bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed connective tissue disease complicated by pneumatosis cystoides intestinalis and malabsorption syndrome: Case report and literature review
Authors: Wakamatsu Manami , Inada Ken‐ichi , Tsutsumi Yutaka
Published: December 2008

A case of mixed connective tissue disease (MCTD) in a female with positive ribonucleoprotein antibody and overlapped manifestations of systemic lupus erythematosus and der‐matomyositis is presented. During the last 9 years of her 13 year clinical course, she repeatedly manifested abdominal distension, pneumoperitoneum and malabsorption syndrome. She died, aged 54 years, of respiratory failure secondary to pulmonary compression from marked abdominal distention. Autopsy revealed esophageal fibrosis with ulcer‐ation and the typical appearance of pneumatosis cystoides intestinalis (PCI), in association with atrophy and fibrosis of the inner circular muscle layer of the small bowel. The association of PCI with MCTD is reviewed briefly.
Müllerian adenosarcorna of the cervix: Differentr'al diagnosis, histogenesis and review of the literature
Authors: M Ginesa , Pérez Garcia‐Rostán y , Troyas Rosa Guarch , Bercero Efena Almudévar
Published: December 2008

A new cam is reported of müllerian adenosarcoma, presenting as a ‘benign cervical polyp’ protruding through the vulva of a 44 yearold woman admitted with abnormal vaginal bleeding. This report emphasizes the importance of a careful examination of the stroma and special features of the entrapped glands in order to contribute to an earlier and proper diagnosis. The literature is reviewed and the probable histogenesis of this tumor and differential diagnosis with embryonal rhabdomysarcoma (sarcoma botryoides), adenofibroma, malignant mesodermal tumor and carcino‐sarcoma is discussed.
Immunohistochemical study on choline acetyltransferase in the spinal cord of patients with amyotrophic lateral sclerosis
Authors: Oda Yoshio , Imai Satomi , Nakanishi Isao , Ichikawa Tomoyuki , Deguchi Takeo
Published: December 2008

The authors developed a polyclonal antibody against a fusion protein containing 598 amino acids from a human choline acetyltransferase (ChAT) cDNA and 12 amino acids derived from an expression vector, and examined immunohistochemical reactivity for ChAT in large motor neurons (30 μn and more in somal minimal diameter) of the lumbar spinal cords of four patients with amyotrophic lateral sclerosis (ALS) and of four control cases. In controls, the number of large neurons included in the tissue with a total thickness of 100 μm ranged from 74 to 105 (average 87). About 60–90% (average 80%) of the neurons were positively stained in their perikarya with an anti‐human ChAT antibody. In the cases of ALS, the number of large motor neurons was greatly reduced (25–60, average 38). About 4–13% (average 8%) were positively stained. These results indicate that not only large neurons are reduced in number, but also their positivity for ChAT is decreased in the anterior horn of ALS spinal cord.
Primary malignant lymphoma of the intestine: Clinicopathologic and immunohistochemical studies of 39 cases
Authors: Kojima Masaru , Nakarnura Shigeo , Kurabayashi Yoshiyuki , Shimizu Kazuhiko , Hosomura Yasuo , Ohno Yoshihiro , Itoh Hideaki , Yoshida Katsue , Sano Takaaki , Sakurai Shinji , Iwasaki Shigeru , Fujisaki Masato , Suchi Taizan , Joshita Takashi
Published: December 2008

Clinicopathologic and immunohistochemical features in 39 cases of primary intestinal non‐Hodgkin's lymphoma (NHL) in Japanese patients were studied. Only resection materials in stage IE and IIE‐1 were included in this study because of the certainty that the intestine was the primary site of the lymphoma. The updated Kiel classification was used to classify NHL Histologically, only two cases (5.1%) were follicular lymphomas, and the others were diffuse lymphomas. Twenty‐eight patients (71.8%) had high‐grade NHL and 11 (28.2%) had low‐grade NHL. Twenty (71.4%) of the 28 high‐grade NHL were centroblastic lymphomas, and 14 (70.0%) of these 20 cases of centroblastic lymphoma were the polymorphic variant. Ten (90.9%) of the 11 low‐grade NHL were low‐grade mucosa‐associated lymphoid tissue (MALT) lymphomas. Macroscopically, 18 patients had polypoid masses, 17 ulcerative tumors and four had diffusely infiltrating NHL. Seven of the 10 low‐grade MALT lymphomas were polypoid masses. Immunohistochemically, 35 lesions (89.7%) were of the B cell phenotype and three (7.7%) were of the T cell phenotype. In the remaining case, the cell lineage could not be determined. No lesions were considered to be Of histio‐cytic origin. The 5 year survival rate for high‐grade B cell lymphomas was poorer than for low‐grade B cell lymphomas, and the present study indicated that the histological grade of the intestinal B cell lymphomas was a prognostically significant factor.
Detection of the Epstein‐Barr virus in primary gastric lymphoma by in situ hybridization
Authors: Liu Qiang , Ohshirna Koichi , Masuda Yuichi , Kikuchi Masahiro
Published: December 2008

The Epstein‐Barr virus (EBV) has been shown to be associated with numerous human malignancies including Burktt's lymphoma and nasopharyngeal lymphoepithelioma. In addition, some typical gastric adenocarcinomas were also recently reported to demonstrate EBV relevance. The present study was designed to detect EBV in primary gastric lymphoma, using the in situ hybridization (ISH) method, in which oligo‐nucleotide probes for the EBERl RNA and the EBV DNA W region have been used. Of the 49 cases of primary gastric lymphoma studied, which all showed B cell immunopheno‐type, EBER1 sequences could only be found in four cases, including two low‐grade cases and two high‐grade cases of histological subtypes while the number of positive cells was less than 50% of the tumor cells. In one case of low‐grade mucosa associated lymphoid tissue (MALT) lymphoma, the EBER1 ‐positive neoplastic cells were found in the regional lymph node, but the primary site of the stomach showed no positive signals. The EBV presence was further confirmed by the EBV DNA ISH. Using the ISH method, rare or occasional positive lymphoid cells (probably non‐tumorous bystander cells) could be detected in 10 other cases including all histological subtypes. The present study shows that only a small proportion of primary gastric lymphoma is associated with EBV, and such positive cases could be found in both high‐ and low‐grade histological subtypes. It is also suggested that the EBV presence in the neoplastic cells of some cases of primary gastric lymphoma is most likely a secondary phenomenon.
Transferrin receptor distribution and iron deposition in the hepatic fobufe of iron‐overloaded rats
Authors: Lu Jlan‐Ping , Hayashi Keiki
Published: December 2008

