bluuebunny/crossref_metadata_2025 huggingface dataset:
Heat shock protein 60 (HSP60) immunoreactivity in gastric epithelium associated with Helicobacter pylori infection: A pitfall in immunohistochemically interpreting HSP60‐mediated autoimmune responses
Authors: Kamoshida Shingo , Satoh Yoshihiro , Kamiya Shigeru , Tsutsumi Yutaka
Published: March 2003

Previous studies have suggested that heat shock proteins (HSP) of Helicobacter pylori (H. pylori) are involved in the induction of autoimmunity mediated gastritis. In the present report, the cross‐reactivity between H. pylori‐related HSP60 and gastric epithelial cells was investigated by the indirect immunoperoxidase method using two monoclonal antibodies (mAb) against H. pylori‐derived HSP60, H9 and H20. H9 is reactive with an epitope common to bacterial HSP60, while H20 is specific to H. pylori HSP60. A total of 70 paraffin‐embedded gastric biopsy specimens were analyzed after heat‐induced epitope retrieval. Both mAb were cross‐reactive with the gastric epithelial cells, with a higher frequency seen for the H9‐reactive epitope. The frequency of positive epithelial decoration was not significantly different between H. pylori‐positive and H. pylori‐negative gastric mucosae. A variety of epithelial and non‐epithelial cells were immunostained with mAb H9, while mAb H20 was cross‐reactive only with small intestinal epithelia. Reactivity was mainly located in the Golgi area and rarely in the cytoplasm. These results suggest a noteworthy pitfall in immunohistochemical interpretations of HSP60‐associated autoimmune reactions in the gastric mucosa.
Primary giant cell malignant fibrous histiocytoma of the lung: A case report
Authors: Kimizuka Goro , Okuzawa Ken , Yarita Tutomu
Published: March 2003

A rare case of malignant fibrous histiocytoma of giant cell type originating in the lung of a 46‐year‐old woman is presented. The patient complained of having a cough that had lasted for a few weeks. A chest X‐ray photograph showed a tumor shadow on the left lung. Histological and cytological examination of the biopsy specimen revealed that the tumor was a kind of sarcoma. An operative procedure was selected because of tumor invasion into the trunk of the left pulmonary artery, which was discovered on computed tomography examination, and because metastatic tumor was excluded clinically. The tumor was almost encapsulated and 6 × 6 × 6 cm in size; however, it also showed invasion into the pulmonary artery and bronchial lumen. A histological survey of the tumor showed a wide range of patterns such as fibrous, pleomorphic, fascicular and osteoclast‐like giant cell figures; however, the osteoclast‐like giant cell area was predominant. Immunohistochemically, the tumor cells were positive for vimentin, CD68 for histiocytic marker and α1‐antichymotrypsin, and negative for keratin, epithelial membrane antigen, S‐100 protein, MT‐1, desmin, myoglobin and lysosome. No primary tumor was found clinically in any part of the patient’s body at 2 and 4 months after operation. Consequently, she was diagnosed as having primary giant cell malignant fibrous histiocytoma of the lung.
A case of hereditary amyloidosis transthyretin variant Met 30 with amyloid cardiomyopathy, less polyneuropathy, and the presence of giant cells
Authors: Nakamura Yoichi , Yutani Chikao , Nakazato Masamitsu , Date Yukari , Baba Takeshi , Goto Yoichi
Published: March 2003

Transthyretin‐Met 30 (TTR‐Met 30) is a variant of transthyretin and is usually associated with familial amyloid polyneuropathy. It is rare that patients with TTR‐Met 30 will primarily develop amyloid cardiomyopathy. This report presents a patient with late‐onset TTR‐Met 30 who primarily developed amyloid cardiomyopathy, with less amyloid polyneuropathy in the peripheral nervous system than is usually seen. An autopsy was performed, and histological examination revealed many foreign‐body giant cells and macrophages in the area of amyloid deposition that was found in nearly all of the organs.
Gross type‐matched study of clinicopathologic features of advanced gastric carcinoma with replication error
Authors: Kang Gyeong Hoon , Kim Bohng Hee , Lee Tae Jin , Shim Yhong Hee , Gong Gyungyub , Ro Jae Y.
Published: March 2003

Sporadic gastric carcinomas with replication error (RER) have been described and have distinct clinicopathological features, such as: older age group, predominant antral location, elevated gross type, near‐diploidy, expanding pattern (Ming’s classification), intestinal type, low desmoplastic response, and less frequent lymph node metastasis. Previous study revealed that replication error‐positive (RER+) advanced gastric carcinomas (AGC) had a preponderance of Borrmann type 2. Regardless of RER status, AGC of Borrmann type 2 usually exhibit expanding pattern (Ming’s classification), intestinal type, and low desmoplastic reaction. Therefore, to better characterize the clinicopathological features of RER+ gastric carcinomas, gross type‐matched analysis would be necessary. We analyzed 53 cases of Borrmann type 2 AGC for RER status using polymerase chain reaction analysis of eight microsatellite loci and compared the clinicopathological features between RER+ and RER‐negative (RER–) tumors. Sixteen (30.2%) out of 53 cases were RER+ phenotype which had a significant association with female sex, older age, expanding pattern, small and uniform nuclei, and low DNA index (P < 0.05). However, RER status was not significantly associated with histological differentiation, histological type (Lauren’s classification), desmoplastic response, intratumoral lymphoid infiltration, and tumor location. Most of the previously known clinicopathological features of RER+ AGC were related to Borrmann type 2, except for female sex, older age, expanding pattern, and low DNA index.
Anaplastic carcinoma of the pancreas with rhabdoid features
Authors: Kuroda Naoto , Sawada Taeko , Miyazaki Eriko , Hayashi Yoshihiro , Toi Makoto , Naruse Keishi , Fukui Takayuki , Nakayama Hirofumi , Hiroi Makoto , Taguchi Hirokuni , Enzan Hideaki
Published: March 2003

