Mucinous cystadenoma with malignant transformation arising in the renal pelvis

Mucinous cystadenoma with malignant transformation occupying the lower half portion al the right renal peivis in a 64 year-old Japanaese man was rocorded. The patient had recent dysuria but no clinical history of pyelonephritis or urollthiasis. Under the clinical diagnosis of unusual renal cyst, the right total nephrectomy was pertormed. Grossly, the cystic tumor, 5 cm across, formed a mondocular lumen filled with mucins and showed no direct communication with the renal peivis Inside. Microscopically, the epithetial lining was characterbad by a single layer of benign much producing columnar cells that scatered foci of non-invasive papillary projections with cell Stratifiation and nuclear atypla suggestive of malignancy. Although there was non-specific chronic pyelttis, no pyeittis cystica et glandularis was encountered. Of circa 60 glandular neoplasms arbing In the renal peivis reported previously, adenomas are only five Including two mucinous cystadenomas, while the remainder are adenocarcinomas. The histological findings of mucinous cystadenoma in the present case may represent the process of a transition from adenoma to adenocarcinoma. The result suggests the possibility that adenoma-carcinoma sequence may exist among the glandular neoplasms arising in the renal peivis. The histogenesis was unciarffled.     

Inappropriate mucin production in gall bladder metaplasia and neoplasia–an immunohistological study

This study demonstrates the presence of three antigens in glandular metaplasia occurring in patients with cholecystitis and cholelithiasis: specifically carcinoembryonic antigen (CEA), large intestinal mucin antigen (LIMA) and small intestinal mucin antigen (SIMA). These antigens could not be detected in normal gall bladder mucosa or in squamous metaplasia of the gall bladder. The occurrence of the three intestine-associated antigens in three carcinomas was irregular. In one mucinous carcinoma, only SIMA could be demonstrated. In one adenocarcinoma, SIMA was present in small areas of mucinous change, whilst CEA was present in the nonmucinous malignant tissue. In a mixed mucinous and non-mucinous adenocarcinoma with widespread dissemination, the three antigens were present both in the primary tumour and the metastases. These observations suggest that all forms of glandular metaplasia of the gall bladder are intestinal in nature and at least a proportion of gall bladder carcinomas are of an intestinal type. Finally they provide further immunological evidence that glandular metaplasia of the gall bladder should be considered a pre-malignant condition.     

Immunohistochemical demonstration of progesterone receptor in hepatobiliary cystadenoma with mesenchymal stroma

A case of hepatobiliary cystadenoma with mesenchymal stroma is documented in which unequivocal immunostaining for progesterone receptors was observed in mesenchymal cells. These cells were negative for oestrogen receptor. This suggests that the proliferation of the stromal component may be related to the presence of endogenous progesterone.     

Ultrastructural changes in the mucosa of the gall bladder during temporary experimental ischemia

Temporary ischemia of the gall bladder was produced in rabbits by application of a silk ligature to the cystic artery. Histological examination revealed vascular disturbances, consisting of hyperemia, stasis of blood, and focal hemorrhages. Electron-microscopic investigation showed an increase in the number of dark epithelial cells, widening of the intercellular space, and loosening of the structure of the basement membrane with the formation of defects in it and invagination of epithelial cells into the submucosa. The most marked changes were found after occlusion of the cystic artery for 30 min on three occasions. The severity of the destructive changes depend not so much on the duration of ischemia as on the number of occlusions.Department of Pathological Anatomy, Stomatological Faculty, Medical Stomatological Institute, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR, A. I. Strukov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 81, No. 4, pp. 489–492, April, 1976.     

Mechanism of the inhibitory action of oxytocin on transport of isotonic fluid through the gall bladder epithelium

The effect of oxytocin on the intensity of absorption of Ringer's solution by the epithelium of the isolated frog gall bladder and on the total Mg-, Na-, K-ATPase activity in its cells was studied. In doses of 0.5–20 m.u/ml, added on the side of the serosal surface of the organ, oxytocin reduced the intensity of isotonic fluid transport and the Na, K-ATPase activity of the epithelial cells of the gall bladder; Mg-ATPase activity was unchanged under these conditions. With an increase in the oxytocin concentration the values of the parameters studied fell exponentially. It is concluded that inhibition of the transport function of the gall bladder epithelium by oxytocin is connected with its inhibitory action on the Na, K-ATPase of the epithelial cells.A. A. Bogomolets Institute of Physiology, Academy of Sciences of the Ukrainian SSR, Kiev. (Presented by Academician of the Academy of Medical Sciences of the USSR N. N. Gorev.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 78, No. 11, pp. 10–12, November, 1974.     

