Biomedical subjects
Publications and source records attributed to M Takemiya.
A case of congenital, solitary, cutaneous mesenchymal hamartoma in the palm of the left hand is reported. The mass was composed mainly of an intimate mixture of fibrocollagenous bundles and islands of mature fat cells, distorted blood vessels with smooth muscle in the wall, and eccrine sweat glands. Many mast cells were scattered throughout the fibrocollagenous bundles. The mast cell may be an important cell in this hamartoma.
Between 1976 and 1988, 135 patients with solar keratosis (SK) and 53 patients with squamous cell carcinoma (SCC) on the sun-exposed skin, but without apparent preceding diseases such as burn scars, chronic radiodermatitis, chronic arsenic poisoning, or xeroderma pigmentosum, were encountered. Sixteen of the SCC patients also had SK on other areas of sun-exposed skin. There were 31 SCC patients also showing SK (SK-SCC) and 22 SCC not showing SK (DN-SCC) within the same histologic sections. The mean ages of the patients with SK-SCC and with DN-SCC were similar. Metastases to regional lymph nodes were observed in 5 SK-SCC patients, of whom 3 died of the disease, and in 5 DN-SCC patients, of whom 4 died of the disease. The five-year post-operative survival rates were 70% in SK-SCC and 74% in DN-SCC; the ten-year post-operative survival rates were 70% in SK-SCC and 44% in DN-SCC.
From among 524 histologic specimens of seborrheic keratosis (SK), 29 showed acantholysis, not related to pemphigus, Darier's disease, actinic keratosis or acantholytic squamous cell carcinoma. Acantholysis was found in 24 (23.3%) of the irritated type of SK, almost exclusively in the squamous cell nests showing dyskeratosis and spongiosis between and around squamous eddies or horn cysts. Clinically, 65.5% of the lesions were located on the face and scalp, 20.7% on the trunk and 13.8% on the limbs. It was speculated that dyskeratotic, degenerative changes of the keratinocytes together with spongiosis were responsible for the acantholysis.
A 77-year-old man was seen with florid, vegetating nodules in the umbilical, axillary and inguinal areas, scaly erythema in the trunk and fragile nails. Histologically, marked to moderate acanthosis and papillomatosis with intraepidermal abscesses composed of acantholytic cells, eosinophils and neutrophils were seen in the vegetating lesions which showed intercellular IgG deposit by the direct immunofluorescence technique. There were no circulating pemphigus antibodies. The lesions were successfully treated by topical corticosteroids. However, flaccid bullae with hypopyon showing subcorneal acantholysis and intercellular IgG deposits continued to develop. After 3 1/2 years, circulating pemphigus antibody of IgG2 subclass was demonstrated.
A case of Bloom's syndrome with lung cancer treated by radiation therapy is described. Squamous cell carcinoma of the lung responded well to a tumour dose of 50.4 Gy. The most serious complication of therapy was an oesophageal stricture induced by only 30.6 Gy to the mediastinum. Brief reviews of radiation-induced oesophageal stricture and radiosensitivity in Bloom's syndrome are presented.
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A 38-year-old Japanese male with Bloom's syndrome (BS) and porokeratosis of Mibelli (PM) developed multiple carcinomas of the skin and lung. There were multiple, spontaneous chromosomal aberrations and frequent sister chromatid exchanges (SCE). Cutaneous delayed-type hypersensitivity reactions were defective and serum IgM was decreased. The lung cancer was treated with radiation, which was effective but caused a severe pulmonary atelectasis and esophageal stricture. The patient expired one-and-a-half years later because of pneumonia. Autopsy disclosed an adenocarcinoma of the colon. The concurrent PM was considered responsible for the occurrence of multiple skin cancers.
Substantial evidence has accumulated that the Sézary syndrome is grouped together as "cutaneous T-cell lymphoma" and forms a subset of T-cells programmed for helper interactions with B-cells in their production of immunoglobulins; IgA, IgG, and IgM. The authors describe an autopsy case of a 64-year-old Japanese man, with cutaneous T-cell lymphoma in association with IgE-type lambda hyperimmunoglobulinemia. The serologic and immunocytochemical studies suggest that Sézary cells from our patient are T-cell proliferations in association with IgE-specific helper activity. In addition, histiocytosis was interestingly noted, for the first time, in the generalized lymph nodes, spleen, and bone marrow by the autopsy. The cytoplasm of swelled histiocytes contained IgE-type lambda immunoglobulin by the PAP method that probably represented altered immunoglobulin.
