bluuebunny/crossref_metadata_2025 huggingface dataset:
Giant hidradenocarcinoma: A report of malignant transformation from nodular hidradenoma
Authors: Lim Sung‐Chul , Lee Mi‐Ja , Lee Mi‐Sook , Kee Keun‐Hong , Suh Chae‐Hong
Published: December 2008

A giant hidradenocarcinoma presented by a 75‐year‐old female Is reported. The patient had a malignant transformation within a nodular hidradenoma involving the right postauricular area, which was treated by mass removal and a right radical neck dissection with a free‐flap covering. Malignant hidradenocarcinoma is the least common adnexal tumor of uncertain origin. They are usually malignant from their inception, but some develop from a benign counterpart. To the authors' knowledge, only three cases have been reported previously. Two histologically distinct components were seen in this tumor: (i) typical nodular hidradenoma, which constituted a small part of the tumor; and (ii) carcinoma with areas of transition. The secretory cells of hidradenocarcinoma showed decapitation secretion on light and electron microscopic observations, which is evidence of apocrine differentiation. Histologically, this case was concluded as a hidradenocarcinoma arising from a long‐standing nodular hidradenoma. A literature review is presented and the histological, immunohisto‐chemical and ultrastructural features are described.
Matrix‐producing carcinoma of the breast: Case report with radiographical and cytopathological features
Authors: Murata Tetsuya , Ihara Shinji , Kato Hiroya , Tanigawa Kenji , Higashiguchi Takashi , Imai Takazumi , Matsushita Tom , Nakamura Kazuyoshi , Nakayama Tsuyoshi , Shiraishi Taizo , Moriya Takuya
Published: December 2008

A case of matrix‐producing carcinoma (MPC), which is a unique variant of breast cancer, is described with cytopathological and radiographical findings. A 75‐year‐old female presented with a palpable mass in her right breast. After confirmation of the cytopathological diagnosis, the patient received a right mastectomy with ipsilateral axillary lymph node dissection. The histopathological examination revealed MPC. The Union Internationalis Contra Cancrum postoperative clinical stage was IIB. The patient is well and without disease 18 months after the surgery.
Endovascular papillary angioendothelioma (Dabska tumor)
Authors: Fukunaga Masaharu
Published: December 2008

The histological diagnosis of endovascular papillary angioendothelioma (EPA) (Dabska tumor) is controversial although the tumor is included in the World Health Organization classification. Papillary endothelial proliferation with a central hyaline core is one of the most characteristic features of EPA; however, this type of proliferation has been observed in other vascular tumors, such as angiosarcoma, retiform hemangioendothelloma and glomeruloid hemangioma. Several vascular tumors have EPA‐like foci and EPA is not well defined generally. Endovascular papillary angioendothelioma may not be a distinct entity and may well include a heterogeneous group of lesions.
The expression of thymidine phosphorylase/platelet‐derived endothelial cell growth factor is correlated to angiogenesis in breast cancer
Authors: Yonenaga Fumiyo , Takasaki Takashi , Ohi Yasuyo , Sagara Yoshiatu , Akiba Suminori , Yoshinaka Heiji , Aikou Takashi , Miyadera Kazutaka , Akiyama Shinichi , Yoshida Hiroki
Published: December 2008

It has been shown that human thymidine phosphorylase (TP) Is Identical to platelet‐derlved endothelial cell growth factor and has angiogenlc actlvhy. In the present study, the expression of TP was examined In 139 mammary carclnomas and 35 benign mammary disorders using biochemical and lmmunohlstochemlcal methods. Moreover, In order to evaluate the significance of TP expression in mammary carcinomas, the relationship between vascular density and various cllnicopathological factors, including age and menopausal status of patients with a mammary carcinoma, were compared wtth the size, nodal status, expression of estrogen receptor (ER), progesterone receptor (PgR), c‐erbB‐2, p53 and TP of a mammary carcinoma. Thymidine phosphorylase expression Increased in both the nuclei and cytoplasm of mammary carclnoma cells in comparison to mammary benign disorder cells. The number of mlcroves‐sels In mammary carcinomas was generally correlated to the number of tumor cells with TP expression in cytoplasm. The number of cells with TP expression in cytoplasm was significantly large In tumors that measured 34 cm In diameter, compared wtth tumors measuring 1–2 and 5–6 cm in diameter. In mammary tumors of 1–4 cm diameter, TP expression and vessel denslty were slgnlficantly high in tumors negative for ER or positive for cerbB2 and In tumors positive for TP or cerbB2, respectively; whereas tumors of 5–6 cm In diameter were not modified by any cllnlcopathological factors. The results lndlcated that TP plays an Important anglogenetic role In mammary carcinomas, especially tumors with a certain progression.
Periacinar collagenization in patients with chronic alcoholism
Authors: Kuroda Junji , Suda Koichi , Hosokawa Yoshinori
Published: December 2008

To examine the development of pancreatic fibrosis In alcoholics, the fibrosis types grouped according to Martin's classification were examined by immunohlstochemistty using an antibody against α‐smooth muscle actin (α‐SMA). The initial stage of periacinar collagenizatlon was also Investigated by electron microscopy. The total incidence of pancreatlc fibrosis at autopsy of the 29 alcoholics was significantly higher than that of the 40 non‐alcoholics. lntralobular sclerosis was observed to be the most frequent type of fibrosls regardless of alcohol intake. No differences in the enhancement of α‐SMA expresslon in each type of fibrosis were found between the alcoholics and non‐alcoholics. Electron microscopically, myofibroblasts were found around acini in the early stage of periacinar collagenization, and were accompanled by numerous fine filaments (8–15 nm in diameter). The various changes In zymogen granules (ZG), lysosomes and lipld droplets were augmented in the acinar cells of alcoholics. Medlumdensity materials were also found in dilated rough endoplasmic retlculum (RER). The contents of ZG and RER occasionally leaked out. In conclusion, pancreatlc fibrosis was increased in alcoholics; myofibroblasts may play an important role in the initial stage of periacinar collagenizatlon; and the intracellular transport blockage of protein as represented by abnormalities of ZG, ER and lysosomes may contribute to the development of periacinar collagenization.
Synchronous and metachronous lung carcinomas: Molecular evidence for multicentricity
Authors: Hiroshima Kenro , Toyozaki Tetsuya , Kohno Hiromasa , Ohwada Hidemi , Fujisawa Takehiko
Published: December 2008

