Acta pathologica japonica最新文献

A case of adenoendocrine cell carcinoma of the gallbladder with adenomucous cells and neuroendocrine cells is reported. A histochemical and immunohistochemical study revealed that the primary tumor in the gallbladder was composed of mucus-secreting and/or argyrophil cells. Furthermore, the tumor showed a positive reaction to carcinoembryonic antigen (CEA) in all tumor cells, to chromogranin A and cytokeratin in many tumor cells, to endocrine granule constituent (EGC) in some tumor cells, and to serotonin and somatostatin in a few tumor cells. In addition, a few mucous cells showed argyrophilia and EGC-positivity in their cytoplasms. This case suggests that the adenoendocrine cell tumor is derived from endodermal stem cells as a result of bidirectional (exocrine and endocrine) differentiation.

Morphometric analyses were performed on 11 cases of well-differentiated gastric adenocarcinoma and six cases of gastric adenoma. The values for the mean nuclear area (AN), the index for roundness of the nucleus (FX), and the nucleus/cytoplasm ratio (N/C) were larger in the carcinoma group than in the adenoma group (P < 0.01; t-test). The value of nuclear numerical density (NA) was larger in the adenoma group than in the carcinoma group (P < 0.01; t-test). There was an overlap between the N/C ratio in the carcinoma and adenoma groups. It was concluded that roundness and enlargement of the nucleus, and a low nuclear density are important prerequisites for distinguishing the common type of adenocarcinomas from adenomas. An additional morphometric analysis was performed on seven cases of mucosal carcinoma. A three-dimensional discriminant analysis using AN, FX and NA revealed that of these seven cases, three were consistent with the carcinoma group while one case was consistent with the adenoma group. The remaining three cases were judged as borderline.

A case of lipofibromatous hamartoma in the foot is described. This tumor-like lesion commonly occurs in the hands, wrists and forearms of young persons. The median nerve is affected in the great majority of cases. Only very rarely, however, is it found in the nerves of the foot. It is believed that the present study is the seventh reported case of lipofibromatous hamartoma in the foot, and is the first case reported in Japan. A review shall be made of the six reported cases in the foot.

A case of lymphocytic interstitial pneumonia was studied immunophenotypically and with molecular methods in order to clarify its lymphocytic clonality. The patient, a 43 year old Japanese female, underwent lobectomy for a suspected malignant lymphoma as no clear diagnosis could be made from the biopsy specimen. An ill-demarcated, yellowish and elastic firm lesion measuring 60 x 35 x 20 mm in size was located in the peripheral part of the middle lobe of the right lung. Histologically, the alveolar, peribronchial-vascular and subpleural interstitia within the lesion were thickened markedly with severe cellular infiltration largely composed of small lymphocytes with germinal centers. Immunostaining revealed immunoglobulin (Ig) kappa and Ig lambda-bearing cells to be evenly distributed, suggestive of polyspecificity. Immunoglobulin gene analysis further demonstrated the unrearranged germ-line DNA but no rearranged band. These results strongly indicated a reactive process rather than a neoplastic nature for the lesion.

Liver histology was compared in patients with chronic hepatitis C to note the differences between responders and non-responders to interferon treatment. Fifty-eight patients were administered interferon in varying doses and over various periods, and were then followed up for 1 year. According to the improvement status of serum alanine aminotransferase (ALT) levels during this period, the patients were classified into complete responders who showed complete normalization of ALT; partial responders who exhibited a significant decrease, but not complete normalization of ALT; and non-responders who did not reveal any significant decrease of ALT. Before application of the interferon treatment, liver biopsies were analyzed in four parameters and given scores from 0 to 5 for three groups in cord with no prior knowledge of the efficacy. The parameters included necroinflammation, fibrosis/lobular distortion, portal lymphocytic reaction and portal (or fibrous septal) outline destruction. Results indicated that there were no significant differences in the score of necroinflammation and portal lymphocytic reaction between the complete responder group and the non-responder group. In contrast, the complete responder group exhibited weaker fibrosis/lobular distortion and less portal outline destruction than the non-responder group. The partial responder group was more akin to the former group in these parameters. Thus, it is safe to conclude that liver histology may predict the efficacy of interferon treatment.

