AIM: To assess a newly developed immunohistochemical detection system, the EnVision++. METHODS: A large series of differently processed normal and pathological samples and 53 relevant monoclonal antibodies were chosen. A chessboard titration assay was used to compare the results provided by the EnVision++ system with those of the APAAP, CSA, LSAB, SABC, and ChemMate methods, when applied either manually or in a TechMate 500 immunostainer. RESULTS: With the vast majority of the antibodies, EnVision++ allowed two- to fivefold higher dilutions than the APAAP, LSAB, SABC, and ChemMate techniques, the staining intensity and percentage of expected positive cells being the same. With some critical antibodies (such as the anti-CD5), it turned out to be superior in that it achieved consistently reproducible results with differently fixed or overfixed samples. Only the CSA method, which includes tyramide based enhancement, allowed the same dilutions as the EnVision++ system, and in one instance (with the anti-cyclin D1 antibody) represented the gold standard. CONCLUSIONS: The EnVision++ is an easy to use system, which avoids the possibility of disturbing endogenous biotin and lowers the cost per test by increasing the dilutions of the primary antibodies. Being a two step procedure, it reduces both the assay time and the workload.

https://jcp.bmj.com/content/jclinpath/51/7/506.full.pdf

The EnVision++ system: a new immunohistochemical method for diagnostics and research. Critical comparison with the APAAP, ChemMate, CSA, LABC, and SABC techniques.

Mullerian adenosarcoma of the uterus: a clinicopathologic analysis of 100 cases with a review of the literature.

Combination chemotherapy in the treatment of advanced Hodgkin's disease.

This report describes six patients with endodermal sinus tumor of the vagina and cervix, a polypoid friable tumor whose clinical presentation in girls younger than age 3 years simulates the presentation of sarcoma botryoides. In four of the six patients, the referring diagnosis was sarcoma botryoides. Five patients were treated with excisional surgery, and all six with chemotherapy. One patient with pulmonary metastases maintained a complete clinical response to vincristine, actinomycin-D, and cyclophosphamide (VAC) for 11 months. This is the first report of such a response. One patient with a vaginal lesion remains clinically free of disease 2 years after local excision and 18 months of VAC chemotherapy. This is the first report of apparently successful therapy that allowed retention of childbearing potential. Four of the six patients have been disease-free from 2 to 23 years. After examining the world literature, it is concluded that a combination of chemotherapy and surgery offers a reasonable prospect of cure with a minimum of serious side effects.

Endodermal sinus tumor of the vagina and cervix

Endodermal sinus tumor of the vagina: a report of nine cases and review of the literature.

Endodermal sinus tumor arising in the endometrium.

The authors report a case of signet ring cell lymphoma, a rare variety of germinal (follicular) centre cell neoplasm. Its clinical, histological and ultrastructural findings are compared with those of the nine cases previously described. Original immunocytochemical results are presented and discussed.

Signet ring cell lymphoma: a case report.

The clinicopathologic features of 4 cases of Mullerian adenosarcoma of the uterine body and 1 of the cervix are reported. They showed the characteristic pattern of benign epithelial growth within sarcomatous stroma. In the cervical tumor, malignant heterologous stromal cells were also present. All the patients are alive and well, confirming the good prognosis of this neoplasm. The authors think that the presence of a malignant heterologous component probably does not imply a worse prognosis.

Müllerian adenosarcoma of the uterus: a report of 5 cases.

Application of immunocytochemistry to formalin-fixed, paraffin-embedded material tends to provide capricious results, even when employing the unlabelled antibody peroxidase-antiperoxidase (PAP) method. This study shows that treatment of tissue sections with pronase, a protease isolated from a strain of Streptomyces griseus, prior to performance of the PAP procedure greatly enhances its sensitivity. The optimum conditions for use of this enzyme in detecting intracellular immunoglobulins are given.

L Serra

Papers

Endodermal sinus tumor arising in the endometrium.

Signet ring cell lymphoma: a case report.

Müllerian adenosarcoma of the uterus: a report of 5 cases.

The use of pronase enhances sensitivity of the PAP method in the detection of intracytoplasmic immunoglobulins.

Giant cell arteritis of the uterus