Histopathological Diagnosis

Buds of granulation tissue filling the distal airspaces (alveoli, alveolar ducts, respiratory bronchioles, bronchioles) constitute the histological hallmark of OP, with associated features including mild interstitial inflammatory infiltrate, type 11 cell hyperplasia, and intra-alveolar foamy macrophages (Pig. 3) (2,3,14,33). However, this elementary lesion is in no way specific and may be seen as a minor feature in other disorders such as infections, NSIP, hypersensitivity pneumonitis. 

OP has been associated with numerous stimuli and clinical contexts (Table 3) (22,24,25,96,102-104). A comprehensive list can be found elsewhere (27). OP 

AUografts (lung, hone marrow, kidney, liver)  

Corticosteroids are the current standard treatment of OP (2,6,9,11,16-19), although spontaneous improvement has occasionally been reported (2). Clinical improvement is usually observed within two days after treatment onset. At imaging, pulmonary infiltrates usually markedly improve within a few days and disappear completely within a few weeks. The speed of response to corticosteroids in OP is slower than in chronic idiopathic eosinophilic pneumonia, but faster than in NSIP and roughly comparable to hypersensitivity pneumonitis. The spectacular and reproducible response to corticosteroids can further be considered as an additional diagnostic feature of the clinical syndrome of OP, and if this response is poor, the initial diagnosis should be reconsidered. Removal of the causing agent should be done in secondary OP, whenever possible. 

After resolution has been obtained, corticosteroids are usually tapered over 6 to 12 months, but there is no consensus regarding the optimal doses of prednisone and treatment duration. In patients with typical COP, we start at a dose 

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Pemak, A., Iwanik, K., Majewski, P, Grzymislawski, M., and Pernak, J. 2005. Ionic liquids as an alternative to formalin in histopathological diagnosis. Acta Histochemica, 107 149-56. 

Johnson, T.L., Barnett, J.L., Appelman, HJ)., Nostrant, T. Candida hepatitis. Histopathologic diagnosis. Amer. J. Surg. Pathol. 1988 12 ... 

Endothelial cell differentiation in hepatocellular adenomas implication for histopathological diagnosis. J. Hepatol. 2004 41 259 - 266... 

A recent MRS study undertook the task of comprehensively analysing a spectral data set of irradiated prostate tissue against early endpoints of local therapeutic effect and clinical outcome. The gold standard endpoint against which the MR spectra were calibrated was histopathologic diagnosis. Spectral metabolic changes in prostatic tissue after radiotherapy were described, and the MRS data, when combined with a multivariate SCS-based analysis, were able to identify residual viable tumour.71... 

The anxiolytic effects of a kava preparation (Kavasporal Forte ) were examined by Neuhaus etal. (2000) in a randomized placebo-controlled trial in 20 patients with acute anxiety. These patients were awaiting the results of a histopathological diagnosis for suspected mammary carcinoma. When compared to placebo, a week s treatment with the kava product significantly reduced their anxiety as well as symptoms of depression. No adverse effects were reported by any of the patients. 

Since the 1980s, immunohistochemistry (IHC) has dramatically transformed the approach to histopathologic diagnosis, specifically in the diagnosis and classification of tumors, and more recently in the diagnosis of infectious diseases in tissue samples. ... 

Immunohistochemical staining has been used in the histopathologic diagnosis of viral hepatitis C however, IFIC for this virus is not as effective as serologic assays and detection of FICV RNA in serum. 

Gatter KC, Abdulaziz Z, Beverley P, et al. Use of monoclonal antibodies for the histopathological diagnosis of human malignancy./ Clin Pathol. 1982 35 1253-1267. 

The needle biopsy makes a variety of tissues available for study. Liver, skeletal muscle, kidney and iliac crest bone can be obtained and have been used in research. Liver biopsy is the most widely used of these procedures since this is a large and fairly homogenous organ, and the technique is widely employed for the histopathological diagnosis of common liver disorders. 

Liver metastases are rare in nonseminomatous testicular tumors and are always associated with bulky lateroaortic involved lymph nodes, and frequently with mediastinal lymph node and multiple lung metastases. Thus, local approaches often take place long after systemic chemotherapy. Survival is directly correlated with the final histopathologic diagnosis virtually all patients with fibrosis or necrosis and with mature teratoma are alive at 5 years, versus only 50% of patients when cancer cells are present [50]. For renal tumors (Wilms or adenocarcinoma), the results are satisfactory after hepatectomy and are close to those achieved for colorectal primaries [51]. For sarcomas, several series report a survival rate of approximately 20% at 5 years [52]. In the largest series in the literature [53], 11% of the patients submitted to hepatectomy for liver metastases from sarcoma were alive at 5 years, and 80% of recurrences arose in the liver. For melanoma, some rare long-term survivors have been reported [54]. Nevertheless, median overall survival improved in the resected patients versus the patients who underwent exploration but were not resected. 

Fig. 10.1. Imaging characteristics of a malignant ovarian lesion. Sagittal T2-weighted image demonstrates a large adnexal lesion extending to above the umbilical level. It is clearly separated from the uterus and compresses the rectum. It is composed of multiple solid elements and multiple cysts. Throughout the lesion and within the cysts, papillary projections (arrows) can be identified. Histopathological diagnosis was a serous adenocarcinoma...

Cadmium is a bivalent metal that is used as an anticorrosive and, in association with nickel, copper and silver, in the production of conducting alloys. One of its salts (cadmium sulfide) is used as a colorant for paints and rubber cadmium acetate is used in the production of craftware. There are reports in the literature of cadmium granulomas with a sarcoid-like appearance. Occupational exposure to rare metals has been well reviewed recently (McFadden et al. 1989 Kusaka 1993). The histopathological diagnosis is... 

In every case, alternative explanations for the respiratory symptoms observed must be carefully excluded. A constellation of suggestive clinical and radiographical findings, and if necessary, supported by a compatible histopathological diagnosis should alert the clinician and prompt discontinuation of the drug. In selected cases, the initiation of judicious corticosteroid therapy may also be indicated. 

Figure 10.17 Set of overlapping white light images taken from an oral tissue section from a patient, 32 x magnification, showing the centres, II, marked with a +, of the lOpmxlOpm areas from which SRS FT-IR microscopy spectra were recorded. The spectra were numbered 201-258. The histopathological diagnosis is indicated. Spectra excluded from the detailed multivariate analysis occur in the regions marked by the solid black rectangles beneath the images, see text for details.

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