Biomedical subjects
Publications and source records attributed to J Haratake.
Malignant mesenchymoma rarely originates from the gastrointestinal tract. Here we describe a case of an esophageal origin in a 50-year-old man. Computed tomography contributed to the diagnosis by having shown unique ossifications in the tumor.
An unusual case of Waldenström's macroglobulinemia associated with amyloidosis and crescentic glomerulonephritis is described. At autopsy, crescent formation was present in 80% of the glomeruli, and the breaks in the glomerular basement membranes were found at the same place as the deposition of amyloid.
Ten fibrolamellar carcinomas (FLCs), 3 FLC-like cancers, and 5 cases of a sclerosing hepatocellular carcinoma (SHCC) were examined clinicopathologically. The FLCs were found in young people in an equal sex ratio and showed no indications of an HBsAg, AFP, or cirrhosis. FLC cancer cell showed a large eosinophilic cytoplasm and prominent nucleoli. SHCCs were found in middle-aged people, male-predominant, and often positive for HBsAg and AFP. Cancer cells of the SHCC type showed less eosinophilic small cytoplasms and inconspicuous nucleoli. Although these two types are fairly distinctive entities, there were a few still unclassified HCCs with fibrous stroma. Further precise criteria would seem to be required for an accurate diagnosis of FLC.
The physicochemical properties and relationship of bone-resorbing activity and interleukin 1 (IL-1) produced by adult T-cell leukemia (ATL) cells and cell line were studied in vitro. The culture supernatant of ATL cell line, MT2, and peripheral blood lymphocytes freshly obtained from ATL patients had both IL-1 activity detected by the stimulation of murine thymocyte-proliferative responses and bone-resorbing activity detected by the stimulation of 45Ca release from prelabeled murine fetal bones. By Sephacryl S-200 column chromatography, both activities were eluted as a single peak at approximately Mr 15,000. By the chromatofocusing technique, the isoelectric point values of both activities were estimated as pH 4.8 and 5.2. Furthermore, both activities were absorbed with rabbit anti-IL-1 alpha antiserum, but not with anti-IL-1 beta antiserum. These results suggest that ATL cells and cell line produce bone-resorbing activity which corresponds to IL-1 alpha and that this IL-1 alpha is one of the most important causes of hypercalcemia in ATL patients.
This study was done to investigate which histologic type of lung cancer is prevalent among male Japanese copper smelter workers. A panel of eight pathologists was asked to diagnose uniformly prepared materials for 19 occupational series, 87 nonoccupational bronchogenic carcinomas, and 14 benign lesions. The consensus diagnosis was used as reference. The reference diagnoses and the originals without materials employed for verification were designated as finals. Squamous cell carcinoma was the most frequent cell type in the occupational group, which comprised 21 (75.0%) of 28 histologically proven cases. There were three (10.7%) small cell carcinomas, one (3.6%) large cell carcinoma, and three (10.7%) adenocarcinomas. The proportion of Kreyberg group I in the occupational cases was significantly larger than that of lung cancers in the population-based cancer registries in Japan. These findings are compatible with Kreyberg's hypothesis. Above all, squamous and small cell carcinomas were prominent and appeared to be environmentally related bronchogenic carcinomas.
There are few inhalation studies of nickel carcinogenesis. In this study, Wistar male rats were exposed to green nickel oxide (NiO(G)) aerosols (mass median aerodynamic diameter, 0.6 microns) for 7 h/d, 5 d/wk for up to 12 mo. The average exposure concentration was controlled at 0.3 and 1.2 mg/m3 during the exposure. For histopathological examination and measurement of the nickel concentration in rat organs, the rats were sacrificed at 3, 6, and 12 mo of exposure and 8 mo clearance period following 12 mo of exposure. The nickel content in rat lungs that was observed up to 2.6 mg after 12 mo exposure, was proportional to the exposure concentration during the exposure. The clearance of the nickel from the lungs was very slow and the biological half time was determined 7.7 mo. Although the rats were exposed continuously to NiO(G) for 12 mo and kept for 8 mo clearance period, there were no malignant tumors in any of the exposed animals.
This is a case report of a Japanese newborn infant showing bilateral renal dysplasia, severe pancreatic fibrosis simulating cystic fibrosis, intrahepatic biliary dysgenesis, and situs inversus totalis. The chromosomal analysis was normal. A review of the literature showed that there was another case exactly the same. These two rare cases had no difinite evidence of blood relationship, but occurred in the same town in a remote area.
