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Biomedical subjects

K Misugi

Publications and source records attributed to K Misugi.

At least 73 records · Page 4Linked to original sources

Immunohistochemical study of pancreatoblastoma.

Three cases of pancreatoblastoma in children were examined immunohistochemically and the results were compared with those of pancreatic duct carcinoma in adults. The pancreatoblastoma demonstrated positive reactions to alpha-fetoprotein (AFP) (67%: 2/3), alpha-1-antitrypsin (AAT) (100%: 3/3), carcinoembryonic antigen (CEA) (67%: 2/3) and keratin (33%: 1/3), although CEA was only weakly positive in both cases. On the other hand, adult pancreatic duct carcinoma showed positive reactions as follows; AFP: 3% (1/29), AAT: 21% (6/29), CEA: 97% (28/29) and keratin: 93% (27/29). Also, endocrine substances including insulin, glucagon and somatostatin were all negative in the pancreatoblastomas. Two cases of pancreatoblastoma which were immunohistochemically positive for AFP also showed elevation of the serum AFP level clinically. The different expressive pattern of oncofetal antigens in pancreatoblastoma as compared with pancreatic duct carcinoma in adults may provide further supporting evidence for the embryonic nature of pancreatoblastoma, and suggests that such a pattern might be used as a tumor marker for pancreatoblastoma.

Adult↗

Ras p21 expression in nephroblastoma group tumors.

Ras p21 expression in 30 cases of nephroblastoma and related tumors was evaluated by the immunoperoxidase method using monoclonal anti-ras p21 antibody (RAP-5) raised against a synthetic polypeptide fragment of ras p21. In normal renal tissue, the epithelial cells of convoluted and collecting tubules and arterial wall leiomyocytes were positively stained. In nephroblastoma tumors, some of the epithelial cells forming primitive tubular and glomerular-like structures in the nephroblastic-type tumors and the cells with rhabdomyocytic features were positive. However, the epithelial cells in more differentiated glandular structures of epithelial-type tumors, the rhabdoid cells in rhabdoid tumors and the cells in congenital mesoblastic nephroma failed to show positive staining. Nephroblastic cells, stromal cells and sarcomatous cells were also negative.

Antibodies, Monoclonal↗

Analysis of alloantigen-specific suppressor T cells.

The intravenous administration of allogeneic spleen cells successfully induced two distinct subsets of alloantigen-specific suppressor T cells that function at either the induction phase or the effector phase of alloantigen-specific DTH responses. The induction phase suppressor T cells were found to be Lyt2-, and were not genetically restricted by H-2 region genes. The effector phase suppressor T cells are Lyt2+, and their activity is controlled by genes within the H-2 region. The effector phase suppressor T cells mediate antigen-dependent bystander suppression, provided the appropriate alloantigen is present at the site of the immune responses. This effector phase suppression requires cyclophosphamide-sensitive targets. The results of this study suggest that allospecific suppressor T cells and hapten-specific suppressor T cells have a similar mechanism of action.

Animals↗

Appendiceal endometriosis in pregnancy. Report of a case with perforation and review of the literature.

A 25-year old woman at the 26th week of gestation underwent surgery for possible acute appendicitis. Pathological examination of the appendix showed extensive decidual change through the entire wall with perforation and surrounding acute inflammatory cell infiltration. To our knowledge, the present report is the second case of appendiceal endometriosis with this rare complication in the literature. The previously reported cases of appendiceal endometriosis which manifested clinically during pregnancy are briefly reviewed.

Adult↗

"Black thyroid" associated with minocycline therapy. A report of an autopsy case and review of the literature.

An autopsy case of a 69-year-old woman showing black discoloration of the thyroid gland designated as "Black thyroid" was reported. The patient received long-term, high dose antibiotics minocycline therapy (total dose: 70 g) for bronchial asthma associated with respiratory infection and died of uterine cancer. The thyroid gland was coal black in color and histological examination revealed numerous dark brown pigments scattered in the follicular epithelium and colloid matrix. Special stains and electron microscopic examination suggested these deposited pigments to be consistent with lipofuscin. Histological examination of the thyroid glands in consecutive 500 autopsy cases revealed intimate relationship between deposition of lipofuscin pigments in the follicular epithelium and age of the patients. But, massive deposition of lipofuscin in the thyroid alone did not make the thyroid black and addition of minocycline appeared to be necessary for the black discoloration.

Aged↗

Undifferentiated renal cell carcinoma in infancy: report of a case and review of literature.

