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S M Bonsib

Publications and source records attributed to S M Bonsib.

At least 19 recordsLinked to original sources
PubMed1992

Renal artery stenosis modifies glomerular injury in antineutrophil cytoplasmic antibody-associated disease.

A 68-year-old man presented with renal failure, heart failure, gastrointestinal bleeding, and a pulmonary infiltrate. Serologic evaluation revealed a perinuclear antineutrophil cytoplasmic antibody (ANCA) at a titer of 1:1280, which on immunoblot and enzyme immunoassay showed antimyeloperoxidase specificity. Autopsy showed microscopic polyarteritis based on the presence of necrotizing alveolitis and crescentic glomerulonephritis. The extent and activity of the glomerular disease was modified by a right renal artery stenosis (RAS). Twenty percent of glomeruli on the right and 82% glomeruli on the left contained crescentic lesions. Furthermore, predominantly active lesions were associated with renal artery stenosis, while the contralateral kidney contained mostly organized crescents. This observation suggests that hemodynamic factors or its sequelae can influence the onset and severity of ANCA-associated disease.

Aged↗
PubMed1991

Renal oncocytoma: diagnostic utility of cytokeratin-containing globular filamentous bodies.

Sixty-six renal cortical epithelial tumors were classified by light and electron microscopy into 18 oncocytomas and 48 renal carcinomas, and their pattern of cytokeratin and vimentin reactivity was evaluated by immunoperoxidase using paraffin-embedded tissue. We found by electron microscopy that most oncocytomas (11 of 15) contain globular filamentous bodies that consist of a complex of intermediate filaments and organelles. These structures were found to correlate on immunohistochemistry with a discrete punctate cytoplasmic pattern of cytokeratin reactivity, provided the antibody preparation contained specificity for cytokeratins 8 and 18. A similar punctate finding was not observed in four oncocytomas nor in the 48 renal carcinomas. Although 11 oncocytomas failed to express vimentin, seven tumors showed focal reactivity restricted to rare individual cells in areas of sclerosis (five tumors) or in cell clusters bordering central scars (two tumors). We conclude that many oncocytomas contain a potentially diagnostically useful punctate pattern of cytokeratin reactivity and that focal vimentin reactively may be observed in otherwise typical oncocytomas, restricted to tumor cells appearing to be undergoing atrophy.

Adenoma↗
PubMed1991

Immunocytochemical characterization of a monoclonal antibody directed against mitochondria reactive in paraffin-embedded sections.

The monoclonal antibody mES 13 was previously produced against bacterially expressed BALB ras p21 and was reported to have both membrane and cytoplasmic reactivity in formalin-fixed, paraffin-embedded tissue sections. In the current study, the cytoplasmic reactivity of mES 13 is investigated and demonstrated to be mitochondrial. Immunoelectron microscopic studies showed specific labeling of mitochondria without labeling of other organelles. In normal tissues, the antibody strongly labeled tissues known to have large amounts of mitochondria such as renal tubules, hepatocytes, and myocardium. The pattern of reactivity of tumors generally mimicked that of normal tissues, with carcinomas and melanomas usually showing stronger staining than sarcomas and lymphomas. Two granular cell tumors were negative. Among renal neoplasms, mES 13 strongly labeled renal oncocytomas and granular cell renal cell carcinomas and showed weaker staining of clear cell and chromophobe cell tumors. The mES 13 antibody should be useful in the characterization and diagnosis of tumors in which oncocytoma is in the differential diagnosis, especially when only paraffin-embedded tissue is available for study.

Adenoma↗
PubMed1990

Relationship between renal histology and plasma antithrombin III activity in women with early onset preeclampsia.

Renal biopsy was performed in 12 women with the clinical diagnosis of severe, early-onset preeclampsia at the time of cesarean delivery for the express purpose of aiding future counseling on the risk of recurrence. The mean gestation at delivery was 30 +/- 3 weeks. The mean birthweight was 1090 +/- 505 gm. Four women (33%) were multiparous. Antithrombin III activity was determined immediately prior to delivery unrelated to clinical care and as part of other protocols. The biopsy was performed without difficulty in each, although the sample was inadequate in one patient. The clinical diagnosis of preeclampsia was confirmed in nine (82%). However, three of the nine had underlying renal disease, as did the two women without histologic evidence of preeclampsia (42% of the total). Correlations between laboratory parameters with the histopathologic diagnoses were sought. Neither uric acid, creatinine, blood urea nitrogen, platelet count, or 24-hour urinary protein measurements aided the differentiation of the various subgroups. Antithrombin III activity in women with biopsy-supported preeclampsia (77% +/- 12%) was significantly lower than that in women without histologic evidence of preeclampsia (116% +/- 8%). Antithrombin III activity correctly predicted biopsy findings in at least 9 of 11 (82%). These preliminary findings confirm the high frequency of underlying disease in women with early-onset preeclampsia. Although low antithrombin III activity does not differentiate between "pure" preeclampsia and superimposed disease, a normal antithrombin III activity is reassuring and more consistent with a nonpreeclamptic renal complication than with preeclampsia.