The present study Is aimed to evaluate the genetic evidence for multicentricity of synchronous and metachronous multiple lung carcinomas. Nineteen cases of synchronous multlple lung carcinomas and 11 cases of metachronous multiple lung carcinomas were analyzed for p53 protein overexpression by lmmunohistochemlstry (DO‐7) and for genetic abnormality of the p53 gene by loss of heterozygosity (LOH) at chromosome 17p and by poly‐merase chaln reaction (PCR)‐singlestrand conformation polymorphism (SSCP) analysis. They were also analyzed for K‐ras mutation. DNA from three patients was also sequenced by the dideoxy sequencing method to confirm the presence of mutations and determine the base substitutions. Different spectrums of genetic changes, which were evaluated by a combination of p53 mutation, LOH at chromosome 17p and p53 overexpression, were observed in 11 of 19 cases of synchronous multiple lung carcinomas (57.9%) In the present study. Slmllarly, five of 11 cases of metachronous multiple lung carcinomas (45.4%) showed a different pattern of genetic changes. The present data suggest that some of the multiple carcinomas have dlfferent clonal orlgins, although their histological types are identical, and support the use of genetic markers In the differential diagnosis between metastasis and second primary carcinoma of the lung.
Proliferative activity of calcifying odontogenic cysts as evaluated by proliferating cell nuclear antigen labeling index
Authors: Takata Takashi , Lu Yong , Ogawa Ikuko , Zhao Ming , Zhou Zhi Yu , Mock David , Nikai Hiromasa
Published: December 2008

The calcifying odontogenic cyst (COC) presents with diverse hlstologlcal features; thus, several subclasslfl‐cations have been proposed. To evaluate the slgnlficance of the various histological features and subtypes of COC from the perspectlve of proliferative activity, the proliferating cell nuclear antigen (PCNA) labellng index (LI; the percentage of positive nuclei) was assessed immunohistochemlcally in 25 cases of COC (21 benign and four malignant). All of the benign cases were of the cystic variety and further subclas‐sified into non‐proliferative subtype (NPS; four cases); proliferative subtype (PS; eight cases); and COC associated with odontoma (COCaO, nlne cases). The PCNA U of the mallgnant COC (65.2 ± 5.6) was slgnlflcantly higher than that of the benlgn COC (11.6 ± 9.0; P = 0.002). Non‐proliferative subtype (6.8 ± 2.8) showed the lowest PCNA LI and PS (17.2 ± 11.2) the highest of among the three subtypes of benign cystic COC (P = 0.028). In nine cases of COCaO, six showed epithelial lining of the non‐proliferative type as NPS and the other three had lining wlth proliferative features as PS. The PCNA LI of the latter COCaO group (14.3 ± 6.6) was significantly higher than that of the former (6.1 ± 4.3; P = 0.05), as Seen between PS and NPS. These results demonstrate that PCNA LI is a possible parameter for differentiating mallgnant COC from benign COC and, whatever the subtypes, the proliferative features In the lining are the main factor influencing the prollferatlng actlvity of COC.
The clear cell variant of epithelioid intravenous leiomyomatosis of the uterus: Report of a case
Authors: Han Hye Sung , Park In Ae , Kim Sung Hyup , Lee Hyo Pyo
Published: December 2008

A case of very rare uterine clear cell epithelioid leiomyomatosls Is reported. The patient presented with a recurrent pelvlc mass after hysterectomy 2 years earlier. The recurrent tumor was located mainly In the vessels of the broad llgament as worm‐like plugs. The revlewed hysterectomy speclinen showed a typical multi‐lobuiated intramural mass together with worm‐like plugs wlthin the myometrlal vessels. Computer tomography exhlbited metastatic nodules In both lungs. According to an histologlcal examlnatlon, all the tumor cells were of epltheliold type and contalned abundant clear cytoplasm. Characteristic large, thick‐walled blood vessels were observed. Immunohisto‐chemical staining and ultrastructural examinatlon sup ported smooth‐muscle origin In this case. Electron mlcrosmplc study revealed that the clear cytoplasm was attributed to the presence of numerous dllated mitochondria that had lost their crlstae. The patient is still alive wlth the disease 28 months after surgery.
Müllerian cysts of the mesentery and retroperitoneum: A case report and literature review
Authors: Lee Jungwon , Song Sang‐Yong , Park Chang Soo , Kim Bohyun
Published: December 2008

Müllerian cyst of the mesentety and retroperitoneum is an extremely rare disease entity. Only two photomicrograph reports have been published. A 47‐yearold Korean woman presented with abdominal distention. A mesenterlc cystic mass, measuring 25 × 23 × 18 cm, was found between the liver and right adnexa without any connection with adjacent organs. The cyst was multilocular with gray‐white, rubbery walls of relatively uniform 0.2 cm thickness. Microscopically, the lining cells were ciliated and cuboidal to low columnar with an incomplete lining of smooth muscle bundles, adipose tissues, lymphovascular spaces, and lymphocytic aggregates. Ultrastructurally, the lining cells had Intercellular junctions, and cilia or microvllli on their luminal surface. The lining cells were immunoreactive for cytokeratin, epithelial membrane antigen and vimentin. To the best of our knowledge, this is the first demonstration of ultrastructural and lmmunohistochemical findings of Miillerian cyst of the mesentery and retroperitoneum in the English literature.
Histological evidence for cell proliferation activity in cystic tumor (endodermal heterotopia) of the atrioventricular node
Authors: Aral Tomio , Kurashima Chieri , Wada Sachiko , Chida Kouji , Ohkawa Shin‐ichiro
Published: December 2008

