bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral T‐cell Lymphoma of AILD (Angioimmunoblastic Lymphadenopathy with Dysproteinemia) Type Involving Gastrointestinal Tract
Authors: Nakamura Shigeo , Takagi Norio , Kitoh Kuniyoshi , Koshikawa Takashi , Hayashi Kayoko , Yamamoto Kazuhito , Suzuki Hisamitsu , Oyama Atsushi , Ueda Ryuzo , Suchi Taizan
Published: August 2010

A case of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) which showed widespread involvement of the gastrointestinal tract is reported. A lymph node biopsy specimen showed the characteristic histological features of AILD. During the progression of the illness, lymphomatous lesions developed in the gastrointestinal tract, complicated by cytomegalovirus infection. A double immunoenzymatic study using a combination of Ki 67 antibody and antibodies against surface antigens demonstrated that CD3+, CD4., and/or T cell receptor (TCR) beta+ cells were predominant (67–68%) among the population of proliferating Ki 67+ cells, rather than CD8+ or CD22+ cells. Clonal rearrangement of the TCR beta chain gene was also detected. These findings provide further evidence for the neoplastic nature of lesions of this type, and the diagnosis of peripheral T cell lymphoma.
Effects of Nicotinamide and Its Isomers on Iron‐induced Renal Damage
Authors: Kawabata Teruyuki , Ogino Tetsuya , Mori Masaharu , Awai Michiyasu
Published: August 2010

The effects of three isomers of pyridinecarboxamide (picolinamide (2 pyridinecarboxamide), nicotinamide (3 pyridinecarboxamide) and isonicotinamide (4 pyridinecarboxamide)) on iron‐induced renal damage were studied. Pyridinecarboxamide (250 mg/kg body weight, ip) was administered 10 min before injection of ferric nitrilo‐triacetate (Fe(III)‐NTA) (7.5 mgFe/kg body weight, ip). In picolinamide‐treated rats, the renal tubular necrosis induced by Fe(III) NTA was attenuated and serum creatinine did not increase. Picolinamide most efficiently suppressed renal lipid peroxidation in vivoinduced by Fe(III) NTA. Non heme iron levels in the kidneys after Fe(III) NTA injection did not differ in groups to which pyridinecarbox‐amides were administered. To elucidate the protective effects of picolinamide, we studied the action of pyridinecarboxamides on lipid peroxidation and DNA damage in vitro. These isomers inhibited iron‐induced lipid peroxidation of linolenic acid. Picolinamide had no effect on DNA damage, but nicotinamide and isonicotinamide promoted DNA damage by iron, especially when ascorbate was used as a reductant. None of these pyridinecarboxamide isomers changed the chlelate structure of Fe(III) NTA as shown by electronic absorption spectra. Among the three isomers, picolinamide most effectively protected the kidneys against iron‐induced renal damage, since it not only inhibited iron‐induced lipid peroxidation, but also had little enhancing action on DNA damage by iron.
Characterization of Transmural and Subendocardial Infarction by Typing and Grading of Ischemic Lesions in Autopsied Human Hearts
Authors: Kuwao Sadahito , Kameya Toru , Kasai Kiyoshi , Niitsuya Masato , Nishiyama Yasukazu
Published: August 2010

Two types of myocardial infarction, transmural and subendocardial, were macroscopically examined, and the gross and microscopic findings were correlated. The transmural type usually consisted of yellowish brown coagulation necrosis in the center of an infarcted focus and coagulative myocytolysis at the marginal zone. The subendocardial type was characterized by coagulative myocytolysis throughout the entire focus. Wavy fiber and colliquative myocytolysis of non‐specific ischemic lesions were seen only microscopically in both peripheral and subendocardial areas of infarcted foci. Coagulation necrosis was associated with obstructive thrombus formation in 79% of cases as a result of absolute ischemia in the transmural type. Coagulative myocytolysis was associated with obstruction by plaque hemorrhage in 27% of cases, and multivessel disease was frequently encountered in the subendocardial type due to insufficient blood supply. Based on histo‐chemical and immunohistochemical examinations, the ischemic lesions were graded in descending order of coagulation necrosis, coagulative myocytolysis, wavy fiber, and colliquative myocytolysis. The close relation between coagulation necrosis and the transmural type as well as that of coagulative myocytolysis with the subendocardial type suggests two different pathogenetic mechanisms of transmural and subendocardial infarction.
Primitive Neuroectodermal Tumors of Bone and Soft Tissue
Authors: Ushigome Shinichiro , Shimoda Tadakazu , Nikaido Takashi , Nakamori Kazuhito , Miyazawa Yoshio , Shishikura Akihiro , Takakuwa Toshifumi , Ubayama Yuji , Spjut Harlan J.
Published: August 2010

Primitive neuroectodermal tumors (PNET) of the bone and soft tissue were reviewed by immunohistochemistry and partly by morphometry, focusing particularly on histologic changes in recurrent or metastatic foci, in order to elucidate their probable histogenetic relationship with Ewing's sarcoma (ES) and its extraskeletal counterpart (EES). Eleven cases of bone tumor (average patient age; 15.1 yr) and 12 cases of soft tissue tumor (average patient age; 22.1 yr) which disclosed unequivocal Homer Wright rosettes and/or at least foci of ganglion cell differentiation either in a given primary tumor or metastatic (or recurrent) foci were selected from small round cell tumors primarily categorized as ES or EES. Most of the cases for which follow up biopsy samples were available disclosed prominent Homer Wright rosettes in the metastases, whereas the primary tumors showed features of ES and lacked rosettes. In only one case, Homer‐Wright rosettes were absent in the metastatic tumor. Most cases had been treated by combined intensive chemotherapy and radiotherapy, which might have influenced cell differentiation. Neural markers (neuron‐specific enolase, neurofilament protein and others) were positive in most cases. Three cases with otherwise typical histologic features of ES or EES showed minute foci of ganglion cell differentiation, as confirmed by morphometry and neural markers. These results suggest that ES (or EES) and PNET are histo‐genetically related, but represent different stages of cell differentiation.
Cardiac Rupture Complicating Hemorrhagic Infarction after Intracoronary Thrombolysis
Authors: Ishibashi‐Ueda Hatsue , Imakita Masami , Fujita Hirotaka , Katsuragi Michiaki , Yutani Chikao
Published: August 2010

