GASTRIC PLASMACYTOMA WITH ROD-SHAPED INTRACYTOPLASMIC INCLUSIONS

A 78-year-old man with primary gastric plasmacytoma showing massive rod-shaped intracytoplasmic inclusions is presented. The patient was initially diagnosed as having a benign gastric ulcer and underwent partial gastrectomy. Around the ulcer of the resected stomach specimen, diffuse proliferation of plasma cells with massive rod-shaped intracytoplasmic inclusions was noticed by light microscopy. Immunohistochemically, these cells were found to contain IgM-kappa-type immunoglobulin upon peroxidaseantlperoxidase (PAP) staining. Electron microscopy showed that the intracytoplasmic inclusions were localized in the rough endoplasmic reticulum and had a lattice structure with a periodicity of about 120 Å.     

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.     

甲状腺的淋巴流向

本文在50例胎儿和新生儿尸体上,用器官内淋巴管注射方法,观察了甲状腺的淋巴流向。除观察了甲状腺淋巴的一般流向以外,还观察到有2例人们尚有争议的特殊流向。其中有1例甲状腺左侧下外侧部的1条集合淋巴管直接注入甲状腺中静脉,有1例左侧下后部的1条集合淋巴管直接注入胸导管。     

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.     

家兔甲状腺的淋巴流向

用活体淋巴管注射法，研究了４０只家兔甲状腺的淋巴流向。甲状腺的集合淋巴管多是注入颈深淋巴结，一部分汇入喉腹侧淋巴结及气管旁淋巴结。在６例有一条集合淋巴管直入颈内静脉或静脉角。     

UNDIFFERENTIATED CARCINOMA OF THE THYROID GLAND WITH OSTEOCLAST-LIKE GIANT CELLS

Three cases of undifferentiated carcinoma of the thyroid gland with osteoclast-like giant cells resembling those of giant-cell tumor of bone are presented. The clinical and morphologic characteristics of these cases are described and the literature concerning these tumors is reviewed. The lesions occur in elderly people, grow rapidly and are fatal, as do the usual undifferentiated carcinomas of the thyroid gland. Nevertheless, the tumors differ histologically from the usual undifferentiated carcinoma of giant cell or spindle cell type in having the osteoclast-like giant cells with many, small, uniform, benign appearing nuclei. All three tumors contained partial areas of moderately to well differentiated carcinoma; papillary carcinoma in two, and follicular carcinoma in one. Although the histogenesis of the osteoclast-like multinucleated giant cells is not definitely established, it is proposed that the giant cells are reactive in nature and histiocytic in origin because of their benign appearance, phagocytic activity, high level of acid-phosphatase activity, and some ultrastructural features and that they are formed by fusion of mononucleated histiocytes.     

不同程度脑外伤后甲状腺激素水平的临床观察

按脑外伤后10小对GCS评分，随机选择轻，中、重度脑外伤病例各30例．分别测其入院时，第一周内各天及第14天早晨甲状腺激素水平，发现甲状腺激素水平与病情及其变化明显相关；1．T3下降最快，最明显，且病情越重下降越显著；2．T4持续下降低于正常值提示预后不良；3．rT2随病情加重而升高，但恢复较快；4．FT3，FT4变化基本与T3，T4相同，但不如其显著；5．TSH早期可升高，危重组低于正常值。     

人甲状腺促性腺激素释放激素及其受体的表达

目的　探讨人甲状腺中是否存在促性腺激素释放激素 (GnRH)及促性腺激素释放激素受体 (GnRH R)并细胞定位 ,试图从转录及翻译水平讨论人甲状腺可否合成GnRH及GnRH R ,为探讨GnRH可能影响甲状腺的功能提供形态学依据。　方法　采用免疫组织化学法和原位杂交技术。　结果　所测人正常甲状腺组织均呈较强的GnRH和GnRH R免疫反应阳性 ,甲状腺滤泡上皮细胞、滤泡旁细胞均为阳性细胞。免疫反应阳性物质主要分布在阳性细胞胞质内 ,胞核呈阴性。原位杂交结果同免疫组织化学染色基本一致 :甲状腺滤泡上皮细胞胞质和滤泡旁细胞胞质可检测到较强的GnRHmRNA及GnRH RmRNA阳性杂交信号。胞核均呈阴性 ,未检测到杂交信号。　结论　人甲状腺不仅表达GnRH和GnRH R ,而且可以自身合成GnRH和GnRH R。GnRH可能以自分泌的方式影响甲状腺的生理功能     

PSEUDOLYMPHOMA OF THE THYROID

An unusual case of pseudolymphoma of the thyroid is reported. The tumor was histologically characterized by good demarcation, mature lymphocytes with prominent follicle formation and germinal centers, and mature plasma cells. Immunohistochemical staining revealed a similar distribution of T- and B-cells to reactive lymph nodes and a polyclonal nature of the plasma cell infiltrate. These findings are closely related to the entity, pseudolymphoma in other organs. Differential diagnosis from follicular lymphoma or ectopic thymic tissue is discussed. ACTA PATHOL JPN 38: 1329-1336, 1988.     