The malignant rhabdoid tumor (MRT) is histologically characterized by the invasive proliferation of polygonal to ovoid cells with abundant eosinophilic cytoplasm and eccentric vesicular nuclei with a prominent nucleolus. MRT frequently occurs in the kidney, but may also arise in other organs. However, MRT should be strictly distinguished from carcinomas with rhabdoid features. A post‐mortem examination of a 68‐year‐old woman found an anaplastic carcinoma of the pancreas with rhabdoid features displaying extensive invasion into the neighboring tissues. To the best of our knowledge, this is the first case of a pancreatic tumor with rhabdoid features. Pathologists should consider that carcinomas showing rhabdoid features may also appear in the pancreas. As pancreatic tumors with rhabdoid features have characteristic histopathological features and poor prognosis compared to other pancreatic tumors, careful histopathological differential diagnosis is important.
Fulminant hepatic failure in the elderly: A clinicopathological study of autopsy cases aged over 65 years
Authors: Sawabe Motoji , Arai Tomio , Esaki Yukiyoshi , Fukazawa Toshio , Takubo Kaiyo , Hirokawa Katsuiku
Published: March 2003

The pathology of fulminant hepatic failure (FHF) in the elderly is little known because of its very low frequency. Thirteen autopsy cases, all above 65 years of age (mean ± SD, 72 ± 6 years), and 10 younger control cases, all below 40 years of age (30 ± 7 years), were analyzed. The elderly group comprised 10 cases with subacute FHF and three cases with acute FHF, while the younger group comprised seven cases with subacute FHF and three cases with acute FHF. The most predominant pathological type in the elderly group was submassive hepatic necrosis (10 cases), followed by acute hepatitis with bridging hepatic necrosis (AH‐BHN; two cases) and massive hepatic necrosis (one case). In two cases of submassive hepatic necrosis, hepatic regeneration seemed to be insufficient for the suggested history. The underlying diseases and terminal complications were significantly more frequent in the elderly group than in the younger group. In conclusion, the immune response in the elderly group is found to be strong enough to cause massive or submassive hepatic necrosis. However, impaired hepatic regeneration is occasionally observed in the elderly cases and AH‐BHN is often lethal because of frequent underlying diseases and severe complications.
Mxi1 is a potential cellular target of carcinogens and frequently mutated in experimental rat tumors and tumor cell lines
Authors: Wang Dong‐Yu , Xiang Yun‐Yan , Li Xiao‐Jin , Hashimoto Mitsuyoshi , Tanaka Masamitsu , Sugimura Haruhiko
Published: March 2003

Mxi1, a member of the Myc family of transcription factors, negatively regulates Myc oncoprotein activity and thus may be a tumor suppressor gene. It is mutated in a few human prostate cancers. Rat Mxi1 was isolated as a selective overexpressive message in rat esophageal cancer induced by N‐nitrososarcosine ethyl ester using differential display and polymerase chain reaction cloning. Reverse transcription, single‐strand conformation polymorphism analysis and subsequent DNA sequencing were used to screen mutations for the rat Mxi1 coding region including the functional domains, Sin3‐interacting, helix–loop–helix and leucine zipper in samples from 24 rat tumor tissues and various cell lines. Seven mutations were revealed to exist in six rat tumors (including two esophageal tumors and a breast cancer), and three rat tumor cell lines: Leydig cell tumor, osteogenic sarcoma, and pituitary tumor. No coding changes were detected in 34 samples of human sporadic gastric adenocarcinoma. A silent base substitution (GAG to GAA) at codon 131 was also identified in six rat tumors as well as in one human gastric cancer. Our results indicate that Mxi1 is often mutated in experimental rat tumors but mutations are rare in human sporadic cancers. The Mxi1 tumor suppressor gene may be a cellular target of strong carcinogens. Considering the frequency of mutations in chemical carcinogen‐induced tumors, searches for Mxi1 mutation in human tumors should be directed toward patients with a specific epidemiological background.
Clinicopathological study of pleomorphic xanthoastrocytoma: Correlation between histological features and prognosis
Authors: Sugita Yasuo , Shigemori Minoru , Okamoto Kenichi , Morimatsu Minoru , Arakawa Masahiro , Nakayama Kenji
Published: March 2003

The correlation between histopathological characteristics and prognosis was studied in six cases of pleomorphic xanthoastrocytomas (PXA) found in five patients. With regard to the duration from onset to the resection of the tumor, and the postoperative course, three cases had a favorable prognosis, although one case fatally recurred and in another, serial CT showed rapid tumor growth for 3 years. The histological characteristics of the favorable group of PXA comprised remarkable degeneration, low mitotic activity and a low MIB‐1 labeling index. In contrast, the characteristics of the latter two cases of PXA rarely showed degeneration, had atypical mitoses, increasing mitotic activity and a higher MIB‐1 labeling index, which indicates that the findings of degeneration, atypical mitoses, mitotic activity and MIB‐1 labeling index correlate with the biological behavior of PXA. However, with regard to histological appearance and clinical course, PXA are tumors with a wide range of biological behavior.
Molecular characteristics of eight gastric cancer cell lines established in Japan
Authors: Yokozaki Hiroshi
Published: March 2003

