Yoshiro Fukuda

The liver in systemic lupus erythematosus: pathologic analysis of 52 cases and review of Japanese autopsy registry data

We present pathologic findings for 52 livers (51 autopsy specimens and one wedge biopsy specimen) from patients with systemic lupus erythematosus (SLE). Hepatic congestion was the most common disease (40 livers), followed by fatty liver (38), arteritis (11), cholestasis (nine), peliosis hepatis (six), chronic persistent hepatitis (six), nonspecific reactive hepatitis (five), cholangiolitis (four), nodular regenerative hyperplasia of the liver (three), and hemangioma (three). The data obtained here suggest that arteritis of the SLE liver is more common than has been recognized previously. One patient had hepatic infarction complications induced by arteritis. On the basis of the findings in the present study and a review of the literature, we suggest that hepatic infarction resulting from arteritis is rare in SLE. On the other hand, while occurrence of nodular regenerative hyperplasia of the liver in SLE patients has been considered to be rare, our findings suggest that it may be more common than has been recognized previously. Although congestion and cholestasis may be acute terminal illnesses, fatty change is considered to be specific to the SLE liver. Statistical analysis indicates that exposure to a large dosage of glucocorticoids is a significant factor in the etiology of severe fatty liver. In addition, our review of Japanese autopsy registry data for 1,468 patients with SLE indicates that the incidence of chronic liver diseases in SLE autopsy cases is as follows: chronic hepatitis, 2.4%; cirrhosis, 1.1%; and liver fibrosis, 0.8%.

Effect of disuse on the ultrastructure of the achilles tendon in rats

SummaryWe examined the influence exerted, through disuse of the hindlimb, on the collagen fibres of the achilles tendon in rats. With disuse the body mass decreased by 28%, and the mass of soleus muscle decreased by 20%. A decrease in the surface area and diameter was observed in the experimental group when compared to the control group. A histogram of the collagen fibres showed a decrease of the thick fibres in the experimental group. The maximum surface area of collagen fibres in the experimental group was seen to be only 43% of that of the control group. These results showed a decrease in the thickness of the collagen fibres of the achilles tendon through disuse. This seemed to suggest that resistance to tension is decreased by disuse.

Induction by degraded carrageenan of colorectal tumors in rats.

Degraded carrageenan derived from the red seaweed Eucheuma spinosum was given to Sprague-Dawley rats through the diet, in drinking water or by stomach tube for up to 24 months. Carrageenan-induced squamous cell carcinomas, adenocarcinomas and adenomas in the colorectum were observed. Some rats had metastases to the regional lymph nodes of squamous cell carcinomas. These results show that degraded carrageenan is carcinogenic to the colorectum of the rat.

Treatment of biliary atresia: A study of our operative results

The operative results in 87 biliary atresia cases were investigated from the aspect of the histologic findings in the liver and the remnant of the extrahepatic bile ducts, and the details of the operative procedures. The degree of liver fibrosis, the liver cell changes, and the type of extrahepatic bile ducts are closely related to our operative results. Our operative results have been improving since 1977 due to the advancement of microsurgical techniques and a new type of operative procedure for prevention of ascending cholangitis. Twenty-five of 29 cases (86.2%) surgically corrected are alive, showing bile excretion, and are in a satisfactory general condition.

A HISTOPATHOLOGICAL STUDY OF THE LIVER IN PARAQUAT POISONING: –An Analysis of Fourteen Autopsy Cases with Emphasis on Bile Duct Injury–

Fourteen autopsy cases of paraquat poisoning were studied. Seven of the eight patients who died within 4 days after the ineestion of paraquat showed hepatocytic injury, and three of them revealed bile duct injury. Hepatocytlc injury was similar to that of carbon tetrachloride intoxication. Bile duct injury consisted of epithelial changes of the bile ductules and bile ducts. Cholestasis in the bile ducts was produced by the injury. The affected blle ductules and ducts had hydropic and necrotic epithelium, associated with the infiltration of neutrophils and histiocytes in the lntraductal and periductal tissues. The severity of bile duct injury increased gradually from the bile ductules to the septal bile ducts. The extrahepatic billary tract showed the same injury as the septal bile ducts in one case. It is considered that bile duct injury was produced by a direct corrosive effect of paraquat. Five of the six patients who survived more than 8 days revealed intrahepatic cholestasis, the pathogenesis of which was not clearly understood.

