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才男性の左肺下葉に発生した原発性肺平滑筋肉腫の一剖検例を若干の文献的考察を加え報告した.左下葉原発巣 (38×26×20mm) は外科的に切除されたが再発し術後3年6ヶ月で死亡した.剖検時その再発巣は左胸腔から左側胸壁皮下及び腹腔内にかけて巨大腫瘤を形成していたにもかかわらず, 転移巣は認められなかった.尚, 臨床経過は4年2ヶ月であり, 本例は本邦第37例目の原発性肺平滑筋肉腫報告例である

In this study we examined the expression of platelet-derived growth factor (PDGF) A-chain and PDGF receptor genes in seven human gastric carcinoma cell lines and 15 gastric carcinoma tissues. Expression of mRNA for PDGF A-chain was found in all gastric cell lines and all gastric carcinoma tissues. Two of the seven gastric carcinoma cell lines expressed PDGF receptor mRNA. Out of the 15 gastric carcinoma tissues, eight showed enhanced expression of PDGF receptor mRNA and all of them demonstrated prominent fibrous stroma. Moreover, the incidence of enhanced expression of PDGF receptor mRNA was higher in scirrhous carcinoma than in well differentiated adenocarcinoma. These results strongly suggest that PDGF produced by tumor cells acts as a paracrine growth factor for production of fibrous stroma in gastric carcinomas.

Control mechanisms of normal differentiation are disrupted in cancer cells but can be restored by treatment with site-selective cAMP analogs. The cellular events associated with such changes entail compartmental redistribution of the cAMP-dependent protein kinase type II regulatory subunit, RIIβ. The results of this study indicate that the molecular mechanisms of action involve changes in specific DNA-binding activity of putative transcription factors. Gel retardation analyses revealed that nuclear extracts from cells of various human cancer cell lines [colon cancer (LS-174T), gastric cancer (TMK-1), and leukemia (K-562)] and rodent pheochromocytoma (PC12) show a concentration-dependent increase in binding activity to a synthetic DNA that contained the cAMP-responsive element 5′-TGACGTCA-3′ after treatment with 8-C1-cAMP. Such an increase in cAMP-responsive element binding activity was not observed in the 8-C1-cAMP-unresponsive MKN-1 gastric cancer cells. These findings indicate that the antitumor activity of site-selective cAMP analogs may reside in the induction of transcription factors that restore normal gene regulation in cancer cells.

Cybrid clones were isolated by fusing mouse embryonal carcinoma (PCC4) cells with cytoplasts of rat myoblastic cells (L6TG X CAPr). Although some clones were similar to PCC4 (Type II), a high proportion (88%) were differentiated; the differentiated cells had a mesh-like arrangement (Type I) or were flat with many projections (Type III). Protein patterns of both Type I and Type III cells changed markedly from that of PCC4 cells. Type III cells lacked alkaline phosphatase and expressed endo A and B proteins predominantly. One Type III clone produced alpha-fetoprotein and plasminogen activator (visceral endoderm-like), while another clone consisted of trophectodermal cell-like giant cells. Therefore it was shown that introduction of the somatic cell cytoplasm induces differentiation of teratocarcinoma stem cells, suggesting a cytoplasmic element (or elements) regulating gene expression.

A case of giant pigmented tumour of the scalp which developed in a 47-year-old woman is reported. Macroscopically, the tumour showed a peculiar two-layered structure, consisting of an upper non-pigmented and a lower pigmented portion. Histologically, it was composed of elongated neurofibromatous tumour cells with abundant collagen fibres in the non-pigmented portion and round naevus-like cells with abundant melanin pigment in the pigmented portion. S-100 protein and neurone-specific enolase were demonstrated in most of the tumour cells, but neurofilament and myelin basic protein were not detected. Electron microscopy revealed melanosomes in the tumour cells of the pigmented portion. These findings might support a melanocytic origin for the tumour, but the lack of superficial pigmentation and the associated hair loss were against this. The tumour may represent an example of duality of neural crest differentiation.

Estrogen receptors (ER) in human gastric carcinomas were examined immunohistochemically using a specific monoclonal antibody to human ER. ER-immunoreactivity (ER-IR) was positive in 30 (27.8%) of the 108 gastric carcinomas examined. ER-IR was located in the nucleus of cancer cells. The incidence of ER-IR positive gastric carcinoma was not significantly different between male and female cases. However, the positive tumour cells were observed in 28 (39.4%) out of the 71 poorly differentiated adenocarcinoma, the incidence being significantly higher than that in well differentiated adenocarcinoma (p less than 0.01). There was no significant difference in the incidence of ER-IR between scirrhous carcinoma and non-scirrhous poorly differentiated adenocarcinoma. Synchronous expression of ER and epidermal growth factor receptor was found in 8 of the 26 scirrhous carcinomas (30.8%). Patients with ER-IR positive scirrhous gastric carcinomas showed a much worse prognosis than those with ER-IR negative scirrhous carcinomas.

A case of bizarre leiomyoblastoma (BL) of the cervix uteri which developed in a 44-year-old premenopausal woman was reported. The tumor was found as a cervical polyp by routine pelvic examination. Histologically, it was composed of epithelioid and bizarre, often multlnucleated, giant tumor cells without elevated mitotic counts and necrosis. Electronmicroscopically, abundant myofilaments in epithelioid tumor cells were observed. Immunoreactive desmln, GPK-MM (creatinine kinase mm-isozyme), and myosin could be demonstarted in most of the epithelioid tumor cells. These immunohisto-chemical findings seemed to reflect on the differentiation of the tumor cells to smooth muscle and provide a reliable evidence for the smooth muscle origin. The histogenesis and relationship between the histopathological findings and clinical behaviour of uterine BL were also discussed.