Under the condition of obvious iron‐overload, there is a zonal hernoeiderin (iron) deposition in hepatic lobules. The deposition is heavtest in the periporfal (zone 1) and lightest in the perivenws (zone 3) hepatocytes. However, the mechanism for this pattern of iron deposition is obscure. Hepatic tissues from control, iron‐deficlent or ironoverloaded Wistar rats me used to study its pathogenesis. iron‐deficiency was Induced by a low Iron regimen. Ironoverload was produced by repeated intraperitoneal injections of ferric nitrilotriace‐We (Fe3+‐NTA) for 1–4 months. Liver tissues of the rats were lmmunohistochemically and histochemically stained for tmnaferrin receptor (TfR), transferrin (Tf), ferritin (Ft), and iron. The staining intensity of TfR, Tf and Ft increased in hepatocytes of iron‐deflctent rats and decreased in that of the iromverloaded in comparison with the control rats. TfR atalning was strong in zone 1, with gradual transition into weak staining in zone 3 hepatocytes of the rat liver. TfR located primarily on the hepatocyte membrane. Tf had both membranous and cytoplasmic distribution. Many hepatocytes in group B had strong cytoplasmic Tf staining. Conversely, only a few hepatocytes had weakly stained cytoplasmic Tf in group C. Hepatocytes and Kupffer cells were Ft positive in control rats. Ft was distributed only in the cytoplasm. The staining intensity of Ft was stronger in zone 3 than in zone 1 hepatocytes of iron‐deficient rats. In iron‐overloaded rats, the iron deposition was severe in zone 1 and mild in zone 3 hepatocytes. These findings suggest that uptake of iron into hepatocytes in vivo is regulated and mediated by TfR and Tf. Gradient TfR distribution from zone 1 to 3 hepatocytes and active TfR‐Tf mediated iron uptake resuited in the zonal iron deposition in the hepatic lobule of iron‐overloaded rats.
Immunoglobulin idiotypic specificity of AIDS‐associated lymphomas and their experimental model
Authors: Cui Li Xin , Ikenami Michihiro , Katano Harutaka , Takanashi Masakatsu , Machinami Rikuo , Mori Shigeo
Published: December 2008

B cell non‐Hodgkin's lymphoma (B‐NHL) occurring in im‐munocompromised hosts, such as acquired immune deficiency syndrome (AIDS) patients, is a high‐grade malignancy resistant to regular chemotherapy. To determine whether immunotherapy with public anti‐Ig idiotype antibodies can be used to treat these NHL, the lg idiotype specificity of six NHL in AIDS patients (AIDS‐ML) and 23 B‐NHL experimentally induced in immunocompromised mice (SCID mice) was investigated. One of the six AIDS‐ML and two of the 23 experimental B‐NHL reacted monoclonally with a single public antibody, while one AIDS‐ML and three experimental B‐NHL reacted polyclonally with two or three different antibodies. The presence of Ig idiotypic polyclonality requires special consideration with regard to the introduction of anti‐Ig idiotype immunotherapy in these cases.
Mucin histochemistry of ovarian mucinous cystadenomas expressing gastrointestinal characteristics
Authors: Nomura Kouichi
Published: December 2008

Fifty‐four cases of ovarian mucinous cystadenoma, including twa cases containing ciliated cells representing the müllerian epithelial origin, one case admixed with serous adenoma component and six cases associated with mature teratoma, were examined for the demonstration of gastrointestinal characteristics using periodic acid‐Schiff, alcian blue, galac‐tose oxidase‐Schiff, paradoxycal concanavalin A (ConA), Grimelius and Fontana‐Masson stains. Of 41 endocervical‐type mucinous cystadenomas not associated with teratoma, 34 cases (83%) showed ConA positivity, expressing gastrointestinal characteristics. As both cases with ciliated cells and the case with serous adenoma component exhibited ConA positivity, the ovarian surface epithelium is supposed to undergo mucinous metaplasia possessing gastrointestinal characteristics. As to the histogenesis of the ovarian mucinous tumors, the metaplasia theory is suggested.
Intercellular adhesion molecule‐1 expression by macrophages in human gastrointestinal carcinoma: Possible roles as host immune/inflammatory reaction
Authors: Mizoi Takayuki , Ohtani Haruo , Suzuki Yukimasa , Shiiba Ken'ichi , Matsuno Seiki , Nagura Hiroshi
Published: December 2008

Tumor‐associated macrophages (TAM) are one of the factors which modulate the carcinoma progression. The present study described immunohistochemical expression of intercellular adhesion molecule‐1 (ICAM‐1) in stromal cells in human gastrointestinal carcinoma identifying the cell types by immunoelectron microscopy. In colon and gastric carcinomas, ICAM‐1‐positive cells were mostly stromal cells, and major cell types were identified as macrophages and fibroblasts by immunoelectron microscopy. Macrophages were characterized by their ovoid shape, cytoplasmic projections, abundant vacuoles, phagocytosis, and paucity of rough endoplasmic reticulum. Fibroblasts contained stacks of rough endoplasmic reticulum. Macrophages were major cells among ICAM‐1‐positive cells along the invasive margin, while fibroblasts were predominant in the stroma within carcinoma in colon and intestinal‐type gastric carcinomas. Lymphocytes positive for lymphocyte function associated antigen (LFA‐1), a counter‐receptor of ICAM‐1, were densely distributed along the invasive margin, and sparsely in the stroma within carcinoma. In diffuse‐type gastric carcinoma, most macrophages were dendriticshaped and negative for ICAM‐1. Our study suggests that the invasive margin is an area similar to active inflammation, where the antigen presenting cells (macrophages) and lymphocytes may interact via the ICAM‐1/LFA‐1 adhesion.
Minigemistocytic astrocytoma with frequent apoptoses: Analysis of tumor growth
Authors: Higami Yoshikazu , Shlmokawa Isao , Okimoto Tomoaki , Otani Hiroshi , Kishikawa Masao , Zlnnouchi Takafumi , Hiura Tsuyoshi , Nishimura Syuhei , Ikeda Takayoshi
Published: December 2008

