Autoimmune pancreatitis associated with biliary stricture,immune thrombocytopenic purpura and lung fibrosis

We report an autoimmune pancreatitis case with diverse manifestation of biliary stricture, lung ?brosis and immune thrombocytopenic purpura. The patient was a 70‐year‐old man who presented with jaundice. Abdominal ultrasonography and computed tomography revealed enlargement of the entire pancreas and endoscopic retrograde pancreatography showed diffuse irregular narrowing of the main pancreatic duct. Endoscopic retrograde cholangiography revealed a band‐like stricture of the bile duct in the hilar hepatic region with intrahepatic duct dilation. Chest X‐rays and computed tomography revealed interstitial ?brosis of the bilateral lower lungs. Thrombocytopenia and purpura appeared. Antinuclear antibody, anti‐Ro (SS‐A) and anti‐La (SS‐B) antibodies and rheumatoid factor were positive. All manifestations responded well to steroid therapy. From the present case it would appear that a multitude of manifestations are linked within one syndrome. If we encounter patients with autoimmune pancreatitis, we should not focus on a disease but rather on the possibility of a syndrome complex.     

Meningiomas of the temporal bone

Meningiomas should be considered in the differential diagnosis of otologic tumors arising from the middle ear and mastoid. It is generally recognized that meningiomas may invade the temporal bone via direct extension from the intracranial space (secondary). It is not generally recognized that meningiomas can develop initially in the middle ear cleft (primary). Representative cases of primary and secondary meningiomas of the temporal bone are described, and clinical aspects of diagnosis and surgical management are discussed. In order to assess the pathogenesis of meningiomas of the temporal bone, histological studies were done on 200 temporal bone specimens. In certain specimens, ectopic arachnoid granulations, from which primary meningiomas may originate, were identified and described, according to location. One specimen was most unusual in that it contained ectopic glial as well as arachnoidal tissue.     

Primary Carcinomas of Urinary Bladder Diverticula

Two cases of carcinoma arising from the urinary bladder diverticulum were found at autopsy. Both patients had hematuria as a chief complaint and were found to have a tumor mass in the bladder on cystoscopic examination. However, owing to various difficulties the tumors could not be diagnosed before death. Autopsy revealed that the tumors in both cases had arisen within diverticula and had grown into the orifice of the diverticula giving the appearance of ordinary bladder tumors. Histological examination showed that in Case 1, two carcinomas, a keratinizing squamous cell carcinoma and a transitional cell carcinoma, had developed separately in a diverticulum. This may be the first case report of two cancers in a bladder diverticulum. There were no metastases in this case. Case 2 had an undifferentiated carcinoma with metastases to many organs including the lung, liver, and lymph nodes.     

Quinaldopeptin, a novel antibiotic of the quinomycin family

Quinaldopeptin, a new type of quinomycin antibiotic, was isolated from the culture of Streptoverticillium album strain Q132-6. The antibiotic exhibited strong in vitro antimicrobial and cytotoxic activity and significantly prolonged the survival time of mice inoculated with a murine tumor. Quinaldopeptin is a symmetric cyclic peptide linked only by peptide bonds and differs from known antibiotics of the quinomycin family by the lack of ester linkage.