Eiji Ido

HLA-DR antigen- and S-100 protein-positive dendritic cells in esophageal squamous cell carcinoma— Their distribution in relation to prognosis

SummaryThe distribution of immunohistochemically labeled HLA-DR antigen- and S-100 protein-positive dendritic cell (DR+ DC and S100+ DC) was investigated in 59 human esophageal squamous cell carcinomas (SCCs). A dense infiltration of both DR+DC and S100+DC was detected in 11, only DR+ DC in two, and only S100+ DC in one. In the remaining 45 tumors infiltrating DC were sparse. By means of double immunostaining or the miroor section method, three different types of DC, namely S-100-negative and HLA-DR-positive DC(S100− DR+ DC), S-100-positive and HLA-DR-negative DC(S100+ DR− DC) and double-positive DC (S100+ DR+ DC) were clearly identified. With regard to postoperative survival, these patients with tumours in which there was a dense infiltration of DR+ DCs and/or S100+ DCs showed a significantly better survival rate than those in which DC were sparse (DR+ DCs—P<0.001; S100+ DCs—P<0.01). These results indicate that DC infiltration may be a prognostic factor in esophageal SCCs.

High serum levels of CA125 and interleukin-6 in a patient with Ki-1 lymphoma

We report a 53‐year‐old‐man with an aggressive Ki‐1 lymphoma who had high serum CA125, a marker protein of the epithelial ovarian cancer, and interleukin‐6 (IL‐6) concentrations. Both CA125 and IL‐6 levels decreased after chemotherapy and elevated with disease progression. The patients lymphoma cells obtained before chemotherapy grew continuously in vitro, were IL‐6 dependent and were found to secrete CA125 in culture medium. These results indicate that CA125 can be secreted by Ki‐1 lymphoma cells and IL‐6 may promote the growth of Ki‐1 lymphoma cells.

HIGH FREQUENCY OF APOPTOSIS IN INFANTILE CAPILLARY HAEMANGIOMA

Infantile capillary haemangioma (ICH) is a well‐established clinicopathological entity which often regresses spontaneously. To elucidate the cause of spontaneous involution of ICH, the apoptotic and proliferative activities in seven cases of ICH were compared with those in five cases of lobular capillary haemangioma (LCH), using formalin‐fixed paraffin‐embedded tissue sections. The number of apoptotic cells detected by the modified in situ end‐labelling method was significantly higher in ICH than in LCH, while the proliferative activities evaluated with mitosis and Ki‐67 antigen expression did not differ significantly. Lewisy (Ley) antigen, an apoptosis‐associated marker, was expressed in all cases of ICH but in none of LCH, while labelling for p53 protein and bcl‐2 protein was almost completely negative in both tumours. These findings clearly demonstrate a much higher apoptotic activity in ICH than in LCH and suggest that apoptosis might be a cause of the spontaneous involution of ICH.

Lung squamous cell carcinoma producing both parathyroid hormone-related peptide and granulocyte colony stimulating factor

An autopsy case of a 61 year old male with primary squamous call carcinoma of the lung with associated marked leukocytosls and hypercalcemla Is reported. High levels of serum parathyroid hormone‐related peptide (PTHrP) and granulocyte colony stimulating factor (GCSF) were detected. The tumor cells distinctly showed positive cytoplasmic knmunoreactions with anti‐PTHrP and anti‐GCSF antibodies. Marked granulocytosls and thin bony trabeculae lacking osteoblasts were observed in the vertebral bone. Calcium deposits were found In the proximal tubules of the kidneys. Infarcts were seen as a result of fibrin thrombosis of the splenic artery. The tumor was successfully transplanted into nude mice in which the high levels of serum PTHrP and GCSF were reproduced. These results indicate that the tumor simultaneously produced both PTHrP and GCSF causing the paraneoplastic syndromes of hypercalcemia and ieukocytosis.

Adult T cell leukemia/lymphoma with massive involvement of cardiac muscle and valves.

An autopsy case of a 58‐year‐old woman with massive cardiac Involvement of adult T cell leukemia/lymphoma (ATLL) is reported. She developed cardiac failure due to aortic and mitral regurgitation with cardiac infiltration of ATLL cells, and underwent replacement of both aortic and mitral valves. Studies of the cut‐surfaces revealed diffuse thickening of the subendocardial wall of the left chamber with widespread whitish‐brown tumor infiltrates. In the regions surrounding the replaced aortic and mitral valves there was also massive tumor cell infiltration. The tumor cells infiltrating the cardiac muscle wall were T cell in origin and exhibited Leu‐3a (CD4)‐positive immunoreaction. Ultrastructurally, tumor cells contained markedly indented nuclei and some were attached directly to the muscle cells. These findings suggest that this was an unusual form of ATLL with widespread involvement of the heart.

