Ganglion cells in Ewing's sarcoma following chemotherapy: A case report

A case of Ewing's sarcoma of the bone, arising in the right radius of a 12-year-old girl, which showed unique histologic features after pre-operative treatment, is reported. The light microscopic features of a biopsy sample were those of a small round cell tumor showing positive immunoreaction with antibodies against the product of the MIC 2 gene (O13), neuron-specific enolase, neurofilament, and synaptophysin, but no morphological differentiation. The patient received combined intensive multi drug chemotherapy and radiation before surgery. Examination of the surgical specimen showed that the tumor was less cellular than that in the biopsy specimen, and was composed mainly of loosely textured large cells mimicking ganglion cells, occasionally forming Homer-Wright rosettes. An lmmunohistochemical study revealed that neural differentiation was enhanced. Immunoreactivity for Leu-7 also became positive. Although the patient underwent postoperative chemotherapy, she died of multiple lung and bone metastases 30 months alter the diagnosis. Autopsy showed that metastatic foci were made up of densely packed small round cells like those seen In the biopsy samples, but associated with prominent Homer-Wright rosettes. To the authors' knowledge, this is the first report of a tumor being replaced almost entirely by ganglion cells after preoperative chemotherapy and radiotherapy.     

THE ROLE OF MONOCYTE CHEMOATTRACTANT PROTEIN-1 (MCP-1) IN THE PATHOGENESIS OF COLLAGEN-INDUCED ARTHRITIS IN RATS

Collagen-induced arthritis was produced in rats by intradermal immunization with type II collagen and the expression and production of monocyte chemoattractant protein-1 (MCP-1) were examined by immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), and Northern blot analysis. Two to three weeks after the immunization, the hindfeet showed swelling and redness, followed by the development of severe arthritis, particularly in the ankle joints. During this period, prominent infiltration of neutrophils and macrophages was observed. Sandwich ELISA and Northern blot analysis revealed that MCP-1 concentrations in the joint lavages and MCP-1 mRNA levels in the joint tissues both peaked at 2 weeks after the immunization. By immunohistochemistry, various types of cells, particularly neutrophils, macrophages, synovial cells, and vascular endothelial cells, stained positively for MCP-1. Finally, injection of a neutralizing monoclonal antibody against rat MCP-1 significantly decreased the number of exudate macrophages in the lesions and reduced the ankle swelling by about 30 per cent compared with controls. These results suggest that MCP-1 plays a critical role in this model in the recruitment of monocytes and in the development of arthritis. © 1997 John Wiley & Sons, Ltd.     

CUTANEOUS B-CELL LYMPHOMA CONSISTING OF LARGE CLEAVED CELLS WITH MULTILOBATED NUCLEI

A 65-year-old man was seen at the Ushioda Hospital in Au-gust 1989, because of a 1-month history of a tumor on the scalp. The tumor was excised and the diagnosis was malig-nant lymphoma. The patient was then referred to our de-partment in September 1989. Several nut-sized lymph nodes wvepa-b and m-fepa for 2 months. Since then, the patient has been free of disease up to the time of writing, July 1992, a period of 2.5 years. Biopsy samples taken from the tumor on the scalp showed a monomorphous infiltrate of large lymphoid cells throughout the entire dermis and subcutis, with a definite clear zone (Fig.1). A high-power view showed diffuse large lymphoid cell infiltration. Numerous mitotic figures were also seen. The lymphoid cells had multilobated nuclei and distinct nucleoli (Fig. 2). Monoclonal antibodies such as Leui (CD5), Leu2a (CD8), Leu3a (CD4), Leu4 (CD3), MT-1 (CD43), Leu14 (CD22), LN1 (CDw75), and Leu26 (CD20), and polyclonal antibodies such as anti-kappa, anti-lambda, anti-IgG, anti-lgA, anti-IgM, and anti-lgD were purchased from commercial sources. Optimal dilutions of the monoclonal antibodies and heteroantisera were assessed beforehand by titration on suitable tissue samples. The antigens recognized by the monoclonal anti-bodies and heteroantisera were investigated by either the avidin-biotin peroxidase complex (ABC) method on cryostat sections or the peroxidase-antiperoxidase complex (PAP) method on paraffin sections, as described elsewhere.¹ The immunologic properties of the infiltrating cells were determined using skin biopsied in August 1989, and October 1989. Large lymphoid cells, which formed the major popu-lation of infiltrating cells, were positive for CD20, CD22, and HLA-DR and negative for CD3, CD4, CD43, and CD45RO. From these findings the patient was diagnosed as hav-ing primary cutaneous B-cell lymphoma, diffuse large non-cleaved cell type, as classified by the Working Formulation.²     