Senile Nagoya, Shibata, Yasuda (NSY) mice developed amyloidosis and died from renal failure as a result of amyloidosis. NSY mice were first reported as experimental congenital diabetic mice by Shibata et al. in 1980. This study questioned whether NSY mice died from diabetic nephropathy. The authors of the present study investigated the life span and cause of death in these mice. The life span of NSY mice was found to be 618.7 +/- 72.5 days. NSY mice that lived for more than 400 days showed rising blood urea nitrogen and large amounts of amyloid deposits in the glomerulus of the kidneys. NSY mice died of renal amyloidosis. Immunological methods revealed that AApoAII was evident in the amyloid deposits of NSY mice. Apart from the kidneys, amyloid deposition was also found in the tongue, esophagus, stomach, small intestine, large intestine, rectum, lung, heart and adrenal glands. Amyloid deposits were found to a slight degree in the liver and the spleen. The most dominant amyloid deposition in NSY mice was seen in the glomerulus of the kidneys. From the point of view of amyloid depositional distribution, NSY mice were unique compared with other spontaneous amyloid mice.

A comparative immunohistochemical study of two different monoclonal antibodies against different epitopes on the neural cell adhesion molecule (N-CAM) was performed. Various normal tissues and lung tumors were examined for reactivity with NCC-LU-243, a monoclonal antibody which recognizes a peptide epitope on N-CAM, and monoclonal antibody 735 (MoAb 735), which reacts with a polysialic acid chain epitope on N-CAM. When acetone-fixed normal tissues were used, the immunoreactivities of MoAb 735 and NCC-LU-243 were not identical. In lung tumors, almost all small cell cancers (SCLC) and carcinoid tumors, and some non-SCLC were stained by both monoclonal antibodies. NCC-LU-243 stained the cell membrane only of almost all SCLC cells and clusters of non-SCLC cells. MoAb 735 stained the cell membrane of SCLC in a patchy manner and not only the cell membrane but also the cytoplasm of some non-SCLC. However cytoplasmic staining was evaluated as 'not positive'. The number of positive cases and the size of the positive tumor cell population determined by cell membrane staining with MoAb 735 were smaller than those determined with NCC-LU-243 in both SCLC and non-SCLC cases. In routinely formalin-fixed materials, the immunoreactivity of both monoclonal antibodies, especially of NCC-LU-243, decreased after prolonged fixation as in surgically resected and autopsy materials. However, both monoclonal antibodies were found to be useful when materials were fixed for a short period of time as in biopsy specimens.

Recent reports of Ewing's sarcoma (EW) and extraskeletal Ewing's sarcoma (EEW) support the hypothesis that these tumors are neuroectodermal in origin. Primitive neuroectodermal tumors (PNET) of bone (32 cases) and soft tissue (25 cases) including those previously categorized as EW in 27 cases and EEW in 15 cases were carefully studied histologically, immunocytochemically and morphometrically, focusing on tumor cell differentiation. This study attempts to subclassify these tumors on the basis of the size of tumor cells and nuclei, their variations (uniformity or diversity), arrangement of tumor cells (rosette or non-rosette), focal differentiation to larger ganglion-like cells, and staining intensity for neural markers. All tumors were histologically subclassified as small, medium or large cell types, three basic subtypes (rosette type, abortive rosette type, non-rosette type) and four complementary subtypes (fibrillary type, non-fibrillary type, angiomatoid type, ganglion cell type). Classic EW or EEW is consistent with small or medium, non-rosette, non-fibrillary type tumors, previously described large cell EW with large, non-rosette, fibrillary or non-fibrillary type tumors, and classic neuroectodermal tumor with small or medium, rosette, fibrillary type tumors, according to the present subclassification. Clinicopathologic correlations with the different subtypes are discussed. Long-term survival, more than 5 years, was seen in patients with small cell type, and those younger than 14 years of age.

Point mutations in the mitochondrial tRNA(leu(UUR)) gene have been recently reported in patients with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). To investigate the relationship between the degree of heteroplasmy and the organ damage, the ratio of mutant and wildtype genes was quantitated in 14 different organs obtained at an autopsy case of MELAS. The percentages of mitochondrial tRNA(leu(UUR)) gene carrying an A to G transition mutation at nucleotide 3243 were determined by the restriction enzyme digestion of the polymerase chain reaction products. The organs largely depending on oxidative phosphorylation for the sources of energy contained higher proportions of the mutant tRNA(leu(UUR)) gene than organs with a lower oxygen demand. However, the percentage of the mutant genes was similar in both symptomatic and asymptomatic organs with a higher oxygen demand.