大鼠实验性胃溃疡期间甲状腺的组织学和酶组织化学的研究

雄性Wistar大鼠80只,分成溃疡组、盐水组和空白组。溃疡组在无菌条件下打开腹腔,将少量冰醋酸注入胃粘膜下层,造成实验性胃溃疡;盐水组模拟手术,用等量生理盐水注入胃粘膜下层;空白组为正常大鼠。在手术后1～28天分批取材,进行组织学和酶组织化学观察。盐水组:手术后2～21天,甲状腺滤泡细胞的AcP、AlP、α-GPD、SDH、G 6 PD和NsE的活性减弱,并且比空白组的低,手术后4～21天,滤泡细胞变低,滤泡腔变大;溃疡组:手术后2～21天的AlP活性比盐水组略高,但比空白组的稍有减弱,α-GPD、SDH和G6 PD活性都比盐水组高,与空白组的相同。NsE与盐水组的相似,在手术后4～21天,此酶活性有所减弱。手术后4～10天溃疡组的滤泡细胞变低,滤泡腔变大。手术后14天,滤泡细胞高度恢复正常,滤泡腔大小与空白组的相似。本实验结果与家兔实验性胃溃疡期间甲状腺滤泡细胞功能活性增强基本一致。从而提示,在实验性胃溃疡期间,大鼠和家兔的甲状腺滤泡细胞可能都参与了胃溃疡修复的代谢活动。     

IMMUNOHISTOCHEMICAL LOCALIZATION OF KERATIN, VIMENTIN AND MYOSIN IN SALIVARY GLAND TUMORS

An immunohistochemical study on keratin, vimentin, and myosin was performed in 117 specimens of human salivary gland under normal and several neoplastic conditions. In normal glands, positive immunostaining for keratin was observed in the inner cells of all ductal systems, whereas myosin and vimentin were the cytoskeletal components of myoepithelial cells. In pleomorphic adenoma, the inner cells showing a tubular pattern demonstrated positive immunostaining for keratin, and the outer cells as well as the neoplastic cells with a solid and myxoid pattern exhibited positive immunostaining for all antibodies. Monomorphic tubular and trabecular adenoma, and adenolymphoma showed positive immunostaining for keratin, although one case of tubular adenoma exhibited positive immunostaining for all antibodies. Squamous cell carcinoma, adenosquamous carcinoma, and mucoepidermoid tumor showed positive immunostaining only for keratin, but one case of adenocarcinoma, two cases of adenoid cystic carcinoma, and clear cell tumor disclosed positive immunostaining for keratin and vimentin.     

用HRP法研究猫甲状腺的神经供给,特别是传入神经纤维的来源

用成年猫15隻,将30～50％的HRP20～30微升注入右侧甲状腺侧叶。结果除在注射侧的颈上节、结状节、疑核、迷走神经背核以及C_(7-8)、T_(1-6)后根节发现标记细胞外,并在对侧疑核也发现少数标记细胞。     

家兔实验性胃溃疡期间甲状腺的组织学和组织化学变化(Ⅰ.滤泡细胞)

用成年雄性家兔52只,分为溃疡组、盐水组和空白组。溃疡组在无菌条件下打开腹腔,将少量冰醋酸注入胃粘膜下层,造成实验性胃溃疡;盐水组模拟手术,用生理盐水注入胃粘膜下层;空白组为未经处理的正常家兔。三组动物饲养条件相同,分别在手术后1～40天取材,进行组织学和组织化学的观察。盐水组:手术后3～28天,甲状腺滤泡细胞的酶活性比空白组的低,手术后7～28天,滤泡细胞变低,滤泡腔增大;溃疡组:手术后1～3天,滤泡细胞的各种变化与盐水组的相同,手术后7天,部分酶活性增高。手术后14～28天,溃疡组的AcP、SDH、G6PD、PO、ATP酶和AIP活性都比盐水组的高。滤泡细胞内PAS阳性的胶体小滴数量,也比盐水组的多,细胞较高,滤泡腔直径较小。手术后40天,两组动物的各项观察指标都恢复正常。本文结果提示,在家兔实验性胃溃疡期间,甲状腺滤泡细胞可能参与了抗疾患的代谢活动。     

PAPILLARY CARCINOMA OF THE THYROID GLAND WITH ANAPLASTIC TRANSFORMATION IN THE METASTATIC FOCI An Immunohistochemical Study

An immunohistochemical study was made on an autopsy case of papillary carcinoma of the thyroid with anaplastic transformation in the metastatic foci occurring in a 72-year-old woman. The anaplastic carcinoma cells were sarcomatous in appearance, and they were vimentin-positive and cytokeratin-negative. Whereas, papillary tumor cells which were intermingled in the anaplastic carcinoma contained both cytokeratin and vimentin. The close correlation between tumor cell anaplasia and the expression of the different intermediate filament proteins in thyroid carcinoma was briefly discussed.     