Patterns of age-dependent changes in the numbers of lymph follicles and germinal centres in somatic and mesenteric lymph nodes in growing C57Bl/6 mice

The timing of the first appearance of lymph follicles and germinal centres in various lymph nodes, and the ways in which numbers of these and IgM-synthesising cells increase within the nodes, were investigated in male and female C57Bl/6N mice aged from 4 d to 16 wk. The lymphoid organs examined were the Peyer's patches, spleen, somatic (submandibular, deep cervical, brachial, axillary, inguinal and popliteal) and visceral (mesenteric and lumbar) lymph nodes. Primary follicles appeared in most somatic lymph nodes 6 d after birth. The number of follicles per node then increased rather sharply in larger lymph nodes and slowly in smaller nodes, up to 28 d of age, reaching a level which varied according to the location of the node. Thereafter, the number of follicles in the somatic lymph nodes increased only slightly to moderately, reaching a peak or plateau at 8–12 wk. In the mesenteric (ileocaecal) nodes, primary follicles first appeared at 12 d, then increased linearly during the suckling period and after weaning to reach a plateau at 8 wk of age. Germinal centres appeared in the submandibular and mesenteric nodes at 28 d and their numbers increased consistently in the latter, while remaining low in the former. The impact of possible 'natural' exogenous antigen stimulation of the various lymph nodes was estimated from the presence of IgM-synthesising cells and germinal centres. Differences between the patterns of age-dependent changes in the numbers of lymph follicles observed in the somatic and mesenteric lymph nodes during their ontogeny are discussed in relation to differences in the magnitude of the exogenous antigen stimulatory effect. We also found that the variations in the numbers of lymph follicles produced in somatic lymph nodes at different locations during the first 28 d after birth reflected differences in the dimensions of the body regions drained by a particular somatic lymph node at this stage of development.     

Cardiac atrial natriuretic peptide in monocrotaline-induced pulmonary hypertensive rats

To determine the time course and potential triggers for synthesis of atrial natriuretic peptide (ANP) in right ventricle during the development of right ventricular hypertrophy (RVH), we measured mean right atrial pressure, right ventricular systolic pressure (RVSP), immunoreactive ANP (iANP) concentrations in plasma, and cardiac iANP concentrations and contents of monocrotaline (MCT)-induced pulmonary hypertensive rats treated with a subcutaneous injection of MCT (40 mg/kg). Following the development of RVH and pulmonary hypertension, iANP concentrations in plasma and iANP concentrations and contents in ventricular tissues increased with time. At the third week after treatment, iANP concentrations in MCT rats increased 6-fold in plasma, 57-fold in the right ventricular free wall, 20-fold in the ventricular septum and 10-fold in the left ventricular free wall compared with those in controls. At the third week, iANP contents of total ventricular tissues in MCT and control rats were 29% and 0.8%, respectively, of the corresponding atrial contents. The iANP concentrations and contents of right ventricular free walls in MCT rats were greater than those of any other parts of ventricular tissues. The iANP concentrations in right ventricular free walls were very closely related to RVSP (r = 0.93, P < 0.001). In MCT rats, iANP concentrations in right atrial tissues decreased with time. This study shows that ventricular ANP contributes to the amount of ANP stored within the heart in MCT rats and that pressure overload may be one of the triggers for ANP synthesis in the right ventricle.     