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Seventy four white male Wistar rats were divided into two groups and given weekly subcutaneous injections of 30 mg 1,2-dimethylhydrazine (DMH) 2HC1/kg body weight for 10 or 15 weeks, respectively, and the histological properties and distribution of DMH-induced rat carcinomas were investigated. The carcinomas induced by DMH were classified mainly into mucin producing carcinomas and non-mucin producing ones. In the large intestine, the group treated for 15 weeks induced significant incidences of mucin producing carcinomas composed mainly of cells containing intracellular mucin. Mucin producing carcinomas consisted of poorly differentiated adenocarcinoma, signet ring cell carcinoma and mucinous carcinoma, and these often coexisted within the same tumor mass. Mucin producing carcinomas tended to develop in the proximal colon and caecum, while non-mucin producing carcinomas were frequent in the distal colon. This method was thought to be a useful model to study glycoproteins of cancer cells.
Two hundred twenty seven lesions of DMH-induced intestinal carcinomas of 68 male Wistar rats were investigated by means of histochemical and electron microscopic properties to study their histogenesis and mucinogenesis. Among the epithelial glycoproteins, surface glycoprotein on the microvilli with glycocalyces was distinguishable from mucin in the cytoplasm based on histochemical staining and ultrastructural findings. From the phenotypic characteristics of glycoproteins, it was suggested that DMH-induced carcinomas could be classified into mucin producing carcinomas composed mainly of cells containing intracellular mucins and non-mucin producing ones. The mucin producing carcinomas consisted of poorly differentiated adenocarcinoma, signet ring cell carcinoma, and mucinous carcinoma presumably resulting from various degrees of differentiation into goblet cells. Their staining attitude varied and cells with neutral mucin, sialomucin and sulphated mucin were observed in the signet ring cell carcinoma. In addition, abnormal synthesis of glycoproteins was observed with ConA-paradox staining and PATS/PB/KOH/PAS. These histochemical properties suggested irregulatory synthesis of glycoproteins in carcinomas. In non-mucin producing carcinomas, glycoproteins were found mainly on the apical surface and contained sialomucin. A deviated differentiation into an absorptive cell could form an intracytoplasmic cyst filled with an aggregation of glycocalyces, so becoming another type of signet ring cell.
The autopsy findings in a 58 year old female with the typical glucagonoma syndrome with heart muscle hypertrophy are described. Despite remission of a skin rash and hyperglucagonemia following removal of metastatic liver tumors, the patient died of massive cerebral hemorrhage caused by uncontrolled hypertension and septic cerebral angiitis. On the basis of surgical and autopsy materials, the tumors in the pancreas and liver were defined as malignant glucagonoma by histological, histochemical, immunohistochemical, and ultrastructural studies. The pathohistological changes in several organs that might be related to the hypersecretion of pancreatic glucagon are discussed.
The results of clinical endocrine and metabolic studies on a 57-year-old female with surgically and autopsy verified glucagonoma syndrome were presented. All of the clinical manifestations of glucagonoma syndrome so far reported in the literature were noted but there was no evidence indicating the presence of multiple endocrine adenomatosis. The plasma IRG level was always more than 20 times above the normal, and the IRG response to insulin and tolbutamide injection was abnormal and the results of the other endocrinological studies revealed less remarkable features, if any. The surgically removed metastatic tumor of the liver contained an enormous amount of IRG and an appreciable amount of IRI, indicating that the elevated plasma IRG was mainly of tumor origin. These results clearly indicate that in glucagonoma there is some abnormality in glucagon release from the tumor. In addition to these findings, hypocalcemia, cardiac left ventricular hypertrophy and gastrointestinal dysfunction reportedly due to hyperglucagonemia were also seen in this patient.
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