Adolescent↗
PubMed1990

Chromophobe cell carcinoma: analysis of five cases.

Five cases of a recently characterized renal neoplasm, chromophobe cell carcinoma, encountered during an ultrastructural and DNA flow cytometric study of renal cortical neoplasms are described. These tumors usually are dark on gross examination and often are associated with focal hemorrhage or necrosis. Microscopically the tumor cell cytoplasm ranges from clear to eosinophilic, potentially eliciting a broad differential diagnosis encompassing renal cell carcinoma and oncocytoma. Ultrastructural studies disclosed the diagnostically required numerous complex cytoplasmic vesicles of unknown composition and origin, and DNA ploidy studies revealed an aneuploid cell population in three of five cases, which correlates with the malignant potential.

Adult↗
PubMed1990

Renal biopsy frozen section: a fluorescent study of hematoxylin and eosin-stained sections.

When frozen sections of kidney are stained with hematoxylin and eosin (H&E) and viewed by standard fluorescence microscopy, crisp detail of nephron and vascular basement membranes is revealed. We studied by H&E fluorescence, control kidneys, and 85 renal biopsies which span a broad range of renal disease. We found that H&E fluorescence provides useful initial orientation by revealing the presence of cortex or medulla and number of glomeruli and vessels. It also reveals major structural alterations of nephron and vascular basement membranes (sclerosis, disruption, atrophy) and heavy deposition of abnormal material (fibrin, immune deposits, paraprotein). When coupled with direct immunofluorescence, a much greater understanding of the disease process is possible, prior to review of permanent sections.

Benzopyrans↗
PubMed1990

Pulmonary-renal syndrome with "triad" involvement due to small vessel vasculitis.

We describe the clinical course and morphologic findings of a 22-year-old woman presenting with a systemic disease that included nasal ulceration, hemoptysis and rapidly progressive renal failure. Biopsies of nasal septum and lung revealed small vessel leukocytoclastic angiitis while renal biopsy showed a diffuse crescentic glomerulonephritis. Immunosuppressive therapy resulted in remission of clinical symptoms and resolution of glomerulonephritis as documented in a followup biopsy. Although her clinical presentation with triad organ involvement strongly suggested Wegener's granulomatosis, this case illustrates that other varieties of vasculitis may mimic Wegener's granulomatosis.

Adult↗
PubMed1989

Clinical outcome of three discrete histologic patterns of injury in severe lupus glomerulonephritis.

There is a spectrum of glomerular pathology in patients with severe lupus glomerulonephritis (GN) that includes (1) severe segmental GN (SEG) with greater than or equal to 50% of glomeruli involved by active segmental inflammation, (2) diffuse GN, and (3) membranous GN with associated severe SEG or diffuse GN (MGN + PGN). The clinical and laboratory characteristics at entry and at follow-up of 85 patients in a prospective therapeutic trial of plasmapheresis were examined to determine if these morphologic variants had prognostic implications. Addition of plasmapheresis to the therapeutic regimen did not affect outcome, and the two treatment groups were analyzed together. Patients with the three patterns of lupus GN were similar demographically and clinically, and they had similar serum creatinines at entry (SEG, 1.87 +/- 0.28 mg/dL [mean +/- SE], v diffuse GN, 2.11 +/- 0.21, v MGN + PGN, 2.12 +/- 0.26; P = 0.75). Although significant differences were found in the initial serum C3 (SEG, 46 +/- 5 mg/dL, v diffuse GN, 34 +/- 3, v MGN + PGN, 45 +/- 3; P = 0.02) and urinary protein excretion (SEG, 3.6 +/- 0.6 g/24 h, v diffuse GN, 6.0 +/- 0.7, v MGN + PGN, 6.7 +/- 0.9; p = 0.03), none of the clinical or laboratory data predicted the morphologic pattern of the glomerular lesion. Adverse outcomes included defined clinical stop points, nonfatal renal failure, and death. One half of the patients with MGN + PGN (13/26) had an adverse outcome, compared with 5/24 patients with SEG and 11/35 patients with diffuse GN. This trend was supported by actuarial analysis of outcomes showing that patients with MGN + PGN had the lowest cumulative proportion without adverse outcome after 175 weeks of follow-up (MGN + PGN, 0.40, v SEG, 0.77, v diffuse GN, 0.64; P = 0.04). We concluded that (1) at presentation, the specific glomerular lesion in severe lupus GN cannot be predicted on clinical or serological criteria alone; (2) on the basis of morbidity and mortality, cases with all three morphologic variants should be classified as severe lupus GN; and (3) patients with MGN + PGN appear to experience more adverse outcomes than patients with SEG or diffuse GN.

