Biomedical subjects
Publications and source records attributed to M Kojiro.
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A 60-year-old woman with a left ovarian tumor had a high level of serum estrogen and alpha-fetoprotein (AFP). Serum estrogen levels decreased to the normal level shortly after the operation. The resected tumor presented marked luteinization of stromal cells, and immunohistochemically, AFP was found to be positive in some tumor cells.
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Fourty three autopsy cases of cholangiocarcinoma and 18 cases of Thorotrast-related cholangiocarcinoma were macroscopically studied. They were classified into two types, according to the intrahepatic location of the tumors; middle-peripheral type and hilar type. Most Thorotrast-related cases (83%) were middle-peripheral type, while the non-Thorotrast-related cases were hilar type (68%). According to the gross characteristics of the tumor. They were classified into four gross types: infiltrative type (54%), nodular type (21%), periductal type (18%), and diffuse type (7%). Non-specific liver cirrhosis (mixed macro and micronodular type) was associated in 4 of non-Thorotrast related cases, and the association of biliary cirrhosis was found in 3 of the non-Thorotrast cases of the hilar type.
A 68-year-old male was admitted to the Kurume University Hospital with a diagnosis of hepatocellular carcinoma (HCC). Serum CEA levels ranged from 3.7 ng/ml and 6.8 ng/ml during the course. Serum AFP levels were at normal range at admission and elevated to 13,250 ng/ml 3 months before death. He died of liver failure 17 months after admission. An autopsy disclosed diffuse infiltrative tumors distributed throughout the liver with metastasis to the bilateral lungs. Histologically, tumors of the liver consisted of elements of both HCC and cholangiolocellular carcinoma. Cholangiolocellular carcinoma is believed to occur from the canals of Hering or cholangiole, and this case may provide further information as to the histogenesis of combined HCC and cholangiocarcinoma.
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A new cell line (DMBA-OC-1) from 7,12-dimethylbenz (a) anthracene (DMBA) which induced ovarian carcinoma in rat was established and characterized. DMBA-OC-1 cells showed a paving-stone-like growth pattern at around the 10th to 20th passage, but at the point exceeding the 40th passage the cells showed a spindle form, having strong trends both towards flocculation and piling-up. Furthermore, diastase-resistant PAS-positive and hyaluronidase-digested Alcian blue positive substances were observed in cytoplasms. The cells also showed marked phagocytic activity. These findings suggest that DMBA-OC-1 cells are most likely the site of mesothelial cell origin.
This report describes a case of primary aortoduodenal fistula (PADF) in an 83 year-old male admitted a local hospital with massive hematemesis. Endoscopy failed to reveal the site of hemorrhage. During his course, he had two episodes of hematemesis and melena. On the 77th hospital day, he died of acute hemorrhagic shock resulting from massive hemorrhage in the gastrointestinal tract. An autopsy revealed adhesion and a fistulous communication between an atherosclerotic abdominal aneurysm and the third portion of the duodenum. Primary aortoenteric fistula (PAEF), including PADF, is an uncommon but lethal complication of aortic aneurysm. Since fistula formation occurs most frequently between the abdominal aorta and duodenum, upper gastrointestinal endoscopic examination and aortography at the earliest possible moment are necessary to obtain a correct diagnosis before surgery.
A cutaneous meningioma in the left upper eyelid was found in a 51-year-old woman. Histologically, arachnoid villi-like feature, meningothelial structure, and numerous psammoma bodies were evident. In the present case, it was predicted that the tumor originated from the extracranial arachnoid cell rests.