Hepatobiliary cystadenoma with mesenchymal stroma: expression of oestrogen receptors in formalin-fixed tissue

We report three cases of hepatobiliary cystadenoma with mesenchymal stroma in which oestrogen receptor immunostaining was carried out, after using a microwave method of antigen retrieval. In one of the tumours immunoreactivity for oestrogen receptors was demonstrated within the mesenchymal stromal cells. The presence of oestrogen receptors supports the theory that oestrogens act as tumour promoters and may explain the female predilection.     

Malignant transformation in endometriosis of the urinary bladder

A case of primary intravesical endometrioid carcinoma is described, together with a review of the literature. This represents the fourth reported case of malignant transformation in vesical endometriosis.     

Morphological changes in human gall bladder carcinoma cell line-NOZ due to epirubicin and doxorubicin

Epirubicin is widely used in various cancer therapies because its side effects and less than those of doxorubicin. We compared the direct effects of doxorubicin and epirubicin to cellsin vitro. In this study, we used the human gall bladder carcinoma cell line-NOZ. We evaluated the cytocidal effects using a DNA fluorimetric assay with fluorochrome Hoechst 33342. The addition of epirubicin in a culture medium showed stronger cytocidal effects than the addition of doxorubicin. Morphologically, after treatments with the two drugs, cells were enlarged, large vacuoles appeared in the cytoplasm, and concentrated microvillus-like structures due to doxorubicin were observed by transmission electron microscopy. This study was presented at the 25th Annual Meeting of the Clinical Electron Microscopy Society of Japan, Matsumoto, September 28–30, 1993.     

肝炎和肝硬化患者胆囊B超改变的观察与分析

目的研究肝炎肝硬化患者胆囊彩色B超声像图变化，并探讨其临床意义。方法采用彩色超声诊断仪对139例肝炎和肝硬化患者及65例非肝炎体检者进行胆囊超声检查。结果慢性肝炎、重型肝炎、肝硬化患者组与非肝炎对照组彩色B超胆囊异常率比较均差异非常显著（P〈0．01）。慢性肝炎与重型肝炎、肝硬化组之间胆囊异常率也存在明显的差异（P〈0．05）。结论慢性肝病患者胆囊异常并不是胆囊本身炎症所致，胆囊声像图的改变对判断肝脏实质性病变的严重程度及指导临床治疗有一定的作用。     

Argentaffin cells, intestinal metaplasia and antral metaplasia in carcinoma of the gall bladder

The occurrence of argentaffin cells, intestinal metaplasia, and antral metaplasia has been studied in 20 gall bladders with carcinomas, in a papilloma, and in 20 specimens of cholelithiasis. Argentaffin cells were present in six carcinomas, but in only one specimen were they present in large numbers. Only one adenocarcinoma contained occasional argyrophil cells and no argentaffin or argyrophil cells were seen in the papilloma. Five of the 20 specimens of cholelithiasis contained occasional argentaffin cells. Intestinal and antral metaplasia were found in four carcinomas, in the papilloma, and in seven of the 20 specimens of cholelithiasis. It is suggested that metaplastic changes may play a role in the pathogenesis of carcinoma of the gall bladder.     

Congenital absence of the gall bladder

Summary Congenital absence of the gall bladder is an extremely rare embryological aberration with a reported incidence ranging between 0.013 and 0.075%. This report, the first from South Africa, discusses 2 cases of gall bladder agenesis, bringing to 413 the number of cases reported in the literature. In confirming the diagnosis of an agenesis of the gall bladder, it is necessary to exclude the abnormal locations which are intrahepatic, retrohepatic, on the left side, or within the lesser omentum or falciform ligament and retroperitoneal. Patients with gall bladder agenesis are classified into 3 categories: i) Multiple foetal anomaly (12.9%), ii) Asymptomatic (31.6%) and iii) Symptomatic (55.6%). Notwithstanding current diagnostic modalities, this rare condition may still present a dilemma to the abdominal surgeon. Agenesis of the gall bladder is a well-recognised but uncommon congenital abnormality. With the advent of minimal access surgery laparotomy may be avoided as the condition, when suspected, may be confirmed by ERCP and CT scan.

