Biomedical subjects

M Enjoji

Publications and source records attributed to M Enjoji.

At least 163 records · Page 9Linked to original sources

PubMed1985

Juvenile xanthogranuloma. Clinicopathologic analysis and immunohistochemical study of 57 patients.

Fifty-seven cases of juvenile xanthogranuloma that fulfilled the classic description of histologic findings of the disease were analyzed clinicopathologically and immunohistochemically. Two forms could be distinguished: 47 cases of the infantile form and 10 of the adolescent and young adult form. The infantile lesion was found at birth in 8 patients (17%), and was noted within 1 year after birth in 33 (70%). Twenty-two had multiple lesions and five of the six for whom follow-up was feasible had spontaneous involution. About half of the lesions were located on the head and neck, 30% on the trunk, and 20% on the extremities. All six adolescents had a solitary tumor located in the head and neck region. Comparison of the latter form with reticulohistiocytoma and cutaneous fibrous histiocytoma was established from a differential point of view. Immunohistochemically, most lesions of juvenile xanthogranuloma displayed a positive reaction for lysozyme and alpha-1-antichymotrypsin and were negative for S-100 protein, thereby suggesting that the essential constituents of this lesion would derive from the mononuclear phagocyte system.

Adolescent↗

PubMed1985

Hepatoblastoma producing both alpha-fetoprotein and human chorionic gonadotropin. Clinicopathologic analysis of four cases and a review of the literature.

A clinicopathologic study was done of four cases of hepatoblastoma with precocious puberty, together with an analysis of 21 such cases reported in the literature. All four patients were males, the age ranging from 11 to 35 months. Three of the four patients died within 12 months after operation, but the fourth is living. Histologically, all patients had a hepatoblastoma with the coexistence of both fetal and embryonal type cells, although predominantly fetal in two and predominantly embryonal in the other two. Tumor giant cells were rarely encountered in all these cases. Both alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) in the serum or urine increased in our four cases and in five other cases reported in the literature. Though the serum AFP level paralleled the severity of clinical symptoms, the serum or urine hCG did not necessarily correspond to the clinical course. It is likely that these poorly prognostic virilizing hepatoblastomas secrete two different tumor markers, AFP and hCG, from different cells, and that these functioning tumor cells may not always exist concurrently in the recurrent or metastatic tumor.

Carcinoma, Hepatocellular↗

PubMed1985

Glandular or mucus-secreting components in squamous cell carcinoma of the esophagus.

A review of 195 patients with carcinoma of the esophagus disclosed 41 cases (21.0%) with glandular and/or mucus-secreting components, in addition to the ordinary component of squamous cell carcinoma. These tumors could be grouped into three types according to representative histologic features of glandular and mucus-secreting portions: glandular type (23 cases), cribriform type (11 cases), and mucoepidermoid type (7 cases). The histologic features of the three types were reminiscent of those of adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma of salivary glands, respectively. Moreover, areas showing glandular or mucus-secreting differentiation were in greater part located in the submucosa and the lamina propria mucosae, thereby suggesting that such differentiation had arisen in the esophageal glands or their ducts. In all 41 cases, the ordinary element of squamous cell carcinoma, invasive, or noninvasive, was admixed in various proportions with the glandular components, indicating that this type of esophageal tumor had originated not only from the covering squamous epithelium but also from esophageal mucous-gland or ductal epithelium. The findings also support the concept of the field origin of carcinogenesis in esophageal carcinoma.

Carcinoma↗

PubMed1985

Malignant pheochromocytoma with ganglioneuroblastoma elements in a patient with von Recklinghausen's disease.

A 14-year-old girl with numerous café-au-lait spots in her skin was hospitalized because of fever, weight loss, and a mass of the right upper quadrant of the abdomen. Despite intensive chemotherapy, she died 6 months after admission. The autopsy revealed a right adrenal tumor with metastases to liver, lungs, vertebrae, and lymph nodes. Histologically the tumor was a pheochromocytoma with small foci of ganglioneuroblastoma. The catecholamine contents of the tumor were markedly elevated, as confirmed by the catecholamine fluorescence technique. Electron microscopically, the tumor cells contained intracytoplasmic membrane-bound chromaffin granules of varying sizes and shapes. This may be the first report of the concomitant occurrence of malignant catecholamine-secreting pheochromocytoma with ganglioneuroblastoma elements in a patient with von Recklinghausen's disease.

