bluuebunny/crossref_metadata_2025 huggingface dataset:
A MIXED TUMOR OF THE OMENTUM MAJUS IN AN ADULT WITH DISCUSSION RELATED TO HEPATOBLASTOMA
Authors: Takeuchi Tadao , Hiramatsu Ryoji , Tsuru Takeshi , Hamada Tetsuo , Sato Tatsuo
Published: December 2008

A mixed tumor of the omentum majus found at autopsy of a 28‐year‐old man with a huge liver tumor is described. The primary tumor was identified in the omentum majus by macroscopic, histologic and electron‐microscopic observations. The tumor was finally diagnosed as a mixed tumor which resembled a hepatoblastoma consisting of immature and embryonal types of epithelial component and of mesodermal tumor including hemangioma, osteoid and myxomatous tissues in the primary lesion. Widespread multiple metastases of the epithelial component mainly to the liver, and partially in the lungs, diaphragm and lymph nodes were noted. The levels of alphafetoprotein and carcinoembyronic antigen were within normal limits, but the epithelial component showed a resemblance to primitive hepatocytes. This tumor was discussed related to hepatoblastoma in an adult, with the features compatible with descriptions of the same tumors reported previously in the literature.
CHORIOCARCINOMA IN INFANT AND MOTHER
Authors: Aozasa Katsuyuki , Ito Hiroshi , Kohro Takashi , Ha Kyung‐sae , Nakamura Masahiro , Okada Akira
Published: December 2008

A 2‐month‐old female baby was noticed to have liver tumor. A hemangioma of the right lobe was suspected from the findings by celiac angiography. Histologic findings of the surgically resected material revealed choriocarcinoma of the liver. At autopsy, multiple metastatic nodules were found in the lungs, but remnant liver, ovaries, uterus, mediastinum, and sacrococcygeal region were free of tumor. The ovary had several thecalutein cysts, and the endometrium of the uterus showed pseudodecidual change of the stroma. The mother died two months later. Although histologic materials were not available, the clinical findings including a high value of serum HCG seemed to show that she had been affected by choriocarcinoma. The most probable origin of the choriocarcinoma in the infant from the mother is discussed.
EXTRAVESICAL MALACOPLAKIA
Authors: Tanaka Toshio , Sakuma Hideo , Takahashi Kiyoshi , Kumon Hiromi , Ohmori Hiroyuki
Published: December 2008

A 61‐year‐old woman was found to have a right flank mass. Radiologically, the mass was thought to be of renal origin. Surgically, however, the tumorous lesion adhered tightly not only to the cortical surface but extended to the retroperltoneum and psoas muscle Pathological examination confirmed the lesion to be malacoplakia which was characterized by the presence of von Hansemann cells and Michaelis‐Gutmann bodies. Despite the effort made to focus on the initiating site of the tumor, it was considerably difficult to decide whether it originated from either an extremely superficial part of the renal cortex or renal capsule or retroperitoneum itself. Histochemical and electron microscopical investigations on the von Hansemann cells and Michaelis‐Gutmann bodies were made. The pathogenesis of malacoplakia was briefly discussed with particular emphasis on its possible occurrence in the patients under various therapeutic regimes.
PRIMARY CEREBRAL MALIGNANT LYMPHOMA WITH MACROGLOBULINEMIA AND CARCINOMA OF THE COLON
Authors: Katayama Yosei , Shimoyama Norihiko , Yagihashi Soroku , Kuribayashi Nobuo , Takeuchi Hiroshi , Saruta Eisuke , Ohtani Mitsuhiro
Published: December 2008

A case of primary cerebral malignant lymphoma, immunoblastic type was reported. The immunoelectrophoresis of the patient serum showed an abnormal bow of IgM lambda type. Autopsy revealed that the cerebral lymphoma showed no extracranial spread except for adenocarcinoma of the colon with hepatic metastasis. Ultrastracturally, some of the lymphoma cells showed plasmacytoid differentiation. Immunoperoxidase study showed intracytoplasmic polyclonal immunoglobulins in non‐neoplastic plasma cells around the colonic carcinoma, in the bone marrows, and spleen. However, neither IgM nor lambda light chain was found in the cerebral lymphoma cells. The source of the macroglobulinemia in this case was discussed.
SQUAMOUS METAPLASIA WITH RESERVE CELL HYPERPLASIA IN THE ESOPHAGOGASTRIC JUNCTION ZONE
Authors: Takubo Kaiyo
Published: December 2008

The entire mucosa of the esophagogastric junction zone (E.G.J.) was examined histologically in 63 cases of total gastrectomy and 47 cases of esophageal resection. The squamocolumnar junction in E.G.J. was classified into three types, 1. Clear‐cut demarcation type was found in 21 (19%) out of the total 110 cases, 2. Subepithelial inclusions of ectopic gastric epithelium type in 81 (74%) out of 110 cases, and 3. Barrett esophagus type in 8 (7%) out of 110 cases. By the primary disease, 4 out of 8 cases of type 3 were found in the cases of esophageal ulcer, and 4 were present in the cases of esophageal cancer. The mucosa of E.G.J, showed a squamous metaplasia with reserve cell hyperplasia as in the cervix uteri. The reserve cell hyperplasia was observed in 26(24%) out of 110 cases, and there were two cases which showed atypical change and nodular proliferation. The reserve cell hyperplasia and its atypical change were considered to be one of the sites for the development of squamous cell carcinoma in the junction zone. It was suggested that the primary site of squamous cell carcinoma in E.G.J, was not limited to the esophageal flat stratified squamous epithelium.
CYTOCHEMICAL MARKERS OF MURINE LEUKEMIAS AND LYMPHOMAS
Authors: Yoshida Haruhiko , Akeho Masahiro , Okamoto Kimio , Yumoto Tokichi
Published: December 2008

