bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant peripheral nerve sheath tumor arising in benign ancient schwannoma: A case report with an immunohistochemical study
Authors: Mikami Yoshiki , Hidaka Toshimi , Akisada Takeshi , Takemoto Takuji , Irei Isao , Manabe Toshiaki
Published: March 2003

A rare example of malignant transformation in an ancient schwannoma arisng in the right side of the neck of a 51‐year‐old man without any clinical manifestations suggesting neurofibromatosis is described. The tumor, approximately 4 cm at its largest dimension, was well circumscribed and had a direct connection with the sympathetic nerve. Microscopically, the central portion of the tumor showed features of ancient schwannoma characterized by extensive hyalinization with cystic degeneration, scattered spindle cells with hyperchromatic and tapered nuclei, and some symplastic changes. However, predominantly in the outer portion, a proliferation of spindle‐shaped cells with enlarged nuclei was present. The nuclei of these cells showed irregular contours, coarse granular chromatin texture, and conspicuous nucleoli. Mitotic figures and small necrotic foci with scattered apoptotic bodies were also seen. Immunohistochemically, S‐100 protein was almost negative in areas consisting of overtly atypical cells where the mitotic index evaluated with MIB‐1 antibody was 30.5%. In contrast, S‐100‐positive bland spindle cells were scattered in an extensively hyalinized area with a labeling index less than 3%. P53 protein was strongly positive in atypical spindle cells. Although it is a very uncommon event, definite nuclear atypia, frequent mitotic figures, and the existence of small necrotic foci should be recognized as indicating a diagnosis of malignant degeneration of benign schwannoma. Immunohistochemistry would be useful as an ancillary technique in such a setting.
Solitary squamous cell papilloma of the lung in a 40‐year‐old woman with recurrent laryngeal papillomatosis
Authors: Harada Hidekazu , Miura Katsutoshi , Tsutsui Yoshihiro , Mineta Hiroyuki , Urano Makoto , Abe Masato , Kuroda Makoto , Kasahara Masao
Published: March 2003

A rare case of recurrent respiratory papillomatosis (RRP) is reported with a review of the literature. A 40‐year‐old Japanese woman had suffered from RRP since 1 year of age. She developed a pulmonary squamous papilloma with a thin‐walled cavity, which was suspected as being lung carcinoma. The trachea and bronchi around the tumor were intact, and no malignant transformation was present. Two types of human papillomavirus, 6 and 16, were detected, both in the laryngeal and pulmonary papillomas by in situ hybridization and the polymerase chain reaction method. To date, only 40 cases of juvenile laryngeal papilloma with pulmonary involvement have been reported in the English literature.
Ciliated foregut cyst of the gallbladder: A case report and review of the literature
Authors: Nam Eun Sook , Lee Hyang Im , Kim Duck‐Hwan , Choi Chul Soon , Kim Yong Bum , Kim Joo Seop , Shin Hyung Sik
Published: March 2003

A case is presented of a ciliated cyst of the gallbladder in a 36‐year‐old Korean woman which was incidentally found on ultrasonographic study. A cystic mass measuring 1.5 × 1 × 1 cm was found in the fundus of the gallbladder. The cyst was unilocular and intramural without communication to the lumen. Microscopically, the cyst wall was lined by a single layer of pseudostratified, ciliated, columnar epithelium and goblet cells with underlying smooth muscle layers. This was considered to be the cyst arising from the embryonic foregut and showing differentiation toward respiratory structures. The term ‘ciliated foregut cyst of the gallbladder’ is suggested here.
Mature teratoma of the uterine corpus with thyroid differentiation
Authors: Cappello Francesco , Barbato Francesco , Tomasino Rosa Maria
Published: March 2003

A case of a clinically silent mature teratoma of the uterine corpus is reported. A 55‐year‐old woman presented with multiple uterine leiomyomas. The discovery was incidental, because the patient was asymptomatic. Macroscopically, a colloid–hemorrhagic‐looking nodule was present. Histologic and immunohistochemical studies showed that this tumor was a small thyroid mass.

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Clinicopathological findings in patients who have undergone epilepsy surgery in the first year of life
Authors: Prayson Richard A.
Published: March 2003

Epilepsy presenting early in childhood may be associated with a neurologically devastating clinical course and have significant implications for the child's development. There are limited published data regarding the clinicopathological features of patients who have undergone epilepsy surgery in the first year of life and the role such surgery may have in reducing seizure frequency. This study retrospectively reviews the clinicopathologic features of eight patients from a tertiary care setting who underwent surgery for epilepsy in the first year of life. Eight infants, including seven males and one female, underwent surgery for epilepsy at 3–11 months of age (median 7.5 months). Age at the time of seizure onset ranged from birth to 2 months. Epileptogenic foci were localized by electroencephalographic and radiographic studies to the right side in five patients and left side in three patients. Histopathological findings in excised tissues included cortical dysplasia (n = 7), hemimegalencephaly (n = 3), and Sturge–Weber syndrome (n = 1). Dysplasia was marked by abnormalities in cortical lamination and neuronal orientation (n = 7), neuronal cytomegaly (n = 6), increased molecular layer neurons (n = 5) and balloon cells (n = 2). One patient was known to have epidermal nevus syndrome. Two patients required additional surgery for continued seizures. At last known follow up, all but one patient, who died in the postoperative period, were alive with no or decreased seizures at postoperative intervals of 3–60 months (median 13 months). Surgery can potentially ameliorate epilepsy in patients less than 1 year of age. Most of the patients in this series had cortical dysplasia as the underlying pathology of their epilepsy.
Aberrant expression of β‐catenin and mutation of exon 3 of the β‐catenin gene in renal and urothelial carcinomas
Authors: Zhu Xudong , Kanai Yae , Saito Atsushi , Kondo Yutaka , Hirohashi Setsuo
Published: March 2003