Adolescent↗

PubMed1985

Atypical fibroxanthoma distinguishable from spindle cell carcinoma in sarcoma-like skin lesions. A clinicopathologic and immunohistochemical study of 21 cases.

A clinicopathologic study was done of 21 cutaneous, sarcoma-like lesions previously diagnosed as atypical fibroxanthoma, spindle cell carcinoma, or dermal sarcoma. These lesions were most commonly presented as a solitary, often ulcerated nodule, occurring on exposed skin of the face in the elderly or, occasionally, on roentgen-damaged or burnt skin of the head, leg, or hand. Microscopic features of the 21 lesions were, however, not alike, thereby implying that such sarcoma-like lesions had derived from heterogeneous origins. The immunohistochemical staining in a comparative study with two other cases of unequivocal spindle cell squamous carcinoma suggested that these lesions could be histogenetically divided into two different groups: (1) the major group of true atypical fibroxanthoma, consisting of 19 cases, and (2) the minor group of probable spindle cell squamous carcinoma, consisting of 2 cases. Despite a wide histologic spectrum and of heterogeneity of these lesions, there was a benign clinical course in the majority, due in part to the small size and superficial location of the lesions.

Adult↗

PubMed1985

Malignant smooth muscle tumors of the retroperitoneum and mesentery: a clinicopathologic analysis of 44 cases.

Forty-four cases of leiomyosarcoma arising in the retroperitoneum (33 cases) and mesentery (11 cases) were analyzed clinicopathologically, and four were examined ultrastructurally. These tumors were more common in women (61%) than in men (39%), and the median age of the patients was 59 years. Except for three tumors, most were large and over 10 cm in the greatest diameter. Twenty-seven tumors were classical leiomyosarcomas, while seven were composed predominantly of epithelioid cells and classified as malignant leiomyoblastoma (epithelioid leiomyosarcoma). In addition to the classical microscopic features, dedifferentiated areas resembling malignant fibrous histiocytoma were noted in three cases. Ultrastructurally, the tumors were characterized by smooth muscle tumor cells showing a spectrum of differentiation of varying degrees. Of the 42 patients for whom follow-up information could be obtained, 33 (79%) died within a period of five years after the initial treatment. Mitotic activity showed no significant correlation with biological behavior; ten of the 15 patients in whom the mitotic counts were less than five per 10 high-power fields (HPF), expired of the tumor.

Adult↗

PubMed1985

Bronchogenic cyst in the abdomen.

A bronchogenic cyst was found in the abdomen, in the retroperitoneum adjacent to the superior pancreatic body. The cyst was unilocular and contained about 100 ml pale yellow mucinous fluid. Microscopic examination revealed a pseudostratified columnar ciliated or cuboidal epithelium, seromucous glands, smooth muscle and cartilage, the distinctive features of bronchogenic cysts. This aberrant location of the cyst is explicable if abnormal buds of the tracheobronchial tree are pinched off and migrate into the abdomen in an early embryonic stage before the canal linking the abdominal with the thoracic cavity is closed by fusion of the future components of the diaphragm.

Bronchi↗

PubMed1985

Malignant soft tissue neoplasms with the histologic features of renal rhabdoid tumors: an ultrastructural and immunohistochemical study.

Five round cell neoplasms of the soft parts that histologically resembled malignant rhabdoid tumors of the kidney were studied. The tumors were composed mainly of poorly differentiated round or, sometimes, polygonal cells, with a minority of elongated cells; the cytoplasm of many of the cells contained filament-laden acidophilic inclusions. Ultrastructurally, the intracytoplasmic structures were seen to consist of aggregates of 10-nm intermediate filaments, and immunohistochemical staining revealed the presence of cytokeratin and vimentin. All five patients with this tumor had an aggressive clinical course; three of the patients died shortly after the initial diagnosis. As this tumor does not seem to be linked to any known entity, it is referred to as malignant rhabdoid tumor of the soft parts and could be a heterogeneous entity.

Adult↗

PubMed1985

Elastofibromatous lesion of the stomach in a patient with elastofibroma dorsi.

A 69-year-old woman underwent partial gastrectomy because of peptic ulcer which resisted medical treatment. The resected stomach exhibited a wide thickening of the antral wall around a 1.2 X 0.8 cm ulcer. The cut surface showed a gray-white thickened submucosal layer and had a rubbery elastic consistency. Microscopically, the thickened areas consisted of abundant acellular collagen fibers containing numerous elastinophilic, thick, serrated fibers and globules, identical with the elastofibroma fibers seen in elastofibroma dorsi. Reexamination of the patient revealed bilateral subscapular masses; one of these was biopsied and proved to be an elastofibroma dorsi.

