Shozo Takahashi

Chronic Graft-versus-Host Disease with Follicular Involvement

The clinical and histopathological findings in a 25‐year‐old Japanese male patient who suffered from chronic graft‐versus‐host‐disease (GVHD) with follicular involvement are described. The patient had been diagnosed as aplastic anemia and underwent an allogeneic bone marrow transplant (BMT). In the eighth month thereafter, pruritic follicular red papules developed over his trunk and extremities. A biopsy specimen revealed histological exocytosis of lymphocytes into the hair follicles and basal‐cell vacuolization of the follicular epithelium. Analysis of T‐lymphocyte subpopulations in the dermis revealed a predominance of CD4 positive cells. To our knowledge, several cases of acute follicular GVHD have been reported (1, 2); however, the occurrence of chronic GVHD with follicular involvement (chronic follicular GVHD) has not been clearly documented.

Cutaneous Metastasis of Renal Cell Carcinoma: An Electron Microscopic Study

A case of cutaneous metastasis of renal cell carcinoma in a 67‐year‐old man is described. Right side nephrectomy had been performed three years earlier, and a renal cell carcinoma was diagnosed. Following a bruise, the patient noticed an erythematous nodule on the scalp. Histological examination of this skin lesion showed atypical tumor cells consisting predominantly of clear cells with a honeycomb‐like or adenoid structure. Electron microscopic examination revealed that the tumor cells were divided into three groups: clear cells with abundant glycogen, dark cells with abundant mitochondria, and intermediate cells containing both glycogen and mitochondria in varying proportions. Some of the tumor cells with an adenoid pattern had a brush border‐like structure in the lumen. These results support the diagnosis of metastatic renal cell carcinoma. An electron microscopic approach may aid in diagnosis of cutaneous metastasis from renal cell carcinoma.

A case of erythromelanosis follicularis faciei with a unique distribution.

A 16‐year‐old Japanese boy with erythromelanosis follicularis faciei (EFF) with an unusual distribution is described. The clinical features of classic EFF consist of reddish‐brown discoloration of the skin with fine follicular hyperkeratosis in the preauricular areas, and occasionally on the temples and the lateral aspects of the neck. The present case is unique in that similar lesions also occurred on the auricles and eyebrows. Both light and electron microscopic findings of the lesions were consistent with the diagnosis of EFF.

ULTRASTRUCTURE OF INCONTINENTIA PIGMENTI ACHROMIANS, WITH SPECIAL REFERENCE TO MELANOCYTES AND NERVE ENDINGS

Studies of a new Japanese case of incontinentia pigmenti achromians were made by electron microscopy.