Kazuo Hara

Distribution of S-100b protein in normal salivary glands and salivary gland tumors

Immunohistochemical studies were performed for the presence of S-100b protein in non-neoplastic and neoplastic salivary gland tissues by the peroxidase anti-peroxidase (PAP) method. Some cases of pleomorphic adenoma were investigated by immuno-electron microscopy. S-100b protein could not be detected in epithelial cells of intercalated ducts, acini, striated ducts and excretory ducts of non-neoplastic salivary gland. However, myoepithelial cells surrounding the acini and intercalated ducts were specifically stained by S-100b protein. In pleomorphic adenomas, S-100b protein-positive cells could be mostly observed in the myxoid and chondroid areas, and the basal layer cells of the double-layered ductal cells were also positive. In clear cell adenoma, the clear cells were also S-100b protein positive. In adenoid cystic carcinomas, S-100b protein-positive cells could be found in trabecular areas, but not in tumor cells showing cribriform-pattern. In other tumors (Warthins tumor, oxyphilic adenoma, basal cell adenoma, mucoepidermoid tumor and acinar cell carcinoma), S-100b protein positive cells were seldom observed. Immuno-electron microscopically, S-100b protein was diffusely distributed in the cytoplasm of myoepithelial cells as well as of tumor cells of pleomorphic adenoma, being distributed especially on the membrane of endoplasmic reticulum and the outer nuclear membrane.

Usefulness of Contrast-Enhanced Endoscopic Ultrasonography in the Differentiation Between Malignant and Benign Lymphadenopathy *

BACKGROUND/AIMS:Endoscopic ultrasonography (EUS) is considered the most useful diagnostic modality for regional staging; however, it is still difficult to diagnose lymph node metastasis by EUS images only. In this study, we report the usefulness of contrast-enhanced EUS (CE-EUS) in the evaluation of benign lymph nodes (BLN) or malignant lymph nodes (MLN) based on blood flow patterns.SUBJECTS AND METHODS:In the retrospective study, CE-EUS was performed in 46 patients in whom EUS revealed lymph node in the mediastinum or abdominal cavity. The subjects consisted of 22 patients with BLN and 24 patients with MLN. The lesions were examined by EUS, and the maximal and minimal diameters of lymph nodes were measured. Thereafter, the shape and internal echoes were investigated, and the findings were morphologically classified based on Catalanos report. Enhancement effects and the diagnostic capability of CE-EUS were evaluated. In the prospective study, BLNs were differentiated from MLN using the enhancement patterns on CE-EUS based on the results of the retrospective study, and the diagnostic capability was evaluated.RESULTS:In the retrospective study, there were no significant differences in the maximal diameter and maximal/minimal diameter ratio between MLN and BLN. The morphology was classified into four types. Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 88.2%, 77.3%, and 82.1%, respectively. On CE-EUS, the enhancement pattern was classified into three types. The BLN lesions showed uniform enhancement (19/22). In all patients with MLN, a defect of enhancement was observed (24/24). The sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 86.4%, and 92.3%, respectively. In the prospective study, the sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 81.8%, and 92.0%, respectively.CONCLUSIONS:CE-EUS is useful for differentiating BLN from MLN.

Histochemical studies of intercellular components of salivary gland tumors with special reference to glycosaminoglycan, laminin and vascular elements

In 41 salivary gland tumors, the characteristics of the intercellular components and vascular endothelial cells were surveyed by immunohistochmical staining for laminin and factor VIII-related antigen (VIII R:Ag), and by mucopolysaccharidase-digestion for glycosaminoglycan (GAG). In myxomatous areas of pleomorphic adenomas, small vessels (diameter 6.5 ± 0.11 µm) were frequent and found to be negative or weakly positive by VIIIR:Ag staining although endothelial cells were clearly positive for VIIIR:Ag in capsule surrounding the tumor tissues. Alcian blue stainability was diminished by treatment with both Streptomyces hyaluronidase and chondroitinase. By laminin staining, a vascular pattern was clearly detected, but the majority of tumor cells were not stained. In adenomatous areas, the basement membrane-like linear laminin-staining reaction was observed to be weak and inconsistent around some tumor cell nests. However, in adenoid cystic carcinomas, laminin-positivity was much more intense than in other tumors such as pleomorphic adenoma, mucoepidermoid tumor and adenocarcinoma. In cylindromatous areas, the inner luminal surface in the pseudocysts was markedly positive for laminin, and there was weak positivity around tumor cell nests having a trabecular pattern. By immunoelectron microscopy, a juxtacellular network of replicated basal lamina of tumor cells which lined the inner surface of pseudocysts was positive for laminin. Alcian blue-positivity in the pseudocyst was abolished with heparitinase and chondroitinase, but not with hyaluronidase.

