bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcomatoid carcinoma of the small intestine: Histologic, immunohistochemical and ultrastructural features of three cases and its differential diagnosis
Authors: Fukuda Takeaki , Kamishima Tomoko , Ohnishi Yoshihisa , Suzuki Toshimitsu
Published: December 2008

Three cases of sarcomatoid carcinoma of the small intestine are presented. One of them was found accidentally in the duodenum of a patient with a well differentiated adenocarcinoma and a malignant lymphoma that were limited to the stomach. The other two cases arose from the lleum. All of the tumors were whitish, soft and ulcerated with focal hemorrhage and necrosis and showed expansive growth. Each tumor consisted of a mixture of polygonal and spindle shaped anaplastic neoplastic cells arranged in sheet, short fas‐cicular or haphazard fashion, with no finding suggesting epithelial differentiation. Special stains demonstrated intra‐cellular mucin in only a small number of tumor cells in two cases, but not in the other case. Immunohistochemically, the tumor cells of two cases at both primary and metastatic sites showed a positive immunoreaction for cytokeratin and epithelial membrane antigen. In the other case, only a few tumor cells at the metastatic site, but not at the primary site, showed cytokeratin positivity. Various numbers of tumor cells positive for vimentin, α‐1‐antitrypsin (AAT), α‐1‐antichy‐motrypsin (ACT) and KP‐1 were detected in each case. Ultrastructurally, some populations of tumor cells possessed various amounts of tonofilaments with a few Intercellular connections between adjacent tumor cells. These cases should be classified as sarcomatoid carcinoma of the small intestine, despite partial or complete loss of epithelial features, and distinguished from the various sarcomas.
Multiple small intestinal stromal tumors with skeinoid fibers in association with neurofibromatosis 1 (von Recklinghausen's disease)
Authors: Ishida Tsuyoshi , Wada Ikuo , Horiuchi Hajime , Oka Teruaki , Machinaml Rikuo
Published: December 2008

A case of multiple small Intestinal stromal tumors (SIST) with skeinoid fibers of the jejunum arising in a 50 year old male with neurofibromatosis 1 (NF‐1) is reported. Seven small tumors of the jejunal wall were incidentally found and excised during an operation for abdominal and retroperitoneal neuroflbromas. Histologlcally, the tumors were composed of uniform spindle‐shaped cells with fascicular pattern, almost indistinguishable from the histology in leiomyoma. Periodic acid Schiff stain‐positive hyaline globules were observed among the tumor cells. Ultrastructurally, these globules were stromal tangles of curvilinear, fluffy fibrils, consistent with skeinoid fibers. The electron‐dense granules, possibly neurosecretory granules, were found In the cytoplasm of the tumor cells. Immunohistochemically, the tumor cells were positive for vimentin, neuron specific enolase and CD34, but negative for muscle markers and S100 protein. The association of NF‐1 and multiple SIST with skeinoid fibers may have clinical implications. The multiple occurrence of SIST with skeinoid fibers seems to be often cited as one of the gastrointestinal manifestations of NF‐1. The possible site of origin of SIST with skeinoid fibers in NF‐1 may be the enteric autonomlc nerve plexus in the small intestinal wall.
Myofibroblastic tumor of soft tissue displaying desmin‐positive and actin‐negative immunophenotypes
Authors: Yang Peng , Hirose Takanori , Seki Kunihiko , Hasegawa Tadashi , Hizawa Kazuo , Sano Toshiaki
Published: December 2008

Myoflbrobiasts have ultrastructural and functional characteristics Intermediate between fibroblasts and smooth muscle cells. Previous studies Indicated that most myoflbroblasts express actin and vlmentin but not desmln Immunophenotypes. Two benign Intramuscular myoflbroblastic tumors which displayed a desmin‐positive and actin‐negative immunophenotype are reported. The tumors occurred on the back of a 45 year old man who had neurofibromatosls 1 and the thigh of a 37 year old man without neurofibromatosis. Both tumors were encapsulated and composed of short intersecting bundles of spindle cells in a collagenous background. Although the tumors were cellular, nuclear pleomorphism was minimal and mitotic figures were rare. Characteristically, most tumor cells were Immunoreacttve strongly for desmin and vlmentln but gave negative staining for muscle‐specific actin, α‐smooth muscle actin, α‐sarcomeric actin, myosin, S‐100 protein, cytokeratins, and CD34. On electron microscopy, the tumor cells were characterized by short spindle‐indented nuclei, abundant cytoplasmic intermediate filaments, prominent piasmalemmal pinocytosis and frequent cell coverage by basal lamina. Aggregation of thin myofilaments with focal condensations was identified occasionally. Although the tumors showed distinct morphological and immunohistochemical features enabling delimitation from other soft tissue lesions, they may overlap histologically with myoflbrobiastoma of the breast, lymph node and soft tissue, low grade malignant nerve sheath tumor, lelomyosarcoma, cellular schwannoma, inflammatory flbrosarcoma and nodular fasciitis.
Gastric and intestinal mixed and solely intestinal types of intestinal metaplasia in the human stomach
Authors: Inada Ken‐ichi , Nakanishi Hayao , Fujimitsu Yasunobu , Shimizu Nobuyuki , Ichinose Masao , Miki Kazumasa , Nakamura Shigeo , Tatematsu Masae
Published: December 2008

