[Uptake of 201TlCl and 99mTc-tetrofosmin in neurofibroma: a case report].

A 34-year-old man with neurofibromatosis type 1 (von Recklinghausen's disease) was examined by 201TlCl and 99mTc-tetrofosmin scintigraphies. Hypervascularity was observed in the largest tumor of the right thigh. The tumor was also depicted on both scintigrams. Tumorectomy was performed and the pathologic examination revealed it to be a neurofibroma measuring 10 x 7 x 4 cm in size. These findings suggested that 201TlCl and 99mTc-tetrofosmin scintigraphies generally were unable to distinguish malignant from benign neurofibromas with certainty.

Primitive neuroectodermal tumor in sinonasal region.

An elderly woman having a nasal tumor diagnosed as alveolar rhabdomyosarcoma was referred to our hospital. Histological reexamination of the patient revealed that the tumor was composed of lobules of compactly arranged small round atypical cells. The atypical cells contained large oval to round vesicular nuclei, and scanty cytoplasm showing PAS positive glycogen material. The tumor cells were immunohistochemically positive for NSE, S-100 protein and vimentin, but showed negative reaction for myoglobin, desmin, EMA, keratin, LCA, chromogranin and MIC2. Ultrastructurally, the tumor cells contained a few cluster of glycogen particles and less organellae and filaments, and there were no cytoplasmic processes, neurosecretory granules or neurofilaments. Pathological findings suggested primitive neuroectodermal tumor resembling extraskeletal Ewing's sarcoma, but negative reaction for MIC2 immunohistochemically could not ascertain the diagnosis. Location of the tumor and age of the patient of the present case were unusual.

Affinity of four lectins for endocervical and endometrial non-neoplastic and neoplastic glandular epithelium.

AIMS: Endocervical and endometrial tissues were stained with four lectins to determine the difference in staining pattern between non-neoplastic and neoplastic conditions of these tissues. METHODS AND RESULTS: The lectins used were Ulex europaeus agglutinin (UEA), Dolicho biflorus agglutinin (DBA). Concanavalin A (Con A), and Phaseolus vulgaris agglutinin (PHA). Endocervical tissues included normal endocervical glands, microglandular hyperplasia, minimal deviation adenocarcinoma and endocervical adenocarcinoma, well to poorly differentiated types. Endometrial tissues were collected from normal endometrium, simple glandular hyperplasia, complex hyperplasia, atypical hyperplasia and adenocarcinoma grades 1-3. Non-neoplastic and neoplastic endocervical and endometrial glandular epithelium showed positive reaction for UEA, Con A and PHA. Non-neoplastic glands showed mild to moderate intensity and apical and/polar type of staining pattern for all lectins. Endocervical adenocarcinoma including minimal deviation adenocarcinoma (MDC) and adenocarcinoma well to moderately differentiated type showed diffuse cytoplasmic type of staining pattern for all lectins, but poorly differentiated adenocarcinoma of endocervix showed only a stromal pattern for all lectins. Endometrial hyperplasia and adenocarcinoma grades 1-3 showed positive reaction for all lectins except for DBA. The staining pattern of endometrial hyperplasia was variable, but adenocarcinoma grades 1-3 showed diffuse type. CONCLUSION: Intensity and staining patterns of lectins are helpful in distinguishing between endocervical and endometrial non-neoplastic and neoplastic lesions. Intense positive reaction of MDC, especially for Con A and PHA, can differentiate this lesion from normal endocervical glands. The stromal type of staining pattern of poorly differentiated endocervical adenocarcinoma can also have diagnostic significance. Negative reactions of DBA lectin for endometrial adenocarcinoma can be used for differentiating it from endocervical adenocarcinoma.

Intestinal Behçet's disease--pathognomonic changes in intramucosal lymphoid tissues and effect of a "rest cure" on intestinal lesions.