Cystic tumor (endodermal heterotopla) of the atrioventricular (AV) node in a 95‐year‐old female is described. Electrocardiograms showed complete AV blockage with a narrow QRS morphology resulting from the long‐standing first degree of AV blockage since age 61. A cardiac pacemaker was implanted at age 83. The patient died of pneumonla at age 95. Autopsy demonstrated a normal heart weight (320 g), normal coronary artery and normal myocardium. Histological examination of the conduction system revealed a marked fibrotic sinoatrial (SA) node and a cystic lesion In the lower rlght atrium, including the approaches to the AV node. The bundle of His and its branches were completely intact. Cellular nests and cystlcally dllated tubules were scattered within a loose tlssue stroma, whlch measured 18 × 12 × 5 mm. There were several mitotic figures among the tubules, as well as nuclear fragments similar to apoptotic bodies and exfoliation of the tumor cells. lmmunohistochemical studles demonstrated a positive reactlon for eplthellal membrane antigen, carcinoembryonic antigen, CAW‐9, cytokeratln and secretory component in the tubular cells, and a negative reaction for thrombomodulin. Endocrine cells among the tubules were positive only for calcltonin and serotonin. Ultrastructurally, sparse microvilli and desmosome‐llke structures between the tumor cells were observed. These findings support that this leslon orlginates from the endoderm. Moreover, it is likely that progression in the degree of AV block may be explained by the cell proliferation activity of the tumor.
Anglomyofibroblastoma of the vulva: Case report
Authors: Ustun Cazip , Malazgirt Zafer , Kandemir Bedri , Kocak Idris , Bolat Ipek , Gumus Salim
Published: December 2008

Anglomyxomas are a group of relatively rare mesenchymal myxold tumors. Three types of angiomyxomas have been Identltled: superflciat anglomyxoma, aggresslve anglomyx‐oma and anglomyoflbroblastoma. These tumors have a predllection for occurring in the perineum of middie‐aged femaies and are often clinically diagnosed as Bartholin's cyst A case of a 42‐year‐old female with a perineal angiomy‐ofibrobtastoma mimicking a Bartholin's cyst is presented. The pathological and clinical characteristics of this tumor are discussed.
Sarcomatous dermatofibrosarcoma protuberans metastasized to the lung: Preservation of CD34 expression in tumor cells
Authors: Ohtani Noriko , Fukusato Toshio , Tezuka Fumiaki
Published: December 2008

A case of metastatic dermatofibrosarcoma protuberans (DFSP) In a 47‐year‐old woman is presented. Dermatofibrosarcoma protuberans occasionally recurs, but rarely metastasizes. The patient underwent local removal of the nuchal tumor by a general practitioner, followed by a rapid recurrence. She underwent total removal of the tumor and a diagnosis of spindle cell sarcoma was made after an Incisional biopsy was performed. This lesion had both a typical DFSP‐like area and a flbrosarcoma (FS)‐like area. After 7 years, an abnormal lung shadow was observed and a segmental lung redon was petformed. Histologically, the lung tumor was similar to the FS‐like area in the nuchal tumor. Confirming CD34 expression in the tumor cells, this lung tumor was diagnosed as metastatic DFSP. Usually CD34 expression is unique to DFSP but almost negative in FS‐like areas. In the present case, the FS‐llke area in the nuchal tumor showed decreased CD34 reactivity, as previously reported, but the FS‐like area In the metastatic tumor still widely preserved CD34 expression. The presented case suggests that the FS‐like area in DFSP is histogenetically different from typical FS or malignant fibrous histiocytoma.
Immunohistochemical analysis of TrkA neurotrophin receptor expression in human non‐neuronal carcinomas
Authors: Koizuml Hirotaka , Morita Mikita , Mikaml Shinya , Shibayama Eiichi , Uchikoshi Toshiyuki
Published: December 2008

The Trk family of tyrosine protein kinase receptors plays a significant role in the development and maintenance of neural tissues. It has been recently shown that Trk receptors are also expressed by a wide range of normal non‐neuronal tissues in humans in a cell type‐specific manner. In the present study, the expression patterns of TrkA in 337 non‐neuronal invasive carcinomas of 15 different human tissues were investigated immunohistochemically. Overall, 133 (39%), 101 (30%) and 103 (31%) tumors exhibited strong, moderate and no TrkA Immunoreactivity, respectively. Esophageal and thyroid carcinomas expressed high levels of TrkA, whereas the levels in gastric and colon cancers were low. TrkA expression was detected not only in carcinomas originating from TrkA‐positive normal counterpart tissues, Including the esophagus, breast, lung and uterus, but also in those from TrkA‐negative tissues/cells of the thyroid, liver and ovary. Immunostaining for nerve growth factor‐β, the specific ligand for TrkA, in esophageal and breast carcinomas demonstrated its immunoreactivity in stromal fibroblasts and some TrkA‐expressing tumor cells. These results suggest that paracrine/autocrine regulation via stromal/tumoral NGF‐tumoral TrkA interaction may be involved In the growth of certain non‐neuronal carcinomas.
Neuroepithelial and ependymal changes in HTX rats with congenital hydrocephalus: An ultrastructural and immunohistochemical study
Authors: Nojima Yuji , Enzan Hideaki , Hayashi Yoshihlro , Nakayama Hirofumi , Kiyoku Hiroshi , Hiroi Makoto , Mori Koreaki
Published: December 2008

