Yukio Tashiro

Systemic Lupus Erythematosus Associated with Multiple Nodular Hyperplasia of the Liver

Three autospy cases of systemic lupus erythematosus with uinique association of multiple nodular hyperplasia (MNH) of the liver, portal hypertension, and hypertensive pulmonary vascular disease are reported. None of the patients had received oral contraceptive or androgenic steroid, but they were treated with glucocorticoids for 2 to 11 years. Raynauds phenomenon, sclerodactyly, and mild impairment of the kidney were the common clinical features. Macroscopically, MNH is characterized by many nodules scattered throughout the non‐cirrhotic liver, and histologically, each nodule is made up of normal‐appearing hepatocytes and not encapsulated. Portal tracts are scanty in the nodules. MNH seems to be a regenerative‐hyperplastic process, but its true nature still remains unclear. Relationships between MNH and portal hypertension, MNH and pulmonary hypertension, and collagen disease and pulmonary hypertension are discussed. A brief review of the literature concerning multiple benign hepatocellular tumors similar to MNH is also presented. ACTA PATHOL. JPN. 32: 547∼560, 1982.

Small cell carcinoma (non-oat cell type) of the esophagus concomitant with invasive squamous cell carcinoma and carcinoma in situ: a case report

A case of double primary invasive carcinoma of the esophagus, consisting of well‐differentiated squamous cell carcinoma and non‐oat cell small cell carcinoma without squamous differentiation, is presented. This is the first reported case of a double or multiple primary invasive carcinoma of the esophagus in which one component is small cell carcinoma (oat cell or non‐oat cell). Furthermore, the mucosal epithelium around the non‐oat cell small cell carcinoma revealed multiple dysplasia and carcinoma in situ. These lesions were definitely separated from the invasive carcinoma and from each other. The results suggest that pure non‐oat cell small cell carcinoma of the esophagus without squamous differentiation is derived from the esophageal squamous epithelium, and is a variant of squamous cell carcinoma.

EXPERIMENTAL PHOSPHOLIPIDOSIS INDUCED BY 4,4′-DIETHYL-AMINOETHOXYHEXESTROL

The effect of a generalized phospholipidosis inducing drug, diethylamino‐ethoxyhexestrol (DH, a coronary vasodilator), was studied using rats. The initial alterations are characterized by the appearance of abnormal cytoplasmic inclusion bodies. At the early stage of DH administraion, they appeared near the Golgi apparatus. Histochemical and ultrastructural evidence showed that the inclusion bodies consisted of polar lipid, mainly of phospholipids. From cytochemical and biochemical observation, the lysosome was regarded as the primary site of the drug‐induced morphological changes. The drug‐induced abnormal cytoplasmic inclusion bodies were of three basic morphological types, i.e., multilamellated, crystalloid and finger‐print‐like bodies. Additionally, many intermediate forms were found showing structural features of those basic types. These drug‐induced cytoplasmic changes, namely storage of phospholipids, were considered to be reversible both morphologically and biochemically after the cessation of DH administration.

A Case of Crohn's Disease which Initially Presented with Diffuse Inflammation in the Rectum and Sigmoid Colon

Abstract: This case report describes a female patient with Crohn s disease who had diffuse proctosigmoiditis without a longitudinal ulcer or cobblestone appearance at the initial attack. She was treated with sulfasalazine on the presumptive diagnosis of ulcerative colitis. Two and a half months later, painful ulcers in the oral cavity and a deep longitudinal ulcer in the sigmoid colon were found, and a non‐caseous granuloma was revealed in the biopsy specimens taken from the sigmoid colon. A definitive diagnosis of Crohns disease was established from these findings and treatment with a corticosteroid was effective.