Molecular characterization of eight gastric cancer cell lines established in Japan are summarized according to the genetic and epigenetic alterations and growth factor status. TMK‐1 poorly differentiated adenocarcinoma cell line harbors mutant p53 tumor suppressor gene and rearrangement of p15MTS2. MKN‐1 adenosquamous carcinoma line with mutant p53 reveals silencing of E‐cadherin by promoter CpG hypermethylation. MKN‐7 well‐differentiated adenocarcinoma cell line has amplification of c‐erbB2 oncogene and cyclin E gene. MKN‐28 well‐differentiated adenocarcinoma cell line reveals mutations in p53 and APC tumor suppressor genes and silencing of CD44. The MKN‐45 poorly differentiated adenocarcinoma cell line with wild‐type p53 is characterized by homozygous deletion of p16CDKN2/MTS1/INK4A and p15MTS2, amplification of c‐met oncogene and promoter mutation of E‐cadherin. MKN‐74 derived from moderately differentiated tubular adenocarcinoma has wild‐type p53. KATO‐III signet ring cell carcinoma line has genomic deletion of p53, amplification of K‐sam and c‐met oncogene and mutation of E‐cadherin. HSC‐39 signet ring cell carcinoma cell line harboring p53 missense mutation has homozygous deletion of p16CDKN2/MTS1/INK4A and p15MTS2, amplifications of c‐myc, c‐met, K‐sam and CD44 gene and mutation in β‐catenin gene.
METHYLATION STATUS OF BCL6 DISTINGUISHES DNA SAMPLES FROM BENIGN AND MALIGNANT LYMPHOPROLIFERATIVE DISORDERS
Authors: JME Taylor , PR Gould , SM Cairns , DV Spagnolo , PH Kay
Published: March 2003

INTRODUCTION: Deregulation of DNA methylation occurs early in neoplastic transformation. Increased cytosine methylation leads to chromatin compaction with gene inactivation, and hypermethylated DNA in condensed chromatin may be less susceptible to mutation and translocation. Cytosine methylation sites in non‐malignant cells are highly regulated, in contrast to the regional hyper‐ and global hypomethylation frequently found in lymphoid and other neoplasms. This preliminary study assessed the methylation status of BCL6 upstream from exon 1. BCL6 encodes a transcription factor essential
for normal germinal centre formation and for B cell development after antigen stimulation.
It is a repressor of gene transcription but its target genes are ill‐defined. In
some categories of B cell non‐Hodgkin lymphoma (B‐NHL), somatic mutation and translocation
of BCL6 are frequent.

METHODS: DNA was extracted from 60 lymphoproliferative disorders (LPD) comprising 24 benign LPD, 30 B‐NHL (low and high grade) and 6 T cell neoplasms. The level of BCL6 methylation was assessed by Southern hybridization: DNA was digested
with HpaII and MspI (methylation sensitive and insensitive respectively),
and restricted BCL6 fragments were detected with a 32P‐dCTP radiolabelled
4 kb SacI BCL6 probe that hybridized to exon 1 and 5′ flanking sequences. Following autoradiography, the size and relative density of hybridized fragments was used to assign methylation status.

RESULTS: HpaII digested DNA from benign LPDs was characterised by fragments
of approximately 0.9 kb, 3.6 kb, 3.9 kb, 4.6 kb and 4.9 kb, and using GenBank sequence
NT5962, 3 methylated MspI restriction sites were predicted. Of 22/24 (92%)
HpaII digested DNA samples from benign LPDs, the 3.6 kb, 3.9 kb, 4.6 kb and
4.9 kb fragments all had either similar density, or the latter two fragment sizes
had relatively greater density. 28/30 (93%) HpaII digested DNA samples
from B‐NHL had a decrease in relative density of the 4.6 kb and 4.9 kb fragments
compared to the 3.6 kb and 3.9 kb fragments, and one sample had a 3.3 kb fragment.
Of the 6 HpaII digested DNA samples from T cell neoplasms, 3 samples had fragments larger than 4.9 kb, 1 sample had 4.6 kb and 4.9 kb fragments having less density than the 3.6 kb and 3.9 kb fragments, and 2 samples had findings indistinguishable from benign LPD samples.

CONCLUSION: This study of the methylation status of the upstream flanking region of BCL6 indicates there may be alternative deregulatory mechanisms leading
to hypomethylation in the majority of B‐NHL and hypermethylation in some T cell neoplasms.
Whether hypomethylation of BCL6 in B‐NHL predisposes to somatic mutation and translocation of this gene remains to be investigated.
THE VALUE OF HPV DNA TYPING IN THE DISTINCTION BETWEEN ADENOCARCINOMAS OF ENDOCERVICAL AND ENDOMETRIAL ORIGIN IN BIOPSY MATERIAL
Authors: M Plunkett , B Brestovac , G Sterrett , J Thompson , F Frost , D Smith
Published: March 2003

Introduction and aims: Distinguishing between adenocarcinomas of endocervical and endometrial origin histologically can be difficult, particularly in curetting specimens with minimal material for examination. Endocervical adenocarcinomas have been shown to contain HPV DNA of certain ‘high risk’ subtypes, whereas this has not been consistently demonstrated in endometrial adenocarcinomas. The aims of this study were to look at whether HPV DNA typing could aid in this differential diagnosis.

Methods: The study investigated the frequency of HPV DNA in paraffin embedded tissue samples from endocervical and endometrial adenocarcinoma specimens using PCR amplification techniques designed to detect HPV DNA including high risk subtypes 16, 18, 31, 33, 45 and 58. Cases were selected from PathCentre and King Edward Memorial Hospital files, mainly curetting specimens with subsequent definitive hysterectomy. All cases were reviewed by a gynaecological pathologist. Control specimens included CIN III lesions, squamous cell carcinomas (SCC's) of the cervix and lung, and colonic adenocarcinomas. Measures to prevent cross contamination were implemented.

Results: HPV DNA was detected in 11 of 11 (100%) CIN III lesions, 9 of 10 (90%) cervical SCC's, 0 of 100 (0%) colorectal adenocarcinomas and 1 of 10 (10%) SCC's of the lung. 26 of 34 (76.5%) endocervical adenocarcinomas contain HPV DNA with 20 (55.6%) containing high risk subtypes, compared to 2 of 29 (6.9%) endometrial carcinomas, one with high risk subtype.