An 80‐year‐old woman with acute myocardial infarct intracoronary thrombolysis by a large dose of urokinase four hours after the onset of chest pain. Despite the patient having no chest pain after intracoronary thrombolysis and her general condition being stable, she died suddenly on the 4th hospital day. Autopsy revealed hemopericardium due to cardiac rupture, which occurred at the center of the transmural hemorrhagic infarction of the anteroseptal wall. The massive hemorrhagic infarction was promoted by reperfusion from thrombolytic therapy. She had also classic risk factors for cardiac rupture, such as hypertension, senility, female gender, and first acute myocardial infarct. Therefore, the present case demonstrated that hemorrhagic infarction increased the incidence of cardiac rupture.
A Case of Adult T‐cell Leukemia/Lymphoma, Histologically Presenting CD30‐Positive Large Cell Lymphoma
Authors: Tsuji Motomu , Kobashi Akio , Hashimoto Kouji , Tako Hajime , Ikeda Hiroya , Fukushima Yukio , Terada Nobuyuki
Published: August 2010

A 48 year old Japanese woman with adult T‐cell leuke‐mia/lymphoma (ATLL), histologically presenting CD30 positive large cell lymphoma is reported. The patient, who was from an ATLL endemic area in Japan, had cutaneous nodules in the head, trunk, and extremities, and cervical lymph node swelling; these had been found three months before her admission to our hospital. A biopsy specimen of a skin lesion showed diffuse large cell lymphoma; the lymphoma cells were positively stained with CD30 (Ki 1/ Ber H 2), CD4 (helper T), and CD25 (interleukin 2 receptor) antibodies. Anti HTLV‐1 antibody (ATLA) was detected in the serum, and molecular cytogenetic studies of lymphoma cells showed both positive T‐cell receptor rearrangement and HTLV‐1 specific DNA sequences.
Immunohistochemical Localization of Gangliosides in ENU‐induced Rat Glioma
Authors: Takeshima Fuminao , Iwasaki Keisuke , Shimokawa Isao , Ikeda Takayoshi , Matsuo Takeshi
Published: August 2010

Biochemical studies have indicated that the structurally simple gangliosides, including GD3 and GM3, are major glycolipid components of glioma tissues. In order to clarify the localization of the gangliosides in ethylnitrosourea‐induced rat glioma, an immunohistochemical study was performed using antibodies against GM1, GM3, and GD3. The results obtained in normal fetus, newborn, and adult rat brain, and also in human glioma, were compared. In fetal and newborn rat brain, GD3 was present mainly in the neuroepithelial cell surface of the matrix and subependymal layers of the ventricular wall, but GM3 and GM1 were not detected. In adult rat brain, GD3 positive cells were absent, or present in diminished number, and GM1 was found chiefly in the neuropil of the cerebral cortex. Most of the rat glioma cells were positive for GD3, but not for GM1. It was demonstrated that the ganglioside composition of glioma cells was similar to that of immature neuroectodermal cells in fetal and newborn rat brain. Furthermore, the number of GD3‐positive oligodendroglioma cells increased with tumor growth. In anaplastic gliomas and gross oligodendrogliomas, most tumor cells expressed not only GD3 but also GM3. These results suggest that GD3 is a marker of proliferating neuroectodermal cells, and that activity of the key enzymes in ganglioside synthesis alters with tumor growth and anaplastic change. Acta Pathol Jpn 42: 558–565, 1992.
Sebaceous Gland and Sweat Gland Carcinomas of the Skin Clinicopathological Study and Significance of c‐erbB‐2 Oncoprotein Expression
Authors: Hasebe Takahiro , Mukai Kiyoshi , Ishihara Kazuyuki , Kaneko Akihiro , Shimosato Yukio
Published: August 2010

Thirteen sebaceous gland carcinomas and 10 sweat gland carcinomas were examined to elucidate any important histological parameters influencing their prognosis, and the relationship between immunohistochemical expressions of c‐erbB‐2 oncoprotein and survival of the patients was analyzed. Sebaceous gland carcinomas with vacuolated cytoplasm in more than 50% of whole tumor area, with necrosis, and without lymphoid cell infiltration in tumor nests and stroma had a higher incidence of tumor recurrence and tumor‐related death than tumors with vacuolated cytoplasm in 50% or less of whole tumor area (p < 0.01), without necrosis, and with lymphoid cell infiltration in tumor nest and stroma (p < 0.05). Sweat gland carcinomas of all cases with fatal outcomes demonstrated tubular differentiation in 20% or less of whole tumor area, lymphatic permeation and desmoplastic reaction. Three sebaceous gland carcinomas and three sweat gland carcinomas were positive for c‐erbB‐2 oncoprotein. Two of three sebaceous gland carcinomas, and all three sweat gland carcinomas developed tumor recurrence and ended in tumor‐related deaths. Sweat gland carcinomas with c erbB 2 expression had significantly shorter survival than those with negative immunostain (p < 0.01). Cytoplasmic appearance, tumor necrosis, and lymphoid cell infiltration in tumor nests and stroma of sebaceous gland carcinoma, and tubular differentiation, lymphatic permeation, and growth patterns of sweat gland carcinoma are considered to closely correlate to the prognosis. Immunohisto‐chemically detected c erbB 2 oncoprotein may be an indicator of bad prognosis. Acta Pathol Jpn 42: 585–594, 1992.
Carcinoid Tumor of the Middle Ear Containing Serotonin and Multiple Peptide Hormones A Case Report and Review of the Pathology Literature
Authors: Hosoda Syun , Tateno Hiroo , Inoue Hanae Kito , Isojima Genzo , Kondo Sadahiko , Konishi Takayoshi
Published: August 2010

