Hidemasa Kishimoto

Plasma cell granuloma of the stomach. A report of a case associated with gastric cancer

Plasma cell granuloma arose multifocally in the stomach combined with gastric cancer (adenocarcinoma). The immunohistochemical study demonstrated the polyclonal nature of the plasma cells in the former lesion, and confirmed the diagnosis of plasma cell granuloma.

OCCLUSION OF THE BASILAR ARTERY

The present report dealt with thirteen autopsied cases of basilar artery occlusion. The age of the patients ranged from fifty one to seventy six years with a mean age of fifty six years, and there were eleven males and two females. Basilar artery occlusion was found in one in every 160 autopsies. The average length of the clinical course of the disease was five months. Many patients had a history of hypertension, diabetes mellitus, and cerebrovascular attacks. The neurological signs and symptoms of basilar artery occlusion extremely varied and were complicated. In our series, occular bobbing, palatal myoclonus, Foville syndrome, and Millard‐Gubler syndrome are significant. Arteriosclerotic thrombosis is the most important etiologic factor. The site of occlusion was most frequently encountered in the lower third of the basilar artery. Areas of softening were prominent in the midbrain and the pons. In the cerebellum, softenings were present particularly in the areas supplied by the superior cerebellar artery. Infarcts in the thalamus and the temporo‐occipital lobes supplied by the posterior cerebral artery were observed very frequently. The distribution of softening was related to the site of occlusion of the basilar artery and the collateral circulation through the Willis ring.

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.

HUMAN DUCTUS ARTERIOSUS

The present study deals mainly with the ductus arteriosus of preterm infants of gestational age less than 29 weeks, birth weight less than 1200 g, and postnatal age less than 72 hours. Excised ductus were histologically examined postmortem and compared to those of infants of more advanced gestational age. Intimal cushion and duplication and/or interruption of the internal elastic lamina of the ductus arteriosus were employed as the indicators of the maturation of the ductus arteriosus. The ductus arteriosus of infants with gestational age more than 29 weeks showed histologically more mature features than those of 28 weeks or less. It is considered that there is a relation between gestational age and histologic maturation of the ductus arteriosus.

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.

MECHANISM OF THE FORMATION OF MEGAMITOCHONDRIA BY COPPER‐CHELATING AGENTS V. FURTHER STUDIES ON ISOLATED MEGAMITOCHONDRIA

Effect of cuprizone has been studied on some biochemical properties of megamitochondria obtained from the mouse liver. (1) Contents of Ca2+, Mg2+ and Cu2+ in the blood or the liver homogenates were not altered by cuprizone‐intoxication, whereas those in liver mitochondria were significantly altered: after 3‐4 days’intoxication, content of Ca2+ was decreased and was remarkably increased after 14‐15 days’intoxication. Content of Mg2+ behaved contrarily. (2) Both cytochrome oxidase and ATPase activities were unchanged in the liver megamitochondria, but monoamine oxidase (MAO) activity was significantly decreased. Value of I50 (50% inhibition) for MAO was determined to be 0.33 mM using the control liver mitochondria. Cuprizone had almost no effect on MAO activity of kidney or heart mitochondria both in vivo and in vitro. (3) The amount of lysolecithin was increased in the liver megamitochondria.

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.

MECHANISM OF THE FORMATION OF MEGAMITOCHONDRIA BY COPPER‐CHELATING AGENTS IV. ROLE OF FUSION PHENOMENON IN THE CUPRIZONE‐INDUCED MEGAMITOCHONDRIAL FORMATION

Megamitochondria were induced within 36‐40 hours in mouse hepatocytes by injecting cuprizone into the peritoneal cavity. Induction of megamitochondria was dependent upon the amount and the time intervals of the injection of cuprizone: 200 mg of cuprizone/kg of body weight ‐ injected every 12 hours or 400 mg of cuprizone/kg of body weight ‐ injected every 24 hours. When the latter amount of the noxious reagent was administered to the animal every 12 hours, fatty changes of the liver was observed. Involvement of the fusion phenomenon in the mechanism of megamitochondrial formation is discussed in the light of turnover rates for various components of the mitochondrion.

Glutaric aciduria type II: autopsy study of a case with electron-transferring flavoprotein dehydrogenase deficiency.

An autopsy study of glutaric aciduria type II in a 62-day-old Japanese boy is presented. The diagnosis was made by analysis of organic acids in the urine. Immunoblot analysis of liver homogenate confirmed the diagnosis, revealing absence of electron-transferring flavoprotein dehydrogenase. The major findings were fatty changes of variable degree in many organs and tissues, the most severe being found in cardiac myocytes, hepatocytes, renal tubular epithelium, and skeletal muscle fibers. Other pertinent findings included multicystic and dysplastic kidney, pulmonary alveolar proteinosis, and spongiosis and gliosis of the spinal cord. The thymus was markedly depleted, and lymphocytes in the lymph nodes were mainly B cells. Although some of these changes may have been secondary to the sepsis and immunosuppression complicating 2 months of intensive care, the abnormal organic acid metabolism with severe acidosis may have been a significant contributing factor.

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.