The present study attempted to clarify the significance of aberrant expression of β‐catenin protein and mutation of exon 3 of the β‐catenin gene in renal and urothelial carcinogenesis. β‐Catenin expression was examined immunohistochemically and mutation of the β‐catenin gene was analyzed by polymerase chain reaction‐single strand conformation polymorphism (SSCP) and direct sequencing. β‐Catenin immunoreactivity was observed at the cell membrane in all 30 renal cell carcinomas (RCC) examined, and no RCC showed a mobility‐shifted SSCP band. Of 46 transitional cell carcinomas (TCC) examined, there was reduced expression of β‐catenin, as compared with its expression in non‐cancerous transitional epithelium, in 22 cases (48%) and β‐catenin accumulation in the nucleus in five cases (11%). Of four renal pelvis TCC examined, point mutation of exon 3 of the β‐catenin gene at codon 45 resulting in amino acid substitution (Ser to Phe) was detected in one (25%). The incidence of reduced expression of β‐catenin correlated significantly with the growth pattern (superficial type vs invasive type) of TCC (P< 0.05). These data indicate that: (1) aberrant β‐catenin expression may be at least partly involved in urothelial carcinogenesis, but less significantly so in renal carcinogenesis, and (2) it may be associated with the progression of TCC showing invasive growth.
Mott cell tumor of the stomach with Helicobacter pylori infection
Authors: Fujiyoshi Yukio , Lnagaki Hiroshi , Tateyama Hisashi , Murase Takayuki , Eimoto Tadaaki
Published: March 2003

A plasma cell tumor of the stomach with unusual histology is reported. Macroscopically, the tumor formed two ulcers in the gastric body, and microscopic examination revealed proliferation of plasma cells producing immunoglobulin G kappa monotypic immunoglobulin, with metastatic infiltration in some perigastric lymph nodes. Most of these plasma cells had various‐sized Russell bodies in the cytoplasm; hence the tumor may be called Mott cell tumor. The Russell bodies showed a strong affinity to concanavalin A by lectin immunohistochemistry, compared with those in reactive Mott cells. In addition, Helicobacter pylori (H. pylori) infection was proved by Gimenez stain and immunohistochemistry. The mixture of some centrocyte‐like cells and presence of reactive lymph follicles with follicular colonization by tumor cells suggest that this lesion may be a variant of mucosa‐associated lymphoid tissue lymphoma in association with H. pylori infection. The patient has shown no evidence of recurrence of the tumor after 11 years of follow up.
Histologic heterogeneity and mucin phenotypic expression in early gastric cancer
Authors: Saito Atsushi , Shimoda Tadakazu , Nakanishi Yukihiro , Ochiai Atsushi , Toda Gotaro
Published: March 2003

Although the major histologic type in small gastric cancers, less than 10 mm in diameter, is differentiated‐type adenocarcinoma (D.Ca), the incidence of D.Ca and that of undifferentiated‐type adenocarcinoma (UD.Ca) is almost the same in all early gastric cancers. Histologic conversion from D.Ca to UD.Ca has been speculated, however, a detailed examination of this phenomenon has not yet been performed. Three‐hundred and 51 early gastric cancers (D.Ca, 150 (42.7%) lesions; UD.Ca, 93 (26.4%) lesions; and mixed differentiated and undifferentiated type (D&UD.Ca), 108 (30.8%) lesions; tumor size less than 10 mm in diameter; 64 lesions, more than 10 mm, 287 lesions) were examined histochemically with paradoxical concanavalin A type III and high‐iron diamine‐Alcian blue (pH 2.5), and immunohistochemically with antigastric mucin antibody. The associations between tumor size, tumor differentiation and phenotypic expression of mucin were examined. Regardless of the tumor size, mucin phenotypic expression in the mucosal lesions examined was preserved. Of 47 cancers with a gastrointestinal mucin phenotype (GIM type) or a gastric mucin phenotype (GM type) measuring less than 10 mm, 35 (74.5%) consisted of D.Ca and 12 (25.5%) of both D&UD.Ca and UD.Ca, while of 224 GIM or GM type cancers measuring more than 10 mm, 64 (28.6%) consisted of D.Ca and 160 (71.4%) of both D&UD.Ca and UD.Ca. Differences between these two groups were statistically significant (P < 0.001). Of 15 cancers with an intestinal mucin phenotype (IM type) measuring less than 10 mm, 12 (80.0%) consisted of D.Ca and three (20.0%) of both D&UD.Ca and UD.Ca, and of 50 IM type cancers measuring more than 10 mm, 35 (70.0%) consisted of D.Ca and 15 (30.0%) of both D&UD.Ca and UD.Ca. Differences between these two groups were not statistically significant. These findings suggest that small D.Ca showing gastric mucin expression may transform into UD.Ca during the progression of early gastric cancer.
Useful polyclonal antibodies against synthetic peptides corresponding to immunoglobulin light chain constant region for immunohistochemical detection of immunoglobulin light chain amyloidosis
Authors: Hoshii Yoshinobu , Setoguchi Mihoko , Iwata Takako , Ueda Junko , Cui Dan , Kawano Hiroo , Gondo Toshikazu , Takahashi Mutsuo , Ishihara Tokuhiro
Published: March 2003