Seven transplantable leukemias and lymphomas which occurred in NZB mice were characterized immunologically and cytologically as B‐cell type of L66‐, 2709‐, 2769‐find S77‐lines, and T‐cell type of TH17‐, TH90‐and 829‐lines. These were also studied with enzyme histochemistry in tissue sections. All B‐cell tumors revealed strong activities of ATPase and 5′‐nucleotidase and one expressed AlPase activity on the cell surface. Two thymic lymphomas (TH17‐and TH90‐lines) and one T‐cell leukemia (S29‐line) showed negative reactions of ATPase and 5′‐nucleotidase but positive activities of AcPase and non‐specific esterase localized in their cytoplasms. AlPase activity was expressed in TH90‐lymphoma but not in TH17‐and S29‐lymphomas. AlPase recognized in L66‐and TH90‐lymphomas showed similar reaction to those of Nagao's isoenzyme. The splenic follicles of normal NZB mice reacted to ATPase and 5′‐nucleotidase in B‐cell area (primary follicles) and to AcPase and non‐specific esterase in T‐cell area (PALS) with the localized reaction. Data suggest that four enzymes of ATPase, 5′‐nucleotidase, AcPase and non‐specific esterase are useful for the differentiation of B‐and T‐cells and their malignant counterparts.
EFFECT OF FIBRIN ON ARTERIAL ENDOTHELIAL CELLS IN VITRO:—An Electron Microscopic Study—
Authors: Okadome Kenichiro , Kinjo Mitsuru , Tanaka Kenzo
Published: December 2008

An interaction between fibrin and arterial endothelial cells was studied in vitro electron microscopically by the modified method of Warren et al. Microvilli and cytoplasmic processes attached to fibrin threads in an early period of fibrinolysis and fibrin threads showed fine fibrillar or granular appearance in the lysed areas. Dilatation of endoplasmic reticulum and increase in number of intracytoplasmic vesicles, mainly in the luminal side of endothelial cells, were noted in the endothelial cells in the lysed areas. Fibrinolytically active endothelial cells were observed in 38 out of 100 endothelial cells of the rat aorta. Therefore, we suggest that microvilli of endothelial cells might play an important role in release of plasminogen tissue activator from the endothelial cells, and a heterogeneity of the endothelial cells exists in the reactivity to fibrin.
AN ELECTRON MICROSCOPIC STUDY ON THE RETICULOENDOTHELIAL CELLS IN THE LYMPH NODES
Authors: Sakuma Hideo , Kasajima Takeshi , Imai Yutaka , Kojima Mizu
Published: December 2008

In an attempt to clarify the cytological characteristics of the RES cells in the lymph nodes and their embryological correlations, lymph nodes and lymph node anlages of germ‐free rats, nude mice, and human fetuses were light and electron microscopically examined. On the basis of differences of intracellular organelles, their behaviors for reticulum fibers and of endogenous peroxidatic activity, histiocytes should be reasonably distinguished from the cells conventionally called reticulum cells. Reticulum cells and histiocytes respectively are destined to differentiate in different directions from the early stage of development of the lymph node anlage. Sinus endothelial cells are ontogenetically originated and differentiated from the endothelial lining cells of lymphatic vessels. Primitive reticular cells are differentiated into mature reticulum cells in the lymph nodes, they transform into the lympho‐reticular cells, further into lymphoblasts, and finally develop into medium‐sized lymphocytes.
AMYLOIDOSIS: Intrafollicular Amyloid in Normal Parathyroid Glands
Authors: Iwata Takako , Imada Naoki , Nakamura Hidenori , Fujihara Shigeyoshi , Yamashita Yoshimi , Yokota Tadaaki , Kamei Toshiaki , Uchino Fumiya
Published: December 2008

Normal parathyroid glands from 128 autopsies aged 12 to 82 were examined and intrafollicular amyloid was found in 53 cases (41.4%). There was a clear association with age of the patients. Intrafollicular amyloid is thought to be concentrated material originating from the stored parathormone or its derivatives.
HISTOLOGIC MAPPING OF INFARCTED MYOCARDIUM A New Method for Evaluation of Myocardial Infarct in Autopsy Cases
Authors: Shin Phyjou , Onishi Shunzo , Minamino Takazo , Kitamura Hajime
Published: December 2008

A histologic mapping of myocardium was deviced for the evaluation of myocardial infarction in autopsy cases. By this method, it is possible to understand the three dimensional extension, density and spreading or repairing mode of an infarct in the heart, and should be also possible to estimate the damaged myocardial mass. Furthermore, references of both clinical information and the findings from simultaneously examined coronary arteries gave this technic an efficient means for the clinicopathologic evaluation of myocardial infarction.
COMPARATIVE IMMUNOPATHOLOGIC STUDIES OF THROMBOTIC THROMBOCYTOPENIC PURPURA, HEMOLYTIC‐UREMIC SYNDROME AND DISSEMINATED INTRAVASCULAR COAGULATION
Authors: Hayasaka Takashi , Yoshiki Takashi , Shirai Toshikazu , Ninomura Nobumasa , Itoh Tetsuo
Published: December 2008

The vascular lesion of thrombotic thrombocytopenic purpura was characterized by two distinct types of changes in the arteriole of the heart and brain: (1) multiple incomplete vascular occlusions due to the subendothelial deposits composed of a homogeneous fibrin fibrinogen‐like substance and platelets without the formation of polymerized fibrin; (2) vascular wall thickening due to the intramural granular deposits of IgM and β1C.

