[Pituitary apoplexy--clinico-pathological studies in the past 10 years with special reference to 6 cases].
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Biomedical subjects
Publications and source records attributed to T Kameya.
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A histopathological analysis of six cases of Castleman's tumor by means of light and electron microscope was performed, with a review of literature. All cases were hyaline-vascular type as described by Keller et al. The morphology of lymphnoid follicles in the lesions varied according to the presence or non-presence of the germinal center which was from large active to amaciated hyalinized. The lymphnoid follicle was essentially similar to that of normal lymph node undergoing some reactive process. Depending on the observation of serial sections, the lesions had lymphatic sinuses around the blood vessels in the tumor parenchyma, some of which were proved to be connected to the abortive marginal sinuses. These findings and some clinical records suggest that the lesion originates from the lymph node and is a result of its reactive hyperplasia.
A gastric choriocarcinoma cell line synthesizing human chorionic gonadotropin (HCG) was established in 1971 by Oboshi et al. and was found to possess human placental alkaline phosphatase. The present paper also deals with the relationship between the cell growth and HCG secretion and with cellular localization of HCG and human placental alkaline phosphatase by cytochemical and ultrastructural methods. This cell line was found to secrete HCG during cellular proliferation, with the maximum secretion in the stationary phase (about 1 muIU/cell/48 hr), and the hormone could be detected in a small proportion of mono- and/or multinuclear cells in both logarithmic and stationary phases. The organ-specific, heat-stable, L-phenylalanine-sensitive, immunoreactive human placental alkaline phosphatase was localized on the cell membrane of many cells. Ultrastructurally, the line consisted mainly of cytotrophoblastic and intermediate cells in the process of syncytial formation, with more or less squamous metaplasia. From these findings it was concluded that the cell line maintained the properties of trophoblastic cells from morphological and functional aspects, i.e., it was a cell line with two distinct marker substances.
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During the period between 1967 and 1983, there were 28 WDHA patients in Japan. Clinically, these patients were not very different from those reported in western countries, but we have been able to add a few observations as follows. First, the WDHA patients with pancreatic endocrine tumors and those with neuroblastic tumors were present in almost equal numbers. Second, fluctuating hypercalcemia was often observed in patients with this syndrome, but it was not observed in any watery diarrhea due to the other etiologies. Third, the WDHA patients who have multiple endocrine neoplasia (MEN) type 1 have multiple tumors in the pancreas, indicating that the patients with MEN should be managed in a different manner in regard to determining tumor location as well as applying surgical treatment. When various types of tumors were examined for VIP content, it was found that many tumors have the potential to produce VIP, and when VIP is produced in large amounts, plasma VIP levels become elevated, resulting in the WDHA syndrome.
A unique case of adenocarcinoma of the lung that showed aerogenous extension is presented. Although the primary focus was the usual invasive bronchioloalveolar carcinoma, the tumor cells were dissociated, floating and filling the alveolar spaces, the bronchioli, and the small bronchi at the periphery of the primary tumor and in every involved area in other lobes of the lung. Massive tumor cells were expectorated in coincidence with the appearance of abnormal densities on chest X-ray films. Ultrastructurally the dissociated tumor cells had numerous microvilli on the cell surface and rarely showed intercellular junctions. The tumor cells also contained well-developed rough and smooth endoplasmic membranes, crista-vesicular-type mitochondria, electron-dense granules, and granules with myelinlike figures. No mucous granules and no Clara-cell-type secretory granules nor lamellar bodies of the type seen in normal granular pneumocytes were seen. From these findings, it was concluded that the tumor cells in this case were rather poorly differentiated but somewhat resembled the hyperplastic cuboidal alveolar cells seen in the damaged lung and that they proliferated freely in airways, presenting aerogenous metastases. The biologic behavior of this tumor might be partly explained by the incohesive nature of the tumor cells.