For the immunohistochemical detection of immunoglobulin (Ig) light chain amyloidosis on formalin‐fixed, paraffin‐embedded tissue sections, we prepared polyclonal antibodies against synthetic peptides corresponding to positions 118–134 of Ig λ light chain and positions 116–133 of Ig κ light chain. Nineteen cases of systemic Ig λ light chain amyloidosis (Aλ amyloidosis), 10 cases of systemic Ig κ light chain amyloidosis (Aκ amyloidosis), one case of immunohistochemically unclassified systemic amyloidosis and five cases of localized Aλ amyloidosis were tested with these antibodies. Anti‐λ (118–134) antiserum and the affinity‐purified antibody both reacted with 18 of the 19 cases of systemic Aλ amyloidosis and all cases of localized Aλ amyloidosis, although the immunoexpression was somewhat variable in intensity in different areas within the same specimen in both systemic and localized amyloidosis. The signal intensities in plasma cells and serum reacted for anti‐λ (118–134) antiserum were weaker than signals obtained with commercially available anti‐Ig λ light chain antibodies. Anti‐κ (116–133) antiserum and the affinity‐purified antibody reacted with nine of the 10 cases of systemic Aκ amyloidosis. We conclude that these antibodies against synthetic peptides corresponding to the Ig light chain constant region are useful for the classification of amyloidosis on formalin‐fixed, paraffin‐embedded tissue sections.
Maturation of macrophages from peripheral blood monocytes in Kawasaki disease: Immunocytochemical and immunoelectron microscopic study
Authors: Ariga Shiro , Koga Mayumi , Takahashi Mutsuo , Ishihara Tokuhiro , Matsubara Tomoyo , Furukawa Susumu
Published: March 2003

Kawasaki disease (KD) is regarded as a cytokine‐associated disorder. Despite intensive investigation into the etiology of KD, this remains unclear, although monocytes and macrophages are thought to play an important role. We examined peripheral blood monocytes using a monoclonal antibody, PM‐2K, which recognizes mature macrophages but not monocytes. This study was conducted in 12 patients with KD, three patients with sepsis and 12 control subjects. Approximately 8% of whole peripheral blood monocytes from patients with acute KD were observed to be PM‐2K positive. Approximately 15–20% of peripheral blood CD14+ monocytes from these patients were positive for PM‐2K antibody (as determined by immunoelectron microscopy). PM‐2K‐positive monocytes had significantly fewer numbers of intracytoplasmic peroxidase‐positive granules than monocytes from control subjects. In contrast, PM‐2K‐negative monocytes from patients with acute KD had a significantly greater number of peroxidase‐positive granules in the cytoplasm than in those from controls. Monocytes from patients with sepsis displayed PM‐2K immunocytochemical staining, similar to that in monocytes from patients with KD. These results suggest that during the acute stage of KD, monocytes partly differentiate into macrophages in the peripheral circulation.
Ovarian carcinoma recurring as carcinosarcoma
Authors: Moritani Suzuko , Moriya Takuya , Kushima Ryoji , Sugihara Hiroyuki , Harada Minoru , Hattori Takanori
Published: March 2003

Malignant mixed mesodermal tumor is a rare tumor of the ovary and its histogenesis is controversial. We report the case of an ovarian tumor that seemed to be a pure carcinoma and recurred as a carcinosarcoma, and suggest a possible histogenesis for this kind of tumor. The patient was a 62‐year‐old Japanese woman. The primary tumor was confined to the right ovary and was a histologically poorly differentiated endometrioid adenocarcinoma with focal squamous differentiation. The tumor recurred as peritoneal dissemination 9 months later showing a histological appearance of carcinosarcoma of heterologous type. The recurrent tumor also contained intermingled foci of similar histology as the primary tumor. The carcinomatous component of the recurrent tumor showed more obvious differentiation to adenocarcinoma with increased expression of epithelial markers compared to the primary tumor. Epithelial membrane antigen was positive also in a few cells of the sarcomatous component, which implies that this tumor had features of metaplastic carcinoma. The DNA ploidy pattern of the primary ovarian tumor was diploid, while an additional aneuploid subpopulation appeared in the recurrent tumor. These findings suggest the possible histogenesis of carcinosarcoma of the ovary as progression and clonal evolution of endometrioid adenocarcinoma.
Prognostic significance of neuroendocrine differentiation, proliferation activity and androgen receptor expression in prostate cancer
Authors: Segawa Naoki , Mori Ichiro , Utsunomiya Hirotoshi , Nakamura Misa , Nakamura Yasushi , Shan Liang , Kakudo Kennichi , Katsuoka Yoji
Published: March 2003

Androgen, acting via the androgen receptor (AR), is associated with the development and progression of prostate cancer. Anti‐androgen therapy is widely used to manage prostate cancer. However, the conversion of the tumor from a hormone‐sensitive to a hormone‐insensitive status causes such therapy to fail. Several mechanisms have now been put forward for this conversion, including neuroendocrine (NE) differentiation of the tumor cells. In this study, we evaluated the prognostic significance of tumor‐cell proliferation activity, NE differentiation and AR expression. Formalin‐fixed, paraffin‐embedded sections were prepared from 42 patients with adenocarcinoma of the prostate. Using antibodies to AR, the Ki‐67 antigen (MIB‐1), chromogranin A and synaptophysin, immunohistochemical expression of AR, tumor proliferation activity and NE differentiation were analyzed. Our study revealed that AR expression was significantly lower in adenocarcinoma (52.2 ± 27.1%) than in non‐tumorous prostate tissue (68.3 ± 18.3%; P < 0.001). NE differentiation was found in 50% of the tumors, which was correlated with the Gleason score (P < 0.05). An univariate analysis revealed a significant correlation between progression‐free survival with both AR expression (P < 0.01) and proliferation activity (P < 0.001). NE differentiation was not a prognostic factor in this study.
Giant intracranial granular‐cell tumor arising from the abducens
Authors: Ogata Sho , Shimazaki Hideyuki , Aida Shinsuke , Miyazawa Takahito , Tamai Seiichi
Published: March 2003