A 69‐year old man complaining of longstanding hearing loss and mild otorrhea was found to have a mass obliterating the external auditory canal and polypous tympanic mucosa with accompanying absence of the tympanic membrane and ossicular chain. Tumors excised from the external auditory canal and tympanum showed histologic features essentially characteristic of a carcinoid tumor: a ribbon or festoon arrangement of tumor cells, formation of anastomosing cords and glandular spaces, presence of numerous argyrophilic as well as argentaffin secretory granules within many of the tumor cells, and ultrastructur‐al evidence of neurosecretory granules in the tumor cell cytoplasm. Immunohistochemically, the tumor was found to contain not only neuronal marker substances such as neuron‐specific enolase, S 100 protein and chromogranin A, but also serotonin and multiple peptide hormones such as pancreatic polypeptide, glucagon, cholecystokinin and leucine‐enkephalin. A review of the pathology of 17 previous cases of carcinoid of the middle ear suggested that this type of carcinoid may have a variegated hormone profile among carcinoids of foregut origin, and hormonally may resemble ileal carcinoid arising from the midgut, although their histogenetic origins may differ, because of frequent production of serotonin. Acta Pathol Jpn 42: 614–620, 1992.
Abscess‐forming granulomatous lymphadenitis: Histological typing of suppurative granulomas and clinicopathological findings with special reference to cat scratch disease
Authors: Kojima Masaru , Nakamura Shigeo , Hosomura Yasuo , Shimizu Kazuhiko , Kurabayashi Yoshiyuki , Itoh Hideaki , Yoshida Katsue , Ohno Yoshihiro , Kaneko Akihiro , Asano Shigeyuki , Wakasa Haruki , Suchi Taizan , Johshita Takashi
Published: August 2010

In order to clarify the histological and immunohistochemical characteristics of suppurative granuloma in abscess‐forming granulomatous lymphadenitis (AGL), and the relation between AGL and cat scratch disease (CSD), 36 cases of AGL were studied. The combined results showed that there were two types of suppurative granulomas. The suppurative granulomas histologically revealed small lymphocytes of predominantly T cell phenotype distributed among the epithelioid histiocytes bordering central necrotic areas in the suppurative granulomas. These suppurative granulomas could be further subdivided into two groups, mainly those with and without the intermingling of large transformed cells of B‐cell phenotypes: Type B granuloma with large transformed B cells and Type A without large transformed B cells. Both types of granulomas were observed in a varying degree in most cases. According to the predominant type of granulomas, 36 patients with AGL were further classified into two groups: Group I of Type A dominance and Group II of Type B dominance. Warthin‐Starry (WS) silver stain positive bacteria, which are said to be a causative agent of CSD, were present in about 50% of both groups. No Brown‐Hopps' Gram‐positive bacteria, fungus, toxoplasma, Chlamydia or Bacillus Calmette‐Guerin antigen were found in any case. Clinically, there was no significant difference between these two groups. On the other hand, the detection of WS‐positive bacteria seemed to have some relationship with the duration of disease and the history of exposure to cats, and 70% of AGL cases occurred in autumn without a single concurrent epidemic.
Nucleolar organizer regions in human maxillary sinus squamous cell carcinoma
Authors: Kuwabara Hiroko , Miyaguchi Marnoru , Uda Hirotsugu , Krenhcs Tibor , Sepp Robert , Sakai Schun‐ichi
Published: August 2010

A silver colloid technique for nucleolar organizer regions (AgNOR) was applied to paraffin sections of maxillary sinus squamous cell carcinomas (MSSCC) of 25 patients. The patients were divided into two groups, one with MSSCC recurring in the primary lesion after treatment with radiotherapy, chemotherapy and for surgery and one without recurrence. Notable differences between the numbers of NOR in neoplastic epithelia and the normal mucosa were observed (P = 0.0001), but there were no differences between the numbers of NOR in the recurrent and non‐recurrent carcinomas. This investigation found no prognostic importance in the number of AgNOR in MSSCC.
Silver‐binding argyrophilic nucleolar organizer regions (AgNOR) in gall‐bladder cancer: Correlations with malignant grading and prognosis
Authors: Suzuki Tadamichi , Takano Yasuo , Kida Yoshiki , Okudaira Masahiko
Published: August 2010

Silver‐binding nucleolar organizer regions (AgNOR) were investigated and compared in 43 cases of gall‐bladder cancers and 10 normal gall‐bladder samples using an image analyzer. The mean numbers of AgNOR per nucleus (AgNOR number) were 3.28 ± 1.38 in the gall‐bladder cancers and 1.86±0.20 in the normal gall‐bladder cases. The respective mean areas of AgNOR per nucleus (AgNOR area) were 6.96±3.78 μm2 and 1.89±0.21 μm2. The differences were statistically significant (P<0.0001) for both parameters. In addition, increased frequency and enlargement were both apparently correlated with poor prognosis (P<0.011 and P < 0.046, respectively), with AgNOR number and AgNOR area showing tendencies for increase in cases of histologi‐cally high grade malignancy, advanced cancer and regional lymph node involvement.

