bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation and distortion of podocytes in rat remnant kidney
Authors: Shimojo Hisashi
Published: December 2008

A sequence of alterations of podocytes as well as the development of glomerulosclerosis was analyzed in a five‐sixths nephrectomy rat model. Morphometric measurements showed a gradual enlargement in glomerular size without any increase In the number of podocytes in the glomerulus. Structural changes of podocytes appeared as early as 4 weeks after operation, and increased their degree and extent with time. In electron microscopic studies, changes of podocytes In the early stage consisted of foot process stretching and thinning, and cell body attenuation accompanied by pseudocyst formation. As weeks passed, these changes became prominent and were occasionally associated with podocyte detachment from the glomerular basement membrane followed by tuft adhesion and the development of segmental sclerosis. In parallel to the structural changes, Immunohistochemical staining demonstrated a marked Increase of desmin expression in the glomerulus with Intense staining in podocytes. Podocyte alterations were Identified as an adaptation to the enlargement of the glomerulus and, consequently, the podocytes seemed to fail to adapt to the structural changes of the glomerulus. The present study supports the hypothesis that podocyte defects are responsible for both the Initiation and progression of glomerular damage. Furthermore, the findings may provide the hypothesis that the native disposition of podocytes in the glomerulus participates In the development of glomerular lesions in a focal and segmental fashion.
Cartilaginous membranocystic lesions mimicking membranous lipodystrophy of bone
Authors: Okada Kyoji , Hoshi Naoto , Kawamura Koichi , Yamada Shin
Published: December 2008

Two cases are presented in which membranocystic lesions were observed in the cartilaginous tissue of surgical specimens. In both cases, the histological and ultrastructural features were reviewed, and S‐100 protein distribution was examined immunohistochemlcally in one case. In both cases, the membranocystic lesions were observed to be adjacent to ballooned chondrocytes. In one case, several chondrocytes showed partially membranocystic lesions in their cytoplasm. The chondrocytes and nuclei in membranocystic lesions were stained positively for S‐100 protein. It is suggested that the membranocystic lesions in the cartilaginous tissue were associated with the degeneration of the chondrocytes.
Isolated intracranial Rosai—Dorfman disease: Case report and literature review
Authors: Huang Hsuan‐Ying , Huang Chao‐Cheng , Lui Cheun‐Chung , Chen Han‐Jung , Chen Wei‐Jen
Published: December 2008

Rosai‐Dorfman disease, first described in 1969, is a rare Idiopathic histioprollferative disease affecting the lymph nodes. Typical clinical features Include bilateral painless lymphadenopathy, fever and polyclonal hypergammaglobu‐linemla. In approximately 43% of cases, extranodal sites may be Involved and occasionally represent the initial or sole manifestation of the disease. Central nervous system manifestations are exceedingly rare, and only 17 cases have been recorded, among which there are merely seven Isolated Intracranial cases without concurrent nodal or other extranodal Involvement. Herein, we report a 38‐year‐old male presenting with generalized tonic‐clonic seizure and radiological findings indicative of meningioma. Complete physical examinations and laboratory surveys demonstrate the absence of involvement at other body sites. Microscopically, the lesion consists of proliferative histiocytes exhibiting emperipolesis coupled with the characteristic cytoplasmic staining against S‐100 protein. The differential diagnosis of polymorphic Inflammatory meningioma‐mimicking masses is discussed, and a review of previously reported intracranial Rosai‐Dorfman disease is presented.
Diffuse biliary tract involvement mimicking primary sclerosing cholangitis in an experimental model of chronic graft‐versus‐host disease in mice
Authors: NONOMURA AKITAKA , KONO NAOKO , MINATO HIROSHI , NAKANUMA YASUNI
Published: December 2008

Experimental graft‐versushost disease (GVHD) across minor histocompatibility antigens was developed by injecting spleen and bone marrow cells (9:1) of congenic B10.D2 mice into sublethally Irradiated BALB/c mice, and the histologic features of the Iiver were studied for up to 14 months after transplantation. Both intrahepatic and extrahepatic bile ducts were severely involved in the GVHD process and showed features of non‐suppurative cholangitis. Inflammatory cells, mainly lymphocytes, abutted the bile ducts and Infiltrated Into the duct eplthellal layer together with a variety of degenerative changes in the epithelial cells. The peak Inflammatory activity occurred about 2–3 weeks after transplantation. Thereafter, the inflammatory cell Infiltration around the bile ducts and In the bile duct epithelial layer gradually became reduced in severity, although the infiltration persisted during the entire 14 month observation period. Periductal and duct wall fibroplasia began about 1 week after transplantation and gradually progressed. After 2–3 months post‐transplantation, distinct ductal and periductal fibrosis of both intrahepatic and extrahepatic blle ducts was observed. This histologic feature resembled that of primary sclerosing cholangitis (PSC). These results suggest that PSC lesions might develop as a result of chronic cellular Immunologic mechanisms In GVHD across minor histocompatibility barriers.
Further study of hepatitis C virus RNA detection in formalin‐fixed, paraffin‐embedded liver tissues by ligation‐dependent polymerase chain reaction
Authors: MIYAUCHI LKUO , MORIYAMA MITSUHIKO , ZHANG DAVID Y. , ABE KENJI
Published: December 2008

