Norimasa Arita

Giant hepatic angiomyolipoma.

phoma of the heart in two patients with the acquired immunodeficiency syndrome. Arch. Parhol. Lab. Meti. 1987; 111; 254 256. HAMBLEN AS. In: Lynlpphokines. Oxford: IRI. Press, 1988. J A V l E R BU. Y A U N T W J , CROSBY D T . H A L L T C . Cardiac metastases in lymphoma and leukaemia. 06. Chrsl 1967; 52; 481-484. MCALLISTCK H A , FENOGLIO J J . A r l m o/ ~ U ~ ~ Z O Y Pur/iolo,y.y, Tumours of the cardiovascular system. 2nd series, fasicle 15. Washington, DC: Armed Forces Institute of Pathology, 1978. ROBINSON FC. Aneurysms of the coronary arteries. Am. Hmi-I J . 1985; 109; 129 135. ROH LS. PAPARO GP. Primary malignant lymphoma of the heart in sudden unexpected death. J . Forensic Sciences 1982: 27; 718-722.

MALIGNANT GRANULAR CELL TUMOR OF THE ESOPHAGUS

Malignant granular cell tumor of the esophagus found in a 70‐year‐old female was reported. Microscopically, the tumor showed a variety of the histology from compact proliferation of polygonal granular cells in pseudo‐epitheliomatous pattern to plexiform proliferation of elongated granular and fibroblastic cells in neuroflbromatous pattern, and the tumor cells frequently contained eosinophilic globules in the cytoplasm. Histochemically, argyrophilic neurofibrils in the stroma and argyrophilic cytoplasmic processes or grains were seen. Immunohistochemically, the tumor cells showed positive reaction with S–100 protein (S–100), but all reactions with myoglobin (MG), desmin (DM), fibronectin (FN), creatinine phosphokinase–mm (CPK), factor gthrelated antigen (F8RA), alpha–1–antitrypsin (AIAT), alpha–1–anti–chymotrypsin (AIACT), keratin (KN), and carcinoembryonic antigen (CEA) were negative. Electron microscopy revealed that the tumor cells had typical lysosomal granules filled with proteinaceous electron dense materials and fine membrane‐bound particles sized 15 to 45 nm resembling virus or neurosecretory granule.

Expression of sphingosine kinase 2 in synovial fibroblasts of rheumatoid arthritis contributing to apoptosis by a sphingosine analogue, FTY720

Gene expression profiles in synovial tissues from rheumatoid arthritis (RA) patients have yielded useful information on the pathogenetic process of the synovitis. In one group of them, sphingosine kinase 2 (SPHK2), a nuclear protein regulating cell proliferation, seemed to be highly expressed, undergoing a different pathogenetic process of synovitis. In the present study it was clarified that SPHK2 was expressed in the synovial fibroblasts of the synovial tissues obtained from the knee joints of the RA patients. In the cultured synovial fibroblasts from these patients, SPHK2 was more highly expressed than that in the human macrophage cell line, THP‐1 and human dermal fibroblasts. SPHK2 was expressed in and around the nucleus and transferred to the cytoplasm and cell surface by the administration of epidermal growth factor, associated with the increased expression of sphingosine‐1‐phosphate. A sphingosine analogue, FTY720, which is activated by phosphorylation specifically by SPHK2, mediated apoptotic signaling of the cultured synovial fibroblasts. These findings suggest that SPHK2 may regulate the autonomous proliferation of synovial fibroblasts as one of the predisposing genes to RA and could be a target for a novel therapeutic strategy for RA.

Pericardial malignant mesothelioma: Case report and discussion of immunohistochemical and histochemical findings

An extremely rare case of malignant mesothelioma of the pdcardium is reported. The tumor appeared to be the Uphasic type of diffuse malignant mesothetioma which presgnt many small to tine lipid droplets in the cytoplasm, particularly that of the epithelial cell, and a positive immunohistochemical reaction with antibodies to low molecular weight cytokeratin (45–50 kDa) in all of the tumor cells. The literature is also reviewed and the presence of lipid droplets and the importance of the immunohistochemical positivity to low molecular weight cytokeratin for differential diagnosis from other malignant tumors, such as invasive adeno‐carcinoma or primary sarcoma of the pleura, or soft tissue sarcoma involving the pleura is discussed.

Solitary plasmacytoma of the submandibular lymph node with stromal amyloid deposits.

This report concerns a case of solitary extramedullary plasmacytoma of the left submandibular lymph node in a 56‐year‐old man. The tumor showed monoclonal proliferation of abnormal plasma cells which revealed highly positive stainings of both methylgreen pyronin and kappa light chain using the immunoperoxidase technique in the cytoplasms, and further revealed massive‘.amyloid’deposits in the stroma, which suggested the possibility of sequential amyloid formation upon the secretion of paraprotein by tumor cells.

Sclerosing encapsulating peritonitis and non-occlusive mesenteric infarction found at autopsy in a man who had undergone continuous ambulatory peritoneal dialysis: a histochemical and immunohistochemical study.

