Shiro Kitamura

A hitherto unreported vascular tumor of the kidney: a proposal of "juxtaglomerular cell tumor".

A well encapsulated round tumor was found in the kidney nephrectomized from a young hypertensive woman. The main body of the tumor was composed of small vessels similar in caliber to the glomerular afferent arterioles and polygonal cells derived from them inbetween. These cells contained characteristic granules demonstrable by the Bowies procedure. Histological assumption of a renin‐producing tumor was substantiated by the demonstration of plasma renin activities before and after the surgery. The patients blood pressure returned immediately to normal after nephrectomy. A term of ‘iuxtaglomerular cell tumor’ was proposed to this hitherto unreported tumor. ACTA PATH. JAP. 18: 197–206, 1968.

Pathology of Tularemia

Tularemia is known as Yato-byo, which means wild rabbit disease. It was thus named by the late Dr. Hachiro OHARA, who presented a report entitled “Concerning an acute febrile disease transmitted by wild rabbits observed in 6 cases of this disease ” in 1925”’). It was only two days later in the same year when AOKI et al.(1)(2) reported about a new disease, which was transmitted from rabbit to man. Furthermore, IWAMOTO et aI.@) observed the histological changes of the lymphnodes removed from the same cases. In the same year, OHARA,(~~) succeeded to develop a typical tularemia in a human body by the voluntary assistance of his wife, in which experiment he painted the blood of the tularemiaaffected rabbit on the healthy skin of the back of her left hand. Through this rare experiment, it was definitely proved that Pasteurella tularensis could invade into and infect through the skin which was intact macroscopically. Then after, OHARA became aware of the existence of a similar disease in America, and in 1925, sent Francis a copy of his report together with the samples of the serum and lymphnodes of the patients. As the identity of Yato-by0 (Wild rabbit disease) of Japan and tularemia of America was established, both serologically and histopathologically, Francis named tularemia of Japan after OHARA’S name : “ OHARA’S Disease.”(5) Through the generosity of Dr. Shoichiro OHARA, son of the late Dr. Hachiro OHARA, the authors could have an opportunity to survey the studies on the epidemiology of tularemia and to examine the lymphnodes of the patients histologically. In addition, the comparative studies on the histology in tularemia and tuberculosis of the human material and the experimental animals have been carried out. The results will be presented in this paper through the following items. 1) Epidemiological observation of tularemia in Japan. 2) Pathological studies of the primary cutaneous lesion and the regional

An autopsy case of relapsing polychondritis

The first autopsy case of relapsing polychondritis in Japan in a 25‐year‐ old woman was presented. The disease began first in the nasal septum, and gradually involved both external ears and the respiratory tract.

THREE AUTOPSY CASES OF CHRONIC THYROIDITIS ASSOCIATED WITH OTHER DISEASES

Three atuopsy cases of chronic thyroiditis complicated with other diseases are reported and discussed. Case 1. She was found to have had goitre a t the age of 26 years, and since then the goitre was found repeatedly to become swollen until the time of admission. Cardiac catheterization revealed high pressure in the pulmonary artery (mean 69mm Hg), in the right ventricle (mean 46 mmHg) and in the right atrium (mean 9 mmHg), but a normal pressure of the pulmonary capillary. As to the tests for thyroid function; MBR was -13% and PBI was 4.47 per 1OOrn l . She was suddenly attacked by severe dyspnea and chest pain accompanied with cyanosis 6 months after hospitalization, and died on the next day. Marked intimal thickening and typical “glomoid structure” were seen in the peripheral branches of the pulmonary artery of both lungs. The heart was enlarged, showing typical appearance of cor pulmonale. The thyroid gland was enlarged, 47g in weight, having diffusely firm consistency and decreased collodial content. Histological exmaination revealed remarkable disappearance and atrophy of follicles with markedly reduced collodial content, in which a few acidophilic epithelia were detectable. In places remarkable increase of connective tissue was observed, accompanying moderate infiltration of plasma cells and lymphocytes. There were even lymph follicles, but except for one or two of the follicles (Fig. l), they usually lacked a germinal center. Small arteries showed advanced proliferative endoarteritis and plasma cells were infiltrated around the small veins. A woman aged 68 was hospitalized with symptoms of decompensated A patient, 33 years old female, was admitted to our Clinic.

Two autopsy cases of renal hypertension with hydronephrotic pyelonephritis due to fibrous retroperitonitis.

Two autopsy cases of renal hypertension with hydronephrotic pyelonephritis due to fibrous retroperitonitis are reported.

AN AUTOPSY CASE OF HYPERVITAMINOSIS D

An autopsy case of hypervitaminosis D was reported, in which vitamin D, 500×104 I.U., was administrated during a 6 months period and the patient died of uremia. Calcium was found to be deposited in the kidneys, lungs stomach, heart, blood vessels and esophagus. The mechanism involvoved in the calcium deposition was discussed.

Aschoff body induced by prolonged sensitization

Histological changes in the heart, especially on the formation of Aschoff body by prolonged sensitization with egg‐white for over one year were studied using 30 rabbits.

Histological studies of radiation pneumonitis.

Many clinical and experimental observations have been made on pulmonary lesions after roentgen irradiation of the thorax in foreign countries. In our country, however, the first autopsy case of radiation pneumonitis was reported in 1942(4’7), and until recently only a small number of the cases has been mentioned, probably owing to the low voltage of the X-ray irradiated. With the use of high voltage X-ray, radium and Co60, radiation pneumonitis has considerably increasedc6> 7 9 19), about which, however, pathological studies with human materials arc comparatively rarec2’ 33 5 9 11> 203 22), and there have many opinions on the mechanism in the development of pulmonary fibrosis resulting from irradiation. In this paper pathogenesis of radiation pneumonitis will be discussed from a morphological point of view.

EXPERIMENTAL RHEUMATOID ARTHRITIS-LIKE FEATURES INDUCED BY PROLONGED SENSITIZATION WITH FOCAL ANTIGENS

Prolonged sensitization with emulsion of an autologous or isologous subcutaneous abscess of Arthus type induced by injection of hen egg‐white was performed in 34 rabbits which were divided into (high responder and intermediate responder groups (H‐ and M‐groups) according to individual difference of immune responses. The development of a rheumatoid factor‐like substance (RFLS) was demonstrated after 30 experimental days and subsequently observed in 21 out of 33 rabbits. There was no significant difference in the incidence of RFLS between both groups. As to the relation between the development of RFLS and types of focal antigens, the group of the autologous W‐substance showed a higher incidence of RFLS than the N‐substance. Acute and/or chronic synovitis was demonstrated in 13 of 33 rabbits and inflammatory changes were more intensive and extensive in the later period of experiment. Presence of RFLS in the affected synovial tissues, chiefly in the cytoplasm of plasma cells and mononuclear cells, occasionally in a free state was revealed by immunofluorescent study, and depositions positive for IgG and beta 1C were observed in the wall of blood vessels and fibrinous thrombi in the affected synovial tissues.

AN AUTOPSY CASE OF RENAL DISEASE SIMILAR TO LIPOID NEPHROSIS MODIFIED BY STEROID TREATMENTZ

An autopsy case of a 20 year‐old female with lesion similar to those of lipoid nephrosis and given a large amount of steroid hormones was reported. The kidneys showed peculiar findings which were similar to those of diabetes mellitus and possibly modified by long‐standing use of steroids. In the present case, however, exudative lesions were prominent and nodular lesions were scanty in contrast with those of Kimmelsteil‐Wilson syndrome.