To generate a novel understanding of Intestinal metaplasia (IM) on the basis of cellular differentiation status, a total of 132 gastric surgical specimens were studied using gastric and small intestinal cell markers by much histochemical and Immunohistochemical techniques. The cases were divided into two types: (i) gastric and intestinal (GI) mixed type; and (ii) solely intestinal (I) type, with the reference to the presence of gastric and/or intestinal cell markers. The GI mixed type was subdivided into six subtypes: (i) a subtype consisting of surface mucous (Su), pyloric gland (Py), Intestinal absorptive (Ab), and goblet (Go) cells, but lacking Paneth (Pa) cells, GI(Pa‐); (ii) a GI(Pa‐) subtype without Py cells, GI(Py‐, Pa‐); (iii) a GI(Pa‐) subtype without Su cells, GI(Su‐, Pa‐); (iv) a GI(Su‐, Pa‐) subtype with Pa cells, GI(Su‐, Pa+); (v) a Gi(Pa‐) subtype with Pa cells, GI(Pa+); and (vi) a GI(Pa+) subtype without Py cells, GI(–, Pa+).The I type was subdivided Into: (I) a subtype consisting of cells with Ab and Go cells, I(Pa‐); and (ii) a I(Pa‐) subtype with Paneth cells, I(Pa+). The GI mixed subtypes, except for the GI(Py‐, Pa‐) and GI(Py‐, Pa+), were characterized by Intestinalized gastric plts connected with underlying pyloric glands. Immunohistochemical staining of proliferating cell nuclear antigen (PCNA) revealed a common prolifemtive cell zone between the two. The GI mixed type, especially the GI(Pa‐) subtype, predominated in the pyloric mucose, while the I type was most frequent In the fundle region, suggesting that the pathogenesis of IM differs between these two locations. The results of the study confirm that IM is an abnormal and unstable differentiation status between the stomach and small Intestine.
Cytokeratin expression in normal human thymus at different ages
Authors: Masunaga Atsuko , Sugawara Isamu , Nakamura Hisayoshi , Yoshitake Tsuyoshi , Itoyama Shinji
Published: December 2008

Subsets of thymic epithellal cells were examined Immuno‐histochemically to determine whether or not their pheno‐types change during thymic growth and at early involution in terms of cytokeratin (CK) expression. Five monoclonal antibodies specific for CK4, CK8, CK13, CK18 and CK19 were used and applied for 16 neonatal, three Infantile and one adult thymus speeimen, which had been obtained at autopsy, that were normal macroscopically and microscopicaily. CK4, CK8, CK13, CK18 and CK19 were expressed simultaneously in the cortex, medulla and subcapsular area with the exception of CK4, which showed expression on the adult thymus. Light and electron microscopy showed that CK8 and CK19 expression was overlapped. Thus, It was thought that CK8 and CK19 formed complexes in the cytoplasm of thymic epithelial cells. The Immunoreactivity to CK4, CK13 and CK18 were attenuated or disappeared In the subcapsular area during the early involution stage. Interestingly, two patterns of CK18 expression were observed in the neonatal and Infantile thymus tissues, which Indicated that the thymic microenvironment was changeable even under normal conditions.
Subcellular localization of Bcl‐2 protein in synovial sarcoma
Authors: Kawauchi Shigeto , Noguchi Shin‐ichi , Fukuda Toshiro , Tsuneyoshi Masazumi
Published: December 2008

The subcellular locallzation of Bcl‐2 protein In surgically resected, fixed‐frozen tissue specimens of seven tumors from six caws of synovial sarcoma and a synovial Sarcoma cell line was examined using laser‐scanning confocal microncopy and immunoelectron microscopy. Bcl‐2 protein in synovial sarcoma cells was detected in the nuclear envelope, endoplasmic reticulum membrane, and mitochon‐drial circumference. Based on the finding of pre‐embedding Immunoelectron‐microscopy observation, the distribution of Bcl‐2 protein in such membranous organella was patchy. A computer‐based Image analysis failed to reveal any quantitative differences between the Inner and the outer mitochondrial membranes. The tumorigenesis of synovial sarcoma is also discussed from the viewpoint of Bcl‐2 overexpression.
Mucosa‐associated lymphoid tissue lymphoma coexisting with epithelioid granulomas in the stomach of a patient with systemic sarcoidosis
Authors: Fukuda Takeaki , Sato Keiichi , Tachikawa Shinzo , Ohnuki Keizo , Ohtani Hideo , Suzuki Toshimitsu
Published: December 2008

Malignant lymphoma arising in the stomach of a 23‐year‐old Japanem man with systemic sarcoldosis is presented. The patient was followed because of systemic sarcoidosis involving the lungs, eyes, and lymph nodes. Biopsy specimens from the stomach were repeated because of recurrent eplgastraigia and multiple ulcerations. Some of the specimens revealed epithelloid granuiomas with no caseous necrosis, which confirmed gastric involvement of sarcoidosis. Three years after the initial diagnosis, biopsy specimens taken from the stomach were diagnosed as malignant lymphoma of the large cell type. The resected stomach revealed muiticentric mucosa‐associated type malignant lymphoma of low‐grade B cell type, with foci of high‐grade transformation coexisting with numerous epithelioid granulomas with no caseous necrosis. Epithelloid granulomas were observed in all the respected lymph nodes, liver, and appendix, which had been obtained at operation, whereas malignant lymphoma was limited to the stomach. Hellcobacter pylori (H. pylori) infection was also observed in the stomach. Consequently, the present report is a rare case of coexistence of malignant lymphoma and involvement of sarcoidosis in the stomach. Both H. pylori infection and active sarcoid noduies may play a role in the development of malignant lymphoma, although the exact mechanism remains undear.
Clinicopathology of spinocerebellar degeneration: Its correlation to the unstable CAG repeat of the affected gene
Authors: Yagishita Saburo , Inoue Masayuki
Published: December 2008

