Paraganglioma of the posterior mediastinum diagnosed by immunohistochemical staining

Paraganglioma of the mediastinum are rare neoplasms. To date, no definitive morphologic criteria exist that correlate with the clinical outcome of these tumors. We have encountered a case of paraganglioma in which biological behavior was assessed by immunohistochemical staining to determine whether supplementary postoperative treatment was needed. A 28-year-old man came to our hospital because of an abnormal shadow on a radiogram of the chest. He had no symptoms. Hematological findings were unremarkable. Diagnostic imaging suggested a neurogenic tumor. Surgical resection was performed in September, 2002. A typical nesting pattern (Zellballen) and positivity for chromogranin on immunohistochemical staining were evident, indicating neuroendocrine characteristics, and paraganglioma was diagnosed. Tissue specimens indicated an MIB-1-labeling index of 1.3% on MIB-1 staining, and a relatively well maintained distribution of S-100 protein-positive sustentacular cells, which were suggestive of a benign tumor. The patient did not receive any supplementary therapy postoperatively but was given careful follow-ups.     

Synthesis and characterization of 1,3,4-oxadiazole-containing polyethers from 2,5-bis(4-fluorophenyl)-1,3,4-oxadiazole and various aromatic diols

Six 1,3,4-oxadiazole-containing polyethers with reduced viscosities of 0,65–1,17 dL · g^?1 were synthesized by high-temperature solution polycondensation of an activated difluoride, 2,5-bis(4-fluorophenyl)-1,3,4-oxadiazole, with aromatic diols possessing a variety of ring structures. The expected chemical structures were confirmed by IR and ¹H NMR spectroscopy and elemental analysis. Of all the polymers, two polyethers were highly crystalline and soluble only in limited solvents such as o-chlorophenol and conc. sulfuric acid. The other polyethers were amorphous and dissolved readily in a variety of organic media including polar aprotic solvents, phenols and chlorinated hydrocarbons. Colorless to slightly yellow-colored, transparent and tough films could be cast from the N-methyl-2-pyrrolidone or o-chlorophenol solutions. The mechanical properties were excellent and their tensile strength, elongation at break and tensile moduli were in the ranges of 53–80 MPa, 4–12% and 1,3–2,0 GPa, respectively. The amorphous polyethers had high glass transition temperatures of 195–259°C. All the polyethers were highly thermally and thermooxidatively stable and exhibited no weight loss up to 400°C, with 10% weight loss being recorded at 464–514°C in air.     

Preparation and characterization of fluorine-containing aromatic condensation polymers, 5. Aromatic polybenzimidazoles from 4,4′-(hexafluoroisopropylidene)dibenzoic acid and aromatic tetramine tetrahydrochlorides

Two novel fluorine-containing aromatic polybenzimidazoles were synthesized by direct polycondensation of 4,4′-(hexafluoroisopropylidene)dibenzoic acid with 3,3′-diaminobenzidine tetrahydrochloride and 1,2,4,5-benzenetetramine tetrahydrochloride. The effect of introduction of fluorine on the synthesis and properties of these polymers is discussed. The new polybenzimidazoles show good solubility in organic solvents, excellent mechanical properties and high thermal stability.     

An Immunohistochemical Study of Sebaceous Carcinoma with Anti-Keratin Monoclonal Antibodies: Comparison with Other Skin Cancers

Formalin-fixed and paraffin-embedded tissue specimens of six cases of extraocular sebaceous carcinoma were studied immunohistochemically with eight anti-keratin monoclonal antibodies, 34βB4, 35βH11, Ks13.1, Ks19.1, PKK1, LP34, KL1 and AE1. The staining patterns of sebaceous carcinoma were compared with those of normal sebaceous glands and other skin cancers which should be distinguished from sebaceous carcinoma histopathologically. The other skin cancers compared were eccrine porocarcinoma, malignant clear cell hidradenoma, extramammary Paget's disease with underlying adenocarcinoma, malignant trichilemmoma, and squamous cell carcinoma. Most cases of sebaceous carcinoma were stained with 35βH11, Ks19.1, LP34, KL1 and AE1, while normal sebaceous glands were positive only with 35βH11, LP34, KL1 and AE1. By immunostaining, sebaceous carcinoma was distinguishable from extramammary Paget's disease with underlying adenocarcinoma, squamous cell carcinoma, malignant trichilemmoma, and eccrine porocarcinoma, but was not clearly distinguishable from malignant clear cell hidradenoma. These findings demonstrate that sebaceous carcinoma shows positive reactions with antibodies to simple epithelial keratin, probably as a result of neoplastic transformation, and that immunohistochemical examination using anti-keratin monoclonal antibodies is useful in distinguishing sebaceous carcinoma from several other skin cancers.     