To clarify the pathognomonic changes of intestinal lesions of Behçet's disease and to determine effective therapeutic measures, we recruited 13 patients with the intestinal form of this disease for study. We performed pathology studies on the resected specimens of 7 patients and treated 5 of the other 6 patients with a low-residue diet. Pathology examination revealed that 6 of 7 had inflammatory ulcerations in the ileocecal region. The ileal ulcers were mainly on the antimesenteric side. We observed remnants of Peyer's patches at the margins of the major ulcerative lesions in 2 of 2 patients examined. There were aggregations of lymphocytes resembling destroyed lymph follicles in the superficial layer at the mouths of small fissuring lesions, and ulcer scars were also noted in Peyer's patches in 4 of 5 other patients. X-ray and endoscopic examinations revealed the disappearance of intestinal lesions in 5 patients within 1 month during, or following the low-residue diet treatment. We found the intestinal lesions of Behçet's disease at sites coinciding with intramucosal lymphoid tissue. The "rest cure" for the affected bowel was effective, i.e., there was significant alleviation of gastrointestinal symptoms and the intestinal lesions disappeared. We speculated that acute exudative inflammation, abscess formation, and consequent ulceration may occur in these tissues by the same mechanisms as those that operate in the positive needle-prick reactions seen in patients with Behçet's disease.

[Establishment and pathological study of a new poorly differentiated mucinous gastric cancer cell line].

We succeeded in establishing a human gastric carcinoma cell line (KE-97) from oncocytes obtained from the mesentery disseminated metastatic focus of a 52-year-old male stomach cancer patient. From a histopathological point of view the gastric carcinoma was clearly a mucin-producing mucinous carcinoma, portion of which were mixed with poorly differentiated adenocarcinoma and signet-ring cell carcinoma. The oncocytes were fused into a mass and exhibited a suspended proliferating system, with a doubling time of about 28.8 hours. Transplantation of the cancer cells into skid mice resulted in a tumor system in all cases, and histologically, mucinous vacuoles were found in the cell membranes. With immunological staining they were found to be positive for anti-CEA antibodies, anti-CA19-9 antibodies and anti-ICAM-1 antibodies. Autopsy found extensive hematogenous metastasis (lung, liver) and cancerous peritonitis. KE-97 is mucinous carcinoma, and it was reported with the belief that it is a useful cell line upon the investigation of its cancer metastasis mechanism and cytological characteristics.

[Establishment and characterization of strain KE-39 derived from human gastric cancer].

We succeeded in establishing a human gastric carcinoma cell line (KE-39) from oncocytes obtained from the primary focus of a 77-year-old male stomach cancer patient. From a histopathological point of view the gastric carcinoma was a poorly differentiated adenocarcinoma exhibiting a funicular from and a structure with a solid vesicular focus. The oncocytes adhered to glass and proliferated in cell clusters, with a doubling time of about 38.4 hours. Upon transplantation of the cancer cells into nude mice, no visible tumors were found, but from a histological point of view poorly differentiated adenocarcinoma similar to the primary focus was found in all cases. With immunological staining they were found to be positive for anti-CEA antibody and anti-CA19-9 antibody, but negative for anti-ICAM-1 antibody. KE-39 is a cell line which was established from the primary focus, and it was reported in the belief that it is a useful cell line, upon the investigation of its cancer metastasis mechanism and cytological characteristics.

[Liver cirrhosis, its definition and classification--from a morbid anatomical point of view].

Cirrhosis of the liver is a principally a morphological entity, and it has been assumed to be an end-stage condition of all chronic active liver diseases. Morphologically, liver cirrhosis can be defined briefly as "a pathological condition characterized by diffuse pseudonodule formation throughout the entire liver". Fundamental pathogenetic changes in the cirrhotic process are hepatic necrosis, increase of connective tissue and regeneration of hepatocytes. For the sake of convenience, liver cirrhosis is classified into two groups; common and specific types. The former included postnecrotic, posthepatitic, alcoholic and mixed types of cirrhosis, and congestive, biliary, parasitic cirrhosis and Wilson disease were grouped into the latter. It should be mentioned that morphological diagnostic criteria is much more rigid for the common types than those of the specific type. Special stress has been laid on the importance of structural changes not only in the parenchymal disorganizations, but also in the stromal vascular changes in the cirrhotic process.