Ligation‐dependent polymerase chain reaction (LPPCR) Is a novel, simple and sensitive PCR assay that could be useful for the molecular diagnosis of various viral infections. This assay uses two capture probes for RNA isolation and two hemiprobes for the subsequent PCR. To investigate its usefulness, In the field of pathological diagnosis, further study of this new PCR technology to detect hepatitis C virus (HCV) RNA was carried out in formalin‐fixed, paraffin embedded (FFPE) liver tissues and the results compared with those obtained by the reverse transcription (RT)‐PCR method. We analyzed routinely processed FFPE liver specimens of surgical origin from 13 anti‐HCV‐seropositive Japanese patients with hepatocellular carcinoma (HCC). As a result, HCV‐RNA was detected In FFPE liver specimens In 12 of the tested patients (92.3%) by the LDPCR method without the use of reverse transcription. In contrast, HCV‐RNA was detectable In eight out of 13 cases (61.5%) by the RT‐PCR method. These results indicated that LD‐PCR was useful for HCV‐RNA detection in routinely processed FFPE liver specimens.
Immunohistochemical studies on expression of human vascular smooth muscle myosin heavy chain isoforms in normal mammary glands, benign mammary disorders and mammary carcinomas
Authors: OHYABU LKUYA , TAKASAKI TAKASHI , AKIBA SUMINORI , NOMUM SATORU , ENOKIZONO NOBUMASA , SAGARA YOSHIATSU , HIROL JUNKO , NAGAI RYOZO , YOSHIDA HIROKI
Published: December 2008

The expression of myosin in normal and diseased mammary glands of 199 Japanese women was evaluated immuno‐histochemically by the avidin‐biotin peroxldase complex method using antibodies to three human smooth muscle myosin heavy chain isoforms derived from the vascular smooth muscle: myosin SM1 is expressed consistently from fetal stage to adulthood, myosin SM2 appears only in well‐differentiated smooth muscle after birth, and myosin SMemb is more abundant in embryonic aortas. SM1 was expressed in myoepithelial cells of normal mammary glands and fibrocystic diseases and in myoepithelial‐like tumor cells In the basal layer of fibroadenomas and phyllodes tumors. SM2 was expressed only In the myoeplthelial cells of mammary glands in breastfeeding women. SMemb was expressed more Intensely In the cytoplasm of luminal epithelial cells in larger fibroadenomas (P<0.01), or In the cytoplasm of carcinoma cells In lnvaslve ductal carcinomas with metastasized lymph nodes (P<0.001) and In those of higher histological grade (P<0.0001). Multivariate logistic analysis showed a significant correlation only between the expression of SMemb and histological grade (P<0.0001), which is a prognostic factor of mammary carcinomas. These findings suggested the possible prognostic value of SMemb.
Effect of prolonged staining with hematoxylin on detectingHelicobacter pyiori inhematoxylin‐eosin‐stained gastric mucosa
Authors: TAZAWA KENICHI , TSUTSUMI YUTAKA
Published: December 2008

Helicohacter pylorl (H. pylorl) Is ldentlflable in hematoxyiin‐eosin (HE)‐stalned preparations, particuularly under a prolonged hematoxylln staining condition. The stalnlng intensity ofH. pyloribodies was Increased when the hemetoxylln stalnlng period was doubled from 5 min, the routine period of Meyer's hematoxyiin stalnlng, to 10 min. The stalning intenstty of the background eplthellal nuclei was only mildly increased. Hematoxylin‐eosin staining employing a prolonged hematoxylin staining period gave detedablllty ofH. pyloricomparable to May‐Glemsa and lmmunoperoxldase staining. The modified HE method is thus Very useful and practical for identifyingH. pyloriin routine gastric biopsy specimens.
Basaloid‐squamous cell carcinoma of the oral mucosa: Report of two cases and study of the proliferative activity
Authors: ABIKO YOSHIHIRO , MURAMATSU TAKASHI , TANAKA YOUICHI , OHUCHI TOMOYUKI , SATOH MASAAKI , OKUMURA KAZUHIKO , SHIBATA TOSHIYUKI , LNOUE TAKASHI , KANAZAWA MASAAKI , ARISUE MAKOTO , SHIMONO MASAKI , KAKU TOHRU
Published: December 2008

Two cases of basalold‐squamous cell carcinoma (BSC) of the oral mucosa are described. The first case occurred at the floor of the mouth in a 58‐year‐old man, and the second case occurred at the mandibular gingiva in a 79‐year‐old woman. The laboratory data of the first case showed a positive response to hepatitis C virus antibody. in the first case, the tumor mass measured 4 times 4 cm in size, and was i‐texl at the lingual side of the median mandible beside the sublingual gland. In the second case, the tumor mass measured 25 times 15 mm In size, and was located in the alveolar mucosa of the right mandible. Histologically, both tumors showed a neoplastic epithelium arranged in a solid pattern with evidence of peripheral palisading, central necrosis, and some squamous differentiation. The pro‐ilferathfe activities of the BSC were compared with conventional squamous cell carcinomas (SCC) in the oral floor and gingiva, respectively, by employing a sensitive argy‐rophillc nuclear organizer region (AgNOR) staining method. The number of AgNOR per nucleus of the BSC was higher than that of any other SCC cases. The results support the opinion that BSC of the oral mucosa has a worse prognosis than conventional SCC.
Macrofollicular variant of papillary thyroid carcinoma
Authors: NAKAMURA TOSHITSUGU , MORIYAMA SHIN‐ICHI , NARIYA SHOJI , SANO KENJI , SHIROTA HIROSHI , KATO RYOHEI
Published: December 2008