An unusual nodular transformation of the liver was found in a 53-year-old man with meningoencephalitis who died of brain stem herniation. Postmortem examination revealed marked neuronal ischemic changes and bronchopneumonia as well as meningoencephalitis. The liver showed no significant lesions macroscopically. Histologically, there were many small nodules, less than 1 mm in diameter and composed of clear hepatocytes, throughout the liver. The liver cells in these nodules showed mild hyperplastic changes. Many fine granules, stained by orcein and Victoria blue, were found exclusively in the hepatocytes of these nodules. We describe the peculiar histopathology of this case with reference to some related lesions.
A massive hepatic infarction was found in a 44-year-old man who had suffered from polyarteritis nodosa for two years. The polyarteritis had been well controlled by administration of corticosteroids, but he died due to an opportunistic fungal infection. At autopsy, a massive hepatic infarct and a fresh thrombus occluding the right portal vein trunk were found. In addition, occlusion of the heptic arterial branch with fibrosis and dissociation of elastic fibers due to polyarteritis was noted. Massive hepatic infarction is uncommon. The clinicopathologic features of this case are described, and the pathogenesis of hepatic infarcts is discussed.
Seventy-five consecutive primary liver cancers that had a hepatic resection have been examined clinicopathologically. Eighteen were HBsAg+ cases (mean age: 50.9 yr) and 57 were HBsAg- cases (mean age 60.1 yr). HBsAg was not detected in the livers of the 57 HBsAg- cases, though it was found in the noncancerous parts of 16 of these cases and in the cancerous parts of 3 of the 18 HBsAg+ cases. A histologic, comparative study between the HBsAg+ and HBsAg+ cases showed no significant morphologic differences, except for somewhat frequent portal invasions in the former. From the viewpoint of prognosis, the ominous signs seem to be a positivity of serum HBsAg, large tumors, the presence of a portal and/or hepatic venous invasion, the presence of intra-and/or extrahepatic implants, and a high Edmondson's grade.
Orcein-positive hepatocellular material (OPHM), found in 18 of 44 hepatocellular carcinomas (HCC), was compared histochemically and ultrastructurally with similar granular materials in other liver diseases. OPHM was not found in 15 control livers, 45 metastatic liver cancers or ten cholangiocellular carcinomas. OPHM in HCC was stained with orcein when the tissue sections were preoxidized. In addition, it was positively stained with rhodanine and rubeanic acid for copper. These findings were identical to the OPHM in Wilson's disease, in primary biliary cirrhosis and in neonatal livers. Seven of 12 resected HCC revealed cytoplasmic dense bodies ultrastructurally in which an x-ray microanalyzer demonstrated copper. OPHM in HCC, a granular accumulation, was concluded to be rich in copper-protein complex, and might correspond to dense bodies derived from lysosome ultrastructurally. The pathogenesis and biologic significance of this copper overload in a number of HCC are also discussed.
Presented here is the case of a 69-year-old woman with pancreatic cancer. Efforts were made to discover the origin of the cancer but without success. Tumor nodules were scarcely observed in the pancreas macroscopically at autopsy, while histological examination of the pancreas revealed the presence of a well-differentiated adenocarcinoma (duct cell carcinoma). The invasion to the wall of the intrahepatic bile duct was also observed microscopically.
There are few investigations concerning the cumulative toxicity of agricultural chemicals by repeated inhalation. In this study, Wistar male rats were exposed to methomyl powder (mass median aerodynamic diameter, 4.4 microns) for a single 4-hr exposure, or for 4 hr/day, 5 days/week for 3 months. The average exposure concentrations were controlled at 9.9 mg/m3 for the single exposure and at 14.8 mg/m3 for repeated exposures by a dust generator consisting of a continuous fluidized bed with an overflow pipe and a screw feeder. After the repeated exposures, plasma and red cell cholinesterase activities, and lipid concentrations of the rat lungs were measured and histopathological examinations were performed. There was no evidence of cumulative effects on the red cell cholinesterase activity, histopathological changes and lipid concentration in 3-month repeated inhalation.
A prostatic adenocarcinoma with argyrophilia and many Paneth cell-like granules in a 91-year-old man is reported. The initial symptom was pollakisuria, and the laboratory data showed no significant abnormality except for moderate anemia. Through radiologic examinations a right hydronephrosis and metastatic cancer of the lumbar vertebra were suspected. Because prostatic cancer was suspected, a needle biopsy of the prostate was performed. Routine histologic examinations revealed a moderately differentiated adenocarcinoma of the prostate. By hematoxylin and eosin stain, eosinophilic large granules like those of Paneth cells were found in many cancer cells. In addition, argyrophilic cancer cells were seen by Grimelius' stain. Immunoperoxidase staining elucidated a definite reactivity for lysozyme in the granules like Paneth cells. Ultrastructurally, the granules of Paneth cell-like cancer cells were electron-dense spherical bodies with a medium diameter of 540 nm. Prostatic adenocarcinoma with argyrophilia is rare, and the argyrophilic adenocarcinoma with Paneth cell-like granules is very rare in the prostate.