Serotonin was examined immunohistochemically in seven tubular adenomas, 194 adenocarcinomas and 41 endocrine cell tumours of the stomach. In tubular adenomas, serotonin-containing cells showing argentaffinity were present in the lower portion of the adenomatous glands and were considered to be an expression of intestinal character. Scattered serotonin-containing tumour cells were found in 60 (30.9%) of 194 adenocarcinomas regardless of their histological type. Cell fusions between carcinoma and enterochromaffin (EC) cells might be a possible mechanism for the occurrence of serotonin-containing cells within the tumour. In 17 (54.8%) of 31 endocrine cell carcinomas, serotonin-containing tumour cells were observed in a variable degree in contrast to the absence of these cells in classical carcinoid. Moreover, diffuse serotonin reactivity was found in four cases of scirrhous endocrine cell carcinoma. The histogenesis and the occurrence of serotonin-containing cells in each type of gastric tumour is also discussed.

The correlation between gallbladder stones (gallstones) and various gallbladder diseases was examined. The incidence of gallstones was 47.1% in cases of nonneoplastic epithelial polyp, 48.0% in adenoma, and 59.1% in adenocarcinoma. There was no relation between the incidence of gallstones and sex. The incidence of gallstones in cancer cases showed no difference among histological gradings. Non neoplastic epithelial polyps, adenomas and carcinomas were divided into metaplastic type and non metaplastic type based on the presence or absence of metaplastic changes. Comparison of the incidence of gallstones showed that cases of metaplastic type polyp and adenoma had a higher incidence of gallstones than non metaplastic type polyp and adenoma. In the cases of cancer, no differences were observed in the incidence of gallstones between metaplastic type and non metaplastic type carcinomas. However, comparison among early carcinomas showed that metaplastic type carcinoma had a significantly higher incidence of gallstones than the non metaplastic type. These results suggest that gallstones may play an important role in the histogenesis of gallbladder diseases of the metaplastic type. Acta Pathol Jpn 39: 582 585, 1989.

A total of 49 gastric tubular adenomas and 6 tubular adenomas with foci of adenocarcinoma from surgically resected stomachs were examined histologically and immunohistochemically for gut peptide hormones, serotonin, carcinoembryonic antigen (CEA), secretory component (SC), and lysozyme. A variety of endocrine cells were detected in tubular adenoma with mild to moderate atypia. Both the frequency and distribution density were highest for serotonin-containing EC cells, often showing hyperplasia, followed by glicentin-containing L cells, somatostatin-containing D cells and motilin-containing Mo cells in the order given. Adenoma cells with SC immunoreactivity were more dominant than those with CEA immunoreactivity. In tubular adenoma with severe atypia, endocrine cells were markedly decreased, whereas adenoma cells with CEA immunoreactivity were increased. The distribution density of lysozyme-containing cells in tubular adenoma of the intermediate zone and fundus was significantly higher than that of the antrum. In the subjacent mucosa of the adenoma, L cells and SC-positive epithelial cells were detected in 24 and 33 cases, respectively. These findings suggest that gastric tubular adenoma develops from intestinal metaplasia. In addition, gastric tubular adenoma showed a tendency to lose various intestinal markers with increase of histologic atypicality.

Electron microscopic study was made on precancerous and cancerous lesions in glandular stomach of rats induced by MNNG. Three types of lesions, were found: regenerative glandular hyperplasia, adenomatous hyperplasia and adenocarcinoma. These were compared with the fine structure of similar lesions produced by X-irradiation in the glandular stomach of mice. The precancerous lesion in the present study demonstrated formation of adenomatous hyperplasia by epithelial cells which included mucoid cells characterized by sparce surface microvilli, a few erratic terminal webs, small number of mucous granules, many small mitochondria, and a bizarre nucleus. The development of these mucoid cells seems to be related with the growth of gastric carcinoma. The ultrastructure of adenocarcinomas revealed many structural variations or abnormalities of cellular differentiation. They were classified into 1) surface and pit mucous cell type, 2) pyloric gland cell type, 3) goblet cell type, 4) paneth cell type, 5) intestinal epithelial cell type, 6) endocrine cell type, 7) oncocyte type, 8) filament-rich cell type, and 9) anaplastic cell type involving intracellular microcyst cells. Filament-rich cells were found in poorly differentiated adenocarcinoma or scirrhous carcinoma and may be derived from metaplasia of tumor cell.

A rare case of diffuse papillomatosis of the gallbladder complicated with tuberculosis is reported. The mucosa of the gallbladder displayed a diffuse papillary pattern composed of excrescences that varied in size and height. The proliferative glands contained many Paneth cells, and the diffuse papillomatosis appeared to be derived from metaplastic-type epithelium. Tuberculous granulomas were observed in the serous layer of the gallbladder. The relationship between diffuse papillomatosis and tuberculosis of the gallbladder is discussed. ACTA PATHOL JPN 38: 1473–1480, 1988.