A rare case of a macrofollicular variant of papillary thyroid carcinoma occurring in an 18‐years‐old male is described. The extirpated tumor, 5.5 × 5.5 × 3.5 cm In size, was well demarcated and multinodular, and histopathologically showed a predominantly macrofolllcular structure reminiscent of adenomatous goiter or macrofollicular adenoma. In the tumor tissue, however, there were several small foci of microfollicular or paplllary structure with the nuclei charae teristic of papillary carcinoma. Parts of the macrofollicular areas also showed similar nuclear characteristics with a transition to microfollicular or papillary areas. Incomplete capsular invasion and minimal vascular invasion were also present. Additional resected specimens contained small metastatic nodules in the residual left lobe and lymph nodes. Immunohistochemistry showed a small number of p53‐positive tumor cells in the microfollicular or papillary areas. It is suggested that this tumor is a well‐differentiated variant which should be distinguished from benign thyroid lesions, although there have been some cases of metastases which appear related to capsular and/or vascular invasion.
Ganglion cells in Ewing's sarcoma following chemotherapy: A case report
Authors: MAEDA GO , MASUI FUMIAKI , YOKOYAMA RYOHEI , SHIMODA TADAKAZU , MATSUNO YOSHIHIRO , MUKAI KIYOSHI , OHTOMO KATSUYUKI , BEPPU YASUO , FUKUMA HISATOSHL
Published: December 2008

A case of Ewing's sarcoma of the bone, arising in the right radius of a 12‐year‐old girl, which showed unique histologic features after pre‐operative treatment, is reported. The light microscopic features of a biopsy sample were those of a small round cell tumor showing positive immunoreaction with antibodies against the product of the MIC 2 gene (O13), neuron‐specific enolase, neurofilament, and synaptophysin, but no morphological differentiation. The patient received combined intensive multi drug chemotherapy and radiation before surgery. Examination of the surgical specimen showed that the tumor was less cellular than that in the biopsy specimen, and was composed mainly of loosely textured large cells mimicking ganglion cells, occasionally forming Homer‐Wright rosettes. An lmmunohistochemical study revealed that neural differentiation was enhanced. Immunoreactivity for Leu‐7 also became positive. Although the patient underwent postoperative chemotherapy, she died of multiple lung and bone metastases 30 months alter the diagnosis. Autopsy showed that metastatic foci were made up of densely packed small round cells like those seen In the biopsy samples, but associated with prominent Homer‐Wright rosettes. To the authors' knowledge, this is the first report of a tumor being replaced almost entirely by ganglion cells after preoperative chemotherapy and radiotherapy.
Neuroendocrine carcinoma of the liver: An autopsy case
Authors: FUKUNAGA MASAHARU
Published: December 2008

An autopsy case of hepatic neuroendocrine carcinoma Is descrlbed. An 84‐year‐old man had a white solid tumor measuring 5 cm In greatest diameter and multiple small nodules In the non‐cirrhotic liver. Microscopically, these lesions were characterized by solid nesting, trabecular, and Insular arrangements of small‐ to medium‐sized cells. The tumor cells were argyrophllic and electron microscopy showed dense core granules and formation of bile canall‐culi. lrnmunohlstochernlcally, the tumor cells were positive for cytokeratln CAM 5.2, chromogranln A, Leu‐7, neuron‐specific enolase, and α‐fetoprotein. The tumor was diploid by flow cytometry. The patient had metastases in the vertebrae, lung, pancreas, and an hepatic hilar lymph node. The patient had an occult rectal tumor of Intramucosal well‐differentiated tubular adenocarcinoma without metastasis. No alternative primary source of the endocrine tumor was detected. The patient died 1 month after presentation.
Gastrospirillum hominis and Helicobacter pylori infection in Thai individuals: Comparison of histopathological changes of gastric mucosa
Authors: Yali Zhang , Yamada Nobutaka , Wen Min , Matsuhisa Takeshi , Miki Masaru
Published: December 2008

The presence of Helicobacter pylori (H. pylori) in the stomach is closely associated with histological signs of chronic active gastritis and peptic ulcer. Another spiral organism named Gastrospirillum hominis (G. hominis) has led to further interest in the bacterial pathogenesis of gastritis. Due to the low prevalence of G. hominis, it is difficult to evaluate its biological behavior. Recently 16 cases of G. hominis‐associated gastritis were found in 257 Thai individuals, which made it possible to study the biological characteristics of G. hominis and its relationship with gastric mucosal inflammation. The results showed that H. pylori and G. hominis could be easily observed in the lower third of the mucous layer and in the mucosa of the gastric pits by means of toluidlne blue staining. Both bacteria immunostained positive. Helicobacter pylori were usually in the shape of curved bacillary while G. hominis often appeared in spiral configuration. In 257 cases of Thai subjects, 169 cases were found to be H. pylori positive, the detection rate was 65.7%, and 16 cases were G. hominis positive, with a 6.2% detection rate. In G. hominis infection, 43.6% of cases had normal gastric mucosa. Superficial, erosive and atrophlc gastritis cases were 13.2, 10.9 and 12.5%, respectively. Mucosal inflammation was usually severe in H. pylori, but neutrophil polymorph infiltration was often mild and focal in G. hominis Infection. Although no G. hominis infection with carcinoma was shown in our cases, the occurrence of mucosal atrophy, metaplasia and dysplasia was higher in both bacterial infections compared with H. pylori‐ and G. hominis‐negative cases. It is suggested that G. hominis may be partly responsible for the mucosal inflammation and some malignant‐associated lesions.
Multiple developmental pathways of highly aggressive breast cancers disclosed by comparison of histological grades and c‐erbB‐2 expression patterns in both the non‐invasive and invasive portions
Authors: Tsuda Hitoshi , Hirohashi Setsuo
Published: December 2008