The recent advances in gene analysis have greatly facilitated the classification of autosomal dominant spinocerebellar ataxia (SCA). Analyses of linkage in large families with SCA have assigned gene foci to at least 8 chromosomes. One gene is located in the short arm of chromosome 6 (6p22‐p23) and causes spinocerebellar ataxia type 1 (SCA1). A gene in the long arm of chromosome 14 (14q24.3‐q32) underlies Machado‐Joseph disease (MJD). A third gene locus is assigned to the short arm of chromosome 12 (12p2‐pter) causing dentatorubropallidoluysian atrophy (DRPLA). The gene for spinocerebellar ataxia type 2 (SCA2) is located in the 12q23–24. Subsequently, a sporadic counterpart of hereditary olivopontocerebellar atrophy of the Menzel type is clearly defined, and all the syndromes (non‐hereditary olivopontocerebellar atrophy, striatonigral degeneration and Shy‐Drager syndrome) are now lumped under the term of multiple system atrophy (MSA). Oligodendroglial cytoplas‐mic inclusions appear to be specific for and diagnostic of MSA. As the clinical features in SCA are variable and often appear to overlap with one another, which makes accurate classification difficult if not possible, the genotype is required for their unequivocal classification. However, major neuropathological features clearly distinguish SCA1 from SCA3/ MJD cases; the medial segment of the globus pallidus and intermediolateral column lesions in SCA3/MJD, and inferior olive and cerebellar cortical degeneration in SCA1. It has been stated that neurodegeneration in SCA3/MJD is more homogeneous than in SCA1 or SCA2 and that degeneration of the pallidoluysian system is not present in the latter. The pertinent pathology in each of the three types of SCA is illustrated. The background of clinicopathology and genetic analysis of dentatorubropallidoluysian atrophy is also reviewed.
Involvement of tumor necrosis factor‐α, interleukin‐I β, interleukin‐8, and interleukin‐I receptor antagonist in acute lung injury caused by local Shwartzman reaction
Authors: Imamura Sumitaka , Matsukawa Akihiro , Ohkawara Susumu , Kagayama Motoko , Yoshinaga Masaru
Published: December 2008

A local Shwartzman reactlon (LSR) was prepared in rabbit lung as a model of acute lung injury. To induce LSR, intratracheal injection of lipopolysaccharide (LPS) 10 μg into the lower lobe of the right lung, followed 24 h later by I.v. injectlon of LPS (10 μg/kg). In the lung with the LSR, myeloperoxidase activity, representing neutrophil accumulation, peaked at 1–2 h and was sustained for 48 h after challenge with i.v. LPS. The lung water content peaked at 12 h, and decreased gradually. Histological findings showed diffuse interstitial widenlng, lntra‐alveolar leukocyte infiltration with hemorrhage, and alveolar exudate formation. The production of tumor necrosis factor‐α (TNF‐α), interleukin‐1 β (IL‐1β), interleukin 8 (IL‐8), and IL‐1 receptor antagonist (IL‐1Ra) in the lung was analyzed. TNF‐α first elevated and peaked at 0.5h (66.±16.7ng/g.lung), subsequently, 11–1β and 11–8 increased and peaked at 2h (17.8 ± 3.4 ng/g. lung and 336.9±49.6ng/g.lung, respectively). IL‐1Ra was present even before the challenge, and the production increased to show a dual peak (0.5 h, 1.5±0.2 μg/g.lung; and 2h, 1.6±0.1 μg/g.lung), and a large concentration of IL‐1 Ra was sustained for 48 h. lmmunohistochemistry showed that the cellular source of these cytokines was alveolar macrophages and infiltrating neutrophils. Thus, disclosing the kinetics of the generation of cytokines led to a better understanding of thelr roles, namely TNF‐α as an initiator, IL‐1 and IL‐8 as amplitier and effector, and IL‐1 Ra as regulator of the intensity of acute inflammation.
Pale islands in medulloblastoma consist of differentiated cells with low growth potential
Authors: Iijima Misa , Nakazato Yoichi
Published: December 2008

Cerebellar medulloblastomas are the most common embryonal neoplasms occurring in the pediatric age group. Thirty‐five specimens from 28 cases of medulloblastoma and variant neoplasms were examined to elucidate the histopathologic significance of the reticulin‐free pale islands. In 10 specimens, there were light‐looking areas corresponding to pale islands: three specimens from desmoplastic and seven from classic medulloblastoma. The difference in cell population, 1.73‐fold more cells in dark areas than in light areas (P< 0.001), seemed to be a major factor in the formation of the biphasic architecture. Immunohistochemically, occasional tumor cells in both areas were found to express neuronalphenotypes. In addition, positive immunoreactivity for glial markers was exceptional. There was significant difference in the staining indices (SI) for cell proliferation markers. The light areas consistently showed low SI values (mean MIB‐1 SI, 5.75; mean PCNA SI, 11.8) compared with the dark areas (mean MIB‐1 SI, 22.7; mean PCNA SI, 44.9). It is suggested that light areas (pale islands) consist of more differentiated cells of neuronal lineage with relatively low proliferation potential. These tumor cells might proliferate in a group, and then expand, thereby compressing the surrounding tissue to form pale islands.
Early hepatocellular carcinoma macroscopically resembling adenomatous hyperplasia: Pathological resemblance to carcinoma‐in‐situ
Authors: Wakasa Kenichi , Haba Tomoko , Hamada Tomomi , Sasaki Masaomi , Sakurai Masaml
Published: December 2008

The pathological features of 11 nodules of early hepatocellular carcinoma (EHCC) were studled. Their macroscopic features resembled those of adenomatous hyperplasia and differed from those of advanced hepatocellular carcinomas (AHCC). The EHCC extended along the hepatic lobular structure and lacked expansive growth. The endothelial cells in the dnusoids of EHCC did not react to Ulex europeeus aggiutinin 1 (UEA1) like adenomatous hyperplasla or other liver parenchyma, whereas the endothelial celis in the AHCC did react to UEA1. immunohistochemically, CD68‐positlve Kupffer cells were noted in the alnusolds of EHCC, whereas in the AHCC Kupfter cails were not seen. Tumor emboli in the portal vein and intrahepatic metastases were not Identified In EHCC. which seemed to be carcinoma‐in‐situ or a microinvasive stage of hepatocareinogenesis.
Synchronous and metachronous multicentric squamous cell carcinomas in the upper aerodigestive tract
Authors: Shan Liang , Nakamura Yasushi , Nakamura Misa , Zhang Zhiqiang , Jlng Xuefeng , Hara Takeshi , Yokoi Toyoharu , Kakudo Kennichi
Published: December 2008