To Investigate the pathogenesis of congenital hydrocephalus the brains of HTX rats aged between 16 days and 4 weeks and the brains of normal Wlstar rats of the same ages were examined. In the fetal HTX rat brains, the lateral ventricles were symmetrically dilated from 20 days of gestation. The neuroeplthelium bordering the ventricles showed thinning with cellular disarrangement and deformity. Similar neuroepithelial abnormalities were also found in the lateral ventricles of the HTX rat brain with no macroscopic signs of hydrocephalus at 20 days of gestation. The neuroepithelium showed flattening of the cells, widening of the intercellular spaces, formation of microvilli on the detached lateral cell surfaces, and frequent macrophage infiltration. On the other hand, the neuroepithelial cells of the third ventricle and the aqueduct were affected less severely or showed no significant abnormalities. Immunohistochemlcally, most of the neuroepithelium and ependyma of the lateral ventricles were positive for vimentin in both prenatal and postnatal hydrocephalic HTX rats, while a small number or none of those in normal control rats were positive. These morphological changes suggested that preferential involvement of the lateral ventricular neuroepithelium might be closely associated with the pathogenesis of congenital hydrocephalus in HTX rats.
Transforming growth factor J3 type II receptor (TGFpRII) mutation in gastric lymphoma without mutator phenotype
Authors: Yasuml Kazuhiko , Guo Rong‐Jun , Hanai Hiroyuki , Arai Hajime , Kaneko Eizo , Konno Hiroyuki , Takenoshita Selichi , Hagiwara Koichi , Sugimura Haruhiko
Published: December 2008

A new mutation in the serine‐threonine klnase domain of the transforming growth factor β type II receptor (TGFpRII) was found in a case of diffuse, B cell non‐Hodgkin's lymphoma of the stomach. A mfssense mutation (ACA to GCA, Thr to Ala) was detected In exon 5, and a wild type allele was also present. This Is the first naturally occurring mutation in the klnase domain of this gene identified in human primary lymphoma. The replication error at three loci was negative, and the poly A tract of exon 3, which is frequently a target of mismatch repair genes, was intact. Malignant lymphoma of B cell origin in the stomach Is an addition to an expanding catalogue of tumors with TGFβRII alterations, and the biological sequelae of the change in the functional domain and the clinical characteristics of the patient in this study are intriguing.
Atypical decubital fibroplasia in a young patient with meiorheostosis
Authors: Yamamoto Motol , Ishida Tsuyoshi , Machinami Rikuo
Published: December 2008

A case of atypical decubital fibroplasia of the right forearm arising In a 25‐year‐old male with meiorheostosis is presented. The diagnosis of meiorheostosis involving the right‐sided bones was made by radiographical studies, and the patient has been obliged to use crutches due to the contracture and limited range of motion of the right leg. Two painless masses occurred in the subcutls of the posterior aspect of the right forearm over the excrescences of the underlying ulna due to melorheostotlc deformity. Grossly, ill‐defined firm masses, which measured 3×6×1.5 cm and 4×5×1 cm, respectively, were white and intermingled with yellow fatty tissue. Histologically, the lesions consisted of a proliferation of plump flbroblastlc cells with abundant collagenous stroma. Vascular proliferation and occasional eosinophilic degeneration of the collagen fibers were also seen. The gross and hlstologlcal features were those of atypical decubital fibroplasia (ischemlc fasciltis). Immunohlstochemlcally, the plump flbroblastic cells were positive for vimentin, but negative for desmin, muscle specific actln, and α‐smooth muscle actin. Chondroid metaplasia was focally noted and round‐shaped cells within this area were positive for S‐100 protein. This lesion seemed to be a flbroblastlc response against the long‐standing, Intermittent ischemia of the subcutaneous tissue between the bony excrescences due to meiorheostosis and the weight‐bearing forces of the crutch.
Recommendations for the reporting of tissues removed as part of the surgical treatment of cutaneous melanoma: Association of Directors of Anatomic and Surgical Pathology
Authors: Cochran Dr Alistair J.
Published: December 2008

The Association of Directors of Anatomic and Surgical Pathology have developed recommendations for the surgical pathology report for common malignant tumors. The recommendations for cutaneous melanoma are reported herein.
Expression of splice variants of CD44 in thyroid neoplasms derived from follicular cells
Authors: Gu Jing , Daa Tsutomu , Kashima Kenji , Yokoyama Shigeo , Nakayama Iwao , Noguchi Shiro
Published: December 2008

Isoform expression of CD44 in follicular carcinoma (FC) of the thyroid was analyzed by Immunohistochemlcal staining and compared to the isoforms In follicular adenoma (FA) and papillary carcinoma (PC) of the thyroid. Variant isoforms of CD44 (CD44v) were detected In these neoplastic cells but not In non‐neoplastlc cells. CD44v6 was expressed In PC with nodal metastasis and also in FC at significantly higher frequencies than those in PC without metastasis and FA. The frequency of expression of CD44v3 was significantly higher In PC with nodal metastasis than in PC without metastasis. The reverse transcription‐polymerase chain reaction (RT‐PCR) followed by Southern blotting analysis revealed the presence of a transcript for a variant of CD44 that contained variant exon 6 in FA, FC and PC. DNA sequencing of the products of RT‐PCR yielded three species of cDNA for CD44v. One of the cDNA corresponded to a transcript that contained variant exon 6. These results suggest that Immunohistochemlcal staining and RT‐PCR with Southern blotting analysis for CD44v6 might be a useful diagnostic tool for the differentiation of FC from FA and that the expression of CD44v3 and CD44v6 might be important for the development of nodal metastasis in cases of PC.
The Quilty lesion enigma: Focal apoptosis/necrosis and lymphocyte subsets in human cardiac allografts
Authors: Gopal Shanthi , Narasimhan Uma , Day John D. , Gao Robert , Kasper Edward K. , Chen Chi‐Long , Cina Steve , Robertson Abel L. , Hruban Ralph H.
Published: December 2008

