Masanobu Kumakiri

Combination effect of photodynamic and sonodynamic therapy on experimental skin squamous cell carcinoma in C3H/HeN mice

We studied a combination of photodynamic therapy (PDT) and sonodynamic therapy (SDT) for improving tumoricidal effects in a transplantable mouse squamous cell carcinoma (SCC) model. Two sensitizers were utilized: the pheophorbide‐a derivative PH‐1126, which is a newly developed photosensitizer, and the gallium porphyrin analogue ATX‐70, a commonly used sonosensitizer. Mice were injected with either PH‐1126 or ATX‐70 i.p. at doses of 5 or 10 mg/kg.bw. At 24 (ATX‐70) or 36 hr (PH‐1126) (time of optimum drug concentration in the tumor) after injection, SCCs underwent laser light irradiation (88 J/cm2 of 575 nm for ATX‐70; 44 J/cm2 of 650 nm for PH‐1126) (PDT), ultrasound irradiation (0.51 W/cm2 at 1.0 MHz for 10 minutes) (SDT), or a combination of the two treatments. The combination of PDT and SDT using either PH‐1126 or ATX‐70 as a sensitizer resulted in significantly improved inhibition of tumor growth (92–98%) (additive effect) as compared to either single treatment (27–77%). The combination using PH‐1126 resulted in 25% of the treated mice being tumor free at 20 days after treatment. Moreover, the median survival period (from irradiation to death) of PDT + SDT‐treated mice (>120 days) was significantly greater than that in single treatment groups (77–95 days). Histological changes revealed that combination therapy could induce tumor necrosis 2–3 times as deep as in either of the single modalities. The combination of PDT and SDT could be very useful for treatment of non‐superficial or nodular tumors.

Crystalline lamellae in the endothelial cells of a type of hemangioma characterized by the proliferation of immature endothelial cells and pericytes—angioblastoma (Nakagawa)

Two babies were found to have large hemangiomas. Histologically there were many islands of compactly packed mesenchymal cells in the deep dermis and subcutaneous tissue. Electron microscopically there was proliferation of immature endothelial cells and pericytes. Characteristic crystalline lamellae were in the endothelial cells. Our two cases seemed to be an independent entity from other benign angiomas because of the distinct clinical, histologic, and ultrastructural features. The suggested diagnosis was angioblastoma (Nakagawa; Miki and Matsumoto), hypertrophic hemangioma (Watson and McCarthy), and benign hemangioendothelioma (Stout).

Eruptive vellus hair cysts—a facial variant

A 29-year-old man and a 29-year-old woman developed over fifty asymptomatic, slate-colored macules disseminated mainly on the forehead. Histologic study revealed keratinous cysts in the dermis, lined by a few layers of epithelial cells with rudimentary hair bulb-like structures. The cysts contents were vellus hair fragments and laminated horny material. Ultrastructural studies of the second case disclosed that the keratinization of the cyst wall was similar to that of the infundibular portion of the outer root sheath. It is suggested that our two cases are a type of follicular hamartoma. Similar follicular hamartomas, eruptive vellus hair cysts have been reported previously. The cysts were located in the chest and/or extremities and had a tendency to be eliminated transepidermally. Although these clinical features were different from ours, the characteristic histologic features were the same; therefore, our cases might be a variant of eruptive vellus hair cysts.

Leukemia cutis in acute myelomonocytic leukemia: infiltration to minor traumas and scars.

We describe a patient with acute myelomonocytic leukemia who demonstrated leukemic cell infiltration to scratched wounds and scars from trauma. A 65‐year‐old Japanese woman developed low grade fever, headache and exanthema. Hematology testing disclosed leukocytosis of 95,600/mm3 with 65% monocytes and 9% blast cells. Infiltrated erythema and nodules were disseminated over most of her body. Moreover, linear scratched wounds and traumatic scars were indurated. Skin biopsy showed dense atypical mononuclear cell infiltration with monocytic characteristics.

