A Case of Hamartomatous Adiposity--A Rare Type of Goiter

A rare case of hamartomatous adiposity of the thyroid occurringin a 4-year-old Japanese boy was studied by light and electronmicroscopy. This tumor-like disorder was composed of predominantlyadipose tissue and fibrous connective tissue with muscle fibersbut only a small amount of thyroid follicles at the periphery.The ultrastructural appearance showed corresponding featuresof mature fat cells, fibroblasts and other mesenhymal cellsin various grades of differentiation, and especially of striatedmuscle cells with myofilaments having electron-dense Z-lines.The findings suggest that this tumor is a hamartomatous or heterotopicdisorder caused by histogenetic malformation during embryonaldevelopment rather than a true neoplasm.     

Blood Vessel Invasion in the Primary Site and Involved Lymph Nodes of Breast Cancer: Its Significance to Hematogenous Metastases

One hundred sixty-nine patients who had had radical mastectomywere investigated for blood vessel invasion in the primary tumorsites (TBVI); and 72 of these patients with regional lymph nodemetastasis were examined for blood vessel invasion within andin the vicinity of the involved lymph node (NBVI). Although distant metastases occurred more frequently in thepatients with blood vessel invasion in the tumor than in thosewith no blood vessel invasion, the differences were rather smallwithin respective negative and positive node metastasis subgroups. Analysis of blood vessel invasion in the involved lymph nodeshowed higher incidences of distant metastases in the subgroupswith positive blood vessel invasion in the lymph node than inthe subgroups with no such invasion; 42.1% 5s. 9.5% (negativeTBVI subgroup) and 47.4% 5s. 15.4% (positive TBVI subgroup). ^* This work was supported by a grant-in-aid for cancer researchfrom the Ministry of Health and Welfare.     

Breast Carcinoma Arising in Cystosarcoma Phyllodes: Report of a Case with a Review of the Literature

An extremely rare case of coexistent carcinoma arising in acystosarcoma phyllodes of the breast is reported. A 41-year-oldJapanese woman was referred with a lump in the right breast.A tumor measuring 5.6x3.6x3.2 cm was removed by local excision.Histological examination revealed foci of papillo-tubular carcinomawithin the benign cystosarcoma phyllodes. Radical mastectomywas performed and the axillary lymph nodes showed no metastasis.While 22 cases of coexistent carcinoma and cystosarcoma phyllodesin the same breast have been reported, in only nine of thosecases, the carcinomas including this case have developed withinthe cystosarcoma phyllodes.     

Monotypic epithelioid angiomyolipoma of the kidney: A case report

A case of monotypic variant of epithelioid angiomyolipoma (AML) observed in a 62-year old woman is reported. The patient complained of abdominal fullness caused by a huge left renal mass without evidence of tuberous sclerosis complex. Imaging studies showed a left renal mass with an area showing hemorrhage and necrosis. The left renal mass, spleen and pancreatic tail were removed en bloc transabdominally. The resected tumor weighed 1200 g and showed focal necrosis and hemorrhage. Microscopically, the tumor was composed exclusively of atypical polygonal cells with copious eosinophilic cytoplasm, pleomorphic nuclei and prominent nucleoli. Tumor cells were considered to derive from perivascular epithelioid cells, and exhibited strong positive staining for HMB-45 and c-KIT, but were negative for epithelial, smooth muscle, and neural markers. As this tumor had none of the typical elements of classic AML, the final pathological diagnosis was monotypic epithelioid AML.     

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.     

Pseudosarcomatous Fasciitis of the Breast Simulating a Malignant Neoplasm: A Case Report and Ultrastructural Study

A rare case of pseudosarcomatous fasciitis of the breast simulatingbreast cancer in clinical and gross features was studied bylight and electron microscopy. The pseudo-tumor was located in the right breast of a 59-year-oldJapanese woman, who underwent a radical mastectomy. The tumorcells were mainly composed of fibroblast-like cells within fibrousstroma and appeared to infiltrate into the subcutaneous fattytissue. Normal or atrophic lobules and ductules of the mammarygland were also found with occasional microcalcification. The ultrastructure of the tumor cells showed poorly developedrough endo-plasmic reticula, and abundant intracytoplasmic microfilaments.This finding suggests that the pseudotumor cells were proliferativefibroblasts derived from the superficial fascia of the breast.     

