibodies in gammopathy associated with peripheral demyelinative neuropathy.

A sural nerve biopsy from a patient with benign monoclonal IgM kappa gammopathy and sensory-motor demyelinative neuropathy, revealed marked loss of myelinated fibers and focal axonal degeneration as well as widespread demyelination and remyelination with onion-skin formation. Almost all myelinated fibers displayed characteristic widening of the myelin lamellae as well as excessive thickness and/or exuberant outfoldings of myelin, reminiscent of that seen in tomaculous neuropathy. Many endoneurial capillaries were lined by fenestrated endothelium, indicating breakdown of a normal blood-nerve barrier. The endoneurium contained large amounts of extracellular proteinaceous material. Immunofluorescence and immunoelectron microscopy performed on the nerve of the patient, demonstrated selective deposition of IgM kappa gammaglobulin, exclusively in the areas of splittings of the myelin lamellae. Schwann cells contained cytoplasmic myelin debris labelled with IgM kappa only. In the indirect immunofluorescence and immunoelectron microscopy, serum of the patient reacted with the whole thickness of compact peripheral myelin of a normal human nerve. There was no immunoreactivity with the central myelin, Schwannoma cells, glial cells, axons or neurons. Demonstration of the selective presence of monoclonal IgM in widened lamellae of myelinated fibers, as well as bound to the internalized myelin debris in Schwann cells and macrophages, indicates a pathogenetic role of monoclonal paraprotein in myelin injury. Demyelination is promoted by development of endothelial fenestrations in the endoneurial capillaries and breakdown of the blood-nerve barrier.

Aged↗
PubMed1992

Diagnostic value of microvillus-matrix associations in tumors.

Until now microvillus-matrix associations have been reported to occur only in mesotheliomas and hence this phenomenon is thought to be of value in distinguishing mesothelioma from pulmonary adenocarcinoma. We report here the occurrence of microvillus-matrix associations in two pulmonary adenocarcinomas which reduces the value of this phenomenon in the differential diagnosis of these tumors.

Adenocarcinoma↗
PubMed1991

Immunoelectron microscopy of Rosenthal fibers.

Seventeen intracerebral gliomas containing Rosenthal fibers (RF) were studied by an immunoperoxidase method for localization of ubiquitin (UB), glial fibrillary acidic protein (GFAP), desmin and vimentin (VIM). The majority of RF showed an immunohistochemically negative core surrounded by a ring of overlapping reactions for UB, GFAP and VIM. Many RF were entirely negative for UB and intermediate filaments (IF). Immunoelectron microscopic localization of UB and GFAP was performed on seven selected tumors. UB was found in all RF and on IF in the proximity of RF. GFAP reaction was localized on astrocytic IF, including those trapped within RF, and within the granular component of some RF. In contrast to the light microscopic studies, neither GFAP- nor UB-negative RF were found on immunoelectron microscopy. VIM reaction on IF and a few RF was demonstrated in one tumor processed at low temperature into Lowicryl; it was much weaker than that for GFAP. Many cells with RF contained lysosome-like inclusions with material displaying electron density similar to adjacent RF; few of these inclusions were reactive for UB. It is concluded that RF formation is associated with ubiquitination of astrocytic IF. GFAP- and VIM-immunoreactive IF and products of their disintegration contribute to RF material. It is also suggested that the lysosomal system of astrocytes partially degrades RF.

Animals↗
PubMed1990

Ultrastructural study of acinar and intercalated duct organization of submandibular and parotid salivary gland.

According to some current hypotheses, the morphology and organization of the intercalated duct/acinar interface of salivary gland have implications for the induction of tumors in this organ. However, this region has received limited detailed investigation. To study the organization of the terminal ductal segments of salivary gland, conventional transmission electron microscopy of human parotid and submandibular glands and canine submandibular gland was combined with 3-dimensional observations of polymer casts of the canine submandibular ductal system; the latter were prepared by retrograde injection of acrylic resin via the main excretory duct with subsequent digestion of the gland tissue. The division of intercalated ducts, into first- and second-order branches, and acinar arrangement is more complex than previously suggested. The entire surface of each elongated second-order intercalated duct is covered with acini projecting in all directions. In the human gland, some acini abut directly on the intercalated duct surface, whereas others are connected by a short stalk of intercalated duct cells; in comparison with canine submandibular gland, the latter may be a modification producing a third-order of the intercalated duct unit. All of these features combine to produce a highly efficient secretory apparatus with a large proportion of acinar cells to each intercalated duct.