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Absence congénitale de la vésicule biliaire

Résumé L'absence congénitale de la vésicule biliaire est une malformation dont l'incidence est évaluée de 0,013 à 0,075 %. Nous rapportons deux observations d'agénésie de la vésicule biliaire, représentant les premiers cas de l'Afrique du Sud, nous les confronterons au 413 cas de la littérature. Pour confirmer le diagnostic d'agénésie de la vésicule biliaire, il est nécessaire d'exclure les localisations vésiculaires anormales, soit intra-hépatiques, soit rétro-hépatiques, soit dans le foie gauche, soit à l'intérieur de l'omentum ou du ligament falciforme, voire même rétro-péritonéales. Les patients porteurs d'agénésie de la vésicule biliaire sont classés en trois catégories : 1) Sujets porteurs de multiples anomalies foetales (12,9 %) 2) Sujets asymptômatiques (33,6 %) 3) Sujets avec manifestations cliniques (55,6 %). Néanmoins, les modalités diagnostiques habituelles peuvent, dans de rares conditions, se présenter dans le cadre d'une urgence chirurgicale abdominale. L'agénésie de la vésicule biliaire est une malformation bien connue, mais reste une anomalie rare. Avec l'avènement des abords chirurgicaux à minima, la laparotomie peut être évitée à condition que dans les cas suspectés, on réalise une exploration par endoscopie rétrograde des voies biliaires et pancréatiques (ERCP) et un scanner abdominal.

     

Expression of MUC1 and MUC2 mucin core proteins and their messenger RNA in gall bladder carcinoma: an immunohistochemical and in situ hybridization study

Expression of mucin core protein MUC1 and MUC2 was examined at the protein and mRNA level in 55 cases of carcinoma and 20 of dysplasia, and in 15 non-dysplastic epithelia of the gall bladder. In non-dysplastic epithelium, MUC1 protein was not expressed, while in dysplasia, MUC1 was focally expressed in ten cases, particularly in those associated with carcinoma. In carcinoma, MUC1 was expressed heterogeneously, and the frequency and extent of MUC1 expression increased with histological dedifferentiation. MUC1 was found on the apical cell surface and also in the cytoplasm in well- and moderately-differentiated carcinoma, and on the cell border in poorly-differentiated cases. In infiltrative regions, MUC1 expression was more predominant and MUC1 frequently leaked outside the foci of carcinoma. By contrast, MUC2 was focally expressed in non-dysplastic as well as in dysplastic epithelia and more frequently in well-differentiated adenocarcinoma. MUC2-positive cells resembled goblet cells, whether in non-dysplastic epithelium, dysplasia or carcinoma. Cell proliferative activity was higher in MUC1-positive than in MUC1-negative carcinoma cells. Distributions of MUC1 and MUC2 mRNA signals and of MUC1 and MUC2 proteins were similar in carcinoma and dysplasia. These results suggest that MUC1 expression by gall bladder carcinoma may reflect histological dedifferentiation, increased proliferative activity, and invasiveness, while MUC2 expression is related to lower proliferative activity and reflects some differentiation towards goblet cells; and that MUC1 expression in gall bladder dysplasia reflects malignant transformation. Copyright © 1999 John Wiley & Sons, Ltd.     

Chondrosarcomatous differentiation in metastatic deposit of serous papillary cystadenocarcinoma

A rare case of serous papillary cystadenocarcinoma of the ovary showing chondrosarcomatous differentiation in a metastatic deposit late in the clinical course is reported. A 49-year-old female underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for bilateral ovarian tumors. Histological diagnosis was serous papillary cystadenocarcinoma of both ovaries with lymph node metastasis. After six courses of chemotherapy, she was confirmed to be in complete remission following a second laparotomy. Following additional chemotherapy, a third laparotomy disclosed swollen left inguinal lymph nodes. In one of these nodes, approximately 5.0 cm in greatest diameter, the predominant histological features were: chondrosarcoma of the bone and soft tissue, with small foci of serous papillary adenocarcinoma and squamous epithelium. A histological transition between mesenchymal and epithelial areas was identified. Immunohistochemical positivity for broad-spectrum cytokeratin (AE1/AE3), vimentin, epithelial membrane antigen, and S-100 protein was observed in both chondrosarcomatous and epithelial areas. The current evidence may suggest that the chondrosarcomatous differentiation was derived from the metastatic epithelial component.     

Defective development of the gall bladder and cystic duct in Lgr4‐ hypomorphic mice

Leucine‐rich repeat (LRR) ‐containing G protein coupled receptor (LGR) family members are characterized by the presence of a seven‐transmembrane domain and LRR motifs. We describe a new function for Lgr4 in the development of the gall bladder and cystic duct and in the epithelium–mesenchyme interaction. Lgr4 expression was observed in the gall bladder epithelium when the gall bladder primordium elongated ventrally. Although Lgr4 hypomorphic mutant (Lgr4^Gt/Gt) embryos developed a normal gall bladder bud at embryonic day (E) 10.25, no further elongation was observed at later stages. At E12.5, the mesenchyme surrounding the gall bladder had completely disappeared in Lgr4^Gt/Gt embryos, while the gall bladder remained unelongated. Neighboring tissues such as liver and pancreas were unaffected, as revealed by expression of marker genes. This is the first report of a mutant mouse that lacks a gall bladder and cystic duct without affecting the other tissues that derive from the same hepatic diverticulum. Developmental Dynamics 238:993–1000, 2009. © 2009 Wiley‐Liss, Inc.     