A Case of Acquired Lymphangioma Due to a Suspected Old Filariasis and a Review of Literature

A 65-year-old man presented in 1992 with multiple papular lesions on the scrotum and foreskin. His medical history revealed that, at the age of 25, he was diagnosed as having filariasis and treated conservatively at a hospital in Hawaii. The histologic study of the scrotal skin showed large, dilated vascular spaces in the upper dermis lined with a single layer of endothelial cells that were negative for Factor 8-related antigen. The diagnosis was acquired lymphangioma due to a suspected old filariasis infestation, although serologic tests for filarial antibodies were negative. The paper also presents a review of the literature of acquired lymphangioma in Japan with a brief discussion of etiology and nomenclature.     

Sarcomatoid hepatocellular carcinoma with osteoclast-like giant celIs: Case report and immunohistochemical obsewations

Hepatocellular carclnoma (HCC) with osteoclast-like giant cells (OGC) developed in the cirthotic liver of a 42-year-old male. Serum protein induced by vitamin K absence or antagonist II was elevated preoperatively. The patient died of the disease on the 28th postoperative day. Hlstologically, the tumor consisted of OGC and mononuclear cells (MC). The OGC were characterized by benign-appearing nuclei, whereas the MC had atyplcal nuclei with a considerable number of mitoaes. A vaguely trabecular pattern was observed In the focal area of the tumor, but no evidence of overt HCC was found. lmmunohlstochemical analysis revealed that both OGC and MC were diffusely positive for histlocytic and mesenchymal markers. Some MC were focally posltive for cytokeratins 7, 8 and 19, and for albumin. Our clinical, histological and Immunohistochemical findings suggest that the MC were derived from hepatocytes, with some mesenchymal features, but the OGC were non-neoplastic and reactive histiocytes.     

Serum Concentration of 5-S-Cysteinyldopa in Pediatric Patients with Giant Pigmented Nevi

The serum concentrations of 5-S-cysteinyldopa (5-S-CD) in pediatric patients with giant pigmented nevi (GPN) were investigated and compared with those of pediatric patients with small- or medium-sized congenital nevi (CN), or non-melanocytic benign skin tumor (control group). Serum 5-S-CD levels in the GPN group (N=21), particularly in patients less than 5 years old, were significantly higher(highest concentration 38.4, mean ± S.D. 16.6 ± 9.4 nmol/L) than those in the CN (N=22) or control groups (N=26). Serum 5-S-CD levels in the CN group were not significantly different from those in the control group. There was a significant correlation between the serum 5-S-CD level and size (surface area) of the GPN. There was a significant inverse correlation between the serum 5-S-CD level and age in the CN and control groups, but not in the GPN group. Serum 5-S-CD levels were transiently elevated immediately after treatment of patients with GPN with a combination of skin abrasion and cryotherapy with solid carbon dioxide. These results suggest that serum 5-S-CD levels in the GPN group reflected the 5-S-CD derived from GPN, particularly in patients less than 5 years old. This indicates that melanogenesis may be accelerated in infant patients in the GPN group.     

Iung cancer associated with usual interstitial pneumonia

There were 83 cases of usual interstitial pneumonia (UIP) in 3712 consecutive autopsy cases during 1972 to 1992 in Toranomon Hospital. Primary lung cancer had arisen in 40 cases of UIP in that period. The prevalence of lung cancer (48.2%) in UIP was significantly higher than that of lung cancers (9.1%) in the age-matched general population without UIP (P < 0.001). The prevalence of association of multiple lung cancer in UIP (20.W0) was also significantly increased. Thus, UIP showed a remarkable potency to develop lung cancers. The lung cancer cases in UIP had obvious smoking habits. Both the rates of smokers and the quantity of smoking were significantly increased in the lung cancer cases in UIP (P < 0.05). There was a distinct anatomical distribution of lung cancer in UIP. Most cancers in UIP (98%) arose in the peripheral area of the lung (P < 0.001, compared to lung cancer cases without UIP) with close relation to the honeycombing lesion. Studies on surgical specimens with small cancers showed that most tumors in UIP arose in the border area between honeycombing and the non-fibrotic area. Thus, the front of the remodeling of the lung is suspected to be a potential field of developing lung cancer. The chronic inflammatory process resulting in the remodeling of the lung may play an important part in the development of lung cancer in UIP under the circumstance of heavy smoking.     

Merkel Cell Carcinoma: Report of Three Cases

Three cases of Merkel cell carcinoma are reported: Case 1 on the upper eyelid with regional lymph node metastasis, Case 2 with spontaneous regression after repeated biopsies, and Case 3 presumably developing on the lesion of pre-existing Bowen's disease. In Case 2, the biopsy specimen was characterized by numerous apoptotic cells in the periphery of the tumor nests surrounded by lymphocytic infiltration. In Case 3, the tumor developed after injury to the pre-existing lesion of Bowen's disease.