To determine the developmental stages at which the highly malignant phenotype of breast carcinoma is acquired, the histological grade and c‐erbB‐2 oncoprotein expression status were examined for both the ductal carcinoma in situ (DCIS) and Invasive components of 437 separate Invasive breast carcinomas. In 218 invasive carcinomas with high‐grade atypla (grade 3), the DCIS components were grade 2–3 In 158 cases (73%). Twenty‐seven (12%) showed an obvious stepwise Increase from grade 1 DCIS to grade 3 invasive carcinoma, and 25 of these tumors had DCIS components covering > 325% of their area. Ductal carcinoma in situ components were undetectable In 33 (15%) of invasive carcinomas. The Incidence of c‐erbB‐2 overexpression was higher in grade 3 carcinomas with grade 2–3 DCIS components (55%, 80 of 146) than in those with grade 1 DCIS components (5%, one of 25). The Incidence was also higher in grade 3 carcinomas with DCIS components covering ≥ 25% of the tumor area (71%, 39 of 55) than in those with DCIS over > 325% of the total area (36%, 42 of 116) or without DCIS components (6%, two of 33). There appeared to be three prototypic pathways to high‐grade breast carcinoma: (i) invasion by a high‐grade DCIS regardless of the extent of DCIS spread; (II) invasion by a low‐grade DCIS during the microscopic stages, accompanied by an obvious enhancement of the grade; and (iii) development of an invasive carcinoma ab inltlo. c‐erbB‐2 overexpression appeared to be frequently involved in the early development of the first group but showed little relation to the invasive process in any of these three pathways. The histological grade and c‐ertB‐2 overexpression appeared to be largely established during the early microscopic stages of a DCIS or invasive carcinoma.
Nodular mucinosis of the breast: Report of three cases
Authors: Michal Michal , Ludvíková Marie , Zámečník Michal
Published: December 2008

Three cases of nodular mucinosis of the breast are presented. They occurred in one male and two female patients. The patients had no signs of Carney's syndrome. All lesions were located under the nipple. They were poorly circumscribed and unencapsulated. They were soft and had a gelatinous consistency and white color. No patient had any evidence of recurrence or metastasis 6 months, 3 years and 6 years, respectively, after the surgical excision. The mucinous tissue consisted of acid mucopolysaccharldes, which stained Alcian blue, Hale's colloidal iron positively, and they were periodic acid‐Schiff (PAS) negative. Muci‐carmine reaction was only faintly positive. The lesion should be distinguished particularly from mucocele‐like lesions of the breast by the location, nodular arrangement, absence of accompanying ductal hyperplasia and staining properties of the mucous substances.
Histiocytoid breast carcinoma: Histological, immunohistochemical, ultrastructural, cytological and clinicopathological studies
Authors: Shimizu Satoru , Kitamura Hajime , Ito Takaaki , Nakamura Takeshi , Fujisawa Jun , Matsukawa Hiroshl
Published: December 2008

Histiocytoid breast carcinoma (HBC) is a rare variant of breast carcinoma and often causes a diagnostic dilemma because of its histological similarities to some types of breast cancer and benign lesions. To elucidate the incidence of HBC and its biological properties, histological specimens from 1010 breast cancer patients treated at Yokohama Minami Kyosai Hospital between 1972 and 1996 were reviewed. Three cases of pure HBC and three cases of combined HBC (two with pleomorphlc lobular carcinoma and one with apocrine ductal carcinoma) were found, yielding an Incidence of 0.3% for each. Two of the three pure HBC cases contained foci of in situ lobular carcinoma. Targetoid and Indian file invasive patterns, the features characteristic of lobular carcinoma, were present in all three pure HBC cases and in two of the three combined HBC with pleomorphic lobular carcinoma. These results, together with those of previous studies, suggested that the majority of HBC are of lobular origin, although the apocrine ductai origin is also possible in a small number of HBC. Diastase‐resistant periodic add‐Schiff‐positive granules and granular immunoreactivities for gross cystic disease fluid protein‐15 (GCDFP‐15) were characteristic of the histiocytoid tumor cells in both the pure and combined HBC, suggesting the apocrine differentiation of tumor cells. All three pure HBC cases were in stage 1 and were free of the disease for up to 5 years and 1 month after the lumpectomy. Thus, the prognosis of HBC appears to be dependent on the stage of the disease and may not always be poor, as indicated by the original report mentioning a preferential eyelid metastasis.
Neuroendocrine carcinoma of the breast with Merkel cell carcinoma‐like features
Authors: Fukunaga Masaharu
Published: December 2008

A case of neuroendocrine carcinoma of the breast with Merkel cell carcinoma‐like features occurring In a 38‐year‐old female Is described. A 2.5 × 2.5 × 1.3 cm tumor in the upper‐outer quadrant of the right breast was ill‐defined, yellowish white and rubbery. Microscopically, the tumor was characterized by a diffuse proliferation of non‐cohesive round cells. The tumor cells had round nuclei with finely dispersed chromatin and inconspicuous nucleoli. The cytoplasm was generally scant, pale to eosinophilic, and argyrophilic. There were scattered foci of small nests or intraductal proliferations. Immunohistochemically, many tumor cells showed positive reaction for CAM5.2, vimentin, chromogranin A, and synaptophysin. The tumor was also positive for neuron‐specific enolase (NSE), Leu‐7, calci‐tonin, S‐100 protein, and glial fibrillary acidic protein. Flow cytometric analysis showed that the tumor was DNA diploid. An axillary lymph node was positive for metastasis. The patient was well, without disease, for 6 years after mastectomy. It is suggested that the tumor might originate from ductal cells and show Merkel cell carcinoma‐like neuroendocrine differentiation.
Lipomatous pseudohypertrophy of the pancreas in a patient with cirrhosis due to chronic hepatitis B
Authors: Sasaki Motoko , Nakanuma Yasunl , Ando Hltoshi
Published: December 2008

