Tomomi Ogino

Medullary carcinoma with lymphocytic infiltration of the stomach. Clinicopathologic study of 27 cases and immunohistochemical analysis of the subpopulations of infiltrating lymphocytes in the tumor

The current study attempts to clarify the possible immune response that occurs in medullary carcinoma with lymphocytic infiltration of the stomach by an immunohistochemical analysis of the subpopulations of tumor‐infiltrating lymphocytes. This carcinoma was histologically characterized by the sparse population of small nests consisting of poorly differentiated carcinoma cells, widely separated by intervening nondesmoplastic stroma infiltrated uniformly with abundant lymphocytes frequently accompanied by lymph follicles. An immunohistochemical analysis revealed that T‐cells were evenly distributed throughout the tumor with intimate contact with individual carcinoma cells, except the lymph follicles consisted mainly of B‐cells. Because of the similarities of morphologic features and subpopulations of tumor‐infiltrating lymphocytes of this carcinoma to the normal lymphoid tissue, an organized immune response combined with cell‐mediated and humoral immunities against the invading carcinoma cells seemed to occur in this type of gastric carcinoma, resulting in a excellent prognosis compared with that in ordinary gastric carcinoma.

Endocrine differentiation of gastric adenocarcinoma. The prevalence as evaluated by immunoreactive chromogranin a and its biologic significance

The prevalence of endocrine differentiation of conventional gastric adenocarcinoma was evaluated on the 212 cases (including 62 mucosal carcinomas) of consecutively resected stomach for adenocarcinoma in our hospital using anti‐chromogranin A (CGA) antibodies. CGA‐positive cells were found in 28 of 150 cases (18.7%) as an integral tumor component. In immunocytochemistry and electron microscopic examinations, we could classify these 28 cases into three groups according to the distribution patterns of CGA‐positive cells. The first group consisted of 12 cases in which scattered CGA‐positive cells were located in neoplastic glands. The second group consisted of six cases of scirrhous carcinoma in which CGA‐positive cells were separated by fibrovascular tissue. The third group consisted of ten cases in which the positive cells were present in clusters. No definite correlation was recognized between the appearance of CGA cells and histologic types of predominance. In the analysis of the hormonal substances coexpressed by CGA‐positive cells, immunoreactive serotonin (SER) was found most frequently, and somatostatin (SS), gastrin (GAS), glucagon/glicentin (GLU/GLI), and peptide‐tyrosinetyrosine (PYY) like immunoreactivities were found in a few tumor cells. CGA‐positive cells occupied limited parts of the tumors in most cases, and they were noticeably more frequent in advanced stage cases. This might explain why endocrine differentiation reflects the dysexpression of the neoplastic stem cells. Furthermore, absence of mitotic figures in this type of cell and negativity of a single colony composed exclusively of CGA cells in metastatic foci suggested that these cells are in a dormant phase and are probably postmitotic.

HEPATOCELLULAR CARCINOMA ARISING IN THE ABDOMINAL CAVITY. An Autopsy Case of Ectopic Liver Origin

An unusual case of extrahepatic disseminating hepatocellular carcinoma in a 64‐year‐old man is reported. The initial symptom was abdominal fullness and progressive ascites. Alpha‐fetoprotein in the serum was 117,000 ng/ml. Exploratory laparotomy disclosed dissemination of tumor nodules throughout the abdominal cavity without any other possible primary tumor. CT scan, ultrasonography and hepatic angiography were unable to detect any tumor lesion in the liver. The final histologic diagnosis was hepatocellular carcinoma, although at first epithelioid mesothelioma was suspected. The present case of hepatocellular carcinoma was thought to have possibly developed from ectopic liver on the peritoneum. ACTA PATHOL JPN 38: 1575‐1581, 1988.

The effect of UFTM therapy on primary and metastatic colon cancer from the same human xenotransplanted into nude mice

Successful simultaneous transplants of a cancer of the ascending colon from a 60 year old woman, taken from 3 sites: the primary focus, a lymph node metastasis, and a hepatic metastasis, into nude mice yielded KHC (-P,-N,-H) strains. These three strains were compared under uniform conditions of nude mouse transplantation from the standpoints of morphological variation, growth rate, and sensitivity to chemotherapy. The results showed no major differences in morphology or growth rate. However, an effect on chemotherapeutic sensitivity was observed in KHC-P and KHC-N, with reduction rates of 25.8 per cent and 31.4 per cent, respectively, in the MMC only treatment group with large doses, and in KHC-N and KHC-H, with reduction rates of 46.5 per cent and 34.9 per cent, respectively, in the UFTM group. Chemotherapy sensitivity not only exhibited heterogeneity by site, but also differed according to the chemotherapeutic agent used. These results indicate that this method of nude mouse transplantation is a good experimental system for comparing primary foci and metastases under uniform conditions, and also strongly suggest the presence of heterogeneity in sensitivity to chemotherapy.

Minute Rectal Cancer Associated with Nodular Involvement —A Case Study—

Abstract: This study presents the case of a patient with minute type Ha rectal cancer with a diameter at its largest of only 5 mm, with infiltration as far as the submucosal layer (sm) and positive parietal lymph node metastasis.

Diagnosis for the depth of gastric cancer by endoscopic ultrasonography.

ラジアルスキャン超音波内視鏡を使用し, 胃癌36例を対象に超音波断層像による癌深達度の判定について検討した.正常胃壁は高エコー層, 低エコー層が交互に現れる5層構造として明瞭に認識出来た.癌巣は一般に低エコーレベルを呈し, 正常5層構造の中断・破壊・不整が深達度判定の指標となった.1群の壁在リンパ節では5mm以上に腫大したものは描出可能であった.正確な深達度診断には癌巣が超音波振動子と垂直方向に位置することが必要で, 幽門狭窄症例などこの条件を満たさない症例では描出不能であった.