A patient with hemolytic‐uremic syndrome 9 days after the onset of the disease, exhibited (1) the formation of fibrin‐thrombi in the glomerular capillary lumens, and (2) the granular deposits of IgM and β1C along the glomerular capillary walls and in the mesangium. In contrast, the case in which the symptoms subsided five weeks after the onset exhibited neither fibrin‐thrombus formation nor the deposits of IgM and βC in the glomeruli. The vascular lesion of disseminated intravascular coagulation accompanied by pancreas carcinoma was located mainly in the capillaries, and were characterized by the formation of numerous fibrin‐thrombi. Although the glomeruli contained numerous thrombi, there was neitherendocapillary proliferation nor deposits of immunoglobulins and complement components.
IMMUNOHISTOCHEMICAL LOCALIZATION OF TYPE I, II, III, AND IV COLLAGENS IN THE LUNG
Authors: Konomi Hiroshi , Hori Hisae , Sano Junjiro , Sunada Hironobu , Hata Ryu‐ichiro , Fujiwara Sakuhei , Nagai Yutaka
Published: December 2008

Type specific rabbit antibodies to bovine type I, 11, 111, and IV (basement membrane) collagens showing no cross‐reaction with other types of collagen were prepared by cross‐adsorption and diethylamiuoethyl‐cellulose romatography. The antibodies to bovine type I and I11 collagens showed a high cross‐reaction with the corresponding human collagens, but those to type I1 and IV collagens did moderate and no cross‐reactions with human type I1 and IV collagens, respectively. By using these antibodies, tissue distribution of various types of collagen in normal bovine lung was examined by indirect immunofluorescence microscopy. Both type I and I11 collagens were found to distribute widely in the interstitium of bronchial tree, bronchial

lamina propria and of interlobules as well as alveolar nipples and adventitia of pulmonary arteries. Type I1 collagen was located only in bronchial cartilage. The tissues mainly stained for type 11 collagen were the alveolar interstitium (also stained faintly for type I collagen) and the intima and media of the arteries. Type IV collagen was located in a membranous fashion in alveolar septa and bronchial smooth muscles and subepithelial layers as well as capillaries and the intima and media of arteries. ACTA PATHOL. JPN. 31: 601–610, 1981.
POLYMYOSITIS AND TOXOPLASMOSIS
Authors: Karasawa Tsutomu , Takizawa Ichiki , Morita Koichi , Ishibashi Hatsue , Kanayama Saburo , Shikata Toshio
Published: December 2008

Extensive severe polymyositis in a patient with toxoplasmosis was presented. Toxoplasmosis was serologically substantiated by a serial two‐tube rise in a toxoplasma‐antibody titer by a hemagglutination test. What appeared to be toxoplasma gondii was detected in areas of myositis. Toxoplasma gondii was found in a single small area of hepatic necrosis, but no other organ or tissue was involved. Thus, the present case was peculiar in respect that skeletal muscles were the major target of toxoplasmosis. A causal relationship between toxoplasmosis and polymyositis was discussed and the literatures were reviewed. Serological investigation and histopathological search for toxoplasma gondii should be done in every case of polymyositis not only for the appropriate therapy but also for the further elucidation of the relationship between toxoplasmosis and polymyositis.
MULTIPLE MALIGNANCIES (SQUAMOUS CELL CARCINOMA AND SARCOMA) ARISING IN A DERMOID CYST OF THE OVARY
Authors: Hanada Masato , Tsujimura Takashi , Shimizu Hiroshi
Published: December 2008

A case of multiple malignancies (squamous cell carcinoma and sarcoma) arising in an ovarian dermoid cyst of a 75‐year‐old woman is reported: this appears, to the best of our knowledge, to be the first well documented example of such a complex tumor. The two malignant components bad a well‐demarcated boundary except for at their junction, a feature more indicative of a collision tumor rather than carcinosarcoma of the ovary. The solid sarcomatous portion displayed a prominently myxoid and pleomorphic appearance with a focal whorling and storiform pattern, the features considered to be compatible with the myxoid varient of malignant fibrous histiocytoma recently defined by Weiss and Enzinger. The patient is alive and well 21 months after surgery.
INTRAUTERINE CANDIDA INFECTION IN PREMATURE BABY
Authors: Nagata Kazuto , Nakamura Yasuhiro , Hosokawa Yoshiaki , Nakashima Teruyuki , Nagasue Naoki , Kabashima Katsuichi , Hidaka Shikoh
Published: December 2008

An autopsy case of pulmonary candidiasis occurring in a neonatal girl was reported. The mycological examination of the lung taken at autopsy revealed only Candida albicans and followed by the elucidation under the microscopic sections prepared with special stains; periodic acid‐Schiff and methenamine silver, in the lung, stomach, umbilical cord, and amnion. The presence of Candida vaginitis in her mother supported the concept that Candida albicans was the etiological agent of the pulmonary candidiasis.
Genetic abnormalities and pathogenesis of familial amyloidotic polyneuropathy
Authors: Murakami Tatsufumi , Uchino Makoto , Ando Masayuki
Published: December 2008

Familial amyloidotic polyneuropathy (FAP) is an autosomal inherited disease, characterized by extracellular amyloid deposits and by peripheral neuropathy. Amyloid fibrils derived from most types of FAP consist of variant transthyretin (TTR) with single amino acid substitutions, and methionine 30 TTR is the most common variant TTR. TTR is mainly produced in the liver and the choroid plexus. Biochemical and molecular biological techniques have been revealing the amyloidogenicity of variant TTR in vitro and in vivo using the transgenic mouse as a model. It will be important for the development of effective therapy to find out the factors, other than variant TTR, which affect amyloid deposition and define the tissue specificity of amyloid.
N‐ras mutation of thyroid tumor with special reference to the follicular type
Authors: Oyama Tetsunari , Suzuki Takeshi , Hara Futoshi , Iine Yuich , Ishida Tsunehiro , Sakamoto Atsuhiko , Nakajima Takashi
Published: December 2008