Actuarial Analysis↗
PubMed1989

Pulmonary-renal syndrome: clinical similarity amidst etiologic diversity.

The medical records and morphologic materials (59 biopsies, 7 autopsies) of 21 patients presenting with a pulmonary-renal syndrome (PRS) were reviewed. A variety of disorders (Goodpasture's syndrome, 3; vasculitis, 7; idiopathic crescentic glomerulonephritis, 7; spurious PRS, 4) may have PRS presentation. Seventeen patients had extrarenal vasculitis and/or crescentic glomerulonephritis and were treated with immunosuppression. Seven patients died, six from complications related to infections and cardiovascular disease but only one from his original disease. Four other patients ("spurious" PRS) who did not have crescents or extrarenal vasculitis did well with supportive therapy alone. We conclude that a pulmonary-renal syndrome is a common manifestation of diverse disorders which differ in their prognosis and therapy. Since clinical parameters alone are too insensitive to resolve the etiologic possibilities, multiple biopsies and serologies tests are required for a reliable diagnosis.

Adult↗
PubMed1988

Renal sinus malignant lymphoma: a case report.

We report a case of renal sinus non-Hodgkin's lymphoma without contiguous adenopathy. Magnetic resonance and computed tomography images of this rare tumor were correlated with a pathologic specimen. On computed tomography the renal sinus lymphoma was evaluated as a well circumscribed, low-density mass owing to the mixture of the lymphomatous cells and fat tissues. Magnetic resonance showed the replacement of the renal sinus fat tissues with a spoke-like solid mass. The renal artery and vein were also evaluated thoroughly and were without tumor thrombosis.

Female↗
PubMed1988

Glomerular basement membrane necrosis and crescent organization.

In order to reveal structural damage to the glomerular basement membranes occurring in crescentic glomerulonephritis and the subsequent connective tissue organization of the crescent, 14 kidney biopsies were treated with detergents to remove cellular components and the tissue remaining examined by transmission (TEM) and scanning (SEM) electron microscopy. The fourteen biopsies were divided into two groups for analysis. Group I (7 cases) contained necrotizing lesions and cellular crescents. Acellular TEM (ATEM) revealed widespread lysis of mesangial matrix, while acellular SEM (ASEM) of five cases revealed three general patterns of GBM necrosis. Group II (7 cases) contained fibrocellular and fibrosis crescents. ATEM and ASEM revealed that collagen fibers initially form along fibrin fibrils and eventually result in formation of lacunar spaces occupied by cells of the crescent. Fibrous crescents were associated with prominent glomerular tuft distortion and entrapment of normal capillary loops. Continuity between interstitial space, matrix of crescent and mesangium were often observed. These observations suggest that lysis of mesangial matrix is extensive and precedes GBM lysis while the pattern of GBM damage fits best with local release of lytic factors. Furthermore, the architectural distortion and continuity which develops between normally segregated compartments (mesangial-interstitial) indicate that both the initial necrosis and the reparative response to injury, contribute substantially to overall nephron dysfunction.

Basement Membrane↗
PubMed1988

Development of fetal lamb lung and kidney in obstructive uropathy: a preliminary report.

Oligohydramnios, whatever the cause, results in lungs that are 'hypoplastic' or at least smaller than normal. The fine structure in such lungs has not been reported previously. Three fetal lambs had both ureters ligated at 60, 72 and 58 days of gestation. They were sacrificed at 117, 143 and 142 days of gestation. The lungs were fixed by tracheal perfusion at 15 mm Hg. Individual lobar volumes were determined, and the lungs were sampled for electron microscopy. Total lung volumes for 2 of the lambs were very close to those previously reported for lungs of equivalent gestation with diaphragmatic hernia. The third lamb had a twin that had been unrecognised at the time of the original procedure. This lamb's lung volumes were normal. The morphological appearances of the lungs at the electron microscopy level are not normal but dramatically different from those previously reported in lambs with diaphragmatic hernia, phrenic nerve avulsion, and fetal tracheostomy. The lungs of the lamb with bilateral ureteric ligation and a normal twin were essentially normal. These preliminary findings point to the need for more studies of lung structure in oligohydramnios/obstructive uropathy models. However, the normal lungs in a lamb with grossly dysplastic kidneys and a normal twin argue against any important renal trophic factor in lung development in the fetal lamb. An interesting sidelight to this investigation was the unequivocal demonstration that early ureteric ligation results in true renal dysplasia in the fetal lamb. The kidneys of the lamb sacrificed at 117 days were smaller than normal and grossly dysplastic. The kidneys of the lambs that underwent ureteric ligation at 60 and 72 days were structurally different, with the ureters ligated at 60 days being small and dysplastic, while those with the ureters ligated at 72 days were larger and appeared almost polycystic.