Animals↗
PubMed1987

Immunohistochemistry and ultrastructure of myoepithelium and modified myoepithelium of the ducts of human major salivary glands: histogenetic implications for salivary gland tumors.

The organization of salivary gland ducts, especially the presence or absence of myoepithelial cells, is central to histogenetic approaches to the classification of salivary gland tumors. Striated and excretory ducts are reported to be devoid of myoepithelial cells but do contain basal cells. To investigate the nature of such basal cells, tissue sections of normal human salivary glands were examined by means of immunohistochemical, ultrastructural, and fluorescent microscopic techniques. With the use of a mouse monoclonal anticytokeratin antibody (3 12C8-1) that, in salivary glands, is specific for myoepithelial cells, these cells associated with acini and intercalated ducts were strongly stained, as were the basal cells of striated and excretory ducts in each case. Ultrastructurally, some basal cells of both striated and excretory ducts had narrow, elongated cellular processes or the main portion of the cell containing parallel arrays of microfilaments with linear densities and micropinocytotic vesicles, whereas in other basal cells tonofilament bundles predominated. A similar range of cytoplasmic features existed in myoepithelial cells associated with acinar and intercalated duct cells. In addition, some duct basal cells have a complement of actin filaments similar to classic myoepithelium of acini and intercalated ducts. Striated and excretory ducts of human salivary glands, therefore, contain fully differentiated and modified myoepithelial cells, both of which express a specific cytokeratin polypeptide that is absent from duct luminal and acinar cells. Differentiation patterns in the intralobular and interlobular ducts suggest that these regions of salivary gland parenchyma cannot be excluded as histogenetic sites for the induction of salivary gland tumors in which neoplastic myoepithelial cells have been shown to have a major role.

Epithelium↗
PubMed1987

Ultrastructural morphology and cellular differentiation in acinic cell carcinoma.

Acinic cell carcinomas, in some instances, contain a component of intercalated duct cells. However, the manner in which this element is integrated within the more obvious acinar cells, as well as the role neoplastic intercalated duct cells play in determining morphologic patterns in acinic cell tumors, has not been fully investigated. Ultrastructural study and immunostaining with antibodies to cytokeratins and to S-100 protein carried out in nine cases of parotid acinic cell carcinoma suggest two basic differentiation patterns. In three cases, the lesions were essentially composed of acinar cells (with variation in the number and form of secretory granules), and one of these tumors was unique in having ultrastructural evidence of differentiated myoepithelial cells. In the second group of six cases, there was light microscopic, ultrastructural, and immunohistochemical evidence of a significant component of intercalated duct cells. By means of both immunostaining (intercalated ducts were positive for keratin and S-100 protein; acinar cells were negative for both antigens) and electron microscopy, flattened-to-cuboidal intercalated duct cells were noted to enclose and, presumably, to be involved in the formation of microcystic spaces. Acinic cell carcinomas with a more solid growth pattern contained groups of intercalated duct cells positive for keratin and S-100 protein. Ultrastructurally, these cells were organized into well-formed ducts related to nests of acinar cells. Acinic cell carcinoma is another class of salivary gland tumor in which there can be an integrated proliferation of intercalated duct and acinar cells and, infrequently, of myoepithelial cells, all organized in a simulation of the intercalated duct-acinar unit of the normal salivary gland.

Carcinoma↗
PubMed1987

Low magnification transmission electron microscopy in diagnostic pathology.

Transmission electron microscopy examination of selected diagnostic specimens, that is, renal and nerve biopsies, can be greatly facilitated by the implementation of slot grid preparations that are inherently devoid of any grid bars. Such preparations are conducive to screening and photography at both low and intermediate modes of magnification without any apparent loss of resolution. The use of this technique in diagnostic electron microscopy is simplified by sequential en bloc staining with both uranyl and lead salts.

Animals↗
PubMed1983

Pleomorphic adenoma, I: Ultrastructural organization of "epithelial" regions.