Using the method of polymerase chain reaction‐single strand conformation polymorphism, the point mutations of the ras oncogenes in a total of 33 thyroid tissues, including 12 follicular adenomas, 6 follicular carcinomas, 11 papillary carcinomas, and 4 undifferentiated carcinomas, were examined. The frequency of the mutation was 3% (1/33) in codon 12,13 of Ki‐ras and 18% (6/33) in codon 61 of N‐ras, including 17% (2/12) in follicular adenoma, 50% (3/6) in follicular carcinoma, 0% (0/11) in papillary carcinoma and 25% (114) in undifferentiated carcinoma. In follicular adenoma, positivity was observed in microfollicular or trabecular subtypes. Furthermore, the mutation of ras was examined in histologically different parts, coexisting in the same tumor in a total of four cases. Both the undifferentiated carcinoma and coexisting follicular adenoma, and both the microfollicular adenoma and trabecular nodule growing in the tumor, had the same N‐ras (61) mutation. Direct sequencing analysis showed that all mutations were CAA (Gln) to CGA (Arg) transition of codon 61, except for CAA to AAA transversion in one case of follicular carcinoma. A similar genetic abnormality of N‐ras genes at codon 61 between follicular adenoma and follicular carcinoma suggests that the mutation of N‐ras at codon 61 might play a part in oncogenesis in follicular tumors.
Clinicopathological and molecular biological studies of gastric adenomas with special reference to p53 abnormality
Authors: Sakurai Shinji , Sano Takaaki , Nakajirna Takashi
Published: December 2008

To determine the role and timing of p53 alteration in gastric adenomas, sequentially biopsied gastric adenomas were lmmunohistochemically studied for p53 overexpression. From a total of 29 cases, 32 adenomas were endoscopically followed up more than 1 year and used in this study. Immunohistochemically, p53 positivity with diffuse or focal staining was observed in 12 of 32 adenomas. During the follow‐up period, only four adenomas transformed to adenocarcinoma, of which three showed p53 positivity by immunohistochem‐istry. The mutation of the p53 gene in exon 5 through 8 was examined in 18 gastric adenomas including four adenomas with malignant transformation. The PCR‐SSCP analysis and DNA sequencing revealed four missense mutations and one silent mutation in five adenomas. The missense mutation was present in three adenomas with diffuse p53 staining and in one adenoma with focal p53 staining. The predominant type of mutation was the G: C to A: T transition. In addition to the p53 gene analysis, Ki‐ras gene was also investigated, but no mutation in codon 12 and f3 was found in the adenomas investigated. This study indicated that gastric adenomas might be one of the precursor lesions of gastric cancer but somewhat different from colon adenomas in regard to growth potential, p53 staining pattern and the rate of Ki‐ras gene mutation.
p53 Immunostaining distinguishes malignant from benign lesions of the gall‐bladder
Authors: Oohashi Yasuhiro , Watanabe Hidenobu , Ajioka Yoichi , Hatakeyama Katsuyoshi
Published: December 2008

The expression of p53 protein was studied in formalin‐fixed paraffin‐embedded specimens of 41 well‐differentiated adenocarcinomas of the gall‐bladder, six cases of acute cholecystiiis and 23 cases of chronic cholecystitis, using a monoclonal p53 (PAb 1801) antibody and streptavidin‐biotin. p53 staining was divided into diffuse, focal or sporadic patterns. The relationship between the p53 Labeling Index (p53 LI) and cellular proliferation was also investigated using monoclonal Ki‐67 (MIB1) antibody. Twenty‐four of the 41 carcinomas (58.5%) had a diffuse staining pattern with a high p53 Ll (47–93%) and 9.8% (4141) had a focal staining pattern with an intermediate p53 LI (22–34%), with no relation to pT stage, tumor size, histologic type or grade of cytologic atypia. The p53 LI was higher than the Ki‐67 LI in these tumors except for one. On the other hand, p53 staining was completely sporadic in the non‐neoplastic specimens with a low p53 LI (0.2–2.8%). The p53‐positive cells in these specimens were located only within areas of Ki‐67‐positive cells. In conclusion, p53‐protein overexpression occurs as an early event in approximately 70% of well‐differentiated adenocarcinomas of the gall‐bladder, and this alteration is maintained during progression from intramucosal to invasive carcinoma. p53 immunostaining can distinguish malignant from benign lesions of the gall‐bladder.
Expression of vascular permeability factor (VPFNEGF) messenger RNA by plasma cells: Possible involvement in the development of edema in chronic inflammation
Authors: Ito Akihiko , Hirota Seiichi , Mizuno Hitoshi , Kawasaki Yoshiaki , Takemura Teiji , Nishiura Tetsuo , Kanakura Yuzuru , Katayama Yoshinari , Nomura Shintaro , Kitamura Yukihiko
Published: December 2008

Edema occurs in some types of chronic inflammation such as nasal polyps, uterine cervical polyps and gastric hyper‐plastic polyps. However, the factors or cellular components involved in the development of edema in chronic inflammation remain to be clarified. Recently, the gene encoding vascular permeability factor (VPF) or vascular endothelial growth factor (VEGF) and the genes encoding its receptors (kinase insert domain‐containing receptor (KDR) and fms‐like tyrosine kinase‐1 [fit‐1]) have been cloned. VPF/VEGF induces vascular hyperpermeability and vascular endothe lial proliferation through KDR or fit‐1 receptors. As there is a possibility that VPF/VEGF may play a role in the development of edema in chronic inflammation, we examined the messenger (m) RNA expression of VPF/VEGF and its recep tors in nasal polyp tissues, which is an example of chronic inflammation with remarkable edema. Using northern blotting, all nasal polyp tissues examined expressed mRNA of VPF/VEGF and KDR. In situ hybridization revealed that VPF/ VEGF mRNA‐expressing cells were scattered in the edematous stroma of nasal polyps. In the adjacent sections, these cells showed the morphological features of plasma cells and expressed mRNA of immunoglobulin light chains. Human B cell leukemia and plasmacytoma cell lines expressed VPF/VEGF mRNA but human mast‐cell leukemia and T cell leukemia cell lines did not. The alternatively spliced pattern of VPF/VEGF transcripts observed in nasal polyp tissues was consistent with that in plasmacytoma cell lines. Taken together, the VPF/VEGF mRNA‐expressing cells in nasal polyps appeared to be plasma cells, suggesting that plasma cells may play an important role in the development of edema in chronic inflammation through the production of VPF/VEGF.
Cell death in colorectal polyps as evaluated by in situ 3‘‐tailing reaction and its relationship to BCL‐2 expression
Authors: Nakamura Toshitsugu , Sakai Toshihiko , Nariya Shoji
Published: December 2008

