Al Muktafi Sadi

A rare case of extramedullary spinal cord germinoma

A rare case of spinal cord germinoma in a 20‐year‐old Japanese female is presented. The tumor was detected at the level of T11 and L3 by myelography. Histological findings of the resected tumor were identical to germinoma, which is characterized by polygonal tumor cells, lymphocytic infiltrate, and granuloma. Tumor cells and lymphocytes reacted with antibodies for placental alkaline phosphatase and CD45, respectively. A few multinucleated giant cells, negative immunohistochemically for human chorionic gonadotropin were also seen. The present case is the 10th case of spinal cord germinoma and is thought to be the first case of such a tumor located extramedullary. Diagnosis of such a rare tumor in an unusual location needs proper histological, ultrastructural and immunohistochemical evaluation.

Primitive neuroectodermal tumor in sinonasal region

An elderly woman having a nasal tumor diagnosed as alveolar rhabdomyosarcoma was referred to our hospital. Histological reexamination of the patient revealed that the tumor was composed of lobules of compactly arranged small round atypical cells. The atypical cells contained large oval to round vesicular nuclei, and scanty cytoplasm showing PAS positive glycogen material. The tumor cells were immunohistochemically positive for NSE, S-100 protein and vimentin, but showed negative reaction for myoglobin, desmin, EMA, keratin, LCA, chromogranin and MIC2. Ultrastructurally, the tumor cells contained a few cluster of glycogen particles and less organellae and filaments, and there were no cytoplasmic processes, neurosecretory granules or neurofilaments. Pathological findings suggested primitive neuroectodermal tumor resembling extraskeletal Ewings sarcoma, but negative reaction for MIC2 immunohistochemically could not ascertain the diagnosis. Location of the tumor and age of the patient of the present case were unusual.

Pigmented neuroectodermal tumor of infancy in the epididymis. A case report.

BACKGROUND Pigmented neuroectodermal tumor of infancy (PNTI) is a rare pigmentary tumor. Cytologic study of this tumor had not been performed before. In the present study, cytology of such a tumor was done in addition to histology, electron microscopy and immunohistochemistry. CASE A 5-month-old infant had a scrotal tumor. After tumorectomy, touch smear for cytology revealed small and large tumor cells. The small cells showed a high nuclear/cytoplasmic ratio, and the large cells contained pigment in their cytoplasm. Histologically, the small cells and large, pigmented cells showed a typical alveolar and tubular pattern, respectively. The small cells neuroblastlike and the large cells showed melanocytelike features ultrastructurally and immunohistochemically. CONCLUSION Cytology has not been applied to the diagnoses of PNTI. In our opinion, fine needle aspiration cytology could be helpful in the preoperative diagnosis of this tumor.

An Autopsy Case of Malignant Lymphoma with Lyell's Syndrome

We present a case of fatal Lyells syndrome which developed following a CT examination using omnipaque 3000 contrast medium. A 59‐year‐old man was suffering from malignant lymphoma. He was readmitted to this hospital due to relapse of fever and lymph node swelling. On the day of readmission, generalized erythema, purpura, and mucosal erosions developed after a CT examination. Steroids and chemotherapy were ineffective, and he expired approximately two weeks after admission. Drug‐induced dermatopathy or leukemic cell infiltration in the skin was clinically suspected. Histological findings disclosed toxic epidermal necrolysis.

A True Hermaphrodite with Bilateral Ovotestes: A Case Report

A 20‐month‐old phenotypically male child with ambiguous external genitalia came to this hospital. Chromosomal and DNA analyses revealed 46/XX karyotype and absence of SRY gene, respectively. Two gonadal masses in the labioscrotal folds histologically showed both ovarian and testicular tissues. Clinicopathological features of the patient suggested true hermaphroditism with bilateral ovotestes.

Expression of PDGF and C‐myc in Atherosclerotic Lesions in Cholesterol‐Fed Chicken