We present a case of an adolescent with a giant intracranial granular‐cell tumor, who presented with diplopia and worsening visual acuity. The tumor measured 8.2 cm at the maximum diameter and occupied the right middle cranial fossa, with intrasellar and suprasellar involvement. It was composed of solid nests of oval or polygonal eosinophilic cells with a focal pseudo‐papillary configuration. Pituitary macroadenoma was suspected from examination of the intraoperative frozen section, but immunohistochemical and ultrastructural findings were consistent with granular‐cell tumor, and they suggested the origin to be the peripheral nerve sheath. Considering that abducens palsy was the first clinical manifestation, the tumor was thought to arise from abducens. From histological findings (focal cellular spindling, mitotic activity and a relatively high Ki‐67 labeling index [10.1%]) and according to Fanburg–Smith’s criteria, the tumor was suspected to have low‐grade malignant potential. Granular‐cell tumor should be included in the differential diagnosis of parasellar tumors, even in young patients or patients with large lesions. Both immunohistochemical and electron microscopic studies are essential for diagnosis.
Pigmented neurofibroma: Report of two cases and literature review
Authors: Inaba Mayumi , Yamamoto Tetsuji , Minami Rieko , Ohbayashi Chiho , Hanioka Keisuke
Published: March 2003

Two cases of pigmented neurofibroma of the skin are reported. In case 1, the tumor was removed from the back of a 55‐year‐old man with no associated neurofibromatosis. In case 2, the tumor was removed from the abdominal wall of a 21‐year‐old woman with neurofibromatosis. Both tumors consisted of benign, short spindle cells and multiple foci of scattered melanin‐laden cells. In case 1, the spindle cells were arranged in a storiform pattern, resembling features of dermatofibrosarcoma protuberans. Immunohistochemically, the spindle cells of both cases were demonstrated to be positive for S‐100 protein and CD34. The melanin‐laden cells stained positively for HMB‐45. This report describes an additional two cases of pigmented neurofibroma that conform to the new diagnostic criteria for this disease.
Bizarre parosteal osteochondromatous proliferation (Nora’s lesion) of the foot
Authors: Horiguchi Hisashi , Sakane Masataka , Matsui Miwa , Wadano Yasuyoshi
Published: March 2003

A 22‐year‐old man presented with a growing lump on the fifth metatarsal of the right foot. Radiographically, the lesion was a calcified mass stuck on to the bone. The T2‐weighted magnetic resonance images showed heterogeneity in intensity. A tumor was suspected and an excisional biopsy was done. The lesion was composed of a cartilaginous cap and bone tissue. Histological examination revealed characteristic features of bizarre parosteal osteochondromatous proliferation (BPOP), such as hypercellularity, a blue tinctorial quality in the osteocartilaginous interfaces, and a scattering of binucleated or bizarre enlarged chondrocytes. Immunohistochemically, basic fibroblast growth factor was expressed in nearly all chondrocytes within the cartilaginous cap, while vascular endothelial growth factor was expressed only in enlarged chondrocytes near the osteocartilaginous interfaces. Reverse transcription–polymerase chain reaction detected chondromodulin‐I transcripts in the tissue of the cartilaginous cap. These findings indicate that the processes occurring in BPOP are similar to those occurring in endochondral ossification in the growth plate, and they support the concept that BPOP is a reparative process. BPOP is a rare tumorous lesion of the bone and is occasionally confused with other benign or malignant conditions. Thus, it is important to consider the clinical, radiographical and the gross histological features of the lesion when making a diagnosis.
Leydig cell tumor of the testis: Comparison of histopathological and immunohistochemical features of three azoospermic cases and one malignant case
Authors: Hekimgil Mine , Altay Barış , Yakut Başak Doˇganavşargil , Soydan Saliha , Özyurt Ceyhun , Killi Refik
Published: March 2003

Leydig cell tumors of the testis are rare, mostly presenting as a testicular mass or as endocrinological symptoms. Here, three patients who were admitted for investigation of primary infertility and one patient presenting with a testicular mass are reported. The histological features were reviewed and an immunohistochemical study was done using a panel of antibodies against cytokeratin, vimentin, inhibin A, S‐100, Ki‐67, follicle‐stimulating hormone, luteinizing hormone, prolactin, p53, bcl‐2, and c‐erbB2. The latter case (lost during follow up of metastatic disease) demonstrated massive tumor necrosis, extension through the tunica albuginea, and a high mitotic activity and MIB‐1 score. Only this malignant case was bcl‐2 positive. Of the two oncogenic markers studied, none of the cases were positive for c‐erb2, while p53 was positive in more than 50% of cells in the malignant case and in one case of infertility with a large tumor, hemorrhage, focal necrosis and atypical cytological features. We recommend the evaluation of infertile men for Leydig cell tumors, and we believe that a panel of antibodies, including Ki‐67, p53 and bcl‐2, used for immunohistochemical analysis could be of diagnostic value in the identification of malignant and borderline cases of Leydig cell tumor.
Histo‐topographic distribution of acute inflammation of the human umbilical cord
Authors: Kim Chong Jai , Yoon Bo Hyun , Kim Miha , Park Jung Ok , Cho So Young , Chi Je G.
Published: March 2003

