Nobuhiro Monma

Adenomyoepithelioma (myoepithelioma) of the breast in a male

Adenomyoepithelioma (myoepithelioma) of the breast in a 47-year-old man is reported. The tumor consisted of a prominent proliferation of spindle cells surrounding mammary ducts. Immunohistochemical and electron microscopic observations confirmed the myoepithelial origin of these spindle cells. This is the first report of an adenomyoepithelioma of the breast that developed in a male.

AN IMMUNOFLUORESCENT STUDY OF GENERALIZED COXSACKIE VIRUS B3 INFECTION IN A NEWBORN INFANT

An autopsy case of a 10‐day‐old newborn with generalized infection of Coxsackie virus B3 (CBV3) was reported. CBV3 was isolated from the blood before death. The patient died of cardiac failure. An immunofluorescent study was carried out on autopsy specimens fixed in formalin and embedded in paraffin. CBV3 antigen was detected in the heart, brain, kidney, lungs, spleen, thymus, and pancreas. In the pancreas CBV3 antigen was predominantly seen in the islet cells. No CBV3 antigen was found in the liver and adrenal glands. Electron microscopic examination revealed virion‐like particles, 20 nm in diameter, in the endothelial cells of the myocardium. ACTA PATHOL. JPN. 35:741‐748, 1985.

Bile canaliculi-like lumina in fibrolamellar carcinoma of the liver: A light- and electron-microscopic study and three-dimensional examination of serial sections

Flbrolamellar carclnoma (FLC) Is a varlant of hepatocellular carcinoma characterlzed by dlstlnct pathologicel features. The presence of Intracellular lumlna resembling blle canalicull was previously reported in tumor cells of FLC on electron microscopy. Using light microscopy, we describe the presence of intracellular lumina In FLC, which was resected from a 15‐year‐old Japanese girl, as round structures lined with a brush‐like border. These lumina occasionally contained blle. Light microscopic examination of 1 μm thick serial sections of Eponembedded tissue samples showed that the lumina were located in the intracellular space without any connection to the Intercellular space. However, we also detected a small number of lumlna that were lined by microville which were present between adjacent tumor cells. Results suggest that the presence of the Intracellular Iumlna in tumor cells probably represents a common histopathologic feature of FLC.

Secretory Carcinoma Coexistent with Mucinous Carcinoma in the Breast

Secretory carcinoma and mucinous carcinoma were found to coexist in the breast of a 67 year old post menopausal woman, although the tumors were separated by a thin fibrous septum. Histochemically, intra‐ and extracellular secretory materials in both carcinomas were strongly positive for alcian blue, PAS and mucicarmine staining, but immunohistochemically negative for α‐ lactalbumin and CEA. Membrane‐bound intracytoplasmic vacuoles showing emiocytosis were observed in both the secretory and mucinous carcinomas by electron microscopy. No differences were observed between the tumor cells of secretory carcinoma and those of mucinous carcinoma by histochemistry, immunohistochemistry and electron microscopy. However, there were definite statistically significant differences in the results of morphometry of tumor cell nuclei. Secretory carcinoma is considered to be an anaplastic variant type of mucinous carcinoma. Acta Pathol Jpn 39: 593 598, 1989.

Subclinical Sjögren's syndrome: A significant 67gallium accumulation in the orbits and parotid glands

An 8‐year‐old girl with hypergammaglobulinemia showed an abnormal 67gallium accumulation in the orbits and parotid glands. Although she did not have any subjective siccant complaints, reported typical histopatho‐logical and sialographs changes suggesting Sjögrens syndrome (SjS) were observed in the salivary glands. Gallium scintigram might be a valuable and non‐invasive diagnostic tool in the diagnosis of children with SjS without sicca symptoms.

Myocardial lesions by Coxsackie virus B3 and cytomegalovirus infection in infants

SummaryImmunofluorescent and electron-microscopic studies were performed to determine the distribution of viral antigens and particles and to clarify the relationship to myocardial lesions in two autopsy cases with generalized infection of Coxsackie virus B3 (CVB3) or cytomegalovirus (CMV). Case 1 was a full-term newborn female infant, without any congenital anomalies, who died of cardiac failure 10 days after birth. CVB3 was isolated from the blood before death. Necrosis of the muscle fibers was observed, frequently accompanying calcification. Numerous histiocytes and a few lymphocytes and neutrophils had infiltrated in and around the necrotic areas. Immunofluorescent study (IF) revealed CVB3 antigen in the muscle fibers and vascular endothelial cells. Case 2 was a female infant, born at 28 weeks of gestation, who died of fatal arrhythmia 50 days after birth. The infant had hemocephalus and a history of idiopathic respiratory distress and underwent an operation for patent ductus arteriosus. Cytomegalic cells were frequently found in the vascular endothelial cells in the myocardium and occasionally in muscle fibers. IF showed the presence of CMV antigen in both endothelial cells and muscle fibers. CVB3 and CMV antigens were detected predominantly in vascular endothelial cells rather than in the muscle fibers. Blood flow disturbance due to endothelial damage is a cause of the myocardial lesion in addition to the direct invasion of the muscle fibers by the virus.

