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High Magnification (high + magnification)
Selected AbstractsMetastatic cutaneous leiomyosarcoma from primary neoplasm of the mesenteryINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2001Kyoung Jin Kim MD A 31-year-old South Korean woman was referred to the dermatology department from the oncology department for the evaluation of a subcutaneous nodular lesion on the back. Three years before, she noted a palpable, fingertip-sized, nontender mass on her right lower abdomen. The mass had increased in size slowly. One year ago, she visited a local clinic and physical examination revealed a 7 × 8 × 7 cm, slightly tender, deep-seated mass on the right lower quadrant of the abdomen. The mass on the ilial mesentery was resected by surgical exploration and tissue examination revealed leiomyosarcoma. She refused adjuvant chemotherapy. Approximately 3 months later, she re-visited the clinic with a tender, subcutaneous nodule on the back. Cutaneous examination revealed a solitary, 2 × 2 cm, well-defined, hard, movable, subcutaneous nodule on the upper back without skin color change (Fig. 1). She complained of tenderness on touching the lesion. Histologic examination of a biopsy specimen showed irregularly arranged spindle cells scattered throughout the dermis. They were arranged in haphazardly oriented or interweaving fascicles. Most of the spindle cells possessed elongated nuclei with blunt ends and some cells had a polygonal outline with irregularly shaped nuclei (Fig. 2). There were many mitoses: 3,4 per high-power (× 400) field. Immunohistochemically, smooth muscle actin and desmin were positive in most of the tumor cells (Fig. 3). S-100 reactivity was not observed. A diagnosis of metastatic leiomyosarcoma was made. About 1 month later, computed tomography showed two, ill-defined, heterogeneous, low attenuation masses in the right lobe of the liver, suggesting liver metastasis. The patient was treated with chemotherapy for 2 months and remains in good condition. Figure 1. 2 × 2 cm, solitary, well-defined, hard, movable, subcutaneous nodule without any overlying skin change Figure 2. (a) Characteristic findings of cutaneous leiomyosarcoma with markedly high cellularity and densely packed transverse and longitudinal fascicles of cells (hematoxylin and eosin, × 40). (b) High magnification of the neoplasm revealing spindle cells with blunt-ended nuclei, pleomorphism, and mitotic figures (hematoxylin and eosin, × 200) Figure 3. Dense cytoplasmic reactivity for smooth muscle actin is apparent (smooth muscle actin, × 200) [source] Morphological spectrum of cyclin D1-positive mantle cell lymphoma: Study of 168 casesPATHOLOGY INTERNATIONAL, Issue 10 2001Yasushi Yatabe Immunostaining for cyclin D1 is essential for reliable diagnosis of mantle cell lymphoma (MCL). However, a small number of cyclin D1-positive lymphomas other than MCL have been encountered. Our goal was to investigate the morphological spectrum of MCL as a disease entity, based on cyclin D1 overexpression. We reviewed 181 biopsy specimens obtained from 168 cases of cyclin D1-positive MCL. Typical findings were the presence of nodular (53.9% of cases) or diffuse (46.1%) histological patterns, containing mantle zone patterns (16.8%), naked germinal centers (33.5%) and perivascular hyaline deposition (83.2%). Unusual findings of residual germinal centers with a mantle cuff (four cases) and follicular colonization (two cases) were seen. High magnification showed a monotonous proliferation of tumor cells with cytological diversity including small (3.0%), intermediate (43.1%), medium (34.1%), medium, large (13.2%) and large (6.6%) cells. Pleomorphic and blastic / blastoid variants were encountered in 9.6 and 7.2% of cases, respectively. Three cases had foci of cells of considerable size, with a moderately abundant pale cytoplasm resembling marginal zone B cells. Two cases showed an admixture of cells which appeared transformed and mimicked the histology of chronic lymphocytic leukemia / small lymphocytic leukemia. In one, neoplastic mantle zones were surrounded by sheets of mature plasma cells, resembling the plasma cell type of Castleman's disease. An admixture of areas characteristic of MCL and of other larger cells, indicating histological progression or a composite lymphoma, were observed in seven cases. In high-grade lesions of five cases, nuclear staining of cyclin D1 was rarely detected. In our experience, cyclin D1 expression was also found in nine lymphomas other than MCL (five plasma cell myelomas, three Hodgkin's disease and one anaplastic large cell lymphoma). The application of cyclin D1 staining prompted us to recognize the broad morphological spectrum of MCL. MCL can be diagnosed with the application of cyclin D1 immunostaining, if careful attention is given to architectural and cytological features. [source] Morphological and immunohistochemical studies on cleft palates induced by 2,3,7,8-tetrachlorodibenzo- p -dioxin in miceCONGENITAL ANOMALIES, Issue 2 2008Kumiko Fujiwara ABSTRACT Morphological and immunohistological examinations were performed to reveal the mechanisms of cleft palate induction by 2,3,7,8-tetrachlorodibenzo- p -dioxin (TCDD). ICR strain mice 8,10 weeks of age were used