Effect of oxytocin on electrical potential and ionic permeability of the apical membrane of frog gall bladder epithelial cells

The effect of oxytocin on the intracellular Na⁺ and K⁺ concentrations, the level of the transmembrane potential difference, and the relative ionic permeability (P_Na/P_K) of the apical parts of the surface membrane of the epithelial cells was studied in experiments on the isolated frog gall bladder. In a dose of 20 milliunits/ml, oxytocin, added to the external incubation solution, reduced the transmembrane potential difference, increased the P_Na/P_K ratio, and led to a very small shift in the Na⁺ and K⁺ concentrations in the intracellular fluid. After exposure of the organ to the hormone for 30 min the membrane potential (MP) of the cells fell from 52.7 to 38.7 mV at P<0.001 (negative charge inside the cell), whereas the value of P_Na/P was increased from 0.083 (control) to 0.175 (experiment) at P<0.001. Meanwhile the intracellular Na⁺ concentration was increased by 18.3 meq/kg and the K⁺ concentration reduced by 5.2 meq/kg intracellular water. This shift in the intracellular concentrations of Na⁺ and K⁺ could result in an evident decrease of only 0.7 mV in MP whereas in fact MP fell by 14.0 mV. Consequently, the decrease in the transmembrane potential difference takes place as a result of an increase in P_Na/P_K under the influence of oxytocin. Electrogenic ion transport through the apical membranes of the frog gall bladder epithelial cells could not be detected.A. A. Bogomolets Institute of Physiology, Academy of Sciences of the Ukrainian SSR, Kiev. (Presented by Academician of the Academy of Medical Sciences of the USSR N. N. Gorev.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 85, No. 2, pp. 136–139, February, 1978.     

Mucinous cystadenocarcinoma of the breast coexisting with infiltrating ductal carcinoma

A recently described and rare variant of breast carcinoma, mucinous cystadenocarcinoma (MCA), is reported in a 65-year-old post-menopausal woman. She presented with a gradually enlarged breast tumor. A well-circumscribed tumor measuring about 3 cm in diameter was noted in the mammographic and ultrasonographic examinations. The mammographic and ultrasonographic findings were indistinguishable from more common mucinous carcinoma (colloid carcinoma) of the breast. The gross appearance of the tumor was well-defined and cystic, consisting of abundant transparent to bloody mucin, as well as whitish solid parts. Microscopically, the tumor was characterized by abundant extracellular and intracellular mucin. It looked like a mucinous cystic neoplasm of the ovary and pancreas. Particularly, few microscopic foci of ordinary intermediate-grade infiltrating ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) were observed around the main lesion in this case. A transition from ordinary DCIS to MCA in situ was found. It might indicate MCA derives from a metaplasia process of ordinary DCIS. MCA can be easily differentiated from mucinous carcinoma by quite different histologic and immunohistochemical findings. According to the previously reported and present cases, MCA of the breast more commonly affects elderly women and has a relatively favorable prognosis.     

Mucinous cystadenocarcinoma of the breast with a basal-like immunophenotype

Mucinous cystadenocarcinoma (MCA) of the breast is extremely rare and was only recently described as a distinct variant of invasive ductal carcinoma of the breast. A case of MCA is reported in a 41-year-old woman. Mammographic and ultrasonographic examinations showed an irregularly shaped 10.0 × 8.0 × 5.5 cm lesion with patching calcification in the upper outer quadrant of the left breast. The gross examination revealed that the tumor has a well-circumscribed edge with a gelatinous cut surface and hemorrhage and necrosis were also noticed in the mass. Microscopically, the mass resembled mucinous cystic neoplasm of the ovary and pancreas closely, with cystic areas lined by columnar mucinous cells and associated with abundant extracellular and intracellular mucin, which is distinctively different from mucinous carcinoma with typically nests of low grade neoplastic cells floating in the mucin pool. The tumor cells were positive for CK7, CK20 and CDX2 were negative and displayed a typical immunophenotype of basal-like breast cancer (ER, PR, HER2 were negative, CK5/6 and EGFR were positive). Metastatic carcinoma was identified in three of 14 axillary lymph nodes. We describe here a very unusual case of breast MCA with basal-like immunophenotype.     

Papillary cystadenoma of the epididymis: a report of two cases with an immunohistochemical study

Two cases of papillary cystadenoma of the epididymis are described. An immunohistochemical study demonstrates that these lesions have a similar pattern of immunostaining to the normal efferent epididymal ductules. This finding supports the theory that epididymal papillary cystadenomas originate from these ductules and are true epithelial tumours of the epididymis.