To estimate variability and reliability in histologic diagnosis (Dx) of lung cancers, lung cancer preparations were divided into eight equal sets and diagnosed independently by an eight-man pathology panel. Majority Dx (Dx affirmed by more than 4 panelists) was regarded as the consensus Dx of each cancer. The consensus rate of each panelist ranged from 78.8% to 96.1% with an average of 89.4%. The consensus rates were not significantly different among the panelists. Relatively high inter-pathologist agreement was observed in squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. However, regarding large cell carcinoma, there was occasional disagreement among the panelists. Forty-seven cancers were reexamined by the same panelists, with no preliminary announcement, 7 months after the first examination to study the intra-pathologist agreement. The rate of the intra-pathologist agreement ranged from 76.6% to 93.3%. Dx of large cell carcinoma was the most intra-changeable. It was concluded that the histologic Dx of large cell carcinoma was the most inter- and intra-changeable, and the most frequent dissenting Dx from it was poorly differentiated squamous cell carcinoma.
Tissue copper contents in 38 primary and 45 metastatic hepatic malignancies and 15 control livers were analyzed by atomic absorption spectrophotometry. The average copper content of 15 control livers was 23.1 +/- 13.0 micrograms/g dry weight (microgram/gdw). The copper content of five cholangiocellular carcinomas (CCCs) and 45 metastatic cancers was almost equal to the control level. Thirty three hepatocellular carcinomas (HCCs) contained a larger amount of copper (61.5 +/- 76.8 micrograms/gdw) than the control livers (p less than 0.05), but the copper content of HCCs showed a considerably wide variation. The average copper content of nine minute HCCs (126 +/- 112 micrograms/gdw) was significantly (p less than 0.05) higher than that of 24 large HCCs (37.2 +/- 39.9 micrograms/gdw). Histologically, orcein and paramethylaminobenzylidene rhodamine positive granules were seen in eight and four of nine minute HCCs, respectively. These granules were also found in some large HCCs, but were never found in CCCs and metastatic cancers. It was concluded that these excessive accumulations of copper and copper-binding proteins might present a helpful finding to distinguish some cases of HCC, especially small HCC, from CCCs, metastatic cancers and hypertrophic regenerative nodules of cirrhotic livers. The significance and possible pathogenesis of these copper accumulations in HCCs require further studies.
Twelve cases of pancreatoblastoma, 7 males and 5 females, were 5 years of age in average and showed an organoid structure consisting of acinar differentiation with squamoid corpuscles. Seven cases died, but 5 lived after surgery. On the contrary, 17 cases of papillary cystic tumor, ductuloacinar adenoma of the pancreas, one male and 16 females, were 21 years of age in average and disclosed a monomorphous pseudopapillary pattern of ductuloacinar type of tumor cells with some degenerative and granulomatous changes. All of the cases had suffered no recurrence after resection. Immunohistochemically, strong positivity for alpha 1-antitrypsin may be associated with the autodigestive process and limited growth of this tumor. Electron microscopically, both tumors showed centroacinar and acinar types of tumor cells. Both tumor cells frequently contained well-developed RER, zymogen-like granules, and annulate lamellae. The ductular or acinar lumina were clear in pancreatoblastoma, but not in ductuloacinar adenoma due to degeneration. Though both tumors disclosed contiguous histogenesis, pancreatoblastoma should be differentiated from ductuloacinar adenoma, based upon the young age, almost equal sex ratio, unfavorable prognosis, high serum AFP level in three measured cases, an organoid structure containing frequent mitotic figures, and the invasive growing margin.
At our University, the rate of hepatic malignancies among the total number of those autopsied was shown to be higher than the mean rate of Japan. The 108 cases investigated included 92 hepatocellular carcinomas (HCCs), 10 cholangiocellular carcinomas (CCCs), 4 cases of combined HCC and CCC, one undifferentiated carcinoma, and one angiosarcoma. The positive rate of serum HBsAg among the HCCs in our series was almost equal to the mean rate of Japan. Twenty-eight HBsAg positive and 64 negative HCCs were clinicopathologically compared. The mean age at death was ten years younger for the positive cases than in the negative ones (p less than 0.05). However, there was no significant difference between both groups in any other biologic or pathologic feature, except for a few minor matters. We describe herein the summary of our cases with reference to a comparison study between HBsAg positive and negative HCC cases.