akeuchi T

Nucleolar Organizer Regions in Hepatocarcinogenesis Induced by N-2-Fluorenylacetamide in Rats: Comparison with Bromodeoxyuridine Immunohistochemistry

The number of silver‐stained nucleolar proteins (AgNOR) was counted in preneoplastic and neoplastic rat liver lesions induced by N‐2‐fluorenylacetamide (FAA) and was compared with that of bromodeoxyuridine (BrdU)‐incorporating cells detected immunohistochemically using monoclonal antibody against BrdU. Male ACI/N rats were given diet containing 200 ppm FAA for 12, 16 or 20 weeks to induce hepatocellular foci and tumors. The mean numbers of AgNOR stained by a one‐step silver colloid method and BrdU‐labeling indices in various liver cell lesions were as follows: nontreated liver (n = 20), 1.20 and 0.08; nonlesional areas (n=20), 1.33 and 0.13; altered liver cell foci (n = 80), 2.04 and 4.05 [eosinophilic cell type (n = 20), 1.78 and 1.82; clear cell type (n=20), 1.45 and 1.77; basophilic cell type (n=20), 1.99 and 4.58; hyperbasophilic cell type (n=20), 2.94 and 8.02]; neoplastic nodules (n = 10), 3.11 and 2.99; hepatocellular carcinomas (n = 10), 7.22 and 8.29. Thus, the mean number of AgNOR and the value of BrdU‐labeling index were well correlated and both values showed a stepwise increase from normal liver cells to liver cell carcinoma, although some scatter was present. These data suggest that mean number of AgNOR may reflect the cellular kinetics in rat hepatocarcinogenesis, and the one‐step silver colloid method for demonstration of AgNOR may therefore be a simple and useful staining to examine the proliferative nature of cells.

Nucleolar organizer regions in rat urinary bladder tumors induced by N-butyl-N-(4-hydroxybutyl)nitrosamine

SummaryThe number of nucleolar organizer regions (NORs) stained by the one-step silver colloid method was measured in preneoplastic and neoplastic bladder lesions induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in rats. Male ACI/N rats, 6 weeks of age, were given 0.05% BBN in drinking water for 5, 8, 12, 18 and 30 weeks to induce preneoplastic and neoplastic transitional cell lesions. The mean numbers of silverstained NORs (AgNORs) in such lesions were as follows: untreated transitional epithelium (n = 6), 1.26 ±0.09; transitional cell epithelium outside focal lesions (n= 10), 1.75 ±0.10; simple hyperplasia (n= 10), 2.01 ±0.15; papillary or nodular (PN) hyperplasia (n= 10), 2.15±0.19; transitional cell papilloma (n= 5), 2.37 ±0.12; transitional cell carcinoma (n= 5), 3.52 ±0.23. Thus, the mean number of AgNORs showed a step-wise increase from untreated and treated, histologically normal transitional epithelium through simple hyperplasia and PN hyperplasia to transitional cell papilloma and carcinoma. These results suggest that the mean number of AgNORs may reflect the proliferative nature of bladder lesions induced by BBN, as reported in preneoplastic and neoplastic lesions in other organs. PN hyperplasias were classified into two types based upon the mean number of AgNORs, indicating that they include reversible and irreversible changes in contrast with simple hyperplasia which is reversible change.

Endovascular Embolization of a Renal Artery Aneurysm Using Interlocking Detachable Coils

A 51-year-old woman with a renal artery aneurysm was successfully treated with endovascular embolization using interlocking detachable coils. The parent vessel was spared, leading to preservation of the uninvolved portion of the kidney.

Fine-needle aspiration cytology of xanthogranulomatous pyelonephritis

Fine-needle aspiration cytology of xanthogranulomatous pyelonephritis in a fifty-seven-year-old Japanese woman is reported. Foamy cells and cells showing a gland-like pattern originating from degenerative renal tubules were found in the aspirated smears. Multinucleated giant cells and cells with pale yellowish cytoplasm were seen in the imprint smears at operation. These findings were diagnostic for xanthogranulomatous pyelonephritis. The cytologic diagnostic differences among xanthogranulomatous pyelonephritis, well-differentiated renal cell carcinoma, and renal oncocytoma are also described.

Significance of AgNOR counts for distinguishing carcinoma from adenoma and hyperplasia in parathyroid gland

Nucleolar organizer region proteins, which can be stained and visualized by an argyrophil technique (AgNORs), are markers of cell activities, such as DNA transcription and proliferation, and they are useful for differential diagnosis between benign and malignant tumors. We counted both AgNOR numbers in 25 parathyroid lesions (three carcinomas, 11 adenomas, 10 hyperplasias, and one hyperplasia with carcinoma) to determine if the AgNOR number could be useful as a diagnostic aid in parathyroid neoplasms and hyperplasias, because it is often difficult to histopathologically distinguish among these lesions. The AgNOR numbers were significantly higher in carcinomas (3.18 +/- 0.05) than in adenomas (1.67 +/- 0.30, P < .001) or hyperplasias (1.85 +/- 0.16, P < .001), but there was no significant difference between adenomas and hyperplasias. These results suggest that AgNORs may be useful as an adjunct to discriminating carcinomas from adenomas or hyperplasias in the parathyroid gland.

Primary signet-ring cell carcinoma of the urinary bladder.

