PRIMARY MUCOSAL HYPERPLASIA OF THE GALLBLADDER

A case of primary mucosal hyperplasia of the gallbladder in a 55-year-old man is reported. Endoscopic ultrasonography demonstrated diffuse mucosal thickening of the gallbladder which was associated with anomalous union of the pancreatico-biliary duct system. Histologically, the mucosa showed villous and spongioid hyperplasia. The mucosa, which consisted of tall columnar cells that were morphologically similar to ordinary gallbladder epithelium, showed no metaplastic changes such as occurrence of mucous glands, Paneth cells, goblet cells, endocrine cells, or lysozyme immunoreactivity. These findings suggested that this disease was based on hyperplasia of ordinary gallbladder epithelium.     

NEUROFIBROMA OF THE GALLBLADDER SEEN AS A PAPILLARY POLYP

A case of neurofibroma of the gallbladder in a 44-year-old woman without von Recklinghausen neurofibromatosis but with right hypochondralgia is reported. The tumor was seen preoperatively as a polypoid lesion and in the resected gallbladder as a papillary polypoid growth over the main intramural tumor mass. Microscopically, the tumor was identified as a neurofibroma with many tactile corpuscle-like structures (Wagner-Meissner bodies), which were found by electron microscopic and immunohistochemical examination to consist of Schwann cells. Twelve cases of non-epithelial neoplasms arising in the gallbladder are also reviewed. ACTA PATHOL JPN 38: 259–268, 1988.     

AN IMMUNOHISTOCHEMICAL STUDY OF NEOVASCULATURE IN HUMAN BRAIN TUMORS

In order to elucidate the characteristics of newly-formed small blood vessels in brain tumors, 51 cases of various types of brain tumor were studied immuno-histochemically. Endothelial cells in all tumor types reacted positively with anti-Factor VIH-related antigen (F-VIII Ag) and UEA-1. Reactivity to UEA-1 was limited to endothelial cytoplasm. Proliferating immature endothelial cells showed weak reactivity to anti-F-VIII Ag. In some cases of benign tumors diffuse reactivity to anti-F-VIII Ag was noted throughout thickened medial areas of the vascular walls, in which reactivity to anti-fibrous collagen and anti-flbronectin was noted. UEA-1 was thought to be a more specific endothelial marker than F-VIII Ag, especially for proliferating and Immature endothelial cells. It is strongly suspected that fibrous collagens are related to the formation of a thickened vascular wall in newly-formed small tumor vessels.     

ADRENOCORTICAL CARCINOMA IN INFANCY

A case of adrenocortical carcinoma associated with congenital heart defect in a 6-month-old Japanese girl is reported. A fist-sized tumor was incidentally noted in the right hypochondrium upon admission for cardiac surgery. No clinical endocrinopathy was evident in this case. The resected tumor was encapsulated with smooth surface and no invasion to adjacent tissues or organs was observed. Histologically, the tumor was composed of small cells with granular or clear cytoplasm, and occasional giant cells with single or multiple nuclei. By electron microscopy, the tumor cells showed various nuclear contours with distinct nucleoli and had a moderate amount of cytoplasm containing abundant rough endoplasmic reticulum and mitochondria with variable-sized electron-dense granules. Intercellular desmosome-llke junctions were observed in some tumor cells. Immunohistochemlcally, the tumor cells contained granules positive for estriol, progesterone and Cortisol. These morphological findings including electron microscopic features suggested that the tumor cells had a malignant character.     

裸鼠人早幼粒白血病突变株细胞(HL-60-AR)异种移植模型的建立

将HGPRT~-的人早幼粒白血病突变株细胞(HL-60-AR)接种于裸鼠皮下,能形成实体性白血病肉瘤。肿瘤组织经光镜形态学、细胞超微结构、细胞化学、LDH同工酶谱、染色体分析、细胞遗传标记、以及分化性状的检测等多项指标鉴定,均类似于原来体外长期培养的细胞株。移植瘤细胞能在裸鼠体内连续传代,迄今已传至第12代。这个裸鼠人白血病细胞异种移植模型的建立,将为研究人类白血病细胞在体内的增殖、分化以及对抗白血病药物治疗的反应,提供一个有价值的实验系统。     

