Sohtaro Fukuchi

Bone metastasis from colorectal cancer in autopsy cases

The incidence of bone metastasis from colorectal cancer is reported to be 10.7% in autopsy cases. However, the characteristics of the primary cancers, as well as the patterns of bone metastasis, remain unclear. We analyzed the clinical and autopsy records of 118 patients with primary colorectal cancer treated either surgically or conservatively and eventually autopsied between 1970 and 1987 at Toranomon Hospital in Tokyo. Bone metastasis was detected in 23.7% (28/118). The average age of patients with bone metastasis was lower than that in patients without bone metastasis (P<0.02). Cancers to the rectum and cecum were accompanied by bone metastasis more frequently than cancers of other portions of the colon. Signet-ring cell carcinoma showed a high incidence of bone metastasis (P=0.041). Bone metastasis from colorectal cancer was associated with liver or lung metastases (P<0.0001). These results indicated that bone metastasis from colorectal cancer is not as infrequent as previously described.

Ectopic Sebaceous Glands in the Esophagus: Report of Two Cases

Abstract: Reports of ectopic sebaceous glands in the esophagus are rare. Six postmortem cases and eight antemortem cases have been reported. In 1990, we studied two patients with ectopic sebaceous glands in the esophagus that were found during endoscopy and confirmed histologically. These lesions macro‐scopically resembled gastric xanthomas.

Mucosal Regeneration of Gastric Ulcer Confirmed by Electronic Endoscopy

We studied the detailed surface structure and changes in the regenerated mucosa during the course of healing of recurrent gastric ulcers treated with lansoprazole or famotidine, using a magnifying electronic endoscope (videoendoscope) and a dye contrast method. The detailed patterns of regenerated mucosa were classified into five types: membranous, spindle-shaped, palisade-shaped, cobblestone-shaped, and almost normal structure. Initially, the membranous regenerated mucosa appears at the ulcer margin and grows into the spindle- and palisade-shaped regenerated mucosa. These latter types of mucosa change gradually into the cobblestone-shaped type, which finally develops into an almost normal structure. Lansoprazole appeared to bring about more rapid growth and changes of the regenerated mucosa than famotidine, although the difference was not statistically significant. We suggest that it is useful, in the assessment of gastric ulcer therapy, to observe the detailed patterns of the regenerated mucosa during the healing process using a magnifying electronic endoscope

A Case of Spontaneous Regression of Primary Malignant Lymphoma of the Stomach

A 62‐year‐old female who complained of discomfort in her upper abdominal region and a poor appetite had an endoscopically documented polypoid lesion with a shallow irregular central depression at the lesser curvature of the angulus. A diagnosis of malignant lymphoma was made following a gastric biopsy. A gastric endoscopy performed about 20 days later revealed a marked increase in size with an ulcerated surface the margin of which had an auricle‐like shape. These findings were compatible with a diagnosis of malignant lymphoma of the stomach. No medical therapy, such as antineoplastic agents, was given during the follow‐up period. A gastric resection was performed 1.5 months after the initial endoscopy. A detailed histopathological examination of the resected gastric specimen revealed a U1‐II type ulcer scar but no malignant lymphoma cells. Very few cases of a complete spontaneous regression of a malignant lymphoma of the stomach have been reported either within or outside of Japan though it is well known that lymphomas show rapid morphological changes in some patients who are followed‐up without any specific therapy. These rare case reports in the literature are reviewed and discussed together with our present case.

OBSERVATION OF THE LASER INDUCED FLUORESCENCE AT THE MUCOSA OF THE ALIMENTARY TRACT (SECOND REPORT)

We observed histologically the Argon laser induced fluorescence on the non-fixed and non-stained frozen section of biopsy specimens or tissue pieces of resected materials in the cases of gastric and colonic cancer . 1) The specific fluorescence of cancer cells could not be observed on the materials of gastric cancer. 2) Red dots of fluorescence were observed on the materials of colonic cancer in two among five cases. 3) The laser induced fluorescence is weak in general immediately after making up the section of the frozen materials. It increases gradually when the section is left at the room temperature. 4) Yellow fluorescence is found at the muscularis m. ucosae, the elastica interna of the artery and fibrous elements in the interstitial tissue immediately after making up the section of the frozen materials, and yellow-green fluorescence appears also in the cells of glandular and interstitial tissues in the course of time .