John Coyne

Post‐transplant T‐cell lymphoproliferative disorder/T‐cell lymphoma: a report of three cases of T‐anaplastic large‐cell lymphoma with cutaneous presentation and a review of the literature

Aims:  To report the clinical, pathological and immunohistochemical features of three cases of post‐transplant T‐cell lymphoproliferative disorder (T‐PTLD) T‐cell lymphoma with primary cutaneous presentation.

Russell body gastritis: a case report.

Russell body gastritis refers to the accumulation of plasma cells containing Russell bodies within the lamina propria. This report describes the first case of monoclonal Russell body gastritis without the previously reported associations.

Mixed adenoma-endocrine tumour of the stomach.

complex-based immunological reaction in the nose. • Treg cells may be important effectors in the pathophysiology of CRS with HCV infection. • IgA and IgD are detected selectively in the extracellular nasal tissues in HCV-infected subjects whether with CRS or subclinical rhinitis. It is possible that during periods of high viral loads, an antiviral immunological response involving activated cytotoxic CD8+ cells results in epithelial nasal damage. IgD acts as receptor for antigen binding and may have a regulatory role in enhancing a protective antibody response of the IgM, IgG or IgA isotypes, or to interfere with viral replication. Interestingly, IgD was detected exclusively in patients with HCV infection presenting with either subclinical or clinical rhinosinusitis in our studied samples. This may indicate an HCV-induced specific B cell response in producing IgA and IgD involving the nasal mucosa. Finally, FoxP3-positive Treg cells have been reported recently to be up-regulated in the peripheral blood of patients with HCV, and stimulation with a defined viral antigen leads to the expansion of two different cell populations: FoxP3) memory ⁄ effector as well as FoxP3+ regulatory virus-specific CD8+ T cells. Our results may indicate a role for Treg cells in down-regulating the immunological response of CRS in HCV patients. Interestingly, a recent study of FoxP3 expression by reverse transcription–polymerase chain reaction (RT-PCR) in different types of CRS failed to show differences in the expression pattern between CRS and controls, and even demonstrated lower expression in CRS with nasal polyps. We propose that nasal mucosal immunity largely reflects the general immunological response to HCV infection even before liver fibrosis supervenes. Important questions to be raised now concern whether this subclinical rhinitis should be treated, and how HCV-induced rhinosinusitis is to be treated.

Metastatic Mammary Carcinoma With DCIS-Like Morphology: A Report of Two Cases

Two cases of breast carcinoma with lymph node metastases are presented. In each case the metastases demonstrated the unusual phenomenon of resembling either cribriform or comedo DCIS. Furthermore both cases had the additional rare feature of demonstrable lymphatic involvement by DCIS-like carcinoma.

Surgical Pathology and The Simpsons

The satirical comedy, The Simpsons, occasionally features the physicians Dr Nick Riviera and Dr Julius Hibbert, the former also, on occasion, practicing as an anesthetist. The psychiatrist, Dr Marvin Munroe, has also taken part. The two physicians have been the subject of a cutting satirical analysis in the medical literature, relevant to modern-day medical practice. It has recently been reported that there will be another series of The Simpsons. With Homer (Figure 1) and Marge (Figure 2) now appearing in surgical pathology (as nonmalignant and benign characters, respectively), perhaps some of their much vaunted and admired logic and wit can now be applied in this field of medical endeavor.