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An autopsy case of renal cancer complicated with multiple oral ulcers is presented. Although serological tests were not available, double viral infection with herpes simplex virus and cytomegalovirus was suspected as causal agents in the retrospective examination. This infection may be a complication in the prolonged stage of cancer patients.

Two autopsy cases of adenoid squamous cell carcinoma of the oral mucosa proper are presented. Consecutive histologic examinations confirmed that adenoid transformation had occurred directly from within the pre-existing usual squamous cell carcinoma during the course of the disease. The adenoid pattern was reproduced in the lymph node metastases in both cases. The behavior and autopsy findings were not significantly different from those of usual squamous cell carcinoma of the oral mucosa.

Sj隸grenQの耳下腺について, 特にいわゆる筋上皮島を中心に観察した。試料は47歳の女性からの生検組織である。光顕的には腺実質は高度のリンパ性細胞で置換され, リンパ性組織内には筋上皮島が散見された。電顕的には, 1.筋上皮島構成細胞は明調細胞, 暗調細胞と筋上皮細胞の3種の上皮細胞で, これら細胞間に浸潤したリンパ球, 形質細胞がみられた。明・暗調の上皮細胞内には時にtonofilamentと考えられる束状の細線維が散見された。2.筋上皮島内外の光顕的に無構造な硝子様物は上皮細胞に隣接した微細線維状物で間質の膠原線維と混在していた。この部ではbasal laminaは不明瞭で, 時に同部に高電子密度で不規則な無構造沈着物をみた。3.筋上皮島周囲の浸潤細胞は主にリンパ球で, 粗面小胞体の発達した形質細胞も散見された。毛細血管には著変はないが, 全般に内皮細胞は腫脹し, 数ヵ所で内皮細胞内の拡張した粗面小胞体内にtubuloreticular structureがみられた。

組織球は全身性に分布しており, 代謝疾患, 炎症, 腫瘍, その他の時に増殖する。口腔領域でも組織球の増殖を主体とした疾患・病変がみられるが, 12例の自験例および文献例をもとにして, これらの疾患・病変について総説的に述べた。口腔領域での発生がみられたものとしては良性線維性組織球腫, 表皮下結節性線維症 (硬化性血管腫) , 黄色腫, 播種性黄色腫, 若年性黄色肉芽腫, 細網組織球腫, 疣贅状黄色腫, 結節性滑膜炎, 組織球症, 悪性線維性組織球腫, 細網肉腫, 脂質代謝障害に由来する細網内皮症, 慢性炎症に伴う組織球の増殖などがある。

Case 1 was 56-year-old female, who had been suffering fom Sjogren's syndrom (SjS) and primary biliary cirrhosis (PBC) and was treated conservatively. Autopsy revealed characteristic findings of major salivary glands in SjS, terminal stage of PBC and widespread miliary tuberculosis. Case 2 was a 35-year-old female, who had been suffering from SjS and SLE, and was received large dose of steroid drugs. Autopsy revealed marked atrophy of the salivary glands, diffuse lupus glomerulonephritis and systemic fungal infection.Autopsy cases with SjS in Japan were reviewed from 1958 to 1978 which were published in the “Annual of the Pathological Autopsy Cases in Japan”. There were 49 cases with SjS during this 21 years, being 44 female cases and 5 male cases. The mean age except 2 cases of suicide was 50.4 years. Collagen disease and/or autoimmune disease were found as a concomitance in many of the studied cases. The causes of death in cases with SjS were listed as systemic infection, respiratory disturbance, heart failure, liver dysfunction, etc.

東京医科歯科大学病理学教室の剖検例より顎口腔領域原発の癌腫120例について組織型と遠隔転移との関係を検討した。組織型は癌腫120例中102例が扁平上皮癌であった。遠隔転移のみられなかった例は120例中58例で, これらは1例以外すべて扁平上皮癌であった。また, 扁平上皮癌例で遠隔転移の有無と腫瘍の分化度との関係などについての検討も行った。