The expressions of epidermal growth factor (EGF) and its receptor were studied immunohistochemically in a total of 156 gastric carcinomas; 26 early and 130 advanced. No EGF immunoreactivity was found in early carcinomas, while EGF-positive tumor cells were detected in 38 (29.2%) of the 130 advanced carcinomas. EGF receptor immunoreactivity was detected in one (3.8%) of the 26 early carcinomas and in 44 (33.8%) of the 130 advanced carcinomas, the incidence being significantly different (p less than 0.01). Out of the 130 advanced carcinomas, 17 (13.1%) had synchronous expression of EGF and its receptor and most of the tumors with strong expression of EGF were positive to EGF receptor. A significant correlation was observed between the depth of tumor invasion and EGF or its receptor immunoreactivity in tumor cells (p less than 0.05). Furthermore, a good correlation was demonstrated between the synchronous expression of EGF and its receptor and the depth of tumor invasion or the tumor staging. The incidence of cases with EGF in metastatic tumors was significantly higher than that in primary tumors (p less than 0.05). Patients with synchronous expression of EGF and its receptor had a far poorer prognosis than those without EGF and receptor.

The hst‐1 gene, previously designated as the hst gene, and seven other oncogenes were examined for possible structural changes in esophageal, gastric and colorectal carcinomas by Southern blot hybridization. The hst‐1 gene was amplified in eight (42.1%) of the nineteen esophageal squamous cell carcinomas and in all four metastatic tumors of lymph nodes. The degree of amplification ranged from two to eight times. Coamplification of the hst‐1 and c‐erbB‐1 gene was found in one case of esophageal carcinoma. However, no amplification of the hst‐1 gene was detected in gastric and colorectal carcinomas.

Gut endocrine cells in a total of 18 gastric adenocarcinomas in inbred Wistar rats induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and gastrin or serotonin, were examined histologically, ultrastructurally, and immunohistochemically for gastrin, somatostatin, calcitonin, glicentin, and serotonin. A large number of argyrophil cells were observed in 17 tumors (94.4%) and 14 tumors (77.8%) had argentaffin cells. Immunohistochemically, C-terminal fragment of gastrin (G17) immunoreactivity was observed in 15 (82.2%) out of the 18 tumors, but 3 G17-positive tumors had no G 34 immunoreactive cells in rats treated with MNNG plus gastrin. Serotonin immunoreactivity was detected in 14 tumors (77.8%). Somatostatin immunoreactivity was detected in 7 of the 11 tumors (63.6%) in rats treated with MNNG plus gastrin whereas no tumor in rats treated with MNNG plus serotonin had somatostatin, the difference of the incidence being significant (P less than 0.05). One endocrine cell carcinoma which consisted mainly of serotonin-producing cells was observed in a rat treated with MNNG plus serotonin. Calcitonin and glicentin immunoreactivity was not demonstrated in any tumors. Ultrastructurally, three types of endocrine granule were found in the tumor cells. These data suggest that hormonal environment in stomach carcinogenesis may influence the expression of endocrine cells within the tumors.

An endocrine cell carcinoma of the extrahepatic bile duct in a 79-year-old man is described. The patient had complaints of jaundice and epigastric pain due to a small tumor located at the confluence of the common hepatic duct with the cystic duct. Microscopically, the tumor showed a well differentiated tubular adenocarcinoma and was confined to the mucosa. Numerous tumor cells showed argyrophil and/or argentaffin reactions. Immunoperoxidase staining revealed that the tumor tissue contained somatostatin-, gastrin-and serotonin-immunoreactive cells. From these findings the tumor was diagnosed as endocrine cell carcinoma. Four years later he remains well without any evidence of recurrence or metastasis. The histogenesis of endocrine cells in the biliary tract is briefly discussed.

The effect of human epidermal growth factor (hEGF) on the growth of various histological types of six human gastric carcinoma cell lines was examined. The cell lines had relatively high affinity EGF receptors (dissociation constant Kd = 10(-9) to 10(-10) M). One gastric cancer cell line, MKN-74 (well differentiated adenocarcinoma) showed no response to hEGF, in cell growth, DNA synthesis or 125I-hEGF cell binding. There were no apparent correlations between histological type and cell growth, DNA synthesis or number of EGF receptors in these cells. The number of EGF receptors and the Kd value of the gastric carcinoma cell lines varied with their internal and external environments. hEGF concentrations corresponding to maximum stimulation in DNA synthesis varied between cell lines. The results suggest some gastric carcinoma cells to have EGF receptors and their growth seemingly to be stimulated by EGF in vitro. There are, however, no obvious correlations between the effect of hEGF on the growth of human gastric carcinoma cell lines or their histological type.

A review of ten surgical cases of medullary carcinoma of the thyroid (MCT) demonstrates the usefulness of establishing a preoperative cytological diagnosis through the immunochemical staining of calcitonin (CT) and CEA in fine-needle aspiration (FNA) biopsy smears. If MCT is suspected after routinely performing May-Grünwald-Giemsa stained cytology of an FNA biopsy in the outpatient clinic, then CT and CEA staining is recommended for confirmation of MCT. The advantages of this immunochemical staining include that it can be carried out in the outpatient clinic within one day and also that it is much less costly than measuring serum CT and CEA.

Ninety-two cases of adenocarcinoma of the gallbladder were classified into the metaplastic or non-metaplastic type, based on the presence or absence of metaplastic changes in the tumour tissues. The differences in biological characteristics were compared between these tumour types. The metaplastic type was more common than the non-metaplastic type in females and the survival rate in this type was better than that in the non-metaplastic type. The modes of tumour spread also differed, the metaplastic type frequently showed lymphatic metastasis, whereas the non-metaplastic type often metastasized by direct invasion. The difference in prognosis might be explained by the different modes of tumour spread. This classification corresponded well to that of gastric carcinoma into intestinal type and diffuse type and the results suggest that it might provide a basis for evaluating various aspects of gallbladder carcinoma.