T-Cell Phenotype Is Associated with Decreased Survival in Non-Hodgkin's Lymphoma

This study was undertaken to determine which if any presentment factors are statistically significant determinants of the clinical outcome in patients with non‐Hodgkins lymphoma. The pretreatment factors in 20 patients with T‐cell lymphoma, including two patients with adult T‐cell leukemia/ lymphoma (ATLL), and 28 patients with B‐cell lymphoma were evaluated. In a stepwise logistic regression analysis, a T‐cell phenotype in addition to high grade histology and pleural involvement demonstrated a statistically significant correlation with decreased response rate, when the analysis did not include patients with ATLL. Analysis by means of the Cox proportional hazards model disclosed that the T‐cell phenotype retained a statistically significant correlation with survival after adjustments for other prognostic factors, whether the study included the patients with ATLL or not. The decreased response rate and survival of Japanese patients with non‐Hodgkins lymphoma in comparison with those reported in Western countries seem to be due to increased intrusion of T‐cell lymphomas. To permit a reliable comparison of reports on new chemotherapeutic regimens from different institutions, the tumor phenotype must be determined in the population studied

THREE CASES OF PRIMARY SPLENIC LYMPHOMA

Three cases of primary splenic lymphoma (two diffuse large cell (DL) lymphomas; and one follicular mixed small cleaved and large cell (FM) lymphoma according to the Working Formulation) are presented. Histologically as well as immuno‐histochemically, all were considered to be of follicular center cell origin. Reticulin stains clearly demonstrated that the white pulp was primarily involved both in FM and DLs. Remnants of clusters of dendritic reticular cells were demonstrated immuno‐histochemically in one case of DL. Primary splenic lymphomas in the Japanese literatures were reviewed and compared with those in the American literatures. It was found that “a solitary mass” was the predominant gross feature (81%) and “reticulum cell sarcoma” was the predominant histologic type (66%) in Japan. In the United States, lymphosarcoma was the predominant histologic type (39%), reflecting the histologic distribution of nodal lymphomas, and “homogeneous” or “miliary” was the predominant gross feature (71%). ACTA PATHOL. JPN. 35: 419–435, 1985.

Weekly CHOP for the treatment of advanced intermediate and high-grade non-Hodgkin's lymphoma.

Between January 1981 and September 1986, 48 patients with advanced (stages III and IV) intermediate and high-grade non-Hodgkins lymphoma (NHL) were treated with weekly CHOP (doxorubicin, vincristine, cyclophosphamide, and prednisolone), using reduced dosages of cyclophosphamide and doxorubicin. Low-dose oral maintenance chemotherapy was given for 2 years to those patients in remission. Twenty-seven patients (56%) of the evaluable 48 patients achieved a complete response and 12 patients (25%) had a partial response, for an overall response rate of 81%. The relapse-free survival for complete responders has been at a plateau of 67% at 16 months, and actuarial survival for complete responders has been 62%, with no deaths occurring beyond 43 months (survival plateau). One treatment-related death occurred, but toxicity was generally modest. The median time required from the start of weekly CHOP to complete response was only 5 weeks. Weekly CHOP can achieve results similar to those obtained by currently popular regimens utilizing a greater number of drugs at higher dosages.

タービンスクロールの内部流動に関する研究 : 第1報,二次流れの計測

A test apparatus of turbine scroll has been devised to investigate the secondary flow phenomena in a scroll. The scroll is of parallel end wall type and based on a logarithmic spiral. The three-dimensional flow field survey can be taken in arbitrary cross sections with a probe traverse mechanism newly developed. Distributions of total pressure and three velocity components have been measured in detail, using a five-hole probe. The secondary flow field is to be dominated by passage vortices on end walls and low energy fluid accumulating on a tongue. The favorable pressure gradient and the inward secondary flow on end walls suppress an extreme growth of wall boundary layer. However, the secondary flow affects the distribution of exit flow angle in the direction of passage height.