Hidetoshi Nakayama

Malignant transformation of lymphadenosis benigna cutis : A possibly transformed case and B-cell lymphoma

This study presents a patient who had had a 10 year history of lymphadenosis benigna cutis (LABC) before malignant lymphoma of the skin subsequently developed. During the LABC stage, the lesion showed several foci of cavernous hemangioma‐like nodules which disappeared spontaneously but reccurred repeatedly. These cutaneous nodules were finally diagnosed as malignant lymphoma of the skin with a histology of diffuse, mixed small and large cell type according to the classification of the Working Formulation. Among the subpopulations of tumor cells, B‐cells were highly predominant. It is suggested that LABC may have the potential to transform into malignant lymphoma (probably B‐cell lymphoma).

Genital Paget's disease with clear cells in the epidermis of the axilla

We report an 84‐year‐old man with extramaminary Pagets disease (EMPD) involving the genital region. Microscopic examination revealed very few clear cells appearing pagetoid in the lower portion of prickle cell layer of the right axilla epidermis, with no clinically detectable eruption. Their histochemical, immunohisto chemical and lectin‐binding reactions were almost identical to those in the genital lesion. However, although the axillary lesion was diagnosed as subclinical Pagets condition, the clinical course showed no aggressive or destructive nature. Our case suggests that not all subclinical Pagets conditions become malignant, and that in some cases the clear cells may be precursors of Pagets cells developing multifocally.

Lichen Nitidus: A Histologic and Electron Microscopic Study

A lesion of lichen nitidus in a 53‐year‐old man was examined by histology and electron microscopy. The histology showed typical features. The electron microscopy revealed primary changes in hydropic degeneration of basal cells which possibly indicated severe edema between the basal keratinocytes and in the subepidermal area. The basal keratinocytes themselves were not particularly altered, except for clustered micro‐vacuolar structures in a small portion of the peripheral cytoplasm. In one of the eight blocks observed, the cytoplasmic process of a mast cell was found between the basal keratinocytes, indicating that mast cells may possibly infiltrate the epidermis in lichen nitidus. Scattered mast cells in the dermis were also noted. Thus primary pathologic changes of lichen nitidus may be induced by severe edema, which was accompanied by inflammatory cells including mast cells, in the region of the dermal‐epidermal junction.

Persistent Facial Ulcerations with a Unique Clinical Appearance: Possible Trigeminal Trophic Syndrome

We reported a 53‐year‐old woman with a persistent facial ulcer which moved gradually from the right marginal portion of the nasal root to the right lateral canthus along the margin of the right lower eyelid. The ulcer healed spontaneously. A similar ulcer developed at the entrance of the right anterior naris. The clinical findings were suggestive of squamous cell carcinoma, deep mycosis, mycobacterial infection, or a related condition. However, no definitive diagnosis could be made from the clinicopathological findings or the laboratory examinations, including bacterial, mycobacterial, and fungal cultures. The characteristic location of the lesion, and course of the disease, however, suggested the diagnosis of trigeminal trophic syndrome.

A case of Bowen's disease with tissue eosinophilia.

An 85‐year‐old Japanese man with Bowens disease on the left inguinal area is reported. Most of the inflammatory cells adjacent to the tumor were eosinophils. Tissue eosinophilia spontaneously improved after biopsy.

Superficiality BCE and IL-2 local administration example of Bowen disease.

表在性BCEとボーエン病の各1例に対してrIL-2局注を行った。投与終了時の組織所見でいずれも好酸球を含む炎症性細胞浸潤と腫瘍細胞が正常表皮細胞様に分化した像が見出された。BCE例の免疫組織化学所見ではOKT 8陽性suppressor/cytotoxic T細胞が多く認められた。IL-2の上皮性腫瘍に対する作用機序として, 表皮細胞調節に関与し, 癌の再分化を誘導する可能性が示唆され, 興味深い所見と考え報告した。

Ten-year statistical observation of Paget illness in the Department of Dematology, Tottori Univ. Hooospital.

1980年1月から1989年12月までの10年間に, 鳥取大学皮膚科に受診したPaget病15例について, 乳房Paget病2例と, 乳房外Paget病13例に分けて検討した。治療は全例に手術が施行された。乳房外Paget病のうち4例に所属リンパ節転移がみられ, 全て臨床的に腫瘤を形成していた。そのうち2例が腫瘍死の転帰をとった。