An unusual case of the signet-ring cell carcinoma of the bladder was reported. A 62-year-old Japanese male had a three-month history of intermittent, painless and gross hematuria. He was found to have a small egg-sized bladder tumor near the right ureteral orifice. A cytologic diagnosis of signet-ring cell carcinoma was made on a bladder washing and was confirmed by cytoscopic biopsy and surgical specimens.

A pretreatment nomogram predicting recurrence- and progression-free survival for nonmuscle invasive bladder cancer in Japanese patients

PurposeOur aim was to provide nomograms that allow urologists to easily calculate a nonmuscle invasive bladder cancer patient’s risk of recurrence and progression.Materials and methodsWe retrospectively analyzed 800 nonmuscle invasive bladder cancer patients newly diagnosed between 1991 and 2001 from the Gifu urothelial cancer registry program. We developed the nomogram using the original 500 patients and validated it using the remaining 300 patients. The prognostic factors of recurrence and progression were identified by multivariate analysis in 500 patients.ResultsIn the multivariate analysis, tumor number, shape, grade, and intravesical instillation were associated with recurrence-free survival. Tumor shape and grade were associated with progression-free survival. Six factors for recurrence and three factors for progression were used to make the nomogram. Using the original 500 patients who were modeled for the nomogram, the areas under the receiver operating characteristic curves (AUCs) were calculated to be 0.61 for recurrence and 0.71 for progression. To validate nomogram performance, we applied an additional 300 patients to the nomograms. The AUCs were 0.57 for recurrence and 0.67 for progression.ConclusionsThe nomograms that have been developed can be used to predict the probability of recurrence and progression of nonmuscle invasive bladder cancer.

Malakoplakia of urinary bladder following cadaveric renal transplantation.

Malakoplakia of the urinary bladder following cadaveric renal transplantation in a twenty-two-year-old woman is reported. Urinary tract infection with Escherichia coli persisted postoperatively. Three years later, gross hematuria and fever occurred. Yellow-tan mucosal plaques or nodules were observed cystoscopically, and histologic examination revealed malakoplakia of the urinary bladder with characteristic foamy histiocytes containing Michaelis-Gutmann bodies.

Nucleolar Organizer Regions in Prostate Cancer

A silver colloid technique for the staining of nucleolar organizer regions (NORs) was applied to paraffin sections of 52 clinical prostate cancers, 5 incidental carcinomas of the prostate, 12 benign prostatic hypertrophy (BPH) specimens and 7 normal prostates. The mean numbers of silver-stained NORs (AgNORs) in these lesions were 3.12 +/- 0.52 in clinical cancer, 2.65 +/- 0.64 in incidental cancer, 1.66 +/- 0.16 in BPH, and 1.76 +/- 0.22 in normal prostate. There was a statistically significant difference in agNORs numbers between cancer and benign prostatic tissues (p < 0.001). However, no significant difference was observed in AgNORs numbers between incidental and clinical carcinoma of the prostate. In clinical cancer, only poorly differentiated adenocarcinoma showed a statistically larger number of AgNORs than the well or moderately differentiated group (p < 0.02). Correlation between AgNORs numbers and clinical stage was not obvious. There was no relationship between the number of AgNORs and serum values of tumor markers such as PAP, PSA and gamma-Sm. Moreover, the AgNORs numbers did not show a relation to decreasing rates of serum marker levels during successful anti-androgen therapy. If the patients with prostate cancer were divided into two groups by 2.9 of AgNORs number, the group with the smaller number of AgNORs (n = 14) was found to have a tendency towards a longer disease-stabilizing period than the larger group (n = 17).

Adjuvant chemotherapy for uroepithelial transitional cell carcinoma

SummaryThe effectiveness of adjuvant chemotherapy in transitional cell carcinoma of the bladder (T1/G3 and >=T2) and the upper urinary tract were evaluated. Among a group of 136 patients (male 107, female 29) with such tumors, complete tumor resection was possible in 108, in whom durationof survival and disease-free interval with or without chemotherapy were compared. The combination of antineoplastic agents used was changed from 5-fluorouracil (5-FU)+vincristine (VCR)+bleomycin (BLM) or pepolomycin (PEP)+mitomycin C (MMC) or 5-FU+VCR+PEP+cyclophosphamide (CPM)+adriamycin (ADM) to CPM+ADM+cis-platinum (DDP) or methotrexate (MTX)+vinblastine (VBL)+ADM+DDP. Of the 59 patients in the chemotherapy group, 23 (39%) had side effects due to the treatment; however, fever and gastrointestinal symptoms were the chief adverse effects and were well tolerated. The 5-year survival rate and mean disease-free interval in the chemotherapy group were 76.3% and 24.6+ months, respectively, in bladder cancer patients, and 78.2% and 25.8+ months in those with upper urinary tract tumors. However, in the nonchemotherapy group (n=49) the corresponding values were 62.7% and 21.1+ months in patients with bladder cancer and 67.3% and 42.0+ months in those with upper urinary tract tumor. There was a statistically significant difference (P<0.05) in the disease-free intervals of the two treatment groups for bladder cancer patients. Recurrence, regardless of time, was observed in 25% of chemotherapy cases and in 65% of non-chemotherapy cases, and this difference was also statistically significant (P<0.001). These results suggest that adjuvant chemotherapy for uroepithelial transitional cell carcinoma may be effective in extending survival and significant by protracting the disease-free period, especially in cases of advanced bladder cancer.