Isao Iwasaki

Effects of bis (tri-n-butyltin) oxide on endocrine and lymphoid organs of male rats.

A total of 160 Sprague‐Dawley rats averaging in body weight, were used for hlstopathological and biochemical studies of toxicity of bis (tri‐n‐butyltin) oxide (TBTO). Short‐term effects and long‐term effects were examined. LD50 of TBTO by gastric tubing was 197 mg/kg. The effects of a single dose of TBTO were transient, and rapid recovery followed. TBTO at a a single dose of 100 mg/kg, or a total dose of 390 to 780 mg/kg In 13 weeks, or 780 to 1,560 mg/kg in 26 weeks, caused adrenal hypertrophy, flattening of the thyroid epithelium and atrophy of the thymus and lymph nodes. A single or repeated administration induced swelling and vacuolatlon of aldehyde‐fuchsin‐posltive cells in the adenohypophysls. The lmmunohistochemlcal stainability of the cytoplasm of ACTH‐cells was markedly depressed 24 hours after TBTO treatment, and that of the cytoplasm of TSH‐cells was enhanced. Analogous an inverse relationship was also manifested in the hormonal levels of serum: levels of Cortisol were elevated, while those of T‐4 and TSH were depressed.

Carcinoid in a gastrointestinal duplication

This is a report of a 12-year-old boy having gastric duplication with foci of carcinoid. He complained of right abdominal pain. Physical examination showed a cystic mass in the right abdomen. It was excised operatively. The mass was a duplication cyst composed of gastric mucosa with a muscle layer. Foci of carcinoid was detected in the muscle layer. The tumor cells involved nerve fibers but did not extend to the subserosa. Postoperative blood serotonin and histamine levels were normal. The patient is healthy without signs of recurrence 17 months after operation. This is the second case of gastrointestinal duplication with foci of carcinoid. The findings indicate that careful histologic examination is necessary to determine the exact nature of the cyst.

HEPATIC MICROCIRCULATION OF LIVER CIRRHOSIS STUDIED BY CORROSION CAST/SCANNING ELECTRON MICROSCOPE EXAMINATION

Changes of hepatic microcirculations in 22 autopsy cases of liver cirrhosis were analyzed by corrosion cast/scanning electron microscope (SEM) examination. By this method, the site of arterioportal (A‐P) communication in liver cirrhosis was clearly demonstrated between proliferated portal venules and arterial capillaries. The communications were observed at the same site as in the normal liver and were not at larger arterial and portal vein branches. The findings indicate that the increase of A‐P communication in liver cirrhosis may be called “capillary shunting”. On the basis of the findings, it was postulated that the A‐P shunt could not assist in the development of portal hypertension by the transmission of high arterial pressure to the portal vein but could only compensate for decreased portal flow and/or elevate the oxygen concentration in the sinusoids to improve the hypoxic state of the liver parenchyma. It was also demonstrated that the arterial capillarization of the interstitial septa in micronodular wide septal cirrhosis was more prominent than that in macronodular thin septal cirrhosis. A grade of portal vein reduction and compensatory arterialization in a fibrous septum have been regarded as an index to estimate the advancement of liver cirrhosis. Therefere, if alcoholic micronodular cirrhosis could change into macronodular, the process should have occurred at least before the establishment of micronodular wide septal cirrhosis.

BENIGN HEMANGIOENDOTHELIOMA OF THE PANCREAS WITH OBSTRUCTIVE JAUNDICE

A 3‐year‐old boy with benign hemangioendothelioma of the pancreas is reported. He showed the presenting sign of obstructive jaundice. The boy was treated with temporary choledochojejunal bypass without additional treatment. In a 16‐month follow‐up the child has been well and asymptomatic. Laboratory data showed no abnormality. Biopsied specimen of pancreatic head showed hemangiomatous pattern histologically. Immunohistochemical studies of the biopsy revealed positive reaction to factor VHI‐related antigen (FVIII‐RAG), an endothelial cell marker, supporting an endothelial origin. Hemangioendothelioma has a favorable prognosis and spontaneous regression can be expected. So the first treatment of the tumor should be conservative. ACTA PATHOL, JPN. 35: 975–979, 1985.

A cystic adenomatoid tumor of the uterus simulating lymphangioma grossly.