Thirty epithelial polypoid lesions in 24 surgically resected gallbladders were examined histologically and immunohistochemically and then classified into two types according to the characterstics of the epithelium. One type consisted of proliferation of ordinary gallbladder epithelium without any metaplastic change while the other type was characterized by proliferation of metaplastic epithelium, such as mucous glands, endocrine cells and lysozyme-immuno-reactive cells. Moreover, each lesion was subdivided into non-neoplastic epithelial polyp or neoplastic adenoma. We therefore classified the non-neoplastic epithelial polyps into hyperplastic polyps and metaplastic polyps, and the adenomas into ordinary type and metaplastic type. Moreover, we found that atypical glands within metaplastic-type adenoma were not infrequently observed, and that these lesions also presented metaplastic changes. From these results, the possibility of an adenoma-carcinoma sequence was discussed. ACTA PATHOL JPN 38: 181–192, 1988.

The localization of immunoreactive calcitonin (IR-CT) in the human gastric mucosa and tumor tissues was studied using an immunohistochemical peroxidase-antiperoxidase method. A small number of IR-CT-containing cells were observed in both infant and adult gastric antral mucosa and the ratio of IR-CT-containing cells to G cells was about 1:50-100. Moreover, tissue content of IR-CT in normal antral mucosa was 2.37 +/- 0.35 ng/g wet weight. IR-CT-containing cells and G cells decreased with the progress of chronic atrophic gastritis and were totally absent in intestinal metaplastic glands. IR-CT was detected in G cells, suggesting a paracrine relation between gastrin and CT. IR-CT was not found in tumor cells of 35 gastric adenomas and 40 well differentiated adenocarcinomas. On the other hand, it was demonstrated in a very small number of tumor cells in 4 of 46 poorly differentiated adenocarcinomas, and in a good number in 3 of 7 scirrhous argyrophil cell carcinomas. IR-CT in plasma could serve, therefore, as a tumor marker of scirrhous endocrine cell carcinoma, and its production in cancer cells was considered to be eutopic rather than ectopic.

A total of 164 gastric carcinomas comprising 97 advanced cancers and 67 early cancers were examined immunohistochemically for human chorionic gonadotropin (hCG). Tumor cells containing immunoreactive hCG was found in 7 cases or 10.4% of the early cancer cases and in 11 cases or 11.3% of the advanced cancer cases. Moreover, the incidence of hCG–beta subunit positive cells was 8.2% in the advanced cancer cases and 6.0% in the early cancer cases. The incidence of these cells didjnotjdiffer significantly by histological type and by infiltrative growth of gastric carcinoma. However, hCG–containing tumor cells were frequently detected in poorly differentiated or undifferentiated area within the tumor, fa addition, these cells did not contain mucin or argyrophil granules. The three year survival rates indicated a tendency for advanced gastric cancer containing hCG to have a poor prognosis. ACTA PATHOL. JPN. 33: 287–296, 1983.

DNAs from 37 human gastric carcinomas and seven lymph node metastases were analyzed for alterations of the epidermal growth factor receptor (EGFR) gene and oncogenes by the Southern blot hybridization method. The probes used were EGFR gene, c-Ha-ras, v-Ki-ras, N-ras, c-myc, v-myb, v-fos, c-erbB-2, v-erbA, v-abl and v-fes. Amplification of the EGFR gene was detected in only one poorly differentiated adenocarcinoma. Amplifications of c-myc gene and c-erbB-2 gene were each observed in two well differentiated adenocarcinomas. One of these tumors had coamplification of c-erbB-2 and c-erbA genes but there were no amplifications nor rearrangements of other oncogenes. The poorly differentiated adenocarcinom with amplified EGFR gene also showed enhanced expression of EGFR gene by Northern blot analysis and additionally had strong synchronous immunoreactivity for EGFR and EGF.

We report the immunohistochemical and ultrastructural features of a case of duodenal carcinoid (somatostatinoma) combined with cutaneous-type von Recklinghausen's disease in a 65-year-old woman. The duodenal tumor located at the 2nd portion was composed of tumor cells arranged in a trabecular, glandular or nest-like pattern, occasionally associated with eosinophilic globules in the glandular structures. The tumor cells mostly showed strong immunoreactivity with anti-somatostatin antibody. Electron microscopy revealed that every tumor cell contained intracytoplasmic granules with electron-dense cores, 100-300 nm in size, in varying numbers, and intracytoplasmic lumina were rarely detected. The present case including identical cases reported so far suggest that the disease entity is likely to be a combination of duodenal somatostatinoma and von Recklinghausen's disease and/or phaeochromocytoma. This is the tenth case of duodenal carcinoid associated with von Recklinghausen's disease and/or phaeochromocytoma in the world literature and the third case reported as duodenal somatostatinoma.

Immunoperoxidase methods were used to study ABO(H) blood group antigens and carcinoembryonic antigens in patients with transitional cell carcinoma of the bladder. In our study absence of blood group antigens in cancer tissues was not found to be correlated with histologic grade, stage and survival rate in patients with bladder carcinoma, while it was correlated with subsequent intravesical recurrences. In contrast, the presence of carcinoembryonic antigens in cancer tissues was correlated well with histologic grade, stage and survival rate. Our results suggest that immunoperoxidase detection of blood group antigens could not predict poor survival. In contrast, immunoperoxidase detection of carcinoembryonic antigens is of prognostic value in patients with transitional cell carcinoma of the bladder.

