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Biomedical subjects

M Kojiro

Publications and source records attributed to M Kojiro.

At least 181 records · Page 10Linked to original sources

Distribution of albumin- and/or alpha-fetoprotein-positive cells in hepatocellular carcinoma.

Albumin (ALB)-positive cells were identified by an immunoperoxidase technique in 52 of 53 autopsy cases and in all of 13 surgical cases of hepatocellular carcinoma (HCC). The distribution pattern of ALB-positive cells could be classified into three groups: diffuse, localized, and sparse. The diffuse type was the most common pattern and was usually seen in well or moderately differentiated HCC, showing a trabecular growth pattern. The localized or sparse patterns were more frequent in poorly differentiated HCC showing a compact growth pattern. alpha-Fetoprotein (AFP)-positive cells were detected in 37 of the 53 autopsy cases of HCC and 11 of the 13 surgical cases. The number of AFP-positive cells and the intensity of the immunoperoxidase reaction were roughly proportional to serum AFP levels in most cases. In most regions of HCC, there seemed to be an inverse relationship between the number of ALB- and AFP-positive cells, suggesting tht most HCC cells synthesized only one of the two antigens studied. ALB-positive hepatocytes were found in all of the normal or cirrhotic livers examined and in the tumor-free regions of the HCC-containing livers. In contrast, AFP was not detected in nonneoplastic hepatocytes.

Adult↗

Atypical malignant histiocytosis. Its appearance as a single meningeal tumor or as multiple skin tumors.

We studied two unusual cases of malignant histiocytosis (MH). In one case, a solitary intracranial tumor developed in a 20-year-old man eight months before the characteristic symptoms of MH appeared. In the other, a 73-year-old man had multiple nodular skin lesions four months before malignant histiocytes appeared in his blood. In both, the tumor cells were identified as malignant histiocytes by light and electron microscopic, cytochemical, and cytoimmunological criteria.

Adolescent↗

Small multiple carcinoid tumors occurring in the ileum with a pseuodcystic liver metastasis.

A 49-year-old woman was admitted to the hospital with a palpable mass in the right hypochondrium. A laparotomy was performed under the clinical diagnosis of a solitary cyst of the liver. The cystic lesion of the liver was removed. Although the histological finding of the cyst wall showed a similarity to hepatocellular carcinoma of trabecular pattern, the tumor cells with uniform nuclei and little mitotic figure were positive for both argyrophil and argentaffin reaction. The pathological diagnosis was metastatic carcinoid tumor of the liver. There was no carcinoid syndrome nor the other clinical symptoms after the operation and various postoperative examination could not reveal a primary site of the carcinoid tumor. The cystic lesion of the liver recurred ten months after the first operation and a second laparotomy was performed to reveal the primary site in the ileum: three submucosal tumors, 0.8, 0.7, and 0.3 cm. in diameter, two of them, however, extended into the muscle wall or subserosa and conclusively, the small lesion of the ileum metastasized into the liver as a large pseudocystic lesion.

Carcinoid Tumor↗

[Malignant choroid plexus papilloma. An autopsy case report (author's transl)].

Malignant choroid plexus papilloma is a rare disease. The autopsy case of malignant choroid plexus papilloma being suggestive of the youngest in Japan, was reported. This 8-months-old baby had normal delivery history, and the development and growth were not eventful. The patient admitted to the University hospital because of projecting vomiting and meningeal irritating signs at 7.5 months in age, and septic meningitis was most suspected. He died 2 weeks afte the admission. At autopsy, a large papillary tumor with marked necrosis and hemorrhage was seen in the right lateral ventricle. The right lateral ventricle was almost replaced by the tumor. The metastasis to the brain base and the sheeding to the subarachinoidal space of the cerebellum were noted.

Cerebral Ventricle Neoplasms↗

Serum glutamic oxalacetic transaminase/glutamic pyruvic transaminase ratios in hepatocellular carcinoma.