Conclusions: Preliminary results suggest HPV DNA typing could be a useful adjunct in distinguishing between endocervical and endometrial adenocarcinomas on curetting specimens, and possibly in the diagnosis of metastatic carcinomas of the cervix.
Fibrous tumor of the breast in a postmenopausal woman receiving estrogen
Authors: Miyagawa Aya , Yuba Yoshiaki , Haga Hironori , Nishimura Satoru , Kobashi Yoichiro
Published: March 2003

Fibrous tumor of the breast is a rare, benign stromal proliferation with atrophy of the epithelial component. Almost all patients who develop fibrous tumors are premenopausal. An unusual example of fibrous tumor of the breast is reported in a 62‐year‐old postmenopausal woman. The mass, first noted 1 year previously, progressively enlarged over the year. The patient noted a history of taking exogenous estrogens for 10 years. Intense estrogen administration during the year of enlargement may be associated with accelerated growth of the tumor. In addition, positive nuclear staining for estrogen receptor antibodies in stromal cells was demonstrated by immunohistochemical methods.
Expression of p21Waf1, p27Kip1 and cyclin D1 proteins in breast ductal carcinoma in situ: Relation with clinicopathologic characteristics and with p53 expression and estrogen receptor status
Authors: Oh Young Lyun , Choi Jong Sun , Song Sang‐Yong , Ko Young Hyeh , Han Boo‐Kyung , Nam Seok‐Jin , Yang Jung‐Hyun
Published: March 2003

p21Waf1 (p21), p27Kip1 (p27) and cyclin D1 have recently been reported as useful prognostic markers for patients with breast carcinoma. However, studies on these cell cycle regulators in ductal carcinoma in situ (DCIS) have been extremely limited. Therefore, we studied the immunohistochemical expression of p21, p27 and cyclin D1 proteins in 49 DCIS cases and compared the findings with the clinicopathologic parameters (age, tumor size, gross type, histologic type, histologic grade, necrosis and mitotic index), p53 and estrogen receptor (ER) status. A significant correlation was found between positive p21 immunoreactivity (67.3% of the cases) and well‐differentiated histologic grade, non‐comedo type, ER‐positive and p53‐negative (p53–) status. DCIS with p21+/p53– is likely to be the non‐comedo type. The overexpression of cyclin D1 (59.2% of the cases) correlated positively with the ER expression (P = 0.001). The p27 protein expression (46.9% of the cases) correlated with the cyclin D1 immunopositivity (P = 0.0003) and ER expression (P = 0.005). No significant associations were seen in the p27 or cyclin D1 expression and other clinicopathologic parameters. Our results suggest that p21 might be more related to the useful biologic markers in DCIS than p27 or cyclin D1. The significant positive association between p21, p27 or cyclin D1 and ER status, and close association of p27 and cyclin D1 expression might be implicated in the tumor biology of DCIS.
Malignant phyllodes tumor of the breast with expression of osteonectin and vinculin
Authors: Kuroda Naoto , Sugimoto Takeki , Ueda Shosuke , Takahashi Tamotsu , Moriki Toshiaki , Sonobe Hiroshi , Miyazaki Eriko , Hayashi Yoshihiro , Toi Makoto , Hiroi Makoto , Enzan Hideaki
Published: March 2003

Phyllodes tumor is a very rare neoplasm which accounts for 2.5% of all fibroepithelial lesions of the breast. The mesenchymal component of a malignant phyllodes tumor frequently contains heterologous components. We report a case of malignant phyllodes tumor. The patient was a 40‐year‐old woman with a lump on the left breast. Histological examination revealed the lump to be a malignant phyllodes tumor with foci of liposarcomatous differentiation. The mesenchymal tumor cells, including those in the liposarcomatous components, were found to express vimentin, osteonectin and vinculin. However, they showed no immunoreaction to CAM 5.2, desmin, α‐smooth muscle actin (ASMA), neuron‐specific enolase (NSE) nor S‐100. Ultrastructurally, the mesenchymal tumor cells were found to have abundant cytoplasmic organelles, but there was no evidence showing their differentiation to myofibroblasts. Further studies will be necessary to elucidate the significance of vinculin and osteonectin expression in malignant phyllodes tumor.
Vascular amyloid of unknown origin and senile transthyretin amyloid in the lung and gastrointestinal tract of old age: Histological and immunohistochemical studies
Authors: Matsutani Hironobu , Hoshii Yoshinobu , Setoguchi Mihoko , Kawano Hiroo , Gondo Toshikazu , Takahashi Mutsuo , Yokota Tadaaki , Ishihara Tokuhiro
Published: March 2003

The histological and immunohistochemical characteristics and the incidence of amyloid deposits in the tissues of the lung and gastrointestinal tract were investigated in 64 autopsied individuals who were 80 years and older (age range: 80–92 years; mean: 83.3 years). Immunohistochemical examination was performed with antibodies against amyloid A, transthyretin, immunoglobulin λ and κ light chain amyloid fibril proteins, β2‐microglobulin, β protein, apolipoprotein AI, apolipoprotein AII, atrial natriuretic peptide, apolipoprotein E, and amyloid P component. Transthyretin amyloid fibril protein (ATTR) deposits were observed in five cases (7.8%). Gastrointestinal amyloid deposits of unknown origin were observed in the veins of the gastrointestinal tract in 26 cases (40.6%). This amyloid was regarded as portal amyloid with respect to distribution pattern. Pulmonary vascular amyloid deposits of unknown origin were observed in 12 cases (18.8%). These amyloid deposits were found mainly in medium‐sized veins in the lungs and did not react with any antibodies against amyloid fibril proteins except apolipoprotein E and amyloid P component. Eleven of the 26 cases (42.3%) showing portal amyloid also showed pulmonary vascular amyloid of unknown origin. The pulmonary vascular amyloid deposits were similar to the portal amyloid deposits with respect to their morphological features and their relation to elastic fibers in the vessels. Further morphological investigation and biochemical analysis of the pulmonary vascular amyloid and portal amyloid will resolve questions of their origins and relation.
Histopathological study on mechanism and background of tumor‐forming pancreatitis
Authors: Takase Masaru , Suda Koichi
Published: March 2003

