Biomedical subjects
Publications and source records attributed to Y Kimula.
A case of minute squamous cell carcinoma arising in a congenital lung cyst is reported. Two aspects of this case were notable. First, we were able to make the diagnosis of squamous cell carcinoma by bronchial lavage at an early stage. Second, to our knowledge, this is the first case of probable de novo origin of squamous cell carcinoma in a congenital lung cyst.
A 52-year-old woman with Sjögren's syndrome presented with a dense lymphocytic infiltrate around the bronchial gland disclosed by a transbronchial lung biopsy specimen. Two and a half years after the initial evaluation, her pulmonary status had deteriorated and multiple bullae had developed at both lung bases.
Although serum CA 19-9 is considered to be a useful and specific tumor marker for pancreatic cancer, some patients with benign pulmonary diseases show elevated serum CA 19-9 levels. We measured serum CA 19-9 levels of 156 patients with benign pulmonary diseases (55 with asbestosis, 11 with bronchial asthma, 32 with bronchiectasis, 16 with idiopathic pulmonary fibrosis (IPF), 13 with healed pulmonary tuberculosis (HPT) and 29 other benign diseases). The percentage of patients with positive serum CA 19-9 was 42.3% (14.5% in asbestosis, 27.3% in bronchial asthma, 59.4% in bronchiectasis, 81.3% in IPF, 61.5% in HPT and 51.7% in others). In some patients, serum CA 19-9 levels were as high as those found in malignant gastrointestinal diseases. Serum CA 19-9 levels correlated well with disease activity. Immunohistochemically, CA 19-9 was expressed in mucous cells of the bronchial gland and surface of the bronchiolar surface epithelium cells in benign pulmonary disease. Gel filtration study suggested some difference in molecular weight between the serum CA 19-9 antigen of lung cancer and that of benign pulmonary diseases. It is suggested that serum CA 19-9 increases in the case of hyperplasia of the bronchiolar epithelium cells or the mucous cells of the bronchial gland. We conclude that benign pulmonary disease is one of the factors that affect serum CA 19-9 levels.
A thirty-eight-year-old man developed gradually progressing right retro-orbital pain, diplopia on the left lateral gaze, and left ptosis. On examination paresthesia was present on the first division of right trigeminal nerve. Orbital venography revealed obstruction of right superior orbital vein on the entering portion to the cavernous sinus. A daily administration of 30 mg of prednisolone resulted in a rapid improvement of the symptoms. Diagnosis of Tolosa-Hunt syndrome was made on the basis of neurological symptoms, roentgenographic findings and responsiveness to prednisolone. One year later, weakness of right leg accompanied with left cervical and axillary lymphadenopathy was developed. A biopsy specimen of cervical lymph node was identical with the Hodgkin's disease, lymphocyte predominance type. He was treated with COPP regimen; lymphadenopathy decreased in size. We reported a rare case of Hodgkin's disease preceded by Tolosa-hunt syndrome which might be caused by the extranodal lesions.
Pulmonary infarction may be associated with bronchogenic carcinoma. Radiopathological correlation was performed in four patients. There were two cases of squamous cell carcinoma, one case of adenocarcinoma and one case of large cell carcinoma. Infarcts in patients with squamous cell carcinoma were obscured on plain radiographs by a large primary tumor or atelectasis of the affected lobe. Infarcts in adenocarcinoma and large cell carcinoma were clearly demonstrated on plain radiographs; 1 to 2 cm in size, round or polygonal in shape, blurred in margin, and located at the periphery of the same lobe as the primary tumor. Rapid appearance of infarcts was helpful in distinguishing from intrapulmonary metastasis. Invasion of the pulmonary artery, pulmonary vein and bronchial wall in hilar region was thought to be responsible for pulmonary infarction. Pulmonary infarct should be considered in patients with centrally invasive bronchogenic carcinoma, when a small ill-defined opacity appears at the periphery of the involved lobe over a short period.