ヒトの耳下腺は一般に漿液性の腺として認められているが, 新生児で導管部に粘液細胞の存在することは知られている。また, 唾液腺に原発する粘表皮腫は大・小の唾液腺のうちでも耳下腺に最も多い。正常のヒト耳下腺導管上皮に時に粘液細胞が存在することから, 粘表皮腫は唾液腺の導管上皮に由来するのであろうと考えられている。しかし, ヒト耳下腺における粘液細胞の出現頻度や分布状態などを詳細に系統的に検索した報告はほとんどみられない。本研究では, 剖検例より得た耳下腺380例について, 耳下腺組織内にみられた粘液細胞の出現頻度や出現部位などについての検索を行った。粘液細胞は検索例全体の約30%にみられ, 新生児と高年者に比較的多かった。出現部位は導管系, ことに葉間と小葉間の導管部に比較的多くみられた。また, 導管系で粘液細胞の出現をみた例の約72%で, 粘液細胞出現部導管周囲にリンパ性細胞浸潤をみたが, 基礎疾患との間には特別の関係は見出し得なかった。

近年, Sj隸grenQや嚢胞性線維症などの全身疾患の診断の一助として外科的侵襲の比較的少ない小唾液腺の生検の有用性が認識されており, 主として口唇腺が用いられている。しかし, ヒト正常口唇腺の組織学的研究は少なく, とくに電顕レベルにおける詳細な観察はTandlerらの報告をみるにすぎない。今回, 全身麻酔下で得られたヒト正常口唇腺5例を電顕的に検索し, 第1報として終末部を構成する腺房細胞と筋上皮細胞について報告する。電顕的に腺房の分泌細胞は全て粘液性細胞であり, 各成熟段階のものがみられたが, 漿液性のものは認められなかった。粘液性細胞には分泌穎粒の性状により2種類のものが存在すると考えられ, それをI型, II型の細胞とした。更に形態的に未成熟分泌細胞に類似するが胞体内小器官をほとんどもたない細胞, 筋上皮細胞に類似するが胞体内にはわずかのmicrofilamentのみが散在する細胞もみられ, 前者をIII型, 後者をIV型の細胞とした。筋上皮細胞は大体において他の唾液腺, 涙腺, 乳腺で報告されているものと同様の所見であった。以上の所見に加え, I型, II型とした粘液性細胞, III型, IV型とした細胞ならびに筋上皮細胞の関連性についても若干の考察を加えた。

東京医科歯科大学口腔病理学教室において35年間に取り扱った唾液腺原発の粘表皮腫60例について腫瘍の発育様式, 転移, 再発ならびに予後について腫瘍組織の分化度との関連のもとに検討した。腫瘍は分化型と未分化型とに分けられるが, 発育様式は分化型でも被包はみられず, 周囲組織との境界は必ずしも明らかではなかった。また, 顎骨内への浸潤性増殖を伴っていた例が10例みられた。頸部リンパ節郭清術例で転移を確認した例が4例あり, 広範な遠隔転移は剖検例6例中5例に認められた。転移巣の組織像は原発巣のそれと本質的な差がなかった。再発確認例は6例で, いずれも二次症例であった。30例の追跡調査 (6年まで) では, 生存例21例 (70%) , 腫瘍死例8例 (27%) と, 他病死例1例であった。転移と腫瘍死が確認された悪性経過例は12例あり, うち2例は分化型に属するものであった。これらの所見と既報告例の所見を対比検討し, 本腫瘍での良性型の存在について論じた。

HeLa S3細胞を用いて細胞増殖と細胞電気泳動度の相関関係およびCon Aの細胞電気泳動度に及ぼす影響について検討した。培養開始後日数と細胞電気泳動度の関係では, 培養開始後細胞増殖の最も著明な3～4日に細胞電気泳動度も最高値を示し, 両者の推移はほぼ平行関係にあった。Con Aで処理すると細胞電気泳動度は5μg/ml, 10μg/mlの低濃度では増加するが, 20μg/ml以上の高濃度になると減少し.2相性の変化を示した。またこのCon Aによる細胞電気泳動度の反応性変動の程度は, 再生増殖期にある細胞に特に著明であることが判明した。

Crystalloids found in salivary duct cysts of the human parotid gland were examined by scanning electron microscopical observations with electron probe X-ray microanalysis. The cystic spaces were filled with numerous crystalloids which had a variety of forms with slight eosinophilic and glassy appearance. Scanning electron microscopically, crystalloids were hexagonal and rhombohedral in shape, and cutting the surface showed a polycyclic structure or regular parallel lamination. By electron probe X-ray microanalysis, sulphur was the only detected element. The present study suggests that crystalloids resulted from deposition from supersaturated saliva containing sulphur containing compounds into the cystic lumen or into epithelial cytoplasm.