Acute inflammation of the umbilical cord, acute funisitis, is a sign of fetal inflammatory response, and the clinicopathological need for its identification is increasing. This study was conducted in order to describe the topographic distribution of acute funisitis, and thereby to provide more information on the intrinsic nature of acute funisitis and find a better way of pathologically examining the umbilical cord. A total of 10 umbilical cords affected by acute funisitis were histopathologically examined throughout their entire lengths at 1 mm intervals. Pathological examination was done to characterize the extent of the funisitis, the involvement of the vein (phlebitis) or of one or both arteries (arteritis), and the presence of inflammation in Wharton's jelly. Umbilical cord plasma interleukin (IL)‐6 was measured by specific immunoassay to assess whether or not the severity of acute funisitis correlates with fetal cytokine response. It would appear that the inflammatory reaction begins as a discrete, multifocal process which eventually becomes contiguous as the inflammatory reaction proceeds. Umbilical cord plasma IL‐6 concentrations tended to correlate with the extent of umbilical cord inflammation. The initial phase of acute funisitis involves discrete and multiple foci along the length of the umbilical cord. Moreover, the extent of acute funisitis reflects the severity of systemic fetal cytokine response. Therefore, adequate sampling using multiple sections would facilitate the identification of acute funisitis. We propose a standard sampling procedure taking one section from each third of the umbilical cord.
Pleomorphic adenoma of the parotid gland with extensive bone formation
Authors: Shigeishi Hideo , Hayashi Ken , Takata Takashi , Kuniyasu Hiroki , Ishikawa Takenori , Yasui Wataru
Published: March 2003

We report an unusual case of pleomorphic adenoma with extensive bone formation, occurring in the parotid gland of a 58‐year‐old Japanese man. The tumor was a well‐circumscribed mass that measured 20 × 20 × 15 mm and contained extensive bone formation. Histologically, most of the tumor was composed of bone and chondroid tissues. The bone formation with a marrow‐like structure occupied half the volume of the tumor. The chondroid tissues merged continuously into bone tissues. The bone tissue seemed to be formed within areas of chondral tissue by a process of enchondral ossification. Except for the unusual amount of large bone formation, the tumor showed histology of pleomorphic adenoma, particularly at the periphery of the tumor. These histological findings suggest the possibility of extensive enchondral ossification in pleomorphic adenoma.
Primary neuroendocrine carcinoma of the liver: An autopsy case
Authors: Kaya Gürkan , Pasche Christophe , Osterheld Maria‐Chiara , Chaubert Pascal , Fontolliet Charlotte
Published: March 2003

An autopsy case of primary hepatic neuroendocrine carcinoma is described. A 72‐year‐old man had a large tumor mass measuring 22 cm in its greatest diameter and localized to the right, left and caudal lobes of the non‐cirrhotic liver. Microscopically, the tumor was composed of middle‐sized pleomorphic cells organized in ribbons or trabeculae, with scanty intersecting fibrous septae. Immunohistochemically, the tumor cells were positive for multikeratin C11, chromogranin A and synaptophysin. The patient also had metastases in the bone marrow. No alternative primary source of endocrine tumor was detected. The patient died 4 days after presentation.
Histological study of PIVKA‐II expression in hepatocellular carcinoma and adenomatous hyperplasia
Authors: Miskad Upik Anderiani , Yano Yoshihiko , Nakaji Miyuki , Kishi Shinji , Itoh Hiroshi , Kim Soo Ryang , Ku Yonson , Kuroda Yoshikazu , Hayashi Yoshitake
Published: March 2003

Although serum concentration of protein induced vitamin K absence or antagonist II (PIVKA‐II) has been widely used for diagnosing hepatocellular carcinoma (HCC), little information is available concerning tissue PIVKA‐II as an immunohistochemical marker for liver histology. In this study, we examined the expression of PIVKA‐II in precancerous nodules (adenomatous hyperplasia) and various differentiation grades of HCC by immunohistochemical study using the monoclonal anti‐PIVKA‐II antibody (MU‐3). We examined the relationship between tissue PIVKA‐II staining and serum PIVKA‐II level, tumor histology and tumor size. PIVKA‐II was mainly detected in the cytoplasm of the HCC cells. The positive rates of PIVKA‐II were as follows: adenomatous hyperplasia (AH), 0% (0/9); well‐differentiated HCC, 65% (15/23); moderately differentiated HCC, 85% (22/26); poorly differentiated HCC, 54% (7/13). The expression of tissue PIVKA‐II staining in moderately differentiated HCC was significantly higher than in well‐ or poorly differentiated HCC, whereas the serum PIVKA‐II level in poorly differentiated HCC was higher than well‐ or moderately differentiated HCC. There was no relationship between the expression of PIVKA‐II in cancer tissues and serum levels of PIVKA‐II. Immunohistochemical studies revealed that PIVKA‐II was expressed even in small‐sized or well‐differentiated HCC cells, but expression was not detected in AH. It was concluded that PIVKA‐II is a useful immunohistochemical marker, even in small‐sized or well‐differentiated HCC.
CD97, CD95 and Fas‐L clearly discriminate between chronic pancreatitis and pancreatic ductal adenocarcinoma in perioperative evaluation of cryocut sections
Authors: Boltze Carsten , Schneider‐Stock Regine , Aust Gabi , Marwin Christian , Dralle Henning , Roessner Albert , Hoang‐Vu Cuong
Published: March 2003

It is a major problem to distinguish between pancreatitis and pancreatic adenocarcinoma when it comes to the perioperative evaluation of pancreatic cryocut sections. In this respect, pathologists are showing a steadily growing interest in the potential application of apoptotic and dedifferentiation factors as diagnostic and prognostic markers. This study investigated the mRNA and protein expression of CD97, CD95 and Fas‐L in snap‐frozen material obtained from human pancreatic ductal adenocarcinomas (PDC; n = 50), tissues from pancreatitis (PT; n = 40) and normal pancreatic tissues (PN; n = 36). Reverse transcription–polymerase chain reaction (RT–PCR) analysis revealed that CD97, CD95 and Fas‐L mRNA were expressed on a similarly high level in all tissues. In contrast, short time immunohistochemical evaluation showed that the CD95 protein was strongly expressed in PT and PN, but not in PDC. Fas‐L protein was expressed strongly in PDC, whereas only weak or no expression was noted in PT or PN. CD97 protein expression was detected only in PT and in poorly differentiated PDC. Our data demonstrate that CD97, CD95 and Fas‐L can be used as additional markers to distinguish between pancreatitis and pancreatic duct cell carcinoma in cryocut sections.
Esophageal basaloid carcinoma with marked myoepithelial differentiation
Authors: Hishida Tomoyuki , Nakanishi Yukihiro , Shimoda Tadakazu , Igaki Hiroyasu , Tachimori Yuji , Kato Hoichi , Yamaguchi Hajime , Iinuma Gen
Published: March 2003