Quilty lesions, as first described by Billingham in 1981, or ‘Quilty Effect’ (QE) are distinct endomyocardial mononuclear cell infiltrates that have been observed in human heart transplant recipients, as well as in experimental models of heart transplantation. In the present investigations, the pattern and extent of apoptosis (programmed cell death) and myocyte necrosis, as well as specific lymphocyte subsets in Quilty lesions was assessed. Endomyocardial biopsies obtained from 13 patients at 10–3362 days post‐transplant were examined. Apoptosis, as Identified by DNA nick end‐labeling, was found in myocytes at the periphery of Quilty lesions in 11 of 13 cases (85%), and ‘early’ stages of myocyte necrosis, as demonstrated by specific staining with a light chain myosin monoclonal antibodies (mAb), was observed at the same sites in 10 of 13 cases (77%) of both Quilty type A and type B lesions. Apoptosis was not identified in the lymphocyte infiltrates of any of the lesions examined. Lymphocyte subsets were characterized using mAb for T cell receptor (CD3), for helper/inducer T cells (CD4), for cytotoxic/ supressor T cells (CD8) and for mature B cells (CD20). Immunostaining revealed separate clusters of T lymphocytes with less prevalent B cells within the Quilty lesions. CD4+ cells were found in larger numbers than CD8+ cells in all cases. Non‐B, non‐T large lymphocytes were occasionally present. Except for the extent of the cellular infiltrate, no major cytochemical lymphocyte distribution differences were found between Quilty type A and B lesions. Myocyte apoptosis and early necrosis at the periphery of Quilty lesions suggest that early myocyte injury occuring in B lesions may represent initial or ‘abortive stages’ of cardiac allograft rejection. Why these lesions do not progress to overt rejection indeed warrant further detailed studies.
A novel marker of Schwann cells and myelin of the peripheral nervous system
Authors: Aral Hanako , Hirato Junto , Nakazato Yoichi
Published: December 2008

Cellular markers are useful In the immunohlstochemical studies of normal and pathological tissues. Herein, the development of a monoclonal antibody, Schwann/2E, which reacts with Schwann cells and myelin of the peripheral nervous system (PNS) Is described. The Schwann/2E antibody was secreted by a hybrldoma of mouse myeloma cells and mouse spleen cells that were Immunized in vivo with a cytoskeletal fraction of the human spinal nerve. This antibody Immunostalned formalin‐fixed, paraffin‐embedded human, rat, and mouse tissue by the indirect immunoper‐oxldase method. Schwann cells and myelin of the PNS were intensely labeled by the Schwann/2E antibody. Both the nuclei and cytoplasm of the Schwann cells were labeled. As shown by a comparative light and an electron microscopic study, the Schwann/2E antibody immunoreacted with the Schwann cells that had myellnated axons, but not with those that had unmyelinated axons. The endoneurial fibroblast was not immunolabeled. This antibody slightly stained the endothellal cells of the lung and kidney. Myelin and oligodendroglla of the central nervous system did not react with the Schwann/2E antibody. The Schwann/2E antigen was stable In several histologlcal fixatives. These results indicate that, under normal and pathological conditions, the Schwann/2E antibody could be a useful Immunohistochemical marker of Schwann cells and myelin of the PNS.
Microvenular hemangioma
Authors: Fukunaga Masaharu , Ushigome Shinichiro
Published: December 2008

A case of microvenular hemangioma in a 23‐year‐old Japanese female Is described. The patient presented with a slowly growing, solitary reddish plague on her back, which measured 15 × 17 mm. Histologlcally, the tumor was an inflltrative growth throughout the dermls. It consisted of thin‐walled, small‐sized, irregularly branched vascular vessels. The vascular lumina were narrow. The flattened endothelial cells had oval to spindle‐shaped nuclei and scant cytoplasm that were immunohistochemically positive for endothelial markers. The tumor cells lacked cellular atypia, pleomorphism, and mitotic figures. The patient was well without disease 8 months after the excision. Pathologists and clinicians should be aware of the existence of this type of hemangioma with an infiltrative growth and avoid overdiagnosis and overtreatment.
Gastric metastasis from breast cancer: A pitfall in gastric biopsy specimens
Authors: Shimizu Michio , Matsumoto Takayuki , Hirokawa Mitsuyoshi , Shimozuma Kojiro , Manabe Toshiaki
Published: December 2008

A 49‐year‐old woman presented with abdominal discomfort and weight loss. Gastroduodenoscopy showed small polypoid lesions and biopsy specimens suggested primary adenocarclnoma with neuroendocrine differentiation. As the patient had a prior history of metachronous breast cancer, It was concluded that the case was metastatlc carcinoma from the breast. The usefulness of a panel of selected Immunohistochemical markers to determine the primary site of the breast in an appropriate clinical setting is greatly emphasized.
Localized accumulation of Russell body‐containing plasma cells in gastric mucosa with Helicobacter pylori infection: ‘Russell body gastritis’
Authors: Tazawa Kenlchi , Tsutsumi Yutaka
Published: December 2008

One of the gastric biopsy specimens taken from a 53‐year‐old male showed localized accumulation of plasma cells containing Russell bodies, In association with infection of Helicobacter pylori (H. pylori). An endoscoplc study demonstrated multiple ulcer scars in the antrum. Immunohistochemically, H. pylori Infection was Identified both on the surface of the foveolar epithelial cells and in the cytoplasm of macrophages in the lamina propria mucosae. Plasma cells filled with ‘Russell bodies’, so‐called ‘Motts cells’, were immunoreactlve for CD45, CD79a and IgG. This seems to be a previously unrecognized tissue reaction in gastric mucosa associated with H. pylori Infection, which we have called ‘Russell body gastritis’.
So‐called neoplastic myoepithelial cells in chondroid syringomas/mixed tumors of the skin: Their subtypes and immunohistochemical analysis
Authors: NAKAYAMA HIROFUMI , MIYAZAKI ERIKO , HIROI MAKOTO , KIYOKU HIROSHI , NARUSE KEISHI , ENZAN HIDEAKI
Published: December 2008

