Histopathological Features

Grossly, the lungs in PAP are consohdated (2,4). Under light microscopy, the alveolar spaces and bronchioles are filled with granular acidophilic material on hematoxylin and eosin stains, which stain bright pink with periodic acid-Schiff (PAS) and 

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Histopathological features are dominated by the large number of centrally-placed muscle nuclei, sometimes affecting more than 90% of muscle fibers. The nuclei form long chains in the middle of the fiber and are surrounded by cytoplasm, which contains mitochondria and membranous vesicles, but no myofibrils. This morphological appearance has prompted comparison with myotubes, and in fact centronuclear myopathies are sometimes referred to as myotubular myopathies. This is a misnomer, however, since although the affected fibers retain some of the structural features of myotubes, and maturational arrest may play a role in their formation, the vast majority of such fibers are fully differentiated histochemically into either type 1 or type 2. 

The histopathological features of muscle samples from patients with myotonic dystrophy are not particularly distinctive. Early changes appear to be a selective atrophy of type 1 fibers, and hypertrophy of type 2 fibers, but the biochemical and/or physiological basis of these possibly related phenomena is not known. The incidence of degenerating fibers increases with age, although the presence of internally nucleated muscle fibers in early stages of the disease suggests that the muscle retains... 

The clinical and histopathological features of individual neurogenic muscle disorders are determined to a large extent by the balance of the opposing processes of denervation and reinnervation, at least as far as the muscle dysfunction is concerned. The involvement of upper motor neurons in some of these disorders is outside the scope of this chapter and will only be referred to in passing. 

Juvenile dermatomyositis (JDM) is perhaps the most uniform, in terms of clinical and histopathological features, of the whole PM/DM disease complex. Presentation may be before 5 years of age with peak incidence between 8 and 12 years. The disease may remit and recur until well into young adult life. The skin lesions include a facial rash in butterfly distribution across nose and cheeks. Erythematous skin changes are seen over extensor surfaces of joints, especially knees, knuckles and elbows. Muscle involvement is generally evident some time later and takes the form of weakness and stiffness, particularly affecting shoulder and pelvic musculature. Proximal muscles are often worse affected than distal muscles and extensors worse than flexors. In the absence of prompt and effective treatment contractures may occur at elbows, ankles, knees, and hips. Subcutaneous calcification and skin ulceration may be found calcification of deeper-lying connective tissue may be apparent on X-ray. 

The histopathological features of PM may be radically different from those of JDM and ADM. There is little, if any, evidence of involvement of the micro vasculature and the muscle necrosis which occurs appears to be the direct result of targeting of individual muscle fibers. In the dermatomyositis syndromes, antibody-dependent humoral mechanisms are predominant and B-lymphocytes are seen to be the most abundant cell type in almost all JDM cases and a substantial proportion of ADM cases. In contrast, most muscle biopsies from PM patients show evidence of inflammation in which TS (cytotoxic) lymphocytes predominate (Figure 20). Moreover, the distribution of inflammatory cell infiltrates tends to be different. Instead of the mainly perifascicular location of lymphocytes in JDM/ADM, there... 

This form of myositis stands apart from the classical PM/DM syndromes on account of its distinctive clinical and histopathological features. There is no clear difference in incidence between males and females and the disorder is typically one of middle or old age. In the majority of cases, progression is slow and skin involvement is not seen, so that the main question of differential diagnosis is its distinction from chronic PM. Unlike classic PM, weakness involves distal muscles as frequently as proximal muscles. CK levels are usually only moderately raised. A common finding which leads to the correct diagnosis of this condition is its nonresponsiveness to steroid treatment or other forms of immunosuppression. 

Demark-Wahnefried, W., Price, D.T., Polascik, TJ., Robertson, C.N., Anderson, E.E., Paulson, D. F., Walther, P.J., Gannon, M., and Volbner, R.T. 2001. Pilot study of dietary fat restriction and flaxseed supplementation in men with prostate cancer before surgery Exploring the effects on hormonal levels, prostate-specific antigen, and histopathologic features. Urology 58, 47-52. 

Over the past 25 years, there has been a dramatic increase, by over 80%, in the incidence of non-Hodgkin s lymphoma. This is a heterogeneous disease, and the clinical characteristics of non-Hodgkin s lymphoma subsets are related to the underlying histopathologic features and the extent of disease involvement. In general, the nodular (or follicular) lymphomas have a far better prognosis, with a median survival up to 7 years, compared with the diffuse lymphomas, which have a median survival of about 1-2 years. 