Colorectal polyps were analyzed from the standpoint of cell death by using the in situ 3′‐tailing reaction (ISTR), which identifies cell death‐associated DNA double strand breaks, and immunohistochemistry for bcl‐2 oncoprotein (BCL‐2) and for Ki‐67. There were few ISTR‐positive cells in the non‐neoplastic glands, whereas 38% of non‐neoplastic mucosa just adjacent to the adenoma had many labeled nuclei, suggestive of cell death associated with replacement by tumor. The neoplastic glands contained variable number of ISTR‐positive nuclei, mostly showing the morphological feature of apoptotic bodies. In the representative glands with the most prominent ISTR‐labeling, their indices did not have a significant relationship to the grade of atypia, to the prolif‐erative activity (Ki‐67 labeling indices) of neoplastic glands, or to BCL‐2 stainability. In each case, however, the neoplastic glands with no or few ISTR‐labeled nuclei tended to express BCL‐2 intensely, and all lesions of adenoma or carcinoma with more than 15% of ISTR‐labeling indices showed weak BCL‐2 immunoreactivity. In general, BCL‐2 expression was significantly stronger in the adenoma than in non‐neoplastic mucosa and carcinoma, although there was no significant difference of ISTR‐labeling between adenoma and carcinoma. These results indicate that cell death in colorectal neoplastic polyps does not have a significant influence on their growth rate, and that BCL‐2 plays some role, at least in part, in the regulation of apoptosis.
Epstein‐Barr virus genomes in Hodgkin's disease and non‐Hodgkin's lymphomas
Authors: Li Dongxu , Oda Kenji , Mikata Atsuo , Yumoto Norio
Published: December 2008

Seventeen of 40 cases of Hodgkin's disease (HD) and eight of 46 non‐Hodgkin's lymphomas (NHL) were associated with Epstein‐Barr virus (EBV) infection, judged by the EBER‐1in situhybridization (ISH) method. Approximately 40% incidence in HD was comparable to previous reports. Young children and elderly HD patients were more prone to be found EBV positive. Fourteen of 17 HD and two of 8 NHL cases with positive EBER‐1 ISH were also positive on LMP‐1 immunostaining. EBV might have a role in lymph‐omagenesis in these cases. The fact that 7 of 8 EBV‐related NHL were peripheral T cell lymphoma indicates the necessity of a larger‐scale survey on this subject. As the present study revealed four cases with positive LMP‐1 immunostaining but negative EBER‐1 ISH (1 HD, 3 NHL), LMP‐1 alone should not be regarded as a tool to prove EBV infection.
Increased S‐100 protein‐immunoreactivity of Kupffer cells is associated with lymphohematological malignancy
Authors: Niki Toshiro , Oka Teruaki , Shiga Junji , Takahashi Kiyoshi , Geerts Albert , Machinami Rikuo
Published: December 2008

The distribution of S‐100 protein in normal tissue has been studied extensively. However, little is known about its expression in pathologic states. The aim of the present study was to investigate the expression of S100 protein in diseased human liver, especially in Kupffer cells. One hundred cases of autopsy livers originating from patients with various diseases were examined. Increased S‐100‐immunoreactivity of Kupffer cells was observed in six cases. Of the six cases, four were derived from a lymphohematologic malignancy, such as B cell lymphoma, B cell lymphoblastic leukemia, muitiple myeloma and chronic myelogenous leukemia with lymphoblastic crisis. Lymphohematologic malignancy accounted for 16 out of the 100 cases examined. Thus, increased S‐100‐positive Kupffer cells was significantly associated with lymphohematologic malignancy (P<0.01); 25% (4/16) in cases with lymphohematologic malignancy versus 2.4% (2/84) in the remaining cases. Moreover, some of these S‐100‐positive Kupffer cells were positive for S‐100 β‐subunit, which is not normally expressed by Kupffer cells. Although the reason for this increased S‐100‐immunoreactivity is speculative, the authors' hypothesis is that tumor cells may produce some factor(s) that induce the expression of S‐100 protein in Kupffer cells.
Expression of irnmunoreactivities to 75 kDa nerve growth factor receptor, trk gene product and phosphotyrosine in granular cell tumors
Authors: Hoshi Nobuo , Tsu‐ura Yukio , Watanabe Kazuo , Suzuki Tomohiro , Kasukawa Reiji , Sutuki Toshimitsu
Published: December 2008

Nineteen granular cell tumors (GCT) of adults, two congenital granular cell epulides and five epulides fibrosae were immunohistochmically examined to detect the expression of 75 kDs nerve growth factor receptor (NGFR), frk gene product, phasphotyrosine (PT), protein gene product 9.5 (PGP9.5) and S‐100 protein. The NGFR‐immunoreactivity (IR) and trk gene product‐IR were expressed on almost all granular cells of GCT. PT‐IR was also demonstrated on granular calls of all GCT examined, although the frequency of positive cells was low. Congenital granular celi epulides and epulldes fibrosae were negative for NGFR‐IR, trk gene product‐IR and PT‐IR. S‐100 protein was localized in granular cells of adult GCT but not in the granular cells of congenital epulis. On the other hand, PGP9.5 was detected in granular cells of both conditions and in fibroblastic cells of epulis fibrosa. The present results further indicate that GCT is of peripheral nerve Schwann cell origin, while the congenital granular cell epulides are not of neural origin. NGFR and trk gene product expressed on GCT seems to be functional in terms of phosphorylation of the tyrosine residue in the receptor or downstream protein in signal transduction.
Sebaceous carcinoma of the vulva
Authors: Kawamoto Masashi , Fukuda Yuh , Kamoi Seiryu , Sugisaki Yuichi , Yamanaka Nobuaki
Published: December 2008