Angiostrongylus cantonensis: development following pulmonary arterial transfers into permissive and nonpermissive hosts.

The survival, growth, and egg-laying capacity of young adult Angiostrongylus cantonensis, surgically transferred from intracranial sites into pulmonary arteries, were studied. A variety of experimental animals (rats, guinea pigs, mice, and mastomys) were chosen as donor animals and as recipient hosts (rats, guinea pigs, and rabbits). These species were specifically chosen to span the spectrum of host permissiveness relative to worm development in an attempt to understand the mechanisms which underlie species-dependent resistance. Recipient animals were monitored not only for the development of parasites per se but also for antibody production and histopathologic changes. The results indicated that these procedures were technically feasible, with good worm development following intra-rat transfers, as early as 15 days after initial exposure. Studies were performed to analyze the constraints of development both on initial, i.e., prelung and subsequent i.e., postlung development. When worms were obtained from permissive species such as rat or mastomys, transfer into rats resulted in good growth and development; however, worms which developed initially in exposed mice or guinea pigs developed less well in the rat. Conversely, worms which developed initially in permissive host such as the rat, when transferred into a variety of less permissive hosts such as the guinea pig and rabbit, apparently did not survive and caused significant morbidity and mortality within the nonpermissive host. Histopathologic evaluation revealed a strong eosinophilic perivascular and peribronchiolar infiltration as well as granulomatous reactions surrounding the worms in the lungs of recipient guinea pigs and rabbits, changes not observed in the lungs of permissive rat recipients. As reaginic antibody responses were also more prominent in nonpermissive than in permissive animals, it is possible that IgE responses may be more directly related to the phenomenon of morbidity and/or permissiveness than are other aspects of immune response. In support of this contention was the finding of nearly equivalent hemagglutinating antibody production between permissive rats and nonpermissive guinea pigs and rabbits.

PATHOLOGICAL STUDY ON BANTI'S SYNDROME

The liver and spleen of forty‐three autopsy and eighty‐one operated cases with Bantis syndrome and the control cases were examined histopathologically and histometrically, and the obtained results are summerized as follows.

Necrotizing Sialometaplasia in the Mouth Floor Secondary to Reconstructive Surgery for Tongue Carcinoma

Necrotizing sialometaplasia is a benign inflammatory process, which histologically can mimic squamous cell carcinoma. A 63‐year‐old man underwent left hemiglossectomy involving transplantation of a myocutaneous flap for squamous cell carcinoma of the tongue. One month after the operation, necrotizing sialometaplasia occurred in the minor salivary gland tissue of the mouth floor, compressed by the necrotic flap. This case is very unusual because of the ocurrence of necrotizing sialometaplasia in the floor of the mouth. The etiology of the lesion was considered to be ischemia secondary to compression by the necrotic myocutaneous flap. Acta Pathol Jpn 41: 689–693, 1991.

INFANTILE GM1-GANGLIOSIDOSIS WITH MARKED MANIFESTATION OF LUNGS

GM1‐gangliosidosis is a disease characterized by abnormal accumulation of GM1‐ganglioside in the brain and viscera. The disease is characterized by clinical findings similar to Hurlers disease and pathologic features resembling Niemann‐Picks disease but with involvement of the glomerular epithelium. A 14‐month‐old boy, clinically diagnosed as GM1‐gangliosidosis, died of respiratory insufficency and was autopsied except for the brain. Biochemically, marked increase of GM‐ganglioside in the viscera was demonstrated. Pathologically, the foam cells were present in the viscera. Some parts of the cytoplasmic vacuoles in the lungs and spleen contained osmiophilic fibrillar material electron‐microscopically. This case was characterized by marked accumulation of foam cells in the pulmonary alveolar spaces.

Induction of colorectal adenocarcinoma in rats by amylopectin sulfate

The carcinogenicity of orally administered amylopectin sulfate was studied in F344 rats. Amylopectin sulfate induced adenomas and adenocarcinomas in the rat colorectum. The incidences of tumor induction in groups that were given a 5% diet of amylopectin sulfate for 3, 6 and 9 months were 2 out of 20 rats (10%), 9 out of 20 rats (45%) and 12 out of 20 rats (60%), respectively. Squamous metaplasia of the colorectum persisted in all rats and progressed irreversibly. Amylopectin sulfate was deposited in the colorectal lamina propria, submucosa and regional lymph nodes. Amylopectin sulfate induced a lesion similar to that produced by degraded carrageenan in the rat colorectum.