A rare glial tumor known as ‘minigemistocytic astrocytoma (gliofibrillaty oligodendroglioma)’ is reported in a 73 year old Japanese male. A low‐density area found by computed tomography and thought to be an operative scar remaining after hematoma in the right frontal lobe of the cerebrum had been followed for 10 years. This area, however, had been accompanied by a cyst for 2 years and had developed gradually for 1 year prior to dissection. The tumor was poorly demarcated from the surrounding normal tissue macroscopically at operation. Microscopically, the tumor consisted of small gemistocytic cells in uniform sheets intersected by a small vascular stroma with frequent eosinophilic granular bodies, mitoses and apoptotic bodies. lmmunohistochemical examination for glial fibrilliary acidic protein (GFAP) revealed remarkable positive reactivity in the perinuclear cytoplasm, but no immunoreactivity for vimentin or Leu 7 was found. Electron microscopically, rich filaments amngfd in parallel bundles were found in the neoplastic cells. These histological findings are closely consistent with those of previously reported minigemistocytic astrocytoma cases. The GFAP‐rich minigemistocytic astrocytoma with granular bodies and frequent mitoses in the present case is considered to indicate a higher degree of astrocytic differentiation and malignant potential than previous cases. The frequent apoptoses, however, might inhibit tumor growth in this case.
Iimitations of podocyte adaptation for glomerular injury in puromycin aminonucleoside nephrosis
Authors: Kihara Itaru , Yatoita Eishin , Kawasaki Katsutoshi , Yamamoto Tadashi
Published: December 2008

Glomerular synechiae that occurred in nephrotic rats with a single intraperitoneal injection of puromycin aminonucleoside were analyzed by immunohistochemistry, radiolabeled thymidine (PHI‐thymidine) autoradiography, as well as light, electron and immunoelectron microscopy. To discriminate podocytes from parietal epithelial cells (PEC) and monocytes, monoclonal antibodies (mAb) against podocalyxin and ED1 were used. The cell kinetics of glomerular epithelial cells were autoradiographically assessed with isotope labeling procedures before and during nephrosis (co‐labeled), and a mAb against proliferating cell nuclear antigen (PCNA). All the cell types except the podocyte of normal kidneys were labelled with rHI‐thymidine at different rates. Detachment of degenerated podocytes from the outside of the glomerular basement membrane (GBM) is the first step of synechia, and detached sites are confronted by PEC that were hypertro‐phied and frequently radiolabeled. Evidence that podocytes in glomeruli of nephrotic rats can proliferate was shown by the presence of mitoses, rHt]‐thymidine uptake in the co‐labeled experiment, and by PCNA staining, but reepithelialization over bare segments of the GBM with proliferated podocytes is doubtful. It was concluded that glomerular synechia resulted from the limits of podocyte adaptation to glomerular injuries.
Presence of eosinophilic precursors in the human thymus: Evidence for intra‐thymic differentiation of cells in eosinophilic lineage
Authors: Lee Inchul , Yu Eunsil , Good Robert A. , Ikehara Susumu
Published: December 2008

The distribution of myeloid cells in the human thymus was investigated by light and electron microscopy, immuno‐histochemistry, andlor flow cytometry. A series of 74 thymic samples, from newborn to 37 year old patients, were studied. By light microscopy, aggregates of mononuclear cells were frequently present in intralobular septa and outer medulla. Among those cells, eosinophilic precursors (promyelocyte, myelocytes and metamyelocytes) were readily identified. These immature granular cells were present in all pre‐invo‐lutional thymi, and were particularly frequent in the thymi of patients who were younger than 5 years of age. The cells made up 30–50% of the total eosinophilic population and were frequently observed asagroupof cells at variousstages of differentiation, suggesting that they differentiate from preexisting precursors in the thymus. These eosinophilic precursors were mostly located in the intralobular septa and f ibroreticular network at the corticomedullary junction, while mature eosinophils were scattered throughout the thymus. Flow cytometric analyses, using stem cellenriched preparations, showed that cells expressing CD33 or CD34 constituted on average 2.55% and 3.33% (0.09% and 0.12% of the total cells), respectively. CD33+/CD34+ coexpressors were also identified, and they constituted 0.36% of the analyzed cells (0.01% of the total cells). No statistical difference in the proportions of CD33+ andlor 34′ cells was noted between any age groups. It is concluded that eosinophilic precursors present in the thymus differentiate into cells in the eosinophilic lineage in particular areas such as the intralobular septa and f ibroreticular network of the outer medulla in pt'ein‐volutional human thymi.
Differences in c‐fos gene product expression in cancers of the gall‐bladder and biliary tract
Authors: Lee C. Soon
Published: December 2008