In conclusion, AgNOR number and AgNOR area appear to be useful indicators for the grading of malignancies and for the prediction of gall‐bladder cancer prognosis.
An autopsy case of pulmonary artery leiomyosarcoma
Authors: Nakazawa Koh , Itoh Nobuo , Shigematsu Hidekazu , Kanbayasi Takayuki
Published: August 2010

A case of pulmonary artery leiomyosarcoma in a 37 year old Japanese man is reported. The patient complained of chest pain and hemosputum. CT scan and angiography revealed that a tumor arose from the right main branch of the pulmonary artery. The surgical specimen was interpreted as an undifferentiated sarcoma at this time. The tumor recurred 6 months after the resection, and he died of right‐sided heart failure. At autopsy, the pulmonary artery truncus was distended by the tumor, which protruded into the lumen. The tumor was composed of pleomorphic cells, giant cells and spindle‐shaped cells. Many of the tumor cells were immuno‐histochemically positive for alpha‐smooth muscle action and vimentin. Electron microscopy revealed microfNaments with dense bodies in the cytoplasm and a discontinuous basement membrane around the cells. Although adenocarcinoma was also observed in the colon, the authors conclude that the present tumor is not a metastasis but a primary leiomyosarcoma arising from the pulmonary artery. Imaging techniques were very useful for differentiating sarcoma from thrombus in this site, and immunohistochemical demonstration for alpha‐smooth muscle action was necessary for making a histological diagnosis of leiomyosarcoma.
Three‐dimensional analysis of human carotid atherosclerotic ulcer associated with recent thrombotic occlusion
Authors: Masawa Nobuhide , Yoshida Yoji , Yamada Takashi , Joshita Takashi , Sato Shuzo , Mihara Ban
Published: August 2010

To clarify the mechanism of ulcer formation of atherosclerotic plaques in human carotid arteries, autopsy investigations were performed on eight patients who had died of cerebral infarction due to recent carotid thrombosis. Eleven control patients who had carotid atherosclerosis without thrombosis were also investigated. Histological changes of the arteries in serial sections were reconstructed three‐dimensionally. Each artery with occlusive thrombosis was found to have an intimal ulcer at the head of the thrombus on the proximal slope near the base of the thickened atheromatous plaque at the carotid sinus. Most ulcers formed obliquely or longitudinally, were parallel to the vessel axis, had a fusiform shape, and measured 7± 2× 3 ± 1 mm (mean ± s.d.). The ulcers arose by marginal separation of the innermost layer from the underlying layer of the stratified intima. An underlying atheroma developed along the borders of these intimal layers reaching the subendothelium, with thinning of the intimal cap to less than 150 μn. The process of ulceration may be generated by vessel injury induced by hemodynamic forces, such as tensile forces and shear stress. The ulcer may extend along the fragile region where the wall may exhibit uneven compliance due to differences in the tissue structures of each intimal layer. Futhermore, macrophages may play a key role in ulcer formation.
An autopsy case of malignant mesothelioma associated with asbestosis
Authors: Watanabe Mika , Kimura Noriko , Kato Mituyasu , Iwami Daiji , Takahashi Makoto , Nagura Hiroshi
Published: August 2010

An autopsy case of malignant mesothelioma with asbestosis caused by asbestos exposure for 17 years is reported. Autopsy revealed that mesothelioma spread extensively in all serosal tissues including pleura, pericardium, diaphragm, peritoneum and tunica vaginalis testis. Histopathologically, most of the tumor showed an epithelial form, but sarcomatous and microcystic patterns were also observed. The tumor cells had abundant glycogen and hyaluronic acid and, immunohistochemically, they were positive for cytokeratin, vimentin and epithelial membrane antigen (EMA). Long, slender microvilli were characteristically observed in these tumor cells. All of these data were compatible with malignant mesothelioma. Procollagen type I (procol.I) immunostaining was performed to reveal the mesenchymal character of mesothelioma. Both epithelial‐type cells and sarcomatous‐type cells showed positive staining for procol.I, although the latter showed stronger immunoreactivity. Immunostaining for procol.I was found to be one of the useful tools for distinguishing mesothelioma from adenocarcinoma. Using an extraction method for asbestos fibers, asbestos bodies were found in many tissues including lymph nodes, liver, small intestine, spleen, kidney, testis and pleura, in addition to lung parenchyma. Although multiple tumor metastases from an undetermined primary site is not ruled out, ‘multifocal tumorigenesis’ is suspected from the widespread deposit of asbestsos fibers.
A case of low‐grade fibromyxoid sarcoma of the thigh
Authors: Ugai Kazuhiro , Kizaki Tomohiko , Morimoto Kazuo , Sashikata Terumasa
Published: August 2010

A case of low‐grade fibromyxoid sarcoma in the thigh of a 21 year old female is described. The patient had a fist‐sized well‐defined mass in her left thigh that enlarged over a 6 month period. Histologically, the neoplasm showed contrasting fibrous and myxoid areas with a swirling growth pattern. Cellularity was low to moderate, and the stromal cells were benign looking without mitoses or nuclear pleomorphism. The tissue was not noticeably vascular. Some stromal cells were aggregated around the blood vessels. The stromal cells were immunoreactive to vimentin, but were negative to keratin, desrnin, alpha‐smooth muscle actin, actin HHF35, S‐100 protein, neuron‐specific enolase, and epithelial membrane antigen. Ultrastructural examinations of the stromal cells revealed well‐developed rough endoplasmic reticulum, mitochondria, pinocytotic vesicles, and numerous intermediatesized filaments in the cytoplasm. These findings seem to indicate that the stromal cells were fibroblastic in origin. The occurrence of the tumor in a young adult, its location and its large, well defined borders together with the characteristics revealed through histological investigation, indicated that it was in fact what has been termed by Evans as a low‐grade fibrornyxoid sarcoma.
A case of retroperitoneal malignant mesenchymoma
Authors: Fujiyoshi Yasuaki , Nishimura Hiroshi , Irie Koji , Morimatsu Minoru
Published: August 2010

