Giant cell carcinoma of the pancreas.

A case of giant cell carcinoma of the pancreas is reported herein. The patient is a 67-year-old Japanese woman complaining of ascites, general fatigue, loss of weight, abdominal distention, nausea, and vomiting. Cytological diagnosis of ascites revealed adenocarcinoma. At autopsy, a whitish tumor measuring around 5 cm in diameter was found at the head of the pancreas. Metastasis was seen only in the liver. Histological examination displayed bizarre multinucleated giant cells occasionally phagocytosing the tumor cells and neutrophils.

Bronchiolo-alveolar adenocarcinoma with multiple cysts.

An autopsy case of bronchiolo-alveolar adenocarcinoma in the lung is reported. The patient is a 70-year-old male who complained of severe cough with 500-600 ml watery sputum a day, loss of weight. and general fatigue. Autopsy revealed numerous whitish tumors in various sizes with multiple cysts in both lungs, with no metastasis being found in any other organs. Histological findings identified the tumor as a bronchiolo-alveolar adenocarcinoma originating from the lungs. Electron-microscopic findings showed that the tumor cells were covered by prominent microvilli, and contained abundant irregularly-shaped cytoplasmic vacuoles suggestive of mucin.

Hypophosphatasia.

An autopsy case of hypophosphatasia in lethal form in a fetus was reported. The female fetus of 40 gestational weeks was prenatally diagnosed as the specific type of congenital disease, because of no detection of calcification of whole bones by X-ray examination. Autopsy showed decrease of the anterio-posterior diameter of the chest and marked short extremities. Laboratory data revealed an extreme low value of alkaline phosphatase in the serum. Microscopical examinations showed marked retardation of calcification in the trabecule of whole bones. Family pedigree in second generations suggested that this disease was an autosomal recessive disorder and the parents were heterozygous carriers.

Confirmation of the development of multiple renal cell tumors in endstage/long-term hemodialysis kidney revealed typical acquired cystic transformation.

Histopathological study of the endstage kidney in a 50-year-old male who died after intermittent maintainance hemodialysis for 10 years was reported. At autopsy, both kidneys were contracted and characterized by grossly visible discrete multiple cysts. Histopathological study of consecutive sections of both kidneys revealed that these cysts were distributed throughout a completely disorganized parenchyma and were composed of dysplastic epithelial cells of different types and of structures, some of which revealed neoplastic transformation.

[A case of amylase-producing ovarian tumor].

A 51-year-old woman with ovarian carcinoma with hyperamylasemia is reported. She was admitted to Osaka General (JNR) Hospital in July 1982. A cystic tumor was palpated in the pelvis. Serum amylase, mainly the salivary type, in electrophoresis, had increased to 1583 Smith-Roe units/dL, while the pancreas was normal on ultrasonography and CT. Chemotherapy (MFC) was performed, and laparotomy revealed bilateral ovarian tumors. Histologically, they were serous cystadenocarcinoma. Serum and urinary amylase values dropped to the normal range after chemotherapy and surgery, and varied directly with the clinical course. Immunohistochemically, amylase was demonstrated in the tumor tissue by the PAP method. In conclusion, amylase was a useful marker in the diagnosis and follow-up of the present patient.