Fifteen cases of tumor‐forming pancreatitis, detected as tumors by diagnostic imaging or by physical examination were histologically examined. Eleven of the 15 patients were heavy drinkers. Tumorous lesions were located in the head of the pancreas in 11 cases and in the body or tail of the pancreas in four cases. Macroscopic examination revealed tumorous swelling or sclerotic appearance in the pancreatic tissue. Histologically, these lesions showed tumorous swelling with (n= 12) or without (n= 3) a background of chronic pancreatitis. In the former, the tumorous lesions consisted of extensive fibrosis, including necrosis or abscesses, stones and reparative granulation tissue, and there was a successive transition to the surrounding chronic pancreatitis pattern. The latter three tumorous lesions presented with inter‐ and intralobular fibrosis with lymphoid hyperplasia or lymphoplasmacytic infiltration and were adjacent to normal pancreatic tissue. Therefore, tumor‐forming pancreatitis shows at least two distinct types: a reparative tumorous swelling with a background of chronic pancreatitis, which is considered to have given rise to the tumor at some stage; and a lymphoid and fibrous proliferation in normal pancreatic tissue, which is considered to represent an autoimmune‐related disease process.
Histological diversity of vasculitic lesions in MPO–ANCA‐positive autopsy cases
Authors: Sano Kenji , Sakaguchi Nobuki , Ito Makoto , Koyama Masamichi , Kobayashi Motohiro , Hotchi Masao
Published: March 2003

To investigate the variety of histological features of vasculitic lesions in myeloperoxidase‐specific antineutrophil cytoplasmic antibody (pANCA)‐related vasculitis, retrospective pathological analysis was done on 13 autopsy cases, collected from 1990 to 1998 at five hospitals. These cases were classified into three groups: (i) pulmonary–renal syndrome characterized by capillaritis of lung and glomeruli with occasional small‐vessel arteritis and/or phlebitis; (ii) glomerular capillaritis without pulmonary involvement associated with significant small‐vessel arteritis; and (iii) extensive distribution of small‐vessel arteritis with no capillary involvement. The results suggest that pANCA‐related vasculitis encompasses a wide variety of vasculitic syndromes, including pulmonary–renal syndrome, microscopic polyarteritis nodosa, and classic polyarteritis nodosa. pANCA may contribute to pathogenesis in all of these cases.
Autopsy case of alcoholic hepatitis and cirrhosis treated with corticosteroids and affected by Pneumocystis carinii and cytomegalovirus pneumonia
Authors: Ikawa Hirotsugu , Hayashi Yoshitake , Ohbayashi Chiho , Tankawa Hidemitsu , Itoh Hiroshi
Published: March 2003

A case of the very early phase of Pneumocystis carinii pneumonia in a human immunodeficiency virus (HIV)‐negative man with alcoholic hepatitis and cirrhosis treated with steroids is presented. A 40‐year‐old man with a 10‐year history of alcohol abuse was admitted to hospital with jaundice, fever and macrohematuria. Laboratory examinations revealed neutrophilic leukocytosis and a serum bilirubin level of 13.9 mg/dL. The serum bilirubin level rose to 28.5 mg/dL over 1 month. Prednisolone administered orally for 10 days produced a slight improvement in the jaundice and fever. After an interval of a week, it was resumed and maintained for 22 days (total dose, 1555 mg) until the patient died of a massive hemorrhage from ruptured vessels of a gastric ulcer. An autopsy disclosed P. carinii pneumonia in the lower lobe of the left lung, cytomegalovirus infection in both lungs and the esophagus, and esophageal candidiasis. To our knowledge, this is the first report of P. carinii pneumonia together with cytomegalovirus infection in an HIV‐negative alcoholic patient. The present case suggests that a rare opportunistic infection such as P. carinii pneumonia might be caused by treating cirrhosis and alcoholic hepatitis with corticosteroids, even if only for a relatively short period.
Compound melanocytic nevus arising in a mature cystic teratoma of the ovary
Authors: Kuroda Naoto , Hirano Kouki , Inui Yasunobu , Yamasaki Yoshikazu , Toi Makoto , Nakayama Hirofumi , Hiroi Makoto , Enzan Hideaki
Published: March 2003

A 28‐year‐old woman complained of irregular menstruation. Abdominal ultrasound and magnetic resonance imaging (MRI) examinations revealed a cystic tumor in the left ovary. A histological examination of the resected ovary revealed that the lesion was a mature cystic teratoma. In this tumor, components such as skin with appendages, a thyroid gland, mucosa of the digestive tract and a submandibular gland were observed. Interestingly, compound melanocytic nevus was also present in the skin component. To the best of our knowledge, this is the sixth reported case of nevus arising in a mature cystic teratoma of the ovary. Despite the extreme rarity of such a lesion, pathologists should recognize the possibility of such lesions occurring in ovarian teratoma.
E‐cadherin expression in follicular carcinoma of the thyroid
Authors: Kato Noriko , Tsuchiya Takashi , Tamura Gen , Motoyama Teiichi
Published: March 2003

Follicular carcinoma (FC) of the thyroid is distinguished from follicular adenoma (FA) by confirmation of invasion or metastasis. However, it is still unknown how FC acquires the potential for invasion or metastasis. Twenty early FC (pT1 and pT2) were analyzed for immunohistochemical E‐cadherin (E‐CD) expression. Four of four (100%) widely invasive FC showed reduced E‐CD expression, whereas only two of 16 minimally invasive FC showed reduced expression. In most of the minimally invasive FC, both E‐CD and β‐catenin were expressed on cell–cell boundaries, even in areas where capsular invasion occurred. These results suggest that the mechanism of invasion may be different between widely invasive FC and minimally invasive FC, and that E‐CD is probably responsible for the invasion of widely invasive FC. Analysis of methylation of the E‐CD gene promoter using the methylation‐specific polymerase chain reaction (MSP) method revealed no methylated alleles in the DNA from FC.
Chordoma of cervical vertebra protruding into the oral cavity
Authors: Yamashita Atsushi , Hatakeyama Kinta , Marutsuka Kousuke , Fujita Seigo , Ono Seiji , Torihara Koji , Tamura Shozo , Komune Shizuo , Asada Yujiro
Published: March 2003

