A clinicopathologic study was conducted on six patients with intraductal papillary neoplasms of the pancreas. The patients were of both sexes and their ages ranged from 64 to 79 years. Three patients had a long history of symptoms mimicking chronic pancreatitis. The tumors involved the main pancreatic duct in the head-body region either diffusely or focally. Histologic examination showed papillary proliferations of well-differentiated, mucus-secreting cells that occasionally stained for carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9). The proliferations filled the main pancreatic duct, and extended into smaller ducts in some cases. In three patients, the lesions contained foci of pronounced to severe cellular atypia and carcinoma in situ. None of our series or any similar cases reported in the literature has shown invasion into peripancreatic tissue, metastasis, or tumor recurrence after pancreatectomy. Because of their favorable prognosis, intraductal papillary neoplasms should be considered low-grade malignancies that must not be confused with the common ductal adenocarcinoma.
Expression of Le(Y), a difucosylated type 2 chain determinant, has been previously identified as a characteristic of cells undergoing apoptosis. Immunohistochemistry using an antibody for Le(Y), as well as nick-end labeling for the detection of DNA breaks, was done on cervical spinal cord sections from ten patients with amyotrophic lateral sclerosis (ALS) and nine patients who had died from other causes. Le(Y)-positive immunoreactivity was seen in the motor neurons of seven ALS cases, but in none of the other cases. Nick-end labeling was also positive in four ALS cases. Double staining of motor neurons by anti-Le(Y) antibody and nick-end labeling was shown in these cases. Other Le(Y)-positive structures, such as reactive astrocytes and fat-laden microglia/macrophages in the lateral and anterior columns, were negative for nick-end labeling. These results suggest that the mechanism of cell death in the spinal motor neurons of ALS may be apoptosis.
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