Karen L. de Mesy Jensen

Neuroendocrine differentiation in prostatic carcinoma

Specimens from 53 cases of prostatic carcinoma obtained during total prostatectomy or transurethral resection of prostate were analyzed for neurendocrine differentiation with immunocytochemical tests for serotonin, neuron-specific enolase, and chromogranin as well as with the Churukian-Schenk argyrophil reaction. Forty-seven per cent (25 of 53) of the prostatic carcinomas were positive for neuroendocrine differentiation, usually with an overlapping combination of these techniques. Nine per cent (five cases) contained areas with numerous neuroendocrine cells, 11 per cent (six cases) had focal scattered neuroendocrine cells, and 26 per cent (14 cases) had rare neuroendocrine cells. The positive cases spanned the histologic spectrum of prostatic adenocarcinoma; histologically none resembled a carcinoid tumor or a small cell carcinoma. Positive cases were further studied with a battery of antisera to 12 polypeptide hormones. Immunoreactivity to only bombesin (one case) and calcitonin (two cases) was detected. In five cases, neuroendocrine differentiation was studied by electron microscopy and verified at the ultrastructural level.

Endocrine-Paracrine (APUD) Cells of the Human Female Urethra and Paraurethral Ducts

The distribution, immunostaining profile and ultrastructural morphology of human female urethral and paraurethral endocrine-paracrine (APUD) cells was studied. Five urethras obtained from radical cystectomy specimens were stained with antisera to serotonin, neuron-specific enolase, chromogranin, bombesin, calcitonin, somatostatin, prostatic acid phosphatase, prostatic specific antigen and with the Churukian-Schenk argyrophil method. Numerous endocrine-paracrine cells were observed along the entire length of resected urethra, with these cells most numerous in the paraurethral ducts. The endocrine-paracrine cells were positive for serotonin, neuron-specific enolase, chromogranin and the argyrophil reaction. Scattered bombesin and very rare calcitonin immunoreactive cells were noted. The endocrine-paracrine cells were of the open (luminal extensions) and closed cell types and often had multiple long dendritic processes suggesting a primarily paracrine function. By electron microscopy the secretory granule morphology was highly variable. Autonomic innervation of endocrine-paracrine cells was noted. The relationship of female urethral and paraurethral endocrine-paracrine cells to those of the male prostate and urethra is discussed with speculation as to the functional role these cells may play.

Long Term Human Placental Lobule Perfusion — An Ultrastructural Study

The importance of the ultrastructural evaluation of perfused placental tissue was first emphasized by Panigel (1965, 1971). Ultrastructural study of perfused tissue is now generally accepted as mandatory. Several recent publications have addressed the issue of placental ultrastructural changes after in vitro dual perfusion (Contractor et al., 1984; Illsley et al., 1985; Kaufmann, 1985). These studies involved placental tissue evaluated after only 2–4 hr of perfusion. In this paper we present high resolution light microscopic and electron microscopic findings of placental lobules dually perfused for up to 12 hr. There was excellent overall preservation of morphology. Biochemical and physiological evaluations were also performed demonstrating viability throughout the perfusion period.

Large block embedding and "pop-off" technique for immunoelectron microscopy.

A technique for immunoelectron microscopy is described whereby tissue is embedded in large (6 × 12 mm) plastic blocks and reembedded (“popped off”) directly from semithin (3-μm) sections for thin sectioning. This technique is particularly useful in locating relatively sparse cells or tissue structures. Three acrylic plastics were evaluated: Lowicryl K4M, LR Gold, and LR White. Results indicated excellent ultrastructural morphologic preservation and retention of antigenicity with the first two plastics both comparable to conventional methods of processing. Lowicryl and LR Gold were successfully adapted to the large block pop-off technique. Technical problems were encountered with LR White.

Histiomonocytic Malignancy. A Spectrum of Disease in an 11-Month-Old Infant

The initial pathologic diagnosis in an 11‐month‐old girl presenting with a suprarenal mass was true histiocytic lymphoma. The histiocytic nature of the cells was verified by ultrastructural, histochemical, and immunologic studies. The subsequent course featured widespread dissemination as both tumorous masses and diffuse tissue infiltrates, including extensive soft tissue, leptomeningeal, and bone marrow involvement, with a terminal histiomonocytic leukemic phase. Subsequently, this tumor was reclassified as malignant histiocytosis with atypical features, and this case exemplifies the difficulties in classifying some malignant histiomonocytic neoplasms. The overlapping clinical, pathologic, and theoretic features of true histiocytic lymphoma, malignant histiocytosis, and histiomonocytic leukemia are discussed in the context of this case.

A Review of the Ultrastructure of Human Prostatic and Urethral Endocrine-Paracrine Cells and Neuroendocrine Differentiation in Prostatic Carcinoma

Endocrine-paracrine (EP) cells of the human prostate and urethra were first noted as a third epithelial cell type (in addition to basal and secretory cells) in 1944 by Pretl [51]. He designated them clear cells with an affinity for silver (argentaffin reaction). In 1951, Feyrter [35] further characterized these “clear” cells (Helle Zellen) in the prostate and urethra as being not only argentaffin (no reducing agent) but also argyrophilic (exogenous reducing agent added), including some of which were argyrophil only, indicating a heterogenous population of cells. The prostatic and urethral endocrine-paracrine cells are a component of a dispersed neuroendocrine regulatory system first proposed by Feyrter in 1938 [36]. He also coined the term paracrine, since he believed these cells exerted their action on nearby cells and tissues rather than a distant target.

Prostatic Endocrine-Paracrine Cells: Recent Findings and Possible Relationship to Nodular Prostatic Hyperplasia and Prostatic Neoplasia

Endocrine-paracrine cells of the human prostate gland and urethra (APUD) have been studied recently in our laboratory. Cytochemical, immunocytochemical, and ultrastructural investigations have shown these endocrine-paracrine cells to be much more numerous and diverse than previously suspected. These endocrine-paracrine cells are of the open, closed, and dendritic types, and most, if not all, contain serotonin. A few of these cells contain somatostatin. At least four cell types can be defined by silver stains and immunocytochemistry and possibly as many as nine cell “types” based on secretory granule morphology. Endocrine-paracrine (EP) cells could play a central role in the pathogenesis of benign prostatic hyperplasia and carcinoma.