A 70‐year‐old man was admitted to hospital because of oral and cervical masses. Computed tomographic scanning revealed a lobulated mass lesion in the retropharyngeal region, with a protruding extension in the oral cavity and with destruction of the second cervical vertebra. A biopsy was performed under the diagnosis of a retropharyngeal tumor. Histologically, this lesion was composed of vacuolated tumor cells in a solid or cord‐like arrangement, with an abundant myxoid matrix. Immunohistochemically, the tumor cells were positive for pancytokeratin, epithelial membrane antigen and S‐100 protein. The tumor was diagnosed as chordoma. Chordoma presenting as an intra‐oral mass lesion is very rare.
Histogenesis and morphogenesis of depressed‐type early colorectal carcinoma
Authors: Kazama Shinsuke , Ajioka Yoichi , Watanabe Hidenobu , Watanabe Toshiaki , Nagawa Hirokazu
Published: March 2003

The aim of this study was to elucidate the histogenesis and morphogenesis of depressed‐type early colorectal carcinomas (DECas). Eighty‐seven DECas were selected for examination. The 87 DECas included 23 (26.4%) absolutely depressed (ABS) types (depressed mucosa being thinner than the normal mucosa; histologically true depression), 40 (46.0%) relatively depressed (REL) types (the thickness of the depressed mucosa being the same or greater than that of normal mucosa, with depression being relative compared to marginal elevation) and 24 (27.6%) ulcerated (UL) types (no remnant intramucosal component in the depressed area). The rates of residual adenomatous components were 0/23 (0%) for ABS type and 12/40 (30%) for REL type, indicating that the ABS type was thought to have arisen de novo and the REL type was thought to have arisen de novo and via an adenoma–carcinoma sequence. In 13 of the 23 (56.5%) ABS types, carcinoma was located within the depressed area alone, suggesting that many ABS types show a depression from their initial stage. While 33 of the 40 (82.5%) REL types accompanied by marginal elevation consisted of neoplastic mucosa, in 19 of the 33 (57.6%) cases, the depressed area showed a higher grade of atypia than the area of marginal elevation. This suggested that the depression in the REL type was generated secondarily at the center of a pre‐existing, superficially elevated tumor due to progression of its histological grade of atypia. ABS type was speculated to be the precursor of UL type since the two types showed similarity (no statistical significant difference) in percent depression (69.6 vs 64.3%), grade of atypia of carcinoma (52.2 and 79.2% consisted of carcinoma with high‐grade atypia alone), and frequency of being accompanied by non‐neoplastic reactive marginal elevation (56.5 vs 70.8%).
Reverse transcriptase–polymerase chain reaction detection of circulating tumor cells in patients with melanoma: Correlation with clinical stage, tumor thickness and histological type
Authors: Carrillo Esmeralda , Prados Jose , Melguizo Consolación , Marchal Juan Antonio , Vélez Celia , Serrano Salvio , Boulaiz Houria , Mérida Juan Antonio , Aránega Antonia
Published: March 2003

The aim of this study was to evaluate the correlation between the detection of circulating melanoma cells and prognostic criteria for malignant melanoma such as clinical stage, tumor thickness and histological type of the primary tumor. Using a reverse transcriptase–polymerase chain reaction (RT–PCR) technique, melanoma cells were identified by detecting tyrosinase mRNA in peripheral blood from 58 patients with malignant melanoma classified according to the American Joint Committee on Cancer guidelines. The results of the RT–PCR assay for tyrosinase were related to two prognostic markers typically used to evaluate these tumors: clinical stage and thickness. Positive PCR results were more frequent in primary tumors measuring > 4 mm (83%) than in thinner tumors (1.1–4.0 mm, 74%; ≤ 1.0 mm, 23%) (P = 0.005). No statistical correlation was found between the PCR results and histological appearance of the primary tumor. Although further studies are necessary, our results suggest the possible application of the PCR assay for tyrosinase mRNA in clinical evaluation of the prognosis of malignant melanoma.
Coexpression of neural cell adhesion molecules and bcl‐2 in intrahepatic cholangiocarcinoma originated from viral hepatitis: Relationship to atypical reactive bile ductule
Authors: Asayama Yoshiki , Aishima Shin‐ichi , Taguchi Ken‐ichi , Sugimachi Keishi , Matsuura Shuji , Masuda Kouji , Tsuneyoshi Masazumi
Published: March 2003

It has been shown that atypical reactive bile ductules (ARBD) display positive immunoreactivity of neural cell adhesion molecules (NCAM) and bcl‐2. We investigated the clinicopathological features of intrahepatic cholangiocarcinoma (CC) arising in cases of viral hepatitis B or C (VHBC) and examined their relation to ARBD by means of immunohistochemical analysis. Sixty‐eight surgical cases with CC were included in this study. The cause of the background liver disease was hepatitis B surface antigen (HBsAg)(+) in eight cases, antihepatitis C virus antibody (HCVAb)(+) in 13 cases, both HBsAg(+) and HCVAb(+) in one case, and both HBsAg(–) and HCVAb(–) in 46 cases. The average age of patients with CC arising in the HBsAg(+) group was significantly less than that of patients with CC in the HCVAb(+) group (P = 0.0192). Immunohistochemically, CC arising in the HBsAg(+) and HCVAb(+) groups was correlated with coexpression of NCAM/bcl‐2 in the tumor cells (P = 0.0068 and P = 0.0382, respectively). Among the 12 cases of CC coexpressing NCAM/bcl‐2, 11 were of mass‐forming and peripheral type (P = 0.0437), and lymph node metastasis was a rare finding compared with CC showing negative coexpression of NCAM/bcl‐2 (P = 0.0213). The tumor cells of CCs arising in VHBC have some characteristics of ARBD. In such tumors, because lymph node metastases were rarely seen and lymph node dissection did not improve patient’s survival, lymph node dissection can be limited.
Serous microcystic adenoma (glycogen‐rich cystadenoma) of the pancreas: Study of 11 cases showing clinicopathological and immunohistochemical correlations
Authors: Yasuhara Yumiko , Sakaida Noriko , Uemura Yoshiko , Senzaki Hideto , Shikata Nobuaki , Tsubura Airo
Published: March 2003