A rare case Is presented of a 57‐year‐old Japanese male wlth synchronous and metachronous multicentric squamous cell carcinomas (SCC) In the upper aerodlgesthre tract. Durlng a 9‐year‐perlod from the appearance of first primary SCC to autopfky, 14 focl of prlmary SCC and one severe dysplasla developed In wccesalon In the thoraclc esophagus, oral floor, soft palnte, uvula, lingual radix, pirlform recess, hypo‐phsrynx, cervlcal esophagus, trachea and lingual body. The patlent dkd of severe bronchopneumonla due to Gram‐nsgatlve bacterlal lnfectlon that developed as a result of recurrent nerve paralysls. Human papllloma vlrus and Epsteln‐Barr virus, which are risk factors, were not detected by lmmunohlstochemlalry or by the polymerase chaln reaction method. Genetlc analysis revealed the absence of polnt mutations In K‐ras codon 12. Heavy consumptlon of alcohol and excesstve smoklng may have been responsible for the mulcentrk carclnogenesls. Thls Is the first case report In the llterature of the development of so many prlmary SCC leslons In the upper aerodlgeuwe tract during such a short period.
Gastric stump carcinosarcoma with rhabdomyosarcomatous differentiation
Authors: Matsukuma Susumu , Wada Ryo , Hase Kazuo , Sakai Yu , Ogata Sho , Kuwabara Noriyuki
Published: December 2008

Gastric carclnosarcoma is an unusual tumor and its occurrence in the gastric stump Is extremely rare. A report is presented here of a unique case of gastric stump carcinosarcoma with rhabdomyosarcomatous differentiation In a 74‐year‐old man. The patient had undergone partial gastrectomy with gastrojejunostomy (Billroth II method) 30 years previously. The tumor had both adenocarcinoma and sarcoma components, and an immunohistochemlcal study suggested a focal transition between these components. The main sarcomatous components showed fibrosarcomatous features with a scattered distribution of rounded tumor cells, whose rhabdomyosarcomatous differentiation was lmmuno‐histochemlcaily determined. Ultrastructural examination supported the rhabdomyosarcomatous natures. Experience with the present tumor indicates that carclnosarcoma with rhabdomyosarcomatous differentiation can occur in the gastric stump and that this disease Is capable of aggressive behavior.
S‐100 protein is a differentiation marker in thyroid carcinoma of follicular cell origin: An immunohistochemical study
Authors: Nishimura Rieko , Yokose Tomoyuki , Mukai Kiyoshi
Published: December 2008

S‐100 protein, a dimer of S‐100α and S‐100β subunits (S‐100α and S‐100β), is widely distributed in human tissue, and several papers describing S‐100 protein expression in follicular cells of the thyroid have been published. in the present study, 105 cases of thyroid carcinoma (of which 96 were papillary, four follicular, two undifferentiated, and three meduilary) were analyzed immunohistochemically for the expression of S‐100 protein, S‐100α, S‐100β, and thyroglobulin. in papillary carcinoma, 188 lesions were studled and classified into well differentiated types (56 papillary, 45 follicular) and poorly differentiated types (41 trabecular, four solid, eight squamoid, three tall, and one insular), because the histological structure of each tumor was heterogeneous. The percentage of lesions which expressed positively for 5–100 protein and S‐100α, respectively, according to type were: papillary, 96 and 99%; foillcular, 96 and 100%; trabecular, 95 and 100%; solid, 50 and 50%; squamoid, 50 and 757%; and tall, 33 and 100%. The insular type was negative for both. For papillary carcinoma, well differentiated lesions showed stronger S‐100α expression than poorly differentiated lesions. S‐100α expression was weaker In follicular and undifferentiated carcinoma than in papillary carcinoma. Meduliary carcinoma also expressed S‐100α. S‐100β was positive in lesions that expressed S‐100α strongly. Expression of S‐100 protein and S‐100α protein correlated with thyroglobulin synthesis in the follicular cells. It was concluded that S‐100 protein, mainly S 100α. exists in thyroid follicular cells, that it exists In higher quantity in most of the well differentiated lesions but in lower quantity in poorly differentiated or Undifferentiated lesions, and that 5100 protein, especially S‐100α, is a differentiation marker in carcinoma of thyroid follicular cell origin.
Follicular dendritic cell sarcoma complicated by hyaline‐vascular type Castleman's disease in a schizophrenic patient
Authors: Katano Harutaka , Kaneko Kou , Shimlzu Seiichiro , Saito Tsuyoshi , Irié Tarou , Mori Shigeo
Published: December 2008