Hemiresective reconstruction of a redundant ileal conduit with severe bilateral ileal conduit-ureteral reflux

A 58-year-old man was referred to our hospital with high fever and anuria. Since undergoing a total pelvic exenteration due to bladder-invasive sigmoid colon cancer, urinary tract infections had frequently occurred. We treated with the construction of a bilateral percutaneous nephrostomy (PCN), and chemotherapy. Although we replaced the PCN with a single J ureteral catheter after an improvement of infection, urinary infection recurred because of an obstruction of the catheter. Urological examinations showed that an ileal conduit-ureteral reflux caused by kinking of the ileal loop was the reason why frequent pyelonephritis occurred. We decided to resect the proximal segment to improve conduit-ureteral reflux for the resistant pyelonephritis. After the surgery, the excretory urogram showed improvement and the urinary retention at the ileal conduit disappeared. Three years after the operation, renal function has been stable without episodes of pyelonephritis. Here we report a case of open repair surgery of an ileal conduit in a patient with severe urinary infection.     

AM-3K,A NOVEL MONOCLONAL ANTIBODY SPECIFIC FOR TISSUE MACROPHAGES AND ITS APPLICATION TO PATHOLOGICAL INVESTIGATION

An anti-human macrophage monoclonal antibody, AM-3K, was produced using human alveolar macrophages as antigen. The molecular weights of the antigen recognized by AM-3K were 120 and 70 kD. Immunohistochemically, AM-3K reacted intensely with most macrophages in lymphoreticular organs and in many other organs and tissues. In the spleen, AM-3K reacted with red pulp macrophages, some white pulp macrophages, and tingible body macrophages in lymphoid follicles. In the lymph nodes, many macrophages distributed in the outer cortex, paracortical area, medulla, capsule, or within lymphoid follicles showed an intense reaction for AM-3K. Kupffer cells of the liver, macrophages in the connective tissues, and interstitial macrophages of the kidneys, pancreas, testis, and many other organs were also strongly labelled. AM-3K also reacted with macrophages in many pathological conditions. This antibody, however, did not react with dendritic cell populations, such as epidermal Langerhans cells, interdigitating cells in the paracortex of the lymph nodes, and follicular dendritic cells within the lymphoid follicles, nor with cells other than macrophages, including epithelial cells, vascular endothelial cells, lymphocytes, and granulocytes. Reaction products for AM-3K were found on the cytoplasmic membrane of macrophages by immunoelectron microscopy. In both cryostat sections and formalin-fixed paraffin sections, this monoclonal antibody recognized the antigen present on the cell surface membrane of tissue macrophages, but not monocytes or dendritic cells.     

The detection of clonal proliferation in granular lymphocyte-proliferative disorders of natural killer cell lineage

Summary. The clonal proliferation of large granular lymphocytes can be detected in patients with T-cell-lineage granular lymphocyte-proliferative disorders (T-GLPD) by Southern blotting T-cell receptor genes. However, this cannot be applied to patients with natural killer-cell-lineage GLPD (NK-GLPD) as it lacks a clonal marker. We therefore investigated the use of two other diagnostic techniques in evaluating clonal proliferation in Japanese patients with NK-GLPD (n = 4) and T-GLPD (n=3) by chromosomal analysis of peripheral blood mononuclear cells (PBMC) stimulated with either interleukin-2 or phytohaemaggluti-nin, and Epstein-Barr viral (EBV) genomic DNA analysis. Chromosomal analysis revealed abnormal karyotypes in the PBMC of three of four patients with NK-GLPD, whereas EBV analysis showed a monoclonal terminal configuration in the PBMC in the fourth patient. Southern blots revealed rearrangements of the TCR genes in all three patients with T-GLPD but in none of those with NK-GLPD. It is suggested that these methods may be useful in detecting the abnormal proliferation of large granular lymphocytes in NK-GLPD.     

Prevalence of volatile solvent inhalation among junior high school students in Japan and background life style of users

In order to estimate the prevalence of volatile solvent inhalation among junior high school students in Japan and to assess certain characteristics of the lifestyle of these users, the authors surveyed 5240 students 12–15 years of age. This was the first major source of the prevalence of volatile solvent inhalation among junior high school students in Japan, from the point of view of the number of subjects and schools. 1.5% of subjects were students who had inhaled solvents. The regularity of life style rhythm was more significantly disturbed in Lifetime Users than in Non-Users. School life and family life was significantly less relaxed for Lifetime Users than for Non-Users. Drinking alcohol and smoking had a strong relationship with inhaling volatile solvents. The authors suggest that greatly increasing education on the harmful effects of volatile solvents inhalation and increasing the frequency with which the entire family eats dinner together will be an effective prevention strategy in Japan.