Immunohistochemical characterization of a case of duodenal gangliocytic paraganglioma

A case of duodenal gangliocytic paraganglloma (DGP) arising in the ampulla of Vater of an 84 year old male is reported. The present case shows the typical hlstological features with a mixture of epithellold, gangllon‐like and spindle cells. lmmunohistochemically, the spindle cells were positive with antibodies to neuron specific enorse, S‐100 protein and nsurofilament (NF), but negative for anti‐glial fibrillary acidic protein (GFAP), synaptophyaln and myelln basic protein (MBP). Both anti‐Leu‐7 and chromogranin A antibodies gave porritive reactions with a fine granular pattern in the epithellold cells. Most ganglion‐like cells showed the cytoplasmic lmmunorsection with GFAP and a few with NF and synapto physin. In these three tumor components, no reactivity was detected In the antibodies to the neurohormonal peptides tested. The present data are fundamentally in keeping with those previously reported, but add the immunohistochemical positivity of gangllon‐like cells for GFAP, suggesting different neuroglial differentiation.

Mucinous cholangiocarcinoma featuring a unique microcystic appearance

An autopsy case is presented of a peculiar type of intrahe‐patic mucinous adenocarcinoma with microcyst formation arising In a 78 year old Japanese man who died of hepatic coma and renal failure 4 months after onset. Macroscopi‐cally, the cut surface of the lesion revealed a characteristic honeycomb‐like appearance, consisting purely of micro‐cysts, 0.2–0.4 cm in diameter, lined by prolific mucin‐producing adenocarclnoma cells. The lesion did not have large cystic space, flbrous capsule, or benign cystadenoma‐tous component other than neoplastic microcyst formation. The carcinoma cells showed various proliferating patterns, such as irregularly shaped nest‐like, trabecular, papillary and tubular ones, directly Invaded the hepatic parenchyma and portal tract with loose or thick fibrosis, and infiltrated extensively into both intrahepatic and extrahepatic stroma along the vascular structures. From these clinicopathologi‐cal ffndlngs, we conslder the present tumor to be a variant of mucinous cholangiocarcinoma with characteristic microcyst formation rather than a type of cystadenocarcinoma.

Epithelioid sarcoma producing granulocyte colony-stimulating factor

An epithelioid sarcoma of the perineum of a 60-year-old man with widespread metastases produced leukocytosis, myeloid hyperplasia of the bone marrow, and splenomegaly. High titers of granulocyte colony-stimulating factor (G-CSF) were found in the patients serum and primary culture medium of the tumor tissue. The tumor tissue extract contained m-RNA for G-CSF in large quantities, proving that the tumor was the source of this cytokine.

Granular cell tumor expressing myogenic markers in the prostate

A granular cell tumor in the prostate of a 72 year old male is reported. The tumor nest was composed of large polygonal tumor cells, possessing cytoplasmlc eoslnophlllc granules which were positive with PAS stain and resistant to diastase digestion. Immunohistochemically, most tumor cells were strongly positive with anti‐α‐smooth muscle actin and ‐neuron specific enolase antibodies. Only a few scattered tumor cells were reacted with antt‐S‐100 protein antibody. These find‐Ings might suggest smooth muscle differentiation of this case, and provide an additional Insight into the histogenesis of granular cell tumors, especially In their heterogeneity.

Melanosis of the prostate: an immunohistochemical study

We report here a case of prostatic melanosis examined immunohistochemically. The patient was a 70-year-old man with prostatic hyperplasia. Six foci with brown pigmentation were found, not only in stromal cells but also in glandular epithelial cells among many pieces of prostatic tissue. Immunohistochemically, only pigment-laden stromal cells were obviously positive with antibodies to S-100 protein and melanoma (HMB45), but not for CD57, while epithelial cells were only positive for CD57 after depigmentation with bleaching. This is the first report demonstrating immunopositivity of stromal cells for antimelanoma antibody (HMB45), which can label reactive or dysplastic but not normal melanocytes. These results clearly demonstrated that pigment-laden stromal cells are neuroectodermal in origin, and probably reactive or dysplastic but not normal melanocytes.