Akio Mukawa

Automated cytologic screening system (CYBEST model 4): an integrated image cytometry system.

In 1967 we began developing an automated cytologic screening system for uterine cancer. The CYBEST protype was developed in 1972, and current developments have taken us to CYBEST model 4 developed in 1981 with a new desk-size design.

ACQUIRED CYSTIC DISEASE OF THE KIDNEY AND RENAL CELL CARCINOMA ON LONG TERM HEMODIALYSIS

Four surgical cases of acquired cystic disease of the kidney in the third decade are reported, which include renal cell carcinoma in three patients and multiple adenomas and cystadenomas in all patients. The intervening parenchyma of these kidneys was disorganized as end stage kidney and numerous cysts were found in both kidneys. Some of the cysts were lined by hyperplastic epithelium consisting of clear and granular cells arranged in piled up and papillary fashion. These cysts were diagnosed as cystadenoma. Multiple solid adenomas of a 28‐year‐old male on hemodialysis for 6 years were of various size as if arranged in developing stage of the growth. Summing up all cases included in the literature, the mean duration of hemodialysis of the cases with renal tumor was 5.2 years, while 2.9 years without tumor. With increase of duration of hemodialysis, acquired cystic disease of the kidney is exposed to a high risk of developing malignancy.

ADENOID SQUAMOUS CELL CARCINOMA OF THE PENIS Report of a Surgical Case Clinically Manifested with Rapid Lung Metastasis

A surgical case of an aggressive form of adenoid squamous cell carcinoma of the penis was studied. The histological features of the tumor originating from the coronal region of the penis showed a well differentiated keratinized squamous cell carcinoma in the superficial area, which transformed into, with a zone of transition in between, an alveolar structure in the deep invading portion and in the metastatic tumor in the inguinal lymph nodes. The alveolar lining cells exhibited an undifferentiated appearance with prominent nucleoli, frequent mitotic figures, and vascular invasion. These cells were neither dyskeratotic nor acanthotic as described in the literatures. Mucin was negative in the tumor cells and angiosarcoma was ruled out with a sliver impregnation technique. The patient took a rapid downhill course for the ordinary squamous cell carcinoma of the penis, and he expired eight months after penile amputation with a radiological evidence of lung metastasis. These unusual pathological features and an aggressive behavior of this tumor which were not hitherto described for adenoid squamous cell carcinomas necessitated this report. Autopsy was not performed.

ADENOID SQUAMOUS CELL CARCINOMA OF THE SKIN OVERLYING THE RIGHT BREAST: An Autopsy Case Clinically Manifested with Rapid Growth and Widely Spreading Metastases

An autopsy case of a 62‐year‐old woman with a poorly differentiated, aggressive form of adenoid squamous cell carcinoma arising in the skin overlying the right breast was studied. The tumor, 9×8cm in diameter, had rapidly enlarged since one year before admission from a verrucous lesion of 20 years duration. The histologic features of the tumor showed a well‐differentiated squamous cell carcinoma mainly in the superficial areas, which transformed into, with a zone of transition in between, an alveolar or adenoid structure in the deep invading portion. The adenoid tumor cells exhibited an undifferentiated appearance with prominent nucleoli and frequent mitotic figures. These cells partly showed dyskeratotic or acantholytic features. Mucin was negative. The patient died at 8 months after the operation. Autopsy revealed widely spreading metastases in which an adenoid structure was outstanding. These unusual pathological features and an aggressive behavior of this tumor, which were hitherto rarely described for adenoid squamous cell carcinoma, seemed to be a poorly differentiated variant of the tumor. This malignant transformation might be derived from loss of cohesion of the pre‐existing usual well‐differentiated squamous cell carcinoma in the basal and parabasal layers, inparting marked invasiveness of these cells into the supporting connective tissue.

Tay-Sachs disease with conspicuous cranial computerized tomographic appearances.

An autopsy case of a 3‐year‐old female infant with Tay‐ Sachs disease was presented. A cherry red spot in the fundus and a deficiency of N‐acetyl‐β‐hexosaminidase A in the white blood cells were revealed soon after admission at the age of one year. Her parents and sister were found to be healthy carriers. The patient showed a typical clinical course with marked cranial swelling. In addition to the marked ballooning of neurons on light microscope, membranous cytoplasmic body (MCB) on electron microscope and abnormal accumulation of GM2 ganglioside in the cerebral cortex by thin layer chromatography were confirmed in the autopsy specimens. In the late stage of her clinical course, the cranial computerized tomography (CT) demonstrated symmetric and deep‐wavy hyperdense cerebral cortical zones, diffuse hypoden‐sity and diminished volume of cerebral white matter, mild to moderate ventricular dilatation, and a small cerebellum and brainstem. These conspicuous appearances of the cranial CT seem to be characteristic of Tay‐Sachs disease in the late stage, and they are derived from abnormal accumulation of GM2 ganglioside in the cerebral cortex, and diffuse intense demyelination (dysmyelinating demyelination) of the cerebral white matter. ACTA PATHOL. JPN. 35: 1521–1532, 1985.