Lipomatous pseudohypertrophy of the pancreas was found at autopsy In a 52‐year‐old Japanese woman with cirrhosis due to chronic hepatitis B. Clinically, there were no clear symptoms of pancreatic Insufficiency during the entire course. Marked atrophy and fat deposition of the pancreas had already been detected by computed tomography (CT) at least 6 years before her death. She died of hepatic failure due to decompensated cirrhosis. Autopsy revealed uniform enlargement of the pancreas due to massive fat replacement (lipomatous pseudohypertrophy): the exocrine glandular elements showed marked atrophy and loss, while the islets of Langerhans were preserved. Although the etiology and pathogenesls of lipomatous pseudohypertrophy Is still unclear, this case suggests that this condition Is causally related to chronic hepatitis B or other chronic advanced hepatic lesions.
Genetic alterations in primary and secondary hyperparathyroidism
Authors: Shan Liang , Nakamura Yasushi , Nakamura Misa , Yokoi Toyoharu , Kakudo Kennichi
Published: December 2008

Hyperparathyroidism refers to a term representing a wide spectrum of parathyroid disorders that are characterized by the increased production of parathyroid hormone. Hyperparathyroidism was once thought to be tare but is now more commonly recognized, aifecting 1 in 500 women over 40 years of age. Yet the interpretation of parathyroid pathology is still controversial and confusing. Over the past 10 years, genetic changes (ret and menin genes) involved in the pathogenesis of MEN 2 and MEN 1 have been discovered in succession. Different mutations of the calcium‐sensing receptor gene have been identified in neonatal severe hyperparathyroidism and familial hypocalciuric hypercal‐cemia, respectively. The HRPT 2 gene responsible for the development of heredltaty hyperparathyroidism and jaw tumors has been localized on the 1q21–31 locus. Several genetic alterations have also been characterized in primary and secondary hyperparathyroidism. Different genetic alterations appear to involve the development of different types of hyperparathyroidism. These novel advances give us new insights into the pathogenesis of hyperparathyroidism and allow better differentiation between the different types of parathyroid disorders.
Microsatellite instability in young patients with colorectal cancer
Authors: Kim Woo Ho , Lee Hye Won , Park Sun Hoo , Kim Yong II , Chi Je G.
Published: December 2008

Genetic instability Is closely correlated to the pathogenesis of hereditary non‐palyposis colon cancer (HNPCC), which is clinicaily characterized by a family history and early onset. To investigate the role of genetic instabllity in young patients with colorectal cancer (CRC), 22 CRC patients, who were aged younger than 30 at the time of diagnosis, were studied. Patients with famllial adenomatous polyposis were excluded. Among the 22 cases, seven were identifled as microsateillte instability posltive (MI+), and more than five microsatellite markers among the 15 tested markers showed an additlonal band pattern in the tumor tissue. None of the remaining 15 cases showed instability in any microsatellite marker. Two of seven MI+ cases were classic HNPCC. While all MI+ cases had one or no metastatic lymph node, 53.3% of MI‐ cases showed metastasls in two or more reglonal lymph nodes. Allelic deletion of the 17p12–13 chromosome around the p53 locus occurred in 16.7% of MI+ cases, and 80.0% of MI‐ cases showed loss of het‐erozygosity at that locus. hMSH2 Protein expression, assessed by immunohistochemistry, was absent in two cases, both of which were MI+. When we tested two to four sites of MI+ tumors, transforming growth factor β receptor type II was mutated in a homogeneous pattern in five MI+ cases. in addition, frame‐shift mutations of BAX, insulin‐like growth factor II receptor, hMSH3 and hMSH6 were found in three cases, five cases, five cases and one case, respectively. In contrast to the consistent mutatlon of the transforming growth factor‐β receptor type II gene, mutations of other genes varied in different portions of the tumors.
Collagen and elastin synthesis by desmoid tumor in vitro
Authors: Naito Yasuhisa , Ohori Kaneo , Tanaka Masamitsu , Kamo Takaharu , Baba Shozo , Hori Tetsuo , Hashizume Kohei , Sugimura Haruhiko
Published: December 2008

In order to characterize human desrnoid tumors in vltro, the production of collagen and elastin and the expression of collagen types αl(I), αl(lll) and transforming growth factor (TGF)‐β1 mRNA were investigated in six desmold tumors; five derived from familial adenomatous polyposis patients and one from a sporadic case. The proportion of collagen production to total proteln production was determined by 3H‐imlno acid incorporation, an indlcator of collagen synthesis, using high‐performance liquid chromatography (HPLC). The proportion of collagen production to total proteln production was much higher in all six desmoid tumors compared with human skin fibroblasts (HSF). Quantitatively, the rate of elastin synthesis in desmoid tumor cells monitored by valine‐proline peptide was also significantly higher than in HSF. Pro‐αl(l) collagen mRNA was highly expressed in both desmoid tumors and HSF at approxlmately the same level, whereas pro‐αl(lll) collagen mRNA was more abundant in some of the desrnoid tumors than the normal skin flbroblestic cell lines. Tumor growth factor‐β1 mRNA, which is believed to stimulate collagen synthesis, was expressed in both desmoid tumors and HSF to the same extent. These results demonstrate the increased formation of collagen and elastin In desmold tumors In vitro and suggest that the Increased synthesis of elastin rather than of collagen and TGF‐β1 may be Involved in Increased fibrogenesis by desmold tumors.
Schwannoma of the liver: Report of two surgical cases
Authors: Wada Yoshito , Jimi Atsuo , Nakashima Osamu , Kojiro Masamichi , Kurohiji Toshihiko , Sai Koken
Published: December 2008