A human hepatocellular carcinoma (HCC) cell line (KYN-1) has been established from a resected HCC of a 58-yr-old Japanese, male patient with HCC. Original resected HCC was moderately differentiated and proliferated in a solid pattern with vague trabecular structure in part. This cell line has been maintained for 10 mo. through 50 passages. Morphological features of KYN-1 cells demonstrated one or more large, round-to-oval nuclei with prominent nucleoli and eosinophilic polygonal-to-spindle abundant cytoplasm. In addition, some of these cells contained mucicarmin-positive materials in the cytoplasm. The cells exhibited a typical epithelial feature with pavementlike cell arrangement, and lacked contact inhibition. The doubling times of the cells grown in a serum-containing and a serum-free medium were about 31 h and 10 to 11 d, respectively. Functionally, KYN-1 cells produced albumin, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), ferritin, beta 2-microglobulin (BMG), and alpha 1-anti-trypsin (AAT). Positive reactions for albumin, AFP, CEA, and ferritin were identified in the cells by immunohistochemical techniques. Chromosome study revealed the chromosome number in a range from 61 to 74 without mode. The tumorigenicity of KYN-1 cells was identified by the tumor formation after subcutaneous inoculation of the cells into nude mice. The developed tumor showed compact growth of the tumor cells with gland formations containing mucicarmin-positive materials. Features of adenocarcinoma were identified by electron microscopy. The tumor cells were also identified to contain albumin, AFP, CEA, ferritin, and AAT by immunohistochemical techniques. AFP, CEA, and BMG were detected in the sera of nude mice. Thus, KYN-1 cells represented the morphologic features of adenocarcinoma, retaining some characteristics of original HCC. These findings suggest that KYN-1 is a new human HCC cell line with transformation to adenocarcinoma, which will provide useful information to clarify the histogenesis of combined hepatocellular and cholangiocellular carcinoma.
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The association between hepatocellular carcinoma (HCC) and chronic hepatic schistosomiasis (CS) was studied by reviewing, 4,886 autopsies in adults during the past 20 years. In 229 cases of CS, 59 (25.7%) also had HCC. Among cases without CS, 399 (8.5%) had HCC. The incidence of HCC in patients with CS was significantly higher than that of other autopsy cases (p less than 0.01). Serum HBsAg was positive in 25.7% of 35 HCC cases with CS examined for hepatitis B virus (HBV) markers and anti HBs was positive in 10 of the 12 HBsAg-negative cases associated with CS, and in 62.1% of the other HBsAg-negative cases examined. Thus, most of HCC cases, including those associated with CS, probably had HBV infection at one time. Morphological examination revealed varying degrees of non-schistosomal hepatic changes, including macronodular or mixed macro-and micronodular cirrhosis, superimposed on schistosomal fibrosis in about two-thirds of the cases of HCC associated with CS. Although conclusive evidence whether or not schistosomal infection had a direct role in hepatocarcinogenesis could not be obtained, it was predicted that the additional non-schistosomal factors, particularly HBV infection, might play a synergistic role.
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Thirty-five autopsy cases of Thorotrast (TH)-related intrahepatic cholangiocarcinoma were morphologically studied with a comparison to 45 non-TH cases. Latent periods ranged from 25 to 48 years, with a mean of 34.1 +/- 6.6 years. As to tumor location, the peripheral-middle type, in which the main tumor was located in the periphery to middle portion of the liver, was the most common (89.2%) in the TH-related cases, and the hilar type, in which the main tumor was located in the hepatic hilum, was the most common (78.8%) in the non-TH cases. However, there was no close relationship between the distribution of TH deposits and tumor location by soft-X ray examination of the liver slices. Grossly, the massive type with an infiltrative growth was the most common both in the TH- and non-TH cases. Histologically, there were no remarkable differences between the two groups, and tubular adenocarcinoma with varying degrees of fibrous stroma was the most common. In noncancerous areas, proliferation of the bile ducts with slight to moderate atypism and ductular proliferation around Glisson's capsule were found in 30%, and 10%, respectively, of the TH-related cases. However, such changes were also found in the non-TH cases at almost the same incidence.
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The replacing growth of hepatocellular carcinoma (HCC) has been considered as a basic growth pattern at the tumor-nontumor boundary. In order to clarify the ultrastructural characteristics of HCC with the replacing growth, we have studied 59 surgical cases of HCC. At the tumor-nontumor boundary of HCC with the replacing growth pattern, the tumor cells grow to replace the hepatocytes along the liver cell cord, but oppress and distort the adjacent liver cell cord with varying degrees of aggregation of reticulin fiber. Hepatocytes and cancer cells are in direct contact, but some of the hepatocytes are compressed by cancer cells. The sinusoid in the non-cancerous area is continuous with the blood space in the cancerous tissue, and several layers of endothelial cells are often observed. Accordingly, it is predicted that sinusoidal blood through the portal vein and arterial blood through arterial tumor vessels may mix at the tumor-nontumor boundary.
A 68-year-old man with multiple myeloma and systemic amyloidosis also had nodular regenerative hyperplasia (NRH) of the liver. This unusual case is discussed and the association of NRH with various other systemic disorders are reviewed.