Twenty-four major and minor salivary gland pleomorphic adenomas were studied ultrastructurally to determine the growth patterns, organization, and cytologic modifications of the proliferating neoplastic cells. In compact and highly cellular regions, two cell types--luminal epithelial and myoepithelial--could often be identified; their organization mimicked that of the normal salivary gland duct or acinar unit. Results of the study indicate that the principal proliferating tumor cell is a structurally modified myoepithelial cell that frequently shows squamous differentiation. At the immediate margins of cellular regions of many tumor cells, gradual dedifferentiation of modified myoepithelial cells with a loss of squamous features occurs, although in some cells the squamous features are retained to varying degrees. Within cellular regions, the earliest development of matrix occurs in relation to small, basal lamina-lined extracellular spaces between myoepithelial-like cells. Modifications of such intercellular spaces are helpful in tracing the development of myxoid zones and the evolution of cell types in this unique region. The authors postulate that salivary gland pleomorphic adenomas result from the neoplastic transformation of the complete ductal-acinar unit rather than from one particular ductal "reserve" cell.

Adenoma, Pleomorphic↗
PubMed1983

Pleomorphic adenoma, II: Ultrastructural organization of "stromal" regions.

Findings from an ultrastructural study of 24 major and minor salivary gland pleomorphic adenomas suggest that the principal cell type in the myxoid and chondromyxoid regions of these tumors is a structurally modified myoepithelial cell. This interpretation is based on findings in the transitional zone between myxoid regions and compact cellular areas that have a ductal-acinar organization, that is, are composed of luminal epithelial and modified myoepithelial cells. Survey-type low-power electron micrographs allowed appreciation of the original orientation of the major proliferating component of these tumors to the perimeter of ductal-acinar units. The low-power electron micrographs also revealed residual features of this organization, the early development and subsequent sequential alteration of matrix compartments as tumor cells became increasingly separated by extracellular products, and a variety of myoepithelial cell modifications, such as squamous and chondroid metaplasia, resulting from neoplastic induction. According to the authors' interpretation, modified myoepithelial cells in myxoid and chondromyxoid regions form a continuum with similar tumor cells in transitional and solid areas, forming what can be visualized as markedly expanded and merging ductal-acinar units that tend to converge with similarly altered adjacent neoplastic ductal-acinar units. Thus, a multiplicity of processes are involved in the formation of the complex and varied histologic patterns that characterize pleomorphic adenomas.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Characterization of epimyoepithelial islands in benign lymphoepithelial lesions of major salivary gland: an immunohistochemical and ultrastructural study.

Knowledge of the processes leading to the development of epimyoepithelial islands bears on histogenetic and morphogentic processes in salivary gland tumors. Immunohistochemical and ultrastructural investigations of the cellular composition of epimyoepithelial islands were carried out on three examples of benign lymphoepithelial lesions with varying histologic features. The monoclonal anti-keratin antibody 312C8-1, which specifically decorates myoepithelial cells of the normal salivary gland, also stains the myoepithelial cells surrounding residual acini and intercalated ducts in benign lymphoepithelial lesions and the cell population of epimyoepithelial islands, with the exception of persisting luminal epithelial cells. Ultrastructurally, the myoepithelial cells of involuting acini and ducts and the modified myoepithelial cells of epimyoepithelial islands, identified in both locations by the monoclonal antibody 312C8-1, show an increasing complement of tonofilament bundles. In addition, persisting lumens (often distended with lymphocytes) and definite luminal epithelial cells can be seen in electron micrographs of some epimyoepithelial islands. The designation for this characteristic epithelial feature of benign lymphoepithelial lesions is therefore appropriate.

Humans↗
PubMedDate not supplied

A quantitative comparison of light and electron microscopic diagnoses in specimens obtained by fine-needle aspiration biopsy.

