Masayo Wada

Immunohistochemical study of intracellular estradiol in human gastric cancer

Tissues from primary human gastric cancers were examined for intracellular estradiol (E2) by using the avidin‐biotin‐peroxidase complex (ABC) immunohistochemical method on formalin‐fixed paraffinembedded sections. Reaction products of E2 were located only in the cytoplasm of the cancer cells, and not detected in noncancerous gastric epithelium. E2‐positive tissues were found in 23 (44.2%) of 52 male patients, seven (20.6%) of 34 female patients and a total of 30 (34.9%) of 86 patients. In male patients, E2‐positive cases occurred without age distinction. In female patients, however, E2 was not found in patients in older age groups, especially patients in the postmenopausal state. Microscopically, E2 was found frequently in intestinal type of cancers in male patients and in cancer with scirrhous growth pattern, in female patients. This is the first report of the demonstration of E2 in gastric cancer. The findings suggest that hormonal factors are involved in gastric cancer, and that the cancers contain endocrinic characteristics.

[3H]Thymidine autoradiographic and alkaline phosphatase histochemical studies of intestinal metaplasia of the human stomach

SummaryThe relationship between cell proliferation and enzyme activity in intestinal metaplasia of the human stomach was studied using a combined method of [3H]thymidine autoradiography and alkaline phosphatase histochemistry on the same section. Three types of intestinal metaplasia were observed depending on variations in both enzymatic activity and isotope labelling. One type shows alkaline phosphatase-positive cells along the entire length of the glands with [3H]thymidine-labelled cells localized only at the bottom of the glands, resembling the duodenum. In another type of intestinal metaplasia, alkaline phosphatase-positive cells are present on the surface and/or upper half of the glands with mitotically active cells occupying the lower part of the glands. The third variety of intestinal metaplasia is characterized by the absence of alkaline-phosphatase activity and [3H]thymidine-labelled cells present in an extended zone in the lower half of the glands.Differences in labelling patterns of [3H]thymidine and the activity of marker enzyme in various types of intestinal metaplasia seem to reflect variations in cell differentiation during intestinalization of gastric mucosa.

Complete Cure of Malignant Lymphoma of the Stomach with a Huge Adrenal Lesion Achieved by Preoperative Chemotherapy and Surgery: Report of a Case

Abstract We report herein the case of a 53-year-old woman with malignant lymphoma of the stomach who was successfully treated by preoperative chemotherapy and surgery. The patient consulted our hospital with the chief complaint of upper abdominal pain. Endoscopy demonstrated a protruding lesion at the antral posterior wall of the stomach, and a post-biopsy pathological diagnosis of diffuse large cell type B-cell lymphoma was established. Moreover, abdominal ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a tumor measuring approximately 10 cm in diameter in the left adrenal gland. A total of three courses of chemotherapy using the CHOP regimen were given preoperatively. The CHOP regimen consisted of 100 mg of prednisolone administered for 8 days together with 1.9 mg of vincristine, 1 000 mg of cyclophosphamide, and 60 mg of epirubicin administered intravenously on the first day. This resulted in tumor shrinkage, and a distal gastrectomy, lymph node dissection, and left adrenalectomy were subsequently performed. Since the pathological findings of the resected tissue specimen demonstrated complete elimination of the malignant lymphoma, this combination of procedures was defined as having resulted in a complete response. The postoperative course of this patient was uneventful. She is still alive without any sign of tumor recurrence 6 years after her operation, and is being followed up at the outpatient clinic.