The c‐fos gene encodes a 55kDa nuclear protein product that complexes to a cellular protein, p39. The pattern of expression of c‐fos is particularly complex with Increased expression of the protein observed in undifferentiated cultured cells while reduced expression is found during terminal differentiation. The expression of c‐fos gene was studied by immuno‐histochemistry in carcinoma of the gall‐bladder (n=13), biliary tract (n=5) and ampulla of Vater (n=9). Non‐malignant conditions Investigated Include chronic cholecystitis (n=11), gall‐bladder dysplasia (n=3) and adenoma (n=1), and ampullary carcinoma in situ (n=3). Strong positive granular cytoplasmic Immunostaining for c‐fos oncoprotein was present in most gall‐bladder adenocarcinomas (n=11; 85%). The single gall‐bladder adenoma and only one of the dysplasia cases were positive. Most of the cases of chronic cholecystitis showed either absent or only focal to patchy and weak to moderate c‐fos Immunoreactivity In the deeper glands and Rokitansky‐Aschoff sinuses but not in the superficial epithelium. None of the biliary tract and ampullary tumors showed Immunostaining for c‐fos. The difference in c‐fos immunoreactivity between gall‐bladder carcinoma and chronic cholecystitis was statistically significant (P=0.0002; χ2 test with continuity correction). In conclusion, c‐fos protein may be important in the development of gall‐bladder neoplasia with increased c‐fos Immunoreactivity in gallbladder carcinoma but not In chronic cholecystitis, biliary tract and ampuliary neoplasms. These findings suggest that gall‐bladder carcinoma may arise from a different genetic basis compared to biliary tract and ampuliary cancers.
Reactive lymphoid hyperplasia of the liver characterized by an angiofollicular pattern mimicking Castleman's disease
Authors: Tanizawa Tohru , Eishi Yoshinobu , Kamiyama Ryuichi , Nakahara Madoka , Abo Yoshihisa , Sumita Toshiyuki , Kawano Nobuhiro
Published: December 2008

A case of reactive lymphoid hyperplasia of the liver exhibiting a characteristic angiofoillcular pattern is reported. A hepatic nodular lesion was discovered by abdominal echography during clinical follow‐up of abnormal liver function tests. It was diagnosed as hepatocellular carcinoma because of Its hypervascularity when observed by angiography, and surgically resected. Grossly, the lesion was well‐demarcated and measured 2 cm In diameter. Microscopycally, the nodule was composed of lymph follicies with germinal centers, and the hyalinized Inter‐follicular space contained abundant hyalinized vasculature and plasma cells. The surrounding liver tissue exhibited chronic Inflammation with some pecullar angiofolllcular structures mimicking Castleman's disease. An Immunohistoehemical study revealed that the angiofoillcular structure had the same characteristics as a lymph follicle with a general center, and that the plasma cells proliferating in the inter‐follicular space had polyclonal Immunophenotypes. These histological and immunohistochemical findings Indicated that the angiofoillcular structure observed was a kind of reactive lymph follicle, and that this hepatic lesion was reactive lymphoid hyperplasla rather than Castleman's disease or an inflammatory pseudotumor.
Concurrent interfollicular Hodgkin's disease and metastatic breast carcinoma in lymph nodes
Authors: Allal Adbelkarim S. , Weintraub Jonathan , Remadi Sami , Abele Reto
Published: December 2008

The clinical and pathological findings are reported concerning a 73‐year‐old woman with progressive metastatic carcinoma of the left breast, who developed interfollicular Hodgkin's disease within the right cervical lymph nodes. Metastatic carcinoma and Hodgkln's disease were present concurrently as a ‘collision tumor’ In the lymph nodes examined. To the best of the authors' knowledge, this is the first description of a collision tumor with these particular histologic components in this tissue. The factors influencing the coexistence and the order of appearance of the two pathologies in the present case remain unknown.
MIB1 and p53 immunoreactivity in protoplasmic astrocytomas
Authors: Prayson Richard A. , Estes Melinda L.
Published: December 2008

Pure protoplasmic astmqtomas am a group of rarely encountered low grade astfocytic neoplasms. Relatively few studies have speclfically examined this subset of tumors. A series of 18 protoplasmic astrocytomas in 14 males and four females (age range 2.5–52, mean 22 years) were studied in order to examine MlB1 (a marker of cell proliferation) and p53 (a tumor suppressor gene) immunoreactivity. All patients presented with seizures (mean duration 94 months) and three with headaches also. Elght tumors were located in the temporal lobe and six in the frontal lobe. All tumors were characterized by a proliferation of astrocytes with round nuclear contours arranged against a microcystic background. Only rare focl of mild vascular proliferation (3 tumors), rare mitotic figures (1 tumor), and mild nuclear atypia (3 tumors) were observed. Most tumors were primarily cortical in location. Necrosls was not seen in any of the tumors. MiB1 indices (number of MiB1 positive tumor cells/1000 tumor cells evaluated x100) ranged from 0 to 4.3 (mean 0.7); in five tumors, no MiB1 staining was observed. p53 immunoreactivity was noted in 5 of 18 tumors (28%). Five patients received adjuvant radiation therapy and one adjuvant chemotherapy. At last known follow‐up, 11 patients are alive with no evidence of residual tumor (mean 70 months), six patients are alive with evidence of residual tumor (mean 58 months), and one patlent died of complications unrelated to the tumor (36 months) postoperatively. Based on these findings, the conclusions presented are as follows: (i) MlBl indices are generally low in these tumors, corroboratlng the clinical impredon of a slow growing neoplasm; and (ii) p53 immunoreactivity is obsewed in a minority of protoplasmic astrocytomas.
Mouse mammary tumor virus and mammary tumorigenesis in wild mice
Authors: Imal Shunsuke
Published: December 2008

The current knowledge of the distribution of the mouse mammary tumor virus (MMTV) proviral genomes and the mechanism of mammary tumorigenesis by MMTV in mice, with the main emphasis on Asian feral mice, is reviewed. The relevant earlier discoveries on the mode of MMTV transmission are summarized to provide an outline of the biology of MMTV. Finally, the viral etiology of human breast cancer will be discussed.
Basement membrane thickening in the placentae from diabetic women
Authors: Younes Bassam , Baez‐Giangreco Atilio , Al‐Nuaim Lulu , Al‐Hakeem Amal , Talib Zeinab Abo
Published: December 2008

