Primary signet-ring cell carcinoma of the urinary bladder: a case report

We report a case of signet-ring cell carcinoma of the urinary bladder. A 48-year-old female was hospitalized because of general fatigue, pollakiuria and residual sensation. Renal ultrasonography disclosed bilateral hydronephrosis. The serum level of cretinine was 3.1 mg/dl, and we diagnosed the patient with post-renal failure. Cystoscopic examinations revealed non-papillary sessile tumors in the trigone. Histopathological findings of the biopsy specimen demonstrated signet-ring cell carcinoma. There was no evidence indicating bladder metastasis from the cancer in other organs. The patient died of cachexia 5 months after the diagnosis. She was autopsied, and the diagnosis of signet-ring cell carcinoma of the urinary bladder with metastases in various organs was confirmed. This disease is extremely rare and has a poor prognosis. We review the previous cases reported in the literature.     

Gerfelin, a novel inhibitor of geranylgeranyl diphosphate synthase from Beauveria felina QN22047. I. Taxonomy, fermentation, isolation, and biological activities

A new compound, gerfelin, was isolated from a culture broth of Beauveria felina QN22047. It was purified by column chromatography on silica gel and by HPLC. Gerfelin has the molecular formula C15H14O6. It inhibited synthesis of geranylgeranyl diphosphate, which was mediated by recombinant human geranylgeranyl diphosphate synthase (hGGPP synthase) in vitro. The inhibitory pattern of gerfelin was noncompetitive against isopentenyl diphosphate, and uncompetitive against farnesyl diphosphate.     

Glucose hypometabolism and neuropathological correlates in brains of dementia with Lewy bodies

Cerebral glucose metabolism using positron emission tomography (PET) with (18)F-fluorodeoxyglucose was examined in 11 patients with probable Alzheimer's disease (AD), 6 patients with probable, and 1 patient with autopsy-confirmed dementia with Lewy bodies (DLB) as well as in 10 age-matched normal control subjects. Among widespread cortical regions showing glucose hypometabolism in the DLB group, the metabolic reduction was most pronounced in the visual association cortex compared to that in the AD group. Using a metabolic ratio of 0.92 in the visual association cortex as a cutoff (mean-2 SD of normal control subjects), DLB could be distinguished from AD with a sensitivity of 86% and a specificity of 91%. In contrast, apolipoprotein E4 allele frequency and cerebrospinal fluid tau levels did not differ significantly between the two groups. In order to further dissect out neuropathological correlates of the dysfunctional occipital lobe, postmortem brains from 19 patients with AD and 17 with DLB as well as 11 brains from normal controls were examined. A distinct and extensive spongiform change with coexisting gliosis was variably noted throughout cerebral white matter with relative sparing of gray matter in DLB. Notably, the white matter spongiform change and gliosis was most prominently and consistently found in the occipital region of DLB, and the severity of the spongiform change in each brain region generally paralleled to the regional difference in reduced glucose metabolism between the living AD and DLB patients. These findings suggest that (1) among several potential antemortem biomarkers in the diagnosis of DLB, measures of the glucose metabolism in the occipital cortex may be an informative diagnostic aid to distinguish DLB from AD; and (2) a pathological process that generates widespread spongiform change and gliosis in long projection fibers may contribute, at least in part, to the characteristic imaging features of DLB.     

A Glucagon-secreting alpha-cell carcinoma of the pancreas

A case of alpha-cell carcinoma of the pancreas with classic manifestations of glucagonoma syndrome and hepatic metastasis is reported. A diagnosis of glucagonoma was made by the characteristic dermatological findings of necrolytic migratory erythema and hyperglucagonemia. Operative removal of the metastatic tumors resulted in rapid regression of the skin rash and hyperglucagonemia. But a primary focus 1 cm in diameter, with central necrosis, had been left in the head of the pancreas. This was verified by autopsy.

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Résumé Cet article rapporte un cas de glucagonome malin caractérisé par un syndrome typique et des metastases hépatiques. Le diagnostic fut porté sur la constatation d'un érythème nécrolytique migrateur et le taux élevé du glucagon.L'exérèse des metastases hépatiques entraina la régression rapide des lésions cutanées et de l'hyperglucagonémie mais le foyer primitif de 1 cm de diamètre, nécrosé en son centre et laissé en place au niveau du segment céphalique du pancréas entraina finalement la mort. Il fut découvert à l'autopsie.