We describe a case of pancreatic tumor in a 65-year-old woman with typical glucagonoma syndrome. Plasma glucagon (GL) and pancreatic polypeptide (PP) were markedly elevated up to 1404 and 1200 pg/ml, respectively. Histologic examination of the metastatic tumors in liver and lymph nodes showed endocrine-type tumors composed of GL-positive cells some of which coexpressed PP immunoreactivity. Electron microscopy revealed the tumor cells with single-type secretory granules similar to normal A cell granules. Double immunogold staining demonstrated both GL and PP immunoreactivities in the same secretory granules. Biologic and diagnostic significance of coexpression of PP and GL in a single secretory granules of pancreatic endocrine tumors is discussed briefly.
The expression of MMP-2 and TIMP-2 was examined immunohistochemically in a total of 87 colorectal cancer patients. The expression of MMP-2 was in cancer cells: 76.5% (sm), 16.7% (pm), in cancer interstitial region: 92.2% (sm), 58.3% (pm), in transitional mucosal cells: 74.3% (sm), 17.1% (pm) and in transitional mucosal interstitial region: 80.0% (sm), 31.4% (pm). The expression of TIMP-2 was in cancer cells: 41.2% (sm), 16.7% (pm), in cancer interstitial region: 82.4% (sm), 69.4% (pm), in transitional mucosal cells: 57.1% (sm), 22.9% (pm) and in transitional mucosal interstitial region: 89.3% (sm), 57.1% (pm). These results suggest that the expression of MMP-2 and TIMP-2 is induced in the sm cancer stage and is closely related to interactions in the cancer interstitial region for invasion and metastasis in patients with colorectal adenocarcinoma.
The expression of MMP-2 and TIMP-2 was examined immunohistochemically in a total of 36 colorectal cancer patients with synchronous liver metastasis at the time of surgery, and the serum MMP-2 and TIMP-2 levels were also measured in a total of 58 colorectal cancer patients with/without liver metastasis following primary colorectal surgical resection for serological comparison. Although MMP-2 exhibited a significant expression immunohistochemically in the primary colorectal cancer (p<0.05) and TIMP-2 in the synchronous liver metastasis (p<0.01), there was no relationship between the absence/presence of liver metastasis and serum MMP-2 and TIMP-2 levels, respectively. These results suggest that it can be considered difficult to use serum MMP-2 and TIMP-2 levels to predict the status of liver metastasis following primary resection in patients with colorectal adenocarcinoma.
A 20 year-old man was hospitalized with an abdominal mass and abdominal distension. Investigations resulted in a diagnosis of ileus caused by advanced colon cancer with peritoneal dissemination to the pouch of Douglas. Palliative surgery was performed to relieve bowel obstruction and debulk the tumor. Histopathological examination showed that the tumor was a mucinous adenocarcinoma invading the serosa without lymph node metastasis. Ascites collected during the operation was diagnosed as class V. Administration of PSK (3.0 g/day) and UFT (600 mg/day) as adjuvant immunochemotherapy was started postoperatively to achieve tumor dormancy. He has been followed as an outpatient for 2.5 years with no ascites or abdominal symptoms.
The incidence and nature of intranuclear inclusions found in tumor cells of preoperative and postoperative cytologic, histologic and electron microscopic (EM) specimens were studied in 38 cases of papillary adenocarcinoma of the lung in order to assess the cytodiagnostic significance of these inclusions. The overall incidence of the intranuclear inclusions was 34%; the incidence was higher in the well-differentiated type of adenocarcinoma (48%). Four smear and four EM types of inclusions were recognized. Cytoplasmic invaginations (pseudoinclusions), single-membrane-bound inclusions, aggregates of 50-nm tubules and any combination of the above could be distinguished by EM. There was some correlation between the smear and EM types of inclusions. EM analysis suggests that intranuclear inclusions, except for pseudoinclusions, may be derived from the inner nuclear membrane. In routine cytology, the intranuclear inclusion is a good diagnostic marker for papillary adenocarcinoma of the lung.