A light microscopy study was carried out on 48 placentae. Seventeen placentae were obtained from non‐diabetic mothers while the other 31 placentae were from both women with controlled diabetes and women who had an abnormality of the glucose tolerance test. All the women delivered at 38–40 weeks of gestation. Placentae from diabetic patients showed immaturity of the villi, hypertrophy of the capillaries and thickening of the basement membrane of the tropho‐blastJc vllll (3.2 ± 0.35 μm) and the amniotlc membrane (1.8 ±0.3 μm). Focal fibrinold necrosis, an increase in the number of Hofbauer cells and dilatation of villi capillaries were also commonly observed in placentae from diabetic mothers, and the normal cuboidal cells lining the amniotic membrane tended to become tall columnar (17.6 ± 6.3 μm) with distaily located nuciel. Similar findings were observed in patients who had a potentially abnormal glucose toierance test, which suggests the possibility of primary lesion in origin. Therefore, control of hyperglycemia may only partially prevent the development of placental abnormalities.
Participation of endothelial cells in the development of glomerulosclerosis: A study on murine serum sickness nephritis with mitomycin C
Authors: Chowdhury A. K. M. Rownak Hossain
Published: December 2008

To investigate the participation of endothelial cells in glomerulosclerosis, the study was performed in serum sickness nephritis (SSN) with administration of mitomycin C (MMC). SSN was induced in 8 week male Fisher rats by sensitizing them with albumin, chicken egg (EA). Then MMC (0.5mg/kg bodyweight) was injected daily for 3 days and they were killed at 1, 2, 4 and 6 week intervals. Significant mesanglal expansion and sclerosis were observed in the experimental mixed SSN‐MMC group in comparison to the SSN or MMC control group from 1 week to 6 weeks (P < 0.05). Moreover at 1 week, double contour appearance of the glomerular capillary wall, basement membrane splitting and disruption were observed light microscopically in the mixed SSN‐MMC group. Electron microscopy revealed peripheral capillary basement membrane disruption with huge subepithelial, mesangial osmiophilic deposits and epithelial foot process effacement. At 6 weeks, disappearance of the endothelial cell fenestra‐tion and subepithelial basement membrane‐like material formation were observed in the MMC group. Based on these results, it is suggested that MMC induced assault on the glomerular endothelial cell produces prominent glomerular capillary basement membrane disruption at the early phase of SSN, resulting in the accumulation of huge subepithelial and mesangial deposits, mesangial cell proliferation, production of the extracelluar matrix component and initiation of glomerulosclerosis.
Myocardial ischemia due to vascular systemic amyloidosis: A quantitative analysis of autopsy findings on stenosis of the intramural coronary arteries
Authors: Ishikawa Yukio , Ishii Toshiharu , Masuda Shigeru , Asuwa Noriko , Kiguchi Hideko , Hirai Shigeo , Murayama Akira
Published: December 2008

A case is reported of a 65 year old man who suffered myocardial ischemia resulting from extensive stenosis of the intramural coronary arteries secondary to systemic vascular involvement by primary amyloidosis. In the myocardium, there were multiple fibrotic foci scattered mainly in the sub‐endocardlal region of the ventricle. Intramural coronary arteries were stenotic or occlusive due to amyloid‐induced luminal narrowing, but there was no significant stenosis of the epicardial coronary arteries. Quantitative analysis of amyloid deposits in the intramural coronary arteries demonstrated that occlusive arteries were predominant in the surrounding area of myocardial fibrosis, and the extent of coronary stenosis by amyloid deposition was significantly more severe than in hearts of the five control patients who had coronary amyloidosis without myocardial fibrosis. These results indicate that myocardial fibrosis originates from coronary Ischemia due to vascular amyloid deposition. This is the first time that the relationship between myocardial lesions and coronary amyloid deposition has been elucidated using histopathologic quantitative analysis.
Metastasis from small cell carcinoma of the lung producing acute appendicitis
Authors: Gonzalez‐Vela Maria Carmen , García‐Vattuille Ana Isabel , Fernández Fidel Angel , Val‐Bernal José Fernando
Published: December 2008

A case of acute gangrenous appendicitis with perforation caused by metastatie small cell carcinoma of the lung in a 65 year old man is reported. The manifestation of appendicitis occurred more than 4 years after the diagnosis of the bron‐chogenic carcinoma. With longer survival of patients with disseminated tumors it is probable that new manifestations of those malignancies will be discovered. Acute appendicitis due to metastasis from a distant neoplasm should be considered in the differential diagnosis of right lower abdominal pain in the oncology patient.
Phosphaturic mesenchymal tumor, mixed connective tissue variant (oncogenic osteomaiacia)
Authors: Jimura Takahiro Tsu , Sakaguchi Katsuhiko , Aozasa Katsuyuki
Published: December 2008

A case of tumor‐induced phosphaturic osteomaiacia in a 54 year old man is reported. The patient was admitted because of progressive muscle spasms with pain and weakness in the bilateral thighs. Laboratory data showed hypophospha‐temia, decreased tubular resorpnon of phosphate (TRP), a low 1, 25‐dlhydroxyvitamin D level, and a high serum alkaline phosphatase level. Radiologic examinations revealed multiple lesions of osteomaiacia in the ribs, and a small mass in the lower posterior mediastinum. After removal of the tumor, clinical symptoms disappeared and hypopnosphatemia, decreased TRP, and the 1,25‐dihydroxyvitamin D level were corrected. Microscopical examination revealed that the tumor was composed of mature adipose tissues, osseous tissues, and primitive stromai zones including osteoclast‐like giant cells, non‐mineralized woven bone, and various sized blood vessels. Patho‐physiologic observations suggested that the tumor secreted some humoral substances Inhibiting 25‐hydroxyvitamin D‐1α‐hydroxylase activity, renal phosphate resorption, and parathyroid hormone production.
Different expression of Bcl‐2 protein in gastric adenomas and carcinomas
Authors: Uesugi Hidenaga , Saegusa Makoto
Published: December 2008