PRODUCTION OF β-HUMAN CHORIONIC GONADOTROPIN BY GERM CELL TUMORS IN VIVO AND IN VITRO

Production of the β-subunit of human chorionic gonadotropin (β-hCG) by human germ cell tumors was studied in surgical specimens, cultured cells and xenografted tumors. β-hCG was identified most frequently in the syncytiotro-phoblastlc and intermediate trophoblastic components of choriocarcinoma, and it was also detected in syncytiotrophoblastic giant cells, occasionally in association with embryonal carcinoma, and less frequently with yolk sac tumor, seminoma and dysgerminoma. Our experimental data suggest that β-hCG production by syncytiotrophoblastic giant cells in association with embryonal carcinoma is a result of trophoblastic differentiation of embryonal carcinoma. Moreover, it was proved that the production of β-hCG by human embryonal carcinomas is regulated by more factors than is the case for human choriocarcinomas.     

HEPATIC SQUAMOUS CELL CARCINOMA WITH HYPERCALCEMIA IN LIVER CIRRHOSIS

Primary squamous cell carcinoma of the liver is exceedingly rare and has previously been reported in association with hepatic teratoma, hepatic cyst or hepatolithiasis. This paper describes an autopsy case of squamous cell carcinoma which developed with hypercalcemia in a cirrhotic liver. This cancer was characterized histologically, immunohistologically and ultrastructurally, and was found to exhibit immunofluorescence positivity for anti-epidermal keratin monoclonal antibody, together with the presence of tonofllaments scattered sparsely in the cytoplasm of the cancer cells.     

P53在胆囊癌临床预后中的预测意义

目的 探讨P53在胆囊癌患者中表达情况与胆囊癌患者术后临床治疗之间关系。方法 采用免疫组化法检测我院自2010年~2016年47例胆囊癌患者的P53阳性表达情况,并且采用统计学方法比较其临床意义。结果 P53阳性表达与性别、年龄无关（P＞0.05）,与肿瘤大小、手术方式、TMN分期存在密切关系（P＜0.05）;并且P53表达阳性与肿瘤大小、手术方式、TMN分期呈正相关（P＜0.05）,差异有统计学意义。结论 P53可作为胆囊癌患者术后病情预测评估指标之一,对其后续治疗做出指导。     

UNUSUAL RENAL PELVIC TUMOR CONTAINING TRANSITIONAL CELL CARCINOMA, ADENOCARCINOMA AND SARCOMATOID ELEMENTS (SO-CALLED SARCOMATOID CARCINOMA OF THE RENAL PELVIS)

A case of sarcomatoid carcinoma of the renal pelvis in a 66-year-old male is reported. The patient underwent left nephroureterectomy because of renal pelvic tumor and hydronephrosis. Left renal calcification and atrophy had been diagnosed in the patient about thirty years previously. The tumor showed a polypoid configuration and occupied the renal calyces. Histologically, not only solid nests of transitional cell carcinoma (TCC) and adenocar-clnomatous glands but also large spindle-shaped cells with bizarre nuclei simulating sarcoma were identified. Immunoreactlve keratin and epithelial-membranous antigen (EMA) were demonstrated in the sarcomatoid cells, indicating that they were of epithelial origin. So far, only 10 cases of so-called sarcomatoid carcinoma or carcinosarcoma of the renal pelvis have been reported in the world. In this report, we summarize the pathological findings of previously reported cases and discuss the histogenesis of this rare tumor.     

Establishment of a Human Hepatoblastoma Model In Athymic Nude Mice

An athymic nude mouse model of human hepatoblastoma, designated HBL 2, was established. HBL 2 produced α -fetoprotein (AFP) and the serum level in tumor-bearing mouse was roughly proportional to the tumor weight. Reactivity of AFP to Concanavalin A and Lens culinaris lectins indicated that it contained predominantly fucosylated, non bisecting N acetylglucosamine as a sugar moiety. Alpha 1 acid glycoprotein (AAG) was also found in both HBL 2 tumor extract and sera of tumor bearing mice. The serum level, however, was not proportional to either the tumor weight or the value of the tumor extract. In addition, fatty acid binding protein (FABP) was detected in approximately 40% of tumor cells and in tumor extract with polyclonal antibody against liver FABP. Thus, HBL 2 is an unique model of human hepatoblastoma, in that it produces FABP in addition to AAG and AFP. Acta Pathol Jpn 42: 255 261, 1992.     