Serum enzyme activities were studied in 131 cases of hepatocellular carcinoma (HCC), 76 cases of metastatic liver carcinomas (MLC) and 234 cases of hepatic cirrhosis. SGOT was elevated above SGPT in most of the time in these patients, SGOT/SGPT was greater in HCC compared with other groups, and that this ratio increased during the preterminal period more markedly in patients with HCC because of the significant increase of SGOT in the face of relatively stable SGPT. Preterminal rises of alkaline phosphatase and LDH activities were more pronounced in MLC. Leucine aminopeptidase activity exhibited no characteristic feature of diagnostic value. Of the five enzymes, SGOT changes were more closely correlated with the growth of HCC; SGPT reflected more of the liver parenchymal damage while SGOT was probably accounted for in part by tumor-derived GOT. Other clinical and pathological implications are discussed.

Alanine Transaminase↗

Clinicopathologic features of encapsulated hepatocellular carcinoma: a study of 26 cases.

The clinicopathologic features of 26 cases of hepatocellular carcinoma (HCC) surrounded by a grossly distinct capsule-like fibrous tissue were studied. The frequency of this type was 10.3% among autopsy cases of HCC. The mean age of the patients was 64.1 years, which was significantly older compared with that of 143 cases of nonencapsulated HCC. Hepatitis-B surface antigen in serum was positive in 18.7% of the cases studied, the positivity rate being lower than that of HCC in general. Histologically, the tumor was relatively well differentiated and the capsule was the product of slow expanding growth. Intravenous tumor invasion was less frequent compared with other types of HCC. Clinically, celiac angiography proves to be a most useful diagnostic method; a thick capsule may be demonstrated as a thin radiolucent rim around the mass. The clinical course from the early stage is protracted and, if detected early, this type of HCC may be removed surgically.

Adult↗

Angiographic demonstration of intrahepatic arterio-portal anastomoses in hepatocellular carcinoma.

Hepatic angiograms of 114 patients with hepatocellular carcinoma (HCC) were studied, particularly changes in the portal vein branches. Arterio-portal shunts of varying sizes, evidenced by opacification of intrahepatic portal branches, were seen in 72 cases (63.2%), with retrograde opacification of the portal vein trunk in 29 (25.4%). At least four types of shunts were found: (a) through a tumor thrombus in the portal branch, (b) in a retrograde direction via a peripheral tumor nodule, (c) through a small tumor invading or amputating an artery, and (d) through a tumor located near a major portal vein branch and supplied by a large, coiling artery. Postmortem angiography of the liver in 50 patients with HCC suggests that arterio-portal shunts are the result of the special vasculature in HCC and are highly diagnostic when accompanied by other angiographic changes.

Carcinoma, Hepatocellular↗

Carcinoid tumor occurring in cystic teratoma of the kidney: a case report.

Although carcinoid tumors have occurred rarely in benign teratomas of the ovary and the testis, we believe this case is the first reported of carcinoid arising in a benign cystic teratoma of the kidney. The patient was admitted to the Tagawa Hospital with a left abdominal mass and severe epigastric pain. Retrograde and intravenous pyelograms revealed marked dilatation of the left kidney; a renal tumor was diagnosed clinically. At operation, a polycystic tumor weighing 1400g was removed. Histologically, a carcinoid tumor was evident among teratoid tissues, such as columnar epithelium, cartilage, smooth muscle, and mucous secretory glands. The patient did not have a carcinoid syndrome and had an uneventful recovery.

Adult↗

Primary liver cancer coincident with Schistosomiasis japonica. A study of 24 necropsies.

The etiologic relationship of parasitic liver disease to primary liver cancer has long been debated. For this reason, a review of 4611 necropsies was carried out to determine the frequency with which hepatocellular carcinoma occurred in association with schistosomiasis. Of 227 cases of hepatocellular carcinoma, 24 (10.6%) were associated with schistosomiasis japonica. This was significantly higher than the incidence of this carcinoma without schistosomiasis (2.78%). The majority of the 24 cases exhibited the features of a mixed macronodular and micronodular cirrhosis (Gall's posthepatitic cirrhosis); this was super-imposed upon and caused a masking of schistosomiasis fibrosis. By radioimmunoassay hepatitis B antigen was positive in 27% of these cases. A review of the literature indicated that chronic schistosomiasis, on its own, is unlikely to be the cause of primary liver cell carcinoma. Histologic features resembling post-hepatitic cirrhosis combined with a high frequency of hepatitis B antigen suggest that viral hepatitis rather than S. japonicum is the more likely etiologic factor involved, or has a synergistic effect on carcinogenesis.