Serous microcystic adenoma of the pancreas, also known as microcystic adenoma, glycogen‐rich cystadenoma or serous cystadenoma, is an uncommon benign tumor. We have studied 11 cases involving eight women and three men. The average age at diagnosis was 61.7 years. Four tumors were discovered incidentally. Tumors varied from 1.2 to 20 cm in maximum diameter and all were multicystic. Within the pancreas, three were located in the pancreas head, one involved the head and body, one was located in the body, five were in the tail, and one occupied the whole pancreas. Central stellate scar was seen in five (45%) cases. Histologically, all tumors were composed of microglandular cysts lined by clear epithelial cells rich in glycogen, which were separated by fibrocollagenous stroma. The expression of keratin in clear epithelial cells resembled that in ductal and/or centroacinar cells, but not acinar cells. α‐Smooth muscle actin (SMA)‐positive myoepithelial cells and stromal amyloid deposits were not detected. Ultrastructurally, fibrocollagenous stroma was composed of α‐SMA‐positive myofibroblasts and endothelial cells embedded in thick collagen bundles. Regardless of female propensity, estrogen and progesterone receptors were not detected. Therefore, female predominance in this tumor remains to be elucidated.
Expression of thyroid transcription factor‐1 in strumal carcinoid and struma ovarii: An immunohistochemical study
Authors: Hamazaki Shuji , Okino Takeshi , Tsukayama Choutatsu , Okada Shigeru
Published: March 2003

Strumal carcinoid is an ovarian teratoma composed of thyroid tissue and carcinoid, intimately admixed in variable proportions. To further elucidate the histogenesis of strumal carcinoid, the expression pattern of thyroid transcription factor‐1 (TTF‐1) was evaluated in two cases of strumal carcinoid using immunohistochemical techniques. TTF‐1 is a nuclear transcription protein that is selectively expressed in the thyroid and respiratory epithelium, and is thought to be expressed specifically in pulmonary and thyroid neoplasms. While the follicular lining cells of the strumal carcinoid showed positive staining for TTF‐1, the carcinoid element was, for the most part, negative. These results confirm that TTF‐1 is expressed in the thyroidal element of ovarian teratomas and also provide further evidence that the carcinoid component of the strumal carcinoid bears no relation to thyroidal differentiation.
Impact of p53 and Ki‐67 in predicting recurrence and progression of superficial (pTa and pT1) urothelial cell carcinomas of urinary bladder
Authors: Kilicli‐Camur Nurcan , Kilicaslan Isin , Gulluoglu Mine G. , Esen Tarik , Uysal Veli
Published: March 2003

In predicting the aggressive behavior of bladder tumors, the histopathological characteristics of grade and invasive stage are of principal importance. However, for predicting tumor recurrence and progression, these are sufficient only to a limited extent, particularly in the case of superficial (pTa and pT1) urothelial cell carcinomas. New prognostic factors are therefore needed to avoid either insufficient or excessive treatment. In this retrospective study, we investigated the prognostic value of the p53 and Ki‐67 immunoreactivity indices. The present study included 118 superficial urinary bladder tumors consisting of 58 recurrent and 60 non‐recurrent cases. Twenty of the recurrent tumors progressed into a higher grade and/or invasive stage. Paraffin immunohistochemical analysis was carried out using anti‐p53 and anti‐Ki‐67 antibodies on the initial tumor tissues. We concluded that there is a highly significant relationship between the p53 and Ki‐67 immunoreactivities and the histological grade and pathological stage of the tumors (P < 0.0001). We observed a significant relationship between the presence of recurrence and progression and the p53 immunoreactivity index (P < 0.01 and P = 0.017, respectively) and Ki‐67 immunoreactivity index (P < 0.0001 and P = 0.046, respectively). Positivity for p53 and Ki‐67 can demonstrate the risk of recurrence (p53: sensitivity = 76%, specificity = 58%; Ki‐67: sensitivity = 86%, specificity = 48%) and progression (p53: sensitivity = 80%, specificity = 46%; Ki‐67: sensitivity = 85%, specificity = 36%; ). We believe that both of these immunohistochemical markers can be considered valuable in addition to classical histopathological prognostic parameters for predicting recurrence and progression risks.
Glomerulonephritis with microtubular deposits associated with cryoglobulinemia and chronic active hepatitis
Authors: Hirahashi Junichi , Kuramochi Shigeru , Konishi Konosuke , Chikaraishi Akihiro , Takase Osamu , Hayashi Matsuhiko , Saruta Takao
Published: March 2003

A 65‐year‐old‐woman presented with edema, ascites, proteinuria and abnormal liver function tests. A small amount of mixed cryoglobulin was detected in her serum. Liver biopsy revealed mild chronic active hepatitis, but tests for hepatotropic viral infection were negative. Electron microscopy of the renal biopsy revealed glomerular electron‐dense deposits that contained numerous tubular structures. Renal amyloidosis and light chain deposition disease were ruled out by appropriate histological techniques. The ultrastructural findings of renal biopsy suggested either cryoglobulinemic glomerulonephritis or immunotactoid glomerulopathy. Although the exact interrelationship among the peculiar glomerulopathy, cryoglobulinemia and chronic active hepatitis in the present case remains undetermined, this report enlarges the spectrum of glomerulopathy characterized by extracellular deposition of microtubules.
Lobular capillary hemangioma of the oral mucosa: Clinicopathological study of 43 cases with a special reference to immunohistochemical characterization of the vascular elements
Authors: Toida Makoto , Hasegawa Tomomi , Watanabe Fumio , Kato Keizo , Makita Hiroki , Fujitsuka Hideki , Kato Yukihiro , Miyamoto Ken , Shibata Toshiyuki , Shimokawa Kuniyasu
Published: March 2003