An immunohistochemical study of nine cases of chondroid syringomas/mixed tumors of the skin was performed to elucidate the nature of the so‐called neoplastic myoepithellal cells (NMEC) in tumor tissues. These nine tumors contained NMEC of considerable variability in number from one tumor to another. These NMEC were classified Into three types: (i) hyaline cells (plasmacytoid cells); (ii) spindle NYEC; and (iii) polyhedral cells. They showed different immunostaining patterns, as the following describes. Cytokeratin 14 was positive in most of the spindle NMEC and a large number of the polyhedral cells, and in a small number of the hyaline cells. Concerning low molecular weight cytokeratins, most of the hyaline cells showed immunoreactivity, whereas they were negative in many of the spindle NMEC and were expressed only in a small number of the polyhedral cells, α‐Smooth muscle actin and muscle‐specific actin were positive in the spindle NMEC but negative in any of the hyaline cells and polyhedral cells. These findings strongly indicate that the hyaline cells and the spindle NMEC are of the simple epithelial and myoepithelial types, respectively. The findings also suggest that the polyhedral cells show differentiation toward basal cells of the sweat gland dermal ducts or myoepithellal cells.
Vascular invasion of O‐1N, hamster squamous cell carcinoma with high potential of lymph node metastasis: Ultrastructural comparison between lymphatics and blood vessels
Authors: ONO YUKLKO , NAKAJIMA TAMIO , SAKU TAKASHI
Published: December 2008

The ultrastructural modes of lymphatic and blood vessel invasions were studied comparatively In hamsters with squamous cell carcinoma (O‐1N) that had a high potential for lymph node metastasis. The endothellal injury, which was caused by mechanical stretching with the growth of O‐1N, was the lnltial and characteristic feature common to both vascular invasions. Tumor cell nests penetrating the lymphatic lumen through disrupted endothellal cells still maintained their volume and continuity to the underlying tumor cell nests. In contrast, pronounced microthrombotic end neutrophllic reactions occurred at the site of blood vessel penetration. Within the lymphatic lumen, large clusters of O‐1N cells were kept longer In spite of lymphocytic and macrophagic reactions. In blood vessels, clusters of tumor cells that had passed through dense fibrin layers were reduced In size and further disintegrated into smaller pieces by neutrophils. In conclusion, lymphatic invasion is a mechanical process, and smooth and direct invasion of large tumor cell nests into lymphatic vessels Is responsible for causing more prompt and frequent lymph node metastasis in O‐1N than a hematogenous type.
DNA analysis at p53 locus in carcinomas arising from pleomorphic adenomas of salivary glands: Comparison of molecular study and p53 immunostaining
Authors: YAMAMOTO YUZO , KISHIMOTO YOSUKE , WISTUBA LGNACIO I. , VIRMANI ARVIND K. , VUITCH FRANK , GAZDAR ADI F. , ALBORES‐SAAVEDRA JORGE
Published: December 2008

Where and how frequently p53 abnormalities are involved in the development of pleomorphic adenoma (PA) and its malignant progression to carcinoma was investigated. The presence of p53 gene abnormalities was analyzed in eight patients with carcinoma in pleomorphic adenoma (CPA) by polymerase chain reaction (PCR)‐based assays and immunohistochemistry. Normal salivary gland tissue, adenomatous, transitional and carcinomatous areas were microdissected from archival microslides and analyzed for allelic deletions of the p53 gene using two microsatellite markers at the p53 locus; dinucleotide (CA)n repeat and pentanucleotide (AAAAT)n repeat. Loss of heterozygosity (LOH) of the p53 gene was detected in 5796 of adenomas, 86% of transitional lesions and 86% of carcinomas. In contrast, overexpression of p53 oncoprotein was noted immunohistochemically in 13% of adenomas, 50% of transitional areas and 75% of carcinomas. All of the tumors with immunoreactivity for p53 oncoprotein demonstrated LOH. Moreover, when LOH was present in adenomatous or transitional areas, the identical LOH was always detected in the corresponding carcinomatous areas in the same CPA tumors. These findings indicate that p53 gene mutation is an early event and occurs frequently at an early stage of precancerous lesions and may be responsible for most cases of malignant transformation of PA.
DNA analysis at p53 locus in adenoid cystic carcinoma: Comparison of molecular study and p53 immunostaining
Authors: YAMAMOTO YUZO , WISTUBA LGNACIO I. , KISHIMOTO YOSUKE , VIRMANI AWIND K. , VUITCH FRANK , ALBORES‐SAAVEDRA JORGE , GAZDAR ADI F.
Published: December 2008