We are reporting a rare case of an adenomatoid tumor of the uterus having multicystic gross appearance. A 32‐year‐old woman complaining of dysmenorrhea had multicystic mass lesions on the posterior wall of the right cornual region of the uterus. The specimen showed a honeycomb appearance with mucoid content. Microscopically, numerous gland‐like spaces lined with low cuboidal cells were observed beneath the serosa, and mucopolysaccharide material accumulated in the cystic spaces forming honeycomb‐like lesions surrounded by myometrial tissue.

Uterine tumor resembling ovarian sex-cord tumor with osteoid metaplasia.

A rare uterine tumor showing sex‐cord‐like differentiation and marked osteoid metaplasia was found in a 33‐year‐old female. The tumor, occupying the uterine fundus, was multilobular, fleshy, and yellowish white, with punctations and poorly defined tumor margins into the subserosa. The tumor nodules were mostly composed of small, round, rather regular neoplastic cells with scanty cytoplasm and prominent nuclei. Epithelioid neoplastic cells with striking ovarian sex‐cord‐like arrangement, surrounded by fibrous tissue, were noticed. Polygonal neoplastic cells with marked osteoid metaplasia were also detected. The authors introduce an infrequent variant of uterine tumor resembling ovarian sex‐cord tumor with osteoid metaplasia, probably of endometrial stromal cell origin. Because of deep myometrial infiltration without vascular invasion, malignant potential is considered. The patient is now alive without evidence of local recurrence or distant metastasis after abdominal total hysterectomy. ACTA PATHOL. JPN. 36: 1391–1395, 1986.

ISOLATED WELL‐FORMED INTESTINAL TISSUE IN THE UMBILICAL CORD: A Variant of Cyst of Omphalomesenteric Duct

An extremely rare abnormality, a variant of omphalomesenteric duct, was observed in the umbilical cord 1 cm from the entry point into the abdominal wall, which itself was as an isolated mass of well‐formed intestinal tissue free of structural defects. This intestinal tissue seems to be the remnant of an intestinal loop from caudal limb of midgut following physiological herniation during the third month of gestation.

Malignant endometrioid adenofibroma of the ovary with serous cystadenoma.

This is a case report of malignant endometrioid adenofibroma of the ovary with serous cystadenoma in a 42‐year‐old female. It was classified as FIGO serous IA (2) ovarian tumors. Serous epithelium transformation into endometrioid glandular epithelium was disclosed. The patient is now in good condition and followed‐up periodically.

POTENTIATION OF LARGE INTESTINAL TUMORIGENICITY OF CYCASIN DERIVATIVE BY HIGH–FAT DIET AND LACTOBACILLUS IN GERMFREE MICE

Large intestinal tumorigenesis was investigated in germ free (GF) mice following the administration of methylazoxymethanol (MAM) acetate, lard, and lactobacillus arabinosus. Twelve weekly doses of 0.3 mg/10 g MAM acetate given to groups of male weanling, germfree ICR mice, fed either low‐fat (LF) chow alone, or chow with added lard (HF). Additional groups of mice, on the low‐fat diet, were monocontaminated with lactobacillus arabinosus (GA) and they and their GF controls were given 12 weekly doses of 0.2 mg/10 g of MAM acetate. The HF and LF groups were sacrificed after 123 days, and the GA and GF groups after 214 days. Serial sections of the entire large intestine of the MAM acetate‐treated mice revealed many more sessile polyps in the mice maintained on the high‐fat diet. In the mice monocontaminated with lactobacillus, numerous tumors were found, of which 25 percent were invasive. In addition, the polyps found in these animals were generally considerably larger than the polyps found in the GF mice. Atypia occurred in the large intestinal mucosa in all groups. Lard enhanced the large intestinal polypogenesis induced by MAM acetate in germfree mice. Gnotobiosis potentiated the formation of sessile polyps, and carcinogenesis.

NIEMANN-PICK DISEASE ASSOCIATED WITH LIVER DISORDERS

We report a case of Niemann‐Pick disease (NPD) with accumulation of sphingomyelin in reticuloendothelial system (RES), hepatocellular giant cell transformation (GCT), cirrhosis, and multiple hepatocellular adenomata in a 19‐month‐old girl. GCT, but no NP‐cells, were seen at age 3 months by biopsy. Cirrhosis and hepatocellular adenomata were demonstrated in the liver at 19 months of age. Cytoplasmic, probably locally synthesized, globules of alpha‐1‐antitrypsin (A‐l‐AT) were accumulated in the hepatocellular adenomata. A‐l‐AT and alpha‐fetoprotein (AFP) were present in the serum.