Clinical and histopathological features were investigated in 43 cases of oral lobular capillary hemangiomas (LCH) with a special reference to characteristics of the vascular elements. The lesions affected females more than males by a ratio of 1:1.5. Average age of the patients was 52.7 years. The lesions involved the gingiva (n = 15), the tongue (n = 13), the labial mucosa (n = 10) and other sites. The lesions appeared usually as a pedunculated mass with ulceration; size of the lesions was up to 15 mm. Histologically, a lobular area and an ulcerative area were distinguished. The density of vessels was about 1045/mm2 and 160/mm2 in the lobular and ulcerative areas, respectively. The average diameter of the vascular lumen was 9.1   5.6 mm (range: 2.8–42.0 mm) and 18.8  20.9 mm (range: 5.6–139.7 mm) in the lobular and ulcerative areas, respectively. In the lobular area, most of the vessels had an inner layer of endothelial cells showing positive reaction for von Willebrand factor (vWF) and CD34, as well as an outer layer of mesenchymal cells showing positive reaction for alpha‐smooth muscle actin (ASMA). However, in the ulcerative area, there was a variety of types of vessels consisting of various proportions of both endothelial and ASMA‐positive perivascular mesenchymal cells. These results indicate that most of the vascular elements in the lobular area resemble more pericapillary microvascular segments than they do capillaries. Thus, the authors propose the term ‘lobular pericapillary hemangioma’ to represent this type of lesion.
Low‐grade fibrosarcoma of the proximal humerus
Authors: Saito Tsuyoshi , Oda Yoshinao , Tanaka Kazuhiro , Matsuda Shuichi , Sakamoto Akio , Yamamoto Hidetaka , Iwamoto Yukihide , Tsuneyoshi Masazumi
Published: March 2003

We present the clinical, radiographical and pathological features of low‐grade fibrosarcoma of the left proximal humerus in a 23‐year‐old man in whom it was necessary to distinguish the tumor from desmoplastic fibroma, malignant fibrous histiocytoma and intramedullary well‐differentiated osteosarcoma. The patient presented with a 10‐day history of pain in his left upper arm sustained when trying to break his fall with his left hand when slipping in the street. Plain radiography revealed an expanding multilobular osteolytic lesion from the proximal metaphysis to the diaphysis of his left humerus, accompanied by a pathological fracture at the distal portion of the lesion. Open biopsy of the lesion was performed twice; however, a conclusive diagnosis could not be obtained. The patient underwent wide excision and prosthetic replacement of the left proximal humerus. Histologically, the resected tumor was composed of both cellular areas and hypocellular areas. Cellular areas revealed a proliferation of bundles of uniform fibroblastic spindle‐shaped cells with minimal cellular atypia, mixed with abundant intercellular collagenization. Mitotic figures were occasionally seen. Hypocellular areas showed myxoid features with loose bundles of collagen fibers. The patient demonstrates no evidence of disease 42 months after surgery. It is important to detect the scant atypical cells for the differential diagnosis of low‐grade fibrosarcoma and desmoplastic fibroma of bone.
Ultrastructure of chloroplasts in‘Marimo’(Cladophora aegagropila, Chlorophyta), and changes after exposure to light
Authors: Horiguchi Takeo , Yoshida Tadao , Nagao Manabu , Wakana Isamu , Yokohama Yasutugu
Published: March 2003

This study compares the ultrastructure of the inner, dark‐habituated cells of the green ‘Cladophora‐ball’, or Marimo, to that of similar cells at the surface. Cells not exposed to light possess fewer, but larger and more irregular, chloroplasts than do the outer cells. Unexposed chloroplasts have a pyrenoid matrix lacking starch sheaths and containing unusually thick granal stacks. Despite prolonged exposure to darkness, the chloroplasts contain small starch grains. After exposure to light, such chloroplasts divide, become smaller and take on the appearance of those in the outer layer cells. Within 48 h, all of the chloroplasts develop substantial starch grains and the pyrenoids are surrounded by starch sheaths. This response is consistent with previous reports of the recovery of photosynthetic activity in inner cells exposed to light.
Successful treatment of hepatic sarcoidosis with hormone replacement in a postmenopausal woman
Authors: Chida Kingo , Shirai Masahiro , Sato Masaki , Sato Jun , Nakamura Hirotoshi
Published: March 2003

A possible supplementary effect of sex hormone replacement therapy (HRT) for the postmenopausal woman with sarcoidosis is described. A 53‐year‐old woman presented with a 12‐year history of sarcoidosis in the eyes, in the submandibular lymph nodes and in the lungs. In the course of follow up without any medication, her liver function tests were abnormal, and she was diagnosed as having hepatic sarcoidosis. Daily administration of 0.625 mg conjugated oestrogen and 2.5 mg medroxyprogesterone improved her liver function. The results suggest that HRT may help to prevent the progression of sarcoidosis in postmenopausal patients.
Idiopathic bronchiolitis obliterans with organizing pneumonia presenting with spontaneous hydropneumothorax and solitary pulmonary nodule
Authors: Yang Dong Gyoo , Kim Kil Dong , Shin Dong Hwan , Choe Kyu Ok , Kim Sung Kyu , Lee Won Young
Published: March 2003

The first case of idiopathic bronchiolitis obliterans with organizing pneumonia (BOOP) presenting as solitary pulmonary nodule with spontaneous hydropneumothorax is reported in a 54‐year‐old man. A wedge resection of the right lower lobe was performed to show typical histological features of BOOP. This case report demonstrates that BOOP has a very diverse clinical manifestation and stresses the need to include solitary pulmonary nodule with hydropneumothorax in the spectrum of BOOP.