This is a report of a post‐mortem histological, histochemical, and immunohistochemical examination of a rare case of sclerosing encapsulating peritonitis (SEP) and non‐occlusive mesenteric infarction (NOMI), two serious complications of continuous ambulatory peritoneal dialysis (CAPD), with which a man suffering hepatitis C virus (HCV)‐induced liver cirrhosis for 7 years and trauma‐induced paraplegia for 50 years had been treated for 1 year. The direct cause of death was encephalopathy caused by extreme hyperammonemia (11 250 μg/dL in serum). The autopsy revealed that the SEP had drastically reduced the length of the small intestine to 210 cm, 180 cm of which presented acute ischemic enteritis with Gram‐negative bacterial infection. Histological examination of the SEP revealed that the exterior was composed of normal serosal elastic lamina, but with a cocoon‐like appearance remarkably thickened by fibrosis to 3–8 times that of the normal subserosal layer and consisting of spindle cells and blood vessels, with some infiltration of mast cells and lymphocytes. The immunohistochemical examination of the spindle cells revealed few AE1/AE3(+) cells, HHF35(+) cells, and CD34(+) cells, many CD117(+) cells with slight proliferative activity based on MIB‐1 positivity (proliferation index <1%), but no CD44(+) cells. It was concluded that either the few CD34(+) and/or the many CD117(+) cells were mesenteric stem cells that had originated from the serosa, proliferated, then differentiated into myofibroblasts or fibroblasts, producing collagen and hyaluronic acid in the matrix, leading to the gradual formation of the SEP, which was induced by the continual irritation of CAPD.

MALIGNANT FIBROUS HISTIOCYTOMA SHOWING CYTOPLASMIC HYALINE GLOBULES AND STROMAL OSTEOIDS: A Case Report with Light and Electron Microscopic, Histochemical, and Immunohistochemical Study

A 56‐year‐old man died of widespread metastases of malignant fibrous histiocytoma (MFH) primarily developed in the left lower gingiva after a rapid clinical course is reported. Primary and metastatic tumors showed light and electron microscopic, histochemical and immunohistochemical characteristics of MFH together with cytoplasmic hyaline globules and stromal osteoids. Hyaline globules revealed periodic acid‐Schiff positive and diastase resistant reactions but not positive with any histochemical and immunohistochemical reactions. Osteoids were partially calcified and rimmed by osteoblastic tumor cells. The present case of MFH may provide difficulties in the differential diagnosis from some osteoid‐forming sarcomas in soft tissues with relation to the histogenesis.

A fatal case of fungal endocarditis of the tricuspid valve associated with long-term venous catheterization and treatment with antibiotics in a patient with a history of alcohol abuse

We report a fatal case of fungal (candidal) endocarditis of the tricuspid valve with clinico-pathologically interesting findings following and associated with candidal pneumonia during long-term central venous catheterization (CVC) for intravenous therapy and long-term treatment with antibiotics for bacterial and fungal infection in a patient with a history of alcohol abuse. We review the literature on fungal cardiac infection related to long-term catheterization and alcohol abuse, and discuss the pathogenesis.

Aneurysms of the renal arteries associated with segmental arterial mediolysis in a case of polyarteritis nodosa

This is the first report of segmental arterial mediolysis (SAM) accompanied with polyarteritis nodosa (PN), and manifesting aneurysms of the renal arteries. A 73‐year‐old woman was admitted to hospital because of a high fever. Laboratory tests showed leukocytosis with increased CRP level in the serum. Myeloperoxidase‐anti‐neutrophil cytoplasmic antibody (MPO‐ANCA) and proteinase 3 (PR3)‐ANCA were negative. There were no signs indicating infection or malignancy. After admission renal function rapidly deteriorated. Treatment was then started with daily oral prednisolone and hemodialysis. On the 40th day of hospitalization the patient suddenly became comatose. Cranial CT showed a subarachnoid hemorrhage. The patient died and an autopsy was performed. The pathological findings showed necrotizing vasculitis of the small arteries in various organs, but not associated with that of arterioles or renal glomerular lesions, indicating PN. Unexpectedly, the segmental arteries of the bilateral kidneys showed vascular lesions of dissecting aneurysms, indicating SAM. This case indicates that SAM is one of the causes of aneurysms in PN and is clinically important when the clinical course of PN patients rapidly advances.

Noradrenergic hyperinnervation in the heart of stroke-prone spontaneously hypertensive rats.

1. Noradrenergic (NA) nerve fibre distribution was investigated in the epicardium and myocardium of the heart in stroke‐prone spontaneously hypertensive rats (SHRSP) and was compared to that in normotensive Wistar‐Kyoto (WKY) rats. Fluorescent NA nerve fibres in the left and right epicardium of both strains aged 10, 30, 60, 90 and 180 days, and in the myocardium of left and right ventricles and the ventricular septum of both strains aged 30, 90 and 180 days were examined by the glyoxylic acid method. The distribution densities of NA nerve fibres were measured by quantitative image analysis.