Aged↗

PubMed1985

Malignant peripheral nerve-sheath tumors (malignant schwannomas). An immunohistochemical study of 29 cases.

Twenty-nine cases of malignant schwannoma consisted of three groups; 11 tumors associated with von Recklinghausen's disease (group I), nine tumors arising grossly from nerve trunks (group II), and 11 tumors so diagnosed basically on the histologic features (group III). Using the immunoperoxidase methods, the tumors were investigated with regard to S-100 protein, keratin, and epithelial membrane antigen (EMA). Approximately one-third of the cases (10 of 29) were devoid of S-100 positive cells and the remaining two-thirds (19 of 29) contained positive cells, with variable frequencies. The number of S-100 positive cells differed, depending largely on the presence or absence of neurofibroma-like areas in the tumor. The positive cells were rarely found in the group III tumors, which were neither associated with von Recklinghausen's disease nor connected to nerve trunks, even when their histologic features were unequivocal. Certain specific organoid structures in the tumor, such as neuroid or tactoid ones, were positive for S-100 protein. In one of the two malignant epithelioid schwannomas, the tumor cells were strongly positive for S-100 protein, thereby suggesting melanocytic differentiation. This tumor was interpreted as a melanocytic malignant schwannoma rather than a malignant melanoma, based in part on the fact that the overlying epidermis was uninvolved in this patient with von Recklinghausen's disease. True epithelial differentiation in one case of glandular schwannoma was verified by the positive stain of EMA along the inner surface of the glandular element.

Adolescent↗

PubMed1985

Extremely well-differentiated adenocarcinoma ("adenoma malignum") of the cervix in a patient with Peutz-Jeghers syndrome.

In a 29-year-old woman with the Peutz-Jeghers syndrome (PJS), an extremely well differentiated adenocarcinoma (adenoma malignum) of the uterine cervix was detected. The cervical lesion consisted of a polypoid mass, measuring 3.5 cm in greatest diameter, composed of extremely well differentiated tubules resembling those of the endocervical glands, yet containing a few Paneth cells. Immunohistochemical stains displayed cytoplasmic carcinoembryonic antigen in this tumor. The ovaries had no apparent abnormality. The diagnosis of the PJS was based on the presence of numerous hamartomatous polyps of the rectum and cutaneous pigmentation around the lips, fingers, and toes. The patient underwent a simple total hysterectomy and was subsequently treated with chemotherapy. In an 11 year follow-up, there has been no recurrence of the cervical tumor and she is currently well. The clinicohistopathologic differences of this cervical tumor in patients with and without PJS are briefly discussed.

Adenocarcinoma↗

PubMed1985

Myofibroblasts in fibromatoses. An electron microscopic study.

Fifteen cases of fibromatoses were analyzed by electron microscopy, the objective being to compare the incidence and frequency of myofibroblasts in each category. Myofibroblasts were identified in all 15 cases and a considerably large number of these cells appeared in palmar fibromatosis, plantar fibromatosis, and nodular fasciitis. In keloid and cicatricial fibromatosis, however, only a small number of these cells were evident. In seven cases of extra-abdominal desmoid fibromatosis, the frequency of myofibroblasts in the component cells ranged from 10% to 64%, with a mean of 30%. The frequency was high in hypercellular lesions and low in hypocellular lesions, assuming that it would be roughly in parallel to the cellularity of the lesion in extra-abdominal desmoid fibromatosis and in other fibromatoses as well. There appeared to be no particular correlation between the number of myofibroblasts and recurrence of the lesion.

Adolescent↗

PubMed1985

Granular cell tumor of the gallbladder. Report of a case.

A rare case of granular cell tumor of the gallbladder in a 58-year-old Japanese man is presented. This is the third report of such a tumor arising in the gallbladder. The immunohistochemical study demonstrated the localization of the nervous-system-specific protein (S-100 protein) in the granular component cells, thereby supporting the Schwann cell origin of this tumor.

Gallbladder Neoplasms↗

PubMed1985

Malignant giant cell tumor of tendon sheath. Report of a case.