Abnormalities of the p53 tumor suppressor gene were investigated in 22 foci from 14 adenoid cystic carcinomas (ACC) by polymerase chain reaction (PCR)‐based assays for dinucleotide (CA)n and pentanucleotide (AAAAT)n repeat polymorphisms and by immunohistochemical staining for oncoprotein expression. Adenoid cystic carcinomas were divided into lower grade (tubular and cribriform) subtypes and higher grade (trabecular and solid) subtypes. Histologically identified tumor cells were precisely microdissected from archival microslides and were used for molecular analysis. The overall frequency of p53 gene mutations detected by PCR‐loss‐of‐heterozygosity (LOH) analysis was 57% and was higher than the frequency of overexpression of p53 oncoprotein detected by immunostaining (43%). In the molecular analysis of individual histological subtype foci, the number of foci with p53 gene mutation was slgnificantly greater in the higher grade subtype foci than in the lower grade subtype foci and was greatest in solid‐type foci (100%). In all six tumors in which histologically different foci were present In the Same tumors, mutations of the p53 gene were detected. When tumor heterogeneity of the p53 gene was present among different histological foci in the same tumors, the mutations were always detected in the higher grade foci. When lower and higher grade foci were present in the same tumors, the identical mutations detected In the lower grade foci were present in the corresponding higher grade foci. These findings indicate that abnormaliies of the p53 gene are involved in carcinogenesis and/or progression of this tumor and, furthermore, suggest that molecular analyses of ACC may provide information of prognostic importance.
Sebaceous carcinoma of the submandibular gland with high‐grade malignancy: Report of a case
Authors: OHARA NOBUYA , TAGUCHI KOHJI , YAMAMOTO MAMI , NAGANO TOSHIAKI , AKAGI TADAATSU
Published: December 2008

A case of sebaceous carcinoma arising in the left submandibular gland of a 66‐year‐old man is reported. The clinical and pathological examinations revealed a carcinoma, which was of salivary gland In origin, with regional lymph nodal metastases. Pathological findings showed features of highgrade sebaceous carcinoma with spindle myoepitheliomatous differentiation. Neither squamous cell nor duct epithelial‐like cell differentiation was noted. lmmunohistochsmically, tumor cells were positive for cytokeratin, S‐100 protein and vimentin. Lipid was demonstrated in the cytoplasm of the tumor cells. Ultrastructurally, tumor cells contained numerous intracyto‐plasmic lipid droplets. Myoepitheliomatous differentiation is rare in sebaceous carcinoma of the salivary gland. Presented is the second reported case of sebaceous carcinoma arising in the submandibular gland.
Angiomyofibroblastoma of the vulva: A mitotically active variant?
Authors: TAKESHIMA YUKIO , SHINKOH YASUSHI , INAI KOUKI
Published: December 2008

A case of angbmyofibrobiastoma in a 48‐yearold woman is reported. The tumor occurred as a left vulval mass and was treated by simple excision. It was located in the subcutaneous tissue of the left vuiva and was well circumscribed, measuring 2.8 × 2.7 × 2.5 cm. Microscop Ically, the tumor was composed of hypocellular and cellular arees with well‐developed small vessels. Spindle or polygonal cells were arranged with perlvascular accentuation In an edematous or fibrocollagenous background. Some spindle‐shaped or polygonal stromal cells were also arranged in epithelioid nests. In some areas, mitosas were frequent (maximum 3/10 high‐power field). lmmunohistochemicaily, the stromal cells were positive for vimentln and desmin, but negative for α‐smooth muscle actin, S‐100, neurofilament, estrogen receptor, progesterone remptor, CD31 and CD34. The average labeling index of Kl‐67 In stromal cells was 3.1%. Ultrastructural analysis demonstrated that the stromal cells adhered with primitive Junctions and contained lntermediate filaments with no focal density In the cytoplasm. These findings were consistent with anglomyofibrobiastoma, although previously reported cases did not show so many mitoses. Therefore, this case was suggested to be a mitotically active variant.
Extrauterine low‐grade endometrial stromal sarcoma: Report of three cases
Authors: FUKUNAGA MASAHARU , ISHIHARA AKIRA , USHIGOME SHINICHIRO
Published: December 2008

Three cases of rare low‐grade endometrial stromal sarcoma of the extrauterine tissue are presented. Each one occurred In the ovary, pelvic and abdominal cavities. Two were associated with endometriosls. Histologically, the tumors were characterized by an infiltrative and diffuse proliferation of uniform round or oval cells, abundant small vessels, low mitotic activity, the presence of foam cells and vascular Invasion. lmmunohistochemically, all tumors expressed vimentin, muscle markers (desmin, muscle‐specific actin and α‐smooth muscle actin) and progesterone receptors. Two tumors were diploid and one was aneuploid by flow cytometry. All patients were well with no evidence of disease 16–39 months after surgery. It Is suggested that this neoplasm may arise with or without endometriosis under hormonal Influence. This rare variant of Müllerian tumors should not be confused with adenosarcoma and soft tissue tumors, such as smooth muscle tumors and solitary fibrous tumor.
Intranodal palisaded myofibroblastoma with so‐called amianthoid fibers: A report of two cases with a review of the literature
Authors: HISAOKA MASANORI , HASHIOMOTO HIROSHI , DAIMARU YUTAKA
Published: December 2008

Two cases of intranodal myofibroblastoma, a rare primary spindle cell tumor of the lymph node, are described. The tumors arose in the Inguinal or proximal region of the thigh of one middle‐aged and one elderly Japanese male. The tumors were well‐demarcated and composed of a fascicular proliferation of spindle cells with focal nuclear palisading and acellular stellate‐shaped collagen‐rich areas (so‐called amianthoid fibers), and were associated with hemorrhagic areas. lmmunohistochemically, the tumor cells were positive for vimentin and muscle actin. Together with ultrastructural findings of intracytoplasmic microfilaments with focal denslties and profiles of welldeveloped, rough endoplasmic reticulum, these features reinforced the conclusion of myofibroblastic or smooth muscle differentiation of the tumor cells. One of the tumors was analyzed by flow cytometry and was shown to be DNA dlploid. The present report provides cllnicopathological findings of the first two Japanese cases of intranodal myofibroblastoma.
MUC‐1 mucin expression in invasive areas of intraductal papillary mucinous tumors of the pancreas
Authors: YONEZAWA SUGURU , TAIRA MICHIKO , OSAKO MASAHIKO , KUBO MASAAKI , TANAKA SADAO , SAKODA KORO , TAKAO SONSHIN , AIKO TAKASHI , YAMAMOTO MASAYA , LRIMURA TATSURO , KIM YOUNG S. , SATO EIICHI
Published: December 2008