A rare case is reported of malignant mesenchymoma of a retroperitoneal lesion involving the kidney and composed of leiomyosarcoma and liposarcoma. The tumor, measuring 13× 12 ×11 cm and weighing 1910g, arising from the soft tissue of the retroperitoneum or renal capsule, was completely removed surgically. Thirteen months after surgical operation, multiple metastasis was observed. Immunohistochemical and electron microscopical examination showed two different mesenchymal elements. Magnetic resonance imaging findings were compatible with the pathological findings. This case appears to be the second in the world literature.
Mucosa‐associated lymphoid tissue (MALT) lymphoma of the stomach progressing to overt B cell malignancy
Authors: Umemura Shinobu , Tang Xiaoyan , Aihara Hideo , Tsutsumi Yutaka
Published: August 2010

A 70 year old man, who underwent subtotal gastrectomy under the diagnosis of reactive lymphoid hyperplasia 6 years earlier, suffered from diffuse large‐cell‐type B cell lymphoma in the remnant stomach. Retrospectively reviewed, the initial lesion was consistent with mucosa‐associated lymphoid tissue (MALT) lymphoma, a low‐grade B cell malignancy, based upon histologic, cytologic and immunohistochemical features. Both the initial and recurrent tumors revealed the phenotypes of mantle zone cells, DBA4Cpositive. It is noteworthy that the overt lymphoma cells retained the capacity for inducing germinal center‐like nodules consisting of LN1 and DNA7‐positive cells even in the invading site. The diagnosis of reactive lymphoid hyperplasia of the stomach should be made after careful exclusion of the possibility of MALT lymphoma.
Lmmunohistochemical classification of 140 autopsy cases with systemic amyloidosis
Authors: Hoshii Yoshinobu , Takahashi Mutsuo , Ishihara Tokuhiro , Uchino Fumiya
Published: August 2010

One hundred and forty autopsy cases of systemic amyloid‐osis were examined using the potassium permanganate method for distinction of amyloid A protein from other amyloid proteins and an immunohistochemical technique. Of those cases, amyloid proteins were identified in 121 cases. There were 68 cases of amyloid A‐related (AA) amyloidosis and these were the most common type among the cases (56.2%). There were 39 cases of immunoglobulin light chain‐related (AL) amyloidosis (32.2%), six cases of β2‐microglobulin‐related (Aβ2M) amyloidosis (5%), and five cases of transthyretin‐related (ATTR) amyloidosis (4.1%). Minute areas of amyloid deposits in four cases with AA were resistant to potassium permanganate pretreatment. In Aβ2M amyloidosis amyloid deposits were either resistant or sensitive to potassium permanganate pretreatment, from case to case. The coexistence of two different amyloid proteins was seen in three cases: one case had ATTR and Ax types, and two cases had Aβ2M and AA types. Some discrepancies were seen between the immunohistochemical typing and clinical classification of amyloidosis referred to in the Annual of the Pathological Autopsy Cases in Japan, for example, one case of AA type in myeloma‐associated amyloidosis and one case of AL type in secondary amyloidosis. From the present results, the importance of the immunohistochemical method in classifying amyloidosis is stressed.
Interdigitating cell sarcoma: A morphologic and immunologic study of lymph node lesions in four cases
Authors: Nakamura Shigeo , Koshikawa Takashi , Kitoh Kuniyoshi , Nakayama Atsuo , Yarnakawa Mitsunori , Imai Yutaka , Ishii Keiko , Fujita Masahiro , Suchi Taizan
Published: August 2010

lnterdigitating cell sarcoma is an extremely rare tumor. Its presentation and histologic appearance has varied among the reported cases. In this study, the authors investigated four cases of the hematolymphoid malignancy arising within lymph nodes, which were considered to be of interdigitating cell origin. All patients presented in the 6th to 8th decade of life with peripheral lymphadenopathy, and had a relatively indolent clinical course, without bone marrow or skin involvement. Carcinomas were observed as a second neoplasm in two of four patients. Distinctive morphologic features are proliferation of histiocyte‐like cells with nuclear pleomorphism and occasionally multinucleated, paracortical distribution sparing of B‐cell regions, fibrosis, sinus infiltration, and a prominent eosinophi/plasma cell infiltrates. The combination of light microscopic, fine structural, and immu‐nohistochemical features suggested that these tumors derive from interdigitating cells: these tumor cells expressed CD68 (KP1), S‐100 protein and HLA‐DR, but lack CD21 (1F8), desmosomes and Birbeck granules. The diagnosis of interdigitating cell sarcoma should be considered on any pleo‐morphic tumor with the features described in this report.
A case of sarcoidosis revealed in the course of IgA nephropathy
Authors: Tateno Sumio , Kobayashi Yutaka , Kobayashi Furniko
Published: August 2010

A 36 year old man, who had been proteinuric for 14 years due to immunoglobulin A (IgA) nephropathy, was admitted because of an acute exacerbation in renal dysfunction with hypercalcemia. He had presented with aortic regurgitation and increased pulmonary marking by chest X‐ray, but laboratory examinations had failed to make an exact diagnosis, On admission, noncaseating epithelioid granulomas were disclosed by muscle and skin biopsies. Ophthalmological evaluation revealed old uveitis and retinal changes conslstent with sarcoidosis. In this case, IgA nephropathy was thought to be the initial manifestation of sarcoidosis that developed latently. Sarcoidosis should be considered in a differential diagnosis of IgA nephropathy.
A patient with hepatic granuloma formation and angiotensin‐converting enzyme production by granuloma cells during clinical relapse of hepatitis A
Authors: Inuzuka Sadataka , Ueno Takato , Tateishi Hideo , Torimura Takuji , Sata Michio , Tanikawa Kyuichi , Kojiro Masamichi
Published: August 2010