In a patient with pigmented villonodular synovitis of the right knee joint, there occurred a malignant giant cell tumor of tendon sheath. There was clinical evidence of metastasis after the second local recurrence and the recurrent tumors were studied enzyme cytochemically and electron microscopically. Ultrastructurally, the malignant tumor consisted of three principal cell types; histiocyte-like cells, fibroblast-like cells, and intermediate cells, with unique attendance of myofibroblasts. This may be the first report of the presence of myofibroblasts in malignant giant cell tumor of tendon sheath. Enzyme cytochemistry revealed various functional properties of histiocytes.

Humans↗

PubMed1985

Fibroma of tendon sheath: a tumor of myofibroblasts. A clinicopathologic study of 18 cases.

A clinicopathologic study of 18 cases of fibroma of tendon sheath included an immunohistochemical survey of 7 cases and an electron-microscopic examination of one. The age of the patients ranged from 1 to 77 years, with a median of 34 years. The most common site of the tumors was the finger (7 cases), followed by the knee (3), the hand (2), and the foot (2). The median greatest diameter of the tumor was 2 cm. The tumors were attached or closely related to the tendon or tendon sheath, and usually well circumscribed, and multinodular or lobulated. Microscopically, spindle or stellate tumor cells with fuchsinophilic cytoplasm were embedded in a dense fibrous stroma with scattered small blood vessels. Most tumor cells have immunoreaction products for actin in the cytoplasm with accentuation along the cell membrane. Ultrastructurally, many of the tumor cells proved to be myofibroblasts.

Actins↗

PubMed1985

Myositis ossificans. A clinicopathologic study of 21 cases.

This clinicopathologic study concerns 21 patients with myositis ossificans, whose ages ranged from 7 to 81 years (average, 40.3 years). The lesions were located in the thigh (10 cases), upper arm (6 cases), and other sites (5 cases). In all patients the lesion was solitary, and in all but one, it was seen within the muscle. Histologically, the lesions exhibited a wide range of histologic features with different amounts of immature fibroblastic cells, osteoid, cartilage, and young or mature bone accompanied by fibrous connective tissue. They could be classified into three types according to the predominant or most striking histologic features. Type I (6 cases) was characterized by highly cellular areas with islands of osteoid, having occasionally been confused with extraskeletal osteogenic sarcoma. Type II lesions (8 cases) consisted mainly of osteoid and young bone rimmed by osteoblasts, in the occasional presence of cellular areas. Type III lesions (7 cases) were made up almost wholly of mature bone and cartilage surrounded invariably by dense fibrous connective tissue. Prognosis was excellent in 17 patients for whom follow-up information was available. Difference between Type I myositis ossificans and extraskeletal osteogenic sarcoma was briefly described, following an additional review of three cases of the latter.

Adolescent↗

PubMed1985

Extraskeletal Ewing's sarcoma. A clinicopathologic and electron microscopic. Analysis of 8 cases.

This clinicopathologic study concerns 8 cases of extraskeletal Ewing's sarcoma, including electron-microscopic examination of one case. In three patients, autopsy was done. The age of the patients ranged from 12 to 31 years with a median of 16 years. The tumors mainly arose in the soft tissues of the trunk (4 cases) and the lower extremity (3 cases). Histologically, they were made up of closely packed uniform, small cells, arranged in sheets separated by strands of fibrovascular stroma. The tumor cells had round to oval nuclei with finely dispersed chromatin and scanty ill-defined cytoplasm almost invariably containing a fair amount of diastase-digested PAS-positive material. Ultrastructurally, the tumor cells were composed principally of undifferentiated mesenchymal cells, and contained prominent pools of glycogen in the cytoplasm. Aggregates of intermediate filaments were seen in a perinuclear location. These light- and electron-microscopic findings are indistinguishable from those of Ewing's sarcoma of the bone. Differential points from other soft-tissue small round cell sarcomas such as malignant neuroepithelioma (peripheral neuroblastoma), embryonal or alveolar rhabdomyosarcoma were briefly discussed.

Adolescent↗

PubMed1984

Hepatocellular carcinoma with osteoclast-like giant cells.

A case of dedifferentiated hepatocellular carcinoma with osteoclast-like giant cells resembling those of giant cell tumor of bone is presented. The clinicopathologic findings are described, and the literature concerning this type tumor is reviewed. The tumor differed histologically from a pleomorphic variant of hepatocellular carcinoma in that there were numerous osteoclast-like giant cells with numerous, small, uniform, benign-appearing nuclei. To the knowledge of the authors, there has been only one report of this type of tumor arising in the liver. The tumor contained a separate area of a histologically conventional hepatocellular carcinoma, in addition to the above giant cell areas.

Carcinoma, Hepatocellular↗