in the study. TCDD was administered in olive oil on gestation day (GD) 12.5 with gastric tubes at 40 ,g/kg. From GD 13.5 to 16.5, palates were examined by scanning electron microscopy (SEM), hematoxyline,eosin (HE) staining, and immunohistochemical staining of FGFR1/2, TGF-,3, MSX1 and LHX8. In the control group, both of the palatal shelves began elevating on GD 14.0 and finished within 6 h. After the elevation, all of the shelves had completely fused with each other on GD 14.5. In the TCDD-treated group, palatal shelves elevated 1 day later than in the control group. However, all palates had elevated by GD 15.0. After the elevation, the shelves contacted each other and fused; however, they were separated on GD16.0. HE staining showed that medial edge epithelium (MEE) was thinner in the TCDD group than in the control group. MEE observed under a high magnification (×2500) exhibited filopodia-like filaments and the cells were bulged in the control group. In contrast, in the TCDD group, no filaments were observed and the cells were flat with unclear boundaries. Immunohistologically, there were no characteristic findings except for FGFR1. FGFR1 was not expressed in the TCDD group after the fusion phase (GD 14.5). TCDD induces many morphological and molecular changes to MEE cells and causes cleft palates. [source] Morphological Substrate of the Catecholaminergic Input of the Vasopressin Neuronal System in HumansJOURNAL OF NEUROENDOCRINOLOGY, Issue 12 2006B. Dudás It has been postulated that the stress response is associated with water balance via regulating vasopressin release. Nausea, surgical stress and insulin-induced hypoglycaemia were shown to stimulate vasopressin secretion in humans. Increased vasopressin release in turn induces water resorption through the kidneys. Although the mechanism of the stress-mediated vasopressin release is not entirely understood, it is generally accepted that catecholamines play a crucial role in influencing water balance by modulating the secretion of vasopressin. However, the morphological substrate of this modulation has not yet been established. The present study utilised double-label immunohistochemistry to reveal putative juxtapositions between tyrosine hydroxylase (TH)-immunoreactive (IR) catecholaminergic system and the vasopressin systems in the human hypothalamus. In the paraventricular and supraoptic nuclei, numerous vasopressin-IR neurones received TH-IR axon varicosities. Analysis of these juxtapositions with high magnification combined with oil immersion did not reveal any gaps between the contacted elements. In conclusion, the intimate associations between the TH-IR and vasopressin-IR elements may be functional synapses and may represent the morphological basis of vasopressin release modulated by stressors. Because certain vasopressin-IR perikarya receive no detectable TH innervations, it is possible that additional mechanisms may participate in the stress-influenced vasopressin release. [source] Three-Dimensional Representation of the Neurotransmitter Systems of the Human Hypothalamus: Inputs of the Gonadotrophin Hormone-Releasing Hormone Neuronal SystemJOURNAL OF NEUROENDOCRINOLOGY, Issue 2 2006B. Dudas Abstract The gonadotrophin-releasing hormone (GnRH) represents the final common pathway of a neuronal network that integrates multiple external and internal factors to control fertility. Among the many inputs GnRH neurones receive, oestrogens play the most important role. In females, oestrogen, in addition to the negative feedback, also exhibits a positive feedback influence upon the activity and output of GnRH neurones to generate the preovulatory luteinising hormone surge and ovulation. Until recently, the belief has been that the GnRH neurones do not contain oestrogen receptors and that the action of oestrogen upon GnRH neurones is indirect, involving several, oestrogen-sensitive neurotransmitter and neuromodulator systems that trans -synaptically regulate the activity of the GnRH neurones. Although this concept still holds for humans, recent studies indicate that oestrogen receptor-beta is expressed in GnRH neurones of the rat. This review provides three dimensional stereoscopic images of GnRH-immunoreactive (IR) and some peptidergic (neuropeptide Y-, substance P-, ,-endorphin-, leu-enkaphalin-, corticotrophin hormone-releasing- and galanin-IR) and catecholaminergic neurones and the communication of these potential oestrogen-sensitive neuronal systems with GnRH neurones in the human hypothalamus. Because the post-mortem human tissue does not allow the electron microscopic identification of synapses on GnRH neurones, the data presented here are based on light microscopic immunocytochemical experiments using high magnification with oil immersion, semithin sections or confocal microscopy. [source] Lipomatosis of the sciatic nerve: Report of a case and review of the literatureMICROSURGERY, Issue 1 2009Emmanouil M. Fandridis M.D. We report a case of lipomatosis of the sciatic nerve, also known as lipofibromatous hamartoma. A male, 26-year-old, presented with gait impairment, leg pain, and foot drop compatible with sciatic nerve's compression. The preoperative magnetic resonance imaging (MRI) revealed diffuse thickening of the proximal third of the sciatic nerve with adipose tissue interspersed among the nerve fascicles. Internal neurolysis was performed with microsurgical techniques under high magnification. The patient was followed up for a period of 34 months. He significantly recovered, and there was no clinical recurrence of the tumor. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source] Intrinsic haemangioma of the median nerve: Report of a case and review of the literatureMICROSURGERY, Issue 2 2008Marios D. Vekris M.D. Intrinsic haemangioma of the median nerve is an extremely rare tumor that represents a challenge to diagnose and treat. Only a few cases have been reported in the literature. We present a 10-year-old girl who was diagnosed having an intrinsic haemangioma of the median nerve and treated with total surgical resection of the tumor, under high magnification, using microneurolysis and without the need to resect and graft the median nerve. Three years later, the patient is free of symptoms and no recurrence of the mass was noticed. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source] Origin of presacral local recurrence after rectal cancer treatmentBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 10 2010M. Kusters Background: The objective of this study was to obtain detailed anatomical information about the lateral lymph nodes, in order to determine whether they might play a role in presacral local recurrence of rectal cancer after total mesorectal excision without lateral lymph node dissection. Methods: Ten serially sectioned human fetal pelvises were studied at high magnification and a three-dimensional reconstruction of the fetal pelvis was made. Results: Examination of the histological sections and the three-dimensional reconstruction showed that lateral lymph node tissue comprises a major proportion of the pelvic tissue volume. There were no lymph nodes located in the presacral area. Connections between the mesorectal and extramesorectal lymph node system were found in all fetal pelvises, located below the peritoneal reflection on the anterolateral side of the fetal rectum. At this site middle rectal vessels passed to and from the mesorectum, and branches of the autonomic nervous system bridge to innervate the rectal wall. Conclusion: The findings of this study support the hypothesis that tumour recurrence might arise from lateral lymph nodes. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Supplemental wide field-of-view monitor improves performance in surgical telerobotic movement time,THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 4 2006Alex Cao Abstract Background This study investigates the effect of a supplemental wide field-of-view (FOV) monitor on performance at high magnifications where the benefits of robotic surgery have greater importance. Methods Ten surgically naďve participants performed a simple aimed movement task under two different monitor conditions. The task is intended to emulate the need to locate an instrument outside the surgeon's FOV and return it to a ,home' position without the need to zoom. One monitor condition used a narrow FOV (25×) coupled with a supplemental wide FOV (3×). The second monitor condition used only a narrow FOV. Results Using a supplemental wide FOV in addition to a narrow FOV improved task performance by at least 33%, with greater consistency and reliability. Conclusion The supplemental wide FOV monitor provided additional information to the participant, allowing more efficient performance at high magnifications without the need for zooming. Copyright © 2006 John Wiley & Sons, Ltd. [source] In Vivo Diagnosis of Nasopharyngeal Carcinoma Using Contact RhinoscopyTHE LARYNGOSCOPE, Issue 8 2001Martin Wai Pak FRCSEd(ORL) Abstract Objectives To evaluate the potential use of contact endoscopy for the diagnosis of nasopharyngeal carcinoma (NPC). Study Design Prospective study to examine the nasopharynx of 30 patients with nasopharyngeal carcinoma and 18 subjects with normal nasopharynx in a clinic setting using contact rhinoscopes (Karl Storz, Tuttlingen, Germany, 7215 AA, 00 and 7215 BA, 300; 23 cm long; 4 mm in diameter). Methods The superficial cells of the normal nasopharynx and the nasopharyngeal tumors were stained with 1% methylene blue and examined with contact rhinoscopes at high magnifications (×60 and ×150). The areas under examination were then biopsied. The contact endoscopic images were compared with the corresponding hematoxylin and eosin-stained histologic sections of the biopsied tissues. Results Sixty-six procedures were performed in 48 patients. The images of normal pseudostratified ciliated epithelium and squamous epithelium were readily recognized by contact endoscopy in all subjects with normal nasopharynx (10 men and 8 women; mean age, 51.9 y). Twenty-six of 30 patients with NPC (86.6%; 18 men and 8 women; mean age, 50.6 y) were successfully examined by contact endoscopy under local anesthesia. In these 26 patients, two patterns of malignant cells were identified with contact endoscopy. The patterns of contact endoscopic images corresponded well with the histologic findings. Conclusion Contact endoscopy is an accurate and reliable office-based procedure, which allows for in-vivo diagnosis of nasopharyngeal carcinoma. [source] | ||||||||||