A case of rapidly progressed undifferentiated renal cell carcinoma in a 2 2/12-month-old boy is reported. The histology is characterized by sarcomalike spindle and pleomorphic cells and bizarre giant cells, thus creating many difficulties in the differential diagnosis. The diagnosis of renal cell carcinoma was established on the basis of tubular formation by clear and granular cells observed in a few discrete areas. The literature on renal cell carcinoma occurring under 10 years of age was reviewed, with special attention given to histological typing. It is generally believed that renal cell carcinoma in children is well differentiated, but 2 of 39 cases reviewed were undifferentiated. We conclude that renal cell carcinoma in infants or young children may have an undifferentiated, atypical histological appearance and can progress rapidly. The differential diagnosis from anaplastic Wilms' tumor and sarcomatous tumors of the kidney in children is discussed.

Autopsy↗

Idiopathic right ventricular dilation. Special reference to "arrhythmogenic right ventricular dysplasia" and analogous lesions.

Two autopsy cases which showed marked depletion of the right ventricular musculature of the heart accompanied with marked infiltration of the adipose tissue were reported. The first cases was an 18-year-old female who died of right sided congestive heart failure after about 4-years clinical course. The autopsy disclosed marked dilation of the right atrium and ventricle. The entire free wall of the right ventricle was markedly thin. Microscopically, most of the myocardial fibers of the right ventricle were replaced by fat and fibrous tissue. The second case, a 15-year-old boy, whose identical twin was previously diagnosed as arrhythmogenic right ventricular dysplasia designated by Fontaine et al., died suddenly during exercise. He showed no cardiac symptoms but electrocardiogram was abnormal. Autopsy revealed majority of the myocardial fibers of the right ventricular free wall were replaced by fatty tissue. In both cases, fatty infiltration was mainly noticed at the epicardial side and some myocardial fibers remained in the fatty tissue showed hypertrophic and/or degenerative changes. Review of the literature on similar cases showing depletion of the right ventricular musculature including so-called adult's Uhl anomaly, ARVD and dilated right ventricular myocardiopathy was conducted and the relationship of the present cases with these lesions was discussed.

Adipose Tissue↗

Immunohistochemical and ultrastructural study of early lesions of intravascular bronchioloalveolar tumor with liver involvement.

Autopsy findings including immunohistochemical and ultrastructural study of intravascular bronchioloalveolar tumors (IVBAT) of the lung and liver which were incidentally found in a 68-year-old man were reported. The tumors presented as several, small nodular lesions in bilateral lungs and liver. Immunohistochemical study using the antibody against Factor VIII-related antigen and electron microscopic study suggested endothelial nature of both pulmonary and hepatic lesions. The study by using anti-estradiol antibody revealed the presence of estrogen in the cytoplasm of neoplastic cells, suggesting the possibility of the presence of estrogen receptors in the cells. Although the result is still preliminary, some role of estrogen in the development of IVBAT is suggested. The hepatic lesions have been thought to be metastases from the pulmonary IVBAT but the other possibilities such as primary hepatic or multicentric origin must be considered. Review of the previous reports of IVBAT disclosed several cases which were associated with liver involvement.

Aged↗

Pancreatic carcinoma in childhood. Report of an autopsy case and a review of the literature.

Clinical and histological findings of pancreatic carcinoma in a 6-year-old boy are reported. Gradual change of histological appearance of the tumor during his course of 3 years and elevation of serum alpha-1-fetoprotein (AFP) are documented. Two biopsy specimens showed immature histological appearance compatible with pancreatoblastoma, and autopsy material showed well-differentiated adenocarcinoma with distinct ductal and acinar differentiation. Electron microscopy demonstrated zymogen-like granules in the apical portion of the neoplastic cells. Immunoperoxidase method demonstrated AFP in the neoplastic cells in addition to alpha-1-antitrypsin. Literature of pancreatic tumor in the young was reviewed, and characteristics of this case were discussed.

Adenocarcinoma↗

Immunohistochemical study of neuroblastoma and related tumors with anti-S-100 protein antibody.