A total of 44 extrahepatic bile duct carcinomas comprising 13 well-differentiated adenocarcinomas, 25 moderately differentiated adenocarcinomas, and 6 poorly differentiated adenocarcinomas were examined histologically and immunohistochemically for somatostatin, gastrin, and glicentin. Argyrophil cells, argentaffin cells, and somatostatin- and gastrin-immunoreactive cells within the tumor were detected in 46.2%, 15.4%, 23.1%, and 15.4% of well-differentiated adenocarcinomas, and in 16.0%, 8.0%, 12.0%, and 4.0% of moderately differentiated adenocarcinomas, respectively. No tumor tissues of poorly differentiated adenocarcinomas contained endocrine cells. A statistically significant difference in the frequency of argyrophil cells was observed between well and poorly differentiated adenocarcinoma. The incidence of argyrophil cells and somatostatin-immunoreactive cells in nonneoplastic mucosa adjacent to well-differentiated adenocarcinoma was higher than in that adjacent to poorly differentiated adenocarcinoma. Glicentin-immunoreactive cells could not be demonstrated either in tumor tissue or in nonneoplastic mucosa of the extrahepatic bile duct. With reference to the histogenesis of extrahepatic bile duct carcinoma, it was assumed from these results that the development of well-differentiated adenocarcinoma might be closely related to the occurrence of endocrine cells and that poorly differentiated adenocarcinoma might develop from ordinary mucosa.

Glicentin-containing cells (Glic. cells) in intestinal metaplasia, adenoma and carcinoma of the stomach were examined using immuno-histochemical techniques. Glic. cells first occurred in the gastric mucosa of the transitional area between metaplastic and intact gastric glands. They frequently showed hyperplasia or micronoduli in the budding area of the deeper metaplastic glands, but in completely intestinalized mucosa these endocrine cells decreased remarkably. Gastric adenomas with mild dysplasia had a good number of glicentin-immunoreactive cells which were located in the deeper adenoma glands. Gastrin- and somatostatin-positive cells were also detected in the adenomas. The incidence of glicentin-positive tumor cells was significantly higher in well differentiated adenocarcinoma than in poorly differentiated adenocarcinoma. Among the seven cases of scirrhous argyrophil cell carcinoma, three showed glicentin- and glucagon-immunoreactivity in the same area of the tumor. These findings suggest that the selective increase of Glic. cells in intestinal metaplasia may be closely related to the development of gastric adenoma. Glicentin positive tumor cells in gastric carcinomas can be regarded to be an expression of intestinal or fetal markers.

Previous studies have reported that the mice passively sensitized with anti-dinitrophenol (DNP) IgE antibody exhibited IgE-mediated cutaneous reaction with an immediate phase response (IPR) at 1 h and a late phase response (LPR) at 24 h after the challenge of dinitrofluorobenzene (DNFB). We found that the third-phase inflammatory reaction with intense and persisting infiltration of eosinophils, named ‘very late phase reaction (vLPR)’, was induced following IPR and LPR in response to DNFB in actively and passively sensitized mice, and that the peak response of vLPR was at 8 days after the challenge. This reaction was slightly observed in non-sensitized mice. Since the accumulation of eosinophils in vLPR was markedly observed when compared with that of LPR at 24 h, the vLPR may be an important reaction in allergic diseases. The development of vLPR was partly decreased in mast cell-deficient WBB6F1-W/W v mice and was absent in T cell-deficient BALB/c-nu/nu mice in passive sensitization. These results indicate that the vLPR in the triphasic cutaneous reaction may be mainly mediated by T cells and partially by mast cells and/or IgE antibody, and consequently lead to an intense ear swelling accompanying massive infiltration of eosinophils.

Gastric cancer cells express a broad spectrum of the growth factor/cytokine receptor systems that organize the complex interaction between cancer cells and stromal cells in tumor microenvironment, which confers cell growth, apoptosis, morphogenesis, angiogenesis, progression and metastasis. However, these abnormal growth factor/cytokine networks differ in the two histological types of gastric cancer. Importantly, activation of nuclear factor-kB pathway by Helicobacter pylori infection may act as a key player for induction of growth factor/cytokine networks in gastritis and pathogenesis of gastric cancer. Better understanding of these events will no doubt provide new approaches for biomarkers of diagnosis and effective therapeutic targeting of gastric cancer.

One hundred twenty-six gastric carcinomas (68 advanced cancers and 58 early cancers) were examined immunohistochemically for alpha 1 -antitrypsin (AAT), alpha 1 -antichymotrypsin (ACT), and alpha 2 -macroglobulin (AMG) within tumor cells. The incidence of these three protease inhibitors was markedly higher in advanced than in early cancers, regardless of the histologic type of gastric carcinoma. In advanced cancers the incidence of both AAT and AMG was significantly higher in well-differentiated adenocarcinomas than in poorly differentiated adenocarcinomas, but no difference was observed in the expression of ACT between these two types of advanced carcinomas. Eighty per cent of the AAT-positive advanced carcinomas had ACT, and 40 per cent of these tumors also contained AMG. The two-year survival rates clearly indicated that well-differentiated adenocarcinomas with AAT have worse prognoses than well-differentiated adenocarcinomas without AAT, but there was no relation between the expression of ACT or AMG and prognosis. There results strongly suggest that the presence of protease inhibitors in gastric carcinomas is related to the invasive growth of the tumors and that AAT is a tissue tumor marker of well-differentiated adenocarcinomas of the stomach. It may also serve as a biologic marker of high malignancy in patients with these gastric cancers.