Elevation of the serum angiotensin‐converting enzyme (sACE) level and hepatic granulomas were found during a clinical relapse in a 22 year old patient with acute viral hepatitis type A (AVH‐A). The serum transaminase level and sACE level remained high for more than 6 months. In the biopsied specimen of the liver, fibrous rings of granulomas composed of collagen types I, III, and V were observed. Furthermore, the localization of ACE was visible in the rough endoplasmic reticulum of epithelioid cells of granulomas in the liver under electron microscopy using the indirect immunoperoxidase method. These results suggest that granuloma cells in the liver caused by hepatitis A may be involved in ACE production. In addition, other diseases associated with the presence of granulomas in the liver, such as lymphoma, cytomegalovirus infection, visceral leishmaniasis, and lupoid hepatitis, were ruled out. However, the hepatic granulomas disappeared with the healing of AVH‐A. In this regard, the present case is considered to be one of the very few cases of hepatic sarcoidosis.
Chromophobe renal cell carcinoma
Authors: Fukushima Tadao , Nagashima Yoji , Nakatani Yukio , Nakarnura Nobuko , Fukasawa Kiyoshi , Satomi Yoshiaki , Yu Ken , Miyagi Yohei , Aoki Ichiro , Misugi Kazuaki
Published: August 2010

Chromophobe renal cell carcinoma (RCC) is a recently established subtype of RCC, which has rarely been reported in Japan. In this communication, the authors report two Japanese cases of chromophobe RCC together with the immunohistochemical findings. The tumors were composed of sheets and cribriform glands formed by tumor cells with cloudy and reticular cytoplasm. Ultrastructurally, the cytoplasm was filled with numerous microvesicles. The tumor cells were positive for cytokeratin, epithelial membrane antigen, and Tamm‐Horsfall protein. Occasionally, LeuM1‐positive cells were also noted. Vimentin was negative, unlike the usual RCC. Reactivity for peanut agglutinin was more frequent than that to Lotus tetragonolobus agglutinin. The results of this study suggest that the tumor cellq possessed phenotypes similar to the distal nephron rather than to the proximal tubular cells.
Overexpression of p53 protein and Ki67 proliferative index in hepatocellular carcinoma:
Authors: D'Errico A. , Grigioni W. F. , Fiorentino M. , Baccarini P. , Grazi G. L. , Mancini A. M.
Published: August 2010

The overexpression of p53 protein and the Ki67 proliferative index was evaluated in 96 hepatocellular carcinomas (HCC), 67 in cirrhotic livers and 29 in non‐cirrhotic ones, and in 13 non‐carcinomatous lesions, all surgically resected from Italian patients. Overexpression of p53 was detected only in carcinomatous lesions, and was significantly related to the grade of HCC (P < 0.001). In fact, p53 was observed in 7/7 (100%) cases of grade IV, 13/43 (30.3%) of grade III, and 10/ 46 (21.7%) of grade II. The relationship between p53 and Ki67 scores was determined in serial sections from corresponding areas of both diffuse and patchy immunoreactivity. In the overall population, p53‐positive tumors showed a significantly higher Ki67 score (15.9 ± 5.5% vs 9.2 ± 4.3% [P < 0.001]). This observation was evident in all grades of HCC.
Lymphokine‐activated killer cytotoxicity against pancreas adenocarcinoma cell lines and vascular endothelial cells
Authors: Sugiura Hiroshi , Ishikura Hiroshi , Omi Makoto , Kaji Mitsuhito , Iwai Kazuhiro , Kishimoto Takashi , Takahashi Toshiyuki , Kimura Chisa , Kato Hiroyuki , Yoshiki Takashi
Published: August 2010

Eight pancreas carcinoma cell lines of duct cell origin (PCI‐6, 10, 19, 24, 35, 43, 55, and 64) were established. Using one of these lines, PCI‐24, human umbilical vein endothelial cells (HUVEC), and several recombinant cytokines, conditions and specificity of antl‐PCI LAK induction were Investigated, with the focus on a search for lymphokine‐activated killer (LAK) activity that differentiates neoplastic (PCI) from non‐neoplastic (HUVEC) cells. Interferon‐γ (IFN‐γ), IFN‐α, IL‐4, 11–6, and IL‐7, but not tumor necrosis factor‐α (TNF‐α) or IL‐1β, induced a weak LAK activity against PCI‐24, whereas IL‐2‐induced (1000U/mL) LAK exhibited a far more potent cytotoxicity. When these cytokines were added at the suboptimal dose IL‐2 (100U/mL), no significant augmentation in LAK activity was induced. Staphylococcal protein A (SpA) induced LAK activity as potent as that seen with IL‐2 (1000 U/mL). Both IL‐2‐induced and SpA‐induced LAK had a potent, dose‐dependent cytotoxicity against HUVEC. HUVEC inhibited both IL‐2– and SpA‐induced LAK cytotoxicity against PCI‐24 to almost the same extent as seen with PCI‐24. Thus, two potent LAK‐inducers did not generate LAK activity that differentiates neoplastic from non‐neoplastic cells. Thus, in vitro cytotoxicity of LAK agalnst non‐neoplastic endothelial cells is unavoidable when handling cytokines in LAK induction.
Morphological aspects of LFA‐1/ICAM‐1 and VLA4/VCAM‐1 adhesion pathways in human lymph nodes
Authors: Tanaka Hisako , Saito Saburo , Sasaki Hiroyuki , Arai Hisako , Oki Takao , Shioya Naoshi
Published: August 2010