In order to cast light on the possible role of bcl‐2 protein (Bcl‐2) expression In gastric tumorigenesis, 33 cases of gastric adenomas and carcinomas originating from the same stomachs were immunohistocnemically investigated for Bcl‐2 protein (Bcl‐2) expression, accumulation of p53 protein and cell proliferation as determined by the KI‐67 labeling index (LI). Bcl‐2 expression was detected in 24/33 (72.7%) adenomas and in 6/33 (18.2%) carcinomas, the difference being statistically significant (P=0.0O01). Only 4 of 33 (12.1%) cases exhibited expression in both adenoma and carcinoma lesions in the same stomachs. ImmunoreactMty was decreased in areas of cellular and structural atypia in adenoma lesions (P<0.008), and appeared to be positively linked to the tumor progression and the degree of differentatlon in carcinomas, although It did not reach statistical significance. Accumulation of p53 protein was rare In the adenomas but was found in 15/33 (45.5%) of carcinoma lesions, with a significant dissociation from Bcl‐2 immunoreactivity. No apparent relation between Ki‐67 U and either adenoma grading or carcinoma typing was noted, although average KI‐67 LI of the highest labeling areas in carcinomas was statistically higher than in adenomas (P=0.0001). These results indicate that the regulation of Bcl‐2 expression may differ between gastric adenomas and carcinomas, may be correlated with tumor dlfferentiathre features. In addition, p53 accumulation may play an Important role in the onset of malignancy.
Postmenopausal intra‐abdominal desmoplastic small cell tumor
Authors: Fukunaga Masaharu , Endo Yasuhiko , Takaki Keizo , Ishikawa Eisei , Ushigome Shinichiro
Published: December 2008

Intra‐abdomlnal desmoplastic small cell tumor (DSCT) usually occurs In infants and young male adults. A case of DSCT occurring in a 60 year old female Is described. No other apparent primary origin was detected. A mesocolon tumor, measuring 23times12times10cm, was composed predominantly of round to spindle cells which showed epithelioid‐ and focally sarcomatous arrangements. Irnmunohlstochemically, the tumor cells showed perinuclear dot‐like staining of CAM5.2, many cells expressed HHF35, and some cells contained vimentin, epithelial membrane antigen, desmln, alpha‐smooth muscle actin, neuron‐specific enolase, or Leu 7. Electron microscopic examination showed that the tumor cells had mesenchymal‐fibroblastic features. The tumor had an aneuploid DNA content with high S‐phase fraction. The patient, who was treated with adjuvant chemotherapy, was alive, having had three recurrences in 36 months. In the second and third recurrent lesions, increased cellular atypla and fascicular arrangements of spindle cells were observed. DSCT should be included in differential diagnoses of postmenopausal pelvic tumors which show light‐microscopically and immunohistochemically divergent phenotypes.
Analysis of the Epstein‐Barr viral genome in so‐called malignant histiocytosis syndrome
Authors: Kobarl Shinichl , Ohshima Koichi , Sumlyoshi Yoshlakl , Yoneda Satoshl , Takeshtta Morishige , Kikuchi Masahiro
Published: December 2008

Malignant histiocytosis has been described as a proliferation of morphologically atypical hlstiocytes, but It Is difficult to determine whether or not malignant proliferation is present based on morphology alone. Recently the disorder has been thought to be heterogeneous, and therefore a true histtocytlc origin is considered to be rare. The Epstein‐Barr virus (EBV) is thought to have the ability to transform human cells. Therefore, eight cases of malignant MsHocytic (MH) syndrome and five cases of virus‐associated hemophagocytic syndrome (VAHS) were analyzed using a polymerase chain reaction (PCR) and the In situ hybridization (ISH) method in order to determine their relationship to EBV Infection. At the same time, the cellular origin of these syndromes was also studied. The results indicated that three of the MH cases were derived from T cells while four the MH cases were from hlstiocytes. The amplification of the EBV‐LYDMA region, which was used to determine the monoclonallty, was detected in two MH cases and one VAHS case, and all these cases showed only one band. An ISH study also demonstrated the presence of an EBV in these three cases. One of the EBV‐positive cases revealed an amplification of the EBV‐LYDMA region by the PCR method before showing any sign of MH clinically. In the VAHS cases, the EBV genome was detected In hemophagocytic cells. The EBV‐poslttve cases all demonstrated a rapid clinical course. Based on these results it is possible that EBV infection causes similar rapid clinical features in some cases of both MH and VAHS by the same mechanism.
Malignant fibrous histiocytoma of the pancreas
Authors: Haba Reiji , Kobayashi Shoji , Hlrakawa Eiichiro , Miki Hiroshi , Okino Takeshi , Kurokawa Tatsuo , Yamamoto Syuu
Published: December 2008

An extremely rare case of malignant fibrous histiocytoma In the pancreas Is reported. A 70‐year‐old man complained of upper abdominal discomfort. A tumor in the head of the pancreas was demonstrated by ultrasonography and computed tomography. The surgical specimen revealed a relatively well demarcated tumor, 9 × 7 × 6.5cm in size. Microscopically, fibroblastic, histiocytic, and muitinucleated giant tumor cells were observed in the myxoid area, but some tumor cells had proliferated in a storiform‐pleomorphlc pattern. Immunohtstochemically, some tumor cells were positive for lysozyme, α‐1‐antitrypsin, α‐1‐antichymotrypsin, and vimentin. Electron microscopically, tumor cells showed a combination of fibroblastic and histiocytic features. The patient Is currently well with no evidence of recurrence or metastasis 22 months after operation.
Clinicopathologic and mucin histochemical analyses of 90 cases of ovarian mucinous borderline tumors of intestinal and müllerian types
Authors: Nomura Koulchl , Aizawa Shigeo
Published: December 2008