Extraocular sebaceous carcinoma (SC) is a rare tumor usually found on the head and neck. A 78 year old Japanese female who had an asymptomatic vulvar tumor is reported here. The excised specimen showed SC with metastasis to the inguinal lymph nodes. This is the fourth reported case of SC arising from female genitalia, and the second case that apparently arose from the labia minora. Contrary to the previously reported cases, tumor cells in the present case had abundant glycogen. Thus, differential diagnosis of SC from metastatic renal cell carcinoma is difficult morphologically because both of them have glycogen and lipid. Intra‐epidermal invasion of tumor cells has been reported in SC, but a suspected lesion of this phenomenon in the present case was proved to be histiocytic infiltration by immune histochemistry using anti‐CD 68 antibody.
Histiocytoid cardiomyopathy with hypotonia in an infant
Authors: Otani Masako , Hoshida Hiroshi , Saji Tsutomu , Matsuo Norio , Kawamur Sadao
Published: December 2008

A 15 month old fernate, who had suffered from ventricular tachycardia from the prenatal period, experienced cardiac arrest at home. Once she had recovered, ventricular tachycardia occurred rttpestedly. She died 7 months after admisskm. At autopsy, the heart showed many yellowish white nodub In the endocardium. Histologically these nodules consisted of granuiar or foamy histiocyte‐like cells, which had spread to all four chambers. Electron micrographs showed mitochowlrial hyperplasia in these cells. The cells had soate myofibrils in their cytoplasm. These findings were compatible wlth histiocytoid cardiomyopathy. Interestingly, the present case showed hypotonia. Her muscle biopsy revealed decreased activity of cytochrome c oxidBsB, sug‐ting that histiocytoid cardiomyopathy is related to mitochondriat cytopathy.
Expression of CA15–3 in renal cell carcinoma
Authors: Nakarnura Toshitsugu , Hayama Masayoshi , Shirnada Makoto
Published: December 2008

CA15–3 expression was analyzed in renal cell carcinoma (RCC) from the standpoint of the histogenesis of RCC. Tissue sections from surgical specimens of 12 cases of clear cell type RCC and from autopsy specimens of eight fetal kidneys were stained by an indirect immunoperoxi‐dase method using DF‐3. All the RCC cases stained positively for CA15–3, with 10 of the 12 cases showing strong, diffuse immunoreactivity on the cell membrane. Expression of CA15–3, as well as other markers such as epithelial membrane antigen, neuron‐specific enolase, glandular cytokeratin and other lectins, suggest a more complicated histogenesis of RCC, rather than a simple proximal tubular origin.
Pyothorax‐associated lymphoma: Development of Epstein‐Barr virus‐associated lymphoma within the inflammatory cavity
Authors: Fukayama Masashi , Hayashi Yukiko , Ooba Takayo , Funata Nobuaki , Ibuka Tazuko , Koike Morio , Hebisawa Akira , Kurasawa Atuyuki , Fukayama Makiko , Nakahiro Kazuyoshi , Kudoh Shoji
Published: December 2008

Pyothorax‐associated lymphoma (PAL) is a B cell lymphoma that develops in Japanese patients with tuberculosis‐associated chronic pyothorax (TaCP). Epstein‐Barr virus (EBV) has been shown to be causally related to PAL. To clarify the developmental process of PAL, the systemic and local presence of EBV, and serum profile of anti‐EBV antibodies was investigated in TaCP. EBV genome was found in peripheral blood mononuclear cells by PCR in a 10–4‐‐10–5 amount of Raji cell‐DNA in three of four patients with TaCP, but was also identified in patients with pyothorax caused by other diseases (2/2) or without pulmonary diseases (2/6). EBERl in situ hybridization and EBNAS immunocytochemistry revealed clusters of EBV‐carrying cells in the cavity content (3/18) but not at the pyothorax wall; EBV(+) histological lymphoma cells were found in two cases and EBV(+) mononuclear cells were found in one case. A simultaneous increase in serum titers of anti‐EBV viral capsid antigen IgG and IgA antibodies was observed in TaCP (4/16). These results suggest that a local factor, an inflammatory cavity, has a pivotal role in the development of PAL, which might be reflected in the Serum titers of anti‐EBV antibodies in patients with TaCP.
Experimental granulomatous vasculitis induced by sensitization with Ascaris suum antigen in mice
Authors: Alwie Ntappiasse Lailo , Wakaki Kunihiko , Korashige Yoichi , Koizurni Fumitomo
Published: December 2008

Experimental sensitization by repeated intramuscular injection of Ascaris suum antigen (Ag‐As) supplemented with Freund's incomplete and complete adjuvants was carried out in 50 BALB/c CrSl c male mice (sensitized group) for 24 weeks, and the results were compared with those in a control group of 25 mice. At the injection sites of the sensitized group, granulomatous angiitis with eosinophil infiltration was observed in all mice, and fibrinoid angiitis in only four. By light and electron microscopic examinations pulmonary granulomatous vasculitis with a few eosinophils was observed at a high frequency (80%) after 12 experimental weeks. lmmunohistochemical examination revealed pulmonary vascular and perivascular infiltration of L3/T4 (CR4) positive cells, B cells, IgG and C3 positive cells in addition to activated macrophages, Thy‐1 T cells, IgE positive cells, and IgM positive cells after 12 experimental weeks. There were significant increases in the eosinophil cell count of the peripheral blood, the hemagglutination titers of the sheep erythrocytes, IgE and IgM antibodies to Ag‐As by ELISA and Western blotting after 8 experimental weeks. After 12 experimental weeks the lgG antibody to the Ag‐As was low, but it increased significantly, and the sera showed multiple precipitation lines to the Ag‐As by the Ouchterlony method. In conclusion, the pulmonary granulomatous vasculitis in this study is considered to consist of allergic reactions of type IV and probably type III based on type 1.
Iung cancer associated with usual interstitial pneumonia
Authors: Matsushita Hiroshi , Tanaka Sayuri , Saiki Yuriko , Hara Mitsuru , Nakata Kouichirou , Tanimura Shigeo , Banba Jirou
Published: December 2008