beta-Endorphinlike immunoreactivity and somatostatinlike immunoreactivity were detected in the mucosa and muscle layer of normal gastric antrum and corpus and in moderately differentiated adenocarcinoma derived from the antral mucosa. The concentration of beta-endorphinlike immunoreactivity in the normal gastric tissues was 4-15 pmol/g wet wt tissue; this value varied from 9.64 to 241.39 pmol/g wet wt tissue (81.38 +/- 37.82 pmol/g wet wt tissue) in adenocarcinomas. The concentration of somatostatinlike immunoreactivity was 18-25 pmol/g wet wt tissue in normal gastric mucosa, whereas it was 1-2 pmol/g wet wt tissue in adenocarcinomas. Gel exclusion chromatography of beta-endorphinlike immunoreactivity revealed two peaks corresponding to beta-endorphin and beta-lipotropin. In normal mucosa and in the whole layer of antrum, the major peak was eluted near the position of beta-lipotropin, and the minor broad peak was eluted near the position of beta-endorphin. In contrast, in adenocarcinoma, beta-endorphinlike immunoreactivity was eluted broadly at the position of beta-endorphin and the other smaller peak was at the position of beta-lipotropin. Gel exculsion chromatography of somatostatinlike immunoreactivity also showed different patterns between antral mucosa and adenocarcinoma. This study revealed the presence of the opioid peptide, beta-endorphinlike immunoreactivity, not only in normal gastric tissue but also in adenocarcinomas with highly increased concentration and different elution patterns in combination with decreased concentration of somatostatinlike immunoreactivity.

An autopsy case of idiopathic dilated cardiomyopathy with abnormal proliferation of mitochondria in the myocardial cells is reported. The case is that of a 39-year-old male with congestive heart failure. The heart was 700 g and showed marked dilatation of all cardiac chambers with myocardial fibrosis of the left ventricular myocardium and interventricular septum, especially in the basal portion of the left ventricular posterior wall. Myocardial cells were hypertrophied with a marked increase of fine-granular sarcoplasm, containing numerous mitochondria, seen by electron microscopy. The mitochondria were usually round or oval and ranged in size from 0.3 to 1.2 micron in diameter. The cristae of these mitochondria frequently showed a concentric lamellar or reticular configuration. Myofibrils were unusually scarce, but the sarcomere structure and arrangement of myofilaments were well-preserved. Epicardial and intramural coronary vessels were almost normal. From these findings, we consider this to be an adult case of mitochondrial cardiomyopathy.

The phenotypic expression of the human epidermal growth factor (EGF) was investigated immunohistochemically in human foetal submandibular glands from the 5th to 10th month of gestation, adult normal submandibular glands and 48 cases of pleomorphic adenomas. In foetal submandibular glands, both the terminal buds and primary ducts at the intermediate stage of gestation were positive for EGF, and in particular, the outer layer cells of primary ducts showed strong EGF-immunoreactivity. EGF-positive cells decreased as the gestational stage advanced and only ductal cells were weakly positive for EGF at the terminal stage of gestation. In the adult normal submandibular gland, weak immunoreactivity for EGF was restricted to ductal cells. However, 41 (86%) of the 48 pleomorphic adenomas had EGF-positive cells which were distributed among the ductal, chondroid and myxoid portion. No EGF-immunoreactivity was detected in the solid portion of pleomorphic adenomas. These results suggest that EGF may play an important role in the growth and differentiation of foetal cells as well as the proliferation of tumour cells in pleomorphic adenomas.

A total of 30 inbred Wistar rats were orally administered 70 microgram/ml solution of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) for 35 weeks and then tap water for the following 20 to 30 weeks. Four of the 20 females and two of ten males developed carcinoids in the glandular stomach, but no metastasis could be found. Carcinoids developed most frequently in the fundic portion along the greater curvature. Histologically, these tumors were medullary anaplastic carcinomas containing two different endocrine cell populations. The first cell type was argentaffin having the electron-dense, somewhat pleomorphic secretory granules (437-810 nm) and the second type was argyrophil having round granules with a dense core and a pale halo (550 nm). None of these tumors showed endocrine immunoactivity for gastrin, somatostatin, insulin, glucagon, and enkephalin. One of these gastric tumors developed into scirrhous carcinoma, but differentiated adenocarcinoma could not be seen in the glandular stomach.

Sixteen argyrophil cell carcinomas in 59 gastric scirrhous carcinomas were examined histologically, ultrastructurally, and immunohistochemically for polypeptide hormones, CEA, lysozyme, and HCG. In nine of these 16 tumors, polypeptides such as gastrin, somatostatin, and glucagon were demonstrated. Six of these nine tumors contained all three hormones, and three of these six tumors also had argentaffin cells. In all of these 16 tumors CEA were observed. Eight of them had CEA, lysozyme, and acid mucin synchronously. Of the above six tumors containing three peptides, three produced focal HCG. Ultrastructurally, several types of secretory granules were noted. Histologically, these 16 tumors showed poorly differentiated adenocarcinomas or signet ring cell carcinomas. Macroscopically, generalized type was 11 and localized type five. No hormonal syndrome was detected in any of the patients. It was suggested that these scirrhous argyrophil cell carcinomas of the stomach with the multifunction originate from totipotent immature cells of endodermal origin.

