Jishu Ito

Primary non-Hodgkin malignant lymphoma of the breast. An immunohistochemical study of seven patients and literature review of 152 patients with breast lymphoma in Japan.

Background. The breast is rarely primary site for extranodal malignant lymphoma. Most reported primary non‐Hodgkin malignant lymphomas of the breast (PBL) are of B‐cell phenotype.

Immunohistochemical Analysis of Ki-67, p53, p21, and p27 in Benign and Malignant Apocrine Lesions of the Breast: Its Correlation to Histologic Findings in 43 Cases

We examined Ki-67, p53, p21, and p27 immunolocalization in 43 cases of apocrine lesions of the breast and correlated these findings with histologic parameters to understand their biologic significance. Twenty cases were benign, 1 case was borderline, and 22 cases were diagnosed as malignant, including 9 intraductal and 13 invasive apocrine carcinomas. Both the ratio of Ki-67–positive cases (17 of 21 [88.9%] versus 1 of 19 [5.3%]; P < .001) and the Ki-67 labeling index of positive cases examined (15.0% versus 2.7%; P < .005) were significantly higher in malignant than in benign apocrine lesions. None of the benign or borderline cases was immunohistochemically positive for p53, but 15 of 22 malignant cases (68.2%) demonstrated p53 (P < .001). In addition, the ratio of p53-positive cases was significantly higher in high nuclear grade cases (11 of 13 [84.6%]) than in intermediate nuclear grade cases (4 of 9 [44.4%]; P < .05). P53 immunoreactivity was also positively correlated with the nuclear grade of carcinoma cases examined in this study. Neither p21 nor p27 demonstrated any correlation with histologic parameters or findings of the apocrine lesions. Results of these studies suggest that Ki-67 and p53 may be good markers for differentiation between benign and malignant breast apocrine lesions.

MYXOPAPILLARY EPENDYMOMA OF THE LATERAL VENTRICLE

Reported was the first case of myxopapillary ependymoma arising from the right lateral ventricle of a 29‐year‐old Japanese male. The histological and ultrastructural findings were identical to those from the filum terminale.

MEDIASTINAL TUMOR OF THYMIC ORIGIN AND RELATED TO CARCINOID TUMOR

A 32‐year‐old male was found, by a routine x‐ray examination, to have a mediastinal tumor protruding Into the thoracic cavity from the right hilus. The presence of a rosette formation and argyrophil and neurosecretory granules Indicated a carcinoid. The thymic residues adhering to the tumor suggested that this tumor originated from the thymus. Based on the literatures previously published, this case will be the third case reported in this country; importance of the entity of such a tumor was emphasized.

Ossifying renal tumor of infancy: The first Japanese case with long-term follow-up

Jishu Ito1,5

Cystic hypersecretory duct carcinoma of the breast : a case report describing the cytologic features

We report the clinical, cytological and pathological features of so-called cystic hypersecretory duct carcinoma occurring in a 60-year-old Japanese woman. The tumor manifested a multicystic mass ultrasonographically, and aspiration biopsy cytology revealed atypical ductal epithelial cells with vacuolar cytoplasm. A modified radical mastectomy was performed. Histologically, the lesion was characterized by many dilated ducts containing eosinophilic secretions, which resembled thyroid colloid. The ducts were lined by an intraductal micropapillary carcinoma with hobnail-shaped cells, and were positive for lactalbumin immunohistochemically. Additionally, a so-called cystic hypersecretory hyperplasia was seen in the surrounding breast parenchyma. Although a direct transition from the hyperplasia to the carcinoma was not proved, a close relationship between the two lesions was suggested.

ADULT T‐CELL LEUKEMIA WITH GENERALIZED CYTOMEGALIC INCLUSION DISEASE AND PNEUMOCYSTIS CARINII PNEUMONIA

An autopsy case of adult T‐cell luekemia with generalized cytomegalic inclusion disease and pneumocystis carinii pneumonia is reported. Tumor cells had T‐cell characteristics (E‐rosette) and cerebriform nucleus similar to Sèzary cells. Generalized lymphadenopathy, hepatosplenomegaly and an ectopic pancreas in the ileum were found at the time of autopsy. Histologically, leukemic infitration was observed in almost every organ, and perivascular infiltration, vascular invasion were conspicuous findings. Cytomegalic inclusion bodies were observed in most organs(lungs, salivary glands, pancreas, liver, ectopic pancreas, sweat gland, stomach, thyroid gland, pituitary body, etc.). An acute hepatitis, probably caused by cytomegalovirus, was also noted. Presumed correlation of adult T‐cell leukemia, cutaneous T‐cell lymphoma and T‐cell lymphoma was discussed.

Embryonal sarcoma of adult and pediatric kidneys: Report of a case with localized submucosal invasion of the renal pelvis and long‐term survival

A case of cystic embryonal sarcoma of the kidney (CESK) with a rapidly fatal outcome was recently reported. 1 Here, we report another case of a 12‐year‐old boy with a localized but ill‐defined submucosal lesion of CESK in the right renal pelvis. The tumor consisted principally of small mesenchymal cells with oval to spindle nuclei and scanty cytoplasm, infiltrating in dense arrangements. Two growth patterns were distinguished in the tumor cells: (i) a diffuse infiltrating pattern without an epithelial component; and (ii) a foliated pattern with an epithelial lining over the surface. Foci of the diffuse pattern predominated over those that were lobular, infiltrating superficial layers of renal sinuses and along pyramids, in both of which remarkable intravenous invasion was evident. Foci of the foliated pattern invaded deeper portions of a few sinuses and frequently penetrated into their veins, producing together with their epithelial lining a characteristic foliated structure. Lining epithelial cells around lobular foci often appeared hob‐nailed or eosinophilic in the cytoplasm. Despite the remarkable intravenous encroachment, the patient has remained well without a recurrence for more than 26 years after a simple nephrectomy. The present case report expands our understanding of the biological nature of CESK.

CHÉDIAK-HIGASHI SYNDROME: REPORT OF A CASE WITH AUTOPSY AND ELECTRON MICROSCOPIC STUDIES*

A case of a 6‐month‐old boy with Chédiak‐Higashi syndrome was studied by autopsy and electron microscopy. Electron microscopy of leukocytes from peripheral blood and bone marrow indicated that the abnormal intracytoplasmic granules or vacuoles identifiable in light microscopy fell into 3 categories; (1) giant lysosomes; (2) autophagic vacuoles; and (3) phagocytized cells. These observations may support the recent concept that Chédiak‐Higashi syndrome is a possible lysosomal disease.