A case of esophageal basaloid carcinoma with marked myoepithelial differentiation in a 60‐year‐old man is reported. The tumor arose as an exophytic mass, measuring 65 × 60 mm, in the middle thoracic esophagus. Approximately two‐thirds of the tumor surface was covered with non‐cancerous esophageal epithelium. The depth of tumor invasion was limited to the submucosal layer. Histologically, about 70% of the tumor contained a typical basaloid carcinoma component and about 30% contained glandular and intercalated duct‐like components with distinct epithelial and myoepithelial differentiation. The tumor presented no component of distinct squamous cell carcinoma, but a small portion of cribriform‐like structure, which is typical of adenoid cystic carcinoma, was visible. The inner epithelium composing the intercalated duct‐like structure showed immunohistochemical positivity for cytokeratin 14, and the outer epithelium lining adjacent to the stroma showed positivity for α‐smooth muscle actin. These findings supported epithelial/myoepithelial differentiation. To our knowledge, our case is the first patient with an esophageal basaloid carcinoma showing marked myoepithelial differentiation.
Stromal sarcoma of the breast with leiomyosarcomatous pattern
Authors: Kusama Ritsu , Fujimori Minoru , Hama Yoshihisa , Shingu Kiyoshi , Ito Ken‐ichi , Mochizuki Yasuhiro , Yamanda Ken , Matsuyama Ikuo , Tsuchiya Shin‐ichi , Amano Jun
Published: March 2003

We report an unusual case of stromal sarcoma of the breast with leiomyosarcomatous pattern, which recurred locally and was finally treated by radical mastectomy. The tumor was composed of pleomorphic and hyperchromatic spindle‐shaped cells arranged in an interdigitating fascicle. The nuclei were of moderate to severe atypia. An average of 10 mitoses per 10 high‐power fields was seen. Immunohistochemically, the stromal cells were positive for vimentin and α‐smooth muscle actin, but negative for S‐100 protein, cytokeratin and desmin. The average Ki‐67 (MIB1) labeling index in the stromal cells was 34%. Electron microscopic evaluation revealed further evidence of smooth muscle differentiation; stromal cells had frequently indented nuclei, well‐developed rough endoplasmic reticulum, thin basal lamina and dense patch‐like structures within the cytoplasm. Analysis of previous literature on 17 cases reveals mitotic activity of the tumor seemingly of little prognostic value. This case indicated difficulty in diagnosing leiomyosarcoma. The risk of local recurrence remains even if the surgical margin is free of tumor cells.
Peritoneal melanosis combined with serous cystadenoma of the ovary: A case report and literature review
Authors: Kim Na Rae , Suh Yeon‐Lim , Song Sang Yong , Ahn Geunghwan
Published: March 2003

Benign peritoneal melanosis is extremely rare and traditionally occurs in association with ovarian dermoid cysts, but rarely with peritoneal cyst, enteric duplication cyst or gastric triplication. The pathogenesis of peritoneal melanosis, in particular, the origin of the pigment‐producing cells is unclear. We describe a case of peritoneal melanosis that was associated with ovarian serous cystadenoma in a young woman. Ovarian serous cystadenoma has not been previously described as a combined lesion of peritoneal melanosis. Based on the extremely rare incidence of this lesion and heterogeneous combined lesions, the possibility of an incidentally found, coexisting lesion couldn’t be excluded. Here, we suggest that peritoneal mesothelial cells pinched off during the developmental period might be a source of pigment‐producing cells.
Detection of microcystins from cyanobacterial water blooms in Thailand fresh water
Authors: Mahakhant Aparat , Sano Tomoharu , Ratanachot Pannarat , Tong‐a‐ram Taksawan , Srivastava Vishal C. , Watanabe Makoto M. , Kaya Kunimitsu
Published: March 2003

Microcystin content and composition in water blooms collected from two reservoirs and a pond in Thailand were investigated. The dominant species in the water blooms were Microcystis aeruginosa Pleurocapsalean filamentous cyanobacterium. The water blooms contained 0.7–0.8 mg microcystin/g dried sample. This is the first identification of microcystin from Pleurocapsalean filamentous cyanobacterium. The major microcystins in the water blooms were microcystin ‐RR, ‐LR and their (Z) forms as geometrical isomers. Microcystin ‐YR, ‐LA, ‐ThtyrR and ‐AR were also detected as minor variants. A novel variant, L‐2‐amino‐N‐butyric acid‐containing microcystin (microcystin ‐lBu), was identified from water blooms in a pond in Bangkok.
Microcystin production of Microcystis viridis (cyanobacteria) under different culture conditions
Authors: Song Lirong , Sano Tomoharu , Li Renhui , Watanabe Makoto M. , Liu Yongding , Kaya Kunimitsu
Published: March 2003

