Hajime Kuhara

Primary Malignant Lymphoma of the Urinary Bladder A Case Report

A patient with primary malignant lymphoma of the urinary bladder is presented. Grossly, the bladder showed multiple submucosal masses. Histologically and immunohisto‐chemically, diffuse B‐cell lymphoma of the medium‐sized cell type was revealed. On the basis of clinicopathological features, the present case resembled previously recorded cases of bladder lymphoma. The pathogenesis of this primary bladder lymphoma was presumably associated with follicular or chronic cystitis. Primary lymphoma of the bladder is a condition that is very rarely included in series of extranodal lymphomas, and there is a curious sex difference in its occurrence rates between Japan and Western countries. Primary lymphoma of the bladder may be considered a lymphoma that originates from mucosa associated lymphoid tissue. Acta Pathol Jpn 40: 764‐769, 1990.

I-CELL DISEASE

I‐cell disease has been reported by many authors but the electron microscopic findings have been reported only rarely. The patient under study was a female infant with a normal delivery after 38 weeks’normal intrauterine life. She showed the physical findings characteristic of I‐cell‐disease, and the diagnosis was made by the analyses of lysosomal enzymes. The child died at the age of 2 years and 3 months due to respiratory insufficiency. By electron microscopy, various‐shaped membrane‐bound vacuoles were observed in the cytoplasm of various cells such as hepatocytes, myocardial muscle cells, epithelial cells of the renal glomeruli, proximal renal tubular cells, fibroblasts, and chondrocytes. By histochemical analyses we found that these intracytoplasmic storage vacuoles contained glycosaminoglycan and proteoglycan.

Synchronous bilateral double primary lung cancer associated with diffuse interstitial fibrosing pneumonitis (DIFP).

Double primary lung cancer with diffuse interstitial fibrosing pneumonitis (DIFP) was detected in a 61 year‐old man at autopsy. Histologically, alveolar septa in whole lobes of right and left lungs were thickened diffusely with fibrosis, edema, and inflammatory cell infiltration. Alveolar cavities contained fibrinous exudate. A tumor mass measuring 8×5×5 cm occupying the right hilar portion was epidermoid carcinoma involving the right superior lobar bronchus and hilar lymph nodes. There were no metastatic foci in the right middle and lower lobes. In the lower lobe of the left lung, scattered foci of bronchiolo‐alveolar carcinoma and those of epidermoid carcinoma coexisted. There were no metastatic foci in the left upper, lower lobes, and hilar lymph nodes. Both atypical bronchiolar epithelial proliferation associated with bronchiolo‐alveolar carcinoma and squamous metaplasia associated with epidermoid carcinoma were detected at the same time. The clinical and pathological characteristics among 81 reported cases of lung cancer associated with DIFP are reviewed. ACTA PATHOL. JPN. 34: 617–629, 1984.

LUNG CANCER AND CHRONIC INTERSTITIAL PNEUMONIA ASSOCIATED WITH SYSTEMIC SARCOIDOSIS

Lung cancer and chronic interstitial pneumonia associated with systemic sarcoidosis was detected in a 66‐year‐old woman at autopsy. Histologically, hyalinized sarcoid lesions were scattered in cervical lymph nodes, thoracic lymph nodes, abdominal lymph nodes, and spleen. Scattered non‐caseating epithelioid cell granulomas with giant cells were observed in both lungs remoting cancer and chronic interstitial pneumonia. A tumor mass occupying right hilar portion was well‐differentiated squamous cell carcimona involving right upper lobe and right hilar lymph nodes. In the lower lobe of the left lung, a small nodule of poorly differentiated squamous cell carcinoma was detected. Alveolar septa, especially in both lower lobes of the lungs were thickened diffusely with fibrosis, edema, and inflammatory cell infiltration. Alveolar cavities contained hyaline membrane and large mononuclear cells. Atypical bronchiolar epithelial proliferation and squamous metaplasia associated with squamous cell carcinoma were detected. The clinical and pathological characteristics among eight reported cases of lung cancer associated with sarcoidosis and three reported cases of interstitial pneumonia associated with sarcoidosis were reviewed separately. There is no report describing both lung cancer and chronic interstitial pneumonia associated with sarcoidosis.

PARATESTICULAR LIPOSARCOMA: COEXISTENCE WITH URINARY BLADDER CANCER

A 58‐year‐old man with liposarcoma originating from the right paratesticular area was reported. Histologically, liposarcoma showed a well‐differentiated sclerosing type. Coexistence of transitional cell carcinoma of the urinary bladder and liposarcoma was also revealed. The cases of paratesticular liposarcoma in the literature are briefly reviewed.

NEONATAL TYPE OF ARGININOSUCCINATE SYNTHETASE DEFICIENCY

Two autopsy cases of neonatal argininosuccinate synthetase (ASS) deficiency demonstrating the particular histological changes of the liver are presented.