Two surgical cases of benign schwannoma of the liver were examined: A 64‐year‐old female who was admitted to hospital for the treatment of early gastric cancer (case 1) and a 69‐year‐old female who had pitting edema In the legs (case 2). Diagnostic imaging revealed large solid masses located In the caudate lobe through to the left lobe of the liver in case 1 and in the left lobe in case 2. Both patients showed no signs of von Recklinghausen's disease. Partial hepatectomies were performed and the maximum diameter of their resected hepatic tumors was 4 cm and 15 cm, respectively. Histologically, the well‐demarcated tumors were yellowish In color, elastic‐hard In consistency and consisted predominantly of short spindle‐shaped cells proliferatlng In an interlacing fashion. The tumor lesions were separated by fibrous bands and surrounded by a lymphoid cuff. Immunohistochemically, the tumor cells were positive for S‐100 protein. The tumors were diagnosed as benign hepatic schwannoma.
Clear cell odontogenic tumor in the mandible: Report of a case with an immunohistochemical study of epithelial cell markers
Authors: Kumamoto Hiroyuki , Kawamura Hiroshi , Ooya Kiyoshi
Published: December 2008

A ram case of clear cell dontogenic tumor Is presented with an immunohistochemical study using epithelial cell markem. A 35‐year‐old Japanese man was admitted with a complaint of painless swelling In the anterior region of his mandible. Radiological examination showed a relatively well‐defined multilocular radloiucency with root resorption of the adjacent teeth. Despite a subtotal mandlbulectomy, the tumor recurred thm times. Histologically, the tumor was composed of proiiferating clear cells and Infiltrated through the cancellous bone. Histochemical and ultrastruc‐tural analyses detected cytoplasmic glycogen granules in the clear cells. They showed immunoreaetivities for cytokeratin 8,13 and 19, fllaggrin and anti‐ameloblastoma antibodb, suggesting an odontogenic epithelial origin.
Two cases of mesotheliaI/monocytic incidental cardiac excrescences of the heart
Authors: Ikeda Yoshihiko , Yutani Chikao , Imakita Masarni , Ishibashi‐Ueda Hatue , Nakamura Yoichi , Nishida Naoki , Hisaki Ryohei
Published: December 2008

Two cases of mesothelial/monocytic incidental cardiac excrescences In a 66‐year‐old female and an 80‐year‐old male are presented. Lesions had solid and tubular pattern formations which were composed of two predominant cell types of histiocytoid cells and cuboidal cells arranged in strips. The histiocytoid cells were round and had well‐defined nuclei with prominent nuclear grooves. They had a low nuclear to cytoplasmlc ratio. There were no atypical mitoses. lmmunohistochemically, these cells were positive for leukocyte common antigen (LCA) and CD68 (KP‐1) but negative for keratin. The cuboidal cells were present in strips, had haphazardly arranged surface microvilli and had small round non‐cleaved nuclei. These cells were positive for keratin but negative for LCA, CD68, p53, proliferative cell nuclear antigen, α‐smooth muscle actin, Factor VIII, epithelial membranous antigen and vlmentin. These lesions are probably reactive because of their heterogeneous components; an expected feature for an essentially artiiactual lesion that is related to cardiac surgery and invasive catheterization. Immunohistochemical studies are useful for avoiding misdlagnosis of neoplasms.
Ovarian mucinous cystadenocarcinoma with malignant mural nodules
Authors: Nakamura Etsuko , Shirnizu Michio , Mikarni Yoshiki , Kawai Junichiro , Manabe Toshiaki
Published: December 2008

A case of ovarian muclnous cystadenocarcinoma with malignant mural nodules is reported. The patient was a 28‐yearold Japanese female (gravida 0, para 0) with a 2 year history of increasing abdominal fullness and edema of the lower extremity. Physical examination showed a large mass in the abdomen. An abdominal ultrasound and computed tomography demonstrated a multilocular cyst with a solid component. Lymph node and distant metastases were not found. These tests were followed by surgery. The resected right ovarian tumor measured 25 × 22 × 18 cm. On cut sectioning, it was multilocular with multiple mural nodules. Microscopically, the cyst wall was lined with papillary in‐foldings of atypical mucinous epithelium (intestinal type). Nuclear stratification, crlbrlform and back‐to‐back glandular patterns and stromal invasion were observed. In addition, the solid area of the mural nodules showed spindle or polygonal cells with Increased mitotic activity Including atypical mitoses. Nuclear pleomorphism was marked. Necrosis and hemorrhage were also present. Reticulin stain showed these pleomorphic cell clusters circumscribed by reticulin fibers and these cells were immunoreacthre for vimentln and p53.
Adenosarcoma of the uterine cervix presenting as a cervical polyp
Authors: Hino Akiko , Hirose Takonori , Seki Kunlhiko , Uehara Hisanori , Sano Nobuya
Published: December 2008

A case of adenosarcoma arising from the uterine cervix of a 55‐year‐old female who complained of vaginal discharge is reported. A polyp, 6 × 2 × 1.5 cm in size, Identified in the cervical canal was clinically diagnosed as benign cervical polyp and resected. Histologically, the polyp was composed of benign epithelial components and sarcomatous stroma wherein periglandular hypercellularity and some mitoses including atypical ones were noted. Immunohistochemi‐cally, stromal cells were positive for muscle‐type actins, desmin and estrogen receptor. Adenosarcoma is a rare, blphasic tumor of the uterus and usually presents as a polypoid mass in the endometrial cavity. When they arise from the cervix, adenosarcomas may be confused with benign cervical polyps clinically and pathologically. As the former often recurs, microscopic dlfferentlatlon is crucial for further treatment.
Immunohistochemical characterization of two novel monoclonal antibodies that recognize human perivascular cells of the central nervous system and macrophage subsets
Authors: Yokoo Hideaki , Sasaki Atsushi , Hirato Junko , Nakazato Yoichi
Published: December 2008