Forty-two autopsy cases of squamous cell carcinoma of the mobile portion (anterior 2/3) of the tongue was reviewed clinicopathologically and the causes of the failure were studied retrospectively. Thirteen primary lesions (31.0%), even of the T3, T4 stage, were controlled by radiation therapy alone or with chemotherapy, and the effectiveness of the radiation therapy was evaluated. The recurrent tumor, frequently developing from regional lymph node metastases, was resistant to the theray and tended to manifest continuous and diffuse extention, forming a bullky neck tumor. The management of the neck tumor was the most important problem. Rupture of the neck vessels (7.1%) was one of the most serious complications. The incidence of the metastases was higher than that reported in literature. The metastases to the lymph nodes below the level of the clavicle were seen in 42.9% and the hematogenous metastases occurred in 61.9%. Pulmonary infection was the most common complication, being the main direct cause of death in the cachetic state. Five hundred and eighty-four autopsy cases of squamous cell carcinoma of the mobile portion and the base of the tongue collected from the Annual of Pathological Autopsy Cases in Japan were also analyzed.

東京医科歯科大学口腟病理学教室において35年間に取り扱った唾液腺原発の粘表皮腫60例を病理組織学的見地から検討した。検索症例は男27例, 女33例で, 来院時の年齢は18歳より86歳にわたり, 30歳より70歳まで各年代にほぼ均等に分布していた。発現部位は大唾液腺16例と小唾液腺44例で, 大唾液腺では耳下腺に, 小唾液腺では口蓋に多かった。組織学的には実質の分化の程度により3段階に分類した。分化のよいGradeIは8例, 中等度の分化のGradeIIは33例, 分化の悪いGradeIIIは19例であった。GradeIでは腫瘍実質は粘液産生細胞に富み, 嚢胞状あるいは腺様構造の形成が著明であった。GradeIIIでは実質胞巣は粘液産生細胞が少なく, 扁平上皮様細胞に富み, 異型性が著しかった。本腫瘍には粘液産生細胞, 扁平上皮様細胞と中間細胞以外に時に明細胞も認められ, これは小唾液腺例に多かった。その他本腫瘍の名称, 発生頻度組織分類組織構造, 腫瘍細胞の種類, 腫瘍細胞の移行または分化や組織由来などについての検討を行った。

Based upon the autopsy findings, the incidence of distant metastasis was studied to seek the relativity between the method of treatment and the TNM system at the time of initial examination on 31 cases with squamous cell carcinoma in the maxilla-facial region. The results are summarized as follows: 1) The incidence of distant metastasis among all of these cases was 58 per cent. 2) There was no significant difference in the incidence between the groups with radiation therapy and chemotherapy. 3) There was no relativity with the TNM system. 4) In the group with radiation therapy, the incidence at the “sites of the movable mucosa” was significantly higher than that at the “sites of the non-movable mucosa.” 5) There was no relationship to the performance of radical neck dissection.

Experimental autoallergic sialadenitis was induced in SL/Ni mice by one or two injections of syngeneic submandibular gland homogenate emulsified with adjuvant. Light microscopically, there were marked lymphoid cell infiltration in the submandibular glands with high incidence and proliferation of duct epithelia. Furthermore complete alteration of whole glandular lobules in some cases was observed. Ultrastructurally, small and medium sized lymphocytes and plasma cells constituted a major portion of the infiltrating cells, and lymphocytes were frequently observed inside the basal lamina of ductal and acinar regions, especially observed in the small ductal region. In the aggregates of infiltrating cells, the cell remnants of salivary gland epithelia were scattered. Furthermore some of the epithelial cell remnants in aggregates of infiltrating cells could be recognized as epithelial masses which were composed of proliferated duct epithelial cells, though no typical structure of epimyoepithelial islands seen in Sjogren's syndrome was found. Anti-salivary duct antibody was detected in only one case.

Multinodular hyperplastic foci of oncocytes found in mouse submandibular glands were examined ultrastructurally, and their morphogenesis discussed. The oncocytic foci showed lobular architecture surrounded by myoepithelial cells, and tubular formations were frequently present. The cytoplasm of the oncocytes was distended by tightly-packed and non-oriented mitochondria which varied in size and shape. Furthermore, varying numbers of electron-dense fine granules, which were remnants of secretory granules of granular duct cells, were scattered in the cytoplasm. Within the salivary gland parenchyma neighboring the hyperplastic foci of oncocytes, intermediate-type cells between oncocytes and normal salivary gland epithelia were found. The result of the present study shows that the oncocytic change has a tendency to be more frequent in the granular ducts and less in the striated ducts, and that some oncocyte-transformed cells proliferate to form nodular hyperplastic foci.