Ichthyosis follicularis with alopecia and photophobia in a mother and daughter

A mother and daughter having ichthyosis follicularis with alopecia and photophobia (IFAP) are reported, with histopathological and electron microscopic findings. We have followed the clinical course of the mother for 26u2003years since she was 5u2003years old, and the daughter since birth. They have had almost all the classical and some of the minor symptoms of IFAP, including severe photophobia, extensive non‐inflammatory follicular hyperkeratosis, generalized non‐scarring alopecia, hyperkeratosis of the extensor aspect of the four extremities, nail deformity and recurrent cheilitis. In addition, their facial appearance greatly resembles that of previously reported patients. A consistent feature in the mother was florid keratotic inflammatory eruptions on the genital region during each of her pregnancies, which rapidly improved after the delivery. Skin biopsy of the genital lesion showed marked acanthosis with dyskeratosis and spongiotic changes. The electron microscopic examination of diseased skin showed damaged desmosomes with spongiosis. No obvious changes were found in normal appearing skin.

Localized form of multiple glomus tumors: report of the first case showing partial involution.

We recently examined a boy with relatively large multiple glomus tumors on the left scapular region. Histologic examination revealed a typical non‐capsulated glomangioma in the middle and deep dermis; by electron microscopic examination, the tumor cells were seen to exhibit a characteristic smooth muscle cell structure. Thermographic examination revealed the higher temperature of the tumor. Within a year, the tumor showed a partial involution. We think this is the first report of multiple glomus tumor showing a partial involution.

A case of intravascular large B‐cell lymphoma mimicking erythema nodosum: the importance of multiple skin biopsies

Background: Intravascular lymphoma is a rare disease characterized by the proliferation of neoplastic monuclear cells within the lumens of small blood vessels. The neoplastic cells are usually of B‐cell origin, and rarely of T‐cell or histiocytic origin. Although this clinicopathological entity of lymphoma has not been listed in general pathological classifications such as REAL classification or the Working Formulation, it is recently in the WHO classification scheme, which is essentially an updated REAL scheme, and the EORTC classification scheme.

Detection of Selenium in Generalized and Localized Argyria: Report of Four Cases with X‐ray Microanalysis

Electron microscopic and X‐ray microanalytic studies were performed on four cases of argyria; one generalized and three localized. Deposition of electron dense granules was predominantly found on elastic fibers and around basal laminas of secretory portions of eccrine glands, although the amount of deposition was much less in the case of generalized argyria. In all four cases, X‐ray microanalysis revealed that the depositions consisted mainly of silver, selenium, and sulfur. The importance of selenium in the detoxification of heavy metals was discussed.

Atrophic dermatofibroma. Elastophagocytosis by the tumor cells.

A 55‐year‐old woman presented with an asymptomatic red plaque on the left upper back for 6 or 7 years. The lesion was depressed in response to finger pressure. The clinical diagnosis was anetoderma. Histopathologically, the characteristic cells of cellular dermatofibroma proliferated within the thinned dermis, which showed atrophy of about 60 or 70%. The proliferated cells were positive for factor XIIIa and negative for CD34. The involved dermis showed the loss of elastic fibers on elastica van Gieson stain. Electron microscopically, the proliferating cells phagocytized the elastic fibers. We report a typical case of atrophic dermatofibroma and show the possibility that the cause of this disease might be elastophagocytosis between the collagen fibers by the dermatofibroma cells.

Dermal dendrocyte hamartoma with stubby white hair: A novel connective tissue hamartoma of infancy

A previously undescribed hamartoma with stubby white hair was observed in a 1-week-old girl. A deep red, soft nodule with fine wrinkles was present on the back. White bizarre short thick hairs with irregular exterior cuticular squamae were noted. The main cells proliferating in the nodule were fibroblast-like spindle cells that had dendrites and showed positive staining for CD34 antigen. These cells surrounded vessels and nerves. In addition, there were immature hair follicles, relatively thick-walled small vessels, and small adipose cells with fine connective tissue. This hamartoma was considered to be a dermal dendritic cell hamartoma originating from CD34-positive cells.