Monoclonal antibodies specific for the adhesion molecules participating in lymphocyte homing, lymphocyte function associated antigen‐1 (LFA‐1) and very late antigen 4 (VLA4), and their respective ligands, intercellular adhesion molecule 1 (ICAM‐1) and vascular cell adhesion molecule 1 (VCAM‐1), were used to characterize their expression pattern in human lymph nodes by immunohistochemical and immunoelectron microscopic techniques. The location of LFA‐1‐positive lymphocytes and selective expression of ICAM‐1 on the luminal plasma membrane of high endothelial venule endothelium suggested that the LFA‐1/ICAM‐1 adhesion pathway participates only in the initial step of the lymphocyte migration process. Lymphocytes passing through endothelium appear not to be influenced by this pathway. VCAM‐1 was detected occasionally on the endothelium of high endothelial venules in the hyperplastic lymph nodes in the mesentery, but not in peripheral lymph nodes. VLA4‐positive lymphocytes tended to be more frequently observed within high endothelial venules in mesenteric lymph nodes than in peripheral ones. Strong expression of both ligands, ICAM‐1 and VCAM‐1, was noted on the plasma membrane of follicular dendritic cells, and was especially prominent on their labyrinthine folding, and on the interdigitating cells in the paracortex. Furthermore, both LFA‐1‐and VLA4‐positive lymphocytes localized around these cells. This suggests that LFA‐1/ICAM‐1 and VLA4/VCAM‐1 adhesion pathways play an important role in the lymphocyte recognition of antigen‐presenting cells.
Peripheral carcinoid tumor of the lung with focal melanin production
Authors: Fukuda Takeaki , Kobayashi Hiroshi , Kamishima Tomoko , Watanabe Hisashi , Inoue Yoshiya , Ohnishi Yoshihisa , Naito Makoto , Emura Iwao , Hirono Tatsuhiko
Published: August 2010

A case of carcinoid tumor of the lung with focal melanin production was encountered in a 56 year old Japanese woman. The tumor was found 16 years previously by mass survey chest X‐ray and had enlarged two‐fold in the intervening period. The tumor consisted of a variety of tumor cells showing a spindle, polygonal and pleomorphic appearance with abundant vasculature in the stroma. All tumor cells showed argyrophilia, together with a few showing argent‐affinity. Melanin‐containing tumor cells were also present in parts. Ultrastructurally, most tumor cells possessed various numbers of neurosecretory granules and a few of them contained granular type rnelanosomes. Tumor cells were connected with desmosomes and a few of them contained tonofilament‐like microfilaments. Only a few contained both neurosecretory granules and melanin. By immunohistochemistry, serotonin, metenkephalin and β‐endorphin positive cells were observed scattered throughout the tumor. A few tumor cells positive for tyrosine hydroxylase were also detected. Additionally, most tumor cells were positive for keratin. On the basis of these findings, the tumor of the current case is a pulmonary carcinoid tumor with focal melanin production.
Atypical extraventricular neurocytoma
Authors: Moriguchi Sayaka , Yamashita Atsushi , Marutsuka Kousuke , Yoneyama Takumi , Nakano Shinichi , Wakisaka Shinichiro , Nabeshima Kazuki , Asada Yujiro
Published: August 2010

Extraventricular neurocytoma (EVN) is a rare brain tumor that poses diagnostic difficulty. Described herein is a case of atypical EVN arising in a 54‐year‐old woman. A well‐circumscribed lesion (3.0 × 3.0 × 3.0 cm) in the right parietal lobe showed diffuse proliferation of monotonous tumor cells with perinuclear clearing within a delicate fibrillary matrix similar to neuropil. Tumor also showed vascular proliferation and high mitotic activity. Immunohistochemically, these tumor cells were strongly positive for synaptophysin both in the neuropil and in the perinuclear cytoplasm, and were negative for glial fibrillary acidic protein and Olig2. Ki‐67 labeling index was 13.0% in the most stained areas, but accumulation of p53 was not observed. These findings were compatible with those of EVN with histological atypia. EVN should be considered as a candidate in the differential diagnosis of parenchymal brain tumor, especially oligodendroglioma. The important features are the delicate fibrillary matrix similar to neuropil, diffuse and strong immunoreactivity for synaptophysin, and negative immunoreactivity for Olig2. High proliferative activity without accumulation of p53 suggests that other factors are involved in oncogenesis of atypical EVN.
Isolated non‐compaction of the left ventricular myocardium in an adult treated with heart transplantation
Authors: Val‐Bernal J. Fernando , Nistal J. Francisco , Martino María , Garijo M. Francisca
Published: August 2010

Isolated left ventricular non‐compaction is a rare unclassified cardiomyopathy characterized by arrest of normal embryogenesis that results in the persistence of intertrabecular recesses and the development of a spongy myocardium. The pathological diagnosis is often first established at autopsy. Described herein is the case of a 57‐year‐old man with isolated non‐compaction of the left ventricle who had a 17 year history of worsening heart failure and was successfully treated with heart transplantation. To the authors’ knowledge only seven adult patients with non‐compaction cardiomyopathy have been reported to have undergone heart transplantation. Including the present case the mean age of the adult patients at transplantation was 39.5 years (range, 18–60 years). The male : female ratio was 3:1. Both ventricles were involved in 37.5% of cases. The mean follow up was 6.3 years (range, 2 months−17 years). One patient died because of a malignant tumor 9 years after transplantation. The morphological pattern of the isolated ventricular non‐compaction represents a pathological entity discernible from other cardiomyopathies and should be classified as a specific cardiomyopathy. It is likely that surgical pathologists will encounter this entity more frequently due to involvement in transplantation teams.
Immunohistochemical expression of TTF‐1 in various cytological subtypes of primary lung adenocarcinoma, with special reference to intratumoral heterogeneity
Authors: Maeshima Akiko M. , Omatsu Mutsuko , Tsuta Koji , Asamura Hisao , Matsuno Yoshihiro
Published: August 2010