Toxic cyanobacterium Microcystis viridis was isolated from the eutrophic Dianchi Lake of south‐western China. Three microcystins were detected from this strain by high‐pressure liquid chromatography. Among them, [Dha7] microcystin‐RR is the major component and represents about 70–80% of the total toxins of this strain. We examined its microcystin production pattern in relation to culture conditions such as light intensity, nutrition, temperature, pH and growth phase. Of all the factors examined, light intensity and pH influenced the toxin production much more than other factors. At 25°C, a high production of [Dha7] microcystin‐RR was obtained at light intensity 15 μE s‐1 m2, and both low and high pH (pH 7.0 and pH 9.2) enhanced the yield of microcystin‐RR. No strong relationships were found between total toxin and temperature ranging from 15°C. The highest production of total toxins was measured in the mid‐exponential growth phase and lowest production towards the declining growth phase. Remarkable changes in toxin production and morphology emerged coincidentally following the transfer of nitrogen‐deficient cells into fresh MA medium during the time course. These findings may shed light on the correlation between toxin production and morphogenesis of this strain.
Variations in the toxicity of Microcystis species to Moina macrocopa
Authors: Yasuno Masayuki , Sugaya Yoshio , Kaya Kunimitsu , Watanabe Makoto M.
Published: March 2003

The toxins of 23 strains of Microcystis spp. were analyzed and the toxicity of these strains to Moina macrocopa was tested. There were great variations among strains in the amounts of microcystins. Most strains contained toxins and only five out of 23 strains contained no toxins. However, eight strains did not kill any M. macrocopa individuals over 7 days. Conversely, strains containing a large amount of microcystin exhibited very strong toxicity against M. macrocopa, killing 50% after 6 h of exposure. However, the microcystins themselves do not seem to be a major lethal factor against cladocerans. Some strains were not lethal to M. macrocopa, although they contained a quite high concentration of microcystins suggesting the presence of a co‐agent acting together with microcystin. Non‐toxic strains of Microcystis showed variations in their effects on M. macrocopa growth. Microcystis elabens, which does not contain microcystins, was slightly toxic to M. macrocopa. Moina macrocopa starved to death when offered Microcystis holsatica, suggesting that the cla‐doceran might avoid this blue‐green alga.
Chaetoceros phuketensissp. nov. (Bacillariophyceae): a new species from the Andaman Sea
Authors: Rines J. E. B. , Boonruang P. , Theriot E. C.
Published: March 2003

Over 400 species of Chaetoceros Ehrenberg have been described since the genus was created in 1844, making this one of the most species‐rich genera of marine planktonic diatoms. Although Chaetoceros is cosmopolitan in distribution, the temperate north Atlantic taxa are best known. Examination of material from tropical seas suggests that there are numerous Chaetoceros endemic to these biogeographic regions, which await formal description. Chaetoceros phuketen‐sis sp. nov. is described from the Andaman Sea, in the tropical Indian Ocean. It possesses several unusual morphological characteristics not found in temperate taxa, including multiple central processes on terminal valves, vermiform chloroplasts and large size. It is most similar to Chaetoceros buceros Karsten and Chaetoceros bermejensis Hernàndez‐Becerril, which also inhabit tropical seas. These taxa are not easily accommodated in the traditional classification scheme, which was based on turn‐of‐the‐century knowledge of north Atlantic taxa. Approaches for classifying these unusual species include modifications of the extant scheme and creation of a new scheme based on phylogenetic principles.
Evidence for neutrophil activation in occupational asthma
Authors: Jung Ki‐Suck , Park Hae‐Sim
Published: March 2003

In order to evaluate the role of neutrophils in the pathogenesis of occupational asthma (OA), 15 toluene diisocyanate (TDI)‐asthma and six grain dust‐asthma patients were recruited. Controls were the same number of subjects showing negative bronchoprovocation test (BPT) and six house dust mite‐sensitive asthma. Bronchoscopic biopsy specimens were stained with monoclonal antibodies to mast cell (AA1), eosinophil (EG2), pan T cell (CD3) and neutrophil (NE). Serum neutrophil chemotactic activity (NCA) was measured before and 10–420 min after BPT. Sputum interleukin‐8 (IL‐8) and myeloperoxidase (MPO) were also measured. There was a significant increase of NE+ cells as well as AA1+ and EG2+ cells in grain dust‐ and TDI‐asthma compared with house dust‐sensitive asthma (P < 0.05). Neutrophil+ cells and AA1+ cells showed a significant correlation in TDI‐asthma (r = 0.73, P = 0.02). Serum NCA was significantly increased at 10 min after BPT and decreased at 60 min in subjects with TDI‐asthma. In grain dust‐asthma, serum NCA increased at 30 min and decreased at 240 min after BPT (P < 0.05). Sputum IL‐8 and MPO were significantly increased after BPT in both TDI‐ and grain dust‐asthma (P < 0.05). These findings suggested that neutrophils in the lungs might contribute to bronchoconstriction induced by either TDI or grain dust. The possible involvement of IL‐8 in activation of neutrophils was also suggested.
Suppressive effect of saprogrelate hydrochloride on Raynaud’s phenomenon and respiratory failure in patients with systemic sclerosis
Authors: Kato Shiro , Kishiro Izumi , Ohnuma Noboru , Takasaki Keiji , Okamoto Shingo , Nakamoto Takaaki , Kaneko Noboru , Kumamoto Hidero
Published: March 2003

Objective:

In seven patients with systemic sclerosis (SS), we evaluated the clinical effectiveness of oral administration of saprogrelate hydrochloride (SH: 300 mg/day) for 2 months on Raynaud’s phenomenon (RP) and respiratory failure estimated by Hugh‐Jones classification.

Methodology:

We evaluated laboratory data (arterial blood gas (pH, PaO2 and PaCO2), pulmonary function tests (%VC, FEV1/FVC and %DLco), mean pulmonary arterial pressure (mPAP), white blood cell count, C‐reactive protein and the plasma levels of fibrinopeptide A (FPA), β‐thrombogloblin (β‐TG), platelet factor 4 (PF4) and thrombomodulin (TM)) before and after SH administration.