The expression of MUC‐1 mucin (membrane‐associated mucin) and MUG2 much (secretory mucin) were immunohistochemically examined in 46 invasive ductal carcinomas (IDC) and 16 intraductal papillary mucinous tumors (IPMT) of the pancreas. lntraductal papillary mucinous tumors usually reveal expansive growth. However, of the 16 IPMT examined in the present study, three showed an invasive growth pattern, which was similar to ‘mucinous carcinoma’, around the non‐invasive growth areas. Of 46 IDC, MUCl much detected by monoclonal antibodies, DF3 and MY.1E12, was expressed in 44 cases (96%) and in 45 cases (98%), respectively, whereas MUC‐2 mucin detected by polyclonal antibody, anti‐MRP, was not expressed in any of the cases (0%). In contrast, in the non‐invasive growth areas of the 16 IPMT, MUG1 much detected by DF3 and MY.1 E12 was expressed in four cases (25%) and in six cases (38%), respectively, whereas MUG2 mucin detected by anti‐MRP was expressed in 13 cases (81%). The invasive growth areas of the three IPMT showed positive expression of MUG‐1 mucins detected by DF3 and MY.1E12, although the non‐invasive growth areas showed negative expression of MUG1 muclns, except for their focal positive expression in one of the three cases. These findings indicate that the invasive growth areas of IPMT acquire a characteristic of MUC‐1 much expression that is usually seen In IDC.
Confocal observation of senile plaques in Alzheimer's disease: Senile plaque morphology and relationship between senile plaques and astrocytes
Authors: Kato Senri , Gondo Toshikazu , Hoshii Yoshinobu , Takahashi Mutsuo , Yamada Michio , Ishihara Tokuhiro
Published: December 2008

Senile plaques In the brains of Alzheimer's disease (AD) were examined by confocal laser scanning microscopy (CLSM) with the following three findings. First, in sections stained with Congo red, the serial CLSM images of optical sections clearly revealed that a classic plaque is composed of a plaque core and a corona. Radially arranged process‐like structures, corresponding to bundles of amyloid fibrils, formed amyloid cores and stronger signals were detected in the center of some cores. Second, in sections stained with Congo red and anti‐gllal fibrillary acidic protein (GFAP), reactive astrocytes were found around the senile plaques and many astrocytlc processes surrounded the plaque cores and some processes had penetrated into them. Third, three‐dimensional reconstruction on classic plaque revealed that the surface of classic plaque showed a ‘coral‐like’ appearance.
Small intestinal stromal tumors: A clinicopathologic study of 31 tumors
Authors: Chang Mee Soo , Choe Gheeyoung , Kim Woo Ho , Kim Yong II
Published: December 2008

The biologic behavior of gastrointestinal stromal tumors Is difficult to predict, and they can be best studied in a site‐specific fashion. The alms of this study are to analyze the clinicopathologic parameters and assess the prognostic value of p53 (DO‐7) and KI‐67 (MIB‐1) immunoreactivitles in small intestinal stromal tumors (SIST). The hlstopathologic features of 31 SIST were assessed and categorized Into two groups as follows. Group A (clinically aggressive) In which death due to tumor, metastasis, recurrence or relapsed melena were seen (n = 15) and group B (clinically benign; n = 16). For both groups, the period of follow‐up was 30–144 months. p53 overexpression was observed In four tumors (31%) In group A, and In none in group B. For groups A and B, the mean Ki‐67 index was 16.8 ± 12.5 and 8.4 ± 12.6, respectively. Statistical analysis revealed that the significant predictors of malignancy were high cellularity (odds ratio (OR) = 999; 95% confidence interval (Cl) = 0–999); p53 overexpression (OR = 999; Cl = 0–999); size of tumor ± 35 cm (OR = 18.0; Cl = 1.9–171.9); ± 35 mltoses/50 high‐power fields (HPF) (OR = 17.1; Cl = 1.8–165.9); pleomorphism (OR = 17.1; Cl = 1.8–165.9); and necrosis (OR = 11.9; Cl = 2.2–65.1; P<0.05). High Ki‐67 index (≥ 8.4) had a marginal Impact on risk (OR = 4.1; Cl = 0.8–20.2; P = 0.08). In conclusion, high cellularity, p53 overexpression, size of tumor ± 35 cm, ± 35 mitoses/50 HPF, pleomorphism and necrosis are important parameters for the prediction of malignancy in SIST.
Clinicopathologic features and incidence of invasive lobular carcinoma in Japanese women
Authors: Fu LI , TsucMya Shln‐lchl , Matsuyama Ikuo , Ishii Keiko
Published: December 2008

Intending to clarify the true Incidence of Invasive lobular carcinoma of the breast In Japanese women as well as the frequency of unilateral multlcentriclty, 362 cases of clinically defined monocentrlc breast cancer without pre‐operative biopsy (previously fine needle aspiration or needle biopsy were routinely carried out for every case) were examined by whole mammary gland serial sectioning. On the basis of pathology and the World Health Organization classification of breast tumors, each case was assigned to one of two main histologlc types: Invasive lobular carcinoma (ILC) or Invasive ductal carcinoma (IDC). Invasive lobular carcinoma was further separated into classic and variant types by employing previously published criteria. Twenty‐one cases of ILC (5.8%) were diagnosed, which Is more than In most previous Japanese studies. Unilateral multicentric breast carcinoma was detected In 9.5% of ILC and 16.1% of IDC (the difference was found not significant). Microscopically, ILC tumors were found to be, on average, larger than IDC. Patients with classic type ILC tended to be younger than those with variant type or IDC. Estrogen receptor expression was found more frequently In variant type ILC than in classic type. These results suggest that the incidence of invasive lobular carcinoma of the breast In Japanese women is low and that unilateral multicentricity Is not significantly higher in ILC than in IDC.