Clinicopathologlc and mucin histochemical characteristics of 90 cases of ovarian mucinous borderline tumors (MBT) of Intestinal (IMET) and müllerian types (MMBT) were studied to determine whether IMBT and MMBT constitute distinct tumor subtypes. The IMBT (77 cases, 78 lesions) contained goblet cells, absorptive cells and endocrine cells, which represented Intestinal differentiation. The average diameter of IMBT was 13.4 cm. Five patients (6.5%) had stage III disease wtth pseudomyxoma perltonel and one of them died from tumor. Approximately 50% of IMBT demonstrated gastrointestinal characteistics on mucin histochemistry. The MMBT (13 cases, 14 lesions) consisted of mumus columnar cells and eosinophilic cells, with no Intestinal differentiation. MMBT accounted for 15.2% of MBT. MMBT averaged 8.4 cm in diameter, and 29% were associated with endometriosls of the ipsilateral ovary. All patients with MMBT had stage I disease, and none suffered from pseudomyxoma peritonel. All patients whose follow‐up data were available were alive and well, without evidence of tumor recurrence. The mucin histochemical findings in MMBT resembled those of noml endocervix. Results of the present study suggest that IMBT and MMBT have different characteristics and constitute distinct subtypes of MBT.
Primary gastric lymphomas: Morphologic, immunohistochemical and immunogenetic analyses
Authors: Narita Michihiko , Yatabe Yasushi , Asai Junpei , Mori Naoyoshi
Published: December 2008

Morphologic, lmmunohistochemical and lmmunogenetic studies were performed on 28 cases of primary gastric lymphoma from fresh frozen tissue. Eight cases were diagnosed as diffuse large B‐cell lymphoma, four as follicular center lymphoma (follicular), five as mucosa‐associated lymphoid tissue (MALT) lymphoma, three as plasmacytoma, and three as T‐cell lymphoma, two as mantle cell lymphoma, one as follicular center lymphoma (diffuse, predominantly small cell), and one as lymphoplasmacytoid lymphoma, and one as Hodgkin's disease.

From lmmunohistochemical studies, four types of morphologically similar low‐grade lymphomas can be differentiated by a combination of various monoclonal antibodies. Cases of diffuse large B‐cell lymphoma may have a germinal center origin. We observed lympho‐epithelial lesions in cases of non‐MALT lymphomas. We therefore consider that the current diagnostic criterion for MALT lymphoma may not always be valid.

Except for cases of T‐cell lymphoma and Hodgkin's disease, 17 out of 22 cases revealed clonal rearrangement bands of the JH gene. In situ hybridization (ISH) and polymerase chain reaction (PCR) studies revealed the presence of Epstein‐Barr (EB) virus genomes in two and three cases, respectively. Epstein‐Barr virus may play a role in lympho‐magenesis, although on relatively rare occasions.
Expression of mucin antigens and Lewis X‐related antigens in carcinomas and dysplasia of the pharynx and larynx
Authors: Itoh Tetsuhiko , Yonezawa Suguru , Nomoto Mitsuharu , Ueno Kazuyoshi , Kim Young S. , Sato Eiichi
Published: December 2008

Recent studies have Identified that much antigens and Lewis X (Lex)‐related antigens behave like oncodevelopmental tumor‐asnoclated antigens in several human adenocarcino‐mas. However, the expression of these antigens In pharyn‐geal and latyngeal squamous cell carcinomas (SCC) and in the precursor lesion is not fully elucidated yet. In the present study, the expression of mucin core protein antigens associated with the MUC1 gene product (DF3 antigen, mammary‐type apomucin) and the MUC2 gene product (intestinal‐MRP antigen, Intestinal‐type apomucin) much carbohydrate antigens that are associated with the earliest steps in mucin glycosylation (Tn, sialyl‐Tn and T), and Lex ‐related antigens (Lex, Leγ and slayl Lex‐1) In biopsy or resected specimens from 26 normal squamous epithelia (NSE), 49 dysplastic squamous epithelia (DSE) and 51 SCC were examined. The DF3 antigen was not expressed In NSE (0%), whereas it was expressed in 20 DSE (41%) and in 31 SCC (61%). The intestinal‐MRP antigen showed no expression in NSE, DSE or SCC. The Tn antigen showed no expression in NSE, but showed low expression rates In DSE (14%) and in SCC (16%). The sialyl‐Tn and T antigens were expressed in NSE, as well as in DSE and SCC. The T antigen expression increased with progression from NSE to DSE to SCC, while the sialyl‐Tn antigen did not show such a tendency. Any of the three Lex‐related antigens showed no characteristic expression in DSE and SCC. In the eight antigens examined, only DF3 antigen was an effective marker for DSE and SCC in the pharyngeal and laryngeal region. Cytoplasmic expression of DF3 and slalyl‐ Tn antigens were more frequently seen In SCC than in DSE, and might be useful to differentiate SCC from DSE.
Metanephric adenoma of the kidney: Ultrastructural, immunohistochemical and lectin histochemical studies
Authors: Ban Shin‐ichi , Yoshli Shinichi , Tsuruta Atsushi , Gotoh Yoshiya , Onda Tomoko , Shimlzu Yoshlhiko , Shibata Toshikatsu
Published: December 2008

A case of metanephric adenoma, a rare benign tumor of the kidney is reported, and the results of ultrastructural, immunohistochemical, and lectin histochemical studies are presented. The patient was a 47 year old Japanese man presenting wlth a left renal tumor by ultrasonography. The nephrectomy material revealed a well‐demarcated tumor with medullary appearance, and on histological examination the tumor was composed of cuboidal cells forming regular small tubules with hyallnous stroma. Incomplete glomeruloid structures were formed in a few elongated tubules com‐posed of columnar cells. Metanephric blastema was not observed in the tumor or in the normal kidney. By electron microscope, the tumor cells were observed to be immature cells with microvilli at the apical surfaces. The neoplastic tubules were surrounded by basal lamina. The tumor cells were immunoreactive for Leu 7, epithelial membrane antigen, vimentin, and low molecular weight cytokeratin, and were weakly immunoreactive for S‐100 protein. Peanut agglutinin, soybean agglutinin, and Dollchos bifiorus agglu‐tinin were bound to the apical surfaces of the tumor cells.
Why is cyclooxygenase‐2 expressed in neuroendocrine cells of the human alimentary tract?
Authors: Nakajima Takashi , Hamanaka Kozue , Fukuda Toshio , Oyama Tetsunari , Kashiwabara Kenji , Sano Takaaki
Published: December 2008