The immunohistochemical expression of thyroid transcription factor‐1 (TTF‐1) was investigated in various cytological subtypes of primary lung adenocarcinoma, with special reference to intratumoral heterogeneity. Three groups were categorized according to cytological subtype: group A, adenocarcinomas with either a Clara cell and/or type II epithelial cell component (Clara/type II) or a mixed Clara/type II and bronchial surface epithelial cell component (BSE) (mCB), in addition to other components; group B, adenocarcinomas with components including either BSE, a goblet cell component (GOB) or a mixed BSE and GOB component (mBG), and lacking Clara/type II or mCB; group C, adenocarcinomas with only a poorly differentiated component (POR). In group A all Clara/type II, mCB, BSE and the majority of POR were TTF‐1 positive. In group B the majority of BSE, POR and all GOB were TTF‐1 negative. BSE and POR in both groups had a different phenotype, possibly reflecting their different natural history. In group C 80% of cases were TTF‐1 positive, suggesting that the majority were derived from group A tumors.
Focal hepatic steatosis surrounding a metastatic insulinoma
Authors: Takeshita Atsushi , Yamamoto Kazuhiro , Fujita Atsushi , Hanafusa Toshiaki , Yasuda Emi , Shibayama Yuro
Published: August 2010

Reported herein is a case of focal hepatic steatosis surrounding a metastatic insulinoma in the liver of a 69‐year‐old woman. The patient complained of losing consciousness after meals, and hypoglycemia and hyperinsulinemia were confirmed. On CT and abdominal angiography a mass, 1 cm in diameter, was seen in the tail of the pancreas. In the early phase of dynamic CT a mass, 5 mm in diameter, was seen in the liver. In the late phase this mass appeared to be 3 cm in diameter. An arterial calcium stimulation/venous sampling test showed insulin levels after calcium injections in the hepatic artery to be extremely high. Thus, the liver tumor was diagnosed as a metastatic insulinoma, and distal pancreatectomy and partial resection of the liver were performed. The pancreatic tumor cells were immunohistochemically positive for insulin. The liver tumor was pale yellow. A white area surrounded the tumor. Histologically, the liver tumor was an insulinoma and the white area was focal fatty change of the liver. High insulin levels are said to inhibit oxidation of free fatty acids into triglycerides, causing free fatty acids to accumulate in hepatocytes. Focal hepatic steatosis caused by the local effects of insulin can present as a focal rim surrounding a metastatic insulinoma.
Differential diagnosis of sarcomatoid mesothelioma from true sarcoma and sarcomatoid carcinoma using immunohistochemistry
Authors: Kushitani Kei , Takeshima Yukio , Amatya Vishwa Jeet , Furonaka Osamu , Sakatani Akio , Inai Kouki
Published: August 2010

Differentiation of sarcomatoid mesothelioma from other sarcomatoid tumors involving the pleura and other structures by light microscopy remains an important diagnostic challenge for surgical pathologists. The purpose of the present study was to investigate the utility of diagnostic immunohistochemistry for differentiating sarcomatoid mesothelioma from its histological mimics: true sarcoma and pulmonary sarcomatoid carcinoma. A total of 39 specimens of mesotheliomas with sarcomatoid components, 43 specimens of true sarcomas, and nine specimens of pulmonary sarcomatoid carcinomas were obtained from Japanese patients and examined using a 10‐antibody panel (calretinin, WT1, AE1/AE3, CAM5.2, epithelial membrane antigen, desmin, α‐smooth muscle actin, S‐100 protein, CD34, and CD68). CAM5.2 had the highest sensitivity and specificity for differentiating sarcomatoid mesothelioma from true sarcoma. The combination of CAM5.2, WT1, and AE1/AE3 is recommended for routine pathological diagnosis. Accurate clinical information is necessary for differentiating sarcomatoid mesothelioma from sarcomatoid carcinoma.
Submassive hepatocellular necrosis associated with infiltration by peripheral T‐cell lymphoma of cytotoxic phenotype: Report of two cases
Authors: Ohtani Haruo , Komeno Takuya , Koizumi Masanori , Kimura Noriko , Tanaka Satoe , Nunokawa Toru , Sato Yasunori , Nakanuma Yasuni
Published: August 2010

Hepatocellular necrosis may be complicated in the clinical course of T‐cell lymphoma. Herein are reported two cases of peripheral T‐cell lymphoma associated with a rapid increase of serum transaminases in their final course. The final diagnoses were enteropathy‐type T‐cell lymphoma of the jejunum (patient 1) and hepatosplenic T‐cell lymphoma (patient 2). The livers of both patients had non‐zonal, well‐demarcated coagulation necrosis (approximately 70% in patient 1 and 40% in patient 2) that was infiltrated by lymphoma cells bearing a cytolytic granule content (granzyme B). Hepatocytes in the necrotic areas in patient 2 showed immunoreactivity for human simplex virus type 1. Although the mechanism of the hepatocyte necrosis is unclear, it is suggested that the hepatocyte submassive necrosis may be related to an infection complicated in the final course of lymphoma or by certain direct effects of the tumor cells.
Olifantiella mascarenica gen. & sp. nov., a new genus of pennate diatom from Réunion Island, exhibiting a remarkable internal process
Authors: Riaux‐Gobin Catherine , Compère Pierre
Published: August 2010

A new diatom genus, Olifantiella gen. nov., has been discovered from the coral reefs of Réunion Island (Western Indian Ocean). This monospecific genus belonging to the Biraphidineae, contains a small, marine taxon, Olifantiella mascarenica sp. nov., which shows close structural similarity with the recently described genus Labellicula Van de Vijver & Lange‐Bertalot, but with significant differences: (i) the presence of a remarkable internal tubular process – the buciniportula; (ii) the easily identifiable external funnel‐shaped opening of this process; (iii) the design of the external raphe endings; (iv) the general shape of the frustules; and (v) a lateral void and elevated crest. The buciniportula, associated with the other characters, is apparently new, and allows the establishment of a new genus. The morphology of this genus is compared with that of related genera, such as Luticola, Diadesmis, Labellicula, Brachysira, Neidium and Nupela, with some comments on the contribution of scanning electron microscopy towards distinguishing new genera, and the possible superabundance of these new entities, particularly of small diatoms.