A previous study demonstrated increased levels of C5a des Arg and increased numbers of polymorphonuclear cells (PMNs) in bronchoalveolar lavage (BAL) fluids of acutely ill patients with summer type hypersensitivity pneumonitis (HP), suggesting the role of immune complexes (IC) in the early stage of HP. The present study was undertaken to compare the BAL findings in patients with acute HP and in animals which were injected intratracheally with preformed IC and to determine the correlation between the sequential BAL findings and the serial histology in animals. The results indicated that total cells recovered by BAL increased up to 24 hours. However, the most striking observation was that the increased number and percentage of PMNs in BAL cells shortly after the intratracheal injection, which the number of macrophages in BAL cells tended to be high, the increase was not statistically significant. Histological examinations revealed peribronchial and intraalveolar infiltration with PMNs at the early stage when intraalveolar infiltration were predominant, and the latest lesions consisted of infiltration with mononuclear cells in the alveolar walls. Furthermore, the cellular findings of BAL cells reflected the histological findings in involved lungs. The present study demonstrated that the sequential BAL changes of acutely ill patients with HP were similar to those of IC-injected animals, suggesting the possibility that IC formed in the airways is involved in the early stage of HP.
Proton magnetic relaxation times, T1 and T2, were determined for rat lungs exposed to 80% oxygen for a duration of 2 weeks. The transverse magnetization decay curve of the lung tissue was multiexponential. A linear combination of two decay curves with different T2 values fits the multiexponential decay suggesting that there are at least two different components of tissue water in the lung. Remarkable prolongation of T1 and T2 was demonstrated as lung injuries progressed in the acute stage of pulmonary edema. Both 1/T1 and 1/T2 were significantly correlated with 1/water content of the lung tissue. In the repair stage, T1 and T2 were significantly shortened. Shortening coincided with the spontaneous resolution of pulmonary edema. Relaxation rates showed no significant correlation with 1/water content in this stage. These results indicate that the physical state of water in the tissue is affected not only by the water content but also by the derangement of macromolecules in pulmonary edema. T2 was more sensitive than T1 for detecting pulmonary damage.
The selective and long-term deposition of iodized oil in the hepatocellular carcinoma (HCC) and its gradual drainage were clinicopathologically analyzed in 13 cases. All patients were Japanese and had an intrahepatic arterial injection of Lipiodol (LIP) mixed with Mitomycin C. The comparison among the follow-up computerized tomography (CT) findings, the observation of the soft x-ray radiogram, and histopathologic studies of the surgical or autopsy materials revealed that the selective deposition of LIP in HCC lasted for a long term, particularly in cases treated by LIP combined with transcatheter arterial embolization (TAE). Also revealed was an extremely gradual decrease of LIP from the HCC. It was thus postulated that, mainly, the accumulated macrophages surrounding LIP around the necrotic cancer tissue and, partially, the intrahepatic lymphatic system itself contributed to this drainage. Further, in histologic sections with lipid staining, x-ray microanalysis proved that the lipid droplets in the cancer tissue included highly concentrated iodine, as a deposition of LIP.
Explore the source record for details and available documents.
A case of bronchial carcinoid with intrapulmonary dissemination was demonstrated. A right upper lobectomy was performed because of an abnormal shadow in the lung detected by an X-ray mass survey. A carcinoid tumor originated from the spur region of the right upper lobe bronchus. The tumor protruded into the bronchial lumen and also extensively expanded into the surrounding alveolar tissue. The tumor showed typical histological features of bronchial carcinoid with a mixed insular, trabecular, and glandular pattern. Multiple implanted foci of tumor cells were found in the periphery of the lobe. The implanted tumor cells replaced the alveolar epithelium without destruction of the alveolar structure, which suggests the possibility of aergenous spread of bronchial carcinoid. This is the first report on bronchial carcinoid with aerogenous spread.
A 31-year-old man, a racing car driver, was submerged in muddy water as the result of an accident. He died from respiratory failure after a 17-day clinical course. Foreign body granulomatosis and massive fibrosis of the lung were revealed at autopsy. The crystalline foreign bodies mainly were composed of silicon and ranged in size from 20 micron to 500 micron in diameter (average, 90 micron). Their distribution in the lungs corresponded to the areas of lung carnification. In this study, the authors demonstrate that near drowning in muddy water causes pulmonary silicate granulomatosis associated with carnificating fibrosis of the lung and term the pulmonary changes "muddy lung."