PAGET'S EXTENSION OF ESOPHAGEAL CARCINOMA: Immunohistochemical and Mucin Histochemical Evidence of Paget's Cells in the Esophageal Mucosa

A 68-year-old male with Paget's disease of the esophagus is reported. The underlying primary esophageal carcinoma was diagnosed as adenosquamous cell carcinoma on the basis of the presence of both adenocarcinoma and epidermoid carcinoma components. There was invasive growth of clear Paget's cells in the esophageal epithelium. Mucin histochemistry disclosed common characteristics of mucin between Paget's cells and adenosquamous cell carcinoma. It was histochemically confirmed that the existence of mucin was a general feature of extramammary Paget's disease. In 13 control esophageal carcinomas including three with adenocarcinomatous elements, Paget's cells were not found in the epithelium. To date only one case of Paget's disease of the esophagus has been described in the literature.     

人红细胞老化过程中花生凝集素和Con A受体电镜细胞化学研究

目的　观察人血液中 ,老化红细胞膜上花生凝集素 (PNA)和刀豆凝集素 (Con A)受体细胞化学反应的变化。　方法　应用金标花生凝集素 (PNAg)和刀豆凝集素 (Con Ag) ,对早期和老化红细胞膜上 PNA和 Con A受体进行电镜细胞化学显示 ,并用计算机图像分析系统对电镜照片进行定量处理。　结果　与早期红细胞相比 ,老化红细胞膜上 PNAg颗粒和 Con Ag颗粒均有明显增多。　结论　老化红细胞膜上唾液酸的丢失导致半乳糖基和甘露糖基暴露的相应增加 ,这种变化可能与巨噬细胞对老化红细胞的识别和吞噬机制有关     

人鼻咽癌CNE－2Z细胞的不同转移潜能克隆株在严重联合免疫缺陷小鼠体内的检验和比较研究

将人类鼻咽癌不同克隆株的细胞悬液移植在严重联合免疫缺陷（ＳＣＩＤ）小鼠和ＢＡＬＢ／ｃ（ｕｎ／ｕｎ）裸小鼠的颈背侧皮下，５６ｄ后处死全部动物进行观察。结果发现，在ＳＣＩＤ小鼠体内移植后ＣＮＥ２Ｌ２为高转移克隆株，其淋巴结转移率为１００％，肺转移率为７１％；而ＣＮＥ２Ｌ４为低转移克隆株，其肺转移率为１３％，淋巴结未见癌转移。这是从１个细胞母系中新筛选出的１个高转移和１个低转移的癌细胞克隆株。实验结果还显示，同ＢＡＬＢ／ｃ（ｕｎ／ｕｎ）裸小鼠相比，ＳＣＩＤ小鼠的恶性表型的表达能力高。另外，皮下移植时肿瘤细胞的数量可能与转移表型的表达有相关性，移植的瘤细胞数越多，转移率越高，反之亦然。     

ENDOGENOUS PEROXIDASE ACTIVITY IN PRIMARY CULTURE OF HUMAN THYROID CELLS Localization and Measurement

Intracellular localization of and an assay method for endogenous peroxidase (PO) activity were studied using primary culture of thyroid cells obtained from patients with hyperthyroidism. PO activity was visualized by cytochemical reaction and was located mainly in perinuclear cisternae and rough endoplasmic reticulum. With increased culture time, the number of cells showing positive PO activity and amount of the enzyme reaction product in individual cells showed a parallel decrease. For measurement of PO activity, cultured thyroid cells were frozen and thawed and then incubated with citric acid buffer solution containing o-phenylenediamine (opd) and hydrogen peroxide. After incubation, the optical density (OD) of the solution colorized by endogenous peroxidase was measured at 405 nm using a microplate reader. About 1 × 10⁴ cells were sufficient for assay of PO activity. Using the above method to assay PO activity and sandwich enzyme immunoassay for thyroglobulin (TG), chronological changes in the PO activity and TG concentration in the culture medium were examined. Although the cells showed no decrease in number, PO activity and TG concentration decreased chronologically. When the ratio of PO activity to TG concentration was calculated, in 3 cases the ratio was almost constant, and in the remaining two, it decreased chronologically. The present biochemical method thus seems useful for determining peroxidase activity of cultured thyroid en masse.     