R5. Raphael, M., Gentilhomme, O., Tulliez, M., Byron, R A., and Diebold, J., Histopathologic features of high-grade non-Hodgkin s lymphomas in acquired immunodeficiency syndrome. The French Study Group of Pathology for Human Immunodeficiency Virus-Associated Tumors. Arch. Pathol. Lab. Med. 115, 15-20 (1991). 

A broad array of human neurodegenerative diseases share strikingly similar histopathological features, e.g., the presence of insoluble protein deposits, such as the neurofibrillary tangles and neuritic plaques of Alzheimer s disease, the Lewy bodies of Parkinson s disease, and the intranuclear inclusions of Huntington s disease [42]. 

Histopathological features of white matter lesions include diffuse myelin pallor (sparing the U-fibers, that are supplied by cortical branches), astrocytic gliosis, widening of perivascular spaces, and loss of oligodendrocytes leading to rarefaction, spongiosis, as well as loss of myelin and axons without definite necrosis, which has also been described as incomplete white matter infarction, which may finally... 

Smith, K.J., Graham, J.S., Moeller, R.B., Okerherg, C.V., Skelton, H., Hurst, C.G. (1995). Histopathologic features seen in sulfur mustard induced cutaneous lesions in hairless guinea pigs. J. Cutan. Pathol. 22 260-8. 

Smith, K.J., Skelton, H.G., Hobson, D.W., Reid, F.M., Blank, J.A., Hurst, C.G. (1996). Cutaneous histopathologic features in weanling pigs after exposure to three different doses of liquid sulfur mustard. Am. J. Dermatopathol. 18 515-20. 

Smith, K.J., Casillas, R., Graham, J., Skelton, H.G., Stemler, F., Hackley, B.E., Jr. (1997a). Histopathologic features seen with different animal models following cutaneous sulfur mustard exposure. J. Dermatol. Sci. 14 126-35. 

P6. Pearson, C. M., Histopathological features of muscle in the preclinical stages of muscular dystrophy. Brain 85, 109 (1962). 

Viggiano, T.R., Gostout, C.J. Portal hypertensive intestinal vasculopa-thy a review of the chnical, endoscopic, and histopathologic features. Amer. J. Gastroenterol. 1992 87 944—954... 

Sahoo, S., Hart, J. Histopathological features of L-asparaginase-induced liver disease. Semin. Liver Dis. 2003 23 295 - 299... 

Deutsch, J., Becker, H., Aubiick, L. Histopathological features of liver disease in alpha-1 antitrypsin deficiency. Acta Paediatr. 1994 393 (Suppl.) 8-12... 

Hdppel, G., Seifert, G., Lindner, H., Dammermann, R., Sack, H.J., Berg, RA. Histopathological features in mixed types of chronic aggressive hepatitis and primary biUary cirrhosis. Virch. Arch. Pathol. Anat. Histol. 1977 373 143-160... 

Kremer JM, Alarcon GS, Weinblatt ME, Kaymakcian MV, Macaluso M, Cannon GW, Palmer WR, Sundy JS, St Clair EW, Alexander RW, Smith GJ, Axiotis CA. Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury m patients with rheumatoid arthritis a multicenter study with literature review. Arthritis Rheum 1997 40(10) 1829-37. 

Poljrvidone storage disease can easily be diagnosed by its histopathological features. Skin biopsy specimens show a variable number of characteristic blue-gray vacuolated cells around blood vessels and adnexal structures, and stain positively with mucicarmine, colloidal iron, and alkaline Congo red and negatively with periodic acid Schiff and Alcian blue. 

A 6-year-old boy developed contact dermatitis following the application of Emla for a skin biopsy to diagnose graft-versus-host disease (24). The histopathological features of the contact dermatitis were simUar to graft-versus-host disease. 

Josephson MA, Chiu MY, Woodle ES,Thistlethwaite JR, Haas M. Drug-induced acute interstitial nephritis in renal allografts histopathologic features and clinical course in six patients. Am J Kidney Dis. 1999 Sep 34(3) 540-8. 

Psoriasis is a common, chronic, papulosquamous disorder of unknown etiology with characteristic histopathological features and many biochemical, physiological, and immunological abnormalities. 

Figure 3 Illustrates several hepatic microgranulomatus foci including giant cell formation, indicated by arrows, induced by administration of the Ba isomer. The histopathological features are identical in every respect with those observed with the racemic mixture. As Table III shows, of che four isomers only one specific isomer. Ba, proved to be responsible for granuloma formation.

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