Platelet-derived growth factor (PDGF) has been reported to be a potent mitogen for mesenchymal cells such as smooth muscle cells and glial ce1ls.l Several reports2,’ have indicated that protooncogenes such as c-myc and c-fos may be involved in the mechanisms of atherosclerosis. The aim of this study is to investigate the role of PDGF and c-myc on the development of atherosclerotic lesions in chickens, which serve as a useful experimental model for the study of athero~clerosis.~ Experimental animals consisted of two groups. Six 4-month-old roosters were fed an atherogenic diet that contained 2% cholesterol and 10% corn oil for 3 months. Five age-matched normal roosters were fed basal diet. The thoracic and abdominal aortas were collected and histologically examined. Immunostaining was performed by the avidin-biotin-peroxidase complex (ABC) (Vector Labs., Burlingame, Calif.) method5 using primary antibodies of PDGF-A, PDGF-B (genzyme), PDGF receptor, Pan-myc (Cambridge Research Biochemicals Ltd.). In situ hybridization was carried out according to the method of Coxet ~ 1 . ~ Probes for detecting the PDGF-A, PDGF-B, PDGF-A receptor, and PDGF-B receptor mRNAs were purchased from Oncogene Science, Inc., and were biotinylated with the terminal labeling kit (Enzo Biochem, Inc.). The probe for c-myc mRNA was prepared by inserting the Sma I cut fragment (exon 11) of pMyc6.514 (offered by Japanese Cancer Research Resources Bank) into plasmid pSP65. According to the modified method of Melton et al.,’ biotinylated RNA probes were synthesized in vitro using sP6 RNA polymerase, the linearized plasmid DNA, and Biotin 1 I-UTP. Biotinylated probes on slides were visualized with Blu GENEm (BRL). A lipid-rich thickened intimal lesion was more frequently seen in the thoracic aortas than in the abdominal aortas of cholesterol-fed roosters. Immunohistochemicat examination disclosed no significant expression of PDGF-A, -B, PDGF receptors, and c-myc in the entire aorta of normal roosters. In cholesterol-fed roostcrs, the intense reaction of PDGF-B, PDGF receptor (PDGF-R), and c-myc was seen in lipid-rich thickened intimal lesions of the entire aorta while no significant reaction of PDGF-A was observed in the same lesions. In situ hybridization study demonstrated

A case report of carotid body tumor

A case of left carotid body tumor is presented. A 47-year-old female patient consulted our otorhinolaryngological clinic with a neck swelling that had persisted for 5 months. On physical examination, a movable and pulsating hard mass measuring 2 x 2.5 cm in size was found on the left side of her neck, near the angle of the mandible. Computed tomography, magnetic resonance image and angiography all demonstrated a well-circumscribed tumor mass showing high vascularity and located at the bifurcation of the left carotid artery. The tumor involved the left carotid artery, but the patency of the artery was preserved. The patient showed satisfactory temporary balloon occlusion test results without neurological complications. Since the tumor was strongly adherent to the carotid arterial wall, the tumor was resected together with the carotid artery. Histologically, the tumor was composed of organoid clusters of round cells with eosinophilic granular cytoplasm. Involvement of tumor cells was seen to the adventitia of the carotid artery, but only slight cellular atypia was seen. Ultrastructurally, two types of cells were observed in the central and marginal portion of the tumor; these were round chief cells with few cytoplasmic neurosecretory granules and spindle-shaped sustentacular cells. Immunohistochemically, the chief cells and sustentacular cells showed positive reaction for neuron-specific enolase and S-100, respectively. The ultrastructural findings suggested the benign nature of the tumor.

Cardiac rhabdomyoma of a neonate: An autopsy case report

A primigravida delivered a cyanosed female infant with a very low Apgar score. Cardiac anomaly of the fetus was detected at 32 weeks of gestation by ultrasonography. The baby died on the day of delivery. Autopsy revealed multiple tumor masses in the interventricular septum and ventricular walls. The tumor originating from the interventricular septum was the largest and measured 3.7 × 3 cm. Histologically, the tumor was composed of large polygonal glycogen‐laden cells and ‘spider‐cells’. Eosinophilic giant histiocytic cells were also observed in the spleen. Ultrastructural features of the tumor cells correlated with those of typical cardiac muscle cells.

Mixed Gonadal Dysgenesis with Gonadoblastoma in a Female with Y Chromosome: Case Report

A young female with primary amenorrhea and male karyotype (46/XY) is reported. Physical examination and clinical investigation of the patient suggested mixed gonadal dysgenesis (MGD). After gonadectomy, a tumor was found on the left side and histologically diagnosed gonadoblastoma. Postoperative decreased level of testosterone and estradiol reflected the activities of the tumor.

Expression of platelet-derived growth factor and c-myc in atherosclerotic lesions in cholesterol-fed chickens: immunohistochemical and in situ hybridization study

Immunohistochemical examination showed no significant expression of platelet-derived growth factor-A (PDGF-A), PDGF-B, PDGF receptors, or of c-myc in the thoracic and abdominal aortas of normal roosters. In cholesterol-fed roosters, intense immunohistochemical reaction for PDGF-B, PDGF receptor, and c-myc was seen in the lipid-rich thickened intimal lesions of the thoracic and abdominal aortas while no significant immunoreaction for PDGF-A was demonstrated in the same lesions. In accordance with immunohistochemical findings, in situ hybridization demonstrated a significant level of expression of PDGF-B, PDGF-A receptor, PDGF-B receptor, and c-myc genes in proliferating intimal cells of the thoracic and abdominal aortas. These results suggest that coordinate actions of PDGF-B and c-myc play an important role in proliferation of intimal cells in the developing atherosclerotic lesions in chickens.