Kanichi Yagawa

Analysis of thyroid carcinoma based on material registered in japan during 1977-1 986 with special reference to predominance of papillary type

Background. As geographic differences have been observed in the characteristics of thyroid carcinoma, an analysis was made on thyroid carcinoma in the iodine rich country of Japan.

Squamous differentiation in thyroid carcinoma. With special reference to histogenesis of squamous cell carcinoma of the thyroid.

Squamous differentiation of thyroid carcinoma was studied clinicopathologically and immunohistochemically in 29 autopsy cases. Tumor cell nests with squamous differentiation (CNSD), which histologically resembled squamous cell carcinoma, were found in 6 cases (20.7%). All of these 6 cases with CNSD had areas of undifferentiated carcinoma, representing 31.6% of 19 cases with undifferentiated carcinoma, and all but one case also showed coexisting papillary carcinoma. The CNSD were histologically associated with undifferentiated carcinoma in 5 cases, and with papillary carcinoma in one case; the CNSD were occasionally intermingled with these types of carcinoma, and there were findings suggesting a histological transition between the CNSD and undifferentiated carcinoma or papillary carcinoma. Immunohistochemistry revealed that all the CNSD were reactive with antibodies for keratin and vimentin, whereas thyroglobulin and desmin were not expressed. It was concluded that the CNSD examined here were most probably due to extensive squamous differentiation (squamous metaplasia) in undifferentiated carcinoma and papillary carcinoma. In addition, the present results may explain the fact that cases diagnosed solely as squamous cell carcinoma sometimes show a prognosis similar to that of undifferentiated carcinoma, and may well represent extensive squamous differentiation in such tumors rather than true squamous cell carcinoma of the thyroid. Acta Pathol Jpn 39: 306 312, 1989.

TWO CASES OF NEVOID BASAL CELL CARCINOMA SYNDROME

Two cases of nevoid basal cell carcinoma syndrome were reported with a review of pertinent literature. The first case was a 59‐year‐old man, whose autopsy was warranted. Signs and symptoms manifested in this case were basal cell carcinoma, generalized multiple nevi, multiple cysts in the jaws and long bones, pits in the palm and sole, frontal and occipital bossing, ossification of the falx cerebri, a bifid rib, renal fibroma and a patent foramen ovale. The family history revealed a hereditary predisposition as to the syndrome. The patient in the second case was a 25‐year‐old man who is still alive. Manifestations in this case included basal cell carcinoma, multiple nevi, multiple jaw cysts, pits in the palm and sole, frontal bossing, calcification of the falx cerebri, cervical vertebral fusion and high‐arched palate. ACTA PATH. JAP. 27: 713 ˜ 727, 1977.

ELECTRON MICROSCOPIC STUDY ON MITOCHONDRIA IN HÜRTHLE CELL ADENOMA OF THYROID

In this investigation Hürthle cell adenoma of the thyroid was observed by electron microscopy. The cytoplasm of the cells consisted chiefly of an accumulation of numerous irregularly shaped mitochondria. Very few other organellae were observed. In addition electron microscopy revealed various degrees of electron density in the matrix of the mitochondria. When 3 dimensional models of the mitochondria were constructed, they revealed the mitochondria to have 3 dimentional forms which sometimes looked as if they might be dividing into two or three parts. The authors felt that this indicated a process of vigorous division of mitochondria and an extension of their life span. However, it was not possible to identify the cause of this division of mitochondria.

HISTOPATHOLOGICAL STUDY OF THYROIDITIS x—SPECIAL REFERENCE TO ITS CLASSIFICATION—

Among all problems on thyroiditis, that of Hashimoto’s thyroiditis, Riedel’s thyroiditis and subacute non-suppurative thyroiditis seems to be the most difficult one at the present time. The etiology and histogenesis of these thyroiditis are yet unknown, and it is still questionable as to whether they are three entirely different diseases, or only one in different stages of the same disease or different features of some reaction. Purthermore, aince the histological findings of these thyroiditis vary extremely, the histological criteria for conclusive diagnosis and for classification depend upon the investigators. It is, therefore, necessary to have a common criterion for its classification in order to discuss and examine the results of studies on thyroiditis under a common histological category. The author has classified subacute non-suppurative thyroiditis and Hashimoto’s thyroiditis into the following subgroups from a histological point.

HISTOPATHOLOGICAL STUDY ON PROGRESSIVE MUSCULAR DYSTROPHY—REPORT OF A CASE WITH AUTOPSY FINDINGS—

A typical case of the Duchenne type of progressive muscular dystrophy with autopsy findings was presented. Changes in the myocardial and smooth muscle of many organs were found, and the skeletal muscles also revealed florid changes.

CLINICO-PATHOLOGICAL STUDIES ON MALIGNANT GOITER.

It is well known that some of the thyroid tumors in spite of their well-differentiated histological features, which do not conform to the generally accepted criteria of malignancy, do produce metastasis. Such kind of tumor has been termed metastasizing struma or malignant adenoma or angio-invasive adenoma, etc. On the other hand, it is a fact that many cases of thyroid cancer having histologically malignant features, show far more benign clinical courses than those of cancer of the other organs. The purpose of this report is to attempt to solve the problems of the clinicopathological character, especially that of malignant goiter, i.e. problem of the correlation between pathomorphological feature and clinicobiological course.

ELECTRON MICROSCOPIC STUDIES OF THE EFFECT OF ACTH AND FLAVIN-ADENINE DINUCLEOTIDE ON ADRENOCORTICAL ATROPHY OF RATS TREATED WITH DEXAMETHASONE PHOSPHATE

In a previous paper the authors described the morphologic observations that the concomitant administration of ACTH and flavin‐adenine dinucleotide (FAD) to hypophysectomized rats exerted a more potent preventive effect on atrophy of the adrenal cortex of the animals than the single administration of ACTH. The present study was made to electron‐microscopically observe the effect of concomitant administration of ACTH and FAD on atrophy of the adrenal cortex induced with the administration of dexamethasone (Dx). The zona fasciculata of the adrenal gland of rats treated with Dx+ACTH+FAD was morphologically closer in cell organelles such as smooth‐surfaced endoplasmic reticulum, mitochondria and chylomicrons to that of control animals than the counterpart of animals treated with Dx+ACTH only. The zona fasciculata of the adrenal cortex of animals treated with Dx+FAD was morphologically similar to that of animals treated with Dx only. These findings suggested that FAD would potentiate the adrenocorticotropic action of ACTH through its physiologic action.