Histological sections of 36 cases of neuroblastoma and related tumors were studied with anti-S-100 protein antibody (PAP method). Schwann cells in the ganglioneuromas and ganglioneuroblastomas always strongly stained. In addition, varying numbers of spindle-shaped or elongated positively staining cells, which were probably Schwann cells and their precursor cells, were demonstrated in ganglioneuroblastoma and differentiating neuroblastoma. Undifferentiated round cell neuroblastoma showed no reaction. Immunohistochemical findings of these cases were classified into four groups (+ +, +, +/-, -) according to the number of the positive cells and compared with prognosis, histological typing, location of the tumors, stage, and age at surgery. The cases with many positive cells, group (+ +) showed excellent prognosis, and group (-) showed very poor prognosis. The results of this study indicate that S-100 protein staining provides a reliable objective method for evaluation of differentiation of the neuroblastoma cells toward Schwann cells, which appears to be an important factor to predict prognosis.

Child↗

[A case of embryonal rhabdomyosarcoma of the kidney].

A case of embryonal rhabdomyosarcoma of the left kidney is reported. A 16-year-old boy was admitted with the complaint of left abdominal pain and fever on January 6, 1983. Radiological examination showed a tumor of the left kidney; and, nephrectomy was performed. Histopathologically the entire tumor was composed of undifferentiated round cells. Diagnosis of embryonal rhabdomyosarcoma was made on the basis of special stains including immunohistochemical study with nervous tissue specific enolase. Although radiation and chemotherapy were performed postoperatively, the tumor recurred and the patient died on October 22, 1983. The problems of differential diagnosis of embryonal rhabdomyosarcoma from sarcomatous types of nephroblastoma, particularly rhabdoid tumor and other undifferentiated renal tumors were discussed. Fifteen rhabdomyosarcoma of the kidney including our case have been reported in the Japanese literature.

Adolescent↗

Peripheral neuroectodermal tumors of the chest wall in childhood.

A retrospective review of primary chest wall malignant tumors of childhood collected at the Children's Memorial Hospital of Chicago was undertaken. Among twelve instances of poorly differentiated neoplasms whose uniform, monotonous structure made accurate classification difficult or impossible by conventional histologic study, there were three tumors with features suggestive of neuroectodermal differentiation. Electron microscopic and immunohistologic findings further strengthened this interpretation, despite the fact that none of the patients had evidence of a primary neuroblastoma outside the chest wall. These results and a review of the pertinent literature support the conclusion that neuroectodermal neoplasms in childhood may present in peripheral somatic tissues with greater frequency than is commonly assumed. The importance of this distinction is discussed, particularly the need to distinguish these neoplasms from Ewing's sarcoma.

Adolescent↗

Histopathologic prognostic factors in neuroblastic tumors: definition of subtypes of ganglioneuroblastoma and an age-linked classification of neuroblastomas.

Histopathologic prognostic factors of 295 pretreatment tumors of a total 641 neuroblastomas and ganglioneuroblastomas were studied with the use of the following proposed tumor classification. The tumors were divided into 2 groups: stroma-poor (235 cases) and stroma-rich (60 cases) according to their organizational pattern (stromal development). The stroma-poor group was classified further into 2 subgroups: favorable stroma-poor (84% survival) and unfavorable stroma-poor (4.5% survival) according to the patient's age at diagnosis, degree of maturation, and nuclear pathology [mitosis-karyorrhexis index (MKI)] of the neuroblastic cells. The stroma-rich group was further classified into 3 subgroups: well differentiated (100% survival), intermixed (92% survival), and nodular (18% survival) on the basis of morphology of the immature element in the tumor tissue without regard to patient's age or quantitative maturation. Favorable stroma-poor and well-differentiated and intermixed stroma-rich groups seem to make good prognosis groups (87% survival), which show gradual progression along a maturational sequence according to the age of the patient. Unfavorable stroma-poor and nodular stroma-rich groups form poor prognosis groups (7% survival) and show morphological evidence of malignant or aggressive behavior, such as inappropriate immaturity for age, higher MKI, and gross nodule formation by immature neuroblasts.

Adrenal Gland Neoplasms↗

Kawasaki disease complicated with mitral insufficiency. Autopsy findings with special reference to valvular lesion.

A case of mucocutaneous lymph node syndrome (Kawasaki disease, MCLS) complicated with mitral insufficiency is reported. This patient showed severe valvulitis, which was thought to be the main cause of mitral regurgitation. Two other patients with MCLS who did not present clinical signs of mitral insufficiency revealed the presence of mild valvulitis. The morphological alterations of cardiac valves were non-specific and mainly consisted of inflammatory infiltration, increment of fibrous connective tissue, and proliferation of small capillaries. In addition to the coronary aneurysms, the involvement of cardiac valves should receive attention as the sequelae of MCLS.

Aneurysm↗