There were 83 cases of usual interstitial pneumonia (UIP) in 3712 consecutive autopsy cases during 1972 to 1992 in Toranomon Hospital. Primary lung cancer had arisen in 40 cases of UIP in that period. The prevalence of lung cancer (48.2%) in UIP was significantly higher than that of lung cancers (9.1%) in the age‐matched general population without UIP (P < 0.001). The prevalence of association of multiple lung cancer in UIP (20.W0) was also significantly increased. Thus, UIP showed a remarkable potency to develop lung cancers. The lung cancer cases in UIP had obvious smoking habits. Both the rates of smokers and the quantity of smoking were significantly increased in the lung cancer cases in UIP (P < 0.05). There was a distinct anatomical distribution of lung cancer in UIP. Most cancers in UIP (98%) arose in the peripheral area of the lung (P < 0.001, compared to lung cancer cases without UIP) with close relation to the honeycombing lesion. Studies on surgical specimens with small cancers showed that most tumors in UIP arose in the border area between honeycombing and the non‐fibrotic area. Thus, the front of the remodeling of the lung is suspected to be a potential field of developing lung cancer. The chronic inflammatory process resulting in the remodeling of the lung may play an important part in the development of lung cancer in UIP under the circumstance of heavy smoking.
A case of human herpesvirus‐6 lymphadenitis with infectious mononucleosis‐like syndrome
Authors: Sumiyoshi Yoshiaki , Kikuchi Masahiro , Ohshima Kohichi , Takeshita Morishige , Eizuru Yoshito , Minamishima Yoichi
Published: December 2008

The findings of a 20 year old woman with lymphadenopathy that was probably caused by an acute human herpesvirus‐6 (HHV‐6) infection are reported. She clinically demonstrated various signs of acute infection such as a high fever, skin rash, liver dysfunction, leukocytosis, an elevation of the erythrocyte sedimentation rate, and a positive change of C reactive protein, which mimicked the symptoms of infectious mononucleosis, but no positive titers for an Epstein‐Barr virus infection were observed. HHV‐6 DNA was detected using Southern blot analysis, polymerase chain reaction, and in situ hybridization in the affected node. Histologically, the lymph node showed an enlarged paracortex and infiltration of transformed lymphocytes and immunoblast‐like cells with some histiocytes and eosino‐phils. Almost all the transformed lymphocytes and immunoblasts were positive for UCHL‐1 (CD45RO), MT‐1 (CD43), and OPD‐4 (CD4), and some of these positive cells demonstrated HHV‐6 DNA.
Solitary fibrous tumor of the nasal cavity and orbit
Authors: Fukunaga Masaharu , Ushigome Shinichiro , Nomura Kouichi , Ishikawa Eisei
Published: December 2008

Solitary fibrous tumors (SFT) are rare spindle cell neoplasms generally associated with the serosal surface, especially the pleura. Two SFT are reported arising in the nasal cavity and orbit, occurring in a 33 year old female and a 21 year old male, respectively. The lesions lacked the characteristic features of other recognized neoplasms that occur in these regions. Immunohistochemically, the tumors cells were diffusely and strongly positive for vimentin and CD34 and some or many tumor cells expressed neuron‐speciflc enolase and Leu‐7. Ultrastructurally, the tumor cells showed no distinct features although they were suggested to be primitive mesenchymal or fibroblast‐like cells. Both tumors were diploid by flow cytometry. The two patients have had benign clinical courses with limited follow‐up. Our findings suggest that SFT is of mesenchymal cell origin and support another location for SFT, indicating additional evidence against mesothelial origin. SFT should be included in the differential diagnosis of spindle cell tumors arising in the nasal cavity and orbit.
Multilocular lymphoepithelial cyst in the thyroid accompanied with a minute thyroid carcinoma
Authors: Watanabe Itaru , Kobayashi Kiyoshi , Yamaguchi Masato , Kasai Morio
Published: December 2008

An aggregate (17 times 13 mm) of a few small cysts was incidentally found in the left lobe of the thyroid of a 42 year old man. The inner surface of the cysts was lined by stratified cuboidal to columnar epithelium, which showed occasional ciliation and keratinization. The cysts were densely surrounded by follicular lymphoid tissue. The lesion was designated as a multilocular lymphoepithelial cyst. Directly adjacent to the cyst‐aggregate a minute focus of papillary thyroid carcinoma (6X6 mm) existed. Tubular or papillary clusters of cancer cells were occasionally contiguous to the lining epithelium, which had penetrated through the lymphoid mantle of the cysts. Histological features of the lesion in the thyroid suggested an origin of the cysts from the developmental rest of the branchial pouch; probably from the ultimobranchial body remnant.
Ubiquitinated cytokeratin inclusions in lichen amyloidosus: An immunohistochemical analysis
Authors: Akamatsu Mayumi , Hori Sadaaki , Tsutsumi Yutaka , Osamura R. Yoshiyuki , Ohkido Muneo
Published: December 2008

Eosinophilic hyaline inclusions were consistently seen in the perinuclear cytoplasm of suprabasal keratinocytes in lichen amyiddosus. The inclusions, negative with amylold staining, were immunoreective for ubiquitin and cytokeratin, and uitrastructuraliy showed aggregations of fine filaments of two size (central thin and peripheral thick). The thin filaments were the main component in the upper epidermal layer. Four monoclonal antibodies (AE1, AE3, KL1 and CAM5.2) and om antiserum (WSS) were used for characterizing cytokeratin expression. The AE1 antibody normally stained the basal cells, but in lichen amyloidosus basal staining mostly disappeared. Instead, groups of suprabasal keratrnocytss were labeled, with AE1 ‐reactive inclusions disfributed therein. In contrast, the KL1 antibody, showing suprabasal staining, failed to react with the inclusions. The includms were weakly reactive with the AE3 and WSS antibodies, which stained all keratinocytes. The CAM5.2 antibody was unreactive. The subepidermal amyloid deposits were negative with all the antibodies. The inclusions were ubiquitinated especialty in the granular layer. Immuno‐electron microscopy disclosed that ubiquitin was more denseiy localized in the thin filaments than in the thick ones. This indicated that cytokeratin expression and metabolism are altered in the affected epidermis, and that ubiquitin functions in the process of degradation of abnormal cytokeratin filaments.
Mesothelial cyst of the adrenal gland
Authors: Fukushima Noriyoshi , Oonishi Tadahiro , Yamaguchi Kazuyoshi , Fukayama Masashi
Published: December 2008