Results:

The frequency and duration of RP, as well as the coldness, numbness and pain of RP were significantly decreased after SH administration (P < 0.05, P < 0.01 and P < 0.001). Respiratory failure estimated by Hugh‐Jones classification was also significantly decreased after SH administration (P < 0.05), and the %DLco was significantly increased (P < 0.01). The mPAP decreased significantly after SH administration (P < 0.05). Plasma FPA, β‐TG and PF4 significantly decreased after administration (P < 0.05 and P < 0.01).

Conclusions:

SH therapy could prevent RP and respiratory failure in patients with SS.
Adenovirus vector‐mediated transfer of 9 kDa granulysin induces DNA fragmentation in HuD antigen‐expressing small cell lung cancer murine model cells
Authors: SEKIYA MITSUAKI , OHWADA AKIHIKO , KATAE MASAHARU , DAMBARA TAKASHI , NAGAOKA ISAO , FUKUCHI YOSHINOSUKE
Published: March 2003

Objective: Granulysin is a tumoricidal molecule secreted by cytotoxic T cells (CTL) and natural killer (NK) cells, that induces apoptotic cell death in tumour cells. It has been demonstrated that small cell lung cancer (SCLC) cell lines are susceptible to NK cells and lymphokine activated killer (LAK) cells, and HuD antigen is assumed to be a target molecule on SCLC cells for host cellular immunity.

Methodology: In order to understand the mechanism of sensitivity of SCLC to cellular immunity, we evaluated granulysin‐induced apoptosis using mouse adenocarcinoma Colon 26 (Colon 26/HuD) cells transfected with the 9 kDa active form of granulysin using an adenovirus vector as a murine model of SCLC cells.

Results: Adenovirus vector‐mediated transfer of 9 kDa granulysin increased DNA fragmentation
in Colon 26/HuD cells 2.5‐fold and suppressed Colon 26/HuD proliferation by 21%
on day 3 (P < 0.05 for each value) compared with the control adenovirus vector transfer. In contrast, adenovirus vector‐mediated transfer of 9 kDa granulysin did not increase DNA fragmentation nor suppress the proliferation of Colon 26 parent cells.

Conclusions: The sensitivity of HuD‐expressing tumour cells to granulysin is likely to partially explain the susceptibility of SCLC to cell‐mediated immunity.
Increased circulating levels of soluble Fas ligand are correlated with disease activity in patients with fibrosing lung diseases
Authors: KUWANO KAZUYOSHI , MAEYAMA TAKASHIGE , INOSHIMA ICHIRO , NINOMIYA KIYOSHI , HAGIMOTO NAOKI , YOSHIMI MICHIHIRO , FUJITA MASAKI , NAKAMURA NORIO , SHIRAKAWA KAMON , HARA NOBUYUKI
Published: March 2003

Objective: The Fas–Fas ligand (FasL) pathway is one of the important apoptosis‐signalling molecule systems. We previously determined that this pathway may be involved in the pathogenesis of fibrosing lung diseases. In the present study, we evaluated the clinical significance of the levels of soluble forms of Fas (sFas) and FasL (sFasL) in serum from patients with fibrosing lung diseases.

Methodology: We measured sFas, sFasL, KL‐6 (a measure of alveolar type II cell damage), surfactant protein D (SP‐D), and surfactant protein A (SP‐A) levels in serum from 35 patients with idiopathic pulmonary fibrosis (IPF), 17 patients with interstitial pneumonia associated with collagen vascular diseases (CVD‐IP), and 13 normal healthy controls using enzyme‐linked immunosorbent assays (ELISA).

Results: The serum levels of sFasL were significantly increased in patients with active IPF and CVD‐IP, compared with those with inactive disease and controls. There was no significant difference in sFasL levels between patients with inactive disease and controls. Serum sFasL levels were significantly correlated with lactate dehydrogenase and KL‐6 levels in IPF. The decrease in sFasL levels following corticosteroid therapy was not correlated with the clinical course of IPF. There was no significant difference in serum sFas levels between IPF or CVD‐IP patients and controls.

Conclusions: Although further studies need to be performed on a large number of patients with histologically proven IPF or CVD‐IP, it would seem that serum sFasL levels may reflect the activity of IPF and CVD‐IP.
Are you busy for the next 5 years? Recruitment in the Childhood Asthma Prevention Study (CAPS)
Authors: MIHRSHAHI SEEMA , VUKASIN NICOLA , FORBES SAMANTHA , WAINWRIGHT CRAIG , KRAUSE WILLIAM , AMPON ROSARIO , MELLIS CRAIG , MARKS GUY , PEAT JENNIFER
Published: March 2003

Objective: The process of recruitment into randomized controlled trials is not often reported. In the present paper, the methods used for recruitment into the Childhood Asthma Prevention Study are reported and the reasons why eligible subjects chose not to participate or withdrew from the trial are examined.

Methodology: Recruitment was conducted at the antenatal clinics of six hospitals in Sydney (NSW, Australia). Pregnant women with a family history of asthma who consented to participate were randomized into one of four groups and were asked to follow a set of interventions. The study will continue until the infants are 5 years old.

Results: Of 7171 women screened, 2095 (29.2%) were eligible, of whom only 616 (29.4% of eligible women) were recruited. The main reasons for not taking part in the study were a lack of interest, ineligibility (on further questioning), inability to be contacted and ‘too busy’. During the first 21/2 years of the trial, 10% of participants withdrew. The most common reasons for withdrawal from the study were loss of contact, family moving interstate or overseas and medical reasons. In families that withdrew from the trial or who were eligible but did not participate, the parents were significantly younger, mothers were less educated and fathers were less likely to be in full‐time employment.

Conclusions: By collecting demographic data on people who withdrew from the study and chose not to participate, we gained a better understanding of why our recruitment rate was low. The preferential recruitment of some sectors of the community has important implications for the ways in which future studies will be planned.