The monoclonal antibodies to cells of monocyte/macraphege lineage were established using a human glial cell‐rich fraction as the Immunogen. The antibodies, named GP‐1 and GP‐2, were originally found to react with perivascular cells of the central nervous system. They are Immuno‐hiaochemically applicable on routinely formalin‐fixed, paraffin‐embedded tissue sections. GP‐1 binds to a lysosomal protein, and GP‐2 to a carbohydrate epitope of the cell membrane and lysosomes. Among the visceral organs, GP‐1 labeled blood monocytes, almost ail kinds of tissue and Infiltrating macrophages in both normal and diseased state, and renal tubules. GP‐1 staining of tissue macrophages tends to be Intensified under Inflammatory conditions. GP‐1 staining also suggested that perivascular cells and macrophages had different ontogeny. GP‐2 immunostained monocytes, Kupffer's cells, red pulp macrophages, Infiltrating macrophages and reactive microglla, but not alveolar or tingible body macrophages. Besides those macrophages, GP‐2 stained mantle zone lymphocytes, some hematopoietic cells, pneumocytes and renal collecting ducts. The staining pattern of ligands on THP‐1 and HL40 neoplastic human macrophage cell lines was dissimilar to that of other macrophage markers, suggesting that they recognize unknown macrophage‐related antigens.
Cutaneous allergic vasculitis: Clinicopathological characterization and identification of apoptosis
Authors: Shi Yipu , Honma Masanori , Koizumi Fumitomo
Published: December 2008

To elucidate the cllnicopathological features of cutaneous allergic (leukocyioclastic) vasculitis (CAV), blopsied skin tissues of 32 patients with CAV were examined immuno‐histopathologically and compared with the main clinical features. Additionally, to obtain some clues to better understand the roles of infiltrating cells, particularly neutrophils in CAV, apoptosis and related antigens were investigated in vivo. The 32 patients with CAV were divided into two groups based on their clinical course: (i) non‐recurrent (group I; nine cases); and (ii) recurrent (group II; 23 cases). Immuno‐histopathologically, group I was characterized by stereotypical necrotlzlng changes of CAV with fibrin exudation of small blood vessels in the upper cutls, and group II was characterized by CAY and flbrous thickening of the vascular walls with significant Infiltration of CD3+, UCHL‐I+ T cells. Group II was subdivided further: groups Ila (15 cases) and Ilb (eight cases); that is, the former was notable for necrotlzing changes of CAV, which tended to spread Into the proper corium down to the lower cutis; whereas the latter exhibited conslderably less marked histological changes of CAV without any spread to the lower cutis. In a comparison of the clinical data among the three groups, there were considerable differences in age, clinical course, localization of purpura and associated disease. In particular, group II showed a high frequency of connective tissue diseases. The presence of apoptosis was seen In a considerable number of neutrophils, and some nuclear debris turned out to be apoptotlc bodies by the in situ terminal deoxytransferase (TdT)‐catalyzed DNA nick end‐labeling (TUNEL) method and electron microscopy. By combining immunohistochemistry wlth TUNEL, the majority of apoptotic neutrophils and nuclear debris was seen to be ingested by macrophages. In immunohlstochemical examinatlons for apoptosls‐related bcl‐2 protein and Fas antigen, bcl‐2 was recognized only In the cytoplasm of infiltrating T cells, and Fas was positively stained on the cellular membranes of infiltrating T cells and neutrophils In a scattered fashion. Thus, a novel method for neutrophil disposal in CAV was suggested.
Giant cell tumor of bone: A clinicopathologic study of prognostic factors
Authors: Masui Fumiaki , Ushigome Shinichiro , Fujii Katsuyuki
Published: December 2008

Forty‐seven cases of giant cell tumor of bone were clini‐copathologically reviewed to determine any useful prognostic factors. Disease recurred In 11 cases. Eight of these cases had initially been treated with lntracapsular piecemeal excision and three cases had been treated with wide excision. Nine of the 11 cases were classified as Grade III, two cases as Grade II, and one case as Grade II + fracture according to Campanacci's radiographic grading system. lntracapsularly excised cases had a high recurrence rate (47.1%). Metastasis to the lung occurred in three cases, each of which had been classified as Grade III. Although the radiographic Grade did not correlate wlth the rate of lung metastasis or recurrence, cases that metastasized to the lung or recurred tended to be radiographically aggressive. Disease recurred in eight of 24 Grade III cases; but in only two of 12 Grade II cases, in one of five Grade II + fracture cases, and none of six Grade I cases. p53 Was expressed by mononuclear stromal cells in SIX cases. Disease recurred In four and lung metastasis occurred In three of these cases. p53 Expression correlated wlth rates of lung metastasis and recurrence. R was concluded that cases in which p53 is expressed have a high potential for lung metastasis and recurrence.
Mediastinal mature teratoma with coexistence of angiosarcoma, granulocytic sarcoma and a hematopoietic region in the tumor: A rare case of association between hematological malignancy and mediastinal germ cell tumor
Authors: Saito Atsuko , Watanabe Kazuo , Kusakabe Takashi , Abe Masafumi , Suzuki Toshimitsu
Published: December 2008