Effects of Recombinant Murine Interferon-{gamma} on Pregnant Mice and Their Fetuses

Effects of Recombinant Murine Interferon- on Pregnant Mice andTheir Fetuses. KATO, I., KIMURA, S., FURUHASHI, T., NAKAYOSHI,H., TAKAYAMA, S., AND UENISHI, N. (1990). Fundam. Appl. Toxicol.14, 658–665. Recombinant murine interferon- (Rec-MuIFN-)was administered intramuscularly to C3H/HeNCrj mice on Days6-15 of gestation at dosage levels of 8 x 10⁵, 4 x 10⁶, and2 x 10⁷ u/kg/day. Dams were killed for examination of fetuseson Day 18 of gestation. Pregnant females that received 2 x 10⁷u/kg/day of Rec-MuIFN- showed uterine bleeding on Days 10–15of gestation and could not maintain their pregnancy. These damsdied on Days 13–17orwerekilled/ieWrem/sonDays 10–15for examination, and therefore no fetal data were availablefor this group. In the 2 x 10⁷ u/kg/day group, the mean absoluteweights of the lung and spleen increased and the mean absoluteweight of the liver, red blood cells (RBC), hematocrit, andhemoglobin decreased significantly. Surviving dams in the 8x 10³ and 4 x 10⁶ u/kg/day groups showed significant increasesin the mean absolute weights of the lung, liver, kidneys, andspleen and a decrease in platelet count. Significant increasesin the weights of the heart and ovaries and decreases in RBC,hematocrit, and hemoglobin were observed in the 4 x 10⁶ u/kg/daygroup. Histopathological examination revealed increased extramedullaryhema-topoiesis in the spleen of the 4 x 10⁶ and 2 x 10⁷ u/kg/daygroups. Fetuses showed no external, visceral, or skeletal malformationsand variations caused by the administration of Rec-MuIFN-7 inany of the treated groups. Although a slight but statisticallysignificant decrease in fetal body weight and a delay in ossificationwere seen in fetuses in the 4 x 10⁷ u/kg/day group, these findingswere considered to be the result of maternal toxicity and notfetal toxicity. No fetal effects were observed i n the 8 x 10⁵u/kg/day group.     

2{alpha},3{alpha}-Epithio-5{alpha}-androstan-17{beta}-yl 1-Methoxycyclopentyl Ether in the Treatment of Advanced Breast Cancer --A Preliminary Clinical Trial--

A new orally active anti-estrogenic steroid, 2,3-epithio-5-androstan-17ß-yl1-methoxycyclopentyl ether (10364-S) was given to 41 advancedbreast cancer patients. Most patients were given a daily doseof 20 mg. The study was preliminary and not a controlled trialusing an already proven androgenic steroid. The remission rateon giving this compound to advanced breast cancer was 11/41or 26.8% and the average duration of the remission was 10.5months. Hoarseness (8/41, 19.5%) and hirsutism (5/41, 12.2%) were relativelyoften seen as virilizing side effects. No unfavorable effectson the hematopoietic organs, the liver or on calcium metabolismwere recognized in the study.     

Significance of Blood Vessel Invasion in the Involved Lymph Node as a Predictor of Blood-Borne Metastases in Breast Cancer--Further Report

Two hundred fifty-six patients who had a radical mastectomywere investigated for blood vessel invasion in the primary tumor(TBVI); and 106 of these patients with regional lymph node metastasiswere examined for blood vessel invasion within and in the vicinityof the involved lymph node (NBVI). Patients with positive TBVI showed a higher incidence of blood-bornedistant metastases, particularly those associated with regionalnode metastases. Further analysis of NBVI among 106 patientswith lymph node metastases indicated higher incidences of distantmetastases in the subgroup with positive NBVI than in the subgroupwith negative NBVI; 40.9% vs. 6.1% in negative TBVI group and48.6% vs. 12.5% in positive TBVI group. Dividing the patientswith positive NBVI into three subgroups relating to the gradeof invasion, the incidence of blood-borne distant metastasesincreased according to the grade of the NBVI. The above results suggest that blood vessel invasion, especiallythe finding in the involved nodes, is important as a predictorof postoperative distant metastases, and adjuvant anticancerchemotherapy is recommended.