Because fine-needle aspiration biopsy (FNAB) is being increasingly used as a primary diagnostic tool, it is essential to obtain the maximum information from the aspirate. Electron microscopy is an adjunctive procedure that is readily applied to FNAB specimens. The value of electron microscopy to the cytopathologist was assessed by comparing the initial, tentative, or interim diagnosis based on light microscopic features with the diagnosis resulting from the ultrastructural characteristics of needle rinse material. Over a 3-year period, 279 FNAB specimens obtained under radiologic control were examined ultrastructurally; of these, 57 (20.4%) were considered inadequate specimens for diagnostic purposes. The remaining 222 FNAB specimens were segregated into four groups: 17 cases (7.7%) in which electron microscopy played a major role because the final diagnosis was unsuspected from light microscopy; 43 cases (19.4%) in which electron microscopy selected a specific diagnosis from a set of differential diagnoses or provided additional information that was clinically relevant; 45 cases (20.3%) in which additional diagnostic information was obtained by electron microscopy but was not clinically relevant; and 117 cases (52.6%) in which electron microscopy was not helpful because the light and electron microscopic diagnoses were the same. In this comparative study, electron microscopy provided a major contribution to the final cytologic diagnosis in 27.1% of the cases (groups 1 and 2). Descriptive examples illustrate how the architectural and cytologic features revealed by electron microscopy assist in establishing the final diagnosis. Examination of needle rinse specimens, particularly aspirates from lung and liver, indicates that most FNABs provide mini-surgical biopsy specimens that are well suited to ultrastructural examination.

Adult↗
PubMedDate not supplied

Immunogold localization of actin and cytokeratin filaments in myoepithelium of human parotid salivary gland.

Myoepithelial cells of salivary gland are uniquely specialized cells; their function is unclear, but the considerable complement of muscle-specific actin suggests contractility is one function. By routine transmission electron microscopy myofilament visualization is variable. Some myoepithelial cells appear to have limited and only focal aggregates of myofilaments, while others seem to have readily appreciated myofilaments within a longitudinally oriented cytoplasmic zone at the basal portion of the cell. However, immunogold electron microscopy using the anti-muscle-specific actin antibody, HHF35, while indicating a basal distribution for the muscle-isoform of actin in a platelike fashion in certain myoepithelial cells, also reveals that others associated with both intercalated ducts and acini have a more generalized distribution of myofilaments throughout the cytoplasm. Actin was also noted within tonofilaments and double immunogold labeling using both the HHF35 and AE1/AE3 (anticytokeratins) antibodies confirmed the variable interrelationship of these two filaments. Within any one myoepithelial cell, actin and cytokeratins might colocalize in some areas of the cytoplasm containing filaments, but not in adjacent zones. These results suggest that intermediate filaments and myofilaments are complexly organized in myoepithelial cells, and that quantitative and qualitative differences exist in the expression and distribution of intermediate filaments and myofilaments. These cells are likely structurally, if not functionally, heterogeneous.

Actins↗
PubMedDate not supplied

Reliability of criteria for ultrastructural identification of neuroendocrine granules.

For full diagnostic use to be made of the neurosecretory granule, the range of sizes, forms, and staining qualities for this cytoplasmic organelle, along with the extent of its expression in various neoplasms, must be established. Neurosecretory type granules occasionally occur in nonneuroendocrine tumors. A series of carcinoids of the lung provides a model for assessing the morphologic types of cytoplasmic granules identified by antibodies to chromogranin A and immunogold labeling. The results show that granule structure in tumors is pleomorphic. Despite having sizes within the expected range, many labeled and, indeed, unlabeled secretory granules are atypical, particularly in structural form. Cell-to-cell variation in the proportion of even typical neurosecretory granules labeling for chromogranin A is the rule. Studies correlating biochemical, immunohistochemical, electron microscopic, and perhaps in situ hybridization characteristics are required to define better the criteria for unequivocal identification of neurosecretory granules in tumors.

Adenocarcinoma↗
PubMedDate not supplied

Intracisternal collagen fibrils in proliferative fasciitis and myositis of childhood.

During ultrastructural examination of a difficult to diagnose tumor, short spacing collagen fibrils (periodicity of banding, approximately 43.2 nm) and native collagen fibrils (periodicity of banding, approximately 53 nm) were found in dilated and vacuolated cisternae of rough endoplasmic reticulum and the perinuclear cistern. Original diagnoses from several histopathologists included alveolar soft part sarcoma, malignant fibrous histiocytoma, atypical fibroxanthoma, and myogenic tumor. The finding of intracisternal collagen (which is but a variety of intracellular collagen) led to the conclusion that this was a fibroblastic neoplasm. This, plus a review of the histologic findings, led to the diagnosis of proliferative fasciitis and myositis of childhood.

Adolescent↗