[The effect of prostaglandin E1 and prostaglandin F2 alpha in the ischemic small intestine of dogs].

The effect of PGE1 and PGF2 alpha in the ischemic intestinal tract were examined. In 40 mongrel dogs, we studied ischemic models of small intestine. PGE1 or PGF2 alpha was injected into the anterior mesenteric artery after reperfusion according to each occlusion time, and the tissue blood flow was measured on both mucosal and serous sides of small intestinal loop by laser flowmeter to examine the relation to the extent of tissue damage. Tissue blood flow of the ischemic intestine after the injection of PGE1 increased by 148-208% in the 3-5 hr occlusion group and by 86-110% in the 7-10 hr occlusion group. Tissue blood flow after the injection of PGF2 alpha decreased by 39-59% in the 3-5 hr occlusion group and by 1-15% in the 7-10 hr occlusion group. These results indicate that the effect of PGE1 and PGF2 alpha in the ischemic intestine would be available up to 3-5 hr of ischemia. Histological examination revealed that viability of the remaining crypt was high in the PGE1 injection group but low in the PGF2 alpha injection group. These findings suggest that PGE1, if try at the early stage, would be effective for the treatment of ischemic lesion.

[An experimental pathologic study of acute small intestinal ischaemic in mongrel dogs--occluded proximal site of anterior mesenteric artery by balloon catheter].

We prepared experimental of small intestinal ischemia by occluding the inlet of the anterior mesenteric artery of adult mongrel dogs with balloon catheters. With these experimental models, the degree of tissue damage of the small intestinal mucosa, which became ischemic, was studied according to the different occlusion times of the anterior mesenteric artery (3, 5, 7, 10, 15 and 30 hours). As a result, ischemic mucosal lesions in the small intestine at an initial stage occurred on the antimesenteric side. In the gross findings of the mucosa when the occlusion time was within 5 hours, linear and spotted lesions appeared in a zone on the antimesenteric side. When the occlusion time was 7 hours or more, these lesions fused and the entire intestinal mucosa became a hemorrhagic lesion. By occluding the anterior mesenteric artery for 22-30 hours, all 6 experimental ischemic animals died.

[Establishment and characterization of a human colonic cancer cell line expressing carbohydrate antigen 19-9 and carcinoembryonic antigen].

Colonic cancer cell strain KE43 was established from a human colonic cancer diagnosed histologically as a predominantly well differentiated adenocarcinoma with minute foci of poorly differentiated adenocarcinoma. The well differentiated adenocarcinoma cell line was identified as the major morphological picture in xenografts of KE43 and 58 in nude mice, but this changed to poorly differentiated adenocarcinoma in passage 105. Doubling time of this cancer cell line was 22.5 hours in passage 105. The modal numbers of chromosomes were 41 and 76. Cancer cells could be heterotransplanted in 100% of the nude mice. The tumor cells produced and secreted CA19-9, CEA and Laminin into the spent medium. This cell line appears to provide a useful system for studying colonic cancer in vivo and in vitro.

[Pathological studies on microvasculature of arteriovenous malformation in the intestinal tract].