Size alterations, both of cell and nucleus, of the centenarian hepatocyte followed a pattern proportionate to aging which was observed in the hepatocyte of non-centenarian groups and clearly followed nonagenarian in location on the graph. When size alterations of the hepatocyte were considered as an aging parameter, the present observation suggests that the centenarian could be a group next to the nonagenarian. The results obtained by present cytomorphometrical analysis do not favor a hypothesis that the centenarian is a select population in terms of longevity.
Explore the source record for details and available documents.
Two possible interpretations of the origin of Lewy bodies and adrenal bodies found in Parkinson's disease are now under discussion: a disorder of (1) catecholamine metabolism or (2) sphingomyelin lipidosis. From the electron probe microanalysis of Lewy bodies and adrenal bodies, we find that the Lewy body contains sulfur, calcium, and phosphorus, and the adrenal body also contains these three elements. Furthermore, a positive correlation was obtained between the X-ray intensity of the sulfur and the diameter of adrenal body. For Lewy bodies, this correlation was not obtained. The results suggest that a common mechanism may exist for the production of Lewy and adrenal bodies, although they differ somewhat in their accumulation of sulfur. It is considered that both structures may originate, in part, from degenerated protein containing sulfur.
Explore the source record for details and available documents.
Twenty-five cases of solitary nodular adenocarcinoma of the human lung were studied histochemically and ultrastructurally and their morphological characteristics were compared to the cells observed in the control lungs. Adenocarcinoma cells of the human lung may be classified into following four types: Type A--cells resembling the bronchial goblet cell; Type B--cells resembling the mucous cell of the bronchial gland; Type C--cells resembling the type II alveolar lining cell; and Type D--cells resembling the nonciliated bronchiolar cell. Twenty-one cases belonging to Type D (84%) and two cases to Type B (8%), and one case each to Types A (4%) and C (4%). For the histogenesis of adenocarcinoma of the human lung, nonciliated bronchiolar epithelium may be the most important. A comparison of 10 cases of bronchiolo-alveolar carcinoma with 15 cases of ordinary (acinar and papillary) adenocarcinoma revealed no clear differences either histochemically or ultrastructurally.
An unusual case of primary reticulosis of the bone marrow in a 67-year-old female has been described. Pathological-anatomical characteristics of the present case are as follows; 1) Primary non-destructive proliferation of neoplastic reticulum cells or their variants, confined to the systemic bone marrow. Metastatic foci were noted in several areas where extramedullary hematopoiesis occurred. 2) Cytologically, neoplastic cells resemble atypical plasmacytic cells. No active phagocytosis was noted in neoplastic cells. 3) Histologically a significant increase in reticulin fibers was observed closely associated with proliferating cells. 4) Electron-microscopically these cells showed developed endoplasmic reticula but were distinguishable from myeloma cells by their irregular cytoplasmic border, which became frequently obscure, and by the presence of a desmosome-like structure. 5) These cells showed a negative immunofluorescent reaction to all types of human immunoglobulin classes. The morphological characteristics of these cells distinguished the disorder from poorly differentiated myelomatosis.
An autopsy case of cemented tungsten carbide pneumoconiosis, the first lethal case in our country, is presented. A 28-year-old woman, who had been engaged in grinding presintered metallic matrix for four years, developed respiratory symptoms. X-ray examinations were indicative of interstitial pulmonary fibrosis. Corticosteroid therapy revealed only little effect. She expired five years after the onset of the symptoms. Postmortem examination showed nonspecific interstitial pneumonitis resulting in marked lung fibrosis. Ultrastructurally, crystals were observed in cytoplasm of presumable macrophages in the fibrotic lung tissue. Electron probe microanalysis of the lung tissue showed the presence of tungsten and other constituents of tungsten carbide except for cobalt. Metal analysis demonstrated a large amount of tungsten in the lung. Cobalt was detected tenfold of the normal value in the bone. In pathogenesis of the pneumoconiosis in the cemented tungsten carbide workers, toxicity of cobalt is most suspectable, and in addition, individual susceptibility may be also important.