Adult↗

Pathology of early hepatocellular carcinoma: progression from early to advanced.

Based on the pathomorphologic studies of resected hepatocellular carcinoma (HCC) and biopsy materials from minute HCCs of the early stage, it has been clarified that the majority of minute HCCs around 1 cm in diameter are well differentiated. When tumors reach approximately 2 cm in diameter, approximately one-third of them display various combinations of more than two cancerous tissues of different histologic grades. In those HCCs, the areas of less-differentiated cancerous tissues are almost always surrounded by well-differentiated ones and diminish in size along with the increase of tumor size. Then, they are completely replaced by moderately to poorly differentiated cancerous tissues. Dedifferentiation phenomenon characterized by such a replacement of well-differentiated cancerous tissues by less-differentiated ones seems to be closely related to tumor proliferation in HCC. Thus, better therapeutic effects may be expected if HCCs are treated while they are well differentiated and are less aggressive.

Carcinoma, Hepatocellular↗

Establishment and characterization of a human combined hepatocholangiocarcinoma cell line and its heterologous transplantation in nude mice.

A human cell line (KMCH-1) derived from a surgical specimen of combined hepatocellular and cholangiocarcinoma has been established. The original tumor consisted of both hepatocellular carcinoma of the trabecular type and cholangiocellular carcinoma. This cell line has been maintained for 26 months through 75 passages. KMCH-1 cells show characteristics of adenocarcinoma on light and electron microscopy. They proliferate in culture in a pave stone arrangement. The doubling time of these cells at the 24th passage was 39 hr. Chromosome analysis revealed a chromosome number ranging from 60 to 98, with a modal number of 74. KMCH-1 cells produced tumors several months after subcutaneous and intraperitoneal transplantations into athymic nude mice. Histologically, the subcutaneous tumors were poorly differentiated adrenocarcinoma, while intraperitoneal tumors were moderately to well-differentiated adenocarcinoma. Hepatocellular carcinoma components were not observed. Thus, KMCH-1 cells demonstrate the feature of cholangiocellular carcinoma in vitro and in vivo. This KMCH-1 cell line is the first established combined hepatocellular and cholangiocarcinoma cell line and may contribute to further investigation of combined hepatocellular and cholangiocarcinoma.

Adenoma, Bile Duct↗

Combined hepatocellular and cholangiocarcinoma: correlation between CT findings and clinicopathological features.

PURPOSE: The purpose of this study was to clarify characteristics of combined hepatocellular and cholangiocarcinoma (HCC-CC) on CT and clinicopathological examinations. METHODS: Dynamic incremental CT was performed on 15 combined HCC-CC patients. CT of the early phase was started at 30 s and of the late phase at 120-140 s, after the start of contrast medium injection at a rate of 3 ml/s. The images and clinicopathological findings were retrospectively compared. RESULTS: Lesions grossly resembling HCC (HCC type, n = 6) were well enhanced in the early phase and changed to low attenuation areas in the late phase. In lesions grossly resembling CC (CC type, n = 9), 8 of 9 lesions were enhanced only at the peripheral portions in the early phase and changed to low attenuation areas or had only central portions enhanced in the late phase. The other CC-type lesion was not enhanced in either the early or the late phase. In all 15 cases, there was no dilatation of the intrahepatic bile ducts. Hepatitis B virus surface antigen was positive in five cases. Hepatitis C virus antibody was positive in 10 cases. Serum alpha-fetoprotein (AFP) levels were > or = 200 ng/ml in seven cases. CONCLUSION: In the CC type, enhanced CT images were compatible with CC, but positivities for virus markers and serum AFP levels were almost equivalent to those in HCC. Therefore, the CC type can be diagnosed as combined HCC-CC by evaluating virus markers and serum AFP levels with CT. In addition, no association of intrahepatic bile duct dilatation was considered to be a characteristic feature of combined HCC-CC.

Aged↗