A MORPHOLOGICAL STUDY OF THE LEFT BUNDLE BRANCH IN THE NORMAL HUMAN HEART

To clarify the distribution pattern of the left bundle branch (LBB) in the human heart, the AV conduction system was studied in 13 autopsied hearts obtained from subjects aged 50 to 80 years. Vertical serial sections (7 μm) of the bundle of His and LBB were prepared and every 20th section was stained alternately with hematoxylin-eosin (HE) or by the elastica van Gieson (EVG) method and examined by light microscopy. Reconstruction was performed using a two-dimensional system in order to histologically differentiate the bundle cells from Purkinje cells. The LBB bifurcated into the anterior and posterior radiations and the cells in the septal portion were almost all Purkinje cells except in two cases showing a septal branch between the two radiations. The LBB usually branched widely from the bundle of His. An extremely anterior fascicle of the LBB was found in all cases. The distribution of the LBB at the top of the ventricular septum was divided into network and continuous types. Purkinje cells were present on both the atrial and apical sides of the two main radiations. It was suggested that these findings resulted from the fact that we morphologically differentiated the bundle cells from Purkinje cells by light microscopy.     

AN AUTOPSY CASE OF IDIOPATHIC ENLARGEMENT OF THE RIGHT ATRIUM, AND A REVIEW OF THE LITERATURE

A 69-year-old man in whom idiopathic enlargement of the right atrium was revealed at autopsy is described. The patient had had cardiomegaly of at least 19 years'duration prior to his death, even though cardiac symptoms were absent. Cause of death was pancreatic carcinoma. Postmortem examination revealed marked and diffuse dilatation of the right atrium and moderate dilatation of the left atrium. Measurement of the cardiac chambers showed that the right and left atria were 7.6 and 4.7 times as large as those of normal hearts, respectively. The volume of either ventricle was about twice the normal value. Histologically, widespread cardiac muscular degeneration and necrosis, diffuse fibrosis, and focal lymphocytic infiltration were found in the right atrium and also, to a lesser degree, in the left atrium. Such pathologic changes were not found in either of the ventricles. The etiology of these muscular changes, which might have been related to atrial enlargement, was unclear. The present case was thought to be consistent with idiopathic enlargement of the right atrium, and a brief review of the literature is given.     

Immunohistological Study of Nonfunctional Parathyroid Carcinoma

The histological and immunohistological features of a nonfunctional parathyroid carcinoma obtained from a 56 year old woman are reported. Macroscopically, the tumor consisted of many small hemorrhagic nodules and showed adhesion to the thyroid gland and esophageal wall. Histologically, the tumor cells resembled parathyroid chief cells, and showed an island like or sheet-like arrangement, the former showing cystic degeneration and containing hemorrhagic fluid in the extracellular space. Tumor cells resembling water-clear cells and oxyphilic cells were also observed. Most of the the tumor cells had glycogen in the cytoplasm. Immunohistologically, the tumor cells showed no staining with anti-thyrogiobulin, JT-95 or anti-cal-citonin antibodies. However, they were stained with antibodies against chromogranin A (Ch A) and the N terminal portion of human parathyroid hormone (PTH (N)). The positive staining with anti-PTH (N) antibody disappeared when the antibody was absorbed with excess synthesized human PTH (N). Immunostaining for PTH (N) and Ch A was useful for differentiation of nonfuctional parathyroid carcinoma from thyroid carcinoma and thymoma. Acta Pathol Jpn 42: 279-285, 1992.     

DIMINISHING PURKINJE CELL POPULATIONS IN THE CEREBELLA OF AGING HETEROZYGOUS PURKINJE CELL DEGENERATION BUT NOT HETEROZYGOUS NERVOUS MICE

Mice homozygous for the recessive, cerebellar affected mutations nervous and Purkinje cell degeneration display an almost complete loss of Purkinje cells during their first two postnatal months. We have recently shown a progressive and age-related loss of Purkinje cells in mutant mice heterozygous for mutations apparently recessive, such as staggerer and reeler , and have thus chosen to investigate whether a similar Purkinje cell loss occurred with aging in +/ nr and +/ pcd heterozygous mice. Purkinje cells were counted on serial sections heterozygous mice. Purkinje cells were counted on serial sections stained with thionin obtained from 17-month-old male and female heterozygous mice and their respective wild-type controls. In the case of the +/ nr wild-type mice, no difference in cell counts was observed. However, +/ pcd mice had significantly fewer (?18%) Purkinje cells (143.700±5.400) than control wild-types (175.100±2.300); p<0.0001) at 17 months. These results extend our previous findings and further support the idea that apparently recessive neurological mutations may exert, at the heterozygous state, a deleterious effect upon Purkinje cells during the aging process.