小児における唾液腺原発上皮性腫瘍の病態あるいは組織像を成人例と対比し, あわせて全唾液腺原発上皮性腫瘍中での比率または組織型などについて欧米での報告例と比較検討を行った。検索対象症例は, 38年間に東京医科歯科大学口腟病理学教室で扱った10例である。腫瘍摘出時の平均年齢は12.7歳で, 女児6例であった。発現部位は口蓋が6例で最も多く, 全体の半数以上を占めていた。組織型別には, 多形性腺腫9例と粘表皮腫1例であった。組織学的には, いずれも成人例に比して著しく相違した所見は明らかでなかった。小児における唾液腺腫瘍の頻度は同一期間中に当教室で扱った全唾液腺原発上皮性腫瘍496例の2.1%に相当し, これは欧米での数値とほぼ同様であった。組織型別には多形性腺腫は249例の3.6%に相当し, 粘表皮腫は46例の2.2%であった。

CBA系マウス38匹を用い左側下顎切歯を抜去し, 20-methylcholanthreneを木綿糸にtween40で浸み込ませたものを投与して発癌実験を行った。1年までの観察期間に3例の悪性腫瘍の発生がみられたが, 2例が扁平上皮癌, 1例が線維肉腫である。扁平上皮癌の発生は抜歯窩を被う重層扁平上皮の増殖性病変が先行し, それを母地として起こることが推察された。

Six cases of lymphosarcoma originating as primaries in the jaws were selected from biopsy and autopsy materials of the Department of Oral Pathology, Tokyo Medical and Dental University, from 1963 through 1970. These cases are recognized as an unusual lymphosarcoma syndrome characterized by primary occurrence in the jaw bones, principally of children, the frequency of multiple origin from the molar regions, the relative infrequency of peripheral lymphadenopathy, the monotonous infiltration of undifferentiated lymphoid cells with the frequent appearance of a “starry sky” pattern, and a fulminant fatal course. These clinical and histological findings resemble those of poorly differentiated lymphosarcoma of Burkitt's type.

Sixteen cases, 5 males and 11 females, of hyperplastic gums resulting from aleviatin administration were histologically studied, and the pathogenesis of the gingival hyperplasia was discussed. The histological examination revealed much identity to the previous observations. However, the authors could not derermine whether in the beginning state of the gingival enlargement the inflammatory cell infiltration occurred or not.

An autopsy case of leiomyosarcoma originating in the maxilla is presented. Although repeated light microscopic findings were consistent with a diagnosis of fibrosarcoma, electron microscopic examination revealed myofilaments with dense patches in the spindle-shaped cytoplasm of the tumor cells. It is suggested that “fibrosarcomas” of the oral cavity diagnosed by light microscopy could be leiomyosarcomas.

口腔粘膜原発の悪性黒色腫に関連してみられる特異な黒色症について, 自験例および本邦報告例の悪性黒色腫の94例を材料にして, 臨床病理学的に, また口腔粘膜の悪性黒色腫の組織発生の観点から考察した。我々は黒色症をその発生の時期によって先行型と, 併存あるいは続発型とに便宜的に分けたが, 94例についてみるといずれかの型の黒色症をみとめたものは62例 (66.0%) で, その中先行型は34例 (36.2%) , 併存あるいは続発型は28例 (29.8%) で, 黒色症を認めなかったものは32例 (34.0%) である。組織発生学的には, 口腔粘膜の接合性母斑はその疫学的考察から悪性黒色腫の一般的な発生母地とは考えにくい。しかるに悪性黒色腫の少なくとも1/3以上は黒色症から発生しており, その時間的経過は1年以上のものが多く (67.6%) , また正常口腔粘膜から発生したものも1/3以上はあると考えられる。したがってこれらの黒色症は前癌性黒色症 (Precancerous melanosis) とよべるものであろう。これらの黒色症とlentigo malignaとの相関々係については, すべての黒色症がlentigo malignaとは考えにくく, 少なくとも一部は反応性のものと考えられる。そして口腔粘膜原発の悪性黒色腫を有する患者には, 口腔粘膜のメラニン細胞を支配する何らかの局所性あるいは全身性の制御因子の存在することが疑われる。