Light and electron microscopic observation on the process of tissue calcification in a case of parathyroid adenoma.

Metastatic calcification in various organs in an autopsy case of parathyroid adenoma was studied by light and electron microscopy. Calcification was observed in kidney, lung, liver, heart, stomach, and thyroid. In the kidney, calcification was found in the tubules and glomeruli. In the liver, calcification was mainly found in Disses space. The kidney, lung, liver, and heart were examined by electron microscopy. Four forms of early calcification were observed: 1) amorphous dense bodies within the mitochondria; 2) needle‐shaped hydroxyapatite; 3) concentric laminated structure; and 4) cytoplasmic vesicles originating in hepatocytes. Calcium phosphate precipitates within the mitochondria were seen as amorphous dense bodies. When calcium phosphate precipitated in the cytoplasmic colloid gel, concentric laminated structures were formed due to Liesegangs phenomenon. Needle‐shaped crystals in the amorphous dense bodies of the mitochondria were interpreted as a phenomenon of epitaxy. Calcification in Disses space was thought to start in cytoplasmic vesicles which were derived from hepatocytes. ACTA PATHOL. JPN. 37: 1621 ‐ 1635, 1987.

METACHROMATIC LEUKODYSTROPHY. Report of Siblings with the Juvenile Type of Metachromatic Leukodystrophy

Two sisters with juvenile metachromatic leukodystrophy are described. The patients were 17 and 20 years old. The younger sister died and an autopsy was perfomed. The elder sister keeps alive. A sural nerve biopsy of both cases revealed an accumulation of metachromatic lipid granules in the Schwann cells and macrophages. The autopsy also disclosed these granules especially in the brain, gallbladder, kidney and pancreas. A lipid analysis of the cerebral white matter showed sulfatide accumulation that was 1.5 times that of controls. Histochemically, the accumulated lipid was different in the brain from that in other organs. An electron microscopic examination of the accumulated metachromatic lipid granules showed various structures such as concentric lamellar, tuffstone, herringbone and hexagonal honeycomb appearances, and some ultrastructural differences between the nervous system and other organs. ACTA PATHOL JPN 38: 1041∼1051, 1988.

Ceroid-lipofuscinosis. Report of two autopsy cases.

Light and electron microscopic examinations were performed on two autopsy cases of ceroid‐lipofuscinosis of the juvenile (Case 1) and late infantile (Case 2) types. Much ceroid‐lipofuscin (CL) was found in nerve cells throughout the nervous system. In Case 1, CL had also accumulated in thyroid follicular cells, glomerular podocytes, and epithelial cells of the ductus epididymidis, and in the endothelium and smooth muscle of vessels. Electron microscopy showed CL in 5% of peripheral lymphocytes sampled when the patient was alive. In Case 2, an accumulation of CL was found in the vascular endothelial cells of the cerebrum, and Kupffer cells and sinusoidal endothelial cells of the liver. The CL was autofluorescent, and was seen to be composed of electron‐dense granules, lipid droplets, lamellar structures, and curvilinear bodies by electron microscopy. Limiting membranes were often found surrounding CL granules. The dolichol level in the cerebral cortex was high in Case 1. Accumulation of CL was found in cells other than nerve cells, although the main signs and symptoms were caused by the involvement of nerve cells. The CL showed various ultrastructural features. ACTA PATHOL JPN 38: 1191∼1203, 1988.

Distal type of renal tubular acidosis after anti-epileptic therapy in a girl with infantile spasms

Abstract An 11-month-old girl was referred to our hospital because of nausea and poor physical activity. She had a 5-month history of infantile spasms, which were successfully treated with valproic acid (VPA) and vitamin B6. Laboratory studies revealed hyperchloremic metabolic acidosis, mainly due to distal type renal tubular acidosis (RTA). Although a renal biopsy, performed 2 months after the onset of RTA, did not demonstrate tubulointerstitial lesions, her clinical course, in which administration of VPA led to an episode of RTA, with gradual subsidence on VPA removal, suggested that the probable causative agent of her distal type RTA was VPA. Although proximal type RTA associated with VPA administration has been reported, distal type is rarely seen. To our knowledge, a similar case has not been reported previously.