During immunohistochemical studies of cyclooxygenase‐2 (COX‐2) on human coion cancers, many strong COX‐2‐immunoreactive cells scattered in the bottom of the crypt of normal coion mucosa were unexpectedly noticed. COX‐2‐immunoreactive cells were morphologically very similar to neuroendocrine cells and were confirmed immunohistochemically to be positive for chromogranin A or serotonin. Moreover, COX‐2‐immunoreactive neuroendocrine cells were observed not only in the large intestine, but also in the stomach, duodenum and small intestine. The role of COX‐2 expression in neuroendocrine cells of the human alimentary tract was speculated.
Clinicopathologic study of nasal T/NK‐cell lymphoma among the Japanese
Authors: Nakamura Shlgeo , Katoh Erika , Koshikawa Takashi , Yatabe Yasushi , Nagasaka Tetsuro , Ishida Hiroji , Tokoro Yoshiro , Koike Koichi , Kagami Yoshfioyo , Ogura Michinori , Kojima Masaru , Nara Yoshiharu , Mizoguchi Yoshikazu , Hara Kazuo , Kurita Soji , Seto Masao , Suchi Taizan
Published: December 2008

A high prevalence of nasal lymphoma expressing a T‐ or natural killer (NK)‐cell phenotype (NTCL) with frequent association of Epsteln‐Barr virus (EBV) has been indicated in Asians. To Characterize NTCL among the Japanese, the clinlcopathdogic features of 32 cases were evaluated and the casses worn also analyzed for EBV‐RNA using an ISH method. Morphologically, 31 cases were Identified by atypical pleomorphic lymphoid infiltrates with polymorphous, anglcentric, and necrotic features. Their lymphoma cells ranged in size from small to large and were mixed in varying proportion from case to case. The other one case showed a monomorphic ‘blastic’ appearance. EBV‐encoded small RNA (EBER) was detected in the neoplastic cells of 27 of the 32 cases examined. In the five EBV‐negative cases, one was the ‘blastic’ type. Clonal T‐cell receptor gene rearrangement was detected in none of seven cases examined. The patients had a median follow‐up of 9 months (range, 1 month to 14 years and 11 months). The Kaplan‐Meler estimate of overall survival was 49% at 5 years, correlating with clinical stage. These data support the concept that most cases of NTCL are identified as tumors with T/NK‐cell characteristics and EBV association, distincity different from other peripheral T‐cell lymphomas. Furthermore, the one case of an EBV‐negative ‘blastic’ variant appears not to fit well Into the pleomorphic category but more closely resembles the pathologic features of extranasal angiocentric lymphoma with lymphoblastold appearance. This study also showed no clear difference in clinical aspects other than the original site or in prognosis, between NTCL and extranasal angiocentric lymphomas despite the higher incidence of EBV association and the tendency for that peculiar anatomical site to be restricted to the former group.
Follicular dendritic cell tumor with histiocytic characteristics and fibroblastic antigen
Authors: Masunaga Atsuko , Nakamura Hisayoshi , Katata Tatsuo , Furubayashi Takayasu , Kanayama Yoshio , Yamada Akihiko , Shiroko Yasuko , Itoyama Shinji
Published: December 2008

A report is presented of a follicular dendritlc cell (FDC) tumor arising In the lymph nodes and Inguen of a 55‐year‐old Japanese female, who had suffered from schizophrenla for 25 years. The left submandibular lymph nodes had completely lost their normal architecture, except for the capsule, due to tumor cell infiltration. Occaslonal nodular structures resembling epltheliold granulomas, attributable, at least In part, to follicular Involvement of tumor cells, were observed. These nodules were composed of epithellold‐ or fibroblast‐like tumor cells forming interwoven fascicles, to which small lymphocytes were attached. Tumor cells were also scattered in the internodular areas. For more atyplcal tumor cells, arranged in a sheet‐like structure, were present In the inguinal specimen, the tumor cells of which expressed Ki‐M4p, CD21, CD35 and other antigens known to be expressed on FDC. Furthermore, they also expressed the monocytdmacrophage antlgens, α1‐antltrypsin, α‐antlchymotrypsin, lysozyme, CD14, CD33, CD68 and Mac387 and fibroblastic antigen. Ultrastructural studies demonstrated lysosomal granules as well as a few desmosomes, Indicating the tumor cells possessed fibrohistiocytic and FDC characteristics.
Malignant fibrous histiocytoma of the cecum: Report of a case and review of the literature
Authors: Hiraoka Nobuyoshi , Mukal Maklo , Suzuki Masako , Maeda Kotaro , Nakajima Ken‐ichiro , Hashlmoto Mitsumasa , Hosoda Youlchlro , Hata Jun‐ichl
Published: December 2008

Malignant fibrous histlocytoma (MFH) of the gastrointestinal tract is extremely rare. Here we report a case of MFH of the cecum and mlew other cases of large bowel MFH in the Ilteratura. A 64‐year‐old man had a large tumor mass in the cecum associated with multiple small peritoneal implants. Hirtologically, most of the lesion showed Inflammatory pseudo tumor‐like appearance; that is, a mixed proliferation of fibroblasts and myofibroblasts loosely arranged in sweeping fascicules or whorled structures and an admixture of chronlc Inflammatory cell Inflltrate. The myofibroblastic nature of the spindle‐shaped cells was conflrmed by their Immunohistochsmical and ultrastructural findings. In addition, there was atypical histlocytic cells Infiltrate In some areas and marked lymphatlc involvement and lymph node metastasis by such histiocytic cells. These features were Interpreted as MFH, although It had to be distinguished from inflammatory fibrosarcoma and leiomyosarcoma. The differential diagnosis is discussed here.