口腔粘膜原発の悪性黒色腫の自験例16例と1900～1970年の本邦における日本人についての報告例102例の計118例について総括した。日本人における症例と欧米人についての報告例を比較してみると, その年齢分布, 原発部位, 初発症状, 経過などの臨床像および腫瘍の組織像などの所見に関しては両者間に著明な差異は認められない。しかし男女比については日本人では性差が欧米人ほどは明らかでなかった。また口腔粘膜原発の悪性黒色腫の発現頻度については, 欧米人に比較して全悪性黒色腫の中で占める比率が高く, また報告例の数から推察して皮膚ににみられるものほど明瞭な人種的差異はないと考えられる。

Summary About 160 cases of odontogenic tumor were studied histologically and a classification of the odontogenic tumor was presented. No clear-cut example of melano-ameloblastoma, odontogenic sarcoma, ameloblastic neurinoma, dentinoblastoma was observed in this study. About a half of the ameloblastoma belonged to Type III. Ameloblastoma of the maxilla was principally Type I. More differentiated types were found mostly in the younger patients. For the reason of a predirection of the ameloblastoma in the mandibular molar region, the developmental relationship between tooth band and jaw bone in this region should be considered. Cyst in the parenchyma might be produced in three ways; keratinous degeneration of the squamous epithelial portion, fine granular lipo-protein or glucolipid degeneration of the epithelium without keratinous changes, and hydropic degeneration of the stellate reticulum. Hyalinous halo surrounding nests of epithelium indicate a simple hyalinous change of the stromal tissue adjacent to the basement membrane or true thickening of the basement membrane like membrana preformativa. Cyst formation of the stroma may be influenced not merely by circulatory disturbances of the stroma, but by some action on the adjoining epithelium. So-called adeno-ameloblastoma should be considered as a variant of ameloblastoma. Its adenomatous structure may be formed from atypical growth of the epithelium of dental origin and not a true glandular structure. Two cases of malignant ameloblastoma were observed in this series. In one instance metastases to the cervical lymphnodes and the upper lip were histologically demonstrated. When we diagnose the odontogenic mesodermal tumors, by means of only histological examination, we should have careful consideration in various instance. Three types of the odontogenic mixed tumor represented various differentiating grade of thetum or tissues. Ameloblastic hemangioma was supposed to be a variant of ameloblastoma with a dilatation of the stromal blood vessels and not with a true hemangioma tissue.

32歳, 女性の下顎に多発性に生じた根尖性セメント質異形成症 (periapical cemental dysplasia) と考えられる1例を報告した。本症の本邦における報告は欧米に比べて極めて少ない。病変の本態についての究明もさることながら, 本症の発生頻度に真の人種的差異があるかどうかということが, まず明らかにされるべき問題であろう。

The ultrastructural changes in the terminal secretory units of the labial salivary glands, in which was demonstrated light microscopically the characteristic appearance of Sjogren's syndrome, were investigated in 12 cases. A small number of lymphocytes appeared interspersed in the dilated interepithelial spaces. Acinar cells showed regressive changes of various degrees, i. e. in the mature acinar cells the secretory granules were irregularly shaped and often found fused to each other while the intracytoplasmic organellae were swollen and destroyed in the immature acinar cells. These findings suggested that both the productive and secretory processes of the secretory granules in the acinar cells were disturbed. And finally the acinar cells appeared completely destroyed and their whole intracytoplasmic contents spilled into the acinar lumen. In some of the terminal units which consisted of immature acinar cells, the acinar cells were arranged irregularly and showed a syncytial appearance. This finding might suggest the socalled tubular metaplasia or canalicular regression. There was no regenerative appearance of the acinar cells. The myoepithelial cells, located in the basal portion of the acinar cells, were more resistant to the inflammatory changes than the acinar cells, however, pyknosis of the cytoplasm, formation of many thin cytoplasmic processes and increase in the number of pinocytotic vesiclae were found in the advanced stage. There were no proliferative changes in the myoepithelial cells.

Sixty-eight cases of benign papillary squamous tumors of the mouth were reviewed to elucidate further their histopathologic variations, as well as to clarify the premalignant nature of these tumors. The cases were classified into five varieties: idiopathic pseudoepitheliomatous hyperplasia (2 cases), papilloma (55 cases), oral florid papilloma (7 cases), inverted papilloma (3 cases) and recurring oral papillomatosis (1 case). The series included very rare cases, to our knowledge, undescribed in the literature. Though a microscopic differentiation between the benign papillary squamous tumors, verrucous carcinoma and well differentiated squamous cell carcinoma is quite difficult, clinical and pathologic recognition of these tumors is imperative, because of the differences in their clinical course and therapeutic requirement. A definite diagnosis should be made after the clinical and microscopic findings have been carefully correlated. Malignant change occurred in the oral florid papilloma and recurring oral papillomatosis.