Intestinal arterio-venous malformation (AVM) is one of the uncommon causes of gastrointestinal hemorrhage and is usually difficult to diagnose before pathological study. Five operated cases with the AVM were presented. The vascular lesions were studied by barium-gelatin injection and routine histological procedures. The AVM lesion was detected in the proximal jejunum and in the distal ileum in each one case, respectively. In two other cases the AVM lesion was observed as a protruded tortuous vascular plexus in colonic mucosa. By the microangiographical study, it was confirmed that the main lesion of AVM was located in submucosal layer with complicating minute AVM in lamina propria of intestinal mucosa. In the mucosal lesion of AVM it was disclosed that arterialization of precapillary arterioles was a remarkable finding. Thickened intimal layer and duplication of internal elastic lamina were recognized in these arteriolar lesions. Two kinds of intestinal AVM were classified, one is located in the submucosal layer and another one is located in mucosal layer. It was suggested that a marked ectasia of mucosal vessels seemed to be a secondary change of the submucosal AVM. The pathogenesis of the mucosal AVM was discussed.

[Establishment and characterization of strain KE-24 derived from human colonic cancer].

Strain KE-24 of colonic cancer cells was established from human colonic cancer diagnosed histopathologically as poorly differentiated adenocarcinoma. Doubling time of the cancer cell line was 32.4 hrs, and the karyotype was 46, xy, t (1q:?), 6p-, 14q+. The cancer cells could be heterotransplanted in 66% of nude mice. The plating efficiency was 17% in a soft agar plate with an inoculum size of 1 x 10(3) cells/dish. The tumor cells produced and released CEA and CA19-9 in the spent medium and these cancer cells were stained with both anti-CEA and anti-CA19-9 antibodies by the immunohistological staining method. Strain KE-24 of the cancer cells could be cultured in the serum-free medium (Media-I) for more than 100 passages.

[An immunohistopathological study on intrahepatic distribution of HBeAga/b in biopsied chronic type B hepatitis].

In order to evaluate the role of a expression of HBV-associated, we investigated histological and cytological distribution of HBeAga, HBeAgb, and HBcAg by immunoperoxidase procedure using monochronal antibodies. Materials submitted for this study were needle biopsied specimens obtained from 41 chronic carriers and serial paraffin sections were used for the immunohistological study. The localization of HBeAga/b antigens was limited in hepatocellular nuclei, and hepatocellular cytoplasm was HBeAg negative, HBeAg was detected in 11 cases (33%) of 33 cases with chronic active hepatitis (CAH) and in 5 cases (63%) of 8 cases with chronic inactive hepatitis (CIH). Among the HBeAg positive 16 cases, HBeAgb was demonstrated in 15 cases, however, HBeAga was revealed only each one case of CAH and CIH, respectively. Most of HBeAg positive cells were distributed in the peripheral zone of the hepatic lobules while the positive cells were found in central to midzonal zones of 3 cases CAH and one case of CIH. All in histopathologically HBeAga/b positive cases were also HBeAg positive serologically. On the other hand, in HBeAg sero-positive patients, histological positive rate of HBeAga/b was in 33% in CAH and 50% in CIH.

[An autopsy case revealing bilateral successive testicular germ cell tumors of different cell types].

A 28-year-old man, evidencing a painless swelling of the right scrotal content, was admitted and, after a diagnosis of a right testicular tumor, a right high orchiectomy was performed. A histological examination of the right testicular tumor revealed a seminoma. Eleven months after this operation, the patient returned, complaining of a painful swelling of the left testis. An examination revealed that his alpha-fetoprotein (AFP) was elevated (3319 ng/ml). A left high orchiectomy was performed after he was diagnosed as a non-seminomatous tumor. Later, a histological examination revealed, however, an embryonal carcinoma. Two months after the second operation, a metastases of right supra-clavicular lymph nodes was uncovered and adjuvant chemotherapy was started. Although he died from the progression of this metastases, at autopsy, the retroperitoneal and para-aortic metastatic lymph nodes revealed a mature teratomatous and embryonal carcinoma.

Myxoid sarcoma arising from the pulmonary trunk.

We reported a case of a myxoid sarcoma of the pulmonary trunk in a 40-year-old women. On light and immunohistochemical studies, spindle-shaped tumor cells revealed the nature of smooth muscle origin.