Hideharu Fujii

FINE STRUCTURAL COMPARISON OF EWINGS SARCOMA WITH NEUROBLASTOMA

Two cases of Ewings sarcoma and two of neuroblastoma, rosette forming and round cell type, were studied electron microscopically and their fine structures were compared. The neoplastic cells of Ewings sarcoma were characterized by aggregated glycogen particles in the cytoplasm. They had pseudopod‐like cytoplasmic processes having tight junctions, which never contained microtubules or mitochondria. Ewings sarcoma cells exhibited several stages of cell maturation and some mature cells possessed a large amount of smooth and rough endoplasmic reticulum, large Golgi complexes and numerous phagosomes containing glycogen particles as well as cytoplasmic organelles. The neoplastic cells of neuroblastoma, rosette forming type, were characterized by synaptic junctions and numerous cytoplasmic processes with production of neurites containing microtubules, neurofibrils, mitochondria and a few catecholamine granules. A few cytoplasmic processes containing mitochondria were observed even in the round cell type.

A histopathological study on senile changes in the human olfactory bulb.

Senile changes in the human olfactory bulb were studied histopathologically in 133 individuals ranging in age from 40 to 91 years with a mean age of 64.3 years. Neurofibrillary tangles (NFTs) in the olfactory bulb were observed in 47 subjects aged over 50 years. The frequency of NFTs was 35.3% (47/133) in total and 40.5% (47/116) among subjects 50 years of age or older. The frequency of individuals with NFTs increased linearly with age. Senile plaques (SPs) were observed in 5 individuals over 60 years old at a frequency of 3.8% (5/133) in total and 5.7% (5/88) among individuals 60 years old or more. Granulovacuolar degeneration was rarely seen, and amyloid angiopathy was not recognized. Senile changes in the hippocampus and parahippocampal gyrus were also examined. In some cases, the frequencies of NFTs and SPs in the hippocampal region were not identical to those in the olfactory bulb. However, it was not apparent whether senile changes first appear in the olfactory bulb or in the hippocampal region.

Glioblastoma with sarcomatous component associated with myxoid change

SummaryThe case of a 22-year-old female suffering from glioblastoma with sarcomatous component (WHO; gliosarcoma) is presented. The tumor consisted of glioblastomatous and sarcomatouos components, and in part of the pleomorphic astrocytomatous region of the glioblastoma there was a prominent production of myxoid matrix. On the basis of its histochemical and immunohistochemical characteristics, the present case strongly suggested that glial cells of neuroectodermal origin assume part of the responsibility for production of myxoid material.

CARDIAC RHABDOMYOMA ASSOCIATED WITH TUBEROUS SCLEROSIS

An autopsy case of cardiac rhabdomyoma associated with tuberous sclerosis in a 27‐day‐old infant is presented. He was born with severe cyanosis. Echocardiogram revealed the presence of multiple mass lesions, some of which protruded into the left ventricle at the level of subaortic valve. From the age of 4 days, cardiac arrhythmia developed and lasted until his death. The arrythmia started as WPW syndrome and atrial extrasystoles and then additional paroxysmal supraventricular tachycardia, ventricular fibrillation, sinus arrest, and S‐A block occurred. Computed tomographic scanning of the brain revealed the presence of symmetric high‐density spots around the central part of lateral ventricle. Before his death paroxysmal supraventricular tachycardia occurred frequently which changed to ventricular fibrillation and he collapsed without urination and then died. Autopsy examination revealed the presence of generalized congestion, multiple nodules of cardiac rhabdomyoma, some of which causing subaortic stenosis, and tuberous sclerosis in the brain. From the clinical and autopsy findings, the direct cause of death was attributable to the cardiac rhabdomyoma.

INTER‐ and INTRA‐PATHOLOGIST VARIABILITY IN HISTOLOGIC DIAGNOSES OF LUNG CANCER

To estimate variability and reliability in histologic diagnosis (Dx) of lung cancers, lung cancer preparations were divided into eight equal sets and diagnosed independently by an eight‐man pathology panel. Majority Dx (Dx affirmed by more than 4 panelists) was regarded as the consensus Dx of each cancer. The consensus rate of each panelist ranged from 78.8% to 96.1% with an average of 89.4%. The consensus rates were not significantly different among the panelists. Relatively high inter‐pathologist agreement was observed in squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. However, regarding large cell carcinoma, there was occasional disagreement among the panelists. Forty‐seven cancers were reexamined by the same panelists, with no preliminary announcement, 7 months after the first examination to study the intra‐pathologist agreement. The rate of the intra‐pathologist agreement ranged from 76.6% to 93.3%. Dx of large cell carcinoma was the most intra‐changeable. It was concluded that the histologic Dx of large cell carcinoma was the most inter‐ and intra‐changeable, and the most frequent dissenting Dx from it was poorly differentiated squamous cell carcinoma. ACTA PATHOL. JPN. 37:1053–1060, 1987.