A case of prostatic phyllodes tumor which developed in a 78-yr-old man is reported. Histologically, the tumor comprised myxomatous and cellular portions with a proliferation of atypical stromal cells. Multinucleated giant cells were occasionally present, but mitoses were rare. Fibroblastic differentiation of the tumor cells was confirmed by numerous rough endoplasmic reticulums and free ribosomes, and by immunoreactivity for vimentin. Approximately one-third of the tumor cells showed estrogen-receptor immunoreactivity at their nuclei. The patient is well, with no evidence of tumor recurrence, five years after the resection. The tumor was diagnosed as being a benign prostatic phyllodes tumor showing fibroblastic differentiation, and of an estrogen-dependent nature.

The expression of Haras oncogene product in rat gastrointestinal carcinomas induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) or 1, 2-dimethylhydrazine (DMH) was studied by Western blotting and immunohistochemistry using anti-Haras p 21 oncoprotein antibody. In Western blotting, high levels of c-Haras p 21 were found in serially transplantable rat duodenal carcinomas induced by MNNG and rat colon carcinomas induced by DMH. mmunohistochemically, c-Haras p21 immunoreactivity was detected in 3 (16.7%) of 17 MNNG-induced stomach carcinomas and in 21 (63.6%) of 33 DMH-induced colon carcinomas, respectively. In the colon carcinomas, c-Ha-ras p 21 immunoreactivity in deeply invasive tumors was stronger than that in superficially invasive tumors and was expressed in all subserosal tumors. Moreover, all of the metastatic colon carcinomas had c-Ha- ras p 21 immuno-reactive tumor cells. These findings suggest that c-Ha- ras p21 expression plays an important role in tumor proliferation, invasion and metastasis of DMH-induced colon carcinoma. ACTA PATHOL. JPN. 37: 1731–1741, 1987.

Using advanced gastric adenocarcinoma and carcinoid as human material and gastric adenocarcinoma in rats induced by MNNG and in mice by localized X-irradiation of the stomach as experimental material, a pathological study was made on the relationship of gastric endocrine cells to gastric cancer. The results of the present study suggest that most of the endocrine cells in the cancer tissue are derived from the didte rentiation of cancer cells. Therefore, the following three may be given as the aformentioned relationship, that is, 1) carcinoid of endocrine cell origin, 2) endocrine cell carcinoma showing undifferentiated adenocarcinoma, and 3) endocrine cell cloning developed from the differentiation of cancer cell of adenocarcinoma. There is the possibility that most of 2) are of 3) origin and thus 2) and 3) should be discriminated from 1), having a functioning tumor in rare cases. The significance of reactive hyperplasia of endocrine cells in the non-metaplastic mucosa of the stomach around cancer and atypical epithelium is not yet determined, but that of EC cell seems at least to be related with the development of intestinal metaplasia in the gastric mucosa.

Amplification of genes other than known oncogenes was analyzed using an in-gel DNA renaturation method, in which a mixture of restriction fragments of radioactively labelled tracer DNA and unlabelled driver DNA was electrophoresed and amplified DNA fragments were visualized after two cycles of denaturation and renaturation in the gel. Different DNA fragments were found to be amplified more than 400 fold in NB1, a neuroblastoma cell line, in Y79, a retinoblastoma cell line and in H69, a small cell lung carcinoma cell line, in addition to 120 to 160-fold amplification of N-myc gene in these three cell lines.

A total of 171 gastric carcinomas comprising 69 advanced cancers and 102 early cancers were examined immunohistochemically for lysozyme. Tumour cells containing lysozyme were detected in 65 cases or 38% of the 171 gastric cancer cases. The incidence of these cells did not differ remarkably by histological type and infiltrative growth of gastric carcinoma. Of the foregoing 65 cases, two well-differentiated adenocarcinomas and three signet ring cell carcinomas had numerous lysozyme-containing tumour cells, 13 had many argentaffin or argyrophil cells, and 40 had various amounts of several types of mucin. In addition, tumour cells containing both lysozyme and mucin could be identified. No correlation could be observed between lysozyme immunoreactivity in the tumour cells and cellular infiltration of granulocytes or macrophages around the tumour. The lysozyme appeared to be produced by tumour cells. The two year survival rates indicate a tendency for advanced gastric cancers containing lysozyme to have a poor prognosis.

Here we report an infantile hemangioendothelioma of the liver that developed in a 6 month-old boy with an interstitial deletion of chromosome 6q. His clinical manifestations included developmental delay, feeding problems, and multiple anomalies including microcephaly, hypertelorism, apparently low set abnormal ears, prominent nasal bridge, cubitus valgus, overwrapping of fingers, cryptorchidism, and micropenis. He died abruptly at age 27 weeks from a perforating duodenal ulcer. Autopsy demonstrated atrial septal defect, microencephaly, and thymic atrophy. A solitary small tumor was found in the liver and diagnosed histologically as the infantile hemangioendothelioma, type 1. This is the first report of a del(6)q with infantile hemangioendothelioma.