Follicular dendritic cell (FDC) sarcoma is an exceedingly rare neoplasm of unknown pathogenesis. A case of FDC sarcoma complicated by the hyaline‐vascular type Cattleman's disease occurring in a schizophrenic male is presented. Swelling of the left cervical lymph node appeared In a 44‐year‐old male schizophrenic who had been reeducated with major tranquilizers for 20 years. He had had a history of cervical lymphadenopathy 14 years before, for which a diagnosis of hyaline‐vascular type Castieman's disease had been made. The present specimen, obtained from the same site, was an enlarged lymph node heavily infiltrated with oval to spindie‐shaped atypical cells but was uninvolved at the periphery. The infiltrating cells showed nodular or sheet‐like growth, occasionally taking fascicular or storiform patterns. Follicular Involvement was also common. Peculiarly, varlous amounts of small lymphocytes were Intermingled with the neopiastic cells. The atypical cells expressed two FDC‐specific antigens, DRC‐1 and K1–M4 antigen, together with a few other markers that are shared by FDC, Including CD21 and HLA‐DR. These findings ciearly show the tumor to be FDC sarcoma. in addition, a peculiar fibro‐hyalinous change in the lymph follicle, which is compatible with hyallne‐vascular type Cattleman's disease, was noted at the periphery of the lymph node where neoplastic cells had not infiltrated. Surprisingly, similar hyaline‐vascular changes were observed in the previous biopsy taken 14 years ago. Meanwhlle, Kaposi's sarcoma‐associated herpesvirus, which is often Identified from generalized Castieman's disease, was not identified in the present case by polymerase chain reaction study. Thus, this case is unique in two aspects: (I) the overlap of FDC sarcoma with hyaline‐vascular type follicular changes: and (II) Its Occurrence in a schirzophrenic patient.
Solitary fibrous tumor of the prostate
Authors: Takeshima Yukio , Yoneda Kenji , Sands Noriaki , Inai Kouki
Published: December 2008

A case of solitary fibrous tumor of the prostate Is reported. A 42‐year‐old man had been complaining of difflcult volding and constlpation for 8 years. Urological and radiological examinations showed a large prostatic mass, and a total cystectomy and prostatectomy were petformed. The tumor was 14×13×11 cm in size, solid with a fibromuscular capsule, and graytan in color. Histological, the tumor was composed of short spindle‐shaped and polygonal cells with mild to moderate nuclear atypla, predominantly arranged in the so‐called ‘patternless pattern’ in a flbrocoliagenous background. Mitoses were occasionally seen. Vascular invasion was also observed. Immunohistochemically, these cells were strongly positive for CD34 and vimentin, and occasionally for desmin. The maximum K1–67 labeling Index of the tumor cells was 4.5%. These findings are consistent with a solitary fibrous tumor. To our knowledge, this is the first report of a solitary fibrous tumor of the prostate in the English medical literature.
Cystic pulmonary metastases of endometrial stromal sarcoma of the uterus, mimicking lymphangiomyomatosis: A case report with immunohistochemistry of HMB45
Authors: Itoh Tomoo , Mochizuki Makoto , Kumazaki Satoshi , Ishihara Teruo , Fukayama Masashi
Published: December 2008

A case of endometrial stromal sarcoma (ESS) showed cystic pulmonary metastases mimicking lymphangiomyomatosis (LAM). A 58‐year‐old female, who had undergone total hysterectomy for low‐grade ESS 16 years previously, had repeated bouts of pneumothorax. Multiple then‐walled cysts in the perlpheral lung were revealed by radiological examinations. In an open‐lung blopsy specimen, cystlc lesions were surrounded by layers of spindle‐shaped cells of varying thickness that resembled LAM. However, In addltion to subtle histological differences from LAM, HMB45 (antimelanoma antibody) showed positive In LAM (n=3), but was negative in ESS (M) and the cystlc leslons of this case. Using myogenic markers (desmin and α‐smooth muscle actin), metastatlc ESS could be immunohistochemically differentiated from mesenchymal cystlc hamartoma (n=1). HMB45 Immunohistochemistry is useful in the differential diagnosis of cystic puimonary lesions.
Causality of parenchymal and vascular changes in rats with experimental thiamine deficiency encephalopathy
Authors: Chen Qi , Okada Shinobu , Okeda Riki
Published: December 2008

The causality of vascular and parenchymal damage to the central nervous system (CNS) was examined In rats with thiamine deficiency. Male Sprague Dawley rats were divided Into two groups; one was given a thiamlne‐deficient diet ODD) and Injected Intraperitoneally with 10μg/100g bodyweight pyrithlamine (PT) In order to analyze morpho‐metrically the topographical and sequential relationship between vascular and parenchymal changes and vase dilatation, and the other was given a TDD and 50 μg/100 g bodyweight PT in order to determine hemorrhagic sites using serial dons. Histological examination showed that sponglotic change occurred selectively in the Interior colllculus (100%) from day 19, and thereafter In the thalamus (95%), mammlllary body (50%) and nuclei olivaris and vestlbularls of the pons (25%), with or without hemorrhage. Simultaneously, glycogen accumulation was also observed In these regions at a frequency similar to that of hemorrhage. Ultrastructurally, however, hydroplc swelling of astrocytic and neuronal processes without glycogen accumulation was observed as early as day 9 In the inferior cofliculus, at which time an Increase of glial fibrillary acldic protein‐positive processes was also recognized. The Superior colllculus was completely spared. From day 22 vasodilatation of the Inferior colliculus occurred, concomltantly with bodyweight loss and neurological symptoms. Twenty‐two examined hemorrhages, which occurred in the thalamus and Inferior colliculus, were distributed along the arterioles or capillarles on the arterial side. In conclusion, the morphological CNS changes caused by thiamine deficiency with administration of low‐dose PT in rats begin as hydropic swelling of neuronal and astrocytic processes, followed by hemorrhage and, thereafter, by vasodllatatlon. The predilectlon for hemorrhage on the arterial side without parenchymal changes suggests that petechial hemorrhage Is not simply secondary to parenchymal changes, but Is due to hemadynamlc change resulting from thlamfne deficiency‐Induced vascular dysfunction.
Expression of Bcl‐2 in human breast cancer: Correlation between hormone receptor status, p53 protein accumulation and DNA strand breaks associated with apoptosis
Authors: Hori Masao , Nogami Tatsuya , Itabashi Masayuki , Yoshimi Fuyo , Ono Hisayuki , Koizumi Sumihiko
Published: December 2008