A case of mesothelium‐lined cyst of the adrenal gland is reported. Although more than 300 adrenal cysts have been reported in the literature, epithelial cell‐lined cysts are rare and comprise only 9% of the cases. An adrenal cyst was found, the lining cells of which had features consistent with mesothelial cells. The inner surtace of the cyst was lined by a single layer of cuboidal cells, which showed alcian blue positive cellular outline. Immunohistochemically, the lining cells were positively stained for keratin, epithelial membrane antigen and CA‐125. Electron microscopic examination revealed many long complex microvilli and desmosomes in the lining cells. There was a basal lamina beneath the cell layer. These morphological and immunohistochemical findings indicated that the lining cell is derived from mesothelium.
Metanephric adenoma of the kidney
Authors: Nonomura Akitaka , Mizukami Yuji , Hasegawa Toru , Ohkawa Mitsuo , Kadoya Masumi
Published: December 2008

A case of a rare renal tumor showing characteristic histo‐logic features is presented. The patient was a 54 year old female, whose renal tumor was incidentally detected on abdominal ultrasound (US) examination. Ultrasound, computed tomography and angiography findings were consistent with a diagnosis of renal cell carcinoma of the hypovascular type. Left nephrectomy was performed. The tumor, which measured 2.6 times2.6 times 2.5 cm, was located in the left renal cortex, and had a uniformly whitish‐yellow cut surface and well‐defined margin. Histologically, the tumor was characterlzed by its monomorphous growth pattern and was composed of uniformly small cells arranged in a tubular or rosette‐like pattern. The tumor cells had scant cytoplasm and the nuclei were small, round and regular. These histo‐logic features resembled the epithelial elements of a metanephric hamartoma in the nephroblastomatosis complex in infants. However, there was no mitosis and cellular atypia was minimal, suggesting benignity. According to these his‐tologic features, the diagnosis of metanephric adenoma was made. Its clinicopathologic features are discussed.
Antigenicities of enteropathogenic Escherichia coli, lysozyme, and alpha‐l‐antichymotrypsin on macrophages of genitourinary malacoplakia
Authors: Joh Kensuke , Aizawa Shigeo , Furusato Masakuni , Shishikura Yuri , Itoh Keigo , Komiya Miyoshi , Hayashi Hirotaka
Published: December 2008

Seven cases of genito‐urinary malacoplakia were analyzed histologically, ultrastructurally and immunohistochemically in a comparison with two cases of xanthogranulomatous pyelonephritis. lmmunohistochemically, von Hansemann cells and Michaelis‐Guttmann bodies, both hallmarks for the diagnosis of malacoplakia, showed a common antigenicity for enteropathogenic Escherichia coli as cytoplasmic granules of varying sizes. These microscopic manifestations corresponded ultrastructurally to a series of phagolysosomal degradations of coliform bacilli. Serogroups against E. coli OK antigens, which were positive for malacoplakic cells, were not confined to a particular group. Macrophages of xanthogranulomatous pyelonephritis did not show the E. coli antigenicity. Antigenicity of lysozyme and alpha‐1‐antichymotrypsin on the von Hansemann cells was equivocal, but these enzymes were strongly positive on macrophages of xanthogranulomatous pyelonephritis. The macrophages of both malacoplakia and xanthogranulomatous pyelonephritis were positive for antihuman macrophage antibody. These results indicate that malacoplakia depends mainly on infection by a non‐specific strain of enteropathogenic E. coli and may arise from defective digestive enzyme activity of infiltrating macrophages. lmmunohistochemical analysis using antisera against E. coli OK antigens, lysozyme and alpha‐l‐antichymotrypsin was useful in identifying the pre‐diagnostic stage of malacoplakia and in differentiating the lesion from xanthogranulomatous pyelonephritis.
Adrenocarticotropic hormone‐independent bilateral macronodular adrenocortical hyperplasia associated with Cushing's syndrome
Authors: Irie Junji , Kawai Kioko , Shigematsu Kazuto , Suzuki Shin , Nomata Koichiro , Minami Yuzo , Kanetake Hiroshi
Published: December 2008

A case of adrenocorticotropic hormone independent bilateral adrenocortical macronodular hyperplasia (AIMAH) is reported. A 59 year old male was admitted to hospital because of hypertension. Subsequently, hypercortisolism, low plasma adrenocorticotropic hormone (ACTH), loss of diurnal rhythm of ACTH, lack of suppression with high dose dexa‐methasone were found and bilateral adrenal enlargement was detected by abdominal computerized tomography and adrenal scintlgraphy. Bilateral total adrenalectomy was performed under a diagnosis of bilateral adrenal hyperplasia associated with Cushing's syndrome. Both adrenal glands were enlarged in size and weight. Bulging nodules were found at the cut section. Microscopically, a variegated histologic pattern including trabecular, adenoid and zona glomerulosa‐like (ZG‐like) structures was revealed in the nodules. lmnunohistochemical examination disclosed positive staining of cytochrome P‐450 1701, negative of 3p‐HSD in the ZG‐like structure. Ultrastructurally, the cells composing the ZG‐like structure were similar to those of the ZG in normal adrenal cortex. The authors agree that AIMAH is one of the entiiies causing Cushing's syndrome, and advise patholo‐gists to keep this disorder in mind when they examine the adrenals in Cushing's syndrome.
Adenolipoma of the thyroid gland
Authors: Mizukami Yuji , Michigishi Takatoshi , Nonomura Akitaka , Noguchi Masakuni , Nakamura Shinobu
Published: December 2008

A rare case of adenolipoma (thyrolipoma) of the thyroid gland is reported. Previously reported cases are reviewed and the pathogenesis of this unusual thyroid lesion is discussed.