To characterize the cytological features of well differentiated adenocarcinoma of the gallbladder, a comparative morphometric analysis was made using 35 histologically classified cases of invasive well differentiated adenocarcinoma, 13 cases of mild dysplasia, 19 cases of severe dysplasia, and 22 control gallbladders. The variables analyzed were nucleocytoplasmic (N/C) ratio and nuclear area (N.A.). Both the mean values of N/C ratio and N.A. demonstrated a progressive increase from control to mild dysplasia, to severe dysplasia and to carcinoma. The differences were statistically significantly different. Discriminant analysis was made with a set for learning and a set for testing, selected from the 89 lesions with random numbers. Using this discriminant function, all the cases except one carcinoma were discriminated as carcinoma, and all the cases of control, adenoma, and mild dysplasia were discriminated as benign lesions. However, cases of severe dysplasia were subdivided into benign or malignant. These results indicate that morphometric analysis clearly differentiates carcinomas from benign lesions, and that the dysplastic mucosal lesions can be divided into benign and malignant, although some difficult borderline lesions exist.

The early ultrastructural events that occur In the gastric epithelial cells of the glandular stomach of rat from 12 hours to 3 weeks after oral administration of N-methyl-N'-nitro-N-nitrosoguanidine were examined and compared with the X-irradiation effects on mouse gastric mucosa. The mucoid cells of the pyloric mucosa, particularly the surface and pit mucous cells exhibited the greatest ultrastructural alterations among the 6 types of gastric epithelial cells. The earliest changes of the mucoid cells were observed in the nuclei, and were characterized by the sequential development of first nucleolar enlargement, which consisted of the increase of both the fibrillar and granular components, followed by the occurrence of nucleolar segregation, reduction and clumping of the chromatin, and irregularity of the nuclear membrane. Significant degenerative changes of the cytoplasm in the mucoid cells could be observed after these nuclear alterations. Later, giant cell formation in the mucoid cells and mesenchymal cells, and the development of epithelial cells containing two cell specificity were found. These ultrastructural alterations of the mucoid cells seem to represent the morphologic manifestations of biochemical interaction between N-methyl-N'-nitro-N-nitrosoguanidine and biological materials.

Collagen types I and III were examined immunohistochemically in 32 cases of gastric carcinoma classified as poorly differentiated adenocarcinoma with scirrhous stroma, well differentiated adenocarcinoma with intermediate stroma, or poorly differentiated adenocarcinoma with medullary stroma. In the stroma of scirrhous carcinoma, types I and III collagens were distributed abundantly in fibrillar or granular patterns with little difference in the intensity of staining. In well differentiated adenocarcinoma, type I collagen was diffusely distributed in the stroma with type III collagen distributed sparsely. In poorly differentiated adenocarcinoma with medullary stroma, the two types of collagen were only found around capillaries, constituting the tumor interstitium. Electron microscopic examination of scirrhous carcinoma showed tumor cells partially covered with fibroblasts, and discontinuous basal lamina, collagen fibers and microfibrils present between tumor cells and fibroblasts. In well differentiated carcinoma, tumor cells were surrounded by fibroblasts, and well developed basal lamina was observed beneath the tumor cells. In poorly differentiated carcinoma with medullary stroma, the stroma consisted of capillaries and very few fibroblasts with discontinuous basal lamina occasionally being present between tumor cells and fibroblasts.

The HST1 gene has previously been found to be amplified in over 40% of squamous cell carcinomas of the esophagus. We performed Southern blot analyses on squamous cell carcinomas of the lung, nasal cavity, uterine cervix and gallbladder, using HST1, INT2 and five other oncogenes as probes. The HST1 and INT2 genes, both of which were mapped to chromosome 11 at band q13, were coamplified in a squamous cell carcinoma of the gallbladder. The degree of amplification exceeded eight fold.

A human cervical clear cell adenocarcinoma cell line was established and named SFCC. The tumor cells were obtained from ascites of a 39-year-old woman who underwent a radical hysterectomy. She had no history of exposure to diethylstilbestrol (DES). The histologic feature of the tumor cells at autopsy showed abundant clear cytoplasm with diastase digested glycogen granule growing in solid nest and tubular pattern. SFCC cells were continuously propagated in vitro during the past 29 months and grown in a monolayered sheet with a doubling time of about 67 hours. SFCC cells resembled the structure of the original tumor and had abundant glycogen granules, lipid droplets in the cytoplasm, and numerous microvilli. Immunohistochemically, SFCC cells had carcinoembryonic antigen (CEA) immunoreactivity in some parts of the cell population. Moreover, they had a relatively high amount of progesterone receptor (20.0 fmol/mg protein; kd, 6.6 nM) but did not have either an estrogen receptor or EGF receptor. The SFCC cell line secreted a high content of tissue peptide antigen (TPA) into the medium, indicating that the SFCC cell line is useful for analyzing the progesterone receptor and TPA production in clear cell adenocarcinoma of uterine cervix.

A case of primary mucosal hyperplasia of the gallbladder in a 55-year-old man is reported. Endoscopic ultrasonography demonstrated diffuse mucosal thickening of the gallbladder which was associated with anomalous union of the pancreatico-biliary duct system. Histologically, the mucosa showed villous and spongioid hyperplasia. The mucosa, which consisted of tall columnar cells that were morphologically similar to ordinary gallbladder epithelium, showed no metaplastic changes such as occurrence of mucous glands, Paneth cells, goblet cells, endocrine cells, or lysozyme immunoreactivity. These findings suggested that this disease was based on hyperplasia of ordinary gallbladder epithelium.

We report a minute carcinoid tumour forming multiple, endocrine nodules or glandular structures and located within a gastric tubular adenoma. The tumour cells were positive for the argyrophilic reaction and a few revealed serotonin immunoreactivity. This case may represent the third histogenetic type of gastric carcinoid tumour.