Light and electron microscopic studies of ameloblastoma were reviewed. The 21 cases of ameloblastoma examined were classified into 12 cases of the plexiform type and nine of the follicular type. The average age of the patients with the plexiform type was 25.3 years, while that of those with the follicular type was 54.4 years. Histologically, in the follicular type, the tumor cells consisted of two cell types, central polyhedral and star-shaped cells resembling the stellate reticulum and peripheral cuboidal and columnar cells similar to the inner enamel epithelium. The resemblance between the tumor follicle and enamel organ was confirmed electron microscopically. In the plexiform type, however the tumor cells did not show two cell types, but resembled squamous epithelium. Electron microscopically, all cells of the tumor strands had relatively numerous bundles of tonofilaments and were joined together by desmosomes. Differentiation of tumor cells to squamous epithelium less evident than in normal surface epithelium. We speculate that these histological differences between plexiform and follicular types represent the differentiation tendency of the remnant of the dental lamina at the time of neoplastic transformation. What decides the histological pattern is unknown but age may be a factor. Central epidermization with keratinization or microcytic changes was frequently seen in the follicular type. Keratinization and microcystic changes rarely occurred in the plexiform type. We do not believe that these changes are a form of involution or result from multipotentiality of the tumor cells.

A case of calcifying epithelial odontogenic tumor was studied histochemically and electron microscopically. This case was characterized by an abundant amount of homogeneous substance and the presence of numerous clear cells. Although the homogeneous substance was shown to be an amyloid material in nature, it was supposed to be an extracellular product of the epithelial tumor cells. The clear cells contained abundant glycogen granules in their cytoplasm.

This paper is a review of 120 cases of primary malignant melanoma of the oral cavity occurring in the Japanese. We have collected 18 cases from our own department and the remainder from the literature. Since malignant melanoma arising from the oral mucosa and ectopic pigmentation are relatively common in Japan, an assumption has grown as to a possible relationship to histogenesis. The analysis of the material and the discussion are focused on these points. Malignant melanoma of the oral cavity is not rare in the Japanese. Some of the cases do not seem to have any relation to oral melanosis, but almost two-thirds of the cases were found associated with it (36.2% of melanoma was associated with pre-existing melanosis, and 29.8% with concurrent or later-developing melanosis). The biological behavior and histologic patterns of these melanoses were similar to those of lentigo maligna of the skin. The pre-existing melanoses seemed to be the most common precancerous lesion of the oral mucosa as far as malignant melanoma was concerned.

Two autopsy cases are presented of spindle-cell carcinoma of the oral cavity, which were transformations from the pre-existing well differentiated squamous cell carcinoma in Case I and verrucous carcinoma in Case 2, after large doses of irradiation. In Case 2, the conventional squamous cell carcinoma existed at the time of biopsy. Our case study suggests that the spindle-cell carcinoma may develop from the verrucous carcinoma by dedifferentiation through the intermediate stage of conventional squamous cell carcinoma.

Twenty-one clinically normal human mandibular condyles were examined by histologic and microradiographic methods obtaining some measurements. The histological structures of condyle were quite different between the child group and other aged groups. The difference in the surface articular zone composed of the fibrous tissue was not so great in all age groups, while there was quite a difference in the structure in the remaining zones. It was clearly demonstrated by microradiogram that the osteons of the subarticular bone plate were more prominent in aging. Abnormal structures of the condyle were revealed in some individuals of the adult and old age groups, which were assumed probably to be the reactive remodelling against the functional changes of the temporomandibular joint.

A fibrous tumor of infancy of the floor of the mouth is reported. The tumor was characterized by congenital occurrence, deeply infiltrating, dense immature fibroblastic cells, focal chondroid differentiation, rapid new growth 3 years following irradiation and no recurrence 6 years after incomplete excision. The diagnosis of an aggressive infantile fibromatosis or juvenile fibromatosis, differentiated fibrosarcoma type, was considered to be the most acceptable.

An autopsy case of fatal strongyloidiasis in a patient with pemphigus vulgaris receiving long-term administration of corticosteroids was presented. There might exist a subclinical stage of 26 years between the acquisition of infection and the appearance of its severe symptoms. It is suggested that the long-term administration of corticosteroids and debilitating diseases increase the pathogenecity of Strongyloides stercoralis by autoinfection, and that fatal strongyloidiasis could be a possible complication of treatment with corticosteroids.