ULTRASTRUCTURE OF KIDNEY FROM THREE PATIENTS WITH HBeAg-ASSOCIATED NEPHROPATHY WITH SPECIAL REFERENCE TO VIRUS-LIKE PARTICLES IN THE GLOMERULAR TUFTS

The biopsied kidneys from three patients with hepatitis Be antigen (HBeAg)-associated nephropathy were observed by light microscopy, immunohistochemistry and electron microscopy. By an indirect technique utilizing horseradish peroxidase-conjugated antisera, HBeAg was found to be deposited in a diffuse granular fashion along the glomerular capillary wall. No deposition of hepatitis Bs or hepatitis Be antigen was detected. The three cases were diagnosed as HBeAg-associated nephropathy. Ultrastructurally, there were finely granular electron-dense deposits in the subendothelial area, basement membrane, mesangial area and subepithelial area of the glomerular tufts. In all three cases, virus-like particles between 30 and 70 nm in diameter were also found in such areas of the glomerular tufts, and rarely in the glomerular capillary lumen and space of Bowman. They occasionally formed clusters in the phagosomes of mesangial cells. In addition, tubulo-reticular structures were noted in the cytoplasm of endothelial cells in the glomerular capillaries. The presence of HBeAg both in the serum and in the kidney and of virus-like particles in the glomerular tufts suggests that HBeAg is causally related to the development of HBeAg-associated nephropathy.     

ADENOMYOEPITHELIOMA OF THE BREAST

We treated a 62-year-old woman with adenomyoepithelioma of the breast, an extremely rare tumor, which showed a bicellular pattern of ductal and myoepithelial elements bearing some histologic resemblance to pleomorphic adenoma of the salivary gland. The tumor was made up of cells positive for actin and S-100 protein, and some positive for epithelial membrane antigen (EMA). Thus, this tumor showed biphasic differentiation towards myoepithelial cells and to duct epithelial cells. Compared with findings in related tumors reported in the literature, the myoepithelial cells in the present tumor were less frequently spindle-shaped and had abundant eosinophilic or clear cytoplasm. A simple mastectomy was done and at the time of writing 20 months later there has been no recurrence. Adjuvant chemotherapy was not prescribed.     

小白鼠甲状腺神经节的形态学观察

应用镀银、硫堇及HE染色法和石蜡连续切片,可见不同鼠龄小白鼠甲状腺内侧缘上端与喉肌之间存在有类似典型的植物性神经节结构。此外,节的附近偶有散在的单个神经节细胞。神经节的位置、数量及大小个体不一,节的外面通常具有结缔组织的被膜,膜的胶原纤难向节内延伸成网、基质内有神经节细胞、神经胶质细胞和毛细血管。此外,尚有穿过节的有髓神经纤维等。神经节细胞散在分布,但以节的边缘为多,为多极神经元,胞体卵圆或不规则,尼氏小体呈细颗粒状,边缘较多,神经原纤维纤细世网。细胞核偏位,大而圆,染色质稀少呈空泡状,核仁明显,1—2个,此外核内尚有数个染色质聚集的不规则小块。幼龄小鼠可见双核神经节细胞。胞体外围有卫星细胞(被囊细胞)形成的被囊。神经节附近有甲状腺动脉、静脉主干同时出现,并显示为神经通路上(或稍偏离)之膨大结构,由其分出节前纤维进入节内,与神经节细胞形成突触。神经节内有错综交织的节前、后纤维及树突形成的神经网。研究表明小白鼠甲状腺附近存在有副交感神经节,其节后纤维分布有待进一步研究。     

MALACOPLAKIA OF THE ENDOMETRIUM An Unusual Case Studied by Electron Microscopy and a Review of the Literature

A rare case of malacoplakia (MKP) of the endometrium in an 88-year-old Japanese woman is presented. By light microscopy, typical Michaelis-Gutmann bodies (M-G bodies) could be identified. Electron microscopic findings revealed M-G bodies in various stages of development. These features suggested that M-G bodies were derived from round electron-dense granules that coalesced to form phagolysosomes. Early-stage M-G bodies were manifested as small, irregular, needle-shaped areas of calcification in phagolysosomes. The present paper reviews 6 cases of endometrial MKP, 5 of which have previously been reported in the literature, and this case being the sixth, to our knowledge.     

CHORIOCARCINOMA OF THE ESOPHAGUS PRODUCING CHORIONIC GONADOTROPIN

An autopsy case of primary esophageal choriocarcinoma in a 42-year-old Japanese male Is reported. The tumor was pure choriocarcinoma typical hemorrhagic and necrotic nature occupying almost the entire circumference of the mid-esophagus. The choriocarcinoma had metastasized to the liver, lung and lymph nodes. In the esophageal tumor, immunohistochemical staining showed the presence of mainly human chorionic gonadotropin (HCG), with human placental lactogen (HPL) in a few syncytiotrophoblastic cells. Only 3 cases of extragonadal choriocarcinoma originating in the esophagus have been reported up to now. The possible pathogenesis and pathological characteristics of primary esophageal choriocarcinoma are discussed.