The expression of Bcl‐2, a suppressor of apoptotic cell death, was Investigated in 52 invaslve carcinomas of the breast using reverse transcription‐polymerase chain reaction and Immunohistochemical methods. After consideration of both sets of results, 42 tumors (80.8%) were confirmed to be positive (Bcl‐2(+)) and 10 (19.2%) were judged negative (Bcl‐2(‐)) for Bcl‐2 expression. Related factors (p53 protein accumulation, hormone receptor status and apoptotic cell index) were also examined using Immuno‐histochemical and in situ end‐labeling methods to elucidate their correlations with Bcl‐2 expression. Bcl‐2 expression correlated significantly with the hormone receptor status, whereas it showed significant inverse correlations with p53 accumulation and the apoptotic index. It was concluded that estrogen and mutant p53 are related to the regulation of Bcl‐2 expression and that the ability to prevent tumor cell death due to Bcl‐2 can be developed by breast cancers.
Adenoid basal carcinoma of the cervix uteri: A case report
Authors: Yoshida Takashi , Fujiwara Keiichi , Shimizu Michio , Kohno Ichiro , Mikami Yoshiki , Manabe Toshiaki
Published: December 2008

We report a rare case of adenoid basal carcinoma of the uterine cervix, unexpectedly found in a uterus resected for the treatment of cervical Intraepithelial neoplasia (CIN) 3. The patient was a 47‐year‐old Japanese female. She received a total abdominal hysterectomy under a diagnosis of CIN 3 of the cervix. Grossly, there were no significant findings in the surgical specimens. Microscopically, in seven of the 12 blocks of the cervix examined, scattered small nests of uniform small cells, which extended 4 mm below the epithelial surface, with dark nuclei and scant cytoplasm were observed. Peripheral palisading as well as the formation of gland‐like or acinar structures were noted. The latter were positive for mucicarmine. Stromal reaction was not obvious. There were also foci of squamous differentiation in some portions of the small nests. Occasional mitoses as well as large atypical cells were also seen in this area. Immunohistochemically, the foci of squamous differentiation were positive for carcinoembryonic antigen. The epithelial surface In other portions showed CIN 3 with crypt extension. Distinction between adenoid basal carcinoma of the cervix and other diseases, such as adenoid cystic carcinoma and squamous cell carcinoma with basaloid features, is Important for clinical management because the clinical behavior of adenoid basal Carcinoma is less malignant.
Pleomorphic hyalinizing angiectatic tumor of soft parts
Authors: Fukunaga Masaharu , Ushigome Shinichiro
Published: December 2008

A case of recently descrlbed pleomorphic hyaliniring anglectatic tumor (PHAT) of soft parts Is reported. The subcutaneous solid tumor arising In the axils of a 58‐year‐old man was histologically characterized by sheets of mitotic ally Inactive oval and pleomorphic cells, Itranuclear cytoplasmic Inclusions, and clusters of ectatic vessels with perivascular hyalinization. Mono‐ and multinucleated giant cells were also present. A hemanglopericytoma‐like pattern of vascularity, pseudovascular spaces, stromal collagen with degenerative changes, and Immunoreactivity for CD34 were observed. Since these features were very similar to those of solitary fibrous tumors of various sites and newly categorized giant cell angiofibroma, it Is considered that PHAT, solitary fibrous tumor, and giant cell angiofibroma may be In the same family of tumor. The tumor was diploid with a low S‐phase fraction. The patient was well with no evidence of disease for 23 months.
Jejunal stromal tumor with skeinoid fibers or myenteric plexoma: A case report
Authors: Pérez Ginesa Ma García‐Rostán y , Díaz Marta Montes , Bragado Federico García
Published: December 2008

Small Intestinal stromal tumors with ‘skeinold fibers’ are uncommon stromal tumors with an associated controversial histogenesis. Although their microscopic appearance Is suggestive of a smooth muscle nature, they lack specific smooth muscle features, as evident by electron microscopy and Immunohistochemistry. They also appear to lack features of neurogenic origin because they fail to react with neural/neuroendocrine markers such as S‐100 protein, neuronapecific enolase and chromogranin. It is interesting, nonetheless, to note that the ultrastructural examination of these tumors may show structures reminiscent of neural differentiation, such as cytoplasmic projections, containing occasional membrane‐bound, densecore, neurosecretory type granules, which mimick the long cytoplasmic processes seen In tumors of neural origin. Moreover, the association of these tumors with Von Recklinghausen's neurofibromatosis, as well as the presence of ‘skeinoid fibers’ in proven neurogenic spindle cell neoplasms such as gastrolntestinal autonomic nerve tumors and schwannomas, suggests that these tumors might also be neurogenic In origin and enhances the diagnostic value of ‘skeinold fibers’ as a possible ultrastructural marker of neural differentiatioin. Thus, light microscopic evaluation is clearly Insufficient to accurately diagnose these tumors and to determine their histogenesis, electron microscopic and Immunohistochemical studies being neccesary. In this article the histogenesis of small Intestinal stromal tumors with ‘skeinold fibers’, regarding a jelunal neoplasm In a 63‐yearsld patient, is reviewed. The light microscopic, immunohistochemical and ultrastructural features are described and compared with findings usually seen in all those stromal tumors which may raise a differential diagnosis, such as smooth muscle stromal tumors, gastrointestinal autonomic nerve tumors, schwannomas, paragangliomas and fibrosarcomas.
Glomerular sequence of events concerning monocyte/ macrophage accumulation and ICAM‐1 expression during experimental serum sickness nephritis in the rat2
Authors: Yang Xiuying
Published: December 2008

