Mitsuhiro Sohma

Multifocal serous cystadenoma of the pancreas. A case report and review of the literature.

SummarySerous cystadenoma of the pancreas is usually unifocal; multifocal tumors are rare. We report a case of multifocal serous cystadenoma of the pancreas in a 48-yr-old female complaining of general malaise. Serum tumor markers, such as CA 19-9, DUPAN-2, and Span-1, were elevated. Abdominal ultrasound (US) and computed tomography (CT) scans revealed two distinct cystic masses in the head and body of the pancreas, respectively. The patient underwent total pancreatectomy. The resected pancreas contained two discrete cystic masses in the head and body; no solid components were observed. Microscopically, the inner surfaces of the cysts were evenly lined by a single layer of low cuboidal or significantly attenuated epithelial cells containing clear cytoplasm and abundant glycogen without other morphological alterations. The histogenesis of serous cystadenoma is not clear; multicentric tumors may be helpful in understanding histogenesis.

Ultrastructure of the absorptive cells in the small intestine of the rat during starvation

SummaryThe ultrastructure of the absorptive cells in the duodenum, jejunum and ileum after 7, 14 and 21 days of starvation was investigated using rats aged from 12 to 18 months weighing about 500 g. In the basal cytoplasm of the absorptive cells (in the duodenum and ileum of 21-day-starved rats and the jejunum of 14- and 21-day-starved rats), the following changes were found: atrophied mitochondrion-like bodies, small vesicles, a short and sparse rough-surfaced endoplasmic reticulum and a lack of density in a portion of the cytoplasm. Moreover, many autolysosomes of various sizes and shapes were encountered in the basal cytoplasm; occasionally these elements accumulated and appeared to fuse to one another. In contrast, in the apical cytoplasm of absorptive cells in the intestine of starved rats, the ultrastructure was similar to that of control rats. It was considered that the apical cytoplasm of the absorptive cells in the starved rat intestine might be preserved as long as possible during starvation in order to absord nutrients when they become available again.

Annulate lamellae of the jejunal absorptive cells in 21-day-starved rats

The ultrastructure of annulate lamellae of the jejunal absorptive cells in control and 21 d starved rats was investigated. Annulate lamellae were only rarely encountered in the jejunal absorptive cells of control rats, and then frequently in small stacks continuous with the rough-surfaced endoplasmic reticulum. In contrast, there was a relatively frequent incidence of annulate lamellae in the jejunal absorptive cells of 21 d starved rats, and larger stacks of annulate lamellae were also observed in spite of marked ultrastructural changes of these cells. The annulate lamellae were also continuous with the rough-surfaced endoplasmic reticulum, which was degenerating. The degenerative process of the absorptive cells following starvation might be related to the origin and function of the annulate lamellae.

Ultrastructural localization of acid phosphatase activity in the jejunal absorptive cells of fasted rats

Ultrastructural localization of acid phosphatase activity was investigated in the jejunal absorptive cells of 21 d fasted rats (about 500 g). The enzyme activity was localized on the membrane of microvilli, the lateral cell membrane, the Golgi complex, the lysosomes and the GERL of Novikoff (a part of the smooth surfaced endoplasmic reticulum located in close proximity to the Golgi saccules) of jejunal absorptive cells. Moreover, the lysosomes of various sizes and shapes with acid phosphatase activity was characteristically encountered in the infranuclear cytoplasm. The lysosomes appeared to be autolysosomes .

Selective Endoscopic Retrograde Pancreatography (Selective ERP) Using a Radifocus Gllidewire–A New Technique for a Diagnostic Pancreatogram

Abstract: We have developed a new method called the “Selective Endoscopic Retrograde Pancreatograpy (Selective ERP)” which uses a Radifocus guidewire to obtain a more precise pancreatogram than a standard ERP. The deep cannulation of a catheter guided by a Radifocus guidewire following standard ERP was easily and rapidly accomplished and precise pancreatograms were successfully obtained. The Selective ERP was very useful not only for obtaining detailed pancreatograms beyond severe stenosis of the main pancreatic duct in ductal cell carcinoma of the pancreas but also in revealing whether mucinous cystadenoma/cystadenocarcinoma communicated with the pancreatic duct or not. In the case of a mucin producing pancreatic tumor, Selective ERP successfully enabled us to obtain a whole pancreatogram and the location and extent of a tumor that standard ERP often fails to reveal because of an abundant accumulation of mucin in the duct.

Annulate lamellae of the pancreatic exocrine cells in starved rats

SummaryThe ultrastructure of annulate lamellae in the pancreatic exocrine cells of rats starved for 3–42 days was studied. Annulate lamellae were rarely encountered in the pancreatic exocrine cells of control rats, but their incidence and size of stack was increased in those of starved rats depending on the duration of starvation, despite marked ultrastructural changes in these cells. Annulate lamellae were located in the paraor infranuclear cytoplasm of the cells and most of them were continuous with the relative normal rough endoplasmic reticulum. A close apposition in parallel was often found between the annulate lamellae and the outer nuclear envelope and occasionally pores in line with those of the nuclear membrane were observed in the lamellae of rough endoplasmic reticulum in 35- and 42-day-starved rats. An unequivocal continuity between the annulate lamellae and the nucleus and/or rough endoplasmic reticulum in pancreatic exocrine cells might be related to their origin and function.