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Presented at the 6th World Congress of the Collegium Internationale Chirurgiae Digestivae, Lisbon, Portugal, September 19, 1980.     

Antitumor Activity and Cellular Accumulation of a New Platinum Complex, (—)-(R)-2-Aminomethylpyrrolidine(1,l-cyclobutanedicarboxylato)platinum(II) Monohydrate, in Cisplatin-sensitive and -resistant Murine P388 Leukemia Cells

We have examined the cytotoxicity and accumulation of (—)-(U)-2-aminomethylpyrrolidine(1,l-cyclobutanedicarboxylato)platinum(II) monohydrate (DWA2114R) in parent and cisplatin-resistant mouse P388 leukemia cells (P388 and P388/DDP), in comparison with those of cisplatin (CDDP) and carboplatin (CBDCA). The degrees of resistance to CDDP and CBDCA, expressed as the ratio of IC₅₀for P388/DDP celts to IC₅₀ for P388 cells, were 75–33 and 100-27, respectively, under the conditions of 2–24 h exposure to each drug at a density of 10⁶ cells/ml. The corresponding values (25–7) for DWA2114R were relatively low. Accumulations of CDDP and CBDCA were reduced in P388/DDP cells; however, no reduction in accumulation of DWA2114R was observed at various exposure periods and concentrations of the drugs. The accumulations of CDDP in P388 and P388/DDP cells at drug concentrations corresponding to the IC₅₀ values for drug exposure periods of 2–24 h were 0.41–0.97 and 13.1–33.7 ng Pt/10⁷ cells, respectively, suggesting that an intracellular mechanism of resistance against CDDP could be activated in P388/DDP cells. P388/DDP cells also showed relatively low resistance to DWA2114R via this mechanism in comparison with CDDP and CBDCA. From the relationship between structure and activity of several Pt-complexes, these different properties of DWA2114R compared with CDDP and CBDCA could be due not only to the differences in carrier ligand structure but also to the properties of the whole molecule associated with the carrier ligand and leaving group.     

A case of intravascular malignant lymphomatosis (angiotropic large-cell lymphoma) presenting memory T cell phenotype and its expression of adhesion molecules.

A case of intravascular malignant lymphomatosis (angiotropic large cell lymphoma), T cell type was reported. The patient, a 59-year-old woman, had reddish or violaceous indurated macules scattered over the entire body surface. Neither lymphadenopathy nor hepatosplenomegaly was recognized. A chest Roentgenogram, whole body CT scan, and 67Ga-citrate scintigraphy yielded normal findings. Serum anti-HTLV-1 antibody was negative. Histopathologically, lesions showed intravascular large mononuclear cell proliferation associated with occasional fibrin thrombi formation in the dermis to subcutis. Immunohistochemically, the large mononuclear cell immuno-phenotype had a memory T cell character. Also, both lymphocyte function-associated antigen-1s, CD11a and CD18, and intercellular adhesion molecule-1 were demonstrated on the tumor cells and vascular walls in the lesions. To our knowledge, the present case is the fourth case of intravascular malignant lymphomatosis in the T cell lineage.     

Evaluation of the brainstem with high-resolution CT in cerebellar atrophic processes

The authors studied the usefulness of computed tomography (CT) for evaluation of the brainstem in cerebellar atrophic processes. Twenty adult subjects without posterior fossa lesion were used for normal CT measurements of the brainstem. The measured values with CT corresponded to those with pneumotomography. Also reviewed were 49 patients with cerebellar atrophy which included spinocerebellar degeneration (25 patients), Shy-Drager syndrome (five), progressive supranuclear palsy (three), chronic phenytoin usage (10), and chronic alcoholism (six). All but the chronic alcoholism group showed atrophy of the brainstem at all locations of measurement when compared with normal controls (p less than 0.05). In addition, the patients with progressive supranuclear palsy had significantly more pronounced midbrain atrophy. In the chronic alcoholism group the measurements of the brachium pontis, the medulla, and the fourth ventricle differed significantly from those of normal controls (p less than 0.05).