Serum sickness nephritis was induced in Fisher rats by preimmunization and repeated immunization with chicken egg albumin. This experimental model is characterized by marked accumulation of monocytes/macrophages (MO) and deposition of immune complexes (IC) in glomerull during the inflammatory stage and, thereafter, the advancement to glomeruloscierods. The correlations between glomerular tissue damage, MO participation, intercellular adhesion molecule‐1 (ICAY‐1) expression and IC deposition were analyzed during the long‐term disease process. The grade of ICAM‐1 expression was well correlated with MO accumulation and IC deposition, and its distribution was observed on the glomerular endothelial layer, mesanglum, and along the parietal epithelial layer of the Bowman's capsule. It is suggested that glomerular MO accumulation is largely affected by the ICAM‐1 expression on glomeruli and, underneath such adhesion molecules, MO may play a role In subendoth‐elial or mesangial migration, mesangial cell activation, inducing sclerosis and monocytic‐epithellal crescent formation.
Low‐grade adenosquamous carcinoma of the breast: A case report with cytologic findings and review of the literature
Authors: Shizawa Soichiro , Sasano Hironobu , Suzuki Takashi , Ishii Hirhi , Takeda Tetsutaro , Nagura Hiroshi
Published: December 2008

The cytological and histopathological featurn of a case of low‐grade adenosquamous carcinoma of the breast In a 47‐year‐old Japanese female was studied. The fine needle aspl rstlon blopsy specimen of this case revealed prolfferating ductal cells and atyplcal squamous cells In the same cell clusters. The resected left breast mass had a relatively well‐circumscribed hard mass measuring 1.6 cm at its greatest dimension. Histologic examination demonstrated the coexistence of atypicai squamous and ductal components in the same lesion, with transition between these two components. Desmoplastic stomal reaction was observed. The majority of ductal components had a two‐layered composition, and sclerosimg adenosls‐like lesions were also observed at the periphery of the tumor. Based on these cytoiogic and histological findings, this tumor was diagnosed as low‐grade adenosquamous carcinoma of the breast This is the first report of the cytological findings of low‐grade adenquamous carcinoma of the breast, and It is Important for pathologists to consider the possibility of low‐grade adenosquamous carcinoma when the cytologlcal findings described above are present in an aspiration cytology specimen of the breast.
Immunohistochemical analysis of the nm23 gene products in testicular seminoma
Authors: Hori Kazutoshi , Uematsu Kunio , Yasoshima Hitoshi , Sakurai Kazunari , Yamada Akihiko , Ohya Munehiko
Published: December 2008

The nm23 gem, has been ldenwied as a metastasis suppressor gene. To clam the role of nm23 as a metastasis sup pressor gene In testicular seminoma, the expression of the nm23‐Hl and ‐H2 proteins (human nucleoside‐dlphosphate kinase‐A and ‐B) was Immunohistochemically examined in 43 patients. Thirty‐six (84%) and 21 (49%) of the 43 primary tumors were posithre for the nm23‐H1 and ‐H2 proteins, respecthrely. There was no significant difference in either nmH1 or ‐H2 expression between the 24 primary non‐invashre tumors and the 19 primary invasive tumors, or between the 31 primary tumors without metastasis and the 12 primary tumors with metastasls. In all, and 5 of 6 meta‐static tumors, the expression of nm23H1 and ‐H2 proteins was obsenred, respectively, and the expression was not decreased in the metestetlc tumors, compared to the primary tumors. In conclusion, the lmmunohistochemlcal expression of both the nm23‐Hl and ‐H2 gene products is not associated with the metastatic status or the invasive status of testicular seminoma, and it Is unlikely to be a useful non‐metastatic Indicator for testicular seminoma. Further studies are needed to elucidate the biological role of nm23.
Clinicopathological analysis on cancers of autopsy cases in a geriatric hospital
Authors: Imalda Katsumi , Hasegawa Ryohei , Kato Toshio , Futakuchi Mitsuru , Takahashi Satoru , Ogawa Kumiko , Asamoto Makoto , Yamamoto Toshiyuki , Suzuki Kanzo , Inagaki Toshiaki , Shinagawa Nagao , Shirai Tomoyuki
Published: December 2008

It is generally accepted that cancers in the eiderly are of low grade mallgnancy. In order to clarify this point, autopsy cases from a medical center for the elderly between 1982 and 1994 were pathologlcally analyzed. Three hundred and fifty (160 males, 190 females) out of a total of 871 (361 males, 510 females) autopsy cases were examined. The Incidence of cancer In varlous age groups were found to be as follows: <69 years, 24/67 (36%); 70–74 years, 401102 (39%); 75–79 years, 54/136 (39%); 80–84 years, 79/180 (44%); 85–89 years, 66/172 (38%); 90–94 years, 59/137 (43%); 95–99 years, 17/56 (30%); and >100 years, 12/21 (57%). The incidences did not significantly differ among the groups, that is, there was no age‐dependency in the Incidence of cancer. Furthermore, the incidences of multiple cancers (two or more different malignancies In one patient) also did not differ. However, deaths due to the cancers showed a tendency to decrease with age. The survival periods of clinical cancer cases without a surgical operation history (time period between the date of diagnosis and death), were age‐related for female cases. However, the rate of distant metastasis was not age‐related. The incidence of latent cancers in individuals over 85 years of age was 79/174 (45.4%) and significantly higher than the value of 69/234 (29.5%) for those under 85. The number of malignant tumors in various organs for the different age groups was also counted and the total numbers of clinical cancers and latent cancers in each organ were, 50 and 23 in the lung, 46 and 20 in the stomach, 41 and 31 in the colon, 0 and 39 in the prostate, and 14 and 0 in the mammary glands, respectively. All prostate cancers were latent cancers, and all mammary cancers were clinical cancers. These findings provide strong evidence that cancers In individuals of advanced age have less mailgnency potential.
Sarcomatoid hepatocellular carcinoma with osteoclast‐like giant celIs: Case report and immunohistochemical obsewations
Authors: Sasakl Atsushi , Yokoyama Shigeo , Nakayama Iwao , Nakashlma Kimihiro , Kim Yang‐ll , Kitano Seigo
Published: December 2008