Animals↗
PubMed1987

Sarcomatoid renal tumors. Clinicopathologic correlation of three cases.

The clinical, light and ultrastructural features of three renal neoplasms demonstrating a sarcomatous appearance on light microscopic examination are reported. At the time of radical nephrectomy, all three tumors displayed aggressive features with capsular invasion and either metastases or invasion of adjacent organs. Ultrastructural examination revealed epithelial features in a pure spindle cell tumor and in a malignant fibrous histiocytoma-like tumor (sarcomatoid renal carcinoma) and smooth muscle differentiation (leiomyosarcoma) in a lesion showing features of malignant fibrous histiocytoma. All three patients died from 1 to 9 months after nephrectomy. Renal tumors with a sarcomatous histologic appearance are aggressive neoplasms that cannot be classified accurately solely by employing light microscopic criteria.

Adult↗
PubMed1987

Coexistent Wegener's granulomatosis and anti-glomerular basement membrane disease.

Wegener's granulomatosis and Goodpasture's syndrome represent two major causes of a pulmonary-renal syndrome. We describe the clinical course and morphologic features of a patient in whom pulmonary manifestations of Wegener's granulomatosis developed and were followed six months later by anti-glomerular basement membrane disease. Although we regard this as a unique and probably fortuitous association, a genetic predisposition or a secondary form of anti-GBM disease cannot be excluded.

Aged↗
PubMed1986

Giant cell tumors of synovium (Pigmented villonodular synovitis) involving the vertebral column.

Giant cell tumors of synovium (pigmented villonodular synovitis) involving the vertebral column recently have been seen in two women: the third and fourth cases to be reported in the English-language literature. Unlike the previously reported cases, both these tumors grew outside the dura and produced symptoms of spinal cord compression. The first case involved lumbar vertebrae 5 and 6; the second, lumbar vertebrae 2 and 3. Even though initial resection of both tumors was incomplete, the patients improved postoperatively. One tumor was known to be unresectable at the time of surgery. In the other patient, a recurrence of symptoms required second and third resections 4 and 8 months after the first, respectively. Although synovial giant cell tumors rarely metastasize, the rate of local recurrence is high, especially if excision is incomplete. For this reason, close follow-up of patients with lesions in the spinal column is indicated. Increased physician awareness that synovial giant cell tumors can occur in the spine will help to ensure that these tumors are not misdiagnosed in this location.

Adult↗
PubMed1986

Two types of collecting duct mitochondria-rich (intercalated) cells: lectin and band 3 cytochemistry.

Anion exchange plays an important role in renal ion transport and acidification. To further understand the molecular nature of renal epithelial anion exchange, we used a monoclonal antibody to the membrane domain (52 kDa) of human erythrocyte band 3 protein to immunocytochemically search for this polypeptide in the rabbit kidney. In cryostat sections, a subpopulation of cells in the cortical and outer medullary collecting tubules showed immunoreactivity; labeling was restricted to the basolateral membrane. Proximal tubules and thick and thin limbs of Henle showed no immunoreactivity. Approximately 11% of cells in the cortical, but 43% of cells in the medullary, collecting tubule were positive for band 3. To determine the type of cells that were band 3 positive, mitochondria-rich (intercalated) cells were identified by their positive histochemical staining for succinic dehydrogenase activity and by their ability to bind peanut lectin at the apical membrane. In the cortical collecting tubule, the majority of mitochondria-rich cells bound peanut lectin but were band 3 negative; the remainder were band 3 positive but lectin negative. This distribution was reversed in the inner stripe of the outer medulla: all mitochondria-rich cells were band 3 positive and lectin negative. Thus mitochondria-rich cells are of at least two types, each of which has a distinct axial distribution pattern. Given available information about in vitro HCO3 transport properties of rabbit collecting tubules, it is likely that the lectin-positive, band 3-negative mitochondria-rich cells secrete HCO3, whereas the lectin-negative, band 3-positive cells reabsorb HCO3 (secrete H).

Animals↗