An association between mediastinal germ cell tumors (MGCT) and hematological malignancies (e.g. acute leukemia, malignant histlocytosis) has been recognized since 1984. A rare case of mediastinal mature teratoma with angiosarcoma, a hematopoietic region and granulocytic sarcoma is reported in a 29‐year‐old male. The resected tumor was 9.0 × 6.5 cm, weighed 65 g and showed extensive necrosis, forming a cyst. The hlstological features of the tumor showed a mature teratoma, which contained a large gland lined by ciliated epithelium, hyalinous cartilage, a paraganglion‐like structure, well‐diierentiated angiosarcoma with atypical hematopoiesis composed of CD34‐positive cells, and mallgnant round cells. The malignant round cells did not stain for CD34 but were positive for leukocyte common antigen (LCA) and c‐kit product. From these findings, the round cells were dlagnosed as granulocytic sarcoma. The patient died of metastasis of the granulocytic sarcoma in the tonsils and cervical lymph nodes 8 months after surgery. A leukemic condition was not present throughout the clinical course. The association between MGCT and hematological malignancy is a distinctive syndrome. However, its pathogenesis is still obscure and the origin of the hematopoietic malignancy has not been fully elucidated. In this particular case, it Is suggested that the granulocytic sarcoma might have arisen from the abnormal hematopoietlc area in the mediastlnal teratoma.
Role of lymph node density in predicting survival of patients with lymph node metastases after radical cystectomy: A multi‐institutional study
Authors: Osawa Takahiro , Abe Takashige , Shinohara Nobuo , Harabayashi Toru , Sazawa Ataru , Kubota Kanako , Matsuno Yoshihiro , Shibata Takeshi , Shinno Yuichiro , Kamota Shinji , Minami Keita , Sakashita Shigeo , Kumagai Akira , Mori Tatsuya , Nonomura Katsuya
Published: December 2008

Objectives:  To evaluate the prognostic role of different clinico‐pathological parameters in node‐positive patients treated by radical cystectomy.

Methods:  A retrospective multi‐institutional study of 435 patients who underwent radical cystectomy between 1990 and 2005 was carried out. Of them, pathological lymph node (LN) metastases were found in 83 patients. Sixty of these 83 patients, whose clinical information and follow‐up data were available, were included in the analysis. Twenty‐five patients had undergone adjuvant chemotherapy, whereas 35 had not. A Cox proportional hazards model was used to determine the impact of the following clinico‐pathological parameters on patient survival: number of resected LNs, number of positive LNs, LN density (defined as the ratio of the number of positive LNs divided by the total number of resected LNs) and adjuvant chemotherapy.

Results:  Median follow‐up for surviving patients was 41 months (range 4–138) after surgery. The median survival time for all patients was 22 months (95% confidence interval, 15–42 months). At multivariate analysis, LN density of 25% or less, adjuvant chemotherapy and pure urothelial carcinoma were independently significant predictors of survival.

Conclusions:  Lymph node density predicts survival in patients with node‐positive bladder cancer.
New braconid wasps from French Cretaceous amber (Hymenoptera, Braconidae): synonymization with Eoichneumonidae and implications for the phylogeny of Ichneumonoidea
Authors: Perrichot Vincent , Nel André , Quicke Donald L. J
Published: December 2008

Two new fossils of Braconidae are described from Albian‐Cenomanian amber of south‐western France, Protorhyssalodes arnaudi gen. n., sp. n., and Aenigmabracon capdoliensis gen. n., sp. n. The former appears superficially similar to the type genus and species of the extinct sub‐family Protorhyssalinae, from Turonian New Jersey amber specimens, and the latter both to Protorhyssalus and to members of the extinct family Eoichneumonidae. However, both new taxa display unique combinations of wing venation characters making confident assignment to sub‐family impossible. Indeed, they are the first braconids ever known to possess both vein 2‐CU and a distinct trace of vein 2‐1A on hindwing. The new fossil taxa are incorporated into a morphological analysis of extinct and extant ichneumonoids. As a result of the analyses we synonymize the Eoichneumonidae with the Braconidae.
Stage‐specific effect of nodal metastases on survival in patients with non‐metastatic renal cell carcinoma
Authors: Capitanio Umberto , Jeldres Claudio , Patard Jean‐Jacques , Perrotte Paul , Zini Laurent , De La Taille Alexandre , Ficarra Vincenzo , Cindolo Luca , Bensalah Karim , Artibani Walter , Tostain Jacques , Valeri Antoine , Zigeuner Richard , Méjean Arnaud , Descotes Jean Luc , Lechevallier Eric , Mulders Peter F. , Lang Herve , Jacqmin Didier , Karakiewicz Pierre I.
Published: December 2008

OBJECTIVE

To quantify the survival disadvantage related to the presence of exclusive nodal metastases (eNM) in patients with otherwise non‐metastatic (M0) renal cell carcinoma (RCC).

PATIENTS AND METHODS

Data were retrieved from 12 institutional databases and yielded 3507 patients with T1‐3N1‐2M0 RCC treated with partial or radical nephrectomy. Cox regression analyses relied on T stage, Fuhrman grade and presence of eNM. Data were analysed using univariable, multivariable and stratified analyses.

RESULTS

Overall 165 (4.7%) patients had eNM; of 2023 patients of stage T1, 23 (1.1%) had eNM, vs 20 of 448 (4.5%) for T2 and 122 of 993 (12.3%) for T3. In univariable analyses the presence of eNM increased the rate of cancer specific mortality (CSM) by 7.1 times. After adjusting for T stage and Fuhrman grade, in all patients eNM increased the rate of CSM by 3.2 times. In stratified analyses adjusted for Fuhrman grade, the increase in CSM related to the presence of eNM was 28.9, 4.3 and 2.5 times (all P < 0.001) for stages T1, T2 and T3, respectively.

CONCLUSIONS

From the prognostic perspective, staging lymphadenectomy appears of most value in patients with T1‐2 RCC, but the low prevalence of eNM questions the practical applicability of nodal staging in those patients. Conversely, in patients with T3 RCC, the prevalence and the prognostic impact of eNM might make a staging lymphadenectomy worthwhile.