Hepatocellular carclnoma (HCC) with osteoclast‐like giant cells (OGC) developed in the cirthotic liver of a 42‐year‐old male. Serum protein induced by vitamin K absence or antagonist II was elevated preoperatively. The patient died of the disease on the 28th postoperative day. Hlstologically, the tumor consisted of OGC and mononuclear cells (MC). The OGC were characterized by benign‐appearing nuclei, whereas the MC had atyplcal nuclei with a considerable number of mitoaes. A vaguely trabecular pattern was observed In the focal area of the tumor, but no evidence of overt HCC was found. lmmunohlstochemical analysis revealed that both OGC and MC were diffusely positive for histlocytic and mesenchymal markers. Some MC were focally posltive for cytokeratins 7, 8 and 19, and for albumin. Our clinical, histological and Immunohistochemical findings suggest that the MC were derived from hepatocytes, with some mesenchymal features, but the OGC were non‐neoplastic and reactive histiocytes.
Juvenile granulosa cell tumor discovered during pregnancy: Case report with immunohistochemical study of steroidogenesis
Authors: Sasano Hironobu , Irnaizumi Hideaki , Nagura Hiroshi
Published: December 2008

A multilobular cystic juvenile granulosa cell tumor in a 33‐year‐old pregnant woman was examined. Pathologlcal examination of the specimen at Cesarian section at 38 weeks of gestation revealed three different histological patterns; diffuse prollferation, trabecular or cord‐like prollferation, and characteristic microfollicular patterns, as well as the presence of numerous luteinized stromal cells. These histological patterns were intermingled and transference among these patterns was detected. Immunoreactivity of steroldo‐genic enzymes including cholesterol side‐chain cleavage, 3β‐hydroxysteroid dehydrogenase and 17α‐hydroxylase was detected only in luteinized stromal cells. However, that of adrenal 4 binding protein, a transcription factor of steroldogenesis, was present in almost all the tumor cells as well as luteinked stromal cells, suggesting that tumor cells acquired the potential of metabolizing and synthesizing steroid hormones. The hormonal environment assoclated with pregnancy altered the histologlcal and biological features of this juvenile granulosa cell factor.
Subcellular organelle analysis applying confocal laser scanning microscopy to the steroid‐producing epithelial ovarian tumor: A technical note
Authors: Yasuda Masanori , Itoh Johbu , Muramatsu Toshinari , Shinozuka Takao , Sasano Hironobu , Tsutsumi Yutaka , Osamura R. Yoshiyuki
Published: December 2008

An epithelial ovarian tumor with steroid production was examined in a 70‐year‐old postmenopausal female. The stromal cells of this tumor were rather dense and occasionally characterized by tuteinization or hyperthecosis, which has been associated with steroidogenesis. Subcellular visualization using confocal laser scanning microscopy (CLSM) successfully led to the identification of 3β‐hydroxysteroid dehydrogenase (HSD) in both mitochondria‐like small particles and endoplasmic reticulum‐like linear profiles, and P450‐aromatase also in endoplasmic reticulum‐like linear profiles, on the three‐dimensional images.
Hemosiderin deposition in portal endothelial cells is a histologic marker predicting poor response to interferon‐α therapy in chronic hepatitis C
Authors: Kaji Kyosuke , Nakanurna Yasuni , Harada Ken‐ichi , Sakai Akito , Kaneko Shuichi , Kobayash Ken‐ichi
Published: December 2008

Interferon (IFN)‐α is regarded as an efficient therapy for chronic hepatitis C, despite the fact that less than 50% of patients receiving 1FN‐α are known to show an initial be chemical response, and several adverse reactions related to this therapy are becoming a serious clinical problem. For a more efficient and safer treatment of IFN‐α, several pretreatment factors to predict a favorable or unfavorable response to IFN‐α therapy are now being evaluated, such as hepatitis C virus (HCV)‐RNA levels In serum and the genotypes of HCV. Recently, the hepatic iron concentration has been reported to influence the outcome of IFN‐α therapy for chronic viral hepatitis. In the present study, whether hemo siderin deposition in liver is a histologic predictor of response to IFN‐α therapy was evaluated, as well as which anatomical location showing the hemoslderin deposition was more closely related to the response to this therapy. Two factors, high titer of HCV‐RNA in serum and hemosiderin deposition in portal endothelial cells, were found to be predictable factors of poor response to IFN‐α therapy, and these two factors were found to be related to each other. Results showed that the hemosiderin deposition in portal endothelial vessels Is an easily evaluable histologic finding, and clinicians and histopathologists are encouraged to use this finding when selecting patients with chronic hepatitis C suitable for IFN‐α therapy.
Late onset type I familial amyloidotic polyneuropathy: Presentation of three autopsy cases in comparison with 19 autopsy cases of the ordinary type
Authors: Takahashi Kiyoshi , Sakashita Naorni , Ando Yukio , Suga Moritaka , Ando Masayukl
Published: December 2008

Clinicopathological features of three autopsy cases of extremely rare late onset type I familial amyloldotic polyneuropathy were presented and compared with 19 autopsy cases of the ordinary type. In the late onset cases, the ages at onset and at death were 27.5 and 24.5 years older, respectively, compared with the ordinary type. Also, duration of the total clinical course form onset to death was 3.7 years less than in the late onset cases. The degree of amyloid deposition was more marked in the heart of the late onset cases, causing prominent cardiac hypertrophy. It was also marked In the kidneys or thyroid of two cases, but slight to moderate in the peripheral or autonomic nervous tissues in all cases. Immunohistochemical Investigation demonstrated the presence of transthyretin (TTR) as an amyloid precursor protein and of serum amyloid P‐component in amyloid deposits in various organs and tissues of the late onset type. These findings, as well as serum levels of variant TTR, were similar